tbuckley/cabot-search huggingface dataset:
Progression-free survival, PFS, depending on the site of lymph-node metastases in patients after salvage lymph node dissection, sLAD, in lymph node only recurrent prostate cancer.
Authors: David Pfister, Tim Nestler, Friederike Haidl, Pia Paffenholz, Florian Hartmann, Axel Heidenreich
Journal: Journal of Clinical Oncology (2022)

131 Background: To analyze the influence of anatomic site in patients with lymph node only recurrent disease in 68 Ga-PSMA-PET. Methods: We retrospectively analyzed PFS after salvage lymph node dissection in 98 patients. Patients were stratified to Group 1 advanced (retroperitoneal) (=9), Group 2 atypical (pararectal, presacral)(n=5), Group 3 typical (A iliaca externa, interna, Fossa obturator, A iliaca communis) (n=74) and Group 4 multifocal (combination of all groups)(n=10) recurrence. There were no statistically significant differences in the four patient groups in preoperative clinical parameters. Results: The most obvious PSA reduction after sLAD could have been demonstrated in patients with atypically located lymph node metastases (3.6ng/ml to 0.25ng/ml) although this did not reach statistic significance. Patients in the advanced group showed stable PSA values (3,55ng/ml to 3.26ng/ml). Significant results are seen in Group3 (2,52ng/ml to 1,7ng/ml)(p=0.01). Even patients with multifocal disease had a significant decrease in PSA (3.24ng/ml to 1.41ng/ml). 6- and 12 months PFS for Group 1-4 was 41.7% and 13.9%, 60% and 40%, 52.7% and 25.7% and 60% and 40% respectively. Conclusions: SLAD is an individual treatment approach for patients with lymph node only recurrent disease after radical prostatectomy and or radiotherapy. In our preliminary results we could not demonstrate a significant difference in early oncologic results in the four patient groups. Nevertheless, there might be an influence by patient numbers in the different groups so that a validation in a larger cohort is recommended.
Eczema, with an Analysis of Eight Thousand Cases of the Disease.
Journal: JAMA (1901)

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
Abstract 360: Association Between Door-To-Balloon Time on Mortality in Patients With ST-Elevation Myocardial Infarction and Cardiac Arrest
Authors: Anirudh Kumar, Chetan P Huded, Michael J Johnson, Venu Menon, Stephen G Ellis, Samir R Kapadia, Umesh N Khot
Journal: Circulation (2018)

Background: Door-to-balloon-time (D2BT) is a national hospital metric for quality of care among patients with ST-elevation myocardial infarction (STEMI) but STEMI patients with cardiac arrest (CA) are excluded from D2BT public reporting metrics. The association of D2BT with mortality in STEMI patients with cardiac arrest (CA) in the contemporary era of rapid primary PCI is unknown. We assessed the association of D2BT and outcomes in patients with STEMI+CA. Methods: We reviewed consecutive cases of STEMI and CA, defined as loss of pulse requiring cardiopulmonary resuscitation and/or defibrillation, treated with percutaneous coronary intervention (PCI) at our center from 1/1/11-12/31/16.We assessed characteristics and outcomes among these patients by quartile of D2BT (Q1: 21-82 minutes, Q2: 83-106 minutes, Q3: 109-139 minutes, Q4: 141-489 minutes). Results: We identified 145 patients with STEMI+CA. Increasing quartiles of D2BT were associated with higher proportion of female sex (p=0.040), Caucasian race (p=0.001), and dyslipidemia (p=0.008). The use of guideline-directed medical therapy prior to PCI (aspirin, P2Y12 inhibitor, and anticoagulant) and the occurrence of in-hospital post-PCI adverse events were similar between groups. We observed a trend toward increased in-hospital mortality associated with increasing D2BT (Q1: 8.3%, Q2: 10.8%, Q3: 19.4%, Q4: 22.2%, p=0.059, Figure). Conclusion: D2BT is associated with in-hospital mortality among patients with STEMI+CA. Efforts should be made to implement systems of care to reduce disparities in D2BT among appropriate patients within this population.
Understanding nanomedicine treatment in an aggressive spontaneous brain cancer model at the stage of early blood brain barrier disruption
Authors: Phillip W. Janowicz, Zachary H. Houston, Jens Bunt, Nicholas L. Fletcher, Craig A. Bell, Gary Cowin, Christopher B. Howard, Dewan Taslima, Nicholas Westra van Holthe, Amber Prior, Vanessa Soh, Saikat Ghosh, James Humphries, Pie Huda, Stephen M. Mahler, Linda J. Richards, Kristofer J. Thurecht
Journal: Biomaterials (2022)
3JC48-3: Novel MYC inhibition in advanced prostate cancer.
Authors: Victor Chalfant, Carlos Riveros, Sanjeev Shukla, Teruko Osumi, KC Balaji
Journal: Journal of Clinical Oncology (2022)

