tbuckley/cabot-search huggingface dataset:
Sequential multistenting protocol in biliary stenosis after liver transplantation: a prospective analysis
Authors: Ilaria Tarantino, Michele Amata, Noemi Cicchese, Dario Ligresti, Luca Barresi, Antonino Granata, Fabio Cipolletta, Fabio Tuzzolino, Mario Traina
Journal: Endoscopy (2019)

Biliary complications are a serious source of morbidity after orthotopic and living-related liver transplantation. Endoscopic retrograde cholangiography (ERC) is the gold standard for patients with duct-to-duct anastomosis because it allows a direct approach for interventional procedures. A retrospective study showed results of a sequential multistenting protocol, without stent removal/exchange, with promising results. We conducted a prospective analysis to assess the clinical success, recurrence rate, and adverse event rate related to this protocol.From May 2012 to April 2018, all consecutive patients with a diagnosis of anastomotic stenosis following liver transplantation were enrolled in the study, and were followed for a period of at least 6 months after the last ERC. During the first ERC, a maximum number of plastic stents (10 Fr) were placed. In subsequent ERCs, scheduled every 3 months up to a maximum of 1 year, additional stents were inserted, as many as possible, without removing the previously placed stents.From May 2012 to May 2018, 87 patients were included in the study and treated with a sequential multistenting protocol. The mean number of stents placed was 3.7 (SD 1.0). Clinical success (stricture resolution and normalization of cholestasis) was achieved in 86 patients (98.9 %). Seven patients (8.0 %) developed complications. Recurrence was recorded in seven patients (8.0 %) after a mean of 992.7 days (SD 622.1).This study represents the first prospective demonstration of the efficacy and safety of a sequential multistenting protocol. A key limitation of the study is the lack of a comparative group treated according to the traditional stent exchange approach.
Outcomes of hepatocellular carcinoma
Authors: Y. Yildirim, O. Ozyilkan, Z. Akcali, E. Remzi, S. Sevmis, B. Demirhan, B. Bilezikci, H. Karakayali, M. Haberal
Journal: Journal of Clinical Oncology (2006)

14141 Background: Hepatocelluler carcinoma (HCC) related mortality remains high although recent advances in management in cancer therapy. Treatment options of HCC can be surgical resection, percutaneus alcohol injection (PAI), transcatheter arterial embolisation (TAE), radiofrequency ablation (RF), systemic chemotherapy or liver transplantation. However it is unclear how effective are these methods for treating HCC. Methods: We reviewed the treatment results of 56 patients diagnosed with HCC between 1996–2005. Local treatment (PAI or TAE) or systemic chemotherapy or curative surgery (resection or liver transplantation) or no therapy was applied. Our inclusion criteria for transplantation were (independent of tumor size and number of tumor nodules) no invasion of major vascular structures and no extrahepatic disease, negative surgical exploration including hilar lymph node frozen section. Kaplan-Meier survival analyses were used to evaluate outcome. Results: Median age at diagnosis was 57 years (range: 18–90). Of 56 patients 20 (35.7%) are alive, 14 (25%) are loss the follow-up and 22 (39.3%) are died. Sixty-eight percent of patients received therapy, and 32% received no specific therapy. Among patients who received therapy transplantation was the most common procedure (n: 18 patients, 47.4%). Three patients underwent surgery (70.9%); local therapies were applied 13 patients (34.2%). Twenty-three (46.4%) patients have single lesion in the liver, 27 (48.9%) patients have multiple lesions. No statistical difference was found in survival of patients with single lesion or multiple lesions (p &gt; 0.05). Median follow-up of patients is 9 months (range: 1–41 months). Patients who underwent surgery or liver transplantation have statistically significant longer survival than patients treated with local therapies (PAI or TAE) (p &lt; 0.01). Conclusion: HCC is a chemoresistant tumor. None of the used chemotherapy regimen demonstrated marked benefit in survival. Complete surgical excision can be curative but only small percentage of HCCs are resectable at the time of diagnosis. However liver transplantation in selected patients can cure both HCC and underlying cirrhosis. Expanded criteria for liver transplantation in our clinic seems to be beneficial on this disease. No significant financial relationships to disclose.
Model Heterogeneity in Predicting Outcomes in Patients with Chronic Myelomonocytic Leukemia (CMML): An Overestimation of Survival in Lower-Risk Group
Authors: Aziz Nazha, Mrinal M. Patnaik, Rami S. Komrokji, Karam Al-Issa, Naval Daver, Guillermo Garcia-Manero, Jaroslaw P. Maciejewski, Alan F. List, Michael R. Savona, Raphael Itzykson, Pierre Fenaux, Valeria Santini, Ayalew Tefferi, Mikkael A. Sekeres, Eric Padron
Journal: Blood (2017)
Prescriptions on Demand
Authors: Tara Jain, Richard J. Lu, Ateev Mehrotra
Journal: JAMA (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 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
Overall Survival (OS) Benefit of Oral Ixazomib in Combination with Lenalidomide and Dexamethasone (IRd) Vs Lenalidomide and Dexamethasone (Rd) in Asian Patients (pts) with Relapsed and/or Refractory Multiple Myeloma (RRMM): Pooled-Analysis from the Tourmaline-MM1 and the China Continuation Studies
Authors: Weijun Fu, Jin Lu, Jie Jin, Yan Xu, Depei Wu, Dao-bin Zhou, Xiaoyan Ke, Xin Du, Xiequn Chen, Wee Joo Chng, Kihyun Kim, Junmin Li, Jae Hoon Lee, Jing Liu, Yeow Tee Goh, Kwang-Wei Wu, Hui Wang, Guohui Liu, Tomas Skacel, Hui Wan, Deborah Berg
Journal: Blood (2018)
It's a black day—metastatic melanoma in the bone marrow
Authors: Barbara J. Bain, John Luckit
Journal: American Journal of Hematology (2019)

