tbuckley/cabot-search huggingface dataset:
Cost-effectiveness of chimeric antigen receptor T-cell therapy in multiply relapsed or refractory adult large B-cell lymphoma.
Authors: John Lin, Lori S. Muffly, Michael Alexander Spinner, James I Barnes, Douglas K. Owens, Jeremy D Goldhaber-Fiebert
Journal: Journal of Clinical Oncology (2019)

7561 Background: Two anti-CD19 chimeric antigen receptor T-cell therapies are approved for large B-cell lymphoma (DLBCL): axicabtagene ciloleucel (axi-cel) and tisagenlecleucel. Each costs $373,000 (wholesale acquisition). We evaluated each therapy’s cost-effectiveness. Methods: A decision analytic Markov model evaluated axi-cel and tisagenlecleucel in multiply relapsed/refractory adult DLBCL from a US health-payer perspective over a lifetime horizon. The model was informed by recent multi-center, single-arm clinical trials. Under a range of plausible long-term effectiveness assumptions, axi-cel and tisagenlecleucel were each compared with salvage chemoimmunotherapy regimens and stem-cell transplantation. Main outcomes were un-discounted life-years, discounted lifetime costs, discounted quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio (3% discount rate). Sensitivity analyses explored uncertainty. Results: In an optimistic scenario, assuming 40% five-year progression-free survival (PFS), axi-cel increased life-expectancy by 8.15 years at $129,000/QALY (95% UI: $90,000-215,000/QALY) gained. At 30% five-year PFS, improvements in life-expectancy were more modest (6.4 years) and expensive ($159,000/QALY [$107,000-281,000/QALY] gained). In an optimistic scenario, assuming 35% five-year PFS, tisagenlecleucel increased life-expectancy by 4.6 years at $168,000/QALY ($104,000-453,000/QALY) gained. At 25% five-year PFS, improvements in life-expectancies were more modest (3.4 years) and expensive ($224,000/QALY [$124,000-1,190,000/QALY] gained). Administering CAR-T to all indicated patients would increase US healthcare costs by $10 billion over 5 years. Price reductions to $250,000 or payment only for initial CR or 90-day CR/PR (at current prices) would allow both therapies to cost &lt; $150,000/QALY down to 25% PFS. Conclusions: At current prices, it is possible that each CAR-T therapy may meet a &lt; $150,000/QALY threshold; this is dependent on long-term benefit compared with chemoimmunotherapy and SCT, which is uncertain. Widespread adoption would increase non-Hodgkin lymphoma healthcare costs substantially. Price reductions or payment for initial CR or 90-day CR/PR would favorably influence cost-effectiveness even if long-term outcomes are modest.
Book Review Poliomyelitis . A handbook for physicians and medical students. Based on a study of the 1931 epidemic in New York City. John F. Landon and Lawrence W. Smith. With a section on the orthopedic after-care of the disease by Garry DeN. Hough, Jr. 275 pp. New York: The Macmillan Company. $3.00.
Journal: New England Journal of Medicine (1936)
Massachusetts Department of Public Health
Authors: Claire F. Ryder, Vlado A. Getting
Journal: New England Journal of Medicine (1950)

The concept of multiphasic screening is not one person's idea, nor a new one, but has evolved logically during recent years from the discovery that individual screening clinics, in which the presence or absence of only one or two diseases is determined, are often costly, may lead to a feeling of false security in the patients screened and take too much time. One of the inherent errors of the present screening program is that the person who has been screened for heart disease, diabetes or cancer may believe (often erroneously) that he is free from other diseases. In addition, in . . .
New stratagems for dealing with Medicare's prospective payment system and other cost-containment measures
Authors: A Vosk
Journal: JAMA (1991)

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 Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal
FDA Regulation of Tobacco Advertising and Youth Smoking&lt;subtitle&gt;Historical, Social, and Constitutional Perspectives&lt;/subtitle&gt;
Authors: Lawrence O. Gostin
Journal: JAMA (1997)