181 Background: The proto-oncogene c-Myc is a transcription factor that is upregulated in several human cancers. Despite its key role, therapeutic targeting of c-Myc remains a challenge because of a disordered protein tertiary structure. The basic helical structure and zipper protein of c-Myc forms an obligate heterodimer with its partner MAX to function as a transcription factor. An attractive strategy is to inhibit MYC/MAX dimerization to decrease c-Myc transcriptional function. Several methods have been described to inhibit MYC/MAX dimerization including small molecular inhibitors and proteomimetics. Methods: We used NOD SCID gamma mice (NGS mice) that are immunodeficient, non-obese diabetic laboratory mice (Jackson Laboratories, Cat #J000077451) carrying patient-derived xenograft (PDX) following implantation of grade IV adenocarcinoma of the prostate from a patient into the flanks of each mouse. For maximum tolerable dose studies, we used C57BL/6 wild type mice (Jackson Laboratories, Cat #J000664). We performed a maximum dose tolerability study with the drug 3JC48-3 up to 100 mg/kg to determine limiting toxicity. We monitored the rate of growth for 2 weeks and measured the final volume of the tumors. Immunoprecipitation studies were performed using the prostate cancer cell line, PC-3, that were treated with the drug 3JC48-3 at different doses (0, 5, 10, and 20uM) for 24 hours and subsequently lysed. Results: We found 3JC48-3 decreases prostate cancer growth and viability in a dose-dependent fashion in vitro. We confirmed the inhibition of MYC/MAX dimerization by 3JC48-3 using immunoprecipitation experiments. Normal mice and mice with patient-derived prostate cancer xenografts (PDX) tolerated intraperitoneal injections of 3JC48-3 up to 100 mg/kg body weight without dose-limiting toxicity. Preliminary results in these PDX mouse models suggest that 3JC48-3 may be effective in decreasing the rate of tumor growth. Conclusions: Our study demonstrates that 3JC48-3 is a potent MYC/MAX heterodimerization inhibitor that decreases prostate cancer growth and viability in association with upregulation of both PrKD1 expression and kinase activity. In addition, 3JC48-3 is well tolerated in prostate cancer PDX mice models and may be a candidate drug for further preclinical development.
Legionnaires' disease.
Authors: A D Macrae
Journal: BMJ (1979)

given to take away.This is based on triple tetracycline, and after their usual meal times have been discussed with them they are advised on the twice-daily dosage times which will produce least disruption to their usual eating habits.They also receive advice on antacids, milk consumption, iron tablets, and "tonics," in addition to the risks of dental teratogenicity and the necessary continuity of antibiotic regimens.It is my hope that in this manner the poor therapeutic response of NSGI to tetracyclines can be enhanced by intelligent patient co-operation.My comments apply, of course, to the use of tetracyclines in any therapeutic situation.
Occult hypovolaemia.
Authors: A. R. Tappin
Journal: BMJ (1968)

report contains no mention of it whatsoever, nor of the danger to which it drew attention.There are hints that the Minister of Health is about to introduce restrictive regulations that will upset a lot of people and probably save not a single life.Before this action is taken the report should be read again, starting with the facts.Meanwhile it would be grossly unfair to pick on catastrophes that have occurred with dentists, while ignoring identical ones that have occurred with doctors and specialist anaesthetists-particularly when the prevention of nearly all such catastrophes is so simple.-Iam, etc.,
Psychotropic drugs.
Authors: W. Sargant
Journal: BMJ (1968)

