bluuebunny/crossref_metadata_2025_split huggingface dataset:
Combination Systemic Therapy for Advanced Renal Cell Carcinoma
Authors: Miller Rowan E. , Larkin James M. G. 
Published: November 2009

Abstract
Outcomes for patients with advanced renal cell carcinoma (RCC) have improved significantly in recent years with the development of novel noncytotoxic systemic therapies. The multitargeted kinase inhibitors sunitinib and sorafenib have been approved for the treatment of advanced RCC, and bevacizumab, a monoclonal anti–vascular endothelial growth factor antibody, has shown significant clinical activity, both as a single agent and in combination with interferon-α. The mammalian target of rapamycin inhibitors temsirolimus and everolimus have led to longer overall survival times in poor-risk patients in the first-line setting and longer progression-free survival times in kinase inhibitor refractory patients in the second-line setting, respectively.
Despite these advances, almost all patients develop resistance to treatment and cure is rarely seen. There is therefore a need to overcome resistance, induce longer lasting remissions, and improve survival. A potential approach to this is to combine active agents, and the clinical data for combination therapy with novel targeted agents in advanced RCC are reviewed here.
Age at Diagnosis and Age at Death in Familial Prostate Cancer
Authors: Brandt Andreas , Bermejo Justo Lorenzo , Sundquist Jan , Hemminki Kari 
Published: November 2009

Abstract

Learning Objectives
After completing this course, the reader will be able to: Assess the relationship between the cumulative prostate cancer–specific mortality rate and the number, age at diagnosis, and degree of relatives affected by prostate cancer.Evaluate the difference in the age at onset and age at death in familial prostate cancer between men with and without a family history of prostate cancer.
This article is available for continuing medical education credit at CME.TheOncologist.com.

Objectives.
A family history of prostate cancer is associated with a higher risk for prostate cancer to first-degree relatives. If greater surveillance of men at familial risk is considered to be useful, population-based estimates of the differences in the age at diagnosis between familial and sporadic prostate cancer cases are needed.

Methods.
The men in the nationwide Swedish Family-Cancer Database were classified according to the number and type of affected first-degree relatives (father or brother) and according to the relative’s age at diagnosis. The cumulative incidence of prostate cancer and cumulative prostate cancer–specific mortality were estimated using a stratified Cox model.

Results.
The cumulative incidence was highest for men with multiple affected first-degree relatives, and it was higher for brothers than for sons of prostate cancer patients. The age to reach the same cumulative incidence as the general population at age 55 years decreased with decreasing age at diagnosis of the relative, ranging from 48.7 years (father diagnosed before 60 years of age) to 53.7 years (father diagnosed after 82 years of age). Prostate cancer–specific mortality was also related to the number and type of affected relatives but there was no clear evidence for a dependency on the age at diagnosis of the relative.

Conclusions.
Men with a father or a brother affected by prostate cancer are diagnosed and die at earlier ages than men without a family history of prostate cancer. This study should encourage further analysis in order to assess the risks and benefits of screening for prostate cancer in men at higher risk.
CXCR4 Expression in Early Breast Cancer and Risk of Distant Recurrence
Authors: Andre Fabrice , Xia Weiya , Conforti Rosa , Wei Yongkun , Boulet Thomas , Tomasic Gorana , Spielmann Marc , Zoubir Moustafa , Berrada Narjiss , Arriagada Rodrigo , Hortobagyi Gabriel N. , Hung Mien-Chie , Pusztai Lajos , Delaloge Suzette , Michiels Stefan , Cristofanilli Massimo 
Published: November 2009

Abstract

Learning Objectives
After completing this course, the reader will be able to: Assess CXCR4 expression in the primary tumor for use as an indicator of a higher risk for bone metastasis in early breast cancer.Evaluate the relationship between CXCR4 expression and the occurrence of metastases in other SDF-1–producing organs, including the liver and lung.Use CXCR4 in different ways in combination with other markers to identify patients to be screened for bony metastases and/or treated preventatively for bone metastasis.
This article is available for continuing medical education credit at CME.TheOncologist.com.

Background.
Chemokine receptor 4 (CXCR4) has been demonstrated to have a critical role in the early metastatic process. The aim of this study was to evaluate the prognostic value of CXCR4 expression in primary breast tumors and describe correlations with the occurrence of metastasis in organs expressing the CXCR4 ligand stromal cell–derived factor 1 (i.e., liver, lung, brain, and bone).

