tbuckley/cabot-search huggingface dataset:
Outcome of colorectal cancer (CRC) patients resected for brain metastases (BM)
Authors: E. Zanon, G. Aprile, F. Tuniz, F. De Pauli, E. Iaiza, N. Pella, M. Saman, M. Skrap, G. Fasola, A. Piga
Journal: Journal of Clinical Oncology (2007)

14530 Background: Advances in systemic treatment for metastatic CRC confer survival advantage, allowing patients to reach a median survival of almost 2 years. As a consequence of this remarkable life extension, the incidence of BM from CRC, though still low, is increasing over time. The presence of BM is considered an index of poor prognosis, even when surgical resection is possible. Methods: To determine if an aggressive approach to BM from CRC could provide patients with clinical benefit or survival advantage, we retrospectively collected data from 29 CRC patients who underwent neurosurgical resection of BM between March 1998 and July 2006. Results: The median age at the time of surgical procedure was 65 years, median ECOG PS was 1, and the majority of patients (26 out of 29) had concomitant metastases at other sites. Lung and liver metastases were both common. Median number of previous chemotherapy regimens was two, with almost all of the patients being exposed both to oxaliplatinum and irinotecan-based regimens. After resection, 30 Gy of external whole-brain radiotherapy were administered to the majority of the patients. At the time of the analysis, 26 out of 29 patients had died, with a median survival time after brain metastasectomy of 210 days (8–682). Only 2 patients died within a month from surgery. We did observe prolonged survival for patients who received post-surgical radiotherapy (Kaplan Maier, p=0.033). Although death due to encephalic progression was reported for the patients with brain as the sole metastatic site, intracranial disease progression was not a clear predictor for poor survival in the whole cohort (p&gt;0.05). Conclusions: Surgical resection of BM from CRC, whether followed by radiotherapy or not, is a feasible and safe technique, offering a chance of prolonged survival. Patients who received radiotherapy after complete neurosurgical resection have a better outcome. No significant financial relationships to disclose.
The Potential for Reducing the Number of Pneumococcal Conjugate Vaccine Doses While Sustaining Herd Immunity in High-Income Countries
Authors: Stefan Flasche, Albert Jan Van Hoek, David Goldblatt, W. John Edmunds, Katherine L. O’Brien, J. Anthony G. Scott, Elizabeth Miller
Journal: PLoS Medicine (2015)

Points• In high-income countries, pneumococcal conjugate vaccines induce strong herd protection that leads to near elimination of vaccine-type disease in vaccinated and unvaccinated alike.• In settings with minimal exposure to pneumococcal vaccine types, individual protection from pneumococcal conjugate vaccine (PCV) is rarely required, and the majority of disease episodes are prevented by controlling vaccine-type transmission.• Following the control of pneumococcal vaccine-type disease and colonisation through vaccination, a PCV schedule with a single priming and a booster dose may be sufficient to sustain that control at reduced costs and should be evaluated.
Ovarian ablation (OA) in pre-menopausal women with early breast cancer prescribed 5 years tamoxifen (T) or T plus chemotherapy (CT)–results from the UK NCRI Adjuvant Breast Cancer (ABC) international trial of 2,144 patients
Authors: J. R. Yarnold, J. M. Bliss, H. Earl, D. George, D. Lawrence, S. H. Mortazavi, T. J. Perren, V. Raina, D. Spooner
Journal: Journal of Clinical Oncology (2004)

