tbuckley/cabot-search huggingface dataset:
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Authors: Ferdinando D’Amico, Silvio Danese, Laurent Peyrin-Biroulet
Journal: Clinical Gastroenterology and Hepatology (2020)

We appreciate the thoughtful comments of Perisetti and colleagues. In line with our article they support our hypothesis that diarrhea in patients with coronavirus disease 2019 (COVID-19) may be related not only to the activity of the new coronavirus but also to the drugs used for its treatment as antibiotics and antivirals. Interestingly, they add that even the cytokine storm generated by COVID-19 may play a role in diarrhea etiopathogenesis by influencing the gut-brain axis and causing increased intestinal permeability.1Jose R. et al.Lancet Respir Med. 2020; (S2213-2600(20)30216-2)Google Scholar If this theory is confirmed, the use of biological drugs such as tumor necrosis factor inhibitors, which selectively block a proinflammatory cytokine and small molecules such as JAK inhibitors, that target entire inflammatory pathways could represent a possible therapeutic option. Two case reports have previously described cases of COVID-19 patients with inflammatory bowel diseases successfully treated with anti–tumor necrosis factor drug2Dolinger M.T. et al.J Pediatr Gastroenterol Nutr. 2020; https://doi.org/10.1097/MPG.0000000000002809Crossref PubMed Scopus (112) Google Scholar or JAK inhibitor,3Jacobs J. et al.Inflamm Bowel Dis. 2020; : izaa093Google Scholar but the impact of these therapies on diarrhea has not yet been investigated. Putative Mechanisms of Diarrhea in COVID-19Clinical Gastroenterology and HepatologyVol. 18Issue 13PreviewWe read with much interest the article "Diarrhea During COVID-19 Infection: Pathogenesis, Epidemiology, Prevention and Management" published by D'Amico et al1 in Clinical Gastroenterology and Hepatology. The article highlights the importance of gastrointestinal symptoms in coronavirus disease 2019 (COVID-19), which are increasingly being recognized. In this article, the authors report that the frequency of diarrhea in COVID-19 could be as high as 50%. They also elaborated on the role of angiotensin-converting enzyme 2 (ACE-2) receptors in severe acute respiratory syndrome–associated coronavirus 2 (SARS-CoV-2)–induced diarrhea. Full-Text PDF
Unusual presentation of leiomyosarcoma of duodenum
Authors: M. O. Perry
Journal: JAMA (1966)

LEIOMYOSARCOMAS of the duodenum are rare lesions, only 63 cases having been previously reported. The preoperative diagnosis of this neoplasm is particularly difficult and is often made by exclusion.<sup>1,2</sup>A 71-year-old woman who presented with signs and symptoms of acute peritonitis was recently treated. At laparotomy, the patient had a massive retroperitoneal hemorrhage, thought to arise from a ruptured aortic aneurysm. The source of bleeding, however, proved to be an extraluminal duodenal leiomyosarcoma. This apparently is the first recorded case presenting in this manner. <h3>Report of a Case</h3> A 71-year-old Negro woman was admitted to Parkland Memorial Hospital with the chief complaint of abdominal pain of seven hours' duration. The patient had been in good health prior to admission when she had the sudden onset of epigastric pain which subsequently involved the entire abdomen. She had one episode of vomiting, but denied having diarrhea, fever, or chills. History was
The Right Time for a Heart Valve Replacement
Authors: Philip Huston Hutchens
Journal: JAMA Cardiology (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 Cardiology 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 Cardiology journal
Abstract P163: Racial, Gender and Regional Variation in Rates of Cardiovascular Hospitalization Among 9 Million US Veterans
Authors: Nirupama Krishnamurthi, Mary A Whooley
Journal: Circulation (2017)

