bluuebunny/crossref_metadata_2025_split huggingface dataset:
Metabolic syndrome (MetS) after platinum-based chemotherapy (CHEM): A multicenter study of North American testicular cancer survivors (TCS).
Authors: Abu Zaid Mohammad Issam , Gathirua-Mwangi Wambui G. , Williams AnnaLynn , Fung Chunkit , Monahan Patrick O. , Feldman Darren R. , Hamilton Robert James , Vaughn David J. , Beard Clair , Cook Ryan , Althouse Sandra K. , El Charif Omar , Sesso Howard D. , Ardeshirrouhanifard Shirin , Einhorn Lawrence H. , Fossa Sophie D. , Travis Lois B. ,   For the Platinum Study Group
Published: March 2017

102 Background: Testicular cancer has an excellent prognosis since the introduction of platinum-based CHEM. However, several European studies report an excess of cardiovascular disease (CVD) in TCS. MetS is a cluster of cardiovascular risk factors that doubles CVD risk, with several European series noting a prevalence ranging from 13-39% in TCS. In the first large multi-center North American study of TCS, we examine the prevalence of and potential risk factors for MetS after modern CHEM (NCI R01 CA157823). Methods: Eligible TCS were <50 y at diagnosis and treated with only first line CHEM after 1990. TCS underwent physical exams, completed questionnaires regarding co-morbidities and health behaviors and had lipid panels, testosterone, and serum soluble cell adhesion molecule-1 (sICAM-1) measured. A single nucleotide polymorphism, rs523349 (V89L), in 5-α-reductase gene ( SRD5A2) previously suggested to associate with MetS in TCS was genotyped. MetS was defined as ≥3 of the following: hypertension (HTN), waist circumference ≥102 cm, triglycerides ≥150 mg/dL, HDL ≤40 mg/dL, and diabetes (Alberti et al, Circulation 2009). Controls (1:1) derived from the National Health and Nutrition Examination Survey were matched on age, race, and educational status. Results: We evaluated 486 consecutively enrolled TCS. Median age at evaluation was 38 y (range: 19-68). TCS had higher prevalence of HTN compared to controls (43% vs 31%, P < .01) but lower prevalence of low HDL (24% vs 35%, P < .01) and abdominal obesity (28% vs 40%, P < .01). Prevalence of MetS was comparable (21% TCS; 22% controls, P = .59). In multivariate analysis, age at evaluation (P < .01), serum testosterone <3.0 ng/mL (OR = 2.0, P = .005), and elevated sICAM-1 (OR for quartiles 2, 3, 4 vs lowest quartile: 2.7 (P = .01), 3.1 (P < .01), and 3.6 (P < .01), respectively) significantly correlated with MetS. The variant rs523349 (VL/LL) did not associate with MetS. Conclusions: One in 5 TCS treated with CHEM developed MetS. Providers should screen for MetS, adequately treat hypogonadism, HTN and hyperlipidemia, and encourage TCS to maintain a healthy lifestyle. Significant elevations in sICAM-1 underscore a role for inflammation in MetS.
Brentuximab-induced peripheral neuropathy: Risk factors and patient experiences.
Authors: Nagle Sarah , Strelec Lauren E. , Loren Alison W. , Landsburg Daniel Jeffrey , Nasta Sunita , Mato Anthony R. , Schuster Stephen J. , Svoboda Jakub 
Published: March 2017

