tbuckley/cabot-search huggingface dataset:
New Persistent Opioid and Benzodiazepine Use After Curative-Intent Treatment in Patients With Breast Cancer
Authors: Mandy R. Sakamoto, Megan Eguchi, Christine M. Azelby, Jennifer R. Diamond, Christine M. Fisher, Virginia F. Borges, Cathy J. Bradley, Peter Kabos
Journal: Journal of the National Comprehensive Cancer Network (2021)

Background: Opioid and benzodiazepine use and abuse is a national healthcare crisis to which patients with cancer are particularly vulnerable. Long-term use and risk factors for opioid and benzodiazepine use in patients with breast cancer is poorly characterized. Methods: We conducted a retrospective population-based study of patients with breast cancer diagnosed between 2008 and 2015 undergoing curative-intent treatment identified through the SEER-Medicare linked database. Primary outcomes were new persistent opioid use and new persistent benzodiazepine use. Factors associated with new opioid and benzodiazepine use were investigated by univariate and multivariable logistic regression. Results: Among opioid-naïve patients, new opioid use was observed in 22,418 (67.4%). Of this group, 611 (2.7%) developed persistent opioid use at 3 months and 157 (0.7%) at 6 months after treatment. Risk factors for persistent use at 3 and 6 months included stage III disease (odds ratio [OR], 2.16; 95% CI, 1.49–3.12, and OR, 3.48; 95% CI, 1.58–7.67), surgery plus chemotherapy (OR, 1.44; 95% CI, 1.10–1.88, and OR, 2.28; 95% CI, 1.40–3.71), surgery plus chemoradiation therapy (OR, 1.47; 95% CI, 1.10–1.96, and OR, 2.34; 95% CI, 1.38–3.96), and initial tramadol use (OR, 2.66; 95% CI, 2.05–3.46, and OR, 3.12; 95% CI, 1.93–5.04). Among benzodiazepine-naïve patients, new benzodiazepine use was observed in 955 (10.3%), and 111 (11.6%) developed new persistent use at 3 months. Tamoxifen use was statistically significantly associated with new persistent benzodiazepine use at 3 months. Conclusions: A large percentage of patients receiving curative-intent treatment of breast cancer were prescribed new opioids; however, only a small number developed new persistent opioid use. In contrast, a smaller proportion of patients received a new benzodiazepine prescription; however, new persistent use after completion of treatment was more likely and particularly related to concurrent treatment with tamoxifen.
Incidence of Monoclonal Gammopathy of Undetermined Significance (MGUS) and Subsequent Transformation to Multiple Myeloma (MM) and Effect of Exposure to Agent Orange (AO) : A Single Center Experience from VA Detroit
Authors: Naresh Bumma, Misako Nagasaka, Seongho Kim, Hema M. Vankayala, Shabbir Ahmed, Pallavi Jasti
Journal: Blood (2017)
Jeremy Metters: former deputy chief medical officer and England’s last HM inspector of anatomy
Authors: Joanna Lyall
Journal: BMJ (2021)

metters080821.f1 

Credit: Reuters/Alamy

As the last person in England to hold the position of HM inspector of anatomy, Jeremy Metters could be said to have worked himself out of a job.

During his tenure, between 1999 and 2005, he chaired a two year inquiry into the retention of brains after postmortem examinations without relatives’ consent. The starting point was an investigation into the circumstances surrounding the death of Cyril Isaacs in 1987, and his widow’s s chance discovery, in 2000, that his brain had been retained for research. The Isaacs report, published in May 2003, found that more than 28 000 brains had been retained between 1970 and 1999, with the relatives unaware in most cases. The report called for strengthening of the law to prevent covert and unconsented retention in future.1 “Anyone who had a postmortem from 1961 to 1999 could have had their brain removed …
Gaps in Evidence for Risk Stratification for Sudden Cardiac Death in Hypertrophic Cardiomyopathy
Authors: Francesco Pelliccia, Bernard J. Gersh, Paolo G. Camici
Journal: Circulation (2021)