535 Background: Substantial survival benefits are reported in women aged <50 with early stage ER positive breast cancer (BC) after OA as a single modality. The additional benefits of OA against a background of long term T or T plus CT in this group are unclear. Methods: The ABC trial is a pragmatic randomised phase III trial. One aspect of ABC compared OA (given as surgery, radiotherapy, or LHRH agonists) vs. none in patients diagnosed with early stage (1–3a) BC. All patients were prescribed 20mg T for 5 years. Elective CT was allowed. Main endpoints: relapse-free survival (RFS) and overall survival (OS). Results: During 1993 to 2000, 2144 (1063 OA, 1081 no OA) patients were randomised from 106 UK and 16 non-UK centres. Pre-treatment characteristics were well-balanced. In total 61% patients were age 41–50 years, 64% node positive, and 68% oestrogen receptor (ER) positive. 89% patients received OA as allocated. OA was given by radiotherapy (69%), surgery (23%) and LHRH agonists (8%). 80% patients received CT (mostly CMF). Results are based on median follow-up of 4.7 years, 565 relapses and 418 deaths. No statistically significant difference was seen in RFS (HR 0.98, 95%CI 0.83–1.16, p=0.81) or OS (HR 0.96, 95%CI 0.79–1.16, p=0.64). No differences were seen by adjustment or in subgroups based on age, nodal status or hormonal status. In addition there was no suggestion of a benefit in RFS (HR 0.95, 95%CI 0.62–1.43, p=0.80) or OS (HR 1.04, 95%CI 0.62–1.73, p=0.88) in the 427 patients randomised against a background of T alone. Conclusion: In this first study to report the added impact of adjuvant OA against a background of 5 years T, no effect of OA on RFS or OS was seen overall or in any sub-group taking 5 years T. No significant financial relationships to disclose.
Abstract 4606: Appetite Ratings on Single-item Visual Analog Scale Identify Patients with Heart Failure at Risk for Malnutrition
Authors: Terry A Lennie, Seongkum Heo, Susan J Pressler, Sandra B Dunbar, Misook L Chung, Eun Kyoung Song, Debra K Moser
Journal: Circulation (2008)

Background : Patients with heart failure (HF) are at risk for malnutrition due to multiple factors. A simple, clinically feasible tool to identify risk for malnutrition is needed. Visual analog scales have been used in studies on appetite but it is unknown whether an appetite scale can be used to identify patients with HF at risk for malnutrition. Purpose : To determine whether differences in kcal and protein intake could be identified in patients with HF grouped by their appetite rating. Method : A total of 137 patients (63% male, 60 ± 12 years, 56% NYHA class III/IV, ejection fraction (39 ± 14%) were recruited from outpatient HF clinics in the Midwest and South. Patients provided detailed 4-day food diaries that were reviewed by a registered dietitian to verify serving sizes and preparation methods and to obtain missing information. Patients were also asked to rate their appetite over the 4 days of diet recording on a 10 mm visual analog with anchors of “no appetite” and “extremely good appetite” Diaries were analyzed by Nutrition Data Systems software. Three series of between-group comparisons of kcal and protein (total and referenced to kg body weight) were made by t-tests using 4 mm (below midpoint), 5 mm (mid-point), and 6 mm (above mid-point) cut-points. Results : Significant differences in kcal and protein intake were identified between groups using the 6 mm cut point. A total of 36% of the patients had low appetite ratings (&lt;6mm). Patients with low appetite ratings consumed 20% fewer total kcals (1555 vs. 1936 kcal, p = .001) and 23% fewer kcal/kg (18 vs. 22 kcal, p = .005) than those with high ratings. The low appetite group also consumed 24% less protein than the high appetite group (62 g vs. 82 g, p = .001). The .71 g/kg protein intake of the low appetite group was below the recommended .8 g/kg protein intake for adults. In contrast, the .91 g/kg protein intake of the high appetite group was above the recommended level. Conclusion : Patients with lower appetite ratings had kcal and protein intakes below recommended levels while those with high appetite ratings had adequate intake. These results provide evidence that rating appetite on a visual analog scale may be a simple tool that could be used clinically to identify patients with HF at risk for malnutrition. This research has received full or partial funding support from the American Heart Association, AHA Great Rivers Affiliate (Delaware, Kentucky, Ohio, Pennsylvania &amp; West Virginia).
Dietetics and Nutrition.
Authors: Maude A. Perry
Journal: JAMA (1931)

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
Abstract 003: Effects of Saturated, Polyunsaturated, and Monounsaturated Fat on Blood Glucose, Insulin Sensitivity, and <sup>2</sup> Cell Function: A Systematic Review and Meta-analysis of 84 Randomized Controlled Feeding Trials
Authors: Fumiaki Imamura, Renata Micha, Jason H Wu, Marcia C de Oliveira Otto, Fadar O Otite, Ajibola I Abioye, Dariush Mozaffarian
Journal: Circulation (2013)