Perspectives on tobacco control in American society have shifted markedly. As the view that smoking as a voluntarily assumed health risk has declined, the social and political environment has become more conducive to industry regulation. This transformation can be traced to the mounting evidence of the health risks of secondary smoke; the addictive quality of nicotine; the vulnerability and exploitation of young people; and industry knowledge of the harmful effects of tobacco. Regulation of tobacco advertising and promotions by the Food and Drug Administration (FDA) raises serious concerns about constitutional protection for commercial speech. However, the minimal informational value of tobacco advertising suggests that it should be afforded a low level of constitutional protection. The FDA regulations impose reasonable "time, place, and manner" restrictions, leave open alternative channels of communication, restrict messages that are harmful to the public health, do not restrict political speech, prevent misleading messages, and help deter the unlawful sale of tobacco products to minors. The regulations meet the traditional criteria for regulating commercial speech, in that the government's asserted interest is strong, the agency's regulations directly advance that interest, and the regulations are no more extensive than necessary. Thus, the judiciary should defend the FDA's historical social and legislative mission to protect the public health.
Promethazine Warning
Authors: Tracy Hampton
Journal: JAMA (2005)

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
Carcinoma of the Breast
Authors: Francis D. Moore, Steven I. Woodrow, Menelaos A. Aliapoulios, Richard E. Wilson
Journal: New England Journal of Medicine (1967)

Primary Treatment of the Localized DiseaseFor the past fifteen or twenty years, there has been an increasing tendency of surgeons to avoid mastectomy in locally advanced cases. This avoidance of radical mastectomy in unfavorable cases marks a distinct advance in the treatment of this disease, and is traceable to the work of many scholars of this subject, but particularly to the studies of Haagensen. He has developed a simple clinical classification of this disease and has emphasized the limitations of radical mastectomy.23 24 25 Haagensen's clinical classification, as employed in the analysis of this disease, should be based solely on the . . .
Characterization of initiated cells in N-methylnitrosourea-induced carcinogenesis of the CNS in the adult rat
Authors: D. M. Kokkinakis
Journal: Neuro-Oncology (2001)

A P R I L 2 0 0 1 99 Glial tumors may originate from the malignant transformation of multipotent glial progenitor cells, but tools to study malignant transformation leading to gliomas are limited by the lack of biological systems that represent early stages of this disease in adult animals.In order to characterize the initiated cells that give rise to gliomas, we have employed the N-methylnitrosourea (MNU) model for induction of brain tumors in adult rats (Rushing et al., 1998).Speci cally, we have isolated and cultured transformed (premalignant) cells from normal-appearing brains of rats exposed to MNU for 10 weeks and from histologically abnormal brains of rats exposed to MNU for 15 weeks.We compared them with cells cultured from control animals under identical conditions.Cultured cells were classi ed according to their morphology, immunophenotype, karyotype, proliferation capacity, and tumorigenicity in athymic mice.Cultures from untreated normal rat brains grew as monolayers and had normal karyotypes (42 X,Y), epithelioid morphology, and slow proliferative capacity (doubling time >120 h).In contrast, cultured cells from brains of MNU-exposed animals had karyotypes that ranged from normal to highly aneuploid.Aneuploid lines grew rapidly in multilayers (doubling time <24 h), had differentiated astrocytic or oligodendroglial morphology and immunohistochemical staining pro le, and yielded tumors in athymic mice.Initiated cells with minor chromosomal aberrations assumed mixed bipolar or tripolar morphologies in high density cultures, proliferated rapidly, but showed contact inhibition and failed to induce tumors when injected s.c. in athymic mice.In general, lines showing no evidence of chromosomal aberrations had the most epithelioid morphology, proliferated slowly (doubling time >72 h), and retained strict contact growth inhibition.The presumed undifferentiated glial progenitor cells in culture from either control or MNU-treated rats variably expressed markers such as vimentin, nestin, and NG2 proteoglycan, and they weakly expressed the mature astrocytic or oligoden-
"Humps" in acute nephritis.
Journal: BMJ (1967)

MEDBCAL JOURNAIconditions in Belfast, Alexandria, and Bombay, where the incidence of defects of the neural tube is high, might be well worth while.The effects of the high consanguinity and twinning rates in Alexandria would also repay further investi- gation.Two other large centres which are considered to be worth special study are Mexico City, where maternal diabetes seems to be unusually prevalent, and Singapore, because of the ethnic diversity of its inhabitants.But even without these developments this work will be well received everywhere as a welcome example of international co-operation in epidemio- logical research.
Medicare payment policy needs corrections
Authors: R. T. Matsui
Journal: JAMA (1985)

