bluuebunny/crossref_metadata_2025_split huggingface dataset:
Molecular Profile and Clinical Variables in Brca1-Positive Breast Cancers. A Population-Based Study
Authors: Musolino Antonino , Michiara Maria , Bella Maria A. , Naldi Nadia , Zanelli Paola , Bortesi Beatrice , Capelletti Marzia , Soldani Linda , Camisa Roberta , Martella Eugenia , Franciosi Vittorio , Savi Mario , Neri Tauro M. , Ardizzoni Andrea , Cascinu Stefano 
Published: July 2019

Purpose To evaluate the clinical features of breast cancer patients with genetic susceptibility to this disease and to investigate the contribution of BRCA1 germline mutations to the phenotype of these tumors. Patients and Methods We reviewed the clinical and pathological records of 102 women with suspected inherited susceptibility to breast cancer consecutively seen at the Genetic Oncology Service of Parma, Italy. Sixty-two patients with a high probability of harboring a germline, cancer-predisposing mutation were tested for BRCA1 mutations. Exon 11 was screened using the protein truncation test and detected mutations were confirmed by direct sequencing (DS). All other exons were analyzed by DS. Results Among the 62 patients with a completed mutation analysis, 48 (77.4%) had wild-type BRCA1, six (9.6%) had variants of unclear significance, eight (13%) had deleterious mutations. BRCA1-associated breast cancers (BABC) were significantly less likely to be diagnosed at stage I than breast cancers in women without mutations (12.5% vs 51%; P = 0.045), more likely to have a high proliferation rate (100% vs 24%, P<0.001), and more likely to be histological grade 3 (100% vs 14%, P<0.001), estrogen and progesterone receptor negative (87.5% vs 13%, P<0.001; 75% vs 23%, P = 0.004), and p53 positive (87.5% vs 30%, P = 0.023). All tumors with BRCA1 mutations were HER-2/neu negative compared with 57% of the non-BRCA1 tumors ( P = 0.04). There were no significant differences between BABC and non-BABC in 20-year relapse-free survival, 20-year event-free survival, and 20-year overall survival. Conclusion In this population-based study, BABC seems to present with adverse molecular features when compared with non-BABC, although the prognosis appears to be similar.
Tumor Cyclooxygenase-2 Gene Suppresses Local Immune Responses in Patients with Hepatocellular Carcinoma
Authors: Iwamoto Akemi , Ikeguchi Masahide , Matsumoto Sachico , Hukumoto Youji , Inoue Masashi , Ozaki Tomohiro , Ataka Masayuki , Tanida Takashi , Endo Kanenori , Katano Kuniyuki , Hirooka Yasuaki 
Published: July 2019

Aims and Background In several neoplastic diseases including hepatocellular carcinoma (HCC) immunosuppression is correlated with disease stage, progression and outcome. Moreover, recent studies have demonstrated that cyclooxygenase-2 (COX-2) enhances tumor growth in HCCs. The present study analyzed the correlation between local immune responses and COX-2 gene expression levels in patients with primary HCCs. Methods Fresh tissues were obtained from 59 patients who underwent resection of an HCC. The COX-2 gene expression levels were quantified by real-time reverse transcriptase-polymerase chain reaction (RT-PCR) and compared with the CD8+ T cell densities detected by immunohistochemistry. Results COX-2 gene expression was detected in 35 of the 59 tumors. The CD8+ T cell density in COX-2-expressing tumors (6.1 cells/high-power field (HPF), x200 magnification) was suppressed compared with that in non-COX-2-expressing tumors (13.6 cells/HPF, P = 0.009). Tumor COX-2 gene expression was associated with a poorer disease-free survival rate. Conclusions Elevation of the tumor COX-2 level is correlated with the suppression of local immune responses in HCCs, suggesting that COX-2 plays a role in early tumor recurrence in the residual liver in patients after HCC resection.
Are Quality Indicators for Radiotherapy Useful in the Evaluation of Service Efficacy in a New Based Radiotherapy Institution?
Authors: Gabriele Pietro , Malinverni Giuseppe , Bona Cristina , Manfredi Manuela , Delmastro Elena , Gatti Marco , Penduzzu Giovanni , Baiotto Barbara , Stasi Michele 
Published: July 2019