Background: Effects of saturated fat (SFA), monounsaturated fat (MUFA), and polyunsaturated fat (PUFA) on blood glucose, insulin sensitivity (IS), and β cell function are not well established. Aim: To systematically quantify the effects of dietary fats on glucose homeostasis in randomized controlled feeding trials (RCTs). Methods: Using PRISMA guidelines, we systematically searched 11 databases for RCTs testing effects of isocaloric diets of varying dietary fat composition on glucose-insulin metrics in adults. We excluded RCTs of supplements or diet advice rather than provision of diets. Data were extracted independently and in duplicate. Using multivariate meta-regression, we estimated dose-response effects of isocaloric exchange of major macronutrients (SFA, MUFA, PUFA, carbohydrate [CHO]), adjusting for protein and fiber, and assessed heterogeneity (α=0.001 adjusted for multiple testing) by prespecified factors. Results: Of 3,661 identified abstracts, 84 RCTs met inclusion criteria, comprising 195 diet arms in 4,837 adults (19-74 y). Replacing CHO with SFA raised fasting glucose (FG), while MUFA and PUFA lowered FG ( Table ). Findings were concordant for HbA1C. Effects on FG were strongest in diabetics and Asians (P interaction&lt;0.001 each); interactions for HbA1c were not statistically significant. Significant effects were not seen on IS or β cell indices by intravenous tests, although fewer RCTs evaluated such tests. Conclusions: SFA raises, while MUFA and PUFA reduce FG and HbA1c. Effects are stronger in diabetics and Asians. Our meta-analysis provides robust quantitative evidence on effects of major dietary fats on glucose-insulin metrics, directing further research and dietary guidelines.
Abstract 4098: Epicardial Amiodarone-Releasing Hydrogel Reduces Inducibility of Atrial Fibrillation in Goats
Authors: Robert W Bolderman, Rob J Hermans, Leonard M Rademakers, Tim S Jansen, Monique M De Jong, Peter Bruin, Aylvin A Dias, Frederik H Van der Veen, Jos G Maessen
Journal: Circulation (2008)

Amiodarone (AM) is one of the most effective anti-arrhythmic drugs to prevent postoperative atrial fibrillation (AF). However, due to systemic side effects, prophylactic AM therapy is only appropriate for patients at high risk for postoperative AF. This study addressed the hypothesis that local epicardial delivery of AM produces therapeutic myocardial drug concentrations, while systemic levels remain low. Goats (n=14) were instrumented with right atrial epicardial patch electrodes, and a PEG-based hydrogel with AM (1 mg/kg bw) (n=9) or without drug (n=5) was applied to the right atrial epicardium. AF inducibility was assessed up to 28 days in awake goats by applying burst stimuli. Myocardial and plasma AM concentrations were analysed by HPLC. AM-hydrogel produced higher subepicardial than subendocardial drug concentrations, which both remained therapeutic up to 21 days after hydrogel application (fig. 1a ). In this period, AF inducibility was significantly lower in the AM-hydrogel group compared to hydrogel alone (fig. 1b ; p&lt;0.05). Plasma AM and metabolite levels were below detection limits (&lt;30 ng/L) during the 28-day follow-up. Epicardial AM-releasing hydrogel produces sufficient myocardial drug concentrations to reduce AF inducibility up to 3 weeks, whereas plasma drug levels remain undetectably low. This study demonstrates that local delivery of anti-arrhythmic drugs is a feasible approach to obtain therapeutically effective myocardial drug concentrations, while minimizing risk for systemic side effects. Locally applied AM-releasing hydrogel may be a novel strategy to prevent postoperative AF. Figure 1a. Amiodarone Distribution in Right Atrium (n=5) Figure 1b. AF Inducibility After Hydrogel Application (mean + SD)
Interim results of two prospective trials measuring plasma total DNA and methylated genes before and after surgery, or chemotherapy, in patients with non-small cell lung cancer (NSCLC)
Authors: C. G. Azzoli, S. Park, P. Ginex, A. Vincent, J. Jones, E. Venkatraman, K. Danenberg, P. Danenberg, V. R. Rusch, M. G. Kris
Journal: Journal of Clinical Oncology (2006)