Congress has recently been confronted with the need to examine carefully the progress toward full implementation of the prospective payment system (PPS) for hospital services under the Medicare program. This review has been undertaken in the context of federal budget deficits that are rising very rapidly. With Medicare expenditures making up such a significant portion of the federal budget, it is difficult to separate the need for federal spending reductions from an objective evaluation of this new Medicare payment policy. Yet, I believe strongly that there are very compelling reasons for us to pause and take stock of what we have accomplished with the PPS and to determine what, if any, refinements are necessary before full implementation of this system. During the recent deliberations of the Ways and Means Committee, my proposal to extend the scheduled transition period in the PPS for one year was adopted. A bipartisan majority of
Abstract 995: A new thiadiazine derivative induces oxidative stress dependent JNK pathway activation and cell death in hepatocellular carcinoma
Authors: Deniz C. Kahraman, Ebru B. Guven, Birsen Tozkoparan, Rengul C. Atalay
Journal: Cancer Research (2019)

Abstract Hepatocellular carcinoma (HCC) is the fifth most common and the second lethal cancer worldwide. HCC is resistant to conventional chemotherapy and radiotherapy due to its highly heterogenous structure. Therefore, it is crucial to design and develop novel therapeutic strategies against HCC. Non-steroidal anti-inflammatory drugs (NSAIDs) have long been studied for the treatment of acute and chronic conditions with pain and inflammation. In recent years, evidence from various studies suggested that NSAIDs reduce the incidence and mortality of various types of cancers. Here, investigated the possible cytotoxic bioactivities of a series of triazolothiadiazine derivatives on HCC cells, which have been previously reported as potent analgesic/anti-inflammatory compounds. For this purpose, we first investigated the anticancer effect of our compounds bearing a triazolothiadiazine core. Initially, 30 compounds were tested against cancer cells. Among all the compounds, three of them (7a, 7b and 7c) showed noticeable cytotoxic activities within µM concentrations and were selected to be screened against a panel of HCC cell lines. Compound 7b was identified as a promising anti-cancer agent against liver cancer cells with cytotoxic doses (less than 5µM) assessed by both the SRB assay and RT-CES analysis and was analyzed with further in vitro and in vivo experiments to disclose the underlying mechanism of its action in HCC cells. Time- and dose- dependent growth inhibition upon treatment with compound 7b was observed due to cell cycle arrest at the G2/M phase and apoptosis. After detecting the activation of SAPK/JNK pathway, it was shown that ROS accumulation was triggering the downstream events and eventually apoptotic cell death. Furthermore, upon treatment with compound 7b, overall survival of xenografts increased, while the tumor size decreased compared to control groups. Additionally, we investigated the potential of this compound on liver cancer stem cell population (CD133+/EpCAM+) which are known to be responsible for drug resistance in HCC. Compound 7b was bioactive against LCSCs and decreased the ratio of CD133+/EpCAM+ population significantly in both Huh7 and Mahlavu cells. Altogether, the anti-tumor and anti-resistance effects of compound 7b approves that this small molecule can be considered as an anti-cancer agent for liver cancer therapeutics. Citation Format: Deniz C. Kahraman, Ebru B. Guven, Birsen Tozkoparan, Rengul C. Atalay. A new thiadiazine derivative induces oxidative stress dependent JNK pathway activation and cell death in hepatocellular carcinoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 995.
Asklepios and the Serpent Symbol
Journal: JAMA (1988)

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
Undocumented HIV Infection
Authors: Susan Andrews
Journal: Annals of Internal Medicine (1995)

Letters15 September 1995Undocumented HIV InfectionSusan Andrews, MD, Dominick Tammaro, MD, and Michael D. Stein, MDSusan Andrews, MDBrown University Rhode Island Hospital; Providence, RI 02903Search for more papers by this author, Dominick Tammaro, MDBrown University Rhode Island Hospital; Providence, RI 02903Search for more papers by this author, and Michael D. Stein, MDBrown University Rhode Island Hospital; Providence, RI 02903Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-123-6-199509150-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Craven and colleagues [1] recently suggested that policies should exist to document HIV infection before the initiation of care. Using a case–control design, these investigators obtained data from 7 index cases and 70 controls and found three factors associated with factitious HIV infection. We believe that their results may not be entirely reliable. The characteristics of the index cases found to be predictive of factitious HIV disease were based in part on historical information provided by those patients. However, because these historical factors (HIV-positive partner, history of attempted suicide) may also be falsely reported, their sensitivity or ...References1. Craven DE, Steger KA, La Chapelle R, Allen DM. Factitious HIV infection: the importance of documenting infection. Ann Intern Med. 1994; 121:763-6. Google Scholar Author, Article, and Disclosure InformationAuthors: Susan Andrews, MD; Dominick Tammaro, MD; Michael D. Stein, MDAffiliations: Brown University Rhode Island Hospital; Providence, RI 02903 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 September 1995Volume 123, Issue 6Page: 470KeywordsHIVHIV infectionsOpportunistic infectionsSuicide ePublished: 15 August 2000 Issue Published: 15 September 1995 Copyright & PermissionsCopyright © 1995 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Abstract 1772: Cardiomyocyte Damage-Released S100A1 Protein Evokes A Proinflammatory Phenotype In Cardiac Fibroblasts
Authors: David Rohde, Melanie Boerries, Herzog Nicole, Gang Qiu, Philipp Ehlermann, Peter P Nawroth, Hugo A Katus, Angelika Bierhaus, Karsten Peppel, Patrick Most
Journal: Circulation (2008)