It is plain that it is difficult to accept the deductions leading to the range of figures quoted as renal thresholds for glucose.Many of the points made in this paper are of the greatest importance in the detection and management of diabetes, and there is no wish to detract from these, but I do not think the renal threshold figures given are necessarily valid.-Iam, etc.,
Longitudinal ctDNA alterations in germline positive CRPC patients.
Authors: Minqi Huang, Ellen B. Jaeger, Sydney Caputo, William Fleming, Malcolm Light, Charlotte Manogue, Isabelle P. Sussman, Alex Lieberman, Brian E. Lewis, Pedro C. Barata, Jodi Lyn Layton, Elisa M. Ledet, A. Oliver Sartor
Journal: Journal of Clinical Oncology (2022)

275 Background: Circulating tumor-derived DNA (ctDNA) is an accessible method for characterizing somatic alterations. We report longitudinal ctDNA screenings of mCRPC patients (pts) who have had germline testing. Methods: Patients with both germline testing and ctDNA assessment were included. Germline testing was performed with a multi-gene cancer panel from Invitae (50-83 genes) and somatic alterations in ctDNA were identified by testing with Guardant 360 (70-83 genes). ctDNA alterations were characterized as deletions, frameshift, missense, nonsense, and other mutations. A total of 177 patients in various stages of therapy had both ctDNA and germline DNA tested. Results: From 2015-2021, 177 mCRPC patients were included and had an average of 3 ctDNA tests. 11.3% (20/177) had pathogenic or likely-pathogenic germline mutations. The common pathogenic germline mutations were in BRCA2 (25%; 5/20), ATM (10%; 2/20), and MSH2 (10%; 2/20). In ctDNA, missense mutations were the most prevalent type of gene alteration in germline negative (n = 539/790, 68%) and germline positive (n = 124/218, 57%) followed by frameshift mutations at 22% (n = 48/218) in germline positive and 10% (n = 80/790) in germline negative patients. Germline positive patients were more likely to have somatic frameshift mutations (OR = 2.09, 95% C.I. (1.3792, 3.1618), p = 0.001) and less likely to have missense mutations (OR = 0.61, 95% C.I. (0.4519, 0.8351), p = 0.002). Other alterations including deletions, nonsense, and other mutations were not significantly different. Of the germline positive pts, BRCA2 mutation was associated with the highest number of somatic alterations. Conclusions: Germline positive CRPC patients were more likely to have frameshift mutations and less likely to missense mutations compared to germline negative CRPC patients. Patients with germline mutations in BRCA2 and TP53 had the highest number of somatic alterations detected in ctDNA over the course of ctDNA evaluation.
Out of the shadows and the silence
Authors: E. D. Mindel
Journal: JAMA (1972)

Children and adults with severely impaired hearing constitute only about 2 1/2% of all hearing-impaired individuals.<sup>1</sup>The problems of the 10 million or more in the latter group have overshadowed the problems of those in the former group. Those who are born deaf or so severely deafened at some time after birth that using hearing for developing or for language is not possible constitute a distinct subculture in our society. May is designated as Better Hearing Month. It serves to highlight the needs of hearing-impaired children who cannot be helped just by the use of hearing aids and placement in regular schools and who will become part of that subculture. We are interested in focussing on the physician's role in the lives of these deaf children and their families. It is to its physician that a family is most likely to turn for guidance when deafness is suspected. Elsewhere,
Abstract 17330: Predictors of Acute Myocardial Infarction During Pregnancy
Authors: Byomesh Tripathi, Varun Kumar, Purnima Sharma, Shilpkumar Arora, Shikha Malhotra, sopan Lahewala, Abhishek Mishra, Abhishek Deshmukh
Journal: Circulation (2018)

