tbuckley/cabot-search huggingface dataset:
Underutilization of standard of care (SOC) treatment intensification in patients (pts) with metastatic castration-sensitive prostate cancer (mCSPC) by specialty.
Authors: Umang Swami, Agnes Hong, Nader N. El-Chaar, David Nimke, Krishnan Ramaswamy, Brandon Diessner, Rickard Sandin, Neeraj Agarwal
Journal: Journal of Clinical Oncology (2022)

183 Background: Intensification of androgen deprivation therapy (ADT) with docetaxel (DOC) or novel hormone therapies (NHTs) [abiraterone, enzalutamide, or apalutamide] has shown to improve survival outcomes and is SOC in men with mCSPC. 1 However, recent evidence indicates that most pts still only receive ADT ± first-generation non-steroidal antiandrogens (NSAA). 2-4 This is one of the first studies to assess the real-world utilization of intensified treatments as first-line (1L) therapies for pts with mCSPC by physician specialty. Methods: This retrospective study used the Optum health insurance claims database, which includes pt claims data from commercially insured and Medicare Advantage populations. Adult pts (≥18 years) had ≥2 claims for prostate cancer (PC) and ≥1 claim for metastasis (the first claim was index date) within 90 days (d) prior to, or any time after, the first claim for PC from January 2014– June 2019. 1L treatments included any systemic treatment for mCSPC within 90 d pre-index, plus any other treatment received within 180 d of the first. Physician specialty was determined from medical or pharmacy claims during 1L treatment and categorized as Urologist; Oncologist; urologists and oncologists (Both); or other specialties (Other). Treatment patterns and pt characteristics across specialties were analyzed descriptively. Results: Of 4,675 mCSPC pts identified, 16% received care from Urologists, 20% from Oncologists, 63% from Both, and 1% from Other. Pts seen by Urologists were more likely to be older and have Medicare compared to pts seen by the Oncologists or Both. Treatment intensification with NHT and/or DOC was numerically higher among Oncologists and Both compared with Urologists. However, all specialties prescribed ADT ± first-generation NSAA most frequently for 1L mCSPC treatment, even in patients with visceral metastases (Table). Conclusions: Despite evidence of improved survival with intensified treatment for pts with mCSPC, we observed its underuse by all specialties and even among pts with visceral metastases. Our results highlight a great need to advance the implementation of evidence-based medicine in mCSPC. 1. Sayegh N et al. JCO Oncol Pract 2021; OP2100206. 2. Ryan CJ et al. J Urol 2021; Online ahead of print. 3. Freedland S et al. Ann Oncol 2021; 32: S650-S651. 4. Freedland S et al. J Clin Oncol 2021; 39(Suppl 15): e5073.[Table: see text]
Surgery, St. Louis
Journal: JAMA (1965)

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
PD-L1 expression and BCG response in nonmuscle invasive bladder cancer.
Authors: Solomon L. Woldu, Thomas Gerald, Vitaly Margulis, Daniel Halstuch, Yaara Ber, Karin Lifshitz, David Margel, Yair Lotan, Liwei Jia
Journal: Journal of Clinical Oncology (2022)

