bluuebunny/crossref_metadata_2025_split huggingface dataset:
Parity and Lactation in Relation to Estrogen Receptor Negative Breast Cancer in African American Women
Authors: Palmer Julie R. , Boggs Deborah A. , Wise Lauren A. , Ambrosone Christine B. , Adams-Campbell Lucile L. , Rosenberg Lynn 
Published: September 2011

AbstractBackground: Estrogen receptor (ER)-negative breast tumors and progesterone receptor (PR)-negative breast tumors occur more commonly in women of African ancestry. Recent research indicates that the effects of reproductive factors may differ by hormone receptor status. We assessed the relation of parity and lactation to incidence of ER−/PR− and ER+/PR+ breast cancer in a cohort of African American women.Methods: From 1995–2009, 457 incident cases of ER+/PR+ and 318 cases of ER−/PR− breast cancer were confirmed by review of pathology data among 59,000 African American women followed in the Black Women's Health Study through biennial questionnaires. HRs and two-sided 95% CIs for the incidence of breast cancer subtypes were derived from proportional hazards regression models that controlled for age, reproductive variables, and breast cancer risk factors.Results: Higher parity was associated with an increased risk of ER−/PR− breast cancer (HR = 1.48, 95% CI: 0.98–1.84 for 3+ versus 0 births, Ptrend = 0.009), and with a reduced risk of ER+/PR+ cancer (HR = 0.53, 95% CI: 0.39–0.73 for 3+ versus 0 births, Ptrend = 0.0002). Among women who had breastfed, high parity was no longer associated with increased incidence of ER−/PR− breast, but the inverse association with ER+/PR+ cancer persisted.Conclusions: The higher incidence of ER−/PR− breast cancer in African American women may be explained in part by their higher parity and lower prevalence of breastfeeding relative to white women.Impact: Increased breastfeeding may lead to a reduction in the incidence of this breast cancer subtype. Cancer Epidemiol Biomarkers Prev; 20(9); 1883–91. ©2011 AACR.
Increased Mortality in Women with Breast Cancer Detected during Pregnancy and Different Periods Postpartum
Authors: Johansson Anna L.V. , Andersson Therese M-L. , Hsieh Chung-Cheng , Cnattingius Sven , Lambe Mats 
Published: September 2011

Abstract
Background: Because of a continued trend toward postponed childbearing, the incidence of pregnancy-associated breast cancer (PABC) is likely to increase. This study investigated the mortality in women with PABC in relation to when the tumor was detected (during pregnancy, different postpartum periods) and by time since diagnosis, compared with women with non-PABC.
Methods: A population-based cohort study of 15,721 Swedish women diagnosed with breast cancer between ages 15 to 44 years, of whom 1,110 (7%) had a PABC (diagnosed during or within two years after pregnancy). Information on outcome and potential confounders was obtained from population-based health registers. Mortality rates and HRs with 95% CIs were estimated.
Results: Women with PABC had higher mortality compared with women with non-PABC diagnosed at the same age and calendar period. Among women with PABC, 46% died within 15 years after diagnosis, whereas 34% died among non-PABC patients. The mortality in both groups peaked at around two years after diagnosis, with the highest peak occurring in women diagnosed 4 to 6 months after delivery (HR = 3.8, 95% CI: 2.4–5.9). An increased mortality among women with PABC remained until 10 years after diagnosis.
Conclusions: Women with PABC had a poorer prognosis compared with women with breast cancer and no recent birth. The mortality increase was most pronounced in the subgroup of women diagnosed shortly after delivery.
Impact: An increased awareness among clinicians may help reduce the mortality in women with PABC, for example, by avoiding undue delays in diagnosis and treatment. Cancer Epidemiol Biomarkers Prev; 20(9); 1865–72. ©2011 AACR.
Cancer Disparities: Unmet Challenges in the Elimination of Disparities
Authors: Gehlert Sarah , Colditz Graham A. 
Published: September 2011

