tbuckley/cabot-search huggingface dataset:
Do prostate MRI reports consider focal therapy when describing diagnostic findings? A descriptive review and analysis of concordance among prostate MRI reports and radical prostatectomy pathology reports.
Authors: Tarik Benidir, Martin Hofmann, Christopher Weight, Eric A. Klein, Andrei Purysko
Journal: Journal of Clinical Oncology (2022)

41 Background: Focal therapy (FT) for prostate cancer (PCa) is becoming an attractive option for men seeking treatments that minimize the morbidity of whole gland therapy. Prostate MRI reports should include lesion location, presence of bilateral extension and presence of multifocality as these radiographic features are essential in selecting appropriate candidacy. We aim to evaluate concordance of disease between MRI and final pathology reports. Methods: We conducted a retrospective review of pathology reports from radical prostatectomies (RP) performed at our institution between 2016-2019, in patients whom also underwent pre-operative prostate MRI’s. The number and locations of PI-RADS ≥ 3 lesions described in MRI reports were compared against the RP findings and assessed for disease concordance in terms of lesion location, extent (unilateral vs. bilateral extent) and/or the presence of tumor multifocality. Fischer’s exact test was used for statistical analysis. Results: A total of 1593 patients underwent RP, among which 416 (26.1%) had preoperative prostate MRI’s. A majority (65.3%) (n = 273/416) of MRI’s reported a single PI-RADS &gt; 3 lesion, 51/416 (12.3%) had negative MRI’s and 22.1% (92/416) described &gt;2 PI-RADS ≥ 3 lesions. A total of n = 388/416 (93.2%) had detailed descriptions of their MRI and path reports for comparative analysis. MRI and final path tumor concordance with respect to unifocal extent or multifocality was low at 37.2%. When a single PI-RADS &gt; 3 lesion was described, concordance with final path was 37.6% as compared to 55.6% when &gt;2 lesions were described (p = 0.006). Discordant findings at final path included the presence of tumor multifocality (80.7%) or the extent of a unifocal lesion (19.3%). Lesions crossing the midline were uncommonly reported on MRI (16%). When prostate midline assessment was included in the evaluation of lesion extent, the degree of concordance with final pathology improved from 33.3% to 64.2% (p = 0.038). Conclusions: Prostate MRI reports have a large discordance with RP reports. Tumor multifocality and/or unifocal disease crossing the midline may not hold significant meaning if the disease is ultimately organ confined and the treatment is aimed at the whole gland. However, in the context of focal therapy, these findings are of germane importance. Radiologists are encouraged to consider focal therapy as a treatment strategy when describing MRI findings and acknowledge the importance of tumor multifocality/bilaterality in this context.
Phase 2 study of neoadjuvant cabozantinib in patients with locally advanced non-metastatic clear cell renal cell carcinoma.
Authors: Mehmet Asim Bilen, Yuan Liu, Bassel Nazha, Jacqueline T Brown, Adeboya O. Osunkoya, Sierra Williams, Wilena Session, Lauren Beth Yantorni, Greta Russler, Sarah Caulfield, Shreyas S. Joshi, Vikram M. Narayan, Christopher Paul Filson, Kenneth Ogan, Omer Kucuk, Bradley Curtis Carthon, Haydn Kissick, Viraj A. Master
Journal: Journal of Clinical Oncology (2022)

