bluuebunny/crossref_metadata_2025_split huggingface dataset:
Alcohol Consumption and Chronic Liver Disease Mortality in New Mexico and the United States, 1999-2013
Authors: Tomedi Laura E. , Roeber Jim , Landen Michael 
Published: April 2018

Objective: Current chronic liver disease (CLD) mortality surveillance methods may not adequately capture data on all causes of CLD mortality. The objective of this study was to calculate and compare CLD death rates in New Mexico and the United States by using both an expanded definition of CLD and estimates of the fractional impact of alcohol on CLD deaths. Methods: We defined CLD mortality as deaths due to alcoholic liver disease, cirrhosis, viral hepatitis, and other liver conditions. We estimated alcohol-attributable CLD deaths by using national and state alcohol-attributable fractions from the Centers for Disease Control and Prevention’s Alcohol-Related Disease Impact application. We classified causes of CLD death as being alcohol-attributable, non–alcohol-attributable, or hepatitis C. We calculated average annual age-adjusted CLD death rates during five 3-year periods from 1999 through 2013, and we stratified those rates by sex, age, and race/ethnicity. Results: By cause of death, CLD death rates were highest for alcohol-attributable CLD. By sex and race/ethnicity, CLD death rates per 100 000 population increased from 1999-2001 to 2011-2013 among American Indian men in New Mexico (67.4-90.6) and the United States (38.9-49.4), American Indian women in New Mexico (48.4-63.0) and the United States (27.5-39.5), Hispanic men in New Mexico (48.6-52.0), Hispanic women in New Mexico (16.9-24.0) and the United States (12.8-13.1), non-Hispanic white men in New Mexico (17.4-21.3) and the United States (15.9-18.4), and non-Hispanic white women in New Mexico (9.7-11.6) and the United States (7.6-9.7). CLD death rates decreased among Hispanic men in the United States (30.5-27.4). Conclusions: An expanded CLD definition and alcohol-attributable fractions can be used to create comprehensive data on CLD mortality. When stratified by CLD cause and demographic characteristics, these data may help states and jurisdictions improve CLD prevention programs.
Perceived Versus Actual Risk of Type 2 Diabetes by Race and Ethnicity
Authors: Yang Kyeongra , Baniak Lynn M. , Imes Christopher C. , Choi JiYeon , Chasens Eileen R. 
Published: April 2018

Purpose The purpose of this study was to examine associations between perceived risk and actual risk of type 2 diabetes by race and/or ethnicity. Methods The study sample included 10 999 adults from the 2011 to 2014 National Health and Nutrition Examination Survey. Sociodemographic, clinical, and behavioral data were collected using interviews and physical examinations. Participants were asked if they felt at risk for diabetes or prediabetes and then asked the reasons why. Data analyses were conducted with SAS to properly analyze complex survey data. Results About 86% of the sample (n = 9496) answered the risk perception question for diabetes, and among those, 28.4% indicated having a high perceived risk. Among this subsample, 38.3% were identified as having an actual risk for prediabetes or diabetes according to the American Diabetes Association guidelines. Across all race groups, the most frequently reported risk factors participants believed to contribute to their risk for diabetes were family history of diabetes, obesity, and poor diet habits. When the percentage of participants with an actual risk factor who correctly perceived it as a risk factor was examined, fewer Asians correctly perceived weight status and physical activity level as a risk for diabetes in contrast to the other racial/ethnic groups. Conclusions Our study showed that when perception was compared to actual risks, associations differed statistically by race. It will be essential to discuss their risk perception to proper screening for diabetes and relevant lifestyle modifications to prevent and delay the onset of diabetes.
Correlation of Nasal Eosinophilia and Response after Nasal Provocation Test in Patients with Nonallergic Rhinitis
Authors: Park Ki‐Ik , Jang Tae Young , Yang Seung‐Chan , Hong Hyung Sun , Kim Young Hyo 
Published: April 2018

