tbuckley/cabot-search huggingface dataset:
Antiemetic efficacy of intravenous (IV) NEPA in patients with breast cancer (BC) receiving anthracycline/cyclophosphamide (AC) chemotherapy.
Authors: Lee S. Schwartzberg, Matti S. Aapro
Journal: Journal of Clinical Oncology (2019)

115 Background: The complexity of administering multi-agent prophylactic antiemetic combinations required to prevent chemotherapy-induced nausea and vomiting (CINV) may contribute to poor guideline adherence seen in multiple studies. NEPA, a combination antiemetic of an NK 1 receptor antagonist (RA) [netupitant (oral)/fosnetupitant (IV)] and 5-HT 3 RA, palonosetron, offers 5-day CINV prevention with a single dose. Unlike other IV NK 1 RAs, the fosnetupitant solution does not require a surfactant, emulsifier, or solubility enhancer and contains no allergenic excipients, thereby minimizing infusion-related toxicities that have been reported with other NK 1 RAs. This study previously reported the safety of IV NEPA in BC patients receiving repeat cycles of AC; there were no infusion-site or hypersensitivity reactions related to IV NEPA reported. The efficacy results of this study are the focus of this presentation. Methods: This was a Phase 3b, double-blind safety study in females with BC naïve to highly/moderately emetogenic chemotherapy. Patients were randomized 1:1 to receive a single 30-min infusion of IV NEPA or a single oral NEPA capsule on Day 1 prior to AC. Oral dexamethasone was also given to all patients before AC on Day 1 only. Complete response (CR: no emesis, no rescue) and no significant nausea (NSN: &lt; 25mm on 100mm VAS scale) rates were calculated daily during the 5 days (0-120 h) post-AC in Cycle 1. No formal statistical comparison between groups was planned. Results: 402 total patients were included in the analysis. Most patients were white (93%) with ECOG status of 0 (75%); the mean age was 55 years. Comparable CR and NSN rates were seen for IV and oral NEPA during each of the 5 days post-AC. Conclusions: As a simplified single-dose formulation, IV NEPA showed high response rates in BC patients receiving AC, with favorable safety as no treatment-related infusion-site/hypersensitivity reactions were reported. Clinical trial information: NCT03403712. [Table: see text]
Abstract 206: Neurological Outcomes and the Time From Collapse to the Initiation of Extracorporeal Membrance Oxygenation in Patients With Out-Of-Hospital and In-Hospital Cardiac Arrest
Authors: Takashi Unoki, Daisuke Takagi, Tomoko Nakayama, Yudai Tamura, Megumi Yamamuro, Hiroto Suzuyama, Eiji Taguchi, Yukihiro Katayama, Tadashi Sawamura, junichi maehara, Tomohiro Sakamoto, Koichi Nakao
Journal: Circulation (2019)