Aims and background A number of documents assess the need for quality assurance in radiotherapy, which must be constantly monitored and possibly improved. In this regard, a system that confirms the quality of a department has been suggested and quality indicators have been used to improve the quality of the service. The National Health Service ( Istituto Superiore di Sanità) approved a National Research Project to increase the quality of radiotherapy. The aim of the present study was to analyze the practical feasibility and efficacy of the quality indicators elaborated by the National Health Service study group in a radiotherapy unit. Patients and methods The voluntary accredited program was carried out by the Radiotherapy Department of IRCC in Candiolo from June to August 2002. We analyzed 8 of the 13 indicators according to the National Health Service Project. For this purpose, 133 consecutive patients treated in our Unit were analyzed, and the results are reported according to the appropriate indicator (number of staff related to patients treated, waiting list, case history accuracy, multidisciplinary approach, number of treatment plans performed by CT, number of fields per fraction, number of portal imaging performed per overall treatment, and patient satisfaction). Results The number of professional staff related to the number of patients treated was easy to calculate and it could be the basis for further evaluation. The overall waiting time was 55.4 days, and it changed for different radiotherapy goals. We obtained 80% conformity in case-history accuracy. The number of multidisciplinary consultations performed ranged between 50% and 100%. The number of CT plans was about 1.6 ± 0.9 plans per patient. The mean number of fields performed per day and per patient is 3.5 ± 1.7 and was in agreement with the fact that more than 50% of treatments in our Center were performed with conformal radiotherapy. An average of 16.7 ±10.0 portal imaging per case was performed. The percentage of patient satisfaction with the staff obtained a very high compliance. Conclusions The self evaluation promoted by the National Health Service Project allows the monitoring of the activities of the service in order to asses critical factors and it can be the starting point to improve the quality of the service and to compare national and international quality assurance results.
Small Cell Lung Cancer in a Young Patient with Osteopetrosis
Authors: Fadda Giovanni Maria , Santeufemia Davide Adriano , Rocca Paolo Cossu , Costantino Salvatore , Sanna Giovanni , Sarobba Maria Giuseppa , Putzu Carlo , Rocca Maria Cossu , Pinna Maria Antonietta , Farris Antonio 
Published: July 2019

Background Osteopetrosis or Albers-Schonberg's disease is a heterogeneous group of rare hereditary troubles of the bone characterized by bone sclerosis due to an alteration of the bone reabsorption mediated by osteoclasts. The defect in the osteoclastic activity is responsible for complete or partial medullary cavities occlusion, with consequent reduced hemopoiesis, and for the excessive fragility of the affected bone segments. Case report We reported the case of a young man of 31 years affected by osteopetrosis in which a small cell lung cancer developed. Results Small cell lung cancer is a particularly rare neoplasm in the young, and even though it is highly sensitive to chemotherapeutic treatment its prognosis remains poor. The greatest clinical problem connected with chemotherapeutic treatment of patients affected by osteopetrosis is the variability of the reduction of their bone marrow reserve, which could expose them to an excessive hematological toxicity caused by the therapy. Conclusions The adoption of suitable prophylactic measures, such as the use of growth factors and drugs selected in relation to their toxicity or given in reduced doses, should be appropriately considered in these subjects.
Ascorbic Acid, Thiamine, and Steroids in Septic Shock: Propensity Matched Analysis
Authors: Sadaka Farid , Grady Justin , Organti Nikhil , Donepudi Bhargavi , Korobey Matthew , Tannehill David , O’Brien Jacklyn 
Published: July 2019