udden cardiac death (SCD) is the most dramatic and catastrophic complication of hypertrophic cardiomyopathy (HCM), 1 with an annual rate of >1%. 1 The identification of those patients most likely to benefit from prophylactic implantable cardioverter defibrillators remains challenging in children and adults.The positive predictive value for appropriate discharges is low (≈20%), and the complication rates in this younger, active population is substantial, including lead problems, infections, inappropriate discharges, and psychological issues.
R-Crizotinib predisposes to and exacerbates pulmonary arterial hypertension in animal models
Authors: Charifa Awada, Yann Grobs, Wen-Hui Wu, Karima Habbout, Charlotte Romanet, Sandra Breuils-Bonnet, Eve Tremblay, Sandra Martineau, Roxane Paulin, Sébastien Bonnet, Steeve Provencher, François Potus, Olivier Boucherat
Journal: European Respiratory Journal (2021)

<b>This study demonstrates that R-crizotinib, a frontline therapy for lung cancer, predisposes to and exacerbates PH in animal models. Caution and regular follow-up should be exercised in lung cancer patients treated with the compound.</b>http://bit.ly/39s6stp
End-to-end prostate cancer detection in bpMRI via 3D CNNs: Effects of attention mechanisms, clinical priori and decoupled false positive reduction
Authors: Anindo Saha, Matin Hosseinzadeh, Henkjan Huisman
Journal: Medical Image Analysis (2021)

We present a multi-stage 3D computer-aided detection and diagnosis (CAD) model2 for automated localization of clinically significant prostate cancer (csPCa) in bi-parametric MR imaging (bpMRI). Deep attention mechanisms drive its detection network, targeting salient structures and highly discriminative feature dimensions across multiple resolutions. Its goal is to accurately identify csPCa lesions from indolent cancer and the wide range of benign pathology that can afflict the prostate gland. Simultaneously, a decoupled residual classifier is used to achieve consistent false positive reduction, without sacrificing high sensitivity or computational efficiency. In order to guide model generalization with domain-specific clinical knowledge, a probabilistic anatomical prior is used to encode the spatial prevalence and zonal distinction of csPCa. Using a large dataset of 1950 prostate bpMRI paired with radiologically-estimated annotations, we hypothesize that such CNN-based models can be trained to detect biopsy-confirmed malignancies in an independent cohort. For 486 institutional testing scans, the 3D CAD system achieves 83.69±5.22% and 93.19±2.96% detection sensitivity at 0.50 and 1.46 false positive(s) per patient, respectively, with 0.882±0.030 AUROC in patient-based diagnosis -significantly outperforming four state-of-the-art baseline architectures (U-SEResNet, UNet++, nnU-Net, Attention U-Net) from recent literature. For 296 external biopsy-confirmed testing scans, the ensembled CAD system shares moderate agreement with a consensus of expert radiologists (76.69%; kappa = 0.51±0.04) and independent pathologists (81.08%; kappa = 0.56±0.06); demonstrating strong generalization to histologically-confirmed csPCa diagnosis.
Intersection of Surging Firearm Sales and COVID-19, Psychological Distress, and Health Disparities in the US—A Call for Action
Authors: Katelin Hoskins, Rinad S. Beidas
Journal: JAMA Network Open (2021)

Nicole Kravitz-Wirtz, PhD, MPH; Amanda Aubel, MPH; Julia Schleimer, MPH; Rocco Pallin, MPH; Garen Wintemute, MD, MPH
Role of connexin 43 in odontoblastic differentiation and structural maintenance in pulp damage repair
Authors: Jiaxin Yin, Jue Xu, Ran Cheng, Meiying Shao, Yuandong Qin, Hui Yang, Tao Hu
Journal: International Journal of Oral Science (2021)

