tbuckley/cabot-search huggingface dataset:
NCCN News
Journal: Journal of the National Comprehensive Cancer Network (2021)

Care TeamsNCCN conducted a 3-day, live virtual congress on October 14-16, 2021, addressing the latest in therapeutic advances, updates to the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines), and treatment debates across the broad spectrum of blood cancers.Incorporating interactive polling and moderator-facilitated Q&A sessions, the NCCN Virtual Congress: Hematologic Malignancies was designed to meet the needs of the full interprofessional care team, including physicians, nurse practitioners, nurses, physician assistants, pharmacists, and other healthcare professionals who manage the care of patients with hematologic malignancies.Additionally, NCCN hosted the NCCN Virtual Nursing Forum: Advancing Oncology Nursing in Hematologic Malignancies, on Friday, October 8, 2021, to provide nurses with comprehensive and clinically relevant information to optimize care for patients with blood cancers."In response to the ongoing COVID-19 pandemic, this year's congress was again presented in a virtual format through both live and on-demand webcasts," said Andrew D. Zelenetz, MD, PhD, Memorial Sloan Kettering Cancer Center (MSK) and congress Co-Chair."While we prefer face-to-face interactions, we are gratified that we were able to still deliver a valuable interactive experience that helps maintain the high quality of patient care across the country-and the globe.""The NCCN Annual Congress for hematologic malignancies provides a platform for leading experts to share and debate the latest evidence and practice recommendations for patient management," said event Co-Chair Ranjana H. Advani, MD, Stanford Cancer Institute."Our hope is that clinicians who attend will be better equipped to put novel therapies and treatment guidelines into practice.
Endorse
Authors: J. Marc Shabot
Journal: Annals of Internal Medicine (2019)

On Being a Doctor1 October 2019EndorseJ. Marc Shabot, MDJ. Marc Shabot, MDUniversity of Texas Medical Branch at Galveston, Galveston, Texas (J.M.S.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M19-1806 Audio Reading - “Endorse” Audio. Michael A. Lacombe, MD, Annals Associate Editor, reads “Endorse” by J. Marc Shabot, MD Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail I don't really know when it happened, but it did. Like many things in life, change occurs slowly, at times imperceptibly. Even though you know that nothing ever stays the same, one day it hits you and you say, “What happened?”Along the way, there were subtle and not-so-subtle signs that I missed, overlooked, or denied. When reviewing a patient's EHR, I would come across abbreviations that were foreign to me: “PNA” (pneumonia), “HFrEF” (heart failure with reduced ejection fraction), “BLLE” (bilateral lower-extremity edema), or “TLBIV” (two large-bore IVs), to name a few.While on the subject of the EHR, ... Author, Article, and Disclosure InformationAffiliations: University of Texas Medical Branch at Galveston, Galveston, Texas (J.M.S.)Corresponding Author: J. Marc Shabot, MD, University of Texas Medical Branch at Galveston, 301 University Boulevard, Galveston, TX 77555-0764; e-mail, [email protected]edu. PreviousarticleNextarticle Advertisement Audio Reading - “Endorse” Audio. Michael A. Lacombe, MD, Annals Associate Editor, reads “Endorse” by J. Marc Shabot, MD Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics 1 October 2019Volume 171, Issue 7Page: 519KeywordsHearingIschemiaLiverLungsOintmentsPatientsPneumoniaPoliomyelitisSplenomegalyThorax ePublished: 1 October 2019 Issue Published: 1 October 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Abstract 127: The Effect of Cutoff Frequency Range on Amplitude Spectrum Area Performance in Predicting Defibrillation Outcome
Authors: Xiaobo Wu, Weilun Quan, Jennifer Bradley, Mary Ann Peberdy, Joseph Ornato, Wanchun Tang
Journal: Circulation (2018)

