bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of the Tyrer-Cuzick (International Breast Cancer Intervention Study) Model for Breast Cancer Risk Prediction in Women With Atypical Hyperplasia
Authors: Boughey Judy C. , Hartmann Lynn C. , Anderson Stephanie S. , Degnim Amy C. , Vierkant Robert A. , Reynolds Carol A. , Frost Marlene H. , Pankratz V. Shane 
Published: July 2010

Purpose Accurate breast cancer risk assessment is vital to personalize screening and risk reduction strategies. Women with atypical hyperplasia have a four-fold higher risk of breast cancer. We evaluated the performance of the Tyrer-Cuzick model, which was designed to predict 10-year risk of breast cancer development, in a well-defined cohort of women with atypia. Patients and Methods The Mayo Benign Breast Disease cohort includes 9,376 women who had a benign breast biopsy between 1967 and 1991. Among those, 331 women with atypia were identified by our study pathologists. Risk factor data for the Tyrer-Cuzick model were collated for each woman and used to predict individual risk of developing invasive breast cancer within 10 years. Results Over a median follow-up of 14.6 years, 64 (19%) of the 331 women developed invasive breast cancer. In the first 10 years after biopsy, 31 women developed invasive breast cancer whereas the Tyrer-Cuzick model predicted 58.9. The observed-to-predicted ratio was 0.53 (95% CI, 0.37 to 0.75). The concordance statistic was 0.540, revealing that the Tyrer-Cuzick model did not accurately distinguish, on an individual level, between women who developed invasive breast cancer and those who did not. Conclusion The Tyrer-Cuzick model significantly overestimated risk of breast cancer for women with atypia, and individual risk estimates showed poor concordance between predicted risk and invasive breast cancer development. Thus, we cannot recommend the use of the Tyrer-Cuzick model to predict 10-year breast cancer risk in women with atypical hyperplasia.
Chemotherapy-Phased Imatinib Pulses Improve Long-Term Outcome of Adult Patients With Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia: Northern Italy Leukemia Group Protocol 09/00
Authors: Bassan Renato , Rossi Giuseppe , Pogliani Enrico M. , Di Bona Eros , Angelucci Emanuele , Cavattoni Irene , Lambertenghi-Deliliers Giorgio , Mannelli Francesco , Levis Alessandro , Ciceri Fabio , Mattei Daniele , Borlenghi Erika , Terruzzi Elisabetta , Borghero Carlo , Romani Claudio , Spinelli Orietta , Tosi Manuela , Oldani Elena , Intermesoli Tamara , Rambaldi Alessandro 
Published: July 2010

Purpose Short imatinib pulses were added to chemotherapy to improve the long-term survival of adult patients with Philadelphia chromosome (Ph) –positive acute lymphoblastic leukemia (ALL), to optimize complete remission (CR) and stem-cell transplantation (SCT) rates. Patients and Methods Of 94 total patients (age range, 19 to 66 years), 35 represented the control cohort (ie, imatinib-negative [IM-negative] group), and 59 received imatinib 600 mg/d orally for 7 consecutive days (ie, imatinib-positive [IM-positive] group), starting from day 15 of chemotherapy course 1 and from 3 days before chemotherapy during courses 2 to 8. Patients in CR were eligible for allogeneic SCT or, alternatively, for high-dose therapy with autologous SCT followed by long-term maintenance with intermittent imatinib. Results CR and SCT rates were greater in the IM-positive group (CR: 92% v 80.5%; P = .08; allogeneic SCT: 63% v 39%; P = .041). At a median observation time of 5 years (range, 0.6 to 9.2 years), 22 patients in the IM-positive group versus five patients in the IM-negative group were alive in first CR (P = .037). Patients in the IM-positive group had significantly greater overall and disease-free survival probabilities (overall: 0.38 v 0.23; P = .009; disease free: 0.39 v 0.25; P = .044) and a lower incidence of relapse (P = .005). SCT-related mortality was 28% (ie, 15 of 54 patients), and postgraft survival probability was 0.46 overall. Conclusion This imatinib-based protocol improved long-term outcome of adult patients with Ph-positive ALL. With SCT, post-transplantation mortality and relapse remain the major hindrance to additional therapeutic improvement. Additional intensification of imatinib therapy should warrant a better molecular response and clinical outcome, both in patients selected for SCT and in those unable to undergo this procedure.
Gemcitabine Plus Bevacizumab Compared With Gemcitabine Plus Placebo in Patients With Advanced Pancreatic Cancer: Phase III Trial of the Cancer and Leukemia Group B (CALGB 80303)
Authors: Kindler Hedy Lee , Niedzwiecki Donna , Hollis Donna , Sutherland Susan , Schrag Deborah , Hurwitz Herbert , Innocenti Federico , Mulcahy Mary Frances , O'Reilly Eileen , Wozniak Timothy F. , Picus Joel , Bhargava Pankaj , Mayer Robert J. , Schilsky Richard L. , Goldberg Richard M. 
Published: July 2010

