tbuckley/cabot-search huggingface dataset:
SAT0179 Back pain and disability before, and after, clinically-diagnosed vertebral fractures
Authors: M Nevitt, L Palermo, D Thompson, D Bauer, K Stone, K Ensrud, H Fink, D Black
Journal: Annals of the Rheumatic Diseases (2001)

<h3>Background</h3> Painful vertebral fractures that come to medical attention (CVFx) comprise less than a third of all new vertebral deformities (VDef), yet account for a large proportion of the pain and disability due to vertebral osteoporosis. Little is known about the natural history of back pain and related disability before and after a CVFx. <h3>Objectives</h3> We compared prefracture levels of back pain and back disability in women who subsequently experienced a CVFx to levels of back pain and disability in women who did not have a CVFx, and examined the duration of increased back pain and disability for 12 months following a CVFx. <h3>Methods</h3> We studied 6,459 women in the Fracture Intervention Trial, aged 55–80 with femoral neck BMD T-score &lt; -1.6. 33% had a baseline VDef. CVFx were self-reported community-diagnosed spine fractures confirmed by central comparison of the diagnostic spine films with the study baseline spine films. Back pain and back-related disability (score 0–20) in the past 4 weeks and number of days back disability (bedrest + limited activity) in the previous 12 months were assessed at baseline (prefracture) using validated instruments. Number of days of severe back pain and disability due to back pain were evaluated for successive 3 month intervals before, and after, a CVFx. Baseline and new VDef during 3 to 4.5 yrs of follow-up were assessed with morphometry. <h3>Results</h3> Women who had a single new CVFx &gt; = 6 months after baseline had greater baseline disability than women who had neither a CVFx nor a VDef during FU, adjusting for age, number of baseline VDef, spine BMD, prior Dx of spine fracture, Geriatric Depression Score and treatment assignment. Women with only a new VDef but no CVFx had intermediate levels of prefracture back pain and disability. Women suffering a CVFx reported a mean of 6 days of severe back pain and 6 days of back disability for the 3 month period before the fracture, and 18 and 32 days (both P &lt; .05 by Wilcoxen test), respectively, for the 3 month period after the fracture. By 5–7 months postfacture mean days of severe back pain were no longer elevated (10; P = . 44), but mean days of disability were still increased (24; P &lt; . 05) at 9–11 months post fracture. <h3>Conclusion</h3> Older women who have chronic back pain are more likely to suffer a CVFx. In those who have a CVFx, average back disability remains above prefracture levels for at least a year after the fracture. Prevention of fractures may be especially beneficial in older women with chronic back pain.
SAT0184 MAINTENANCE THERAPY WITH AZATHIOPRINE ASSOCIATED WITH HIGHER RISK OF FLARE IN PROLIFERATIVE LUPUS NEPHRITIS
Authors: M. Luis, A. R. Prata, H. Assunção, J. A. P. Da Silva, L. Inês
Journal: Annals of the Rheumatic Diseases (2020)

Background: Goals of lupus nephritis (LN) maintenance treatment include prevention of LN flares and long-term preservation of renal function, while minimizing drug iatrogenicity. There is an unmet need for identifying predictors of LN flare in order to guide optimization of maintenance immunosuppression. Objectives: To identify predictors of LN flare after attainment of complete renal response (CRR) in patients with proliferative LN. Methods: Retrospective cohort study over 36 months including patients with SLE fulfilling the ACR’97 and/or the SLICC’12 classification criteria, enrolled in the CHUC Lupus Cohort between 1999 and 2018, with a biopsy-proven proliferative LN (class III/IV) and who attained CRR (proteinuria &lt;0.5g/day and normal renal function, according to EULAR/ERA-EDTA definition) following induction treatment. Only proteinuric flares were considered and defined as doubling of proteinuria to &gt;1g/day. Clinical-analytic characteristics at baseline (time of first CRR attainment after induction) were compared using survival analysis for time-to-flare. Variables with p&lt;0.10 on univariate analysis with Log-Rank tests were further evaluated as predictors with multivariate Cox proportional hazards regression models (Backward Stepwise method, Wald-based), with estimation of hazard ratios (HR) with 95% confidence intervals (95%CI). Results: A total of 50 patients in CRR were included in the analysis (78.4% female, age at baseline 30.0 ± 12.5 years-old). Over the follow-up period, 10 patients (20.0%) experienced a proteinuric flare, within a mean time of 29.1 months (95%CI 26.89-31.37). In univariate analysis, age &lt;30years (p=0.020), arterial hypertension (p=0.020) and presence of anti-RNP antibody (p=0.002) at baseline were associated with higher risk of LN proteinuric flares. In multivariate analysis, age &lt;30 years (HR 26.56; 95%CI 1.93-365.08; p=0.014), arterial hypertension (HR 8.30; 95%CI 1.21-56.92; p=0.031), use of antihypertensive antiproteinuric drugs (angiotensin-converting-enzyme inhibitors or angiotensin receptor blockers) (HR 11.18; 95%CI 1.24-100.66; p=0.031) and maintenance therapy with azathioprine (HR 6.23; 95%CI 1.51-25.66; p=0.011) (Figure 1) were predictors of LN proteinuric flares. Figure 1. Conclusion: In patients with proliferative LN, proteinuric flares are a frequent event after induction treatment leads to CRR. Younger age, arterial hypertension, use of antihypertensive drugs and use of azathioprine as maintenance therapy were risk factors for LN proteinuric flare in this cohort. Disclosure of Interests: Mariana Luis: None declared, Ana Rita Prata: None declared, Helena Assunção: None declared, José Antonio P. da Silva Grant/research support from: Pfizer, Abbvie, Consultant of: Pfizer, AbbVie, Roche, Lilly, Novartis, Luís Inês: None declared
The International Response to Climate Change
Authors: Lindsay F Wiley, Lawrence O Gostin
Journal: JAMA (2009)