ObjectivesWe aimed to evaluate the relationship between nasal eosinophilia and nasal hyperresponsiveness to allergen extract.Study DesignRetrospective chart review.SettingAcademic tertiary rhinologic practice.Subjects and MethodsWe performed allergy tests (skin prick test and multiple allergosorbent test) and nasal cytology for 194 patients with rhinitis symptoms (76 males and 118 females; age, 11‐69 years). According to the results, they were classified into 4 groups: group A (allergic rhinitis with eosinophilia, n = 26), group B (allergic rhinitis without eosinophilia, n = 77), group C (nonallergic rhinitis with eosinophilia syndrome, n = 20), and group D (nonallergic rhinitis without eosinophilia, n = 71). We performed a nasal provocation test (NPT) using house dust mite extract and assessed the changes in symptoms and the decrease in acoustic parameters (total nasal volume and minimal cross‐sectional area [MCA]).ResultsPatients in group C were more likely to have severe rhinorrhea and sneezing than those in group D (P <. 001). After NPT, group C had greater aggravation of nasal obstruction than group D (P <. 001). Group C also showed markedly greater MCA changes as compared with group D 15 minutes after the antigen challenge (P =. 002). There was significant correlation between the number of eosinophils and an increase in nasal obstruction (r = 0.319, P =. 0009), rhinorrhea (r = 0.302, P =. 0017), sneezing (r = 0.219, P =. 0241), change in the total nasal volume 15 minutes after NPT (r = 0.287, P =. 0028), and change in the MCA 15 minutes (r = 0.322, P =. 0008) and 30 minutes (r = 0.250, P =. 0098) after NPT.ConclusionIn patients with NAR, nasal eosinophilia is associated with provocative response after NPT. Further research should be performed to elucidate the mechanisms that underlie this phenomenon.
Long-term outcome of stenting for atherosclerotic renal artery stenosis and the effect of angiographic restenosis
Authors: Zachrisson Karin , Elverfors Sven , Jensen Gert , Hellström Mikael , Svensson Mikael , Herlitz Hans , Falkenberg Mårten 
Published: April 2018

Background Symptomatic renal artery stenosis (RAS) is mainly treated with pharmacological blood pressure control, sometimes with percutaneous transluminal renal angioplasty (PTRA). It is unclear if PTRA benefits these patients over time. Purpose To determine long-term renal function, morbidity, and mortality in patients with symptomatic RAS treated with PTRA, and whether long-term outcomes are associated with angiographic restenosis. Material and Methods Retrospective single-center, long-term follow-up of 57 patients with atherosclerotic RAS treated with PTRA with stent during 1995–2004 and investigated for restenosis with angiography after one year. Outcomes were retrieved from medical records and from mandatory healthcare registries. Mortality rates were related to expected survival in an age- and gender-matched population, using a life-table database. Surviving patients were assessed with blood pressures, laboratory tests, duplex ultrasonography, and radioisotope renography. Results Median follow-up was 11 years 7 months. Major indications for PTRA were therapy-resistant hypertension and declining renal function. Angiographic restenosis at one year was found in 21 of 57 patients (37%). Thirty-six patients (60%) died during follow-up. Main cause of death was cardiovascular events (54%). Mortality was significantly increased, and morbidity and healthcare utilization were high. Hypertension control during follow-up was stable with persistent need for anti-hypertensive medication, and renal function remained moderately reduced with no long-term difference between patients with vs. without restenosis. Conclusion Long-term prognosis after PTRA for atherosclerotic RAS is dismal, with high mortality and morbidity and reduced renal function, despite maintained hypertension control. Restenosis does not appear to affect late outcome.
Ovarian Germ Cell Cancer: Clinicopathologic Analysis and Outcome of 31 Cases
Authors: Kusamura Shigeki , Teixeira Luiz Carlos , dos Santos Marcos António , de Ângelo Andrade Liliana Aparecida Lucci , Campos Torres José Carlos , Sagarra Alberto , Deraco Marcello , Mauricette Derchain Sophie Françoise 
Published: April 2018

Aims The aim of the study was to evaluate some clinicopathologic characteristics and the outcome of patients with ovarian germ cell cancer (OGCC) treated with cisplatin-based chemotherapy. Methods It was a clinical retrospective study. The clinical charts of 31 patients with OGCC assisted at the Department of Obstetrics and Gynecology of the State University of Campinas, Brazil, from January 1986 to June 1997 were reviewed. Results Ten patients had dysgerminoma and 21 patients nondysgerminomatous tumors. Women with dysgerminoma and nondysgerminomatous tumors did not present differences regarding surgical staging, age, ascites or residual tumor after the initial surgery. Frozen section, performed in 16 patients, showed some discrepancy with paraffin histology diagnosis in 8 patients. Platinum-based chemotherapy was used in 5/10 patients with dysgerminoma and in 17/21 patients with nondysgerminomatous tumors, with a 5-year survival of 100% for the dysgerminoma and 53% for the nondysgerminomatous group. Conclusions Women with dysgerminoma and nondysgerminomatous tumors did not present differences regarding clinicopathologic characteristics. The prognosis for patients with dysgerminoma was better than for those with nondysgerminomatous tumors. Frozen section had a high error rate in diagnosing OGCC intraoperatively.
Cellular and Clinical Pharmacokinetic/Pharmacodynamic Basis for Lack of Efficacy of 21-Day Continuous Topotecan in Patients with Untreated Advanced Adenocarcinoma of the Pancreas
Authors: August Mans Dennis Ricardo , Di Leone Luciane , Ferrary Caldas Ana Paula , Maino Marcelo , Almeida Leonardo , Cancela Anna Isabel , Grivicich Ivana , da Rocha Adriana Brondani , Schwartsmann Gilberto 
Published: April 2018