Abstract
Background: The first 20 years of publication of Cancer Epidemiology, Biomarkers & Prevention occurred during a period of increased attention to health disparities and advances in knowledge about their determinants. Yet, despite clear documentation of disparities and advanced understanding of determinants, we have made little headway in reducing disparities at the population level. Multilevel models, such as one produced by the Centers for Population Health and Health Disparities (CPHHD), hold promise for understanding the complex determinants of cancer disparities and their interactions as well as translating scientific discoveries into solutions. The CPHHD model maps across a range of scientific disciplines, from the biological to the social, each with its own disciplinary language and methods. The ability to work effectively across disciplinary boundaries is essential to framing comprehensive solutions.
Methods: After briefly characterizing the current state of knowledge about health disparities, we outline three major challenges faced by disparities researchers and practitioners and offer suggestions for addressing these challenges.
Results: These challenges are how to consider race and ethnicity in disparities research, how best to translate discoveries into public health solutions to cancer disparities, and how to create a research environment that supports the successful execution of multilevel research.
Conclusions: Attention to all three of the challenges outlined above is urgently needed to advance our efforts to eliminate cancer disparities.
Impact: Addressing the challenges outlined above will help to eliminate disparities in the future.Cancer Epidemiol Biomarkers Prev; 20(9); 1809–14. ©2011 AACR.
Impact of Serial Troponin Release on Outcomes in Patients With Acute Heart Failure
Authors: O'Connor Christopher M. , Fiuzat Mona , Lombardi Carlo , Fujita Kenji , Jia Gang , Davison Beth A. , Cleland John , Bloomfield Daniel , Dittrich Howard C. , DeLucca Paul , Givertz Michael M. , Mansoor George , Ponikowski Piotr , Teerlink John R. , Voors Adriaan A. , Massie Barry M. , Cotter Gad , Metra Marco 
Published: September 2011

Background—
Cardiac troponin T (cTnT) elevation is common and is a predictor of outcomes in patients with acute heart failure (AHF). The degree and progression of cTnT release during hospitalization of patients with AHF is unclear. We evaluated the incidence of cTnT release during AHF hospitalization and the relationship of cTnT release with outcomes.

Methods and Results—

The
P
lacebo-controlled
R
andomized study of the selective A(1) adenosine receptor antagonist rolofylline for patients hospitalized with acute heart failure and volume
O
verload to assess
T
reatment
E
ffect on
C
ongestion and renal func
T
ion (PROTECT) pilot study was a multicenter, double-blind study of patients with AHF. Measurements of cTnT were collected at randomization and days 2, 3, 4, and 7. Patients were classified on the basis of their serum cTnT levels at baseline: positive (>0.03 ng/mL), detectable (>0.01 ng/mL), and negative (≤0.01 ng/mL). A detectable cTnT level developed during the study (after baseline) was classified as cTnT conversion: 288 patients were included; 172 (60%) patients had detectable cTnT levels and 97 (34%) had positive values (>0.03 ng/mL) at baseline. Of the 116 patients with negative troponin at baseline, 24 (21%) had elevated cTnT levels by day 7. On multivariable analysis, positive cTnT at baseline was an independent predictor of the composite end point of cardiovascular/renal rehospitalization or death at 60 days (hazard ratio, 1.84; 95% confidence interval, 1.04–3.26;
P
=0.036). Kaplan-Meier curves showed similar worse outcomes in patients with troponin conversion and positive troponin at baseline.

Conclusions—
There was a high prevalence of baseline cTnT elevation in this cohort; 21% of those negative at baseline converted to detectable levels by day 7. Positive troponin at baseline, and conversion to positive levels, were associated with worse outcomes at 60 days.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifiers: NCT00328692 and NCT00354458.
Predictors of Response to Cardiac Resynchronization Therapy in the Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy (MADIT-CRT)
Authors: Goldenberg Ilan , Moss Arthur J. , Hall W. Jackson , Foster Elyse , Goldberger Jeffrey J. , Santucci Peter , Shinn Timothy , Solomon Scott , Steinberg Jonathan S. , Wilber David , Barsheshet Alon , McNitt Scott , Zareba Wojciech , Klein Helmut 
Published: September 2011

Background—
We hypothesized that combined assessment of factors that are associated with favorable reverse remodeling after cardiac resynchronization-defibrillator therapy (CRT-D) can be used to predict clinical response to the device.

Methods and Results—

The study population comprised 1761 patients enrolled in the Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy (MADIT-CRT). Best-subset regression analysis was performed to identify factors associated with echocardiographic response (defined as percent reduction in left ventricular end-diastolic volume 1 year after CRT-D implantation) and to create a response score. Cox proportional hazards regression analysis was used to evaluate the CRT-D versus defibrillator-only reduction in the risk of heart failure or death by the response score. Seven factors were identified as associated with echocardiographic response to CRT-D and made up the response score (female sex, nonischemic origin, left bundle-branch block, QRS ≥150 milliseconds, prior hospitalization for heart failure, left ventricular end-diastolic volume ≥125 mL/m
2
, and left atrial volume <40 mL/m
2
). Multivariate analysis showed a 13% (
P
<0.001) increase in the clinical benefit of CRT-D per 1-point increment in the response score (range, 0–14) and a significant direct correlation between risk reduction associated with CRT-D and response score quartiles: Patients in the first quartile did not derive a significant reduction in the risk of heart failure or death with CRT-D (hazard ratio=0.87;
P
=0.52); patients in the second and third quartiles derived 33% (
P
=0.04) and 36% (
P
=0.03) risk reductions, respectively; and patients in the upper quartile experienced a 69% (
P
<0.001) risk reduction (
P
for trend=0.005).