Purpose The combination of gemcitabine plus bevacizumab produced a 21% response rate and a median survival of 8.8 months in a multicenter phase II trial in patients with metastatic pancreatic cancer. These encouraging data led Cancer and Leukemia Group B (CALGB) to conduct a double-blind, placebo-controlled, randomized phase III trial of gemcitabine/bevacizumab versus gemcitabine/placebo in advanced pancreatic cancer patients. Patients and Methods Eligible patients had no prior therapy for advanced disease, Eastern Cooperative Oncology Group (ECOG) performance status 0 to 2, no tumor invasion of adjacent organs, and no increased bleeding risk. The primary end point was overall survival. Patients were stratified by performance status, extent of disease, and prior radiotherapy. Patients received gemcitabine at 1,000 mg/m2 over 30 minutes on days 1, 8, and 15 every 28 days and bevacizumab at 10 mg/kg or placebo on days 1 and 15 every 28 days. Results Between June 2004 and April 2006, 602 patients were enrolled onto the study and 535 were treated. Median overall survival was 5.8 months for gemcitabine/bevacizumab and 5.9 months for gemcitabine/placebo (P = .95). Median progression-free survival was 3.8 and 2.9 months, respectively (P = .07). Overall response rates were 13% and 10%, respectively. Patients with a performance status of 0, 1, and 2 survived a median of 7.9, 4.8, and 2.4 months, respectively. The only statistically significant differences in grades 3 and 4 toxicity occurred for hypertension (10% v 3%; P < .001) and proteinuria (5% v 1%; P = .002); venous thrombosis grade ≥ 3 was equivalent in both arms (14% and 15%, respectively). Conclusion The addition of bevacizumab to gemcitabine does not improve survival in advanced pancreatic cancer patients.
Oral Syringes: A Crucial and Economical Risk-Reduction Strategy that has Not Been Fully Utilized
Authors: Smetzer Judy L. , Cohen Michael R. 
Published: July 2010

These medication errors have occurred in health care facilities at least once. They will happen again—perhaps where you work. Through education and alertness of personnel and procedural safeguards, they can be avoided. You should consider publishing accounts of errors in your newsletters and/or presenting them at your inservice training programs. Your assistance is required to continue this feature. The reports described here were received through the Institute for Safe Medication Practices (ISMP) Medication Errors Reporting Program. Any reports published by ISMP will be anonymous. Comments are also invited; the writers' names will be published if desired. ISMP may be contacted at the address shown below. Errors, close calls, or hazardous conditions may be reported directly to ISMP through the ISMP Web site ( www.ismp.org ), by calling 800-FAIL-SAFE, or via e-mail at ismpinfo@ismp.org . ISMP guarantees the confidentiality and security of the information received and respects reporters' wishes as to the level of detail included in publications.
Risk for Fractures with Centrally Acting Muscle Relaxants: An Analysis of a National Medicare Advantage Claims Database
Authors: Golden Adam G , Ma Qianli , Nair Vinit , Florez Hermes J , Roos Bernard A 
Published: July 2010