Background In a phase II study, topotecan was evaluated for response and toxicity in patients with advanced pancreatic carcinoma at the schedule of 0.7 mg/m2/day q 21 days q 28 days. Methods Responses were assessed after at least 2 courses using WHO criteria, and toxicity was evaluated after each course according to the CTC-NCI standards. Between December 1995 and September 1997, 15 assessable patients (median age, 55 years; range, 36-74; median ECOG performance, 1; range, 0-3) were included in the study. All had biopsy-proven and measurable disease, a life-expectancy of at least 3 months, and normal bone marrow, liver, and renal function. None of the patients had undergone prior cytotoxic or radiation therapy, and 10 were initially treated by surgery. Twenty-five cycles were assessable for toxicity. Plasma was collected from 7 patients who had received a total of 10 cycles and was, after extraction with methanol at −20°C, analyzed for total topotecan by an HPLC method. The thus determined steady-state concentrations were assessed for their capacity to affect growth and DNA integrity in the BxPC-3 human pancreatic carcinoma cell line after 21 days of continuous exposure. For these purposes, we used a sulforhodamine B staining assay, and agarose gel electrophoresis, respectively. Results Grades 3-4 leukopenia, thrombocytopenia, granulocytopenia, and anemia occurred in 8, 6, 8 and 8 cycles, respectively. Other mild to moderate side effects (grades 1-2) included malaise, nausea and vomiting, anorexia, and alopecia. No objective tumor response was documented. HPLC analysis of patients' plasma showed the attainment of constant steady-state levels of 1.0 ± 0.1 ng/mL during the entire infusion period. At such a concentration, topotecan did not significantly affect growth or DNA integrity in the BxPC-3 cells. Fifty percent cell growth inhibition and appreciable oligonucleosomal DNA fragmentation were only evident with 21 days topotecan ≥ 50 ng/mL. Conclusions Our data suggest that the lack of clinical activity of 0.7 mg/m2 daily topotecan for 21 days q 28 days in patients with advanced pancreatic carcinoma might be partially attributed to the achievement of non-tumoricidal plasma drug concentrations.
Lack of a Time-Factor in Alternating Chemoradiotherapy for Advanced Head and Neck Squamous Cell Carcinoma
Authors: Sanguineti Giuseppe , Benasso Marco , Corvo Renzo , Marcenaro Michela , Ricci Isabella , D'Amico Mauro , Mora Francesco , Vitale Vito 
Published: April 2018

Purpose To assess whether a radiotherapy time factor exists also for patients affected by head and neck squamous cell carcinoma and receiving combined chemoradiotherapy. Methods and materials From 1989 to 1997, of 121 patients affected by stage III or IV head and neck squamous cell carcinoma who underwent alternating chemotherapy and radiotherapy according to the Merlano regimen at our institution, 59 were selected for time factor analysis. Until 1995, if chemotherapy had to be delayed because of bone marrow toxicity, radiotherapy was also delayed accordingly. Since January 1996 in order to avoid treatment-free gaps, radiotherapy was delivered continuously until it was possible to resume chemotherapy. Potential predictive factors of local-regional control were included in univariate and multivariate models. The median follow-up is 26 months (5-121 months). Results As a result of change in treatment policy, mean radiotherapy duration was shorter for 25 patients treated after 1995 (group A, 8.4 weeks) than for those treated during 1995 or before (group B, 9.4 weeks) (t test, P = 0.0012). In contrast, as expected, mean chemotherapy duration remained relatively unchanged through the years (10.9 vs 10.7 weeks for groups B and A, respectively, t test, P = 0.77). At 2 years, the actuarial local-regional control rate was 53 ± 7% for the whole population. The estimated rates of local-regional control at 2 years were 49 ± 10% and 56 ± 9% for patients belonging to groups A and B, respectively. At univariate and multivariate analyses, treatment group was not predictive of local-regional control. Conclusions Our attempt to prospectively limit radiotherapy overall treatment time failed to improve outcome. The data, although obtained on a relatively limited number of patients, suggest that tumor cell repopulation during radiotherapy may not be clinically relevant when chemotherapy is part of the treatment for advanced head and neck squamous cell carcinoma.
Effective Penumbra and Scalloping Effect: A Dosimetric Study in Multifield Radiotherapy with Multileaf Collimator for Prostate Cancer Treatment
Authors: Stasi Michele , Baiotto Barbara , Palamara Federica , Gabriele Pietro , Scielzo Giuseppe 
Published: April 2018