Introduction: Risk stratification of the pregnant population is critical to improving outcomes associated with pregnancy-related Acute myocardial infarction (AMI). Methods: Pregnancy-related hospitalizations (antepartum as well as postpartum) and AMI were identified using appropriate International classification of disease-Ninth revision (ICD-9) codes from nationwide inpatient sample database (2005-2014). Simple logistic regression was used to calculate predictors of AMI during pregnancy. Results: We identified 3,786 cases of AMI from a total of 43,437,621 pregnancy related hospitalization during study period. Compared to pregnant women &lt;20-year, we noted more than 10-fold risk of AMI among patients ≥ 40 years (OR 10.1, 95% CI 5.3-19.0, p&lt;0.001). Other significant predictors of AMI during pregnancy were black race compared to white ( OR 1.6, 95% CI 1.3-1.9, p&lt;0.001), co-existing comorbidities such as hypertension (OR 1.9, 95% CI 1.5-2.5, p&lt;0.001),, thrombophilia (OR 4.8, 95% CI 2.7-8.5, p&lt;0.001), diabetes milletus (OR 1.4, 95% CI 1.0-1.9, p&lt;0.027),hyperlipidemia (OR 13.2, 95% CI 9.9-17.6, p&lt;0.001),smoking (OR 3.3, 95% CI 2.3-4.6, p&lt;0.001), substance abuse (OR 1.7, 95% CI 1.2-2.6, p=0.007), congestive heart failure (OR 26.0, 95% CI 20.3-33.2 p&lt;0.001), deep venous thrombosis (OR 2.8, 95% CI 1.3-6.2, p=0.010) as well as obstetric condition including postpartum hemorrhage (OR 1.8, 95% CI 1.3-2.4, p&lt;0.001),, transfusion during pregnancy (OR 3.2, 95% CI 2.4-4.2, p&lt;0.001), postpartum infection (OR 2,7, 95% CI 1.9-3.9, p&lt;0.001),, fluid and electrolyte imbalance (OR 5.2, 95% CI 4.2- 6.6, p&lt;0.001), and postpartum depression (OR 1.4, 95% CI 1.1-1.9 p=0.013). Conclusions: We identified certain patient-level characteristics which correlated to high risk of AMI. This information can be utilized to decide resource allocation and the introduction of early multidisciplinary intervention among high-risk population
Consent.
Authors: R Gillon
Journal: BMJ (1985)

Gillon contends that consent to medical intervention is by definition informed consent because it requires action by an autonomous agent based on adequate information. Doctors often object that patients are unnecessarily alarmed by too much information about their illnesses or proposed treatments, but many patients are happier if they are told enough to be active in decision making about their care. In any case, the moral obligation to respect the autonomy of other persons requires that patients be given as much information as they want. Even English law, which heretofore left to the doctor the decision on how much information to disclose, has been changed considerably by the House of Lords' appeal judgement in Sidaway v. Bethlem Royal Hospital. The general moral presumption regarding consent should be that patient autonomy takes priority over medical beneficence. Exceptions to this presumption are to be discussed by the author in another article.
Pharmacoepidemiology
Authors: Louis Lasagna
Journal: JAMA (1990)

Pharmacoepidemiology is a growing discipline. Population studies of drug effects are of increasing importance to the pharmaceutical industry, the Food and Drug Administration, litigants, and the medical profession. Information about the adverse effects of drugs derives partly from controlled clinical trials performed prior to registration of a drug, but many effects of interest do not come to light until a drug is taken by large numbers of patients. Nailing down association between a drug and patient injury is difficult; proving causality is even harder. Strom, one of the bright young American pharmacoepidemiologists, has convinced a number of the gurus in the field to write chapters for this book, which can easily serve as a primer for those wishing to get a start on their education in pharmacoepidemiology. Almost half of the book is devoted to individual descriptions of various databases available for pharmacoepidemiologic studies, with attention to their advantages and
Membrane-camouflaged supramolecular nanoparticles for co-delivery of chemotherapeutic and molecular-targeted drugs with siRNA against patient-derived pancreatic carcinoma
Authors: Honglin Tang, Yanan Xue, Bowen Li, Xiaojie Xu, Fu Zhang, Jiajing Guo, Qijun Li, Tingting Yuan, Yuan Chen, Yubin Pan, Yuan Ping, Da Li
Journal: Acta Pharmaceutica Sinica B (2022)
Marriages
Journal: JAMA (1921)

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
Discovery of ARF1-targeting inhibitor demethylzeylasteral as a potential agent against breast cancer
Authors: Jie Chang, Ruirui Yang, Lifan Chen, Zisheng Fan, Jingyi Zhou, Hao Guo, Yinghui Zhang, Yadan Liu, Guizhen Zhou, Keke Zhang, Kaixian Chen, Hualiang Jiang, Mingyue Zheng, Sulin Zhang
Journal: Acta Pharmaceutica Sinica B (2022)

Image 1.
Near patient tests for H pylori perform poorly in primary care
Journal: BMJ (1999)