Conclusion—
Combined assessment of factors associated with reverse remodeling can be used for improved selection of patients for cardiac resynchronization therapy.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00180271.
Heart Disease May Be a Risk Factor for Pulmonary Embolism Without Peripheral Deep Venous Thrombosis
Authors: Sørensen Henrik T. , Horvath-Puho Erzsebet , Lash Timothy L. , Christiansen Christian F. , Pesavento Raffaele , Pedersen Lars , Baron John A. , Prandoni Paolo 
Published: September 2011

Background—
Heart diseases increase the risk of arterial embolism; whether they increase the risk of pulmonary embolism without peripheral venous thrombosis is less certain.

Methods and Results—
We conducted a nationwide, population-based case-control study in Denmark using patients diagnosed with pulmonary embolism and/or deep venous thrombosis between 1980 and 2007. We computed odds ratios to estimate relative risks associating preceding heart disease with pulmonary embolism, pulmonary embolism and deep venous thrombosis, or deep venous thrombosis alone. In this study, 45 282 patients had pulmonary embolism alone, 4680 had pulmonary embolism and deep venous thrombosis, and 59 790 had deep venous thrombosis alone; 541 561 were population controls. Myocardial infarction and heart failure in the preceding 3 months conferred high risks of apparently isolated pulmonary embolism (odds ratio, 43.5 [95% confidence interval (CI), 39.6–47.8] and 32.4 [95% CI, 29.8–35.2], respectively), whereas the risks of combined pulmonary embolism and deep venous thrombosis (19.7 [95% CI, 16.0–24.2] and 22.1 [95% CI, 18.7–26.0], respectively) and deep venous thrombosis alone (9.6 [95% CI, 8.6–10.7] and 12.7 [95% CI, 11.6–13.9], respectively) were lower. Left-sided valvular disease was associated with an odds ratio of 13.5 (95% CI, 11.3–16.1), whereas the odds ratio was 74.6 (95% CI, 28.4–195.8) for right-sided valvular disease. Restricting the analysis to cases diagnosed after 2000 led to lower risk estimates but the same overall pattern.

Conclusion—
Heart diseases increase the near-term risk for pulmonary embolism not associated with diagnosed peripheral vein thrombosis.
Second Internal Thoracic Artery Versus Radial Artery in Coronary Artery Bypass Grafting
Authors: Ruttmann Elfriede , Fischler Nikolaus , Sakic Adel , Chevtchik Orest , Alber Hannes , Schistek Roland , Ulmer Hanno , Grimm Michael 
Published: September 2011

Background—
The best second arterial conduit for multiple arterial revascularization (MAR) is still a matter of debate. Previous studies on the benefit of either using the radial artery (RA) or the right internal thoracic artery (RITA) in coronary artery bypass grafting are not conclusive. The aim of our study was to compare the perioperative and long-term outcome of either RA or RITA grafts as second conduits for MAR.

Methods and Results—

A consecutive series of 1001 patients undergoing first nonemergent coronary artery bypass grafting receiving either RA or RITA as second graft for MAR between 2001 and 2010 were studied. There were 277 patients receiving a RITA and 724 patients receiving a RA in addition to a left internal thoracic artery (LITA). Concomitant saphenous vein grafts (SVG) were grafted in addition as necessary. Propensity score–matched analysis was performed to compare the 2 groups, bilateral ITA±SVG (BITA±SVG group) and the LITA+RA±SVG group relative to overall survival and major adverse cardiac and cerebrovascular events–free survival. Hazard ratios and their 95% confidence intervals were estimated by COX regression stratified on matched pairs. The incidence of perioperative major adverse cardiac and cerebrovascular events was significantly lower in the BITA±SVG group (1.4% versus 7.6%,
P
<0.001). Overall survival (hazard ratio 0.23; 95% confidence interval 0.066–0.81;
P
=0.022) and major adverse cardiac and cerebrovascular events–free survival (hazard ratio 0.18; 95% confidence interval 0.08–0.42;
P
<0.001) were significantly better in the BITA±SVG group compared to the LITA+RA±SVG group.