Background: In older adults, both muscle relaxants and benzodiazepines are associated with sedation and cognitive impairment. Although benzodiazepines have been linked to falls and fracture injuries, no studies have examined the risk of fracture associated with muscle relaxants. Objective: To determine whether muscle relaxants identified in the Beers criteria are associated with an increased risk of fracture injuries and to compare this risk to that with benzodiazepine use. Methods: We conducted a case-control study using both medical and pharmacy claims data from 1.5 million enrollees in the Medicare Advantage plans of a large health maintenance organization. We matched 8164 cases of fractures with 8164 controls based on age, sex, health plan, and comorbidities. We measured the use of muscle retaxants, short-acting benzodiazepines, and long-acting benzodiazepines. Adjusted odds ratios were estimated using conditional logistic regression, Results: After adjusting demographic and clinical covariates, muscle relaxants, long-acting benzodiazepines, and short-acting benzodiazepines were associated with a high risk of fracture injuries, with odds ratios of 1.40 (95% CI 1.15 to 1.72; p < 0.001), 1.9 (95% CI 1.49 to 2.43: p < 0.001), and 1.33 (95% CI 1.15 to 1.55: p < 0.001), respectively. Conclusions: An elevated risk of fracture injuries was noted among older adults using muscle relaxants. Our findings provide evidence of an association between the risk of fractures and the use of centrally acting muscle relaxants in older adults. This association supports current recommendations advising extreme caution in prescribing muscle relaxants to older adults.
Carcinoembryonic antigen concentrations in patients with acute coronary syndrome
Authors: Vassalle Cristina , Pratali Lorenza , Ndreu Rudina , Battaglia Debora , Andreassi Maria Grazia 
Published: July 2010

AbstractBackground:Carcinoembryonic antigen (CEA), one of the most widely used tumor markers, has been recently associated with carotid atherosclerosis. The aim of our study was to evaluate whether CEA concentrations have a role in coronary artery disease (CAD).Methods:Serum CEA concentrations were evaluated in 89 patients, including 50 patients with acute coronary syndrome (ACS) (Group I, 44 with acute myocardial infarction, six with unstable angina, 38 males, 65±2 years) and 39 patients with stable CAD (Group II, 33 males, 66±3 years). In addition, 33 subjects (16 males, 62±2 years) were also included as a control group (Group III).Results:ACS was significantly associated with increased mean CEA concentrations (3.1±0.3 vs. 1.75±0.1 and 1.7± 0.2 ng/mL in Groups I, II and III, respectively, p<0.001). Increased CEA concentrations remained an independent determinant for ACS (OR=3.1, 95% CI=1.2–7.9, p<0.05) after correcting for other significant risk factors.Conclusions:CEA might represent a potential new candidate biomarker for the prediction of risk associated with ACS.Clin Chem Lab Med 2010;48:1339–43.
Variations in systemic biomarkers of oxidative/nitrosative stress and DNA damage before and during the consequent two cycles of chemotherapy in breast cancer patients
Authors: Atukeren Pinar , Yavuz Berna , Soydinc Hilal Oguz , Purisa Sevim , Camlica Hakan , Gumustas M. Koray , Balcioglu Ibrahim 
Published: July 2010

Abstract

Background: Previous studies have suggested the importance of redox regulation in carcinogenesis. The aim of this study was to evaluate the prognostic role of altered redox homeostasis and oxidative DNA damage in patients with breast carcinoma before and during two cycles of chemotherapy.

Methods: This study included 30 patients whose serum samples were obtained on admission before treatment, and after the first and second cycles of chemotherapy, and 20 controls. We investigated serum total antioxidant status (TAS), thiobarbituric acid reacting substances (TBARS), total nitrite/nitrate (NOx), nitrotyrosine (NT), and 8-hydroxydeoxy-guanosine (8-OHdG), as well as antioxidant enzyme activities, such as glutathione peroxidase (GPx), glutathione reductase (GRx).

Results: TBARS, NOx, NT and 8-OHdG concentrations were significantly increased, while antioxidant enzyme activities and TAS were significantly decreased in patients when compared to controls. A concurrent increase in TBARS, NOx, NT, and 8-OHdG and a decrease in antioxidant enzyme activities and TAS were also seen after chemotherapy. No difference was observed in the second cycle of chemotherapy when compared with the first course.

Conclusions: In conclusion, decreased activities of these antioxidant enzymes and low TAS concentrations observed in our study might be due to the depletion of the antioxidant defense system to combat the free radical storm produced by chemotherapy. We suggest that the increased 8-OHdG and other oxidative/nitrosative stress products that we have measured in breast cancer patients may be prognostic risk factors for the magnitude of oxidation in serum.
Clin Chem Lab Med 2010;48:1487–95.
Prevalence of atrophic gastritis in dyspeptic patients in Piedmont. A survey using the GastroPanel test
Authors: Lombardo Lucio , Leto Rosalia , Molinaro Giancarlo , Migliardi Marco , Ravarino Nicoletta , Rocca Rodolfo , Torchio Bruno 
Published: July 2010

Abstract

Background: Chronic atrophic gastritis (CAG) is a precursor of the intestinal type of gastric cancer, the second leading cause of cancer-related death worldwide. GastroPanel is a recently marketed serological kit for the non-invasive diagnosis of CAG, defined by some authors “even more reliable than biopsy histology”. The goal of this study was 1) to evaluate the agreement between the serum gastric profile provided by GastroPanel (PGI, PGII, G-17, AbHp) and histology over CAG diagnosis, and 2) to evaluate the prevalence of CAG by means of GastroPanel in a Northern Italian dyspeptic population.