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 19552: High Igm Levels Are Inversely Associated With Necrotic Core Assessed by Ivus but Do Not Predict Plaque Progression: Results of the Ibis-3 Study
Authors: Victor J van den Berg, Ramzi Khamis, Isabella Kardys, Evelyn Regar, Robert J van Geuns, Nicolas van Mieghem, Patrick W Serruys, Victor A Umans, K. M Akkerhuis, Dorian Haskard, Eric Boersma
Journal: Circulation (2016)

Introduction: Atherosclerosis is a chronic inflammatory disease which involves both the innate and adaptive immune systems. We investigated whether immunoglobulin (Ig) levels and Igs against a spec...
Abstract 12596: Immunomodulatory Therapy Favorably Modifies Coronary Plaque Morphology in Psoriasis
Authors: Youssef A Elnabawi, Nevin J Varghese, Gregory E Sanda, Amit K Dey, Jacob W Groenendyk, Leonard D Genovese, Jonathan H Chung, Aarthi S Reddy, Justin A Rodante, Yvonne Baumer, Martin P Playford, Marcus Y Chen, Joel M Gelfand, David A Bluemke, Nehal N Mehta
Journal: Circulation (2018)

Introduction: Evidence suggests that inflammatory mediators are important in the pathogenesis of atherosclerosis and their inhibition not only reduces cardiovascular (CV) events, but also may favor...
Of Modest Proposals and Non-Identity: A Comment on the Right to Know Your Genetic Parents
Authors: I. Glenn Cohen
Journal: The American Journal of Bioethics (2013)

As Ravelingien and Pennings note, in my 2012 article “Rethinking Sperm-Donor Anonymity: Of Changed Selves, Nonidentity, and One-Night Stands” I am one of the “surprisingly few authors” who have pub...
Olaparib ± bevacizumab versus bevacizumab + fluorouracil in patients with unresectable or metastatic colorectal cancer not progressing on first-line FOLFOX + bevacizumab: Phase III LYNK-003 study.
Authors: Carlos Alberto Mayo, Ellen B. Gurary, Patricia Marinello
Journal: Journal of Clinical Oncology (2021)