Abstract Dental pulp can initiate its damage repair after an injury of the pulp–dentin complex by rearrangement of odontoblasts and formation of newly differentiated odontoblast-like cells. Connexin 43 (Cx43) is one of the gap junction proteins that participates in multiple tissue repair processes. However, the role of Cx43 in the repair of the dental pulp remains unclear. This study aimed to determine the function of Cx43 in the odontoblast arrangement patterns and odontoblastic differentiation. Human teeth for in vitro experiments were acquired, and a pulp injury model in Sprague-Dawley rats was used for in vivo analysis. The odontoblast arrangement pattern and the expression of Cx43 and dentin sialophosphoprotein (DSPP) were assessed. To investigate the function of Cx43 in odontoblastic differentiation, we overexpressed or inhibited Cx43. The results indicated that polarized odontoblasts were arranged along the pulp–dentin interface and had high levels of Cx43 expression in the healthy teeth; however, the odontoblast arrangement pattern was slightly changed concomitant to an increase in the Cx43 expression in the carious teeth. Regularly arranged odontoblast-like cells had high levels of the Cx43 expression during the formation of mature dentin, but the odontoblast-like cells were not regularly arranged beneath immature osteodentin in the pulp injury models. Subsequent in vitro experiments demonstrated that Cx43 is upregulated during odontoblastic differentiation of the dental pulp cells, and inhibition or overexpression of Cx43 influence the odontoblastic differentiation. Thus, Cx43 may be involved in the maintenance of odontoblast arrangement patterns, and influence the pulp repair outcomes by the regulation of odontoblastic differentiation.
Arterial vascular volume changes with haemodynamics in schistosomiasis-associated pulmonary arterial hypertension
Authors: Farbod N. Rahaghi, Joan F. Hilton, Ricardo A. Corrêa, Camila Loureiro, Jaquelina S. Ota-Arakaki, Carlos G.Y. Verrastro, Michael H. Lee, Claudia Mickael, Pietro Nardelli, David A. Systrom, Aaron B. Waxman, George R. Washko, Raúl San José Estépar, Brian B. Graham, Rudolf K.F. Oliveira
Journal: European Respiratory Journal (2021)

<b>Relative loss of vascular volume in small vessels compared to total vascular volume is a marker of pulmonary arterial hypertension in schistosomiasis and is correlated with pulmonary vascular remodelling by haemodynamics</b>https://bit.ly/3bfIlAQ
<i>In vivo</i> detection of teriflunomide-derived fluorine signal during neuroinflammation using fluorine MR spectroscopy
Authors: Christian Prinz, Ludger Starke, Jason M. Millward, Ariane Fillmer, Paula Ramos Delgado, Helmar Waiczies, Andreas Pohlmann, Michael Rothe, Marc Nazaré, Friedemann Paul, Thoralf Niendorf, Sonia Waiczies
Journal: Theranostics (2021)

Background: Magnetic resonance imaging (MRI) is indispensable for diagnosing neurological conditions such as multiple sclerosis (MS).MRI also supports decisions regarding the choice of disease-modifying drugs (DMDs).Determining in vivo tissue concentrations of DMDs has the potential to become an essential clinical tool for therapeutic drug monitoring (TDM).The aim here was to examine the feasibility of fluorine-19 ( 19 F) MR methods to detect the fluorinated DMD teriflunomide (TF) during normal and pathological conditions.Methods: We used 19 F MR spectroscopy to detect TF in the experimental autoimmune encephalomyelitis (EAE) mouse model of multiple sclerosis (MS) in vivo.Prior to the in vivo investigations we characterized the MR properties of TF in vitro.We studied the impact of pH and protein binding as well as MR contrast agents.Results: We could detect TF in vivo and could follow the 19 F MR signal over different time points of disease.We quantified TF concentrations in different tissues using HPLC/MS and showed a significant correlation between ex vivo TF levels in serum and the ex vivo 19 F MR signal. Conclusion:This study demonstrates the feasibility of 19 F MR methods to detect TF during neuroinflammation in vivo.It also highlights the need for further technological developments in this field.The ultimate goal is to add 19 F MR protocols to conventional 1 H MRI protocols in clinical practice to guide therapy decisions.
Health Workers’ Antibody Levels Wane After SARS-CoV-2 Infection
Authors: Bridget M. Kuehn
Journal: JAMA (2021)