A bone marrow aspirate showed abundant macrophages containing melanin (Images, top). In addition there were melanoma cells (Image, bottom left), which were sometimes difficult to distinguish from macrophages. Neutrophils in the bone marrow contained melanin (Image, bottom right). The patient's trephine biopsy specimen was black on macroscopic examination. A buffy coat preparation from the peripheral blood of this patient has previously been reported; both circulating melanoma cells and neutrophils containing melanin were detected.2 A diagnosis of metastatic melanoma can be confirmed by immunohistochemistry but in this case the clinical and morphological features were sufficient for an unequivocal diagnosis. Nothing to report.
Impact of functional outcomes on long-term quality of life after open retropubic radical prostectomy.
Authors: Bjoern Loeppenberg, Christian von Bodman, Marko Brock, Joachim Noldus, Jueri Palisaar
Journal: Journal of Clinical Oncology (2013)

9580 Background: Patients who underwent open retropubic radical prostatectomy (ORRP) for prostate-cancer (PCA) have excellent long-term survival. Besides oncologic safety, recovery of continence and erectile function are highly important, as adverse functional outcomes may have a detrimental effect on health-related quality of life (HRQOL). We report the long-term HRQOL of PCA survivors after ORRP using standardized tools. Methods: Men treated between August 2003 and December 2007 with ORRP for localized PCA at a single academic hospital received validated questionnaires (International consultation on incontinence questionnaire (ICIQ), International index of erectile function (IIEF-5), Erection hardness score (EHS), EORTC QLQ-C30) to assess functional outcomes and HRQOL. Results were correlated with the global-health score (GHS) of the EORTC QLQ-C30 to assess the impact of ORRP on HRQOL. Results: In the study period 1936 men underwent ORRP of whom 1156 (59.7%) received a nerve-sparing (NS) procedure. Questionnaire return-rate was 59% (n=1141) comprising the final study cohort. Median follow-up (FU) was 62 months. Mean age at surgery and FU was 63.7±6.2 and 69.2±6.2 years, respectively. Biochemical recurrence (BCR) occurred in 17.5% (n=200/1141) and 2% (n=40/1936) deceased. Mean GHS in the study population was 71.5±20.8. In the ICIQ 28% (n=320) scored 0 indicating complete continence and 9.9% (n=113) scored ≥11 indicating severe incontinence. The corresponding GHS was 78.1±19.5 and 55.4±21.8, respectively. 68.5% (n=782) of patients used no pads and 17.9% (n=204) ≥2 pads. Corresponding GHS scores were 74.9±19.8 and 58.9±20.7. Using the IIEF-5 in men who received NS, 24.1% (n=154) had no erectile dysfunction versus 50% (n=318) using the EHS. Corresponding GHS scores were 82.2±16.3 and 74.7±19.8, respectively. Patients with BCR had a GHS of 66.8±21.8 versus 72.5±20.5 for patients without. Men who achieved the Trifecta and Pentafecta criteria had a GHS of 83.1±15.1 and 83.3±15, respectively. Conclusions: Incontinence severely impacts the HRQOL of long-term survivors after ORRP while erectile dysfunction and BCR have a lesser effect. Every effort should be undertaken to maintain functional integrity.
Metastatic parathyroid carcinoma: Treatment modalities illustrated with a case report.
Authors: Alison Marie White, Samantha Elizabeth Bowyer, John Andrew Davidson, David Ransom
Journal: Journal of Clinical Oncology (2012)