Background: Encouraging results of extracorporeal cardiopulmonary resuscitation (E-CPR) for patients with refractory cardiac arrest have been shown. However, an optimal timing to switch from conventional CPR to E-CPR are not well established. To determine the optimal timing when E-CPR should be performed, we investigated the relationship between the time from collapse to the initiation of extracorporeal membrane oxygenation (Collapse-to-ECMO time ) and neurological outcomes in patients with out-of-hospital cardiac arrest (OHCA) and in-hospital cardiac arrest (IHCA) treated with E-CPR. Methods: A total of 80 consecutive patients (age 64±16 years, male ratio 76%, shockable rhythm 48%, and OHCA 51%) received E-CPR between January 2012 and May 2019. The primary endpoint was survival with good neurological outcomes at hospital discharge (a cerebral performance category of 1 or 2). Results: Of the 80 patients included, 8 had good neurological outcomes. The rate of male was significantly higher in the good outcome group compared with the non-good outcome group. There was no significant difference in the age and the rates of initial shockable rhythm and acute coronary syndrome between the two groups. IHCA had the better outcomes compared with OHCA, but the difference does not reach significance [15.4% (6 of 39) vs. 4.9% (2 of 41); P=0.1]. The median Collapse-to-ECMO time was significantly shorter in the good outcome group compared with the non-good outcome group (38.5 min, interquartile range [IQR], 19.3-54.5 vs. 58.5 min, IQR, 35.3-76.0: p = 0.04). The area under the receiver operating curve of the Collapse-to-ECMO time for predicting a good neurological outcome was 0.72, and the optimal cutoff time was 60 min. Stepwise multivariate logistic regression analysis including data on age, sex, shockable rhythm, OHCA, and the Collapse-to-ECMO time under 60 min revealed that a male sex (P=0.03), shockable rhythm (P=0.03) and the Collapse-to-ECMO time under 60 min (P&lt;0.001) were significantly associated with the good outcome. Conclusions: The Collapse-to-ECMO time was independently associated with good neurological outcomes. In patients with refractory cardiac arrest, it may be considered to initiate E-CPR within 60 min from collapse regardless of OHCA or IHCA.
Common and Disorder-Specific Neurofunctional Markers of Dysregulated Empathic Reactivity in Major Depression and Generalized Anxiety Disorder
Authors: Xiaolei Xu, Jing Dai, Congcong Liu, Yuanshu Chen, Fei Xin, Feng Zhou, Xinqi Zhou, Yulan Huang, Jinyu Wang, Zhili Zou, Jialin Li, Richard P. Ebstein, Keith M. Kendrick, Bo Zhou, Benjamin Becker
Journal: Psychotherapy and Psychosomatics (2019)
Management of complications
Authors: Thierry Ponchon, Peter Bauerfeind
Journal: Endoscopy (2019)

In this anniversary editorial celebrating 50 years of Endoscopy, we focus on complications in endoscopy. In a paper from Denmark in 1978, Andersen and Clausen reported a study encompassing three important endoscopy topics: complications associated with endoscopy and the related themes of sedation and the outpatient setting [1].
Age-related differences in cannabis use by cancer patients referred for supportive care.
Authors: Diane Portman, Kristine A. Donovan
Journal: Journal of Clinical Oncology (2019)

104 Background: Increasingly, cancer patients are using cannabis in their efforts to manage symptoms. Studies of legal recreational cannabis suggest young adults (YA) may disproportionately account for increases in cannabis use. There are few studies of cannabis use in cancer patients and its effect on symptoms, however, and most have not stratified their results by age. To address this, we examined rates of cannabis use across three age groups: YA ages 18 to 39, adults 40 to 65, and adults older than 65 (OA). We also examined the effects of age and cannabis use on patients’ report of cancer-related symptoms. Methods: We conducted a retrospective review of 1223 cancer patients referred to outpatient supportive care for symptom management between 2014 and 2017. Patients underwent urine drug testing for tetrahydrocannabinol (THC) and completed the Edmonton Symptom Assessment Scale-Revised-CSS during their initial visit. Results: In Chi square analysis, age was significantly associated with cannabis use (p &lt; .001): 30% of YA tested positive for THC compared to 21% of adults and 8% of OA. As a group, cannabis users reported significantly higher scores for pain, tiredness, nausea, lack of appetite, anxiety, depression, difficulty sleeping, and worse overall well-being (p values &lt; .05). In MANOVA, there was a significant interaction effect between age and cannabis use for pain, lack of appetite, shortness of breath, anxiety, depression, difficulty sleeping, and overall well-being (p values &lt; .05). While YA and adults who tested positive for THC reported higher symptom scores for each of these symptoms, OA patients who were THC positive reported lower scores for pain, anxiety, depression, and better overall well-being. Conclusions: Findings suggest that compared to adults and OA, more YA patients are using cannabis in attempts to control cancer-related symptoms. With the exception of OA, cannabis users rate their cancer-related symptoms as more severe than nonusers. Findings support the need for patient education about potential therapeutic benefits and adverse effects of cannabis use in cancer. Prospective, observational studies are needed to characterize patients’ use before and after a cancer diagnosis.
Duration of type 2 diabetes and remission rates after bariatric surgery in Sweden 2007–2015: A registry-based cohort study
Authors: Anders Jans, Ingmar Näslund, Johan Ottosson, Eva Szabo, Erik Näslund, Erik Stenberg
Journal: PLoS Medicine (2019)