Patients and Methods.
CXCR4 expression in primary breast tumors was evaluated by immunohistochemistry in 823 patients included in two prospective clinical trials. CXCR4 expression was considered positive when &gt;1% of tumor cells were stained. The prognostic value of CXCR4 expression was assessed by a Cox regression model adjusted for clinical characteristics. We assessed the association of CXCR4 expression with the rate of distant metastasis to specific organ sites.

Results.
CXCR4 was expressed in 92 of 794 primary tumors (12%). CXCR4 expression was not associated with clinical characteristics. CXCR4 was not prognostic for overall survival and showed a nonsignificant trend toward a higher risk for distant metastasis. CXCR4+ tumors showed a significantly higher risk for bone metastasis. The 10-year incidences of bone metastases were 23% (13.6%–32.6%) and 12% (9.7%–15%) in CXCR4+ and CXCR4− tumors, respectively.

Conclusion.
This study suggests that expression of CXCR4 in primary breast tumors is associated with a higher likelihood of developing bone metastases. This finding could open new avenues for the development of novel adjuvant strategies, including bone-targeting agents.
Plasmacytoid Dendritic Cell Leukemia: A Rapidly Evolving Disease Presenting with Skin Lesions Sensitive to Radiotherapy plus Hyperthermia
Authors: Tecchio Cristina , Colato Chiara , Bonifacio Massimiliano , Krampera Mauro , Maluta Sergio , Pizzolo Giovanni , Girolomoni Giampiero 
Published: November 2009

Abstract
Plasmacytoid dendritic cell leukemia (pDCL) is a rapidly evolving disease, which frequently presents with skin lesions, particularly nodules and plaques with a typical reddish-brown or brown color. Treatment of pDCL is based on multiagent chemotherapy followed by allogeneic hematopoietic stem cell transplant, but skin lesions may be refractory to therapy. Here, we report on a 61-year-old patient affected by pDCL who first presented with multiple cutaneous nodules and plaques on the trunk. Lesions showed an excellent response to radiotherapy plus hyperthermia. Although this treatment did not avoid the systemic evolution of disease, it resolved skin lesions and prevented their relapse, thus representing a therapeutic option to be used in combination with chemotherapy regimens. The case presentation is followed by a general discussion with an emphasis on the diagnosis and treatment of this rare malignancy.
An investigation into the suitability of a commercial real‐time PCR assay to screen for Taylorella equigenitalis in routine prebreeding equine genital swabs
Authors: OUSEY J. C. , PALMER L. , CASH R. S. G. , GRIMES K. J. , FLETCHER A. P. , BARRELET A. , FOOTE A. K. , MANNING F. M. , RICKETTS S. W. 
Published: December 2009

Summary Reasons for performing study: Standard bacteriological methods for identifying Taylorella equigenitalis in cervical smears are time consuming. Therefore, a more rapid real‐time PCR assay was evaluated for its suitability in screening swabs. Objective: To compare the results of a commercially available real‐time PCR assay with routine microbiological culture for the identification of T. equigenitalis, the causative organism of contagious equine metritis, in equine genital swab samples, under ‘field trial’ conditions. Materials and methods: Routine prebreeding genital swabs (n = 2072) collected from Thoroughbred mares and stallions during 2009 were examined together with stored T. equigenitalis positive material. Swabs were cultured for T. equigenitalis using standard microbiological techniques. Bacterial lysates were isolated from the swabs and examined for the presence of a 16S DNA fragment of T. equigenitalis, using a commercial multiplex real‐time PCR assay system. Results: There was complete concordance between positive and negative results obtained by the 2 methods. Real‐time PCR also detected T. equigenitalis DNA from swabs that were negative using standard microbiological culture after 6 months' storage at +4°C but from which T. equigenitalis had been isolated following collection. The sensitivities of realtime PCR and bacterial culture were both 10−3 (equivalent to 3 colony‐forming units). Conclusion and clinical relevance: Routine bacterial culture of T. equigenitalis requires an incubation period of not less than 7 days before a conclusive negative result can be obtained, whereas bacterial extraction and real‐time PCR assay can be completed in less than 6 h. The commercially‐available PCR assay tested provided a rapid and reliable method for the identification of T. equigenitalis from equine genital swabs and could be usefully employed for the screening of mares and stallions for preseason Horserace Betting Levy Board (HBLB) Code of Practice and in other situations such as for bloodstock sales screening requirements, overcoming the current delays imposed by bacterial culture requirements. Its use could be quality assured by the existing HBLB biannual testing scheme for designated laboratories.
A Danish national survey of women operated with mid‐urethral slings in 2001
Authors: AMMENDRUP ASTRID CECILIE , JØRGENSEN ANETTE , SANDER PIA , OTTESEN BENT , LOSE GUNNAR 
Published: December 2009