e16004 Background: We report a case of inoperable metastatic parathyroid carcinoma with life-threatening hypercalcaemia. We achieved rapid control of calcium with denosumab. Methods: Our patient presented with complications of hyperparathyroidism. He underwent a partial parathyroidectomy and hemithyroidectomy. Parathyroid carcinoma was confirmed. There was no metastatic disease. A year later he was hypercalcaemic, 4.15 mmol/L (2.15-2.60 mmol/L), with elevated PTH and creatinine. FDG activity was seen on PET at the thyroid bed and retrocrural space. Extensive pleural metastases limited resection to debulking. The calcium and PTH remained elevated. Hydration and zoledronic acid had little effect. Cinacalcet 90mg QDS led to no improvement in calcium. Weekly zoledronic acid was used to keep his calcium below 4 mmol/L. Two cycles of cyclophosphamide, 5-flurouracil and dacarbazine led to no decline in the calcium. Denosumab is a fully human monoclonal IgG2 antibody with a high affinity and specificity to bind RANK ligand, mimicking Osteoprotegerin, competitively blocking the binding of RANK to its ligand to inhibit osteoclast activation. Results: 120mg was given subcutaneously. By day 8 the calcium had dropped to 2.66 mmol/L. After a second dose, the calcium was 2.33 mmol/L. Bone turnover markers were rapidly suppressed. The calcium was in the normal range for four months with improved renal function. Further denosumab will be guided by serum calcium. Conclusions: Parathyroid carcinoma is rare. The mainstay of treatment is resection, even in metastatic disease. Often the disease is refractory to medical management leading to complications of hypercalcaemia. There is limited evidence for chemotherapy and few strategies to manage resistant hypercalcaemia have been published. In this case refractory hypercalcaemia dramatically responded to denosumab. Denosumab does not require dose adjustment for renal impairment, a common finding with hypercalcaemia. In this case denosumab offered prolonged control of serum calcium. We propose that denosumab should be considered for patients with hypercalcaemia due to parathyroid cancer.
Cell-Based Quadrivalent Inactivated Influenza Virus Vaccine (Flucelvax® Tetra/Flucelvax Quadrivalent®): A Review in the Prevention of Influenza
Authors: Yvette N. Lamb
Journal: Drugs (2019)

Manufacturing influenza virus vaccines using a mammalian cell line rather than embryonated chicken eggs may carry certain advantages. A quadrivalent inactivated influenza virus vaccine produced using the Madin Darby canine kidney cell line has been approved in the EU (Flucelvax® Tetra) and USA (Flucelvax Quadrivalent®; QIVc hereafter) for the prevention of influenza in adults and children. The clinical development of QIVc has built upon that of a cell-based trivalent influenza virus vaccine (TIVc) manufactured using the same processes; the additional influenza B strain contained in QIVc reduces the risk of the strain in the vaccine not matching that in circulation. Pivotal phase III clinical trials in adult and paediatric participants have demonstrated the immunogenicity of QIVc to be noninferior to that of TIVc formulations against shared strains and superior against the influenza B strain absent from each TIVc formulation. Protective efficacy data for TIVc is considered foundational for QIVc and, in a phase III clinical trial, TIVc was effective in protecting adults against antigenically matched influenza strains. Large real-world studies from the 2017/2018 US influenza season further support the prophylactic effectiveness of QIVc, with possible benefits over egg-based vaccines. QIVc was generally well tolerated in clinical trials. In adult and paediatric QIVc recipients, the most common solicited adverse reactions were injection site pain and headache. Reactogenicity was comparable to that of TIVc; no safety signals unique to QIVc emerged. Through circumventing concerns around egg adaptation, QIVc has the potential to be more effective than currently available egg-based quadrivalent vaccines.
Gene copy number of epidermal growth factor receptor (EGFR) by fluorescent in situ hybridization (FISH) in head and neck squamous cell carcinomas (HNSCC) is closely correlated with EGFR protein levels assessed by automated quantitative protein analysis (AQUA)
Authors: P. Weinberger, A. Psyrri, P. Kountourakis, T. Rampias, C. Sasaki, C. Sasaki, B. Haffty, D. Kowalski, G. Fountzilas, D. Rimm, B. Burtness
Journal: Journal of Clinical Oncology (2007)