Background: S100A1, a cardiomyocyte specific inotropic calcium sensor protein, is released from infarcted human myocardium in the extracellular environment and circulation, reaching peak serum levels (1–2 μM) 8–9 hours after clinical onset. As growing evidence indicates that S100 proteins can act as pre-existing danger signals triggering the innate immune system into action upon release from injured host cells, we hypothesized that damage-released S100A1 can act as a cardiac danger signal alerting innate immune cells. Methods and Results: Here we report for the first time that necrotic cardiomyocytes release S100A1 protein in vitro, which is exclusively internalized by cardiac fibroblasts (CFs) in a clathrin- and caveolin-independent manner as shown by IF. Internalized S100A1 specifically activated MAPKs/SAPKs (p38, ERK1/2 and JNK) resulting in nuclear translocation of p65 (NF-kB) as assessed by Western blotting, EMSA and IF. In turn, S100A1 triggered an inflammatory gene program in CFs including enhanced expression of adhesion molecules, integrins, chemokines and cytokines including I-CAM, V-CAM, CD11b/18, IL1-alpha, MCP-1, TNF-alpha, SDF-1 among others as obtained by RT-PCR, Western blotting and ELISA. This resulted in enhanced chemoattraction and adhesion of monocytotic and stem cells to S100A1-activated CF as shown by Boyden-chamber and adhesion assays. In line with their proinflammatory transition, S100A1-activated CFs exhibited decreased collagen-1/-3 expression and de-novo collagen production, enhanced collagenolytic MMP-9 abundance and activity and increased levels of the antiangiogenic matricellular factor thrombospondin-2 reflecting extracellular matrix net degradation. Importantly, the immun-modulatory and antifibrotic actions of S100A1 protein in vitro were restricted to CFs, RAGE independent and occurred at concentrations (0.1–1 μM) that were found in patients after AMI. Conclusion: Our in vitro results indicate that S100A1 has the properties of a pre-exisiting endogenous cardiomyocyte danger signal transforming cardiac fibroblasts into immunmodulatory cells that might recruit innate immune cells to the site of cardiac injury and link cardiomyocyte damage to post-MI inflammation.
Highlights
Journal: JAMA Surgery (2019)

Emergency Medical Service Response Time and Car Crash Death 286Motor vehicle crashes remain a leading cause of trauma-associated death.Emergency medical service response time is a factor that might influence survival.Using a novel linkage of public databases, Byrne and colleagues demonstrated a significant association between response times and car crash mortality in 2268 US counties.These findings suggest that trauma system performance improvement efforts should evaluate the potential contribution of response times to observed regional differences in car crash mortality.
The PROGRESS trial three years later: time for more action, less distraction (commentary)
Journal: BMJ (2004)

ConclusionsOur findings confirm advancing paternal age as a strong independent risk factor for schizophrenia and indicate that 15.5% of cases of schizophrenia in our cohort could be due to the patient having a father who was aged > 30 years at birth.We found a stronger association in subjects without a family history of schizophrenia, providing further evidence to support the theory that accumulating de novo mutations in the germ cells of older fathers might contribute to an increased risk of schizophrenia in their offspring.In England and Wales the average paternal age has increased from 29.2 years in 1980 to 32.1 in 2002. 20 Assuming a background annual incidence rate for schizophrenia of 10/100 000 21 and that the association is causal, our results suggest that the increase in paternal age since 1980 could account for 710 out of the 6633 new cases of schizophrenia diagnosed in the United Kingdom in 2002.
Dystonic symptoms in children. Treatment with carbamazepine
Authors: M. Geller
Journal: JAMA (1974)

Eight patients with dystonia, four with hereditary torsion dystonia and four with acquired dystonia, were treated with carbamazepine in doses ranging from 300 to 1,200 mg/day. Drowsiness was the only side effect and periodic blood cell counts remained normal. All have shown sustained improvement of some manifestations of their illness for periods up to one year. (<i>JAMA</i>229:1755-1757, 1974)