bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cancer Prevalence in the Elderly
Authors: Vercelli Marina , Quaglia Alberto , Parodi Stefano , Crosignani Paolo ,   Itapreval Working Group:, Micheli A. , Gatta G. , Sant M. , Rossi A. Giorgi , Francisci S. , Saltarelli S. , Dell'Era L. , Gasparre N. , Verdecchia A. , Capocaccia R. , Mariotto A. , Dally A. , Corazziari I. , Crosignani P. , Tagliabue G. , Falcini F. , Milandri C. , Vattiato R. , Conti E. , Ramazzotti V. , Caperle M. , Zanetti R. , Rosso S. , Patriarca S. , Federico M. , Mangone L. , Santacroce M. , Barchielli A. , Balzi D. , Crocetti E. , Paci E. , De Lisi V. , Serventi L. , Barili A. , Vercelli M. , Casella C. , Parodi S. , De Leon M. Ponz , Roncucci L. , Benatti P. , Gafà L. , Tumino R. , La Rosa E. , Guzzinati S. , Simonato L. , Bovo E. 
Published: April 2018

Aims and Background To describe the cancer prevalence in elderly Italian people and analyze the differences, if any, with the prevalence among younger subjects. Methods & Study Design The cancer prevalence among elderly patients (65 years and over), the three age classes encompassing elderly age (65-74 years, 75-84 years, 85 years and over) and younger patients (0-64 years) was computed using the PREVAL method on the basis of the incident cases over the period 1976-1992 followed up to 31 December 1992 (prevalence reference date). Data were collected by 11 Italian cancer registries. Results The observed prevalence figures for all cancers (except skin epitheliomas), both sexes combined and considering the whole elderly group, were 1,090 and 3,601 cases per 100,000 one and five years since diagnosis, respectively; the prevalence increased up to the 75-84 age group and showed a slight decrease after age 85. With regard to specific cancer sites, in men bladder and prostate had the highest prevalence 5 years from diagnosis (more than 800 cases per 100,000), followed by colon and lung (about 500 cases per 100,000) stomach and rectum (about 300 cases per 100,000); in women breast cancer ranked first (more than 1,000 cases per 100,000), followed by colon (about 350 cases per 100,000), corpus uteri, stomach and rectum cancers (between 150 and 200 cases per 100,000). For all malignancies and the two sexes combined the prevalence figures were about six times higher in the older than in the younger age group. Conclusions These figures confirm the important role of aging in determining the increase in cancer prevalence. The resulting prevalence figures clearly indicate the cancer burden placed on health care services; moreover, the figures will probably increase in the next decades due to a possible improvement in survival and to the dramatic aging of the population, assuming a stable trend for incidence rates. This picture will represent a major challenge for politicians and those dealing with health care planning and social policies in general, especially in the light of the reduction of the available financial resources and the specific features of medical and social needs in the elderly.
Effects of Gemcitabine in Normaland Transformed Human Lung Cell Cultures: Cytotoxicity and Increase in Radiation Sensitivity
Authors: Pacini Stefania , Milano Franco , Pinzani Pamela , Pazzagli Mario , Gulisano Massimo , Ruggiero Marco , Casamassima Franco 
Published: April 2018

Aims and Background Several anticancer drugs increase cell sensitivity to irradiation. Gemcitabine (2′, 2′ difluorodeoxycytidine) decreases the cellular dNTP pools and thus significantly increases the sensitivity to the DNA damaging effects of low-dose radiation. In this study we have investigated whether gemcitabine may play a role as radiosensitizer also in lung adenocarcinoma treatment. Methods & Study Design We studied this nucleoside analogue in normal and transformed human cell lines (fetal lung and lung adenocarcinoma). After drug treatment, cell lines were irradiated with different doses. Cell damage following drug treatment and/or irradiation was assessed by measuring intracellular ATP level and by the colony forming assay. Results The two cell lines significantly differed in their sensitivity to the toxic effects of the drug; the normal cell line was much more resistant than its transformed counterpart. This difference was observed in both assays, although it was more evident in the colony forming assay. A low radiation dose (50-100 cGy) did not cause any significant damage to transformed cells; normal cells were more resistant and doses up to 500 cGy caused little damage. However, when transformed cells were pretreated for three hours with gemcitabine, even a nontoxic concentration of the drug (1-10 nM) caused a marked sensitization of the cells to irradiation (50-100 cGy). The radiosensitizing effect of gemcitabine could be observed also in normal cells, although these cells were more resistant to the damaging effects of both anticancer treatments. Conclusions This study demonstrates that gemcitabine, a chemotherapeutic agent already used in the clinic, could be proposed as a radiosensitizer for radiation therapy of lung adenocarcinoma, having a clearly potentiating effect on low-dose radiation.
Epithelioid Hemangioendothelioma of the Larynx
Authors: Boscaino Amedeo , Errico Maria Elena , Orabona Pasquale , Tornillo Luigi , Staibano Stefania , Donofrio Vittoria , De Rosa Gaetano 
Published: April 2018

