tbuckley/cabot-search huggingface dataset:
Assessing effectiveness of a self-guided training program for oncology financial advocates.
Authors: Christina Mangir, Lori Schneider, Angie Santiago, Leigh Boehmer, Fitzgerald Draper, Elana Plotkin, Lorna Lucas
Journal: Journal of Clinical Oncology (2021)

271 Background: Financial toxicity can be a devastating side effect for patients with cancer and their families, and may impact access to and delivery of care, treatment compliance, and outcomes. Financial advocates mitigate financial toxicity for patients and their families, liaise between payers/providers/pharmacies/patients, support shared decision-making and care planning processes through provision of cost and coverage information, and mitigate institutional financial toxicity. Training on effective financial navigation interventions, financial health literacy, patient engagement, oncology fundamentals, and measurement of impact is critical for advocates. Methods: The Association of Community Cancer Centers (ACCC) Financial Advocacy Boot Camp is a self-paced eLearning program consisting of 9 modules designed to build knowledge and skills of financial advocates. Users interact with education across two levels within the ACCC Learning Management System. To evaluate effectiveness of this content, pre- and post-assessments and evaluation forms for registered learners from 1/1/2020 to 12/31/20 were exported and exploratory analysis was performed on this data set of 538 participants. Results: 51% of respondents are oncology financial advocates; 7% are industry representatives; and the remaining 42% are a mix of patient navigators, nurse navigators, social workers, pharmacists, APPs, and nurses. 363 participants fully completed at least one of two levels. Most participants agreed or strongly agreed that each of the modules improved their knowledge and skills: 94% increased their ability to incorporate effective screening methods to identify patients at risk of financial toxicity, 95% are better able to review the evolving landscape of health insurance provided by public and private payers, and 97% both increased their ability to find patient assistance programs and resources for patients and can describe how to guide patients through the process of improving insurance coverage. 79% identified specific examples of what they will do differently after the training, including implementing screening and follow-up protocols, adjusting communication approaches with patients, proposing quality improvement projects, and accessing resources. Conclusions: Training, such as the Financial Advocacy Boot Camp, that builds knowledge and skills in financial screening, communication, and navigation can help cancer programs improve staffs’ ability to mitigate patient and institutional financial toxicity. Future research efforts should further define financial advocacy competencies, measure patient and institutional impact of financial navigation interventions, and assess effective practices for implementation of financial advocacy training in cancer programs.
Long-term effects in subgroups of patients with paroxysmal nocturnal hemoglobinuria treated with pegcetacoplan versus eculizumab: 48-week analysis of pegasus phase 3 trial
Authors: R. P. De Latour, C. M. D. De Castro, J. Szer, K. Usuki, P. Hillmen, M. Griffin, M. Al-Adhami, C. Chen, H. Nishimori, I. C. Weitz
Journal: HemaSphere (2021)
구연 : 국내 급성 위정맥류 출혈의 치료 및 예후에 관한 후향적 연구
Authors: 김문영, 백순구, 엄순호, 이정일, 이진우, 천갑진, 손주현, 김태엽, 박수영, 김태효, 이태희, 박성재, 서연석, 한상영, 박승하, 최창수, 황재석, 장병국, 문진수, 이준성, 김상균, 김영석, 권소영, 최원혁, 이창형, 김병석, 장재영, 정승원, 김병호, 심재준, 조용균, 고문수, 이현웅, 권오상, 김도영, 김자경, 김진동, 김창욱, 김홍수, 백용한, 양현웅, 이천균, 임영석
Journal: Clinical and Molecular Hepatology (2009)
Association between utilization patterns and racial disparities in hospice enrollment among women dying of ovarian cancer.
