tbuckley/cabot-search huggingface dataset:
SELECTIONS.
Journal: JAMA (1896)

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
Racial disparity in survival of African-American (AA) patients diagnosed with metastatic prostate cancer: Analysis of surveillance epidemiology and end results program.
Authors: Muhammad Zain Farooq, Trilok Shrivastava, Humaira Sarfraz, Sheeba Habeeb Ba Aqeel, Pingfu Fu, Ankit Mangla
Journal: Journal of Clinical Oncology (2022)

28 Background: Amongst all cancers in men, prostate cancer (PCa) is the most common cancer, and the second leading cause of death. Racial disparities in PCa care in the United States (US) are known to exist. However, it is not clear if this disparity is also noted specifically in patients diagnosed with metastatic PCa (metaPCa). We analyzed the Surveillance Epidemiology and End results Program (SEER) 18 registry, to determine the racial disparity in survival of AA patients diagnosed with metaPCa compared to other races recorded in this registry. Methods: Cancer incidence data was obtained from the SEER 18 registry (2000-2018). The data was analyzed using StataMP 16 (StataCorp) software. Demographic and clinical outcomes were recorded from the registry. We performed univariate Cox regression using proportional hazard model and obtained Kaplan Meier curves to look at the difference in survival based on different age groups and race. Results: A total of 51,979 cases were identified with metaPCa, out of whom 75.8% were Whites. 40,579 deaths were recorded. Mean age group of patients with metaPCa were 70-74 years. Grade 3 poorly differentiated adenocarcinoma was noted in 54.6% patients. There was no statistically significant difference in survival of AA patients with metaPCa compared to Non-Hispanic Whites (NHW) (Hazard Ratio (HR): 0.99; 95%CI 0.96,1.03 p = 0.71) or Alaskan and American Natives (AIAN) with metaPCa (HR:1.048; 95%CI 0.91,1.21 p = 0.539). AA with metaPCa had a statistically better outcome compared to Asian and Pacific Islanders with metaPCa (HR:0.775; 95%CI 0.731,0.821 p = 0.00). Amongst patients with less than 65 years of age with metaPCa, AA patients had statistically better survival than NHW (HR: 0.94; 95% CI 0.89-0.98 p = 0.05). No statistically supported racial disparity in survival was observed in patients above 65 years with metaPCa (AA to NHW patients- HR: 0.99; 95% CI 0.96,1.03 p = 0.71). Conclusions: Although racial disparities exist in survival of all patients diagnosed with prostate cancer, when it comes to those with metaPCA, there is no statistically supported racial disparity amongst AA patients compared to NHW, except for those who are younger than 65 years where white patients have a worse outcome compared to AA diagnosed with metaPCa.
Diagnosis of Lyme Disease
Authors: David Pitrak, Cynthia T. Nguyen, Adam S. Cifu
Journal: JAMA (2022)

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 Journals 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 17088: Role of Caregiver Participation in Outcomes for Patients With Advanced Ambulatory Heart Failure: An Analysis of the Revival Registry
Authors: Nisha A Gilotra, Shawn W Robinson,, Michelle Kittleson, Keyur Shah, Salpy Pamboukian, Donald C Haas, Douglas A Horstmanshof, Dennis McNamara, Rhondalyn Forde-McLean, Wendy C Taddei-Peters, Shokoufeh Khalatbari, Catherine A Spino, Blair Richards, Douglas L Mann, Lynne W Stevenson, Garrick C Stewart, Keith D Aaronson
Journal: Circulation (2018)