120 Background: Brentuximab vedotin (BV) is an immunoconjugate used in Hodgkin lymphoma (HL) and other CD30+ lymphomas. The dose-limiting adverse effect is peripheral neuropathy (BIPN). Predictors of BIPN, effect on outcomes, and the biopsychosocial impact are not well defined. Methods: We conducted a single institution, mixed-methods study of lymphoma patients (pts) who received BV between 1/2010 and 5/2016. A retrospective analysis was conducted in all pts; an open-ended survey was given to pts seen in the prior year. A univariate analysis examined the association between BIPN and potential predictors. Overall survival (OS) and progression-free survival (PFS) were calculated using the Kaplan Meier method. Survey data were analyzed qualitatively via a framework approach. Results: Eighty-nine pts were eligible: 56% were male, 54% had HL, 71% had prior neurotoxic drugs, 93% received single agent BV. The median number of BV doses was 5. Forty-three (48%) pts developed BIPN. It resolved completely in 14 (33%) pts at a median follow-up of 12 mo. The median time to resolution was 13 wks. BV therapy was altered in 21 (24%) pts due to BIPN. There was no difference in PFS (6 vs. 12 mo., p = 0.09) or OS (NR vs. 26 mo., p = 0.11) in pts who had therapy altered due to BIPN. Table 1 lists significant risk factors for BIPN. No additional factors investigated (age, sex, prior neurotoxic agent, underlying neuropathy, diabetes mellitus or BMI) increased risk for BIPN. Fourteen of the 18 (78%) surveyed pts reported BIPN. At a median follow-up of 24 mo., 10 (71%) pts reported ongoing symptoms. BIPN affected quality of life in 50% and work in 20% of pts. Despite significant symptoms from BIPN, all pts were satisfied with their decision to receive BV regardless of disease response. Conclusions: BIPN is a significant adverse event and may fail to resolve in a large subset of pts. Surveyed pts reported that the benefits of BV outweigh the risks. Changes in therapy due to BIPN occur, but this did not affect outcomes in our cohort. Clinicians should be aware of the risk for BIPN and educate pts accordingly. [Table: see text]
Long-term side effects of high-risk neuroblastoma survivors in a referral center in central Illinois.
Authors: Speckhart Beth , Antony Reuben , Fernandez Karen S. 
Published: March 2017

129 Background: Neuroblastoma (NBL) is the most common extra-cranial solid organ malignancy in children. Although low and intermediate-risk patients have a survival of close to 90%, the same cannot be said for patients with high risk (HR) disease. In the last decade multi-modality treatment of HR NBL patients has been intensified to include chemotherapy, surgery, radiation, bone marrow transplantation and immunotherapy and has resulted in improved survival (Yu, 2009). Data regarding the medium to long-term side effects of this intensive multi-modality therapy is now being collected as the population of HR neuroblastoma survivors continues to grow. Methods: We retrospectively reviewed the clinical data of survivors of HR NBL treated at the Children’s Hospital of Illinois diagnosed since 2009 and evaluated the long-term side effects of survivors through 2015. Results: We found 14 NBL patients of whom 10 had HR disease. Four patients died of progressive disease. Therapy-related, long-term side effects occurred in 6 patients: hearing loss (n = 6), adrenal insufficiency (n = 2), focal nodular hyperplasia of the liver (n = 2), linear growth retardation (n = 1). No patient in our cohort developed thyroid or cardiac problems and no patient was diagnosed with a second malignancy in the 5 years of observation. Conclusions: While the improved outcomes seen in HR NBL patients is encouraging, we found in our small cohort hat survivors of multimodality therapy for high-risk neuroblastoma experience significant long-term effects of treatment which impact their quality of life as well as growth and development. As the number of NBL survivors increases our understanding of the long-term therapy related side effects will continue to improve. Larger longitudinal studies are needed to monitor for other possible side effects that may manifest overtime such as cardiomyopathy, disturbances in sexual development, fertility, intellectual function, learning problems and therapy related second malignancies later in life.
Metabolic syndrome in childhood cancer survivors.
Authors: thanga Tamilselvan Santhini , Scott Julius Xavier , Sneha Latha , J Divyalakshmi 
Published: March 2017

145 Background: Reavan in 1988 noted that several risk factors for cardiovascular diseases commonly cluster together, and he recognised them as a disease, named syndrome X, currently known as metabolic syndrome. Metabolic syndrome is a group of disorders related to insulin resistance, characterized clinically by central obesity, hyperglycemia, dyslipidemia and hypertension. There is a growing body of evidence indicating that pediatric cancer survivors are at a greater risk of developing metabolic syndrome. We studied the prevalence of metabolic syndrome in children with cancer who completed their treatment and on follow up. Methods: All relevant past medical data (of the disease, treatment and all events) were collected from the medical records. Tanner staging was perfomred, height was measured using a Harpenden stadiometer. Weight/WAIST circumference were measured. The body mass index (BMI) was calculated as weight (kg)/(height (m)²). BMI ≥90thcentile as per CDC chart was taken as abnormal. Blood pressure was measured on the right arm of the patient. Presence of family history of diabetes, cardiovascular diseases and hypercholesterolemia were taken. Fasting Blood sugar, insulin, HbA1C, lipid profile were done. We used IDF(International diabetes federation) criteria to assess the metabolic syndrome among cancer survivors. This study was approved by our university ethics comittee. Results: Seventy five children who fulfilled the inclusion criteria were included in this study. Out of which 48 were males and 27 were females. Among these, majority of children are treated for acute lymphoblastic leukemia. 8.25% of total population satisfied the criteria of metabolic syndrome. Age, gender, diagnosis, modality of treatment were not to be of statistical significance, however majority of children with metabolic syndrome are in adolescent group. Conclusions: With the better care committed to children with cancer even in developing country, the survival rates are greatly improving and so metabolic syndrome is becoming the major target for intervention in the follow up of cancer survivors. As metabolic syndrome cannot treated by a single drug therapy, it is necessary to have cancer survivors follow up screening.
Virtual weight loss program for African-American breast cancer survivors: Preliminary results.
Authors: Ferrante Jeanne M. , Doose Michelle , Bator Alicja , Devine Katie , Ohman Strickland Pamela , Angelino Alessandra , Lee Jennifer , Koransky Alison , Hwang Kevin , Bandera Elisa 
Published: March 2017