6023 Background: EGFR overexpression correlates with recurrence and with treatment resistance in HNSCC. The mechanisms of EGFR protein overexpression are poorly understood. Nonetheless, previous investigators have not demonstrated a correlation between EGFR gene copy number and protein content, using conventional immunohistochemistry (IHC). The aim of this study was to evaluate the relationship of EGFR gene copy number and protein expression utilizing fluorescence in situ hybridization (FISH) and AQUA, a novel, immunohistochemical method of automated quantitative in situ proteomic analysis which permits subcellular localization. Methods: A tissue microarray composed of 137 HNSCC treated with (chemo)radiation was constructed and analyzed for EGFR copy number by FISH (Vysis/Abbot) and EGFR protein expression (DAKO antibody) using AQUA analysis of EGFR staining scored on a scale of 0–255 and by conventional IHC. Agreement was assessed using kappa. Results: Sixteen (15%) of one-hundred six tumors with FISH results demonstrated EGFR high polysomy and/or gene amplification (FISH+). AQUA demonstrated a range of 3.6–102.2; protein levels assessed by AQUA in the FISH amplified cases were significantly higher (p =0.008) than in the FISH non- amplified ones. Using the EGFR 75 th percentile as a cut-off, AQUA and FISH showed significant agreement (percentage of overall agreement 82%, kappa=0.458, p=0.003). To the contrary there was no concordance between FISH and conventional IHC results in this series. Conclusions: The discrepancy between EGFR gene amplification rate and protein expression by IHC reported previously may be due to the limitations and nonquantitative nature of conventional IHC. EGFR protein content correlates with gene copy number if protein content is quantitated and automatically analyzed, as with AQUA. No significant financial relationships to disclose.
The nuclear expressions of ERK1/2 and p38 can be useful markers for tumor invasiveness and lymph node metastasis in stomach cancer
Authors: H. Chang, K. Choi, S. Lee, K. Yoon
Journal: Journal of Clinical Oncology (2007)

15109 Background: Extracellular-regulated kinases (ERKs) were shown to have a function in cellular proliferation or differentiation and p38 were known as to be involved in apoptotic processes in tumor development. Tissue inhibitors of metalloproteinase(TIMP) have been known to be a important role in tumor cell invasion, which was postulated to be regulated by ERKs and p38. The clinical implication of ERKs and p38 on stomach cancer was investigated Methods: By immunohistochemistry with an antibody specific for dually phosphorylated ERK 1 /2 and 2 , TIMP-1 and -2, and p38 on formaline-fixed paraffin-embedded tissue, we have examined 57 primary stomach cancer consisting of 36 cases of intestinal type and 21 cases of diffuse type carcinomas. One-way ANOV(non-parametric) was used to compare differences among more three groups and paired T-test were used between groups.P&lt;0.05 was considered as statistic significant. Results: The expression rate of ERK1/2 in the nuclei of the tumor cells was 21.5%, The expressions of ERK 2, TIMP-1 TIMP-2, were 56.4%, 50.9%, 61.4%. The expression rate of p38 in the tumor cells was 37.7%.. The p38 expression had significant correlation with invasion depth of tumor(p=0.016), lymph node metastasis(p=0.030), and TIMP-2 expression(p=0.038). ERK1/2 had significant association with tumor invasion(p=0.003), lymph node metastasis(p-0.013), tumor cell grades(p=0.030), and TIMP-1(p=0.029). ERK-2, TIMP-1 and 2 had no significant relationship to tumor invasion and metastasis Conclusions: These results suggest that the nuclear expressions of ERK1/2 and p38 can be the useful markers predicting the progression of stomach cancer towards invasiveness and metastasis No significant financial relationships to disclose.
Abstract 17260: Body Mass Index, Waist Circumference and the 6-Year Risk of Coronary Heart Disease in 708,544 Thai Men and Women: HCUR Study
Authors: Parinya Chamnan, Weera Mahawanakul, Wichai Aekplakorn, Wannee Nitiyanant, Prasert Boongird
Journal: Circulation (2018)