Introduction: Advanced HF requires tremendous resources, and family caregivers generate significant health related cost-savings. Earlier work in the REVIVAL study demonstrated that increased baseline caregiver (CG) burden is associated with subjects exhibiting lower preference for ventricular assist device (VAD) therapy. Hypothesis: We examined whether 1) CG study participation and 2) CG burden predict combined outcome of death, VAD or UNOS 1 transplant in ambulatory advanced HF patients. Methods: We compared REVIVAL subjects with and w/o a participating CG, defined as a consented CG who completed at least one baseline quality of life (QOL) survey. Baseline characteristics were evaluated and the hazard ratio for CG vs. no CG for the combined outcome was determined by a Cox model. Results: Of 337 subjects, 95 (28%) identified participating CGs. CGs were 59 ± 14 yrs old, more commonly female (80%), a spouse/domestic partner (76%), and lived in the same home (86%). Subjects with a participating CG were older (62± 12 vs 59 ± 11 yrs, p=0.025). There were no differences in INTERMACS profile, NYHA class, HF risk scores, renal function or QOL. . Subjects without a participating CG were numerically more likely to experience the outcome of death, VAD or transplant by 1 year compared to those with a participating CG (26% vs. 17%), but the difference in event rate was not statistically significant (HR 1.65, CI 0.96-2.83, p=0.07). (Figure) There was no significant difference in primary endpoint based on CG burden or CG QOL as assessed by Oberst scale or EQ-5D index. Conclusions: In the REVIVAL study, less than one third of ambulatory advanced HF patients had a participating CG, raising the question of whether patients are more likely to progress to advanced HF if lacking a CG. Additionally, not having a participating CG may be related to worse HF outcomes. These data emphasize the need for larger studies to better understand the complex dynamics of the patient-caregiver dyad.
Comprehensive genomic profiling of penile squamous cell carcinoma and impact of HPV status on immune-checkpoint inhibition-related biomarkers.
Authors: Bassel Nazha, Sharon Wu, Jacqueline T Brown, Daniel Magee, Bradley Curtis Carthon, Omer Kucuk, W. Michael Korn, Pedro C. Barata, Elisabeth I. Heath, Charles J. Ryan, Rana R. McKay, Viraj A. Master, Mehmet Asim Bilen
Journal: Journal of Clinical Oncology (2022)

4 Background: Penile squamous cell carcinoma (SCC) is a rare and aggressive malignancy with few treatments in the advanced setting and little success of immune-checkpoint inhibitions (ICI). Around half of penile SCC cases are linked to HPV infection. We aimed to report the landscape of somatic alterations and ICI-related biomarkers in penile SCC in the Caris Life Sciences dataset and to establish signatures for HPV-dependent and HPV-independent oncogenesis. Methods: Penile SCC tumors were analyzed using next-generation sequencing of DNA (TruSeq, 45 genes; NextSeq, 592 genes and NovaSeq, whole exome sequencing (WES)) and RNA (NovaSeq). PD-L1 expression was tested by IHC using SP142. Microsatellite instability (MSI) was tested by fragment analysis, IHC and NGS. Tumor mutational burden (TMB) was measured by counting all somatic mutations found per tumor (TMB-high: &gt;10 mutations per MB). HPV16/18 status was determined using WES when available. Significance was determined using chi-square and Wilcoxon rank sum test and adjusted for multiple comparisons (q-value &lt;0.05). Results: Among the entire cohort (N=108), the median age was 66 years and 79.6% of tumors were primary and 20.4% of tumors were metastatic. In the overall cohort, the most frequently detected mutations were TP53 (46%), CKDN2A (26%), PIK3CA (25%), TERT promoter (22%), KMT2C (16%) and NOTCH1 (14%), consistent with previous reports. Overall, 51% of tumors were PD-L1+ (SP142, &gt;1%), 10.7% had high TMB, and 1.1% had dMMR/MSI-H. Of the 108 tumors, 29 had HPV status tested by WES (HPV16/18+, n=13 and HPV16/18-, n=16). KMT2C mutations (33% vs 0%) and FGF3 amplifications (30.8% vs 0%) were specific to HPV16/18+ tumors, while CDKN2A mutations (37.5% vs 0%) were exclusive to HPV16/18- tumors. HPV16/18+ tumors also had a trend towards decreased TP53 (7.7% vs 63%) and TERT promoter (25% vs 77%) alterations (Table). TMB-high were exclusively found in the HPV16/18+ group (30.8% vs 0%), while PD-L1 and dMMR/MSI-H status were comparable between the two groups. Conclusions: To our knowledge, our comprehensive NGS study of penile SCC somatic alterations is the largest to date. HPV16/18+ vs HPV16/18- penile SCC were molecularly distinct tumors, consistent with previous reports. Our finding that TMB-high was exclusive to patients with HPV16/18+ tumors requires confirmation in larger datasets and could be used for better patient stratification in ICI clinical trials.[Table: see text]
Abstract 178: What is the Role of Clinical Champions for In-Hospital Cardiac Arrest? A Qualitative Study
Authors: Jessica Lehrich, Paul S Chan, Sarah Krein, Joan Kellenberg, Timothy Guetterman, Molly Harrod, Steven Kronick, Brad Trumpower, Saket Girotra, Theodore J Iwashyna, Brahmajee K Nallamothu
Journal: Circulation (2018)