Antibodies to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) decline during the weeks after infection, in some cases falling below the threshold for seropositivity within 2 months, according to a national study of health care workers.
Leonine Facies and Madarosis in a Man With Shortness of Breath
Authors: Carolyn M. Stull, Luke Wallis, Claudia Hernandez
Journal: JAMA Dermatology (2021)

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 Dermatology HomeNew OnlineCurrent IssueFor Authors Podcast 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) 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 Dermatology journal
Neutrophil-derived trail is a proinflammatory subtype of neutrophil-derived extracellular vesicles
Authors: Young-Jin Youn, Sanjeeb Shrestha, Yu-Bin Lee, Jun-Kyu Kim, Jee Hyun Lee, Keun Hur, Nanda Maya Mali, Sung-Wook Nam, Sun-Hwa Kim, Sunwoong Lee, Dong-Keun Song, Hee Kyung Jin, Jae-sung Bae, Chang-Won Hong
Journal: Theranostics (2021)

Aims: Extracellular vesicles (EVs) are membrane-derived vesicles that mediate intercellular communications. Neutrophils produce different subtypes of EVs during inflammatory responses. Neutrophil-derived trails (NDTRs) are generated by neutrophils migrating toward inflammatory foci, whereas neutrophil-derived microvesicles (NDMVs) are thought to be generated by neutrophils that have arrived at the inflammatory foci. However, the physical and functional characteristics of neutrophil-derived EVs are incompletely understood. In this study, we aimed to investigate the differences between NDTRs and NDMVs. Methods: The generation of neutrophil-derived EVs were visualized by live-cell fluorescence images and the physical characteristics were further analyzed using nanotracking analysis assay, scanning electron microscopic analysis, and marker expressions. Functional characteristics of neutrophil-derived EVs were analyzed using assays for bactericidal activity, monocyte chemotaxis, phenotype polarization of macrophages, and miRNA sequencing. Finally, the effects of neutrophil-derived EVs on the acute and chronic inflammation were examined in vivo. Results: Both EVs share similar characteristics including stimulators, surface marker expression, bactericidal activity, and chemoattractive effect on monocytes via MCP-1. However, the integrin-mediated physical interaction was required for generation of NDTRs whereas NDMV generation was dependent on PI3K pathway. Interestingly, NDTRs contained proinflammatory miRNAs such as miR-1260, miR-1285, miR-4454, and miR-7975, while NDMVs contained anti-inflammatory miRNAs such as miR-126, miR-150, and miR-451a. Although both EVs were easily uptaken by monocytes, NDTRs enhanced proinflammatory macrophage polarization whereas NDMVs induced anti-inflammatory macrophage polarization. Moreover, NDTRs showed protective effects against lethality in a murine sepsis model and pathological changes in a murine chronic colitis model. Conclusion: These results suggest that NDTR is a proinflammatory subtype of neutrophil-derived EVs distinguished from NDMV.
Abstract 15173: Association of Specific Statins With Cardiovascular Disease, All-cause Mortality, and Disability-free Survival in Initially Healthy Older Adults
Authors: Zhen Zhou, richard ofori asenso, Enayet K Chowdhury, Andrea J Curtis, Monique Breslin, Rory Wolfe, John J McNeil, Anne M Murray, Michael E Ernst, Christopher M Reid, Joanne Ryan, Robyn L Woods, Andrew M Tonkin, Mark R Nelson
Journal: Circulation (2020)