TPS156 Background: Patients with metastatic colorectal cancer (CRC) often receive intensive platinum-based regimens, such as FOLFOX (fluorouracil [5-FU], leucovorin, oxaliplatin), as first-line (1L) therapy. For patients who do not progress during 1L platinum-based induction therapy, maintenance with a less intensive regimen can enhance clinical benefit and reduce toxicity. The CAIRO3 study showed a progression-free survival (PFS) benefit and a trend toward overall survival (OS) benefit in patients who received maintenance treatment with a fluoropyrimidine and bevacizumab versus observation following induction treatment of six cycles of platinum-based therapy. Olaparib is an oral PARP inhibitor that has efficacy in platinum-sensitive cancers. The randomized, open-label, phase 3 LYNK-003 trial will investigate the efficacy and safety of olaparib, alone or with bevacizumab, compared with bevacizumab plus 5-FU in advanced CRC that has not progressed during 1L induction treatment with FOLFOX plus bevacizumab. Methods: Patients aged ≥18 years with histologically confirmed metastatic or unresectable CRC that has not progressed after 1L induction of ≥6 cycles of FOLFOX plus bevacizumab and who can no longer tolerate oxaliplatin are eligible. Patients must have an ECOG performance status of 0-1, adequate organ function, and provide tumor tissue for biomarker analysis. Patients will be randomly assigned 1:1:1 to olaparib 300 mg twice-daily (BID), olaparib 300 mg BID plus bevacizumab 5 mg/kg every 2 weeks (Q2W), or bevacizumab 5 mg/kg Q2W plus 5-FU 2400 mg/m 2 over 46-48 hours Q2W. Randomization will be stratified by response to prior FOLFOX plus bevacizumab (stable disease vs partial response/complete response), mutation status ( BRAF mut and/or Ras mut vs BRAF wt plus Ras wt ), and number of prior FOLFOX plus bevacizumab cycles (6-8 vs &gt; 8 cycles). Response will be assessed by computed tomography or contrast-enhanced magnetic resonance imaging per RECIST 1.1 by blinded independent central review (BICR) every 8 weeks for the first 12 months and every 12 weeks thereafter. Treatment will continue until documented disease progression, unacceptable toxicity, investigator’s decision to discontinue, or patient withdrawal. The primary endpoint is PFS per RECIST 1.1 by BICR. Secondary endpoints are OS, objective response rate, duration of response, and safety. Approximately 525 patients will be enrolled. Currently, patients are being enrolled at 18 locations in 4 countries. Clinical trial information: NCT04456699.
Unfolding the stomach in the chest
Authors: Konstantinos Miltiadou, Alexandros Chatzidakis, Lazaros-Dimitrios Lazaridis, Nikolaos Oikonomopoulos, Dimitrios Polymeros, Ioannis S. Papanikolaou, Konstantinos Triantafyllou
Journal: Endoscopy (2021)

A 72-year-old woman with obesity presented with recurrent episodes of emesis, mild abdominal pain, and intolerance to oral intake. Overall, she was in good clinical condition. Her vital signs were normal but physical examination revealed mild epigastric tenderness without peritoneal signs or ileus. Laboratory studies were unremarkable but chest X-rays showed distended mediastinum. Computed tomography of the chest and abdomen revealed herniation of nearly the entire stomach into the mediastinum, compatible with mesenteroaxial gastric volvulus ([Fig. 1]).
Benefit-Cost Analysis of Rubella Vaccination Policy
Authors: Stephen C. Schoenbaum, James N. Hyde, Louis Bartoshesky, Kathleen Crampton
Journal: New England Journal of Medicine (1976)

Abstract To analyze rubella vaccination strategies we calculated benefits and costs of prevention of rubella. With no vaccination, lifetime expenditures for congenital rubella syndrome in offspring of females are greater than $35 per female (present value). Expenditures for acute rubella are less than $2.70 per person. Cost, when monovalent vaccine is used, is $3.00 per person. Vaccination of females at 12 years of age yields net benefits 80 per cent larger than vaccination of children at two. When only 80 per cent of the target group accepts vaccine, vaccination at 12 years reduces congenital rubella by 30 per cent more than vaccination at six or two. Vaccination at two and revaccination at 12 (with 80 per cent acceptance at each age) reduces expected natural infections by 80 per cent and expected congenital rubella by 95 per cent. Either single vaccination of females at 12 years or vaccination at two ages would be better than current United States practice of vaccinating children once at an early age. (N Engl J Med 294:306–310, 1976)
SAT0059 Greater efficacy for diclofenac/misoprostol (arthrotec) compared to acetaminophen in a randomised, double-blind, multicenter, crossover clinical trial in patients with osteoarthritis of the hip or knee is most evident in patients with the most severe osteoarthritis
Authors: T Sokka, T Pincus
Journal: Annals of the Rheumatic Diseases (2001)