AbstractObjective. To perform a national survey on self‐reported cure, satisfaction and complications four years after mid‐urethral sling (MUS) for urinary stress incontinence in Danish women operated in 2001. Design. A postal questionnaire survey. Population. All Danish women who received an MUS operation in 2001 extracted from the Danish National Patient Register. Methods. The women received a validated postal questionnaire in 2005. The questionnaire included questions about subjective cure, satisfaction, complications and a Danish version of International Consultation on Incontinence Questionnaire‐Short Form. The study was carried out in cooperation with the Danish National Board of Health. Results. A total of 335 (92%) women responded to the questionnaire, among whom 105 (32%) felt completely cured, 119 (36%) were much improved, 55 (17%) were improved and 48 (15%) unchanged or worse. Cure rate varied between departments from 0% to 67%. Low‐volume departments (<10 operations/year) had a significantly (p = 0.05) lower cure rate compared to the department with a higher volume. Altogether, 238 (73%) women were very satisfied with their operation. Self‐reported bladder emptying difficulties were reported by 103 (32%) and the need for clean intermittent catherization (CIC) at any stage was reported by 21 (7%). No woman was still performing CIC. Of the women, 126 (42%) had made contact with the healthcare system because of their operation after discharge from hospital. Conclusions. Long‐term outcome of MUS operations in Denmark in terms of cure, satisfaction and complication rates seems comparable to international results; however, the decentralized organization with many low‐volume departments seems inappropriate.
Miscarriage and risk of cardiovascular disease
Authors: KHARAZMI ELHAM , FALLAH MAHDI , LUOTO RIITTA 
Published: November 2009

AbstractIn a nationally representative sample (the Health 2000 Survey) comprising 3,937 Finnish women aged 30–99 years, we examined the association of miscarriage (assessed by questionnaire) with risk of cardiovascular disease (assessed by physician's examination and linkages to hospital discharge and drug reimbursement registers). We considered age, smoking, body mass index, waist/hip ratio, physical activity, education, number of previous pregnancies, blood pressure, and fasting blood glucose and cholesterol as potentially confounding factors in the analysis. In women 50–74 years of age who had experienced pregnancy, history of miscarriage tended to be associated with a higher risk of myocardial infarction (age‐adjusted odds ratio (OR): 2.1, 95% confidence interval (CI): 1.0–4.3), and the risk increased significantly with the number of miscarriages (age‐adjusted OR per miscarriage: 1.4, 95% CI: 1.1–1.8). These results suggest that women who experience repeated miscarriages may be at an increased risk of cardiovascular disease later in life.
An economic evaluation of alternative test‐intervention strategies to prevent spontaneous pre‐term birth in singleton pregnancies
Authors: TSOURAPAS ANGELOS , ROBERTS TRACY E. , BARTON PELHAM M. , HONEST HONEST , FORBES CAROL , HYDE CHRIS J. , KHAN KHALID S. 
Published: November 2009

AbstractObjective. To investigate the potential cost‐effectiveness of alternative ‘test‐and‐treat’ strategies in the prevention of spontaneous pre‐term birth before 34 and 37 weeks' gestation.Design. Model‐based economic evaluation.Setting.Clinics, general practices, health centers or any setting delivering antenatal care.Population.Asymptomatic women in early pregnancy and symptomatic women with threatened pre‐term labor in later pregnancy.Methods. Data from systematic reviews of effectiveness and accuracy were combined into strategies and analyzed using a decision‐tree model. Full deterministic and probabilistic sensitivity analyses were carried out.Main outcome measures.Spontaneous pre‐term labor avoided for asymptomatic women and spontaneous pre‐term birth avoided for symptomatic women.Results. The systematic reviews identified evidence on the accuracy of 22 types of tests and on the effectiveness of 40 possible interventions. Cost data were based on secondary evidence, supplemented with primary data from local sources. Testing prior to intervention was not shown to be the most cost‐effective strategy in the main analyses for 34 and 37 weeks. Prophylactic fish oil in asymptomatic women, without prior testing, was highlighted as potentially cost‐effective in preventing threatened pre‐term labor before 34 weeks. In symptomatic women with a viable pregnancy, indomethacin without prior testing was a potentially cost‐effective strategy to prevent pre‐term birth occurring before 37 weeks.Conclusion.An effective, affordable and safe intervention applied to all mothers without prior testing is likely to be the most cost‐effective strategy in the prevention of spontaneous pre‐term labor and birth. The results reported in this paper are important for prioritizing future research, world‐wide.
Radiologic and clinical outcomes with special reference to tumor involvement pattern after stent placement for malignant bronchial obstructions
Authors: Shin Ji Hoon , Song Ho-Young , Kim Kyung-Rae , Kim Jin Hyoung , Kim Sang Wee , Lee Dae-Ho , Hong Sang-Beom 
Published: December 2009