Authors: Megan Mullins, Shitanshu Uppal, Michele L. Cote, Philippa Clarke, Julie J. Ruterbusch, Sarah T. Hawley, Lauren P. Wallner
Journal: Journal of Clinical Oncology (2021)

142 Background: Goals of care conversations are associated with less aggressive end of life care and may be most effective in an outpatient setting. Yet, the relationship between initial utilization of care and subsequent hospice enrollment is unknown. We evaluated whether inpatient, outpatient and emergency department (ED) evaluation and management (E/M) visits differed by patient race/ethnicity, and whether less outpatient management was associated with failure to enroll in hospice in a sample of women dying of ovarian cancer. Methods: Women diagnosed with first and only ovarian cancer who died between 2000 and 2016 and had ≥ one inpatient and outpatient ovarian cancer E/M encounter between diagnosis and the last two months of life in SEER-Medicare were included (N = 8,806). Women whose proportion of outpatient E/M encounters fell below the median were classified as having low outpatient management (vs. high). Multivariable-adjusted logistic regression was used to estimate the association of: (1) race/ethnicity with outpatient management, and (2) outpatient management with hospice enrollment, stratified by race/ethnicity. Models were adjusted for stage at diagnosis, histology, survival time, age, Charlson score, geographic region, and year. Results: In this sample, 29.2% of ovarian cancer E/M took place in an inpatient setting, 66.4% outpatient, and 4.4% in the ED. Non-Hispanic Black women had 53.9% of their E/M occur in an outpatient setting, compared to 67.6% in non-Hispanic White women, 60.7% in Hispanic women, and 64.2% in women of other races (p &lt;.001). Black women had 78% greater odds of low outpatient management when compared to non-Hispanic White women (adjusted OR 1.78, 95%CI: 1.46-2.18). Women with low (vs. high) outpatient management had 33% greater odds of not enrolling in hospice (adjusted OR 1.33, 95%CI: 1.20-1.48). The association of low outpatient management with not enrolling in hospice was most pronounced among Black women (Black adjusted OR: 1.54, 95%CI: 1.02-2.32 vs. Non-Hispanic White adjusted OR: 1.32, 95%CI: 1.18-1.48). Conclusions: Although most ovarian cancer care takes place in an outpatient setting, Black women have the lowest proportion of outpatient care, and low outpatient management was associated with not enrolling in hospice. When deploying interventions to improve goals of care conversations for women with ovarian cancer, racial/ethnic disparities in care settings must be considered.
Immune thrombocytopenia during covid-19 pandemic: An italian monocentric experience
Authors: G. Lapietra, A. Ferretti, E. Baldacci, M. L. De Luca, S. M. Aprile, F. Barone, S. Olivieri, A. Chistolini, C. Santoro
Journal: HemaSphere (2021)

Background: Immune thrombocytopenia (ITP) is an acquired immune disorder characterised by a platelet count  100x109/L). Fever, anosmia, dysgeusia, articular pain and mild-to-moderate respiratory distress were considered typically COVID19-related symptoms. Overall, 15 patients were symptomatic: 11 had only COVID19- related symptoms (64.8%), 1 presented with isolated mucocutaneous bleeding (5.8%) and 3 reported both (17.6%). Two patients did not refer any symptoms throughout the course of the infection (11.8%). Six cases required hospitalization (35.3%): 3 for acute decrease of platelet count and bleeding symptoms (17.6%) (ND ITP=2;ITP relapse=1);3 for pneumonia (17.6%) (ND ITP=1;chronic ITP on treatment=1;ITP on FU=1). Patients with bleeding symptoms were responsive to dexamethasone (40 mg/day, days 1-4) and immunoglobulins (1 g/kg). Patients with pneumonia were successfully treated with antibiotics and oral corticosteroids. The median duration of stay in the hospital was 10.5 days (range 3-20). Eleven patients recovered at home without any bleeding;they did not show any significant change in the platelet count at the first evaluation after quarantine (64.7%). Twelve patients had previously received either steroids (n=8) or steroid+splenectomy (n=4) (70.5%). Serious respiratory distress, requiring mechanic ventilation, was not recorded. Anti-thrombotic prophylaxis of COVID-related thromboembolism was not used and no cases of thrombosis were observed. The viral seroconversion was observed in all patients and no death occurred. Summary/Conclusion: In our experience, ND ITP triggered by COVID- 19 has been responsive to immunoglobulins and steroids. Overall outcome has been favourable also for COVID-19 patients with a stable off-therapy or on treatment ITP.
Rate of venous thromboembolism in gynecologic patients on an ERAS pathway.