545 Background: Intravesical bacillus Calmette Guerin (BCG) is the standard of care adjuvant therapy for high risk non-muscle invasive bladder cancer (NMIBC), yet many patients experience recurrence or disease progression. The mechanism of action of BCG is believed to be related to stimulation of immune surveillance. Relatedly, systemic immune checkpoint inhibition is currently being utilized in advanced bladder cancer and approved for BCG unresponsive NMIBC. We sought to determine the association between PD-L1 expression and BCG treatment. Methods: We identified 102 BCG-naïve patients with high grade (HG) NMIBC treated with BCG. All patients underwent initial transurethral resection (TUR) for pathologic diagnosis. Dako 22c3 assay was used to determine PD-L1 expression. Patients were defined as PD-L1 positive if the combined positive score (CPS) &gt; 0. BCG unresponsiveness was defined by presence of high grade disease at 6 months following adequate BCG (one induction and maintenance cycle or two induction cycles) for pT1 or 12 months for CIS or presence of pT1 at 3 months following induction. HG relapse was defined as presence of any HG disease after being followed for 6 months after BCG. Results: The median follow-up time was 57 months. Median number of BCG maintenance cycles was 1, and 17 (16.7%) patients underwent immediate reinduction BCG. PD-L1 expression was observed 5.9% of pTa, 30.0% of pT1, and 3.6% of CIS. BCG unresponsiveness and HG relapse were observed in 32 (35.6%) and 29 (34.5%) patients, respectively. On univariate analysis, PD-L1 expression was inversely associated with BCG unresponsiveness (OR = 0.112; 95% CI 0.014-0.898) but not high grade relapse (OR = 0.296; 95% CI 0.061-1.440). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of PD-L1 expression for BCG responsiveness were 22%, 97%, 93%, and 41%, respectively. The post-test probability of BCG responsiveness was 93% in patients positive for PD-L1 based on a positive likelihood ratio of 7.33 for PD-L1 expression. On multivariate regression, pT1 (OR = 0.159; 95% CI 0.045-0.600), CIS (OR = 0.247; 95% CI 0.071-0.857), and PD-L1 expression (OR = 15.625; 95% CI 1.779-142.857) were independently associated with BCG responsiveness. Conclusions: PD-L1 expression in HG NMIBC was low, and patients with PD-L1 expression at initial TUR were more likely to harbor invasive disease. Patients showing PD-L1 expression were more likely to demonstrate BCG responsiveness. These findings suggest a role of PD-L1 in the immune surveillance mechanism of BCG at initial pathologic diagnosis and may assist in predicting responses to BCG among patients with HG NMIBC. Further investigation is required to determine if additional immune checkpoint markers have strong correlation with BCG response, particularly among patients without PD-L1 expression.
ADDRESSES.
Journal: JAMA (1891)

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
Abortion.
Authors: P H Gosling
Journal: BMJ (1979)

In England, current legislative attempts, to ameliorate the abuses associated with the 1967 Abortion Act by adopting stricter time limits during which abortions can be performed, will not achieve the effect envisioned by critics of the Abortion Act. Restrictive time limits will not significantly reduce the number of abortions performed for purely social reasons but it will preclude performing a considerable number of medically indicated abortions. Many of these medical conditions cannot be detected during the early stages of pregnancy. A workable alternative to the present abortion situation would be 1) to perform abortions for medical reasons in hospitals within liberal time limits and 2) to perform abortions demanded for social reasons in separate clinics within strict time limits. This suggested arrangement would remove the burden from hospital personnel of participating in abortions which they object to on moral grounds. Physicians, who do not object to performing socially demanded abortions, could be hired by the clinics specifically to perform these tasks. Medically indicated abortions would be paid for under the national insurance plan. Abortions performed at the clinic would not be covered by the government, but the costs would be kept lower than the cost of obtaining illegal abortions. This arrangement would permit women to have abortions for social reasons but would not encourage these abortions. Women do have the right to decide whether or not to have a child, but this decision should be made prior to conception.
Addison's Disease
Authors: J. F. Nicholson
Journal: BMJ (1872)

albumen required to make flesh with this beef-tea and which the blood must have to supply would amount to 149 grains (9.64 grammes).Now, twenty pounds of blood would contain (at go per Iooo) 12,600 grains of albumen ; so that blood may be expected to be able to continue supplying albumen to the material of beef-tea to make flesh some time after any food has been taken.This length of time must be regu- lated by the rate of the formation of urea and that of the waste of tissues.
Commentaire de travail de A. Fritscher-Ravens et al., pp.114
Journal: Endoscopy (2013)