Epithelioid hemangioendothelioma is an uncommon vascular tumor of the soft tissues. Several reports have described this tumor in visceral locations such as liver, lung, and brain. To the best of our knowledge this is the first report of an immunohistochemical and ultrastructural study of a primary epithelioid hemangioendothelioma occurring in the larynx. Difficulties concerning the differential diagnosis and clinical problems arising from surgical therapy in the laryngeal area are also discussed.
Palliative Performance Scale Score at 1 Week After Palliative Care Unit Admission is More Useful for Survival Prediction in Patients With Advanced Cancer in South Korea
Authors: Yoon Seok-Joon , Choi Sung-Eun , LeBlanc Thomas W. , Suh Sang-Yeon 
Published: April 2018

Background: The Palliative Performance Scale (PPS) is a useful prognostic index in palliative care. Changes in PPS score over time may add useful prognostic information beyond a single measurement. Objective: To investigate the usefulness of repeated PPS measurement to predict survival time of inpatients with advanced cancer admitted to a palliative care unit (PCU) in South Korea. Design: Prospective observational cohort study. Setting/Patients: 138 patients with advanced cancer admitted to a PCU in a university hospital in South Korea from June 2015 to May 2016. Measurements: The PPS score was measured on enrollment and after 1 week. We used Cox regression analyses to calculate hazard ratios (HRs) to demonstrate the relationship between survival time and the groups categorized by PPS and changes in PPS score, after adjusting for clinical variables. Results: There were significant differences in survival time among 3 groups stratified by PPS (10-20, 30-50, and ≥60) after 1 week. A group with a PPS of 10 to 20 at 1 week had the highest risk (HR: 5.18 [95% confidence interval, 1.57-17.04]) for shortened survival. On the contrary, there were no significant differences among these groups by initial PPS alone. Similarly, change in PPS was prognostic; median survival was 13 (10.96-15.04) days for those whose PPS decreased after 1 week and 27 (10.18-43.82) days for those with stable or increased PPS ( P < .001). Conclusions: Measuring PPS over time can be very helpful for predicting survival in terminally ill patients with cancer, beyond a single PPS measure at PCU admission.
Measuring Visualized Joint Surface in Hallux Metatarsophalangeal Arthroscopy
Authors: Hull Michael , Campbell John T. , Jeng Clifford L. , Henn R. Frank , Cerrato Rebecca A. 
Published: April 2018

Background: Arthroscopy has been increasingly used to evaluate small joints in the foot and ankle. In the hallux metatarsophalangeal (MTP) joint, little data exist evaluating the efficacy of arthroscopy to visualize the articular surface. The goal of this cadaveric study was to determine how much articular surface of the MTP joint could be visualized during joint arthroscopy. Methods: Ten fresh cadaveric foot specimens were evaluated using standard arthroscopy techniques. The edges of the visualized joint surface were marked with curettes and Kirschner wires; the joints were then surgically exposed and imaged. The visualized surface area was measured using ImageJ® software. Results: On the distal 2-dimensional projection of the joint surface, an average 57.5% (range, 49.6%-65.3%) of the metatarsal head and 100% (range, 100%-100%) of the proximal phalanx base were visualized. From a lateral view of the metatarsal head, an average 72 degrees (range, 65-80 degrees) was visualized out of an average total articular arc of 199 degrees (range, 192-206 degrees), for an average 36.5% (range, 32.2%-40.8%) of the articular arc. Conclusion: Complete visualization of the proximal phalanx base was obtained. Incomplete metatarsal head visualization was obtained, but this is limited by technique limitations that may not reflect clinical practice. Clinical Relevance: This information helps to validate the utility of arthrosocpy at the hallux metatarsophalangeal joint.
Endoscopic Resection of Different Types of Talocalcaneal Coalition
Authors: Aldahshan Wael , Hamed Adel , Elsherief Faisal , Abdelaziz Ashraf Mohamed 
Published: April 2018