Introduction: Both clinical and experimental studies have demonstrated that ventricular fibrillation (VF) waveform-based amplitude spectrum area (AMSA) predicts defibrillation outcome with high sensitivity and specificity. A commonly used cutoff frequency range for calculation of AMSA is 4-48 Hz, but the median VF frequency in patients is less than 7 Hz. In the present study, we investigated whether the AMSA performance in predicting defibrillation outcome may be affected by different cutoff frequency ranges. Hypothesis: A selected cutoff frequency range would affect AMSA performance in predicting defibrillation outcome in patients. Methods: A total of 450 segments (179-defibrillation success and 271-defibrillation failure) of VF waveforms from patients with out-of-hospital cardiac arrest were analyzed. Each 4.096-s segment prior to defibrillation was acquired with a sampling rate of 250 Hz. Using MATLAB (MathWorks, Natck, MA), the AMSA of each segment of VF waveform was calculated with five cutoff frequency ranges (Shown in Figure 1). Sensitivity and specificity were calculated when defibrillation success rate was 50% which was estimated by a logistic regression curve. Area under the receiver operating characteristic curve (AUC) was used to evaluate AMSA performance within different cutoff frequency ranges. Results: AMSA threshold was decreased from 20.5 to 6.5 mV·Hz when the cutoff frequency range was changed from 3-48 Hz to 3-10 Hz (Figure 1). Sensitivity of AMSA in 3-10 Hz was increased by 81.3% compared with that of AMSA in 3-48 Hz. Specificity of AMSA in 3-10 Hz was decreased by 8.1% compared with that of AMSA in 3-48 Hz. The corresponding AUC was increased from 0.724 (3-48 Hz) to 0.768 (3-10 Hz). Conclusions: A cutoff frequency range of 3-10 Hz significantly increases the sensitivity of AMSA for predicting defibrillation success in patients with cardiac arrest with a slight decrease in specificity.
Targeting an IL-6/JAK/STAT/PIM1 pathway in renal cell carcinoma.
Authors: Kimberly Stephanie Meza, Sheldon L. Holder
Journal: Journal of Clinical Oncology (2022)

376 Background: Renal cell carcinoma (RCC) is the most common cancer of the kidney and accounts for over 430,000 new cases worldwide and 179,000 deaths each year. PIM1 overexpression is associated with poor clinical outcomes in patients with RCC. PIM1 is a constitutively active effector serine/threonine kinase with roles in tumor progression including cell proliferation, apoptosis, invasion, and migration. Yet, the mechanisms that underlie PIM1 expression and its function in RCC are not fully understood. Previous studies have implicated the cytokine IL-6 as an activator of STAT3 and stimulator of PIM1 expression in pancreatic cancer. The aim of the present study is to explore expression of PIM1 in RCC and identify potential signaling pathways that influence PIM1 expression. Methods: To evaluate the contribution of PIM1 expression in RCC we first established baseline PIM1 levels across four RCC cell lines (786-O, 769-P, CAKI-1, and RCC-4). Next, we quantified the presence of IL-6 in cell culture supernatants for each cell line using an ELISA assay. IL-6 signals through the JAK/STAT pathway, consequently we then used immunoblotting to determine whether ruxolitinib, a JAK1/2 inhibitor, would affect PIM1 expression. Finally, we examined cell viability post-ruxolitinib therapy using an MTS assay. Results: Our results show that 769-P, 786-O, and CAKI-1 but not RCC-4 cells overexpress PIM1 relative to normal renal proximal tubule epithelial cells. Results from the ELISA assay show that 786-O, CAKI-1, and to a lesser degree RCC-4 cells secrete IL-6 into their media. Interestingly, 769-P cells had little to no IL-6 present in their media. Based on these differences we sought to understand what effect inhibiting JAK may have on PIM1 expression. After treating cells with ruxolitinib, we found that 786-O and CAKI-1 cells show a time and dose dependent decrease in PIM1 levels whereas 769-P cells did not. To understand if these differences correlate with cell viability, we performed an MTS assay after treating cells with ruxolitinib. Preliminary results show that at 8hr post-treatment, CAKI-1 but not 769-P cells display a time and concentration dependent loss of cell viability. Conclusions: Our initial studies suggest that differential expression of PIM1 among RCC cell lines may be linked to autocrine IL-6 secretion. In CAKI-1 cells JAK inhibition decreases PIM1 expression and cell viability. In the context of 769-P cells with high PIM1 expression but low IL-6 secretion levels, JAK inhibition did not affect cell viability. These data suggest that in 769-P cells there exists a non-IL-6 dependent mechanism stimulating PIM1 expression. Further investigation is required to elucidate the contexts of these PIM1 regulatory pathways in order to develop IL-6/JAK/PIM1 targeted anti-cancer strategies in RCC.
Single-Agent Abemaciclib Active in Breast Cancer
Journal: Cancer Discovery (2016)