See also: Endoscopic ultrasound-guided fine needle aspiration training: evaluation of a new porcine lymphadenopathy model for in vivo hands-on teaching and training, and review of the literatureEndoscopy 2013; 45(02): 114-120DOI: 10.1055/s-0032-1325931
Shear-responsive boundary-lubricated hydrogels attenuate osteoarthritis
Authors: Yiting Lei, Xingkuan Wang, Junyi Liao, Jieliang Shen, Yuling Li, Zhengwei Cai, Ning Hu, Xiaoji Luo, Wenguo Cui, Wei Huang
Journal: Bioactive Materials (2022)

Lipid-based boundary layers formed on liposome-containing hydrogels can facilitate lubrication. However, these boundary layers can be damaged by shear, resulting in decreased lubrication. Here, a shear-responsive boundary-lubricated drug-loaded hydrogel is created by incorporating celecoxib (CLX)-loaded liposomes within dynamic covalent bond-based hyaluronic acid (HA) hydrogels (CLX@Lipo@HA-gel). The dynamic cross-linked network enables the hydrogel to get restructured in response to shear, and the HA matrix allows the accumulation of internal liposome microreservoirs on the sliding surfaces, which results in the formation of boundary layers to provide stable lubrication. Moreover, hydration shells formed surrounding the hydrogel can retard the degradation process, thus helping in sustaining lubrication. Furthermore, in vitro and in vivo experiments found that CLX@Lipo@HA-gels can maintain anabolic-catabolic balance, alleviate cartilage wear, and attenuate osteoarthritis progression by delivering CLX and shear-responsive boundary lubrication. Overall, CLX@Lipo@HA-gels can serve as shear-responsive boundary lubricants and drug-delivery vehicles to alleviate friction-related diseases like osteoarthritis.
Thoracic aortic aneurysms and atrial fibrillation: commonality in pathophysiological pathways
Authors: Riccardo Proietti, Gregory Y H Lip, Riaz Akhtar, Mark Field
Journal: Cardiovascular Research (2022)

Atrial fibrillation • Thoracic aortic aneurism • Pathways commonality A thoracic aortic aneurysm (TAA) is a localized dilatation of the ascending and thoracic aorta that can lead to dissection and rupture of the vessel wall. 1 The most worrisome aspect of this clinical condition is related to its silent clinical progression with one in two cases completely asymptomatic and indeed diagnosed incidentally during imaging studies performed for other clinical condition. 1In addition, its first clinical manifestation may occur as an acute dissection which carries a very high risk for extra-and intra-hospital mortality.
Extrapleural Pneumothorax
Authors: R. Nissen
Journal: BMJ (1939)

expectorated daily.X-ray examination revealed cavitation in the left lower lobe-near its upper part posteriorly.Bed rest and general treatment failed to produce any improvement; indeed, the x-ray appearances after three months were, if anything, rather worse (Figs. 10 and 11).Accordingly thoracolysis was advised.On Mlarch 31. 1938,under general anaesthesia (intratracheal oxygenf and chloroform), the posterior ends of ribs six to ten were resected subperiosteally and their periosteal beds cauterized with Zenker's fluid.The immediate post-operative period was uneventful.It was recorded in the notes on Mav 12, 1938, that since operation the patient had done amazingly well: the sputum had decreased from one ouLnce to three spots daily, and on that day he had had none for the first time for years.X-ray examination showed the cavity diminishing in size.A few bacilli were found in one specimen of sputum about the middle of September, after it had been repeatedly negative for about two months.On October 31, 1938, the general condition was excellent;a slight but steady increase in weight having taken place since August, the weight now was 10 st.7 lb., and the sputum was so scanty that a specimen obtained with the utmost difficulty was negative.The x-ray appearances are correspondingly improved and suggest that healing has occurred (Fig. 12).The patient is now being allowed up, and sputum is negative on culture and animal inoculation. Case VIIIAn upholsterer aged 25 was admitted to the sanatorium on November 16, 1937, nine weeks after the first onset of his illness, which was regarded as a bronchopneumonia of the right base.Slight improvement followed routine sanatorium treatment, but in February, 1938, a large basal cavity was seen in the x-ray picture of the right lung.Accordingly an artificial pneu- mothorax was induced, but as this was inadequate it was supplemented on April 6, 1938, by crushing of the right phrenic nerve, and the cavity became a little smaller.On June 30, 1938, there was still a little sputum containing tubercle bacilli, and an occasional slight elevation of tempera- ture to 98.8°F.The pulse ranged between 75 and 100 per
Café‐au‐lait macules overlying segmental macular hyperpigmentation in a pediatric patient: an early sign for mosaic neurofibromatosis type 1
Authors: J. Zhang, W. Qin, S. Hua, M. Li, Y. Tang, Z. Yao
Journal: British Journal of Dermatology (2020)