Introduction: Body mass index (BMI) and waist circumference has been reported to have a positive association with risk of coronary heart disease (CHD) and their optimal levels have been proposed. However, the association was less well described in Asian population. Hypothesis: This study aimed to examine the risk of developing CHD across different levels of BMI and waist circumference in a large retrospective cohort of Thai general population. Methods: This retrospective cohort was derived from the linkage of 2006 health checks data with diagnostic information from electronic health records of 708,544 men and women aged 20 years and above residing in Ubon Ratchathani. We examined the incidence of CHD over 6 years of follow-up in individuals with different levels of BMI defined by the WHO Asia-Pacific cut-offs and central obesity defined as waist circumference higher than half of each individual’s height. Corresponding hazard ratios were computed using Cox proportional hazards regression. Results: Over 3,514,681 person-years, 2,562 CHD cases developed, an overall incidence of 0.73 (95%CI 0.70-0.76) per 1,000 person-years. BMI had a J-shape association with CHD risk, with those with a BMI of 20-22.4 kg/m2 showing the lowest CHD incidence. Waist circumference had a curvilinear relationship with CHD risk, with CHD risk starting to increase after waist circumference of 80 and 85 cm in women and men respectively. CHD risk increased with higher levels of BMI and waist circumference (Table 1). Compared to those with BMI of 20.0-22.9 kg/m 2 and without central obesity, those with BMI higher than 30 kg/m 2 and with and without central obesity had a 1.8 and 2.4 fold increased risk of CHD (Adjusted hazards ratio 1.80 (1.46-2.24) and 2.39 (1.38-4.13) respectively). Conclusions: Different levels of BMI and waist circumference conferred different CHD risk. Change in optimal cut-off of BMI and waist circumference for the Thai population should be considered.
Intestinal Microbiota Injury during Allo-Hsct Is Generalizable across Transplantation Centers and Is Associated with Increased Mortality, Broad-Spectrum Antibiotics, and Decreased Calorie Intake
Authors: Jonathan U. Peled, Antonio Gomes, Marissa L. Buchan, Christoph K. Stein-Thoeringer, John B. Slingerland, Ann E. Slingerland, Daniela Weber, Anthony D. Sung, Molly Maloy, Tatanisha Peets, Sergio A. Giralt, Robert R. Jenq, Ying Taur, Xavier B. Joao, Eric G. Pamer, Nelson J. Chao, Ernst Holler, Marcel R.M. van den Brink
Journal: Blood (2017)
Is WHO’s surgical safety checklist being hyped?
Authors: David R Urbach, Justin B Dimick, Alex B Haynes, Atul A Gawande
Journal: BMJ (2019)

Studies show that the World Health Organization's surgery checklist saves lives around the world, say <b>Alex Haynes</b> and <b>Atul Gawande</b>. But <b>David Urbach</b> and <b>Justin Dimick</b> argue that there's not enough evidence to say for sure
Molecular Profiling of Hepatocellular Carcinoma Using Circulating Cell-Free DNA
Authors: Ahmed O. Kaseb, Nora S. Sánchez, Shiraj Sen, Robin K. Kelley, Benjamin Tan, Andrea G. Bocobo, Kian H. Lim, Reham Abdel-Wahab, Marc Uemura, Roberto Carmagnani Pestana, Wei Qiao, Lianchun Xiao, Jeffrey Morris, Hesham M. Amin, Manal M. Hassan, Asif Rashid, Kimberly C. Banks, Richard B. Lanman, AmirAli Talasaz, Kenna R. Mills-Shaw, Bhawana George, Abedul Haque, Kanwal P.S. Raghav, Robert A. Wolff, James C. Yao, Funda Meric-Bernstam, Sadakatsu Ikeda, Razelle Kurzrock
Journal: Clinical Cancer Research (2019)

Abstract Purpose: Molecular profiling has been used to select patients for targeted therapy and determine prognosis. Noninvasive strategies are critical to hepatocellular carcinoma (HCC) given the challenge of obtaining liver tissue biopsies. Experimental Design: We analyzed blood samples from 206 patients with HCC using comprehensive genomic testing (Guardant Health) of circulating tumor DNA (ctDNA). Results: A total of 153/206 (74.3%) were men; median age, 62 years (range, 18–91 years). A total of 181/206 patients had ≥1 alteration. The total number of alterations was 680 (nonunique); median number of alterations/patient was three (range, 1–13); median mutant allele frequency (% cfDNA), 0.49% (range, 0.06%–55.03%). TP53 was the common altered gene [&amp;gt;120 alterations (non-unique)] followed by EGFR, MET, ARID1A, MYC, NF1, BRAF, and ERBB2 [20–38 alterations (nonunique)/gene]. Of the patients with alterations, 56.9% (103/181) had ≥1 actionable alterations, most commonly in MYC, EGFR, ERBB2, BRAF, CCNE1, MET, PIK3CA, ARID1A, CDK6, and KRAS. In these genes, amplifications occurred more frequently than mutations. Hepatitis B (HBV)-positive patients were more likely to have ERBB2 alterations, 35.7% (5/14) versus 8.8% HBV-negative (P = 0.04). Conclusions: This study represents the first large-scale analysis of blood-derived ctDNA in HCC in United States. The genomic distinction based on HCC risk factors and the high percentage of potentially actionable genomic alterations suggests potential clinical utility for this technology.