Abstract According to results from a phase II study, abemaciclib shows single-agent activity in women with metastatic HER2-negative, ER-positive breast cancer whose disease has progressed on endocrine therapy and chemotherapy. The objective response rate to this investigational CDK4/6 inhibitor was 19.7%, with 28.2% of responses lasting at least a year.
Epidemic malaise.
Authors: P H Gosling
Journal: BMJ (1970)

BIURTISH 499 while they were on a gluten-free diet, but we believe that even these can be explained on the natural history of the disease.After all, the average duration of dermatitis her- petiformis without a gluten-free diet is four years, and we have patients who have had spontaneous remissions (without a glutenfree diet) for periods of up to four years.More cases who needed no dapsone while on their diet and relapsed when the diet was stopped, like case 17 in the series of Drs.Marks and Whittle, are needed to establish that gluten has an effect on the rash, and such case histories have not yet been published.We believe indeed that none of the published evidence shows that the rash, in contrast to the enteropathy, of dermatitis herpetiformis is improved by gluten withdrawal.-Weare, etc.,
Full endoscopic versus open discectomy for sciatica: randomised controlled non-inferiority trial
Authors: Pravesh S Gadjradj, Sidney M Rubinstein, Wilco C Peul, Paul R Depauw, Carmen L Vleggeert-Lankamp, Ankie Seiger, Job LC van Susante, Michiel R de Boer, Maurits W van Tulder, Biswadjiet S Harhangi
Journal: BMJ (2022)

Abstract Objective To assess whether percutaneous transforaminal endoscopic discectomy (PTED) is non-inferior to conventional open microdiscectomy in reduction of leg pain caused by lumbar disc herniation. Design Multicentre randomised controlled trial with non-inferiority design. Setting Four hospitals in the Netherlands. Participants 613 patients aged 18-70 years with at least six weeks of radiating leg pain caused by lumbar disc herniation. The trial included a predetermined set of 125 patients receiving PTED who were the learning curve cases performed by surgeons who did not do PTED before the trial. Interventions PTED (n=179) compared with open microdiscectomy (n=309). Main outcome measures The primary outcome was self-reported leg pain measured by a 0-100 visual analogue scale at 12 months, assuming a non-inferiority margin of 5.0. Secondary outcomes included complications, reoperations, self-reported functional status as measured with the Oswestry Disability Index, visual analogue scale for back pain, health related quality of life, and self-perceived recovery. Outcomes were measured until one year after surgery and were longitudinally analysed according to the intention-to-treat principle. Patients belonging to the PTED learning curve were omitted from the primary analyses. Results At 12 months, patients who were randomised to PTED had a statistically significantly lower visual analogue scale score for leg pain (median 7.0, interquartile range 1.0-30.0) compared with patients randomised to open microdiscectomy (16.0, 2.0-53.5) (between group difference of 7.1, 95% confidence interval 2.8 to 11.3). Blood loss was less, length of hospital admission was shorter, and timing of postoperative mobilisation was earlier in the PTED group than in the open microdiscectomy group. Secondary patient reported outcomes such as the Oswestry Disability Index, visual analogue scale for back pain, health related quality of life, and self-perceived recovery, were similarly in favour of PTED. Within one year, nine (5%) in the PTED group compared with 14 (6%) in the open microdiscectomy group had repeated surgery. Per protocol analysis and sensitivity analyses including the patients of the learning curve resulted in similar outcomes to the primary analysis. Conclusions PTED was non-inferior to open microdiscectomy in reduction of leg pain. PTED resulted in more favourable results for self-reported leg pain, back pain, functional status, quality of life, and recovery. These differences, however, were small and may not reach clinical relevance. PTED can be considered as an effective alternative to open microdiscectomy in treating sciatica. Trial registration NCT02602093ClinicalTrials.gov NCT02602093 .
Drug abuse in athletes. Anabolic steroids and human growth hormone. Council on Scientific Affairs
Authors: George M. Bohigian, E. Harvey Estes, Ira R. Friedlander, William R. Kennedy, John H. Moxley, Paul S. Salva, William C. Scott, Joseph H. Skom, Richard M. Steinhilber, Jack P. Strong, Henry N. Wagner, William R. Hendee, William T. McGivney, Carol M. Proudfit
Journal: JAMA (1988)