340 Background: Cabozantinib is a small molecule inhibitor of the tyrosine kinases c-Met, AXL and VEGFR2 that has been shown to reduce tumor growth, metastasis, and angiogenesis. After the promising results from the METEOR, CABOSUN and Checkmate-9ER trials, cabozantinib was approved for use in patients with advanced renal cell carcinoma (RCC). The increased response rates with cabozantinib in metastatic RCC, along with the other neoadjuvant TKI data, support an expanded role for cabozantinib in the neoadjuvant setting. Methods: Patients with clinical stage ≥ T3Nx or TanyN+ or deemed unresectable by the surgeon with biopsy-proven clear cell RCC were eligible for this study, and received cabozantinib at a starting dose of 60 mg daily for 12 weeks. The primary outcome was objective response rate per RECIST v1.1 (complete and partial responses) at week 12 after the administration of cabozantinib as determined by independent radiologist review. Secondary outcomes included safety, tolerability, clinical outcome (DFS, OS), surgical outcome and quality of life. Results: As of 20 September 2021, 16 biopsy-proven clear cell RCC patients were treated with neoadjuvant cabozantinib. The median age was 56 years (range: 41-84 years) and 81.2% male. All patients completed 12 weeks of treatment, and 15 of them underwent surgery as planned without any delay after completion of 4 weeks wash-out. One patient refused to undergo surgery due to personal reasons and received further systemic treatment. Five patients (31.2%) experienced a partial response, and 11 patients had stable disease. There was no progression of disease while on cabozantinib. Median reduction of primary renal tumor size was 24% (range: 6-45%). The one patient who was deemed to be unresectable became resectable at the end of treatment. Two patients were converted from radical to partial nephrectomy. The most common AEs were diarrhea, nausea, fatigue, hypertension, anorexia, and palmar-plantar erythrodysesthesia syndrome. Intraoperatively, we did not experience any immediate complications. Postoperatively, no surgical complications related to the drug were noted. No treatment related grade 4 or 5 AEs related to cabozantinib or surgery occurred. Two patients had died at the time of analysis (1 due to COVID and 1 unknown cause). Conclusions: Cabozantinib was clinically active and safe in the neoadjuvant setting in patients with locally advanced non-metastatic clear cell RCC. Additional data will be reported including long term outcomes, correlative studies, quality of life, and frailty/sarcopenia indices. Clinical trial information: NCT04022343.
In Brief
Journal: JAMA (1967)

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
Lectures on Diseases of Women and Children
Authors: C. H. F. Routh
Journal: BMJ (1862)

CAUSES.THE causes of endometritis are, cold, miscarriages- or labours, vaginitis, congestion of the uterus, and onanism.The most common cause, however, is abortion or preguancy recurring too frequently.Aran believes that, out of one hundred uterine affections, at least sixty-two per cent.were traceable to these causes.Hence women who do not suckle their children are more liable to these affections; and this because they are likely to become impregnated the sooner.Scanzoni.quoted by Aran, has reduced this statement to figures.Out of one hundred and ninety-six children born of women affected with uterine flexions, only fifty-six had been suckled by their mothers.Aran also states that, of one hun- dred women affected with uterine diseases, seventy had not suckled their own children.
Masthead
Authors: Paul Berk, New York, Andres Blei, Henry Bodenheimer, Herbert Bonkovsky, Lawrence Friedman, T Liang, Irwin Arias, Michael Gerber, Robert Glickman, Jay Boston, Ann Hoofnagle, Albert Jones, San Francisco, Esteban Mezey, Kunio Okuda, Jurg Reichen, Allan Wolkoff, Steven Schenker, San Antonio, Michelle Britton, Debra Segura, Data Meyer, D Montgomery Bissell, Sun Francisco, Anthony Tavill, Eugene Schiff, John Gollan, M Boston, Joseph Councillors, Neil Bloomer, Los Kaplowitz, Nicholas Angeles, Marion Larusso, St Peters, Jay Hoofnagle, Michael Baltimore, William Lee, Jules Dienstag, Joseph Bloomer, Andrew Klein, Glen Arm, Anna Lok, New Orleans, Kevin Mullen, Robert Cleveland, San Ockner, Adrian Francisco, W Hepatology
Journal: Hepatology (1995)
Diuretics
Authors: G. M. Wilson
Journal: BMJ (1963)

in whose memory this lecture was founded, was initially in practice in Andover, where he married a rich widow.Thereafter he became practically independent of his profession, and, it is reported, enjoyed ease and leisure for the cultivation of his mind (Poore, 1881).He was thus a complete contrast to the lecturer who is endeavouring to commemorate him to-day.How- ever, at one time he showed an interest in therapeutics and published an article entitled " On the Use of Cod- liver Oil in Chronic Rheumatism" (Bradshaw, 1845).He reported seven cases successfully treated.In six the cod-liver oil was given along with gin or brandy.In the seventh patient, an old parish midwife aged 71, "the stomach revolted if the dose was given on any vehicle except that of strong whisky," but on this medication there was remarkable improvement." She certainly appeared to grow younger . . .and spent many years afterwards in the glories of longevity."This was attributed unreservedly to the effects of the oil !I fear that neither the design of his investigation nor his interpretation of the results brings us any closer together.
Text-Book of Nervous Diseases and Psychiatry, For the Use of Students and Practitioners of Medicine.
Journal: JAMA (1904)

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
Clip-induced esophageal perforation during endoscopic submucosal dissection: the perfect is the enemy of the good!
Authors: Sophie Geyl, Raphael Olivier, Mathieu Pioche, Martin Dahan, Romain Legros, Jérémie Albouys, Jérémie Jacques
Journal: Endoscopy (2022)