<h3>Background</h3> Acetaminophen (paracetamol) is recommended as initial therapy for osteoarthritis of the hip or knee according to guidelines of the American College of Rheumatology (ACR) prior to use of nonsteroidal anti-inflammatory drugs (NSAIDs), athough patient surveys indicate that most patients regard NSAIDs as having greater efficacy than acetaminophen. <h3>Objectives</h3> To compare responses of patients with osteoarthritis of the hip or knee in a randomised, controlled clinical trial of diclofenac/misoprostol (Arthrotec, ARTH) compared to acetaminophen (ACET) according to severity at baseline of scores of the Western Ontario McMaster (WOMAC) osteoarthritis scale and visual analogue scale (VAS) for pain, the two primary outcomes in the clinical trial. <h3>Methods</h3> 227 patients with radiographic stage 2–4 osteoarthritis of the hip or knee received either 6 weeks of ARTH 75 mg twice a day or ACET 1,000 mg four times a day after a washout period, and then the other drug for 6 weeks, in a randomised, double-blind, multicenter, cross-over clinical trial. Changes in scores for the two primary outcomes while taking ACET or ARTH were analysed accoring to tertiles at baseline for each scale. <h3>Results</h3> Overall, WOMAC pain scores were improved by 7.8 of 100 units (p &lt; 0.001), and pain VAS scores were improved by 14.6 of 100 units (p &lt; 0.001), while taking ARTH verus ACET. Differences between changes in WOMAC scores while taking ARTH versus ACET were 3.1 for patients in the lowest tertile at baseline (p = 0.30), compared to 9.5 for the middle tertile (p &lt; 0.001), and 12.2 for those in the highest baseline tertile (p &lt; 0.001). Differences between changes in pain VAS scores while taking ARTH versus ACET were 4.9 for patients in the lowest tertile at baseline (p = 0.25), compared to 16.6 for the middle tertile (p &lt; 0.001), and 21.0 for those in the highest baseline tertile (p &lt; 0.001). <h3>Conclusion</h3> Patients with mild osteoarthritis of the hip or knee have similar responses to ARTH and ACET, possibly because patients in the lowest tertile have the least capacity for improvement. Patients with more severe osteoarhtritis appear much more likely to benefit from ARTH.
Phase II Single-arm Study of Durvalumab and Tremelimumab with Concurrent Radiotherapy in Patients with Mismatch Repair–proficient Metastatic Colorectal Cancer
Authors: Neil H. Segal, Andrea Cercek, Geoffrey Ku, Abraham J. Wu, Andreas Rimner, Danny N. Khalil, Diane Reidy-Lagunes, John Cuaron, T. Jonathan Yang, Martin R. Weiser, Paul B. Romesser, Zsofia K. Stadler, Anna M. Varghese, Karuna Ganesh, Rona Yaeger, Louise C. Connell, David Faleck, Ghassan K. Abou-Alfa, Kathleen C. Mcauliffe, Pamela Vaiskauskas, Mark L. Solter, Martinique Ogle, Matthew J. Adamow, Aliya Holland, Pallavi Vedantam, Phillip Wong, Taha Merghoub, Efsevia Vakiani, Travis J. Hollmann, Krishna Juluru, Joanne F. Chou, Marinela Capanu, Joseph Erinjeri, Stephen Solomon, Yoshiya Yamada, Nancy Kemeny, Christopher H. Crane, Leonard B. Saltz
Journal: Clinical Cancer Research (2021)

Immune checkpoint inhibition (ICI) alone is not active in mismatch repair-proficient (MMR-P) metastatic colorectal cancer (mCRC), nor does radiotherapy alone result in objective systemic benefit. However, combined radiotherapy plus ICI can induce systemic antitumor immunity in preclinical and clinical models.In this single-center, phase II study, patients with chemotherapy-refractory MMR-P mCRC received durvalumab 1,500 mg plus tremelimumab 75 mg every 4 weeks plus radiotherapy. The primary endpoint was objective response rate (ORR) in nonirradiated lesions. Treatment and efficacy were correlated with peripheral immune cell profiles.We enrolled 24 patients, and report outcomes after a median follow-up of 21.8 (range: 15.9-26.3) months. The ORR was 8.3% (2 patients) [95% confidence interval (CI), 1.0-27.0]. The median progression-free survival was 1.8 (95% CI, 1.7-1.9) months, median overall survival was 11.4 (95% CI, 10.1-17.4) months. Twenty five percent of patients (n = 6) had treatment-related grade 3-4 adverse events. We observed increased circulating CD8+ T lymphocyte activation, differentiation, and proliferation in patients with objective response.This combination of radiotherapy plus ICI study did not meet the prespecified endpoint criteria to be considered worthwhile for further study. However, rare instances of systemic immune augmentation and regression in nonirradiated lesions were observed (an abscopal response). Combination durvalumab and tremelimumab plus radiotherapy is feasible in MMR-P mCRC with a manageable safety profile. Further studies of novel immunotherapy combinations, and identification of biomarkers predictive of abscopal response are warranted.
Tumor bulk as a prognostic biomarker and predictor of benefit from anti-EGFR therapy in patients with metastatic colorectal cancer: Analysis of 476 patients from the ARCAD Clinical Trials Program.
Authors: Benjamin Adam Weinberg, Manel Rakez, Benoist Chibaudel, Tim Maughan, Richard Adams, John Raymond Zalcberg, Axel Grothey, Takayuki Yoshino, Qian Shi, Aimery De Gramont, Dustin A. Deming
Journal: Journal of Clinical Oncology (2021)