Background: The purpose of this study was to describe the technique of endoscopic resection of talocalcaneal coalition (TCC) by using 2 posterior portals and to report the outcomes of endoscopic resection of different types and sites of TCC. Methods: An interventional prospective study was conducted on 20 feet in 18 consecutive patients who were diagnosed by computed tomography to have TCC for which nonoperative treatment had failed and endoscopic resection was performed. The patients were divided into groups according to the site of the coalition (middle facet or posterior facet) and according to type (fibrous, cartilage, or bony). The mean follow-up period was 26 months (range, 6-36). Results: The average preoperative American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot score was 57.7 (range, 40-65), and the average preoperative visual analog scale (VAS) score was 7.8 (range, 6-8). The average postoperative AOFAS hindfoot score was 92.4 (range, 85-98; P < .01). The average postoperative VAS score was 2.4 (range, 1-4). All patients showed no recurrence on postoperative lateral and Harris-Beath X-ray until the end of the study. Conclusions: Endoscopic resection of TCC was an effective and useful method for the treatment of talocalcaneal coalition. It provided excellent outcomes with no recurrence in this short-term study. Resection of the fibrous type had a better outcome than resection of cartilage and bony types. Endoscopic resection of the posterior coalition had a better outcome than resection of the middle coalition. Level of Evidence: Level III, comparative study.
A 24-month advanced magnetic resonance imaging study of multiple sclerosis patients treated with alemtuzumab
Authors: Vavasour Irene M , Tam Roger , Li David KB , Laule Cornelia , Taylor Carolyn , Kolind Shannon H , MacKay Alex L , Javed Adil , Traboulsee Anthony 
Published: April 2018

Background: Tissue damage in both multiple sclerosis (MS) lesions and normal-appearing white matter (NAWM) are important contributors to disability and progression. Specific aspects of MS pathology can be measured using advanced imaging. Alemtuzumab is a humanised monoclonal antibody targeting CD52 developed for MS treatment. Objective: To investigate changes over 2 years of advanced magnetic resonance (MR) metrics in lesions and NAWM of MS patients treated with alemtuzumab. Methods: A total of 42 relapsing–remitting alemtuzumab-treated MS subjects were scanned for 2 years at 3 T. T1 relaxation, T2 relaxation, diffusion tensor, MR spectroscopy and volumetric sequences were performed. Mean T1 and myelin water fraction (MWF) were determined for stable lesions, new lesions and NAWM. Fractional anisotropy was calculated for the corpus callosum (CC) and N-acetylaspartate (NAA) concentration was determined from a large NAWM voxel. Brain parenchymal fraction (BPF), cortical thickness and CC area were also calculated. Results: No change in any MR measurement was found in lesions or NAWM over 24 months. BPF, cortical thickness and CC area all showed decreases in the first year followed by stability in the second year. Conclusion: Advanced MR biomarkers of myelin (MWF) and neuron/axons (NAA) show no change in NAWM over 24 months in alemtuzumab-treated MS participants.
Are injuries only skin deep? The quandary of the ‘Found Down’ patient
Authors: Smith Michael , Pavalonis Albert , Long Zachary , Amberger Melissa , Onursal Elif , Kollipara Karishma , Esposito Christopher , Vanderet Danielle , McLean Ronald 
Published: April 2018