Introduction: The presence of a clinical champion has been associated with improved resuscitation care. Yet little is known about specific characteristics of these individuals that make them more effective. Objective: To identify characteristics of clinical champions at top performing hospitals for in-hospital cardiac arrest (IHCA) survival. Methods: We conducted semi-structured, in-depth interviews with key stakeholders at 9 geographically and academically diverse US hospitals participating in the AHA Get with the Guidelines Resuscitation Registry. We identified these sites using risk standardized IHCA survival during 2012-2014 (top quartile: 5 hospitals; middle quartile: 1 hospital; bottom quartile: 3 hospitals). We gathered data through qualitative interviews on resuscitation processes during 1-2 day site visits that included questions on the presence and role of IHCA clinical champions. Thematic analysis was conducted to identify key elements of high quality resuscitation care. Results: 158 interviews were conducted with over 78 hours of recording; participants included physicians (17.1%), nurses (45.6%), other clinical staff (17.1%), and administration (20.3%). Of 9 hospitals visited, 4 hospitals (all top) had a physician champion with 2 of these also having a nurse co-champion. One hospital (also top) had a nursing champion with engaged physician support. In contrast, 3 hospitals (1 mid, 2 bottom) had nursing champions but without engaged physician support and 1 hospital (bottom) had no champion identified. Several themes emerged (Table) with clinical champions at top performing hospitals: 1) clearly identified; 2) passionate, respected, and admired; 3) proactive and collaborative; and 4) either physicians or nurses with engaged physician support. Conclusions: Top performing hospitals in IHCA have clinical champions with specific clinical characteristics. Leveraging this knowledge may help hospitals improve resuscitation care.
Mixed methods assessment of providers’ needs in the management of advanced renal cell carcinoma.
Authors: Matthew T Campbell, Patrice Lazure, Monica Augustyniak, Edgar A. Jaimes, Mehmet Asim Bilen, Emily Lemke, Ginny Jacobs, Pamela McFadden
Journal: Journal of Clinical Oncology (2022)