Insulin four times daily is better than twice daily for diabetes in pregnancyDiabetes mellitus complicates about 5% of all pregnan› cies.Good glycaemic control reduces maternal and perinatal morbidity, but there are no data on whether intensifying insulin treatment beyond the conventional twice daily regimen is of benefit.In a randomised con› trolled open label study in nearly 400 diabetic pregnant patients Nachum et al found that a four times daily regimen improved both perinatal outcome and maternal glycaemic control compared with the conventional twice daily regimen (p 1223).The rate of severe maternal hypoglycaemia was, however, similar in both groups.
Does concurrent COX inhibition and immune checkpoint blockade improve clinical outcomes in patients with metastatic renal cell carcinoma (mRCC)?
Authors: Premsai Kumar, Yumeng Zhang, Jiannong Li, Brandon J. Manley, Jad Chahoud, Philippe E. Spiess
Journal: Journal of Clinical Oncology (2022)

354 Background: Cyclooxygenase (COX) inhibition is postulated to restore the immune environment and synergizes with immune checkpoint inhibitors (ICI). The concurrent use of COX inhibitors (COXi) and ICI was associated with longer disease control in metastatic melanoma and non-small cell lung cancer. However, its role in mRCC remains unclear. Methods: We retrospectively reviewed 194 patients with mRCC treated with ICI (PD-(L)1 inhibitors +/- CTLA-4 inhibitors or TKIs) at Moffitt Cancer Center between 6/2014-7/2019. Concurrent use of COXi (aspirin [ASA] or NSAIDs) was defined as at least 3 weeks of COXi use during the first ICI course. Clinical characteristics of both arms were compared using Chi-squared or Kruskal-Wallis Rank Sum test. Time to progression (TTP) and Overall survival (OS) were compared using Kaplan Meier’s estimates. Univariate and multivariate Cox proportional hazards model was performed to evaluate the association between clinical factors, TTP, and OS. Results: Of 194 patients, 126 patients (64.9%) took COXi. Median age was 59.7 years and 80.4% were male. COXi arm had fewer patients with &lt; 1 year from diagnosis to systemic treatment (45.9% vs 69.5%, p=0.006) and more advanced age (median: 66 years vs 60 years, p=0.01). IDMC risk group, number of prior therapies, neutrophil to lymphocytes ratio were similar between both arms. Median TTP was 8 months (m) for COXi arm and 12m for ICI only (HR 1.38; 95% CI [0.98, 1.94]). Median OS was 27m for COXi arm and 33m for ICI only (HR 1.05, 95% CI [0.69, 1.59]). Early mortality rate (within 3m of ICI treatments) were similar between both arms. Conclusions: In contrast to melanoma and lung cancer, concurrent use of COXi and ICI did not improve TTP and OS in patients with mRCC. The dual blockade showed a trend for shorter TTP and OS. Further validation studies with larger cohorts are needed to confirm this finding.[Table: see text]
Burns with emollients
Authors: Matthew J Ridd, Sarah Hall, Majella E Lane, Amanda Roberts, Hywel C Williams
Journal: BMJ (2022)

How is it diagnosed?Always ask people presenting with burns about use of emollients.To improve awareness and reporting of the condition, routinely record emollient use in medical records. How is it managed?Management is the same as burns not related to emollient use. How can the risk of harm be minimised?Advise patients to continue using emollients as they are an important and effective treatment and there is no alternative for dry skin and inflammatory skin conditions; however, make everyone aware that emollient residue gets into materials and increases their flammability.Clothing such as dressing gowns that are likely to become impregnated need to be changed and washed regularly.However, while washing washable items may reduce risk, some residue remains even after pre-wash treatments, use of biological and non-biological washing powders, and hot water temperatures, especially in fabrics with higher paraffin content . 16vise patients and carers to also take other precautions, such as avoiding long sleeved or loose clothing when cooking, using a safety lighter, avoiding naked flames, and smoking cessation E-cigarettes and electric hobs are lower-risk alternatives to cigarettes and gas hobs.Give fire risk advice verbally when prescribing and dispensing and encourage patients to inform their families, friends and carers.Posters in healthcare settings, patient information leaflets, and warning labels emollient containers are helpful in reducing risk.In the UK, these are available from the MHRA (see fig 1). 17Ask patients/carers to contact local fire and risk services for advice when patients might be at highrisk.Report adverse incidents involving emollients, including fires and burns, to the relevant national authority (UK: MHRA "Yellow Card" https://yellowcard.mhra.gov.uk/;