Methods: Basal blood samples for GastroPanel parameters evaluation (Biohit Plc, Finland) were collected after an overnight fast from 1387 dyspeptic patients (age range: 18–80 years; F 704). Gastroscopy with two biopsies each of the antrum and corpus was offered to a group of the first 400 consecutive patients (age 18–80 years, F 214) to compare the results of histology and GastroPanel in CAG.

Results: Agreement between GastroPanel and histology for corpus-prevalent CAG was 94%, with a sensitivity and specificity of 80% and 96%, respectively. In our series of 1387 dyspeptic patients, the prevalence of corpus-prevalent CAG, of antral-prevalent CAG and of multifocal CAG (antrum+ corpus) was 10.7%, 3.6% and 2.4%, respectively. Out of the 34 patients with multifocal atrophic gastritis, 12% were under 30 years of age.

Conclusions: GastroPanel is a reliable non-invasive test for diagnosis of CAG and deserves consideration for current use in clinical practice as a valuable diagnostic tool.
Clin Chem Lab Med 2010;48:1327–32.
Clinical significance of serum macrophage-colony stimulating factor (M-CSF) in esophageal cancer patients and its comparison with classical tumor markers
Authors: Łukaszewicz-Zając Marta , Mroczko Barbara , Kozłowski Mirosław , Nikliński Jacek , Laudański Jerzy , Szmitkowski Maciej 
Published: July 2010

Abstract

Background: Hematopoietic growth factors (HGFs), such as macrophage-colony stimulating factor (M-CSF) are produced aberrantly in many malignancies. Esophageal cancer (EC) is characterized by late diagnosis, rapid progression and poor survival. The purpose of the present study was to determine the clinical usefulness of M-CSF in the diagnosis of EC and its histological type – squamous cell cancer of the esophagus (ESCC).

Methods: The study included 80 patients with EC (54 with ESCC and 26 with adenocarcinoma of the esophagus) and 30 healthy subjects. The serum concentrations of M-CSF, carcinoembryonic antigen (CEA) and squamous cell cancer antigen (SCC-Ag) were determined using immunoenzyme assays. We defined the percentage of increased concentrations of proteins tested and the areas under the receiver-operating characteristics (ROC) curves.

Results: In EC and ESCC patients, serum concentrations of M-CSF, CEA and SCC-Ag were significantly higher compared with healthy subjects. Concentrations of M-CSF in both groups analyzed (EC and ESCC) showed a tendency for increases with depth of tumor invasion, the presence of lymph node and distant metastases. The combined use of M-CSF with SCC-Ag increased their percentage of increased concentrations, and this value was higher than for classical tumor markers in both groups analyzed. The area under ROC curve for M-CSF was larger than for CEA in EC patients.

Conclusions: Our findings suggest the potential usefulness of serum M-CSF concentrations as a tumor marker for EC, especially in combination with SCC-Ag. However, the diagnostic value of this cytokine may be limited because of its non-specific nature.
Clin Chem Lab Med 2010;48:1467–73.
A simple liquid chromatography-tandem mass spectrometry method for urinary free cortisol analysis: suitable for routine purpose
Authors: Persichilli Silvia , Gervasoni Jacopo , Iavarone Federica , Zuppi Cecilia 
Published: July 2010

Abstract

Background: The best index of adrenal dysfunction is urinary free cortisol (UFC) measurements performed using a 24-h urine collection. This measurement is also useful in the investigation of Cushing's syndrome. In this paper, we report a simple and selective method for the analysis of UFC by liquid chromatography-tandem mass spectrometry (LC-MS/MS) suitable for use in a high-volume clinical laboratory routine. The results were compared to those obtained using a commercial immunoassay method used in our laboratory.