This report, the first in a three-part series on drug abuse by athletes, responds to adopted Resolution 4 (1984 Annual Meeting) and to Resolution 57 (1986 Annual Meeting), "Human Growth Hormone," which was referred to the Board of Trustees for action. Subsequent reports will cover other classes of abused drugs.
Abstract 17034: Diagnostic Accuracy of Diastolic Pressure Ratio Using a Microcatheter: An Analysis of the ACIST-FFR Study
Authors: Matthew Price, Jaden Yang, Jeffrey Chambers, Arnold Seto, Iam Sarembock, Ganesh Raveendran, Manisha Desai, Allen Jeremias, Mitsuaki Matsumura, William F Fearon
Journal: Circulation (2018)

Background: The diastolic pressure ratio (dPR) is a non-hyperemic index used to measure the ratio of distal coronary to aortic pressure during a diastolic portion of the cardiac cycle. dPR indices measured by a pressure wire have similar diagnostic accuracy as iFR for FFR. The accuracy of dPR using a microcatheter (MC) has not been defined. Methods: The ACIST-FFR study was a prospective, multicenter study of a pressure-monitoring MC in patients with stable CAD. Using an automated software algorithm, dPR with the MC was defined as the Pd/Pa at the location within the diastolic period that was 50% of the distance from the peak of one waveform to the peak of the next waveform, averaged over a 5-beat period. iFR with the MC was computed in the usual fashion by the core laboratory from the original pressure tracings. Results: A total of 161 paired data samples from 11 sites were analyzed. dPR was highly correlated with iFR (R 2 =0.992, AUC=0.998 with a mean bias of -0.0237 (95% CI, -0.0041 to -0.0011) and provided a sensitivity of 98%, specificity 96%, and diagnostic accuracy of 96.9%. The optimal cutpoint of dPR for FFR was 0.91 (AUC=0.886), which provided a sensitivity of 82%, specificity of 80%, and diagnostic accuracy of 81%. The diagnostic accuracy of iFR for FFR was 81%, with a sensitivity of 82%, and specificity 80%. Conclusions: With a MC system, a non-hyperemic diastolic pressure ratio is highly correlated with iFR, and provides similar diagnostic accuracy as iFR for FFR.
Health-related quality of life as a prognostic indicator of biochemical recurrence free survival in high-risk prostate cancer patients following radical prostatectomy.
Authors: Thilo Westhofen, Alexander Buchner, Boris Schlenker, Armin Becker, Christian G. Stief, Alexander Kretschmer
Journal: Journal of Clinical Oncology (2022)

235 Background: Several studies have shown baseline health-related quality of life (HRQOL) to be a valuable prognostic indicator of survival outcomes for various cancer entities in the metastatic setting. To date, there is no evidence regarding the prognostic value of baseline HRQOL for patients undergoing radical prostatectomy (RP) due to localized prostate cancer (PC). The objective of this study was to assess the impact of baseline preoperative HRQOL on survival prognosis for high-risk PC patients following RP. Methods: 1029 patients with high-risk PC according to NCCN risk stratification and prospectively assessed baseline HRQOL prior RP were included. Patients were stratified by the global health status (GHS) domain of the EORTC QLQ-C30 questionnaire, good general HRQOL was defined as GHS≥70 based on validated cut-off levels. Subsequently, a propensity score-matched analysis of 636 patients [n=318 (GHS≥70), n=318 (GHS&lt;70)] was conducted. Primary endpoint was biochemical recurrence-free survival (BRFS), secondary endpoint was metastasis-free survival (MFS). Multivariate Cox regression models were performed to assess prognostic significance of baseline GHS on survival outcomes. Harrell’s discrimination C-index was applied to calculate the predictive accuracy of the model (p&lt;0.05). Results: Median follow-up was 40mo. Applying matching variables age, PSA, pT stage, Gleason grade, positive surgical margin rate, and lymph node involvement, patients subcohorts were well-balanced. 5-yr-BRFS (61% vs. 28%; p&lt;0.001) and 5-yr-MFS (86% vs. 68%; p=0.003) were significantly increased in the GHS≥70 cohort. In multivariate analysis GHS≥70 was confirmed as an independent predictor for increased BRFS (HR 0.60, 95%CI 0.44–0.82; p=0.013) and MFS (HR 0.51, 95%CI 0.30–0.87; p=0.026). Adding baseline HRQOL to our model improved predictive accuracy of BRFS by 8% (Harrell’s C-index of 0.69 vs 0.65). Conclusions: Our findings highlight baseline HRQOL to be a valuable and robust prognostic factor for patients with localized high-risk PC prior RP. Baseline good general HRQOL accurately predicts increased BRFS and MFS.[Table: see text]
Near patient tests in primary care are poorly evaluated
Journal: BMJ (1999)