The presentation of multiple café-au-lait macules (CALMs) in children is a common reason for referral to a dermatologist. Segmental CALMs, a subtype of CALMs, is usually limited to a specific part of the body. Mosaic neurofibromatosis type 1 (NF1; OMIM 162200) is a common congenital disorder associated with segmental CALMs with an incidence of about 1 case/40000 patients, which is lower than the prevalence of patients with germline NF1 mutations1,2.
Hemodialysis for Chronic Renal Failure
Authors: J. R. E.
Journal: Annals of Internal Medicine (1965)

Editorials1 March 1965Hemodialysis for Chronic Renal FailureJ. R. E.J. R. E.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-62-3-621 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptIn 1943, in the Netherlands, under the harsh circumstances of the German occupation, the first practical treatment of a patient with an artificial kidney was performed by a young Dutch physician named Willem Johan Kolff. Although extracorporeal hemodialysis had been conceived as early as 1913 by Abel, Rowntree, and Turner, and had been worked on experimentally by others, it remained for Dr. Kolff 30 years later to put together such a dialyzer and to treat a series of uremic patients. From his work has stemmed the dialyzing programs that today are being carried out the world over. Truly, Willem Kolff...References1. MOORE FD: Give and Take: The Development of Tissue Transplantation. W. B. Saunders Co., Philadelphia, 1964. 182 pp. Google Scholar2. STARZL TE: Experience in Renal Transplantation. W. B. Saunders Co., Philadelphia, 1964. 383 pp. Google Scholar3. RUSSELLMONACO PSAP: The biology of tissue transplantation. New Eng. J. Med. 271: 502, 553, 610, 718, 1964. CrossrefMedlineGoogle Scholar4. MURRAYGLEASONBARTHOLOMAY JERA: Third report of human kidney transplant registry. Transplantation. In press. Google Scholar5. ELKINTON JR: Editorial: Moral problems in the use of borrowed organs, artificial and transplanted. Ann. Intern. Med. 60: 355, 1964. Google Scholar6. LETTERS AND COMMENTS: Moral problems of artificial and transplanted organs. Ann. Intern. Med. 61: 355, 1964. LinkGoogle Scholar7. SCRIBNER BH: Presidential Address: Ethical problems of using artificial organs to sustain human life. Trans. Amer. Soc. Artif. Intern. Organs 10: 209, 1964. MedlineGoogle Scholar8. PAGE IH: Editorial: Artificial prolongation of life. Mod. Med. October 26, 1964. Google Scholar9. LADIMERNEWMAN IRW, EDITORS: Clinical Investigation in Medicine: Legal, Ethical and Moral Aspects. An Anthology and Bibliography. Boston University Law-Medicine Research Institute, Boston, 1963. 517 pp. Google Scholar10. Matthew 7: 12. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byThe Impact of Home Hemodialysis on the Marital Dyad*The Artificial Kidney: Some Approaches to Improved Design and FunctionMedicine and the Fourth EstateJ. R. E. 1 March 1965Volume 62, Issue 3Page: 621-623KeywordsKidneysPatientsRenal failure ePublished: 1 December 2008 Issue Published: 1 March 1965 PDF downloadLoading ...
Manuscripts Approved for JNCI, February 1 to March 1, 1968
Journal: JNCI Journal of the National Cancer Institute (1968)