Introduction: We aimed to study the use of ascorbic acid, thiamine, and steroids (ATS) in patients with septic shock (SS). Methods: Data on 62 patients with SS were collected from Acute Physiologic and Chronic Health Evaluation (APACHE) Outcome database and medical records. The ATS group received full doses of intravenous (IV) ATS (ascorbic acid [1.5 g every 6 hours for 4 days], hydrocortisone [50 mg every 6 hours for 7 days], and thiamine [200 mg every 12 hours for 4 days]). Data included age, gender, APACHE III, acute physiologic score (APS), mechanical ventilation (MV), lactic acid (LA), serum creatinine (Cr), duration of vasopressors (VP, days, median: interquartile ranges [IQR]: [Q1, Q3]), MV-free days (median: IQR [Q1-Q3]), percentage of patients requiring renal replacement therapy (RRT) for acute kidney injury (AKI), and mortality. Propensity analysis was used to match patients on age, gender, MV, APACHE III, APS, LA, and Cr. Results: The ATS group had longer duration of VP (4.5: 4.0-6.0 vs 2.0: 1.0-2.0, P = .001), similar RRT for AKI (26% vs 29%, P = .8), similar MV-free days (10.2: 5.0-15.0 vs 10.2: 1.6-18.0, P > .9), lower intensive care unit mortality (9.6% vs 42%, P = .004), and a trend toward lower hospital mortality (29% vs 45%, P = .2) compared to the NO ATS group. Conclusions: The use of IV ascorbic acid, thiamine, and hydrocortisone might be beneficial in patients with SS.
Effectiveness of a Kansas City, Jail-Based Intervention to Improve Cervical Health Literacy and Screening, One-Year Post-Intervention
Authors: Emerson Amanda M. , Smith Sharla , Lee Jaehoon , Kelly Patricia J. , Ramaswamy Megha 
Published: July 2019

Purpose: To assess effectiveness, 1-year post-intervention, of a program delivered in jails with women to improve cervical health literacy (CHL) and up-to-date Papanicolaou (Pap) screening. Design: Pre-post design to evaluate Pap screening and CHL effects 1 year after our original randomized wait-list control study. Setting: Surveys conducted in Kansas City, 2015 to 2017 (baseline in 2014). Participants: Adult women (n = 133). Intervention: One-week (10-contact-hour), small-group, CHL program. Measures: Surveys to assess CHL components and up-to-date Pap screening. Analysis: χ2 and t tests, followed by best-subsets logistic regression using sociodemographic and CHL components to fit an optimal model for up-to-date screening 1-year post-intervention. Results: 73% (133/182) women retained at 1-year. From pre-intervention, 6 of 8 CHL components improved (.01 > P > .001). Up-to-date Pap screenings increased over pre-intervention (72%-82%, P < .05). Best-subset model to predict up-to-date screening included age; public benefits; medical insurance; 5 CHL components (knowledge, benefits, barriers, seriousness, susceptibility). Conclusion: A brief intervention to promote cervical health literacy, delivered with women during a jail detention, can lead to sustained improvements in CHL and prevention practices.
Cerebral blood flow abnormalities in neuropsychiatric systemic lupus erythematosus
Authors: Jia J , Xie J , Li H , Wei H , Li X , Hu J , Meng D , Zhang Y , Zhang X 
Published: July 2019

Objective To investigate the clinical characteristics, imaging changes and early diagnostic methods of neuropsychiatric systemic lupus erythematosus (NPSLE). Methods Thirty-five SLE patients, of which 16 had overt neuropsychiatric symptoms, underwent examination for multiple autoantibodies, including anti-double-stranded DNA (anti-dsDNA) antibody, anti-nucleosome antibody, anti-cardiac-phospholipid antibody (aCL)-IgG, aCL-IgM, anti-β2-glycoprotein I antibody and anti-ribosomal P antibody, and the SLEDAI score of every patient was recorded. All patients further received neuropsychological tests, including the Mini-Mental State Examination, the Self-Rating Anxiety Scale and the Self-Rating Depression Scale. Imaging examination using 3D arterial spin labeling was performed on 3.0 T MRI scanners. After processing the 3D arterial spin labeling image, the cerebral blood flow map was obtained and the cerebral blood flow value was calculated. Results The values of anti-dsDNA, anti-nucleosome antibody, aCL-IgG and anti-β2-glycoprotein I antibodies were significantly higher in the NPSLE group than those in the SLE group. The SLEDAI scores of the NPSLE group were significantly higher than those of the SLE group. There were no significant differences between the NPSLE group and the SLE group in the directional ability, memory, attention, numeracy, recall ability or language ability scores on the Mini-Mental State Examination scale. Furthermore, there were no symptoms of anxiety or depression in any of the patients, according to the Self-Rating Anxiety Scale and Self-Rating Depression Scale. In the 35 patients with SLE, decreases in blood perfusion were seen in some areas, and were unilateral and asymmetrically distributed. There was obvious asymmetry between sides in areas including the frontal lobe, temporal lobe, parietal lobe and occipital lobe. The incidence of perfusion decreases in frontal lobe in the NPSLE group was significantly higher than in the SLE group. Conclusion Neurological lesions in SLE patients can be detected by arterial spin labeling. Cerebral blood flow abnormalities may be helpful for the early diagnosis of neurological lesions in NPSLE.
Immunotherapy-induced severe neutropenia with neurotoxicity: A case of a 75-year-old woman with ulcerative colitis diagnosed with melanoma
Authors: Patel Rima , Pai Lori 
Published: July 2019