Introduction: Little is known about population-level trends in rates of cardiovascular hospitalizations among U.S. Veterans. Recent adoption of a centralized Corporate Data Warehouse in the Veterans Health Administration (VHA) provides a new opportunity to evaluate trends in national rates of hospitalization among Veterans. We sought to determine the leading causes of cardiovascular (CV) hospitalization, and to compare national rates of CV hospitalization by age, gender, race, ethnicity, geographical distribution and year, among U.S. Veterans. Methods: We evaluated the electronic health records of all Veterans ≥18 years old that accessed VA healthcare services between January 1 2010 and December 31 2014. Among these 9,066,693 patients, we identified the 5 leading causes of CV hospitalization and compared rates of hospitalization by age, gender, race, ethnicity, geographical distribution and year. Results: The top 5 causes of CV hospitalization in VA hospitals were: chest pain (3.23 per 1,000 Veterans per year), coronary arteriosclerosis in native artery (2.36), congestive heart failure (1.82), atrial fibrillation (1.34) and acute sub-endocardial infarction (0.99). Overall, the rate of Veterans hospitalized for one or more of these CV conditions decreased over time, from 9.9 per 1000 Veterans in 2010 to 8.3 per 1000 Veterans in 2014. The odds of hospitalization due to any of the 5 conditions were higher in men vs. women (OR 1.73, p&lt;0.0001), in urban vs. rural areas (OR 1.15, p&lt;0.0001), and in the Southeast vs. Pacific regions (OR 1.08, p&lt;0.0001). As compared with Whites, odds of CV hospitalization were higher in Blacks (OR 1.34, p&lt;0.0001) but lower in Asians (OR 0.50, p&lt;0.0001). Racial, geographic and temporal differences in rates of hospitalization were also observed for each of the individual CV conditions. Conclusions: Among U.S. Veterans enrolled in the VA healthcare system, there is substantial variation in rates of CV hospitalization by age, gender, race, geographical distribution and year.
A quality-adjusted time without symptoms or toxicity (Q-TWiST) analysis of patients in CheckMate 649: Nivolumab plus chemotherapy versus chemotherapy as first-line treatment for advanced gastric cancer/gastroesophageal junction cancer/esophageal adenocarcinoma (GC/GEJC/EAC).
Authors: Ryan Sugarman, Marc Botteman, Nifasha Rusibamayila, Hiep Nguyen, Daniel Lin
Journal: Journal of Clinical Oncology (2022)

273 Background: In CheckMate 649 (CM 649), a randomized phase 3 trial of first-line treatment of advanced GC/GEJC/EAC, patients receiving nivolumab combined with chemotherapy (NIVO plus chemo) experienced superior overall survival (OS), progression-free survival (PFS), and maintained their HRQOL for longer duration versus chemo alone. In this analysis, we combined efficacy and HRQOL data from CM-649 into a single metric, quality-adjusted time without symptoms of disease progression or toxicity (Q-TWiST), to compare the net benefits of NIVO plus chemo versus chemo alone. Methods: In this analysis, OS was partitioned into three health states: time with grade 3/4 toxicity after randomization and before progression (TOX), time without symptoms of disease progression or toxicity (TWiST), and time from relapse or progression until death (ie, relapse, REL). Mean Q-TWiST was determined by multiplying each state’s duration with its utility (U) (U[TWiST], 1.0; U[TOX], 0.5; U[REL], 0.5). Relative Q-TWiST gains (calculated as Q-TWiST difference divided by chemo only OS) of ≥ 10% and ≥ 15% were defined as clinically important and clearly clinically important, respectively, based on established thresholds for clinical importance in prior Q-TWiST literature. Q-TWiST differences between treatments were calculated separately for patients whose tumors expressed PD-L1 CPS ≥ 5 and for all randomized. A threshold utility analysis assessed Q-TWiST differences by varying the TOX and REL utility between 0 and 1. Results: Compared with chemo alone, treatment with NIVO plus chemo was associated with Q-TWiST improvement of 2.8 months (95% CI 1.0-3.7; relative gain 20.6% [clearly clinically important]) in patients with PD-L1 CPS ≥ 5, and 1.8 months (95% CI 0.9-2.7; relative gain 12.7% [clinically important]) in all randomized patients, respectively. Threshold analyses showed that compared with chemo alone, treatment with NIVO plus chemo was associated with statistically significant Q-TWiST improvements exceeding minimum clinically important differences across the full range of TOX and REL utility values. Conclusions: Among previously untreated patients with GC/GEJC/EAC in CM-649, NIVO plus chemo significantly improved quality-adjusted survival compared with chemo alone. Q-TWiST gains with NIVO plus chemo were driven mostly by longer time patients experienced without symptoms of disease progression or toxicity (TWiST), and were associated with statistically significant and clinically meaningful gains. These Q-TWiST results provide further understanding of both a survival and quality of life benefit of NIVO plus chemo versus chemo alone, and may aid clinicians and patients in management decisions for this patient population.
Renewal of the International Immunodeficiency-Cancer Registry at the University of Minnesota
Journal: JNCI Journal of the National Cancer Institute (1984)

Renewal of the International Immunodeficiency-Cancer Registry at the University of Minnesota JNCI: Journal of the National Cancer Institute, Volume 73, Issue 6, December 1984, Page 1492, https://doi.org/10.1093/jnci/73.6.1492 Published: 01 December 1984
COVID-19 and diabetes: a co-conspiracy?
Authors: None The Lancet Diabetes & Endocrinology
Journal: The Lancet Diabetes & Endocrinology (2020)