Authors: Jolyn Sharpe Taylor, Maria Iniesta-Donate, Katherine Cain, Javier Lasala, Gabriel Mena, Andres S. Zorilla Vaca, Larissa Meyer, Pedro T. Ramirez
Journal: Journal of Clinical Oncology (2021)

214 Background: Venous thromboembolism (VTE) is a serious and potentially life-threatening complication of surgery. An Enhanced Recovery After Surgery (ERAS) program is a multimodal care pathway meant to facilitate faster recovery from surgery. ERAS protocols include mechanical and pharmacologic VTE prophylaxis and rapid return to ambulation. Our objective was to evaluate the rate of symptomatic VTE on an ERAS pathway among patients undergoing open and minimally invasive gynecologic surgery (MIS). Methods: Data was collected prospectively on patients undergoing gynecologic surgery on the ERAS pathway at a single academic institution between November 1, 2014 and March 31, 2021. For patients undergoing MIS data were collected from February 1, 2016 to March 31, 2021. Patients undergoing emergency surgery or requiring therapeutic anticoagulation prior to surgery were excluded. For planned open surgery, patients received heparin prophylaxis prior to surgery, sequential compression device (SCD) during surgery and goal directed fluid management. If also diagnosed with malignancy, patients received extended VTE prophylaxis with low molecular weight heparin for 28 days after surgery starting postoperative day 1. For planned MIS, patients received SCD and goal directed fluid management. Descriptive statistics, univariate and multivariate statistical analyses were performed. Results: Of the 3,932 patients, 2,016 (51%) underwent laparotomy, 1,541 (39%) laparoscopy and 375 (10%) robotic approach. The incidence of thromboembolism was 0.5% (N = 21) overall, 0.8% (N = 17) with open approach and 0.2% (N = 4) with MIS approach. Among laparotomy patients, there was 88% compliance with preoperative heparin prophylaxis. Characteristics associated with developing a VTE were black race, malignancy, open surgical approach, surgical time, surgical complexity, and receipt of intraoperative blood transfusion. On multivariate analysis, black race and transfusion remained associated with VTE. Among laparotomy patients, the rate of intraoperative blood transfusion was 5.9% (N = 120), reoperation for bleeding 0.3% (N = 5) and reoperation for hematoma 0.2% (N = 3). Conclusions: We found a low rate of VTE among patients undergoing laparotomy and MIS under an ERAS pathway. The rate of VTE following MIS surgery was low without use of extended pharmacologic VTE prophylaxis or receipt of preoperative prophylactic heparin. Receipt of preoperative heparin prophylaxis prior to open surgery is safe with a low complication rate. This establishes a benchmark for the expected rate of VTE following gynecologic surgery on an ERAS pathway.
Cutaneous Lupus Erythematosus of the Vulvar Skin
Authors: Samar Sheriff, Jeffrey P. Callen, Courtney R. Schadt
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
Changes in systemic cancer therapy prior-authorization requests during the COVID-19 pandemic.
Authors: Helen Parsons, Jingxuan Zhao, Arjun Gupta, Henry J. Henk, K. Robin Yabroff
Journal: Journal of Clinical Oncology (2021)

100 Background: The coronavirus (COVID-19) pandemic transformed norms and approaches to delivering cancer care in the US throughout 2020. While initial reports in regional and single institution studies suggest postponement or modification of cancer treatments, limited evidence exists on the long-term national impact of COVID-19 on cancer treatment throughout the year. Methods: Using de-identified OptumLabs Data Warehouse data, which includes data from the Optum Cancer Guidance Program’s electronic prior authorization (ePA) platform, we compared monthly rates (per 100,000 person-months) of requests for authorization for insurance coverage of systemic cancer therapy in January-December 2020 (COVID) versus January-December 2019 (non-COVID). Results: We identified a total of 94,726 