Background: The effectiveness of specific statins for the primary prevention of cardiovascular disease (CVD) in older adults is not well-characterized. Objective: To assess whether specific statin subclasses according to type, potency and solubility are associated with lower risk of CVD, all-cause mortality and improved disability-free survival in older adults. Methods: The cohort included 18,090 subjects from a primary prevention trial of aspirin, aged ≥70 years, initially free of CVD, disability and dementia, and followed for a median of 4.7 years. Outcomes included major adverse cardiovascular event (MACE, definition see Table ), all-cause mortality and disability-free survival (a composite of persistent physical disability, all-cause mortality or dementia). Three multivariable Cox models were used to estimate hazard ratios (HRs) for each outcome comparing participants taking specific statin subclasses at baseline with baseline statin nonusers. Results: At baseline, participants’ median age was 74.2 years and 5,623 were using statins (31%). Atorvastatin (38%) was the most widely used, followed by simvastatin (30%), rosuvastatin (26%) and other statins (7%, mainly pravastatin). Compared with nonusers, the risk of MACE was significantly lower for atorvastatin (HR: 0.68, 95% CI: 0.48-0.96) and rosuvastatin users (0.59, 0.37-0.94), but not for simvastatin (0.82, 0.57-1.17) or other statin users (1.02, 0.54-1.93). A significant risk reduction in MACE was also seen for high-potency statin users and for both lipophilic and hydrophilic statin users but not for low/moderate-potency statin users. None of the specific statin subclasses was associated with improved disability-free survival or reduced all-cause mortality. ( Table ) Conclusions: In healthy older adults, specific statin subclasses were associated with varying cardiovascular benefits but none was associated with improved disability-free survival or reduced all-cause mortality.
Neonatal Abstinence Syndrome and Maternal Opioid-Related Diagnoses in the US, 2010-2017
Authors: Ashley H. Hirai, Jean Y. Ko, Pamela L. Owens, Carol Stocks, Stephen W. Patrick
Journal: JAMA (2021)

Substantial increases in both neonatal abstinence syndrome (NAS) and maternal opioid use disorder have been observed through 2014.To examine national and state variation in NAS and maternal opioid-related diagnoses (MOD) rates in 2017 and to describe national and state changes since 2010 in the US, which included expanded MOD codes (opioid use disorder plus long-term and unspecified use) implemented in International Classification of Disease, 10th Revision, Clinical Modification.Repeated cross-sectional analysis of the 2010 to 2017 Healthcare Cost and Utilization Project's National Inpatient Sample and State Inpatient Databases, an all-payer compendium of hospital discharge records from community nonrehabilitation hospitals in 47 states and the District of Columbia.State and year.NAS rate per 1000 birth hospitalizations and MOD rate per 1000 delivery hospitalizations.In 2017, there were 751 037 birth hospitalizations and 748 239 delivery hospitalizations in the national sample; 5375 newborns had NAS and 6065 women had MOD documented in the discharge record. Mean gestational age was 38.4 weeks and mean maternal age was 28.8 years. From 2010 to 2017, the estimated NAS rate significantly increased by 3.3 per 1000 birth hospitalizations (95% CI, 2.5-4.1), from 4.0 (95% CI, 3.3-4.7) to 7.3 (95% CI, 6.8-7.7). The estimated MOD rate significantly increased by 4.6 per 1000 delivery hospitalizations (95% CI, 3.9-5.4), from 3.5 (95% CI, 3.0-4.1) to 8.2 (95% CI, 7.7-8.7). Larger increases for MOD vs NAS rates occurred with new International Classification of Disease, 10th Revision, Clinical Modification codes in 2016. From a census of 47 state databases in 2017, NAS rates ranged from 1.3 per 1000 birth hospitalizations in Nebraska to 53.5 per 1000 birth hospitalizations in West Virginia, with Maine (31.4), Vermont (29.4), Delaware (24.2), and Kentucky (23.9) also exceeding 20 per 1000 birth hospitalizations, while MOD rates ranged from 1.7 per 1000 delivery hospitalizations in Nebraska to 47.3 per 1000 delivery hospitalizations in Vermont, with West Virginia (40.1), Maine (37.8), Delaware (24.3), and Kentucky (23.4) also exceeding 20 per 1000 delivery hospitalizations. From 2010 to 2017, NAS and MOD rates increased significantly for all states except Nebraska and Vermont, which only had MOD increases.In the US from 2010 to 2017, estimated rates of NAS and MOD significantly increased nationally and for the majority of states, with notable state-level variation.
Phase II trial of postoperative adjuvant gemcitabine and cisplatin chemotherapy followed by chemoradiation with gemcitabine in patients with resected pancreatic cancer.
Authors: J. h. Kwon, E. K. Chie, J. H. Kim, S. Im, D. Oh, Y. Kim, S. Han, K. Lee, J. Jang, T. Kim, J. S. Kim, H. S. Han, S. Kim, Y. B. Yoon, Y. Bang, S. W. Ha
Journal: Journal of Clinical Oncology (2011)