313 Background: There is a paucity of data regarding the challenges associated with the timely and accurate diagnosis of Renal Cell Carcinoma (RCC) and its effective multidisciplinary management. This study aimed to assess the knowledge and skills of healthcare providers (HCPs) managing and coordinating the care of patients with advanced RCC (aRCC) across multidisciplinary teams. Methods: A sequential mixed methods needs assessment was conducted across the United States with medical oncologists (ONCs), nephrologists (NEPHs), physician assistants (PAs), nurse practitioners (NPs), and registered nurses (RNs). Interviews, transcribed and thematically analyzed, and online surveys, statistically analyzed, were triangulated. Results: A total of 305 HCPs completed an interview (n=40) or the survey (n=265): 78 ONCs, 62 NEPHs, 57 PAs, 55 NPs, 53 RNs. One third (33%) of HCPs reported suboptimal skills in adjusting the dose of a treatment for aRCC in the event of adverse reactions. Interviews underscored a lack of clarity for HCPs on when to reduce the dose or when to discontinue and/or switch to other drugs. Suboptimal knowledge and skills related to toxicities were found (Table). Breakdowns in communication across multidisciplinary teams were identified by 46% of HCPs. Of those, 61% occurred when monitoring side effects and 48% when referring to ONCs. Some NEPHs reported never, rarely, or sometimes being involved with ONCs in the management of nephritis (25%), chronic kidney disease (19%), or acute renal failure (24%). Interviews suggested the role of NEPHs in the care of aRCC is poorly recognized and that NEPHs are perceived to have limited time to spend in the care of cancer patients. Few NEPHs reported gaps in knowledge/skills managing key renal complications such as nephritis (13%/15%), chronic kidney disease (6%/15%), and acute renal failure (9%/9%). Conclusions: This study identified a need to improve HCPs’ knowledge of the signs/symptoms of treatment side effects, skills in identifying/referring patients to appropriate specialists, and skills in managing adverse events. Barriers to involving NEPHs in the co-management of aRCC included a lack of recognition of their role in managing treatment-induced renal complications.These results should inform educational interventions for professionals caring for aRCC patients.[Table: see text]
Variance of mean baseline health-related quality of life across phase III clinical trials in metastatic renal cell carcinoma.
Authors: John Clark Henegan, Francis Garner Bell
Journal: Journal of Clinical Oncology (2022)

329 Background: Health-related quality of life (HRQoL) instruments in clinic trials provide insight into the impacts a disease and therapy have on a person’s well-being. Baseline measurements of global HRQoL reflect a trial population’s quality of life at the start of a trial. It is unknown how baseline mean HRQoL values vary across trials. Our hypothesis: The HRQoL for trials populations would decrease with later lines of therapy but would not be affected by chronological time. Methods: The year the first patient was enrolled in a trial, the number of prior lines of therapy, the HRQoL instrument(s) used, and the trial’s name was recorded along with the intervention arm’s global HRQoL summary statistics (i.e., mean value, standard deviation, and number of respondents). The intervention arm (as opposed to a combination of both arms of the study) was analyzed since the HRQoL at baseline was often balanced between the two arms but baseline HRQoL summary statistics for the entire trial population was not typically available. The baseline HRQoL means were compared across trials using common HRQoL instruments via one-way ANOVA (https://statpages.info/anova1sm.html). A p-value of less than 0.05 indicated there was a significant difference in mean HRQoL values somewhere among the various groups. The Tukey honestly significantly different post-hoc test was used to evaluate which groups were significantly different from others. Results: Mean baseline HRQoL varied significantly across trials for the FKSI-19 (p &lt; 0.001) and the EQ-5D (p = 0.004) instruments. Conclusions: While HRQoL varied across trials for the FKSI-19 and the EQ-5D instruments, post-hoc tests indicated that only the FKDI-19 varied as hypothesized by line of therapy. The EQ-5D baseline HRQoL values variation correlated more by year of first participant. Future research should focus on the applicability of the EQ-5D and EQ-VAS HRQoL instruments in a modern population of patients with metastatic RCC.[Table: see text]
Methadone: evidence of accumulation.
Authors: S T Leslie, R B Miller, C Boroda
Journal: BMJ (1977)