prior-authorization requests for chemotherapy in 2020 compared to 106,272 requests in 2019, indicating a 10.8% overall decline during the pandemic. Prior-authorization request rates were 6.3% higher in March 2020 as many stay-at-home orders were implemented across states (Table). Prior authorization requests then significantly declined in April and May 2020 (3.3% and 14.4% lower rates in 2020 vs. 2019) during the stay-at-home orders before briefly increasing again in June. As COVID-19 infections and deaths increased throughout the fall, requests for prior-authorization significantly declined in each month from August through December 2020. Conclusions: The COVID-19 pandemic led to significant overall declines in requests for prior authorizations for chemotherapy in 2020 versus 2019. While requests rebounded somewhat in early spring and summer of 2020, rates were markedly lower, relative to those in 2019, during COVID-19’s second wave. Overall, these results suggest continued modifications or delays in cancer treatment that may result in worse outcomes for individuals with cancer in 2020 and should be evaluated in future studies. [Table: see text]
Prognostic impact of neoadjuvant chemotherapy in patients with synchronous colorectal liver metastasis: A propensity score matching comparative study
Authors: Masaki Ueno, Koji Komeda, Hisashi Kosaka, Takuya Nakai, Takeo Nomi, Hiroya Iida, Shogo Tanaka, Hisashi Ikoma, Kenji Matsuda, Fumitoshi Hirokawa, Masataka Matsumoto, Daisuke Hokuto, Haruki Mori, Ryo Morimura, Masaki Kaibori, Hiroki Yamaue, Shoji Kubo
Journal: International Journal of Surgery (2021)
World Health Organization‐defined eosinophilic disorders: 2022 update on diagnosis, risk stratification, and management
Authors: William Shomali, Jason Gotlib
Journal: American Journal of Hematology (2021)

The eosinophilias encompass a broad range of nonhematologic (secondary or reactive) and hematologic (primary or clonal) disorders with potential for end-organ damage.Hypereosinophilia (HE) has generally been defined as a peripheral blood eosinophil count greater than 1.5 × 109 /L. After exclusion of secondary causes of eosinophilia, diagnostic evaluation of primary eosinophilias relies on morphologic review of the blood and marrow, standard cytogenetics, fluorescence in situ hybridization, next generation sequencing gene assays, and flow immunophenotyping to detect histopathologic or clonal evidence for an acute or chronic hematolymphoid neoplasm.Disease prognosis relies on identifying the subtype of eosinophilia. After evaluation of secondary causes of eosinophilia, the 2016 World Health Organization endorses a semi-molecular classification scheme of disease subtypes. This includes the major category "myeloid/lymphoid neoplasms with eosinophilia and rearrangement of PDGFRA, PDGFRB, or FGFR1 or with PCM1-JAK2", and the myeloproliferative neoplasm subtype, "chronic eosinophilic leukemia, not otherwise specified" (CEL, NOS). Lymphocyte-variant HE is an aberrant T-cell clone-driven reactive eosinophila, and idiopathic hypereosinophilic syndrome (HES) is a diagnosis of exclusion.The goal of therapy is to mitigate eosinophil-mediated organ damage. For patients with milder forms of eosinophilia (eg, < 1.5 × 109 /L) without symptoms or signs of organ involvement, a watch and wait approach with close follow-up may be undertaken. Identification of rearranged PDGFRA or PDGFRB is critical because of the exquisite responsiveness of these diseases to imatinib. Corticosteroids are first-line therapy for patients with lymphocyte-variant HE and HES. Hydroxyurea and interferon-α have demonstrated efficacy as initial treatment and in steroid-refractory cases of HES. Mepolizumab, an interleukin-5 (IL-5) antagonist monoclonal antibody, was recently approved by the US Food and Drug Administration for patients with idiopathic HES. The use of the IL-5 receptor antibody benralizumab, as well as other targeted therapies such as JAK2 and FGFR1 inhibitors, is under active investigation.