Manuscripts Approved for JNCI, February 1 to March 1, 1968 Get access JNCI: Journal of the National Cancer Institute, Volume 40, Issue 4, April 1968, Pages 875–876, https://doi.org/10.1093/jnci/40.4.875-a Published: 01 April 1968
An update on cosmetic procedures in people of color. Part 2: Neuromodulators, soft tissue augmentation, chemexfoliating agents, and laser hair reduction
Authors: Rebecca L. Quiñonez, Oma N. Agbai, Cheryl M. Burgess, Susan C. Taylor
Journal: Journal of the American Academy of Dermatology (2022)

Recent years have brought forth the undeniable practice gap in dermatology concerning knowledge and experience of cosmetic procedures in people of color (POC). A paucity in the literature regarding evidence-based recommendations for the management of POC undergoing cosmetic procedures and the rise of cosmetic procedures in dermatology serves as a call to action to provide education regarding differences in skin of color that may impact the cosmetic outcomes. To mitigate the current practice gap on the safety, use, and benefits of cosmetic procedures in POC, part 2 will discuss the authors' recommendations and clinical pearls, as well as evidence-based management for neuromodulators, soft tissue augmentation, chemexfoliating agents, and laser hair reduction in POC undergoing cosmetic procedures.
Ras guanine nucleotide-releasing protein-4 promotes renal inflammatory injury in type 2 diabetes mellitus
Authors: Shuai Huang, Junmei Wang, Li Zhang, Shasha Tian, Yao Wang, Xian Shao, Saijun Zhou, Pei Yu
Journal: Metabolism (2022)

Ras guanine nucleotide-releasing protein-4 (RasGRP4) is an activator of Ras protein, which plays significant roles in both the inflammatory response and immune activation. This study determined the role of RasGRP4 in diabetic kidney disease (DKD) progression.CRISPR/Cas9 technology was used to establish RasGRP4 knockout (KO) mice. Diabetes was induced by a high-fat diet combined with five consecutive daily intraperitoneal injections of streptozotocin (60 mg/kg) in C57BL/6J wild-type (WT) mice and RasGRP4 KO mice. Hematoxylin and eosin, periodic acid-Schiff, and Masson's trichrome staining were used to observe the histology of pathological injury. Immunohistochemical staining was used to analyze inflammatory cell infiltration. Quantitative PCR and Western blotting were used to detect the expression of inflammatory mediators and the activation of signaling pathways in renal tissues. In vitro cell co-culture experiments were performed to explore the interactions between peripheral blood mononuclear cells (PBMCs) and glomerular endothelial cells (GEnCs).RasGRP4 KO mice developed less severe diabetic kidney injury compared to WT mice, exhibiting lower proteinuria, reduced CD3+ T lymphocyte and F4/80+ macrophage infiltration, less inflammatory mediator expression including interleukin 6, tumor necrosis alpha, intercellular adhesion molecule-1, and vascular cell adhesion molecule-1, and lower expression levels of critical signal transduction molecules in the NLR family pyrin domain-containing 3 inflammasome and mitogen-activated protein kinase (MAPK)/nuclear factor kappa B (NF-κB) signaling pathways in the diabetic kidney. In vitro experiments showed that the adhesion function of PBMCs of RasGRP4 KO mice was reduced compared to that of WT mice. Moreover, the expression of adhesion molecules and critical signal transduction molecules in the NLRP3 inflammasome and MAPK/NF-κB signaling pathways in GEnCs was stimulated by the supernatant of PBMCs, which were derived from RasGRP4 KO mice treated with high glucose and were also significantly reduced compared to those derived from WT mice.RasGRP4 promotes the inflammatory injury mediated by PBMCs in diabetes, probably by regulating the interaction between PBMCs and GEnCs and further activating the NLRP3 inflammasome and MAPK/NF-κB signaling pathways.