Introduction The ‘found down’ patient presents a unique circumstance for the clinician in that the patients are often unable to provide history of the events preceding their presentation to the emergency department. Studies on this population are limited. Methods The trauma and emergency department registries from January 2013 through December 2014 at an urban level one trauma center were queried for patients described as ‘found down’ and related descriptions. Basic demographic data included patient disposition, Glasgow coma score and injury severity score (ISS), patient requiring intubation, imaging performed, and injuries sustained. Patients were stratified into those managed by the trauma service versus the emergency department. Results A total of 298 patients met criteria to be included in this study, nine of whom died; the average age was 50 years old and 9% of this population was found to have an intracranial hematoma. The subset of patients who had a rapid return to Glasgow coma score 15 had a 6% incidence of having an intracranial hematoma. Four cervical fractures were identified. There was only one intra-abdominal injury. Conclusion Computerized tomography scans of the brain and cervical spine should be performed for all patients who are found down. Intra-abdominal injuries are exceedingly rare and selective use of computerized tomography should be made. Superficial injury does not indicate more significant injury in this population; however, lack of superficial injury does not preclude more significant injuries.
Comparison of day 3 and day 5 thyroglobulin results after thyrogen injection in differentiated thyroid cancer patients
Authors: Sager Sait , Hatipoglu Esra , Gunes Burcak , Asa Sertac , Uslu Lebriz , Sönmezoğlu Kerim 
Published: April 2018

Background: It is necessary to stimulate serum thyroid-stimulating hormone (TSH) levels either endogenously by thyroid hormone withdrawal (THW) or exogenously by administration of recombinant human TSH (rhTSH) for radioactive iodine (RAI) therapy. Thyrotropin alfa (Thyrogen) has many advantages over THW. Radiation dose to laboratory staff while drawing blood for tests on the day 5 is one of the disadvantages of preferring Thyrogen. Our aim was to compare day 3 and day 5 blood test results after Thyrogen injections. Material and method: In our study, Thyrogen was preferred in 32 differentiated thyroid cancer patients with a mean age of 50.5 ± 12.3 years. Thyrogen was injected on day 1 and day 2 intramuscularly in all patients before I-131 was given on day 3. A total of 22 patients received 5 mCi RAI for ablation control scintigraphy and 10 patients received 100–250 mCi RAI for ablation or therapy (high-dose group). Blood tests were performed on day 3 and day 5 after Thyrogen injections. Results: Mean TSH level was 98.1 mg/dl for day 3 and 29.5 mg/dl for day 5. In the diagnostic group, thyroglobulin (Tg) and anti-Tg levels were nearly the same on day 3 and day 5. In the therapy group, day 5 Tg levels were higher than day 3. Conclusion: After Thyrogen injection of two consecutive days, blood sampling might be enough on day 3. Day 5 blood sampling may not be necessary routinely for radiation protection of laboratory staff. For the diagnostic group, if Tg and anti-Tg is normal then 5 mCi imaging may not be necessary.
Diabetes mellitus remission in a cat with pituitary-dependent hyperadrenocorticism after trilostane treatment
Authors: Muschner Adriana Cunha , Varela Fernanda Venzon , Hazuchova Katarina , Niessen Stijn JM , Pöppl Álan Gomes 
Published: April 2018

Case summary An 8-year-old male neutered Persian cat was presented with polyuria, polydipsia, polyphagia and muscle weakness associated with a 7 month history of diabetes mellitus (DM). The cat had initially been treated with neutral protamine Hagedorn (NPH) insulin 2 U q12h, followed by porcine lente insulin 2 U q12h and, most recently, 3 U glargine insulin q12h, without improvement of clinical signs. The cat also suffered from concurrent symmetrical bilateral alopecia of thorax and forelimbs, abdominal distension and lethargy. Hyperadrenocorticism (HAC), specifically pituitary-dependent HAC, was suspected and confirmed through abdominal ultrasonography demonstrating bilateral adrenal enlargement, and a low-dose dexamethasone suppression test using 0.1 mg/kg dexamethasone intravenously. Trilostane treatment (initially 10 mg/cat PO q24h then increased to 10 mg/cat PO q12h) was started and insulin sensitivity gradually improved, ultimately leading to diabetic remission after an increased in trilostane dose to 13mg/cat PO q12h, 14 months after the DM diagnosis and 7 months after the initiation of trilostane therapy. Relevance and novel information DM in cats with HAC is a difficult combination of diseases to treat. To our knowledge this is the first reported case of diabetic remission in a feline patient with HAC as a result of treatment with trilostane. Further work should focus on whether fine-tuning of trilostane-treatment protocols in cats with concurrent DM and HAC could lead to a higher proportion of diabetic remissions in this patient group.
Histology, vascularity and innervation of the glenoid labrum
Authors: Alashkham Abduelmenem , Alraddadi Abdulrahman , Felts Paul , Soames Roger 
Published: April 2018