108 Background: Primary tumor sidedness has emerged as a prognostic and predictive biomarker for patients (pts) with metastatic colorectal cancer (mCRC). Tumor bulk has also been postulated to predict response to anti-EGFR therapy. We sought to evaluate the role of tumor bulk as a predictive biomarker to anti-EGFR therapy in pts with left- (LS) and right-sided (RS) mCRC. Methods: Data from 476 pts with mCRC enrolled across 2 first-line trials of anti-EGFR plus chemotherapy versus chemotherapy were pooled. Pts were included if there was available information on tumor sidedness and tumor bulk. All were KRAS wild-type and BRAF wild-type or unknown BRAF status. The right colon was defined as the cecum through the transverse colon, and the left colon as the splenic flexure through the rectum. Tumor bulk was the mean tumor size of target lesions at baseline, bulky defined as &gt; 3.5 cm. Overall survival (OS) and progression-free survival (PFS) were assessed using Kaplan-Meier and Cox models adjusting for performance status (PS), platelet count, primary tumor (PT) resection, number of metastatic sites, and stratified by study. Results: Pts with bulky tumors (211, 44%) had higher PS, white blood cell and platelet counts, higher CEA, fewer sites of metastatic disease, more liver than lung metastases, and fewer had PT resection. OS and PFS medians in months (mos) are presented in the table with 95% confidence intervals (95%CIs). Bulky tumors had inferior median OS compared with non-bulky (mOS, 17.9 vs. 21.3 mos, HR adj 1.33, 95% CI 1.05-1.69, P = 0.016) although median PFS was similar (mPFS, 8.6 vs. 8.7 mos, HR adj 1.15, 95% CI 0.92-1.42, P = 0.21). Conclusions: Tumor bulk is an independent prognostic factor for OS in KRAS wild-type and BRAF wild-type or unknown BRAF status pts. Pts with non-bulky RS tumors have survival outcomes similar to pts with bulky LS tumors. Although the mPFS for pts with RS tumors treated with anti-EGFR therapy was the lowest across subgroups, this finding was not statistically significant. Further research is warranted into whether pts with bulky RS tumors benefit from anti-EGFR therapy. Clinical trial information: NCT00182715, NCT00640081. [Table: see text]
Demographic Factors and Academic Outcomes Associated With Taking a Leave of Absence From Medical School
Authors: Mytien Nguyen, Seo Ho Song, Angelina Ferritto, Ashar Ata, Hyacinth R. C. Mason
Journal: JAMA Network Open (2021)

This cross-sectional study uses 2007-2012 data from the Association of American Medical Colleges' Matriculating Student Questionnaire to evaluate student factors and academic outcomes associated with taking a leave of absence from medical school.
Endoscopy-assisted magnetic compression anastomosis for rectal anastomotic atresia
Authors: Guifang Lu, Jing Li, Mudan Ren, Feng Ma, Xuejun Sun, Yi Lv, Shuixiang He
Journal: Endoscopy (2021)

Magnetic compression anastomosis (MCA) has been used to achieve anastomotic recanalization to treat severe stenosis or atresia of the biliary tract and digestive tract [1] [2] [3] [4]. Herein, we report successful recanalization by means of MCA in a case of rectal anastomotic atresia.
Bioethics, (Funding) Priorities, and the Perpetuation of Injustice
Authors: Rachel Fabi, Daniel S. Goldberg
Journal: The American Journal of Bioethics (2021)

If funding allocation is an indicator of a field's priorities, then the priorities of the field of bioethics are misaligned because they perpetuate injustice. Social justice mandates priority for the factors that drive systematic disadvantage, which tend not to be the areas supported by funding within academic bioethics. Current funding priorities violate social justice by overemphasizing technologies that aim to enhance the human condition without addressing underlying structural inequalities grounded in racism, and by deemphasizing areas of inquiry most frequently pursued by Scholars of Color. This lack of attention to upstream determinants of health in bioethics research perpetuates a gap in the resources needed to understand the experiences of communities disproportionately experiencing poor health, which is itself a form of epistemic injustice. Both social and epistemic injustices are apparent in the impact of these funding priorities on people of color, both in the public and in the bioethics community.