P12.02 Symptoms of patients with diffuse glioma during stable disease as a potential target for treatment
Authors: J G Röttgering, V Belgers, M C M Kouwenhoven, M Schuur, T J Postma, C M Nijboer, M E van Linde, P de Witt Hamer, L Douw, M Klein
Journal: Neuro-Oncology (2021)

Abstract BACKGROUND Patients with diffuse glioma experience many tumor- and treatment-related symptoms, including fatigue, cognitive deficits, and anxiety. It remains unclear how the frequency and burden of these symptoms change over time and specifically which symptoms patients experience during the stable phase of the disease. We assessed the frequency and burden of common symptoms in glioma patients during stable disease and whether patients were willing to undergo treatment for those symptoms. We suggest a top five of potentially treatable symptoms. METHODS Patients with a diffuse glioma during stable disease completed a questionnaire on symptoms they experienced during the past two weeks, such as irritability, fatigue, stress, pain, depressive thoughts and relationship problems. They rated the frequency and burden of seventeen symptoms on a seven-point numeric scale ranging from ‘never’ to ‘continuously’ and from ‘no burden’ to ‘unbearable’, respectively. Also, they stated whether they were willing to undergo treatment for each symptom. Data was collected retrospectively. The median values of the frequency and burden dimension were calculated for each symptom. We composed a top five of most frequent and burdensome symptoms. We used Kendall’s Tau to correlate frequency, burden and willingness to undergo treatment per symptom. RESULTS Fifty-two patients were included, 77% had a KPS score of 90–100, 23% a KPS score of 70–80 and 40% had a glioblastoma. The top five most frequent and burdensome symptoms were fatigue, memory problems, reduced physical fitness, concentration problems and drowsiness. Fatigue had the highest median value on the frequency (median 4.5, IQR 2.5) and burden (median 4.0, IQR 3.00) dimension and 21% of the patients were willing to undergo treatment for fatigue. Overall 35% of the patients were willing to undergo treatment for at least one symptom. Frequency and burden of symptoms correlated well (median Kendall’s Tau of 0.84 with a range of correlations of 0.73–0.95). Frequency and willingness to undergo treatment correlated less (median Kendall’s Tau of 0.35, range 0.24–0.57), as well as burden and willingness to undergo treatment (median Kendall’s Tau, range 0.28–0.61). CONCLUSION The top five symptoms most often reported by patients with diffuse glioma during stable disease were: fatigue, memory problems, reduced physical fitness, concentration problems and drowsiness. These symptoms may serve as a roadmap for future research on treatment strategies to alleviate these symptoms. SUPPORT/DISCLOSURE This project is funded by The Anita Veldman Foundation (CCA-2019-2-21).
P06.05 The Sitting Position in the Very Young Pediatric Population: Pearls and Pitfalls of a 10-Years’ Experience
Authors: S Linsler, F Teping, J Oertel
Journal: Neuro-Oncology (2021)

Abstract BACKGROUND To investigate pearls and pitfalls of the sitting positioning in the pediatric population with special focus on related morbidity and surgical practicability. MATERIAL AND METHODS A retrospective analysis of a prospectively maintained internal database was performed. All pediatric patients younger than 18 years at date of surgery, who underwent procedures in sitting position between 01/2010 and 10/2020 were included into this analysis. RESULTS A total of 42 of posterior fossa surgeries were performed in 38 children between 01/2010 and 10/2020. Mean age at surgery was 8.9 years (13 months - 18 years). Mean height and weight were 134.4 (± 30.2) cm and 36.6 (± 21.7) kg respectively. Three children (7.9%) were diagnosed with persistent foramen ovale. Electrophysiologic monitoring was unremarkable during positioning in all cases. Mean time needed for anesthesiologic preparation and positioning was 84.5 (± 20.6) minutes. Perioperative blood transfusion was needed in 5 cases (11.9%). Incidence of VAE was 11.9%. There was no VAE related severe complication. One child (2.4%) showed postoperative skull fracture and epidural bleeding due to skull clamp application. Clinical status immediately after surgery was favorable or stable in 33 of the cases (78.6%). CONCLUSION Attentive performance and an experienced surgical team provided; the sitting position remains a safe variant for posterior fossa surgery in the pediatric population. Precautious skull clamp application and appropriate monitoring is highly recommended. Considering eloquent aspects, the sitting position offers excellent anatomical exposure and is ideal for combination with endoscopic techniques.
Impact of branched-chain amino acids and frailty on the management of lenvatinib-related fatigue in patients with hepatocellular carcinoma
Authors: Shigeo Shimose, Shunji Koya, Takumi Kawaguchi, Keisuke Hirota, Sachiyo Yoshio, Takashi Niizeki, Hiroo Matsuse, Takuji Torimura
Journal: Clinical and Molecular Hepatology (2021)