Background Although bariatric surgery is an effective treatment for type 2 diabetes (T2D) in patients with morbid obesity, further studies are needed to evaluate factors influencing the chance of achieving diabetes remission. The objective of the present study was to investigate the association between T2D duration and the chance of achieving remission of T2D after bariatric surgery. Methods and findings We conducted a nationwide register-based cohort study including all adult patients with T2D and BMI ≥ 35 kg/m2 who received primary bariatric surgery in Sweden between 2007 and 2015 identified through the Scandinavian Obesity Surgery Registry. The main outcome was remission of T2D, defined as being free from diabetes medication or as complete remission (HbA1c < 42 mmol/mol without medication). In all, 8,546 patients with T2D were included. Mean age was 47.8 ± 10.1 years, mean BMI was 42.2 ± 5.8 kg/m2, 5,277 (61.7%) were women, and mean HbA1c was 58.9 ± 17.4 mmol/mol. The proportion of patients free from diabetes medication 2 years after surgery was 76.6% (n = 6,499), and 69.9% at 5 years (n = 3,765). The chance of being free from T2D medication was less in patients with longer preoperative duration of diabetes both at 2 years (odds ratio [OR] 0.80/year, 95% CI 0.79–0.81, p < 0.001) and 5 years after surgery (OR 0.76/year, 95% CI 0.75–0.78, p < 0.001). Complete remission of T2D was achieved in 58.2% (n = 2,090) at 2 years, and 46.6% at 5 years (n = 681). The chance of achieving complete remission correlated negatively with the duration of diabetes (adjusted OR 0.87/year, 95% CI 0.85–0.89, p < 0.001), insulin treatment (adjusted OR 0.25, 95% CI 0.20–0.31, p < 0.001), age (adjusted OR 0.94/year, 95% CI 0.93–0.95, p < 0.001), and HbA1c at baseline (adjusted OR 0.98/mmol/mol, 95% CI 0.97–0.98, p < 0.001), but was greater among males (adjusted OR 1.57, 95% CI 1.29–1.90, p < 0.001) and patients with higher BMI at baseline (adjusted OR 1.07/kg/m2, 95% CI 1.05–1.09, p < 0.001). The main limitations of the study lie in its retrospective nature and the low availability of HbA1c values at long-term follow-up. Conclusions In this study, we found that remission of T2D after bariatric surgery was inversely associated with duration of diabetes and was highest among patients with recent onset and those without insulin treatment.
Mechanistic insights of the controlled release capacity of polar functional group in transdermal drug delivery system: the relationship of hydrogen bonding strength and controlled release capacity
Authors: Zheng Luo, Chao Liu, Peng Quan, Degong Yang, Hanqing Zhao, Xiaocao Wan, Liang Fang
Journal: Acta Pharmaceutica Sinica B (2019)

Hydrogen bonding interaction was considered to play a critical role in controlling drug release from transdermal patch. However, the quantitative evaluation of hydrogen bonding strength between drug and polar functional group was rarely reported, and the relationship between hydrogen bonding strength and controlled release capacity of pressure sensitive adhesive (PSA) was not well understood. The present study shed light on this relationship.
Ribonucleotide reductase small subunit p53R2 translocates in cell cycle and plays an essential role for DNA replication
Authors: Xiyong Liu, Bingshen Zhou, Lijun Xue, Jennifer Shih, Jimin Shao, Lijun Zhu, Yun Yen
Journal: Cancer Research (2004)