<h3>Background and objectives</h3> AKI, a frequent complication among hospitalized patients, confers excess short- and long-term mortality. We sought to determine trends in in-hospital and 1-year mortality associated with AKI as defined by Kidney Disease Improving Global Outcomes consensus criteria. <h3>Design, setting, participants, &amp; measurements</h3> This retrospective cohort study used data from the national Veterans Health Administration on all patients hospitalized from October 1, 2008 to September 31, 2017. AKI was defined by Kidney Disease Improving Global Outcomes serum creatinine criteria. In-hospital and 1-year mortality trends were analyzed in patients with and without AKI using Cox regression with year as a continuous variable. <h3>Results</h3> We identified 1,688,457 patients and 2,689,093 hospitalizations across the study period. Among patients with AKI, 6% died in hospital, and 28% died within 1 year. In contrast, in-hospital and 1-year mortality rates were 0.8% and 14%, respectively, among non-AKI hospitalizations. During the study period, there was a slight decline in crude in-hospital AKI-associated mortality (hazard ratio, 0.98 per year; 95% confidence interval, 0.98 to 0.99) that was attenuated after accounting for patient demographics, comorbid conditions, and acute hospitalization characteristics (adjusted hazard ratio, 0.99 per year; 95% confidence interval, 0.99 to 1.00). This stable temporal trend in mortality persisted at 1 year (adjusted hazard ratio, 1.00 per year; 95% confidence interval, 0.99 to 1.00). <h3>Conclusions</h3> AKI associated mortality remains high, as greater than one in four patients with AKI died within 1 year of hospitalization. Over the past decade, there seems to have been no significant progress toward improving in-hospital or long-term AKI survivorship.
Erratum
Journal: JNCI Journal of the National Cancer Institute (1974)

In “Diversity of Envelope Antigens on Murine Type-C RNA Viruses,” by Tadao Aoki, Robert]. Huebner, Kenneth S. S. Chang, Made M. Sturm, and Margaret Liu, on page 1192, table 3, column 4, sixth line should read 2/17 (II) not 2/11 (0).
Exposure-adjusted safety analyses of the VISION phase 3 trial of <sup>177</sup>Lu-PSMA-617 in patients with metastatic castration-resistant prostate cancer.
Authors: Kim N. Chi, Nabil Adra, Rohan Garje, Jeff M. Michalski, Jules Lavalaye, Mette Moe Kempel, Marcia Brackman, Kevin Perraud, Geoffrey Holder, Andrew J. Armstrong
Journal: Journal of Clinical Oncology (2022)

85 Background: In the VISION trial, targeted radioligand therapy with 177 Lu-PSMA-617 significantly prolonged radiographic progression free survival (rPFS) and overall survival when added to standard of care (SoC) in patients with advanced prostate-specific membrane antigen (PSMA)-PET-positive metastatic castration-resistant prostate cancer. There was a higher incidence of treatment-emergent adverse events (TEAEs) with 177 Lu-PSMA-617 + SoC vs SoC. However, treatment exposure was more than three times longer in the 177 Lu-PSMA-617 + SoC arm and thus relative toxicity may have been overestimated. A post hoc analysis of the relationship between exposure and frequency of TEAEs was performed to facilitate comparison of rates between arms. Methods: In this international, open-label study, adult patients previously treated with ≥ 1 androgen receptor pathway inhibitors and 1–2 taxane regimens were randomized 2:1 to 177 Lu-PSMA-617 (7.4 GBq Q6W, ≤ 6 cycles) + SoC or SoC. Safety was a secondary endpoint. TEAEs (regardless of causality) were reported from start of randomized treatment for up to 30 days after last treatment administration (including SoC) or 1 day before subsequent anticancer treatment, whichever occurred first. Overall TEAE incidence was adjusted for treatment exposure by calculating incidence per 100 patient treatment-years (PTY). The analysis was performed for the first occurrence of TEAEs. Results: Exposure-adjusted incidence of any grade, grade ≥ 3 and selected TEAEs are listed in the table. There was similar exposure-adjusted incidence of gastrointestinal events and fatigue and higher exposure-adjusted incidence of musculoskeletal and renal events with SoC compared with 177 Lu-PSMA-617 + SoC suggesting an association with treatment exposure rather than 177 Lu-PSMA-617. Dry mouth, dry eye and acute myelosuppression maintained a higher incidence, confirming relationship with 177 Lu-PSMA-617 treatment. Conclusions: The adjusted safety analysis, accounting for a longer safety observation due to longer rPFS in patients receiving 177 Lu-PSMA-617, reveals a comparable incidence of TEAEs between arms. This confirms a favorable risk/benefit profile of 177 Lu-PSMA-617 added to SoC in this patient population. Clinical trial information: NCT03511664. [Table: see text]