Introduction Immune checkpoint inhibitors have transformed the field of oncology moving immuno-oncology to the forefront of cancer treatment. However, immune checkpoint inhibitors can result in serious immune-related adverse events. Hematologic toxicities are rare with incidence of neutropenia from nivolumab less than 1%. Case report We present a case of refractory neutropenia in a 75-year-old woman with ulcerative colitis on adjuvant nivolumab for stage III melanoma. Management and outcome The patient's neutropenia did not improve with high-dose intravenous steroids, filgrastim, mycophenolate mofetil, or intravenous immunoglobulin. She also developed significant neurological symptoms from nivolumab. She was transitioned to comfort measures given her persistent symptoms and poor functional status. Discussion Though hematologic malignancies of immune checkpoint inhibitors are rare, they should be considered after other diagnoses are excluded. We discuss the serious immune-related adverse effects of immune checkpoint inhibitors in a patient with an underlying autoimmune disease and general treatment approaches.
A comparison of a community-based dementia support programme and nursing home-based day care: Effects on carer needs, emotional burden and quality of life
Authors: van Haeften-van Dijk A Marijke , Meiland Franka J , Hattink Bart JJ , Bakker Ton JEM , Dröes Rose-Marie 
Published: July 2019

Objectives Within an implementation study, we investigated the effectiveness of a combined community-based day care programme for persons with dementia and their carers versus traditional psychogeriatric nursing home-based day care. The effects on needs, sense of competence, burden and quality of life of the family carers were studied. Methods A pretest–posttest control group design among family carers of people with dementia who joined community-based day care centres ( n = 67) or nursing home-based day care centres ( n = 64). Results After six months, family carers using community-based day care more often expressed an unmet need for support regarding psychological distress than carers utilising nursing home-based day care. No effect of community-based day care on sense of competence was found. However, carers with a low sense of competence at baseline using community-based compared to nursing home-based day care became less emotionally burdened by behaviour and mood problems of their relative. Conclusion and discussion: Overall, no added value of community-based day care on needs, sense of competence, burden and quality of life was found. Increased unmet needs on psychological distress may have been caused by the increased awareness of carers participating in the carer programme of community-based day care regarding their own unmet support needs. For carers with a low sense of competence, community-based day care proves to decrease the impact of behaviour and mood problems of their relative. A larger controlled follow-up study is recommended to understand the long-term effects of community-based day care over nursing home-based day care.
The main contributor to the upswing of survival in locally advanced colorectal cancer: an analysis of the SEER database
Authors: Li Yuqiang , Zhao Lilan , Güngör Cenap , Tan Fengbo , Zhou Zhongyi , Li Chenglong , Song Xiangping , Wang Dan , Pei Qian , Liu Wenxue 
Published: July 2019

Background: There is no conclusion about the most important contributor to the upswing of locally advanced colorectal cancer (LACRC) survival. Methods: Data from the Surveillance, Epidemiology, and End Results (SEER) database was extracted to identify colorectal adenocarcinoma cancer patients at stage II and III diagnosed in the two periods 1989–1990 and 2009–2010. The statistical methods included Pearson’s chi-squared test, log-rank test, Cox regression model and propensity score matching. Results: The Cox regression model showed that hazard ratio (HR) of non-surgery dropped from 11.529 to 3.469 in right colon cancer (RCC), 5.214 to 2.652 in left colon cancer (LCC) and 3.275 to 3.269 in rectal cancer (RC) from 1989–1990 to 2009–2010. The 95% confidence intervals (CIs) for surgical resection in 2009–2010 were narrower than those in 1989–1990. HR became greater in LACRC without chemotherapy (from 1.337 to 1.779 in RCC, 1.269 to 2.017 in LCC, 1.317 to 1.811 in RC). There was no overlapping about the 95% CI of chemotherapy between the two groups. The progress of surgery was not linked to the improvement of overall survival (OS) of RCC ( p = 0.303) and RC ( p = 0.660). Chemotherapy had a significant association with OS of all colorectal cancer (CRC) patients ( p = 0.017 in RCC; p = 0.006 in LCC; p = 0.001 in RC). Conclusions: Advancements in chemotherapy regimen were the main contributor to the upswing of CRC survival. The improvements in surgery had a limited effect on improvements in CRC survival.
Describing Normative Foot Temperatures in Patients With Diabetes-Related Peripheral Neuropathy
Authors: Schmidt Brian M. , Allison Sara , Wrobel James S. 
Published: July 2019