821  Ribonucleotide Reductase (RR) is a potential target for antineoplastic agents and is essential in maintaining cell proliferation and integrity. The recently identified small subunit p53R2 has been reported as a p53-dependent cell checkpoint for DNA repair. However, the regulation and function of p53R2 in the cell cycle is still not clear. Flow cytometry analyses and Western blot results revealed that p53R2 coordinated with M1, a large subunit of RR, had the highest expression in the G1 phase, and steadily decreased from the S to the G2/M phase in KB cells; whereas, the small subunit M2 had dominant expression at S-phase. In addition, extracts from cell cycle specific sorted cells displayed RR activity that was consistent with the protein levels of p53R2 and M1. Confocal microscopy investigation indicated that both p53R2 and M2 redistributed with M1 –from the cytoplasm to the nucleus –within two hours of serum addition to starved KB cells. Using nuclear extracts from KB cells, p53R2 was separated into two clear bands. Only one lower band could be detected in the cytoplasm. Immunoprecipitation assay results also demonstrated that only the large band of p53R2 could be co-immunoprecipated by M1. The large band of p53R2 had a weak signal after 96 hours of serum starvation, and was rapidly visible after serum addition to the KB cells. This finding suggested that p53R2 protein might be modified when cells turned from the G1 to S phase in response to DNA replication. In addition, experiments revealed that increased p53R2 in transfected cells might significantly enhance cell growth, while downregulated p53R2 with an antisense technique might slightly inhibit cell growth. In summary, p53R2 and M2 might have different functions and be regulated differently in the cell cycle. M1 and p53R2 located in cytoplasm at the rest cells, and redistribute from cytoplasm into nucleus to provide dNDP for DNA synthesis when cell turned into S phase.
Molecular Profiles of Matched Primary and Metastatic Tumor Samples Support a Linear Evolutionary Model of Breast Cancer
Authors: Runpu Chen, Steve Goodison, Yijun Sun
Journal: Cancer Research (2019)

The interpretation of accumulating genomic data with respect to tumor evolution and cancer progression requires integrated models. We developed a computational approach that enables the construction of disease progression models using static sample data. Application to breast cancer data revealed a linear, branching evolutionary model with two distinct trajectories for malignant progression. Here, we used the progression model as a foundation to investigate the relationships between matched primary and metastasis breast tumor samples. Mapping paired data onto the model confirmed that molecular breast cancer subtypes can shift during progression and supported directional tumor evolution through luminal subtypes to increasingly malignant states. Cancer progression modeling through the analysis of available static samples represents a promising breakthrough. Further refinement of a roadmap of breast cancer progression will facilitate the development of improved cancer diagnostics, prognostics, and targeted therapeutics. SIGNIFICANCE: Analysis of matched primary and metastatic tumor samples supports a unidirectional, linear cancer evolution process and sheds light on longstanding issues regarding the origins of molecular subtypes and their progression relationships.
Proposed Rule for Lowering Lead Levels in Drinking Water
Authors: Rita Rubin
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
Open-label randomised pragmatic trial (CONTACT) comparing naproxen and low-dose colchicine for the treatment of gout flares in primary care
Authors: Konstantinos Parperis
Journal: Annals of the Rheumatic Diseases (2019)

Open-label randomised pragmatic trial (CONTACT) comparing naproxen and low-dose colchicine for the treatment of gout flares in primary careWe read with great interest the article by Roddy et al 1 , published in the Annals of Rheumatic Disease, an open-label study that examined 399 patients presented at primary care centres with exacerbation of gout.The patients were allocated to two treatment arms, one group received naproxen and the second group treated with colchicine, and the primary outcome measured changes in the pain level from baseline over the first 7 days after presentation.Diarrhoea and headaches were more commonly reported in the colchicine group and given there was no difference between the two groups in the primary outcome, the authors recommended naproxen as the first line of treatment in acute gout arthritis, if no contraindication exists.Although the authors pointed out that naproxen might be associated with decreased risk of cardiovascular events compared with the other non-steroidal anti-inflammatory drugs (NSAIDs) commonly used in gout, a recent metanalysis conducted by Bally et al 2 demonstrated that all NSAIDs, including naproxen, have been linked to a higher risk of myocardial infarction.Therefore, given the evidence of serious adverse effects, we do not concur with the recommendation naproxen should be considered as the only first step treatment option.Furthermore, patients with a history of hypertension and/or diabetes mellitus were included in the study, and colchicine would be a reasonable first therapeutic option from a safety profile in this subgroup of patients.Regarding the side effect profile, diarrhoea was evident in 45.9% of patients in the colchicine group versus 20% in the naproxen group, a significantly higher frequency compared with the 23% seen in the low-dose colchicine arm in the Acute Gout Flare Receiving Colchicine Evaluation (AGREE) trial. 3 We wonder why the authors did not use a lower dose regimen from day 2 to 4, for example, the prophylactic dose regime of 0.5-1 mg/day, a widely use dose with an acceptable safety profile supported by the European League Against Rheumatism guidelines. 4 Lastly, given the individual patient's characteristics, comorbidities, preferences and shared decision making, we believe that NSAIDs and colchicine have an essential role in the management of gout flares, and both regimens can be used as first-line treatment.
A computational Framework for generating rotation invariant features and its application in diffusion MRI
Authors: Mauro Zucchelli, Samuel Deslauriers-Gauthier, Rachid Deriche
Journal: Medical Image Analysis (2019)