Aims and background The aim of the study was to test whether the multileaf collimator can be used to replace divergent alloy blocks for field shaping and to evaluate the dosimetric impact of the scalloping effect and the effective penumbra in multifield isocentric configurations routinely used at our department to treat early stage prostate tumor in supine patients. Deviations between measurements and treatment planning system calculations are also discussed in order to estimate the accuracy of effective penumbra calculations carried out by the software in the presence of blocks or a multileaf collimator. Methods The multileaf collimator installed on a dual energy (6 and 18 MV) linear accelerator Varian CLINAC 2100 C/D is an add-on component positioned below the standard jaws, with 40 computer-controlled opposed pairs of tungsten leaves. Transmission, effective penumbra and scalloping measurements were performed with films placed at different depths in a (30 × 30 × 20 cm3) acrylic phantom. A laser scanning photo-densitometer was used to obtain the optical density and the relative dose profile. Effective penumbra and scalloping effect measured data were tested on a software phantom; the phantom, automatically performed with the treatment planning system, was a regular parallelepiped measuring 30 × 30 × 20 cm3 and the acrylic electronic density value. Results For one multileaf collimator-shaped field, the width of effective penumbra was about 2 mm wider than penumbra for cerrobend blocks, at a 45° angle between leaf motion direction and the field edge. Collimator rotation, automatically performed by the treatment planning system, by minimizing the sum of over- and underblocked areas, reduces the differences between the multileaf collimator and blocks. The differences between measured and treatment planning system calculated data were within the treatment planning system dose calculation accuracy limits, as recommended in ICRU Report No. 42. Conclusions Penumbra and, for the multileaf collimator, scalloping effect values seem to depend on the gantry angle, i.e., on the fields path of entry. The values for even fields are higher than the those for odd fields, because the dose gradient at the target edges is steeper for a single field than for two opposite fields, and the interplay of doses from the individual beams increases the distance between the isodose levels. Therefore, in order to reduce scalloping and effective penumbra values, it would be better to rotate the collimators, above all in even-number field techniques. In particular, the six-field technique, used mostly in prostate treatment, shows the same effective penumbra values with the multileaf collimator, with proper collimator rotation, and in blocked fields.
Tumor Microenvironment: What have we Learned Studying the Immune Response in this Puzzling Battlefield?
Authors: Mocellin Simone , Panelli Monica , Wang Ena , Rossi Carlo Riccardo , Marincola Francesco M 
Published: April 2018

Recent developments hallmark the progress in the understanding of tumor immunology and related therapeutic strategies. The administration of interleukin-2 (IL-2) to patients with cancer has shown that immune manipulation can mediate the regression of established cancers. The identification of the genes encoding cancer antigens and the development of means for effectively immunizing against these antigens has opened new avenues for the development of active immunization of patients with cancer. However, an efficient immune response against tumor comprises an intricate molecular network still poorly understood. Only when the code governing immune responsiveness of cancer will be deciphered, new therapeutic strategies could be designed to fit biologically defined mechanisms of immune rejection of cancer. In this review, we propose that the mechanisms regulating tumor rejection in response to vaccination will be more efficiently identified by following the evolution of treatment induced events within the tumor microenvironment taking advantage of recently developed technological tools. As a model, we will discuss the observed immune response to tumor antigen -specific immunization and its relationship with the systemic administration of IL-2.
Radiotherapy after Prostatectomy
Authors: Sanguineti Giuseppe , Franzone Paola , Culp Laura , Marcenaro Michela , Barra Salvina , Vitale Vito 
Published: April 2018