163 Background: Obesity is associated with higher breast cancer recurrence and death, and poorer health and quality of life. African-American (AA) women have the highest prevalence of obesity, obesity-related comorbidities, and breast cancer mortality compared with other racial/ethnic groups. Weight loss after breast cancer diagnosis may lower rates of recurrence and improve fitness, fatigue, and quality of life. Methods: This 6-month randomized controlled trial pilot-tests the use of a Fitbit activity tracker (Fitbit only group) versus Fitbit plus SparkPeople, a free web-based weight loss program (combined group) among 70 AA breast cancer survivors. Paired t-tests assess changes from baseline to 6-months among each participant in primary (weight, body mass index [BMI], percent body fat) and secondary (24-hour caloric intake, daily number of steps, quality of life, self-monitoring strategies, self-efficacy) outcomes. Two-group t-tests assess differences in outcomes between the two groups. Results: Currently, 36 of 46 (78.3%) eligible participants have enrolled and completed baseline assessments. Mean age of participants is 61.7 years (SD 8.7) and mean BMI is 36.9 (SD 7.0). Analyses of the first 25 participants who completed 3-month assessments (Fitbit only N = 12; combined group N = 13) show significant weight loss in both groups; Fitbit only: mean weight change -6.73 pounds, SD 4.61, p < 0.001; mean BMI change -0.96 kg/m2, SD 0.84, p = 0.002; combined group: mean weight change -5.95 pounds, SD 5.84, p = 0.003; mean BMI change -1.03 kg/m2, SD 0.77, p < 0.001. All participants significantly increased tracking of diet (Fitbit only p = 0.016; combined group p < 0.001) and physical activity (Fitbit only p < 0.001; combined group p = 0.001). Though not significant, combined group participants showed greater increases in self-efficacy for eating healthy and reducing fat and calories, and increases in daily steps (+1308 vs. +285 for Fitbit only group). Preliminary analyses show no statistically significant difference in changes in outcomes from baseline to 3 months between the two groups. Conclusions: Both programs show potential as convenient and efficient weight loss methods for African-American breast cancer survivors. Clinical trial information: NCT02699983.
Exercise, metabolic syndrome, and cardiovascular fitness in breast cancer survivors.
Authors: Knobf M. Tish , Sinusas Albert , Holland Margaret , Jeon Sangchoon 
Published: March 2017

165 Background: Metabolic syndrome (MetS) has been reported higher in breast cancer survivors (BCS) compared to age-matched postmenopausal women. The risk for cardiovascular disease and diabetes is significantly increased in women with MetS. Lifestyle behaviors are recommended first line interventions to reduce risk for MetS. Methods: From a 12 month randomized controlled trial (RCT) of a fitness center exercise intervention compared to a home physical activity group, the criteria for MetS (3 of 5 components: waist circumference [WC] ≥ 80cm, triglycerides ≥ 150mg/dL, HDL cholesterol < 40 mg/dL, blood pressure [BP] ≥ 130/85 mmHg, fasting blood sugar [FBS] > 100mg/dL) were used to identify BCS with MetS. General estimating equation was employed for longitudinal changes. Heart rate recovery (reduction in heart rate from peak heart rate at one minute after exercise stress test) was used as a measure of cardiovascular fitness. Pearson correlation coefficients assessed associations between heart rate recovery and metabolic outcomes. Results: Of 148 subjects in the RCT, 21.6% (N = 32) met the criteria for MetS, with a higher baseline incidence in the home (30.1%) versus fitness center (13.3%) groups (p = 0.01). Of subjects on Tamoxifen, 30.9% had MetS, compared to 17.1% on an aromatase inhibitor and 20.7% not on endocrine therapy; these were not significantly different (p = .28). Among those with MetS at baseline, we observed a significant decrease in MetS (p < .01) with significant changes in HDL (p = 0.02) and FBS (p = .01) after the 12 month intervention. The fitness center and home physical activity groups both resulted in fewer subjects meeting MetS criteria at 12 months, but only the home group had a significant change over time (OR = 0.66 (0.44, 0.98) p = .04). Heart recovery rate at 6 months was significantly associated with all 5 MetS components: WC (-0.28 p < .01), triglycerides (-0.32 p < .01), HDL (0.20 p = .04), systolic BP (-0.38 p < .01), diastolic BP (-0.27 p < .01) and FBS (-0.35 p < .01). Conclusions: All-cause mortality now exceeds breast cancer specific mortality. MetS identifies a unique vulnerable population of BCS at high risk for cardiovascular disease. Lifestyle behaviors represent critical risk reduction strategies.
Development and pilot test of a dyadic psychosocial intervention for couples coping with head and neck cancer.
Authors: Badr Hoda 
Published: March 2017