Superficial muscular injury without deep perforation frequently occurs during endoscopic submucosal dissection (ESD) of superficial neoplasms. The optimum management of this not uncommon situation is unclear. Clipping could avoid secondary perforation and postresection coagulation syndrome.
Al-Anon
Authors: M Anthony
Journal: JAMA (1977)

AL-ANON is a self-help program for the spouse, family, and friends of the alcoholic. The 12 steps of Alcoholics Anonymous (AA) are used as their guide for growth. "The sole qualification for membership is that their lives have been or are being deeply affected by close contact with an alcoholic."<sup>1</sup> Ten million Americans are alcoholics. For every alcoholic, at least four others are intimately affected by this disease, primarily the spouse and family of the alcoholic. That means the lives of 40 million men, women, and children are scarred by alcoholism: 40 million reacting to the insane behavior of the alcoholic; 40 million angry, resentful, guilt-ridden, anxiety-ridden people, living from one crisis to another, 50 million sick people. Alcoholism is truly a family illness. <h3>How Does the Family Become So Sick?</h3> In my case, 11 years passed from our marriage (the beginning of our problems) until Helen's introduction into
Disease progression and competing mortality for men undergoing active surveillance for low-risk prostate cancer.
Authors: Kripa Guram, Tyler J. Nelson, Rishi Deka, Michael Vincent Sherer, Gustavo Rodrigues De Moraes, Brent S. Rose
Journal: Journal of Clinical Oncology (2022)

282 Background: Active surveillance is a common management strategy for men with low-risk prostate cancer. However, there is some concern that delaying definitive therapy could lead to progressive disease and a missed opportunity to cure the cancer. We sought to study the impact of Gleason grade progression on the risk of metastases and prostate cancer-specific mortality (PCSM). We then sought to compare the risks of PCSM with the risk of competing mortality in this real-world cohort of men on active surveillance. Methods: This was a retrospective population-based cohort study using patient records from the Veterans Heath Administration Informatics and Computing Infrastructure of patients with a diagnosis of low-risk prostate cancer from January 1, 2001, to December 31, 2015, who were managed with active surveillance. Follow-up extended through March 31, 2020. Low-risk prostate cancer was defined as International Society of Urologic Pathology grade group (GG) 1, clinical tumor stage 2A or lower, PSA level of 10 ng/dL or lower. Active surveillance was defined as no definitive treatment within the first year after diagnosis with at least 1 additional re-staging biopsy after diagnostic biopsy. We identified men with pathologic upgrading to ≥GG2 and ≥GG3. We calculated the cumulative incidence of metastases, PCSM, and non-cancer mortality for men with and without pathologic upgrading. Results: The cohort included 8562 men with low-risk PC. Pathologic upgrading to ≥GG2 and ≥GG3 occurred in 3227 and 1200 men, respectively. For all patients, the 8-year cumulative incidence of metastases and PCSM was 0.8% (95% CI: 0.6-1.0%) and 0.4% (CI:0.3-0.6%), respectively. Pathologic upgrading to ≥GG2 was associated with an increased risk of metastases at 8 years (1.2% vs 0.5%, p &lt; 0.001). Pathologic upgrading to ≥GG3 was also associated with an increased risk of metastases at 8 years (2.7% vs 0.5%, p &lt; 0.001). In contrast, pathologic upgrading to ≥GG2 was not associated with an increased risk of PCSM at 8 years (0.5% vs 0.4%, p = 0.793). Similarly, pathologic upgrading to ≥GG3 was not associated with an increased risk of PCSM at 8 years (0.7% vs 0.4%, p = 0.82). The 8-year cumulative incidence of non-cancer mortality for all patients was 6.5% (95% CI:5.9-7.1%). Overall, the risk of non-cancer mortality was 16.25 (6.5/0.4) times higher than the risk of PCSM, regardless of upgrading status. Conclusions: For men with low-risk PC on active surveillance, pathologic upgrading was associated with a small increased risk of metastases but no increased risk of death from prostate cancer. Regardless of upgrading status, the risk of non-cancer mortality was substantially higher than the risk of PCSM. Future work is required to better tailor the intensity of follow up for surveillance protocols for men at risk of competing mortality.
Diphtheria Immunization
Authors: M. Sorsby
Journal: BMJ (1938)