COVID-19 and diabetes: a co-conspiracy?Patients with diabetes have been in the spotlight since the early stages of the pandemic, as growing epidemiological data have revealed they are at higher risk of severe clinical outcomes of COVID-19.In light of these findings, several diabetes federations around the world have issued statements and provided resources to help patients with diabetes to better understand their risk of COVID-19 and how to more efficiently manage their condition.In May, 2020, with the understanding that the evidence base was still a moving target but that guidance for clinicians was urgently needed, an international panel of experts in the field of diabetes and endocrinology published in The Lancet Diabetes & Endocrinology practical recommendations for the management of diabetes during the pandemic.However, epidemiological data and guidance on COVID-19 and diabetes have focused almost exclusively on type 2 diabetes.In this issue of The Lancet Diabetes & Endocrinology, we publish research assessing the absolute and relative risks of COVID-19 related mortality by type of diabetes in more than 61 000 000 individuals in England.After adjusting for key confounders, such as age, sex, ethnicity, index of multiple deprivation, and geographical region, the odds for in-hospital deaths with COVID-19 were 3•51 (95% CI 3•16-3•90) for people with type 1 diabetes and 2•03 (1•97-2•09) for people with type 2 diabetes compared with people without diabetes.Understanding which risk factors might have a role in the increased severity of COVID-19 in patients with diabetes is a priority for clinical practice and public health.A companion paper published in the same issue used a national dataset linked to national civil death registrations covering 98% of general practices in England to investigate the associations between various risk factors and COVID-19-related mortality in people with both types of diabetes.The authors confirmed the independent associations of several risk factors, such as age, sex, ethnicity, and socioeconomic deprivation, with COVID-19-related death.Importantly, the study also shows that the risk of COVID-19-related mortality is significantly and independently related to hyperglycaemia in people with either type of diabetes.Hyperglycaemia can impair host defences, and poor glycaemic control has been associated with infections.Given that glycaemic control is a modifiable factor
Resistance to activated protein C and factor V Leiden mutation are risk factors for cardiovascular events in treated hypertensive: A five-year follow-up program Thomas K. Makris, Antonios N. Hatzizacharias, Panagiota G. Krespi, George Anastasiadis, George A. Stavroulakis, Argyri Gialeraki, Emmanuel Chronakis, Nicoalos A. Chatzizacharias, Michael K. Kyriakidis. LAIKON General Hospital, Athens, Greece
Journal: Journal of the American College of Cardiology (2001)
A phase II study of pembrolizumab, binimetinib, and bevacizumab in patients with microsatellite-stable, refractory, metastatic colorectal cancer (mCRC).
Authors: Tyler Friedrich, Patrick Jud Blatchford, Robert William Lentz, S. Lindsey Davis, Sunnie S. Kim, Alexis Diane Leal, Zoe Van De Voorde, Matthew R Lee, Meredith Waring, Tiffany Cull, Anne Martin, S. Gail Eckhardt, Wells A. Messersmith, Christopher Hanyoung Lieu
Journal: Journal of Clinical Oncology (2022)

118 Background: To date, immune-checkpoint inhibition for microsatellite stable (MSS) mCRC has been ineffective, though targeted therapy combination strategies may be promising. This phase II, investigator-initiated trial (NCT03475004) was designed to evaluate the efficacy and safety of the three-drug combination of pembrolizumab (pembro), binimetinib, and bevacizumab in patients with advanced, MSS treatment-refractory colorectal cancer. Methods: Patients with mCRC locally determined to be MSS and whom have progressed on two prior lines of therapy were enrolled. Treatment consists of pembro (200 mg every 3 weeks), binimetinib (45 mg BID) and bevacizumab (7.5 mg/kg every 3 weeks) until disease progression or unacceptable toxicity. The primary endpoint is PFS using RECIST v1.1 by investigator review. Additional endpoints include objective response rate, disease control rate at time of first re-staging (2 mo), duration of response, and safety and tolerability. Results: 50 patients have been enrolled (accrual is completed). 53% of patients are male and the mean age is 53.6 (range 31-79). The mean number of prior therapies is 5.3. At the time of preliminary data review, 39 patients are evaluable for response data. The median PFS was 5.8 mo (95% CI 4.2 to 8.9). The objective response rate was 13% with 5 partial responses. 24 patients (62%) had stable disease and 10 (26%) had progressive disease as the best response. The disease control rate at the time of first re-staging was 74%. Median duration of response was 6.5 mo. 19 (40%) patients experienced serious adverse events; the most common grade ≥3 adverse events included transaminase elevation (15%), diarrhea (11%), acneiform rash (9%), hypertension (9%), and anemia (9%). Conclusions: Preliminary results from this phase II study indicate that this regimen of pembrolizumab, binimetinib, and bevacizumab has promising activity and acceptable tolerability in this heavily pre-treated population of patients with MSS metastatic colorectal cancer. Final results will be presented as well as ongoing correlative studies. Clinical trial information: NCT03475004.
Other Books
Journal: JAMA (1964)