Conclusions—
The results of our study provide strong evidence for the superiority of a RITA graft compared to RA as a second conduit in MAR.
Echocardiographic Markers of Elevated Pulmonary Pressure and Left Ventricular Diastolic Dysfunction Are Associated With Exercise Intolerance in Adults and Adolescents With Homozygous Sickle Cell Anemia in the United States and United Kingdom
Authors: Sachdev Vandana , Kato Gregory J. , Gibbs J. Simon R. , Barst Robyn J. , Machado Roberto F. , Nouraie Mehdi , Hassell Kathryn L. , Little Jane A. , Schraufnagel Dean E. , Krishnamurti Lakshmanan , Novelli Enrico M. , Girgis Reda E. , Morris Claudia R. , Rosenzweig Erika Berman , Badesch David B. , Lanzkron Sophie , Castro Oswaldo L. , Taylor James G. , Hannoush Hwaida , Goldsmith Jonathan C. , Gladwin Mark T. , Gordeuk Victor R. 
Published: September 2011

Background—
Noninvasively assessed pulmonary pressure elevations and left ventricular (LV) diastolic dysfunction are associated with increased mortality in adults with sickle cell disease, but their relationship to exercise intolerance has not been evaluated prospectively.

Methods and Results—

Echocardiography, 6-minute walk distance, hemolytic rate, and serum concentrations of ferritin and erythropoietin were evaluated in a cohort of 483 subjects with homozygous hemoglobin S in the US and UK Walk–Treatment of Pulmonary Hypertension and Sickle Cell Disease with Sildenafil Therapy (Walk-PHaSST) study. Tricuspid regurgitation velocity, which reflects systolic pulmonary artery pressure, was 2.7 to <3.0 m/s (mean±SD, 2.8±0.1) in 26% of the subjects and ≥3.0 m/s (mean±SD, 3.4±0.4) in 11%. The LV lateral E/e′ ratio, which has been shown to reflect LV filling pressure in other conditions but has not been studied in sickle cell disease, was significantly higher in the groups with tricuspid regurgitation velocity ≥2.7 m/s. Increased hemolysis (
P
<0.0001), LV lateral E/e′ ratio (
P
=0.0001), blood urea nitrogen (
P
=0.0002), and erythropoietin (
P
=0.002) were independently associated with an increased tricuspid regurgitation velocity. Furthermore, female sex (
P
<0.0001), older age (
P
<0.0001), LV lateral E/e′ ratio (
P
=0.014), and tricuspid regurgitation velocity (
P
=0.019) were independent predictors of a shorter 6-minute walk distance.

Conclusions—
Echocardiography-estimated elevated pulmonary artery systolic pressure and LV lateral E/e′ ratio were independently associated with poor exercise capacity in a large cohort of patients with sickle cell anemia. Controlled trials investigating whether strategies to prevent or delay pulmonary hypertension and/or LV diastolic dysfunction will improve exercise capacity and long-term outcomes in sickle cell anemia should be considered.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov.
Unique identifier: NCT00492531.
Placental Growth Factor Regulates Cardiac Inflammation Through the Tissue Inhibitor of Metalloproteinases-3/Tumor Necrosis Factor-α–Converting Enzyme Axis
Authors: Carnevale Daniela , Cifelli Giuseppe , Mascio Giada , Madonna Michele , Sbroggiò Mauro , Perrino Cinzia , Persico Maria Grazia , Frati Giacomo , Lembo Giuseppe 
Published: September 2011

Background—
Heart failure is one of the leading causes of mortality and is primarily the final stage of several overload cardiomyopathies, preceded by an early adaptive hypertrophic response and characterized by coordinated cardiomyocyte growth, angiogenesis, and inflammation. Therefore, growth factors and cytokines have to be critically regulated during cardiac response to transverse aortic constriction. Interestingly, the dual properties of placental growth factor as an angiogenic factor and cytokine make it a candidate to participate in cardiac remodeling in response to hemodynamic overload.

Methods and Results—
After transverse aortic constriction, placental growth factor knockout mice displayed a dysregulation of cardiac remodeling, negatively affecting muscle growth. Molecular insights underscored that this effect was ascribable mainly to a failure in the establishment of adequate inflammatory response owing to an impaired activity of tumor necrosis factor-α–converting enzyme. Interestingly, after transverse aortic constriction, placental growth factor knockout mice had strongly increased levels of tissue inhibitor of metalloproteinases-3, the main natural TACE inhibitor, thus indicating an unbalance of the tissue inhibitor of metalloproteinases-3/tumor necrosis factor-α–converting enzyme axis. Strikingly, when we used an in vivo RNA interference approach to reduce tissue inhibitor of metalloproteinases-3 levels in placental growth factor knockout mice during transverse aortic constriction, we obtained a complete phenotype rescue of early dilated cardiomyopathy.