MEDCBRIORAL 701 5. B.B.S. is a more suitable diluent than phenol saline for Toxin B. It ensures less deterioration after (a) two to three days at room temperature, and also after (b) four weeks at 4 C. followed by two to three days at room temperature.Cotmpar isoni of two Dick toxinis, A anid B, diluted in B.B.S. or 0.4 per cent.phenol saline (a) two to three days before injection, and (b) one mont/t before injectioni Observers M.L.
Side Effects of Raw Honey
Journal: JAMA (1991)

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
Smallpox vaccination.
Authors: J M Lane
Journal: BMJ (1970)

Nun= 47 that there was more evidence of obstructive respiratory disease in his sample of workers than among the workers exposed to similar products examined by ourselves.'On the other hand, the F.E.V./'V.C. ratio is not age standardized and differences in age struc- ture of the two populations might to some extent account for the difference.Also, a higher proportion of the workers in his sur- vey were sensitized to the B. subtilis derivatives than in our own series.Levels of enzyme concentration in air are not given, but exposure to higher levels for longer periods might account for the difference.-Iam, etc.,
16. Diabetes Advocacy: <i>Standards of Medical Care in Diabetes—2019</i>
Journal: Diabetes Care (2018)

The American Diabetes Association (ADA) “Standards of Medical Care in Diabetes” includes ADA’s current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA’s clinical practice recommendations, please refer to the Standards of Care Introduction. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
Correction
Journal: BMJ (1956)

ANY QUESTIONS?recur.The extent of the pneumothorax, provided the underlying lung seems normal, does not seem to affect the prognosis.There are, of course, exceptions to this general statement-e.g., a young man who developed a spontaneous pneumothorax in the Antarctic wished to return there for two years, and pleurodesis was carried out although he had had only a single attack. Poliomyelitis Season in Western EuropeQ.-Is the poliomyelitis season broadly the same for all Western European countries?Do any of these countries consistently have a markedly higher or lower incidence of paralytic disease than the others ?A.-The comparison of poliomyelitis notification rates in different countries is complicated by differences in completeness of reporting and in the clinical standards used in classifying paralytic and non-paralytic forms of the disease.Broadly speaking, however, the epidemic season is the same in all the countries of Western Europe-a steep rise from June to a peak in September, followed by a sharp fall in the next three months.The experience of different countries differs considerably from year to year, but in the period
Abstract 17213: Crizotinib Exacerbates the Severity of Pah in a Preclinical Rat Model
Authors: Francois Potus, Boucherat Olivier, Provencher Steeve, Bonnet Sébastien
Journal: Circulation (2018)

Introduction: Pulmonary arterial hypertension (PAH) is a lethal vasculopathy histologically associated with remodeling of distal pulmonary arteries and right ventricular failure that is drug-induced in approximately 10% of cases. Recently, PAH induced by chemotherapeutic agents such as RTK inhibitors (e.g. dasatinib) has been described. Crizotinib is a new MET inhibitor increasingly used for the treatment of ALK-positive non-small cell lung carcinoma. Interestingly, crizotinib has been shown to induce endothelial cells (EC) dysfunction (e.g. inhibition of EC survival and angiogenesis) and is symptomatically associated with dyspnea and peripheral oedema in many patients, which are cardinal symptoms of PAH. We thus hypothesized that chronic administration of crizotinib exacerbates PAH. Material and results: We observed a significant increase of mortality rate in PAH rats (Sugen/hypoxia model) treated with daily oral administration of crizotinib (100mg/kg/d for 2 weeks) compared to rats treated with vehicle (6/group; p&lt;0.05). Furthermore, we demonstrated that crizotinib treatment was associated with increases in right ventricular systolic pressure, mean pulmonary arterial pressure and pulmonary vasculature resistance; and decreases in cardiac output and stroke volume (right heart catheterizations in closed chest) compared to vehicle-treated rats with Sugen-induced PAH (4 PAH+crizotinib; 6 PAH+vehicle, 5 PAH and 3 control rats; p&lt;0.05). Histologically, crizotinib administration significantly increased pulmonary arteries wall thickness as well as right ventricular fibrosis (p&lt;0.05). Finally, crizotinib increased macrophage accumulation and size within the lungs of PAH rats (p&lt;0.05). Conclusion: We documented for the first time that crizotinib treatment markedly increases vascular remodeling and macrophage activation with concomitantly marked PAH exacerbation in Sugen rats. This study could have major clinical relevance in the management of patients treated with crizotinib.