Aims and background The role of radiotherapy after prostatectomy is controversial. This paper tries to give some guidelines for everyday practice through an analysis of literature data. Methods The potential role of radiotherapy in the adjuvant and salvage setting is discussed. We also report and interpret available literature data for both settings. Results As regards an increase in or detectable prostate-specific antigen (PSA) after radical prostatectomy, about 40–50% of patients are rendered bNED with local salvage radiotherapy, but only 10–50% are long-term (5 years) biochemically controlled. A timely salvage treatment is crucial to optimize control probability. As regards adjuvant radiotherapy for undetectable postoperative PSA in patients at high risk of failure as judged on pathology, results are more encouraging. Recent data report bNED rates ≥70% at 5 years. Conclusions Although results are far from satisfactory, salvage radiotherapy should be considered for every patient with an increased or detectable PSA after surgery. Adjuvant radiotherapy seems preferable to salvage radiotherapy for patients at high (>30%) risk of failure.
Smoking in Italy, 2002
Authors: Gallus Silvano , Colombo Paolo , Scarpino Vilma , Zuccaro Piergiorgio , Apolone Giovanni , La Vecchia Carlo 
Published: April 2018

Aims and background To update estimates of smoking prevalence in Italy to the year 2002. Methods Population-based, face-to-face survey conducted by the DOXA (the Italian Branch of the Gallup International Association) in March-April 2002 on 3,238 individuals aged 15 or over, representative of the whole Italian population. Results Overall, 26.6% of Italian adults were current cigarette smokers (31.1% of men, 22.3% of women); 19.9% of men and 10.4% of women smoked 15 or more cigarettes per day. Ex-smokers were 15.2% (21.9% of men, 9.0% of women). There was no appreciable difference with reference to geographic area or education in men, but more educated women were more frequently smokers (28%). Compared to 2001, reported smoking prevalence declined by 3.7% in men and 1.3% in women, and the fall was evident in various age groups, including the youngest one (15–24 years). However, part of the fall is likely due to increased underreporting, since these survey figures are appreciably underestimated as compared to sale data. Among ex-smokers, 84% had stopped without support. Among smokers, 37% had tried at least once to stop. Using the Fagerström questionnaire, 69.5% of smokers were classified as low or very low dependent, whereas only 20.0% of smokers were classified as high or very high dependent. Women, younger and elderly, as well as more educated smokers of both sexes tended to be less dependent. Conclusions Self-reported smoking prevalence tends to decline in Italy, although the overall figure (26.6% of Italian adults) remains considerably higher than the USA and several Western European countries.
Reflux Esophagitis as a Possible Risk Factor in the Development of Pharyngolaryngeal Squamous Cell Carcinoma
Authors: Bacciu Andrea , Mercante Giuseppe , Ingegnoli Anna , Bacciu Salvatore , Ferri Teore 
Published: April 2018

Aims and background To determine the role of reflux esophagitis in the development of pharyngolaryngeal squamous cell carcinoma in non-smoking and non-drinking patients. Methods The study population consisted of 92 consecutive non-smoking and non-drinking patients with histologically confirmed squamous cell carcinoma of the pharynx and the larynx. As a control, a group of 125 lifetime non-smoking and non-drinking cancer-free subjects was selected. Results Patients with pharyngolaryngeal cancer had a higher prevalence of reflux esophagitis than the control subjects (P <0.0001). Conclusions Our results confirm that reflux esophagitis in itself is associated with an increased risk of upper aerodigestive tract cancer.
Hürthle Cell Carcinoma: Clinic-Pathological and Biological Aspects
Authors: Carcangiu Maria Luisa 
Published: April 2018

Despite its structural simplicity the thyroid gland can give rise to a wide variety of tumor types. Although a substantial amount of work has been done in the past twenty-five years to redefine the clinic-pathological features of most types of thyroid tumors of follicular cell origin, some aspects of thyroid tumors composed of oncocytes, generally known as Hürthle cell tumors, are still matter of discussion. The major issues concern their very existence as a bona fide tumor type, the occurrence of benign and malignant forms and their relative frequency, the predictive value of morphologic parameters, the natural history of the malignant forms and the classification of Hürthle cell tumors with a papillary growth pattern. The definition of oncocytic cell, oncocytic neoplasm and oncocytic carcinoma as well as the pathologic characteristics and clinical behavior of neoplasms composed of oncocytes will be discussed.