Background: Prior research shows increased foot temperatures are predictive of diabetes-related foot complications. Our aim was to describe normative skin foot temperatures for individuals with diabetic peripheral neuropathy to better inform new technologies. We also explored for potential risk factors which correlate with changes in foot temperatures. Methods: We conducted a retrospective chart review of adult patients >18 years of age with diabetes mellitus and clinically diagnosed diabetic peripheral neuropathy with pedal digital thermometry performed between 2009 and 2018. A total of 58 patients met these criteria. Univariate modeling was based on covariates that may affect foot temperature including age, peripheral arterial disease, toe pressure, seasonality of measurement, smoking pack-years, caffeine use, insulin use, and calcium channel blocker use. Results: In patients with diabetic peripheral neuropathy, mean toe temperatures of 27.67°C (6.300°C), forefoot of 28.58°C (5.36°C), midfoot of 29.21°C (3.81°C), and rearfoot of 29.88°C(3.83°C) were demonstrated. A modest negative correlation between seasonality and toe and metatarsal temperatures ( r = −0.38, P < .05; r = −0.43 P < .01, respectively) was demonstrated. Midfoot temperatures were modestly and positively correlated to the presence of small fiber symptoms ( r = 0.33, P = .03). Positive modest correlation with rearfoot temperatures and amount of pack-year history ( r = 0.30, P = .03) was seen. Conclusion: Normative foot temperatures in neuropathic patients were found to be inversely associated with seasonality at the toe and metatarsal level. Smoking and pack-year history demonstrate modest correlation previously unseen in temperature analyses and warrant further exploration. Normative temperatures in neuropathic patients can better inform new technologies for the prevention of diabetic foot ulcer and Charcot neuroarthropathy.
Use, effectiveness and tolerability of budesonide‐MMX in ulcerative colitis: A real‐life experience
Authors: Maconi Giovanni , Mezzina Nicolò , Landi Stefano , Grillo Simone , Bezzio Cristina , Bosani Matteo , Pastorelli Luca , Dell'Era Alessandra , Chibbar Richa , Carmagnola Stefania , Molteni Paola , Cassinotti Andrea , Massari Alessandro , Ardizzone Sandro 
Published: July 2019

BackgroundBudesonide‐MMX has an established role in the management of relapsing mild‐to‐moderate ulcerative colitis. Data regarding effectiveness and tolerability in real‐life clinical practice are limited.AimThe aim of this study was to assess the use of budesonide‐MMX in ulcerative colitis, as well as short‐term effectiveness and tolerability in real‐life practice.MethodsWe conducted a retrospective study of adult patients with mild‐to‐moderate ulcerative colitis treated with budesonide‐MMX at four tertiary inflammatory bowel disease centres in Italy from June 2016 to February 2018. Demographic and clinical features of patients, the use of budesonide‐MMX, disease course and concomitant therapy were recorded. The primary outcome assessed was clinical remission at 2 months.ResultsA total of 82 patients with active mild‐to‐moderate ulcerative colitis were included in the study with a mean age of 45.9 years and a median partial Mayo Score of 4 (interquartile range 3–5). A total of 41 patients were male. Overall, 36 had extensive colitis, 38 left‐sided colitis and eight proctitis. Treatments at the time of inclusion included 10 patients receiving biologic therapy, seven azathioprine and 54 mesalazine or salazopyrin. The main reasons for the addition of budesonide‐MMX were clinical relapse (47.5%) or inadequate response to current therapy (39.0%). In total, 50% of patients achieved clinical remission, whereas 9.8% had clinical improvement. No response was noted in 40.2% of subjects. Using multivariate binary logistic regression, a moderate degree of activity was the main independent predictor of non‐response. Eight significant adverse effects were reported in six patients with three discontinuing treatment.ConclusionIn real‐life clinical practice, budesonide‐MMX is commonly used in combination with other therapies, both for acute disease flares and for partial response to therapy.