7123 Background: Measuring DNA in plasma using quantitative RT-PCR is a promising method for surveillance of NSCLC. This strategy has the potential to assess response more accurately or quickly than radiologic tests, or to confirm the success of surgical resection and select patients for adjuvant therapy. Methylated genes may be more specific than total DNA for the presence of cancer. Methods: We are conducting two prospective trials measuring total DNA, and 10 commonly hypermethylated genes in the plasma of NSCLC patients before and after therapy. For patients undergoing surgery, plasma samples are collected before, and at three timepoints after surgery (3–8 d, 2–5 w, 2–4 m). For patients on chemotherapy, collections are before, and coincident with up to 3 radiologic response assessments. DNA is extracted from a fixed volume of plasma, and measured using quantitative PCR of the β-Actin gene. After treating DNA with sodium metabisulfite, methylation-specific RT-PCR is performed to amplify the promoter region of APC, p16, MGMT, GSTP1, DAPK, CDH1, RASSF1A, WIF-1, SOCS-3, METH-2, assuming the promoter is fully methylated. Gene levels are normalized to β-Actin in modified DNA. Results: To date, plasma analysis has been completed on 50 patients with advanced NSCLC undergoing chemotherapy (320 planned), and 60 patients with early-stage NSCLC undergoing surgery (400 planned). Pretreatment levels of total DNA are higher in metastatic NSCLC (median 9.2, range 2.2–1020 ng/ml) compared to early-stage (median 3.6, range 0–1280 ng/ml), p &lt; 0.001 by Wilcoxon rank sum test. At least one methylated gene is detectable in pretreatment plasma in 36% of patients with metastatic NSCLC, and 20% of patients with early-stage NSCLC. Conclusions: Methylated genes are rarely found in the pre-treatment plasma of NSCLC patients in this experiment, despite testing a panel of 10 genes. Plasma total DNA levels correlate with NSCLC stage. Correlation of baseline levels of total DNA, and temporal trends during treatment, to overall survival and radiologic response are planned. Supported by R01-CA092315. [Table: see text]
Tuberkulöse Infektion und Augenleiden.
Authors: F. Schieck
Journal: JAMA (1933)

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
Genomic and genetic characterization of human Cholangiocarcinoma identifies treatment options for tyrosine kinase inhibitors
Authors: Jesper B. Andersen, Bart Spee, Boris Blechacz, Itzhak Avital, Mina Komuta, Andrew Barbour, Tania Roskams, Lewis R. Roberts, Valentina M. Factor, Snorri S. Thorgeirsson
Journal: Hepatology (2011)
Organochlorine Compounds and Ultrasound Measurements of Fetal Growth in the INMA Cohort (Spain)
Authors: Maria-Jose Lopez-Espinosa, Mario Murcia, Carmen Iñiguez, Esther Vizcaino, Olga Costa, Ana Fernández-Somoano, Mikel Basterrechea, Aitana Lertxundi, Mònica Guxens, Mireia Gascon, Fernando Goñi-Irigoyen, Joan O. Grimalt, Adonina Tardón, Ferran Ballester
Journal: Environmental Health Perspectives (2015)