4094 Background: Despite potentially curative resection for pancreatic carcinoma the 5-year survival in these patients is less than 20%. Progression of disease can occur both locally and in distant sites. Effective multimodality adjuvant treatment protocol is needed for these patients receiving curative resection. Methods: Patients with curatively resected pancreatic adenocarcinoma (stage IB ~ IIB, AJCC 6th ed.), ECOG PS of 0-2, and no prior chemo- or radiotherapy were eligible. Treatment consisted of chemotherapy with gemcitabine (GEM) 1,200mg/m2 (D1,8) and CDDP 60mg/m2 (D1) every 3 weeks for 2 cycles. Subsequently, patients without progression received chemoradiotherapy (CRT) (50.4 Gy/ 28 Fx) with concurrent weekly gemcitabine (300mg/m2/week). GEM 1,200mg/m2 were given on day 1, 8 every 3 weeks for 4 cycles after CRT. The primary endpoint was to evaluate one year disease free survival (DFS) rate. The secondary endpoints were median DFS, overall survival (OS), and safety. Results: From Oct. 2005 to Sep. 2009, we enrolled 74 patients with curatively resected pancreas cancer (median age 61, M:F = 48:26 ). At the median follow up duration of 45 months (range 10.2 ~ 64.6 months), six patients withdrew consent, 11 patients confirmed disease progression during treatment and 57 patients completed CRT followed by systemic chemotherapy. One-year DFS rate was 62.1%. Fifty-two patients (70.3%) were diagnosed with recurrence. Most of the recurrences were systemic disease (49 patients, 66.2% of all patients). Median DFS was 17.4 months and median OS was 33.6 months in all patients. The stage (73.3% in IIA, 55.6% in IIB, p<0.001) and the nodal status (71.0% in N0, 55.6% in N1, p=0.01) at the time of diagnosis were significantly related with DFS. Toxicities were generally tolerable, 53 events of grade 3 or 4 hematologic toxicity were reported and four patients experienced febrile neutropenia. Conclusions: Adjuvant GEM-CDDP chemotherapy followed by GEM-RT and maintenance GEM showed promising efficacy and good tolerability in curatively resected pancreatic cancer.
Complex Trait Genetics: The Role of Mechanistic “Intermediate Phenotypes” and Candidate Genetic Loci⁎⁎Editorials published in the Journal of the American College of Cardiology reflect the views of the authors and do not necessarily represent the views of JACC or the American College of Cardiology.
Authors: Fangwen Rao, Lian Zhang, Daniel T. O'Connor
Journal: Journal of the American College of Cardiology (2008)
Heart disease leaves its mark: Proteomics-based biosignatures in acute coronary syndromes**Editorials published in the Journal of the American College of Cardiologyreflect the views of the authors and do not necessarily represent the views of JACCor the American College of Cardiology.
Authors: W.Robb MacLellan, Peipei Ping, Thomas Vondriska
Journal: Journal of the American College of Cardiology (2004)