Background: Location of tumor within the tracheobronchial tree as well as its severity can affect the clinical outcome of patients who undergo airway stent placement. Purpose: To evaluate radiologic and clinical outcome, including survival data, with special reference to proposed tumor involvement pattern, in patients with malignant bronchial strictures. Material and Methods: A total of 35 patients who underwent stent placement for malignant bronchial strictures were enrolled over a 9-year period. Tumor involvement pattern was divided into three types based on computed tomography (CT) scans and selective bronchography. Type I was defined as tumor involving only the main stem bronchus; type II, tumor involving the bronchus intermedius and/or the lower lobar bronchus without involvement of the lower-lobe segmental bronchus; and type III, tumor involving the lower lobar bronchus with involvement of the lower-lobe segmental bronchus. Tumor stage, lung collapse/infiltration, radiologic improvement, clinical improvement, and survival were compared according to the tumor involvement pattern. Results: Tumor involvement pattern was of type I, II, and III in 14, 13, and eight patients, respectively. When comparisons were made between types I/II and type III to evaluate the influence of lower-lobe segmental bronchial involvement, radiologic and clinical improvement was significantly lower in type III than in types I/II, while advanced stage, lung collapse/infiltration, and median overall survival were not significantly different between types I/II and type III. Conclusion: In patients with malignant bronchial obstructions involving the lower-lobe segmental bronchus, clinicians must be aware of the possibility of less radiologic and clinical improvement following stent placement.
Signs and Symptoms of Heart Failure: Are You Asking the Right Questions?
Authors: Albert Nancy , Trochelman Kathleen , Li Jianbo , Lin Songhua 
Published: November 2009

BackgroundPatients may not verbalize common and atypical signs and symptoms of heart failure and may not understand their association with worsening disease and treatments.ObjectivesTo examine prevalence of signs and symptoms relative to demographics, care setting, and functional class.MethodsA convenience sample of 276 patients (164 ambulatory, 112 hospitalized) with systolic heart failure completed a 1-page checklist of signs and symptoms experienced in the preceding 7 days (ambulatory) or in the 7 days before hospitalization. Demographic and medical history data were collected.ResultsMean age was 61.6 (SD, 14.8) years, 65% were male, 58% were white, and 45% had ischemic cardiomyopathy. Hospitalized patients reported more sudden weight gain, weight loss, severe cough, low/orthostatic blood pressure, profound fatigue, decreased exercise, restlessness/confusion, irregular pulse, and palpitations (all P &lt; .05). Patients in functional class IV reported more atypical signs and symptoms of heart failure (severe cough, nausea/vomiting, diarrhea or loss of appetite, and restlessness, confusion, or fainting, all P ≤ .001). Sudden weight gain increased from 5% in functional class I to 37.5% in functional class IV (P &lt; .001). Dyspnea occurred in all functional classes (98%–100%) and both settings (92%–100%). Profound fatigue was associated with worsening functional class (P &lt; .001) and hospital setting (P = .001); paroxysmal nocturnal dyspnea was associated with functional class IV (P = .02) and hospital setting (P &lt; .001).ConclusionProfound fatigue is more reliable than dyspnea as an indicator of functional class. Nurses must recognize atypical signs and symptoms of worsening functional class to determine clinical status and facilitate patient care decisions.
APPARENT DDT TOLERANCE IN AN AQUATIC INSECT DISPROVED BY TEST
Authors: Sprague J. B. 
Published: December 2009