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
Aortic sclerosis, inflammation, and adverse cardiac events at 12 months: A prospective study Harish R. Chandra, Nivedita Choudhary, Carol O'Neill, Peter B. George, Sreenivasulu R. Gangasani, Lynn Cronin, Pamela A. Marcovitz, William W. O'Neill. William Beaumont Hospital, Royal Oak, MI
Journal: Journal of the American College of Cardiology (2001)
A natural history of gastroenteropancreatic neuroendocrine tumors evaluated at a tertiary cancer center: An observational study of 2,067 cases.
Authors: Benjamin Daniel Powers, Yaser Ahmad, Gabriel Diaz, Ozlem Tarhan, Taymeyah E. Al-Toubah, Mintallah Haider, Jason B. Fleming, Jonathan R. Strosberg, Daniel A. Anaya
Journal: Journal of Clinical Oncology (2022)

508 Background: Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are the second most prevalent digestive cancer and are increasing in incidence. With relatively indolent tumor growth, survival is often long, even for patients with metastatic disease. However, few studies have assessed long-term survival. Therefore, we analyzed the overall survival (OS) of a cohort of GEP-NET patients at a tertiary cancer center from 2000-2015. Methods: 2,707 patients with a pathologic diagnosis of GEP-NET were identified. 640 patients presented for second-opinion visits and were excluded, leaving 2,067 patients, of whom, 2,053 had vital status data for analysis. Primary sites included jejunum/ileum (small bowel), pancreas, gastric, colorectum, appendix, duodenum, and unknown. OS time was calculated from the date of pathologic diagnosis to the date of last follow-up or death. The reverse Kaplan-Meier method was used to calculate follow-up time. Vital status was identified through linkage to the Florida Cancer Registry. Kaplan-Meier (KM) curves and log-rank test were used for OS analyses. Results: The median age of the cohort was 60.7 years. The median follow-up time was 148.9 months (12.4 years). 1,431 (69.2%) patients presented with distant metastatic disease. Most patients, 1,351 (65.5%), underwent treatment at another facility before presentation. The median OS was 132.2 months (11.0 years) for the cohort and was 108.0 and 245.5 months for patients presenting with and without metastasis, respectively (p &lt; 0.001). For metastatic patients, unknown primary tumor site was associated with the worst median OS (55 months), followed by rectal (77 months), gastric (84 months) and pancreatic (85 months; p &lt; 0.001). Duodenal and small bowel had the longest median OS at 147 and 143 months, respectively. Surgery for metastatic disease had an OS benefit (155.7 months) compared to no surgery (98.3 months). Conclusions: In a large cohort of predominantly metastatic GEP-NET patients with extended follow-up time, median OS was over 11 years and 9 years for patients with metastatic disease. These results suggest that OS at a tertiary cancer center may be greater than historical national administrative analyses when given adequate follow-up time, which is important to avoid bias in survival estimates.[Table: see text]
Commentary
Authors: Klaus Mönkemüller
Journal: Endoscopy (2020)

Obtaining tissue from the biliary tract using standard biopsy forceps may be cumbersome. The authors present a tunneling technique, wherein a dilating catheter is first inserted first into the bile duct, and then the forceps is pushed through the “tunnel” catheter into the bile duct. This technique enables easy access by forceps into the biliary tract, as compared with the free biopsy cannulation technique, which is quite difficult as the forceps tip is stiff and has a 70 – to 90-degree angle from the duodenoscope.
A PROPOSED NEW MEDICAL HOME.
Journal: JAMA (1893)

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
Tuberous Sclerosis
Authors: Fritz E. Dreifuss
Journal: JAMA (1989)

This book requires no introduction. The first edition was published in 1979 and was for years the ne plus ultra concerning information on tuberous sclerosis, based in large part on the comprehensive medical records system of the Mayo Clinic, which allowed Dr Gomez access to a large number of well-studied patients with this disorder. The rationale for a second edition published nine years later requires no defense. There have been major advances in disciplines critical to better understanding of tuberous sclerosis. These include neuroimaging, molecular genetics, and histopathology. The embracing concept of phakomatoses or neuroectodermal dysplasias, derided by Critchley in his foreword to the first edition, has received a formal coup de grace by the confirmation that not only are neurofibromatosis and tuberous sclerosis entirely distinct genetic entities by virtue of their location on the human genome, but that, moreover, the distinctions among various forms of neurofibromatosis are now confirmed