187 Background: Patients receiving radiotherapy for head and neck cancers (HNCs) experience significant persistent side effects such as abnormally reduced salivation, difficulty swallowing, and taste changes. To control these side effects and minimize discomfort, intensive self-care protocols are prescribed, but adherence is poor. Spouses/partners play a critical role in supporting adherence, but often lack knowledge, experience high rates of distress, and display poor communication that can interfere with patient self-management and self-care. Methods: We developed and pilot-tested a skills-training intervention comprised of tailored manuals and 6 counseling sessions delivered over the telephone to HNC patients and their partners. The goal is to reduce healthcare utilization and improve patient and partner quality of life (QOL). To guide the development and content of the intervention, qualitative interviews with 6 HNC patients (83% male) and 6 spouses were analyzed using a grounded theory approach. For the pilot test, couples completed surveys prior to initiating radiotherapy and were randomized to the intervention or usual medical care. Eight weeks later, they completed follow-up surveys. Results: Based on the qualitative findings, we developed the intervention to teach: 1) self-management skills; 2) communication skills; and 3) strategies to improve communal coping and confidence in the ability to work as a team. To date, 20 couples (Mean Age = 57 years; SD = 8) have participated. Solid recruitment (83%) and low attrition rates demonstrate feasibility. Strong program evaluations (Mean = 8.7 out of 10) and homework completion rates (85%) support acceptability. Conclusions: This is the first program in HNC that actively involves both members of the couple to address barriers in the home environment in which self-management occurs. By empowering couples with the skills to coordinate care and support, the program holds great promise for improving self-management behaviors, reducing costly hospitalizations and treatment interruptions, and improving patient and partner QOL.
Evaluation of the psychosocial needs of cancer survivors.
Authors: Pabbathi Smitha , Abid Ariana , Mehta Kanan , Martinez Dinorah Tyson , Hall Carrie , McMillan Susan 
Published: March 2017

207 Background: Even after enduring successful treatment of their cancer, the late physical and psychosocial effects of treatment often continue to haunt as many as 50% of survivors. Furthermore, the needs of cancer survivors differ from those undergoing active treatment. However, there is a lack of comprehensive assessment for providers caring for survivors. Therefore, there is a need for one tool to assess the physical and psychosocial needs as well as evaluate their severity when initially establishing care in general survivorship clinic. In this study, we determine the most commonly identified of these needs as well as the degree to which they impact overall health of this population. Methods: A retrospective chart review of 220 patient records from the past six years in General Survivorship Clinic using Moffitt Cancer Center’s EHR was performed. All patients (ages 18-85 years) diagnosed with cancer without evidence of current disease and who had complete Clinical Needs Assessment Tool for Cancer Survivors (CNAT-CS) were eligible for inclusion. The CNAT- CS is a questionnaire of 36 items on which survivors identify as “not a concern”, “is a concern but I am managing”, or “I need help”. Results: A majority (65.5%) was female and white (81.3%); African Americans made up 11.4%. The mean age was 57.6 (SD = 11.3). Subjects had survived a variety of types of cancer with more than half (57%) having breast cancer. Their mean distress score was 2.75 (SD = 2.86). Fear of recurrence was the concern most often identified (56%), followed by feeling of high stress (50%), sleep disturbances (49%) and memory/ attention difficulties (40%). Highest scores were found on items about fear of the cancer returning (Mean = 0.71; SD = .55), information needed for follow-up care (mean = .64; SD = .59), stress in my life (mean = .60; SD = .65) and trouble with my memory/attention (mean = 0.52; SD = .69). Conclusions: These results indicate a relatively low mean distress score from the distress thermometer. Areas identified most frequently as a concern also tended to be the areas with the highest mean scores. Although almost 20% of survivors were in minority groups, ethnic minorities were underrepresented in this sample. Thus, future studies should focus on increasing the representativeness of the sample.
Perceptions and consequences of cancer-related weight loss among patients with cancer and caregivers.
Authors: Buzaglo Joanne S , Zaleta Alexandra K , Miller Kayla M , Kennedy Victoria , Charap Ellyn Specker 
Published: March 2017