Conclusions—
Our results demonstrate that placental growth factor finely tunes a balanced regulation of the tissue inhibitor of metalloproteinases-3/tumor necrosis factor-α–converting enzyme axis and the consequent TNF-α activation in response to transverse aortic constriction, thus allowing the establishment of an inflammatory response necessary for adaptive cardiac remodeling.
Can Response to Induction Chemotherapy Be a Predictive Marker for Ultimate Outcome in Hypopharyngeal Cancer?
Authors: Han Myung Woul , Ryu In Sun , Lee Sang‐Wook , Kim Sung‐Bae , Roh Jong‐Lyel , Choi Seung‐Ho , Kim Sang Yoon , Nam Soon Yuhl 
Published: September 2011

ObjectiveInduction chemotherapy (ICT) may reduce rates of distant metastases and enhance organ preservation and survival rates in patients with hypopharyngeal cancer. The authors compared survival data in patients who underwent chemoradiotherapy or surgery after ICT and investigated whether response to ICT is a predictive marker for outcome in patients with hypopharyngeal cancer.Study DesignHistorical cohort study.SettingTertiary‐care hospital.Subjects and MethodsThe authors enrolled 97 patients (89 men, 8 women; mean age 61.2 years; range, 29‐80 years) with previously untreated hypopharyngeal cancer who underwent ICT between January 1997 and December 2006 at Asan Medical Center. Disease‐free survival (DFS), overall survival (OS), and laryngectomy‐free survival (LFS) were analyzed.ResultsAt a mean follow‐up of 38.0 months, the 3‐year DFS and OS for all patients were 48.3% and 49.2%, respectively. The 3‐year LFS rate of patients who underwent nonsurgical therapy (n = 85) after ICT was 48.0%. Only response to ICT was associated with DFS (P =. 047), OS (P =. 003), and LFS (P =. 009) in multivariate analysis. When the authors compared survival data in patients who underwent surgical and nonsurgical treatments after ICT, they found that there was no statistical difference in terms of the 3‐year DFS in partial response (42.9% vs 50.5%, P =. 77) and nonresponse groups (50.0% vs 0%, P =. 43) between the 2 treatment types.ConclusionICT permits assessment of tumor responsiveness and alters subsequent therapy accordingly. Response to ICT may be useful in the prediction of ultimate outcomes and organ conservation in patients with hypopharyngeal cancer.
Chemoimmunotherapy for hemophagocytic lymphohistiocytosis: long-term results of the HLH-94 treatment protocol
Authors: Trottestam Helena , Horne AnnaCarin , Aricò Maurizio , Egeler R. Maarten , Filipovich Alexandra H. , Gadner Helmut , Imashuku Shinsaku , Ladisch Stephan , Webb David , Janka Gritta , Henter Jan-Inge ,   for the Histiocyte Society
Published: September 2011

Abstract
Hemophagocytic lymphohistiocytosis (HLH) used to have a dismal prognosis. We report the final results of HLH-94, the largest prospective diagnostic/therapeutic HLH study so far. The treatment includes immunosuppressive and cytotoxic therapy aiming at clinical remission, followed by HSCT in patients with familial, persistent, or recurrent disease. Altogether, 249 patients fulfilled inclusion criteria and started HLH-94 therapy (July 1994-December 2003); 227 (91%) were followed-up for ≥ 5 years. At 6.2 years median follow-up, estimated 5-year probability of survival was 54% ± 6%. Seventy-two patients (29%) died before HSCT, 64 within 1 year, 97% of whom had active disease. In 124 patients who underwent HSCT, 5-year survival was 66 ± 8%; tendency to increased survival (P = .064) in patients with nonactive disease at HSCT. Patients with familial disease had a 5-year survival of 50% ± 13%; none survived without HSCT. Patients deceased during the first 2 months more often had jaundice, edema, and elevated creatinine. Forty-nine patients (20%) were alive without signs of HLH activity and off-therapy > 1-year without HSCT; they presented at older age (P < .001), were more often female (P = .011), and less often had CNS disease (P < .001) or hepatomegaly (P = .007). To conclude, HLH-94 chemoimmunotherapy has considerably improved outcome in HLH. Collaborative efforts are needed to further reduce early mortality, HSCT-related mortality, and neurologic late effects.