AbstractCertain mayflies and stoneflies were present in a forest stream in New Brunswick after frequent yearly sprayings with DDT. Tests showed that a stonefly, Nemoura sp., apparently the most likely insect to have developed DDT tolerance, had not done so. Presence of mayflies and stoneflies in the stream was probably because they survived spraying while in the egg stage, or recovered quickly after spraying, or both.
THE PREDATION OF TENT CATERPILLARS, MALACOSOMA AMERICANA (LEPIDOPTERA: LASIOCAMPIDAE) BY ANTS (HYMENOPTERA: FORMICIDAE)
Authors: Ayre G. L. , Hitchon D. E. 
Published: December 2009

AbstractFirst- and second-instar tent caterpillar larvae are acceptable prey for many native species of ants. The amount of predation which occurs is normally related to ambient temperature. A warm period in early spring allows ants to forage actively and often leads to destruction of the caterpillar colonies whereas a cool spring curtails ant activity and allows the caterpillars to develop beyond the vulnerable period free from predation by ants. In latter instars the caterpillars are protected completely against ants by their dense setae.
CONTRIBUTIONS TO A STUDY OF THE PYRAUSTINAE (LEPIDOPTERA: PYRALIDAE) OF TEMPERATE EAST ASIA. VII
Authors: Munroe Eugene , Mutuura Akira 
Published: December 2009

AbstractThe following new species and subspecies of Circobotys are described: C. elegans n. sp., Taiwan; C. heterogenalis onumalis n. subsp., Hokkaido; C. heterogenalis pertinctalis n. subsp., Shantung, China; C. obscuralis ahyoui n. subsp., Yuennan, China; C. elongata n. sp., Taiwan; C. cryptica n. sp., Japan and China; C. plebeia n. sp., Tapaishan, S. Shensi, China.
CHEMOTAXONOMIC STUDIES OF ANTS: FREE AMINO ACIDS
Authors: Vick K. , Drew W. A. , Young J. , Eisenbraun E. J. 
Published: December 2009

AbstractExtracts of free amino acids from six species of ants (Pogonomyrmex barbatus (F. Smith), P. occidentalis (Cresson), Tapinoma sessile (Say), Camponotus pennsylvanicus (DeGeer), Conomyrma pyramica (Roger), and Novomessor cockerelli (E. André) were analyzed by thin layer, one and two dimensional paper chromatography, and an automatic amino acid analyzer to determine the potential use of qualitative and (or) quantitative data of the free amino acid composition of ants in taxonomic studies. The results demonstrate that no significant qualitative differences exist, but that the automatic amino acid analyzer may be used to show significant quantitative differences in the free amino acid composition of the ants studied.
FLIGHT MUSCLE CHANGES IN BLACK HILLS BEETLES, DENDROCTONUS PONDEROSAE (COLEOPTERA: SCOLYTIDAE), DURING EMERGENCE AND EGG LAYING
Authors: McCambridge W. F. , Mata S. A. 
Published: December 2009

AbstractThe lateralis medius, an indirect flight muscle of Black Hills beetles, degenerated abruptly in females within 3 days after attack. Egg laying began at the end of the 3 days. Thickness of the muscle changed much more than width. Regeneration began in most ovipositing females about 10 days after attack. Steady development of the muscle to its maximum size, reached prior to beetle emergence, offers a method of forecasting emergence.
HOST SELECTION AND OVIPOSITION BEHAVIOR OF NASONIA VITRIPENNIS (HYMENOPTERA: PTEROMALIDAE) ON TWO HOST SPECIES
Authors: Smith G. J. C. 
Published: December 2009

AbstractThe oviposition behavior of the pteromalid parasitoid Nasonia vitripennis (Walker) was investigated in an attempt to explain the difference in population density maintained on two species of host, the housefly, Musca domestica L., and the blowfly, Phaenicia sericata (Meigen). The behavior of a female wasp was significantly affected by the species of host to which she was exposed. When presented with 10 pupae for 24 hours she averaged 14.2 eggs on 3.0 housefly hosts and 8.3 eggs on 7.2 blowfly hosts of the same size.The importance of the alteration in behavior to the population density of Nasonia became apparent when the suitability of the two host species was examined. At all densities of eggs more wasps matured on blowfly pupae than on housefly pupae of the same size. Survival on both hosts decreased as the density of Nasonia eggs increased. The difference in egg distribution, coupled with lower survival on housefly pupae and at increased density suggests a considerably lower production by this parasitoid on housefly hosts, compared with that on blowfly pupae.