Background: Although the glenoid labrum has an important role in shoulder stability, little is known about its composition, vascularity and innervation. The aims of this study were therefore to evaluate the histology, vascularity and innervation of the glenoid labrum. Materials and methods: Ten glenoid labrum specimens (three male, two female: mean age 81.2 years, range 76–90 years) were detached at the glenoid neck. Following decalcification, sections were cut through the whole thickness of each specimen perpendicular to the glenoid labrum at 12 radii corresponding to a clock face superimposed on the glenoid fossa. Then they were stained using haematoxylin and eosin, a silver nitrate protocol or subjected to immunohistochemistry using anti-protein gene protein 9.5 to demonstrate neuronal processes. Results: The labrum was fibrocartilaginous, being more fibrous in its free margin. There was a variable distribution of blood vessels, being more vascular in its periphery, with many originating from the fibrous capsule and piercing the glenoid labrum. Immunohistochemistry revealed positive staining of nerve fibres within the glenoid labrum. Conclusion: The glenoid labrum is fibrocartilaginous, being more fibrous in its periphery, and is vascularized, with the anterosuperior aspect having a rich blood supply. Free sensory nerve fibres were also present; no encapsulated mechanoreceptors were observed. The presence of sensory nerve fibres in the glenoid labrum could explain why tears induce pain. It is postulated that these sensory fibres could play a role in glenohumeral joint proprioception.
Metastatic Paraganglioma and Treatment with Sunitinib: A Case Report
Authors: Cirillo Fernando 
Published: April 2018

Sunitinib malate is a small kinase inhibitor with activity against a number of tyrosine kinase receptors. We treated a young man suffering from a metastatic paraganglioma with sunitinib. In this report we discuss a number of related questions including the correct dosage, schedules and timing of administration of the molecule, the main side effects and their treatment, and evaluation of the treatment response by CT scan. Treatment with sunitinib started at a dose of 50 mg daily for 4 weeks followed by 2 weeks off (4/2). Because of the side effects, the dose was reduced to 25 mg daily (4/2) and then to 25 mg daily (2/1). This resulted in a significant decrease in the plasma chromogranin A value and the radiological size of the metastases, as well as important clinical improvement. After 6 cycles the treatment was stopped because of a rise in plasma NSE values and disease progression. Sunitinib malate can induce marked toxicity, in which case the daily dose should be reduced and a different schedule of administration adopted. Response evaluation by CT scan should take into account tumor necrosis caused by sunitinib. Sunitinib malate is an interesting molecule for targeted therapy also for advanced neuroendocrine tumors. There has been evidence of significant clinical improvement, as in the case reported here. Free full text available at www.tumorionline.it
Durable Complete Response of Hepatocellular Carcinoma after Metronomic Capecitabine
Authors: Brandi Giovanni , De Rosa Francesco , Bolondi Luigi , Agostini Valentina , Di Girolamo Stefania , Nobili Elisabetta , Biasco Guido 
Published: April 2018

Background Hepatocellular carcinoma (HCC) is a highly vascular tumor which is poorly responsive to standard systemic chemotherapy. Recently, various antiangiogenic targeted agents have shown promising activity at different levels of evidence in patients with advanced HCC, suggesting that such treatments might be effective. Case report Since chemotherapy administered with metronomic schedules inhibits angiogenesis, we treated a 64-year-old man with advanced HCC with metronomic capecitabine. After only two months of treatment the HCC nodules disappeared on ultrasonography. This finding was confirmed by a computed tomography scan. After more than three years the patient is still in treatment with minimal toxicity and maintains a complete remission. Conclusions Our case report suggests that metronomic capecitabine may be effective in advanced HCC patients while being also well tolerated. This is important, given the frequent comorbidities of HCC patients. Free full text available at www.tumorionline.it