In this work, we present a novel computational framework for analytically generating a complete set of algebraically independent Rotation Invariant Features (RIF) given the Laplace-series expansion of a spherical function. Our computational framework provides a closed-form solution for these new invariants, which are the natural expansion of the well known spherical mean, power-spectrum and bispectrum invariants. We highlight the maximal number of algebraically independent invariants which can be obtained from a truncated Spherical Harmonic (SH) representation of a spherical function and show that most of these new invariants can be linked to statistical and geometrical measures of spherical functions, such as the mean, the variance and the volume of the spherical signal. Moreover, we demonstrate their application to dMRI signal modeling including the Apparent Diffusion Coefficient (ADC), the diffusion signal and the fiber Orientation Distribution Function (fODF). In addition, using both synthetic and real data, we test the ability of our invariants to estimate brain tissue microstructure in healthy subjects and show that our framework provides more flexibility and open up new opportunities for innovative development in the domain of microstructure recovery from diffusion MRI.
Billed palliative care services and end-of-life care in patients with hematologic malignancies.
Authors: Vinay Rao, Adam J. Olszewski, Pamela Egan, Thomas William LeBlanc, Emmanuelle Belanger
Journal: Journal of Clinical Oncology (2019)

43 Background: Patients (pts) with hematologic malignancies (HMs) often receive aggressive care at the end of life (EOL), leading to lower quality of life. Early palliative care (PC) may improve EOL care, but its benefits are less established in HMs than in solid tumors. We sought to describe the use of billed PC services (BPCS) among Medicare beneficiaries with HMs and associated EOL quality measures. Methods: Using the linked SEER-Medicare registry, we studied Medicare beneficiaries diagnosed with leukemia, lymphoma, myeloma, myelodysplastic syndrome, or myeloproliferative neoplasm who died from 2001-2015. We described trends in the use of BPCS (identified by codes in clinician encounter claims). Among pts surviving &gt;30 days from diagnosis, we compared baseline characteristics and EOL care quality metrics for pts with and without “early BPCS” (initiated &gt;30 days before death). Results: The proportion of pts ( N=139,191, median age 81 years) with any BPCS increased from 0.4% in 2001 to 13.3% in 2015. Median time from first BPCS encounter to death was 10 days and 84.3% occurred during hospital admissions. Use of early BPCS was rare (from 0.2% in 2001 to 4.3% in 2015, with 28% of all first BPCS occurring early) and more frequent in acute leukemia, among black pts, those with higher comorbidity indices or poor performance statuses, and those receiving chemotherapy. Receipt of early BPCS was associated with improved EOL care quality metrics (see Table). Conclusions: Use of BPCS among Medicare beneficiaries with HMs has steeply increased in recent years, but most encounters still occur within days of death. Early BPCS are associated with better EOL care quality metrics similar to those observed in solid tumors. Our results support the need for prospective trials of early PC for pts with HMs. [Table: see text]