224 Background: Cancer-related weight loss affects up to 50% of individuals with cancer, yet our understanding of psychosocial consequences of this weight loss is limited. This study examined patient and caregiver perceptions of symptoms and consequences of cancer-related weight loss. Methods: Patients with self-reported weight loss (n = 15; 26% non-mBC, 13% colorectal, 13% MM, 13% ovarian, 35% other; mean BMI = 22.9) and caregivers of people experiencing weight loss (n = 15) were recruited through the online Cancer Experience Registry. Participants completed a one-hour phone interview about views about weight loss; transcribed responses underwent content and thematic analysis by three coders (agreement = 89%). Results: Across participants, the most commonly reported weight loss-related symptoms included appetite changes (80% of participants), nausea (73%), and taste changes (60%). Most bothersome consequences of weight loss for patients included fear of disease progression (53%), loss of identity (47%), caregiver burden worries (40%), anxiety (27%), and body image concerns/embarrassment about physical appearance (27%). Most bothersome consequences for caregivers were burden of providing care (80%), distress about physical appearance of the patient (80%), changed sense of patient identity (60%), fear of illness progression (53%), and family impact (40%). Weight loss acceptance varied by BMI; obese/overweight patients reported greater acceptance, citing improvements in body image and better physical fitness as reasons for acceptance. Only 33% of patients and 22% of caregivers reported that their healthcare team addressed cancer-related weight loss during medical visits. Conclusions: With respect to cancer-related weight loss, patients and caregivers most often identified psychosocial concerns as bothersome; concerns about weight loss causing changes in physical appearance were more prevalent among caregivers. These results support development of a psychometric measure to evaluate cancer-related weight loss and suggest the need for better integration of cancer-related weight loss concerns into survivorship care plans.
Systemic Lupus Erythematosus Is Associated With Increased Adverse Postoperative Renal Outcomes and Mortality: A Historical Cohort Study Using Administrative Health Data
Authors: Babazade Rovnat , Yilmaz Huseyin Oguz , Leung Steve M. , Zimmerman Nicole M. , Turan Alparslan 
Published: March 2017

BACKGROUND:Systemic lupus erythematosus (SLE) is a common autoimmune connective tissue disease that mainly harms kidneys, heart, lungs, and nervous system. Effects of surgical stimulus and anesthesia combined with SLE-related pathologies may increase morbidity and mortality. Therefore, we aimed to evaluate the association between SLE (versus none) and postoperative renal, cardiac, and in-hospital mortality complications among patients undergoing major surgeries.METHODS:We obtained censuses of 2009 to 2011 inpatient hospital discharges across 7 states and conducted a retrospective cohort study by using International Classification of Diseases and Injuries, Version 9, diagnosis codes, procedure codes, and present-on-admission indicators. We included patients who had major surgery and matched each SLE discharge up to 4 control discharges for potential confounders. We assessed the association between matched SLE patients and controls on in-hospital renal complications, cardiovascular complications, and in-hospital mortality using separate logistic regression models.RESULTS:Among 8 million qualifying discharges, our sample contained 28,269 SLE patients matched with 13,269 controls. SLE was associated with a significantly higher risk of postoperative renal complications, with an estimated odds ratio (99% CI) of 1.33 (1.21, 1.46);P< .001. In addition, SLE was significantly associated with a higher risk of in-hospital mortality, with an estimated odds ratio (99% CI) of 1.27 (1.11, 1.47);P< .001. However, we found no significant association between SLE and cardiac complications, with an estimated odds ratio (99% CI) of 0.98 (0.83, 1.16),P= .79.CONCLUSIONS:This is, by far, the largest clinical study for postoperative outcomes of SLE patients with adequately powered statistical analyses. We concluded that SLE was associated with a higher risk of renal complications and in-hospital mortality but not cardiac events after major surgery. In SLE patients, more aggressive measures should be taken to prevent renal injury in the perioperative period.