Evidence for cerebral dysfunction in people after the Camelford water incident Just over 11 years ago 20 tonnes of aluminium sulphate were accidentally added to the drinking water reservoir serving 20 000 people in the Camelford area of Cornwall.There was delay in reporting the incident to the public, and those exposed started reporting various acute symptoms.Later, they started complaining of loss of concentration and short term memory, but in two sittings of a commission of inquiry their symptoms were attributed to anxiety.On p 807 Altmann et al report the results of studies done on 55 affected people who showed objective evidence of cerebral dysfunction.Anxiety levels had no effect, and unexposed siblings performed normally.Although no measures were available from before the incident, their accounts and the discrepancy with their premorbid IQ suggest that these individuals were affected by the incident, and it is likely that aluminium, as the major neurotoxic agent involved, led to the changes observed.
Adenocarcinoma of the Appendix
Authors: P Burgess, H J Done
Journal: Journal of the Royal Society of Medicine (1989)

Patients presenting with adenocarcinoma of the vermiform appendix at the Royal Preston and Chorley District General Hospitals were reviewed for the 15 year period 1972-1986. Eleven cases were identified, representing a rate of 1 in 956 for all appendicectomies performed. A third of the cases presented as acute appendicitis. However, of 8 patients who initially had an appendicectomy, only 4 subsequently underwent further surgery (right hemicolectomy). One patient died of recurrent disease. Five of the patients presenting were under 60 years of age. During the same period, the total number of appendicectomies performed annually declined by 50%. The study highlights the need to subject all appendicectomy specimens to histological examination, and that the disease presents in a younger age group than commonly seen for malignant colonic neoplasms.
Proctology
Authors: Charles B. Clayman
Journal: JAMA (1979)

In a brief well-organized fashion, the author once again lists the anorectal entities presented to the physician or surgeon. He quickly develops the anatomy of the area, moving then to symptoms and methods of examination. Almost one third of the book is devoted to hemorrhoids and their treatment. Certain diseases of the colon that sometimes involve the rectum are discussed. The last portion of the book briefly discusses a group of somewhat less common anorectal conditions. The author takes pain to emphasize that a clear and frank explanation of the problem may make a crucial difference regarding the patient's tolerance of his condition and treatment.
Diflunisal
Authors: James A. Forbes
Journal: JAMA (1982)

The analgesic efficacy of single 500- and 1,000-mg doses of diflunisal (Dolobid), a new nonsteroidal anti-inflammatory analgesic, was compared in a double-blind study with that of acetaminophen, 600 mg, the combination of acetaminophen, 600 mg, with codeine phosphate, 60 mg, and placebo in 159 oral surgery outpatients. Using a self-rating record, patients rated their pain and its relief hourly for 12 hours after medication. Both doses of diflunisal were significantly more effective than acetaminophen alone and produced peak analgesia comparable to that of the acetaminophen-codeine combination. Diflunisal proved to have an unusually long duration of analgesic action. Acetaminophen and the combination were significantly superior to placebo through hours 2 and 5, respectively; both doses of diflunisal were significantly superior through the end of the 12-hour observation period. None of the active treatments produced more side effects than the placebo. (<i>JAMA</i>1982;248:2139-2142)