Several studies have reported decreases in birth size associated with exposure to organochlorine compounds (OCs), but uncertainties remain regarding the critical windows of prenatal exposure and the effects on fetal body segments.We examined the relationship between prenatal OC concentrations and fetal anthropometry.We measured 4,4´-dichlorodiphenyldichloroethylene (4,4´-DDE), hexachlorobenzene (HCB), and polychlorinated biphenyl (PCB) congeners (138, 153, and 180) in 2,369 maternal and 1,140 cord serum samples in four Spanish cohorts (2003-2008). We used linear mixed models to obtain longitudinal growth curves for estimated fetal weight (EFW), abdominal circumference (AC), biparietal diameter (BPD), and femur length (FL) adjusted by parental and fetal characteristics. We calculated standard deviation (SD) scores of growth at 0-12, 12-20, and 20-34 weeks of gestation as well as size at gestational week 34 for the four parameters. We studied the association between OCs and the fetal outcomes by cohort-specific linear models and subsequent meta-analyses.PCBs were associated with a reduction in AC up to mid-pregnancy, and BPD and FL from gestational week 20 onward. An inverse association was also found between HCB and AC growth in early pregnancy. The reduction of these parameters ranged from -4% to -2% for a doubling in the OC concentrations. No association between 4,4´-DDE and fetal growth was observed.To our knowledge, this is the first study to report an association between prenatal exposure to some PCBs and HCB and fetal growth: AC during the first two trimesters of pregnancy, and BPD and FL later in pregnancy.Lopez-Espinosa MJ, Murcia M, Iñiguez C, Vizcaino E, Costa O, Fernández-Somoano A, Basterrechea M, Lertxundi A, Guxens M, Gascon M, Goñi-Irigoyen F, Grimalt JO, Tardón A, Ballester F. 2016. Organochlorine compounds and ultrasound measurements of fetal growth in the INMA cohort (Spain). Environ Health Perspect 124:157-163; http://dx.doi.org/10.1289/ehp.1408907.
Uterine involvement with metastatic epithelial ovarian cancer is a predictor of poor survival
Authors: F. AbuShahin, M. Catenacci, C. Michener, J. Belinson, K. Zanotti
Journal: Journal of Clinical Oncology (2008)

16521 Background: The objective of this study is to evaluate the frequency of uterine involvement with metastatic epithelial ovarian cancer and its association with survival. Methods: This is a retrospective review of the medical records of patients diagnosed with epithelial ovarian cancer (EOC) or primary peritoneal carcinoma (PPC) between 1995 and 2005. Exclusions were patients who: had a prior hysterectomy, did not have a hysterectomy at the time of the initial debulking, recieved neoadjuvant chemotherapy, had stage I cancer. Statistical analysis was performed using the JMP6 software to compare progression-free survival and overall survival between patients with and without uterine involvement with metastatic EOC. Uterine involvement was defined as the presence of metastatic EOC in the serosa, myometrium, endometrium or cervix. Results: One hundred and forty-eight patients with EOC (89.2%) or PPC (10.8%) were eligible. The median age was 58.9 (29.8 -88.5). Seventeen patients (11.5%) had stage II, 114 (77%) had stage III, and 17 (11.5%) had stage IV. Optimal debulking (<1cm residual disease) was achieved in 74.6% of patients. Adjuvant chemotherapy regimens were combination carboplatin and paclitaxel in 103 patients (70%), other platinum based combinations in 37 patients (25%), and single agent regimens in 8 patients (5%). The uterus was involved with metastatic disease in 85 patients (57.4%). Uterine involvement was more frequent in patients with suboptimal debulking (79.4%) than in patients with optimal debulking (49.5%), p= 0.001. Progression-free survival and overall survival were significantly longer in patients with no uterine involvement than in patients with uterine involvement (mean 37.6 vs 21.5 months, p= 0.03) and (mean 75.1 vs 44.3 months, p= 0.004) respectively. On multivariate analysis and after controlling for stage and debulking status, uterine involvement was an independent predictor for overall survival p= 0.02 and trended toward significance with progression-free survival p= 0.08. Conclusions: Uterine involvement with metastatic EOC correlates with poorer overall survival, independent of stage and debulking status. This correlation may reflect inherent tumor aggressiveness and chemoresistance. Larger studies are needed to confirm our findings. No significant financial relationships to disclose.
Hyperglycemia and the Lung
Authors: R. J. Cusack, J. Ball, B. J. Philips
Journal: Intensive Care Medicine (2003)

An estimated 150 million people worldwide have diabetes [1]. A further 200 million have glucose intolerance and 40% of these will become diabetic over 5–10 years. By 2010 it is expected there will be 220 million diabetics, the majority of who will have type II diabetes, an increase compounded by an increasing prevalence of obesity and sedentary habit. The potential morbidity and mortality has serious worldwide economic implications [2].