Methods: Urine samples containing 50 ng of internal standard (Cortisol-9,11,12,12-d4) were deproteinized using centrifugal filters with a molecular weight 10,000 Da cut-off and injected on a reversed phase column. Cortisol was analyzed in highly selective reaction monitoring in positive atmospheric pressure chemical ionization mode, at a resolution of 0.4 amu full width half maximum, and following the transitions related to the precursor 363.2 for cortisol and 367.2 for deuterated cortisol. The method validation included analysis of precision, linearity, sensitivity, recovery and interference from structurally similar steroids. UFC from 230 subjects was measured using LC-MS/MS and electrochemiluminescence immunoassay (ECLIA) methods.

Results: The calibration curves exhibited linearity and reproducibility in the range 7–10,000 nmol/L. Total imprecision was lower than 10%. The limit of detection and limit of quantification were 2 and 7 nmol/L, respectively. Mean recovery was higher than 90%. Structurally similar steroids do not interfere in the proposed method, but cause a significant change in the ECLIA results. Cortisol values obtained using the ECLIA method were always higher than those obtained using the LC-MS/MS method, with the bias directly proportional to cortisol concentrations. The reference values calculated using 180 normal subjects were 11–70 μg/day.

Conclusions: The proposed method is sensitive, simple, free from interferences and reliable for routine use.
Clin Chem Lab Med 2010;48:1433–7.
Effects of Background Color and Predation Risk on Color Change in Fire Salamander Larvae
Authors: Segev Ori 
Published: July 2010

The threat-sensitivity hypothesis assumes individuals should demonstrate flexibility in response to perceived predation risk and vary the intensity of anti-predator responses in concert with perceived risk of predation. Substrate color matching is adaptive as it enables organisms to become less conspicuous to both their prey and predators. I hypothesized that newborn fire salamander (Salamandra infraimmaculata) larvae will respond fast through physiological color change to contrasting backgrounds, becoming lighter against a white background and darker against a black background. Additionally, in accordance with the threat-sensitivity hypothesis, I expected a background color x predator interaction—i.e., that predator presence will further enhance the focal larvae color-matching response.To explicitly test these hypotheses I conducted a replicated outdoor mesocosm experiment. I used a two-by-two factorial design: pools of black or white background color crossed with the presence or absence of a larger cannibalistic conspecific. Digital photos of the focal larvae's dorsal view revealed that larval brightness and chroma changed accordingly against the contrasting black and white backgrounds to increase background matching. Although not statistically significant, larvae tended to show a stronger color-change response towards enhanced background matching in the presence of the free predator. Larval survival was strongly reduced in the presence of the larger conspecific, with no apparent effect of background color. This study demonstrates thatSalamandralarvae are capable of environmentally induced physiological color change and highlights the need for further investigation into the interplay between threat intensity, mechanisms of risk assessment, and physiological antipredator responses.
Environmental Review Approaches by Fish and Wildlife Agencies in the United States and Canada
Authors: Pender Danielle R. , Harris Fred A. 
Published: July 2010

We surveyed U.S. state and Canadian provincial fish and wildlife agencies regarding their participation and approach to environmental review (i.e., review of project permit applications or proposals for environmental impacts). Most agencies dedicated a personnel unit to environmental review ranging from 1 individual to a staff of 38, and staffs are administered within various divisions or programs. Agencies annually reviewed from 10 to 7,500 projects for environmental impact, and state and provincial agencies spent an average of 3,681 hours (state) and 700 hours (provincial) on projects monthly. An average of 1,760 hours (state) and 390 hours (provincial) was spent annually on proactive measures such as environmental education and land use planning. Most agencies viewed environmental review as very important; however, agencies generally reported limited success in influencing the outcome of reviewed projects, and many identified this as a dissatisfying aspect of the review process. State and provincial agencies have adopted a variety of approaches to accomplish environmental review. Examining the alternative strategies and approaches employed among agencies may add perspective and provide successful models to enhance other agencies' programs.
Se realizó un sondeo en las agencias estatales y provinciales de Pesca y Vida Silvestre de los Estados Unidos de Norteamérica y Canadá en cuanto a su participación y enfoque de evaluaciones ambientales (i.e. revisión de los proyectos para solicitar permisos o propuestas de impacto ambiental). La mayoría de las agencias designan unidades de recursos humanos para revisión ambiental que van de 1 individuo hasta 38, y el personal es administrado dentro de varias divisiones o programas. Las agencias, cada año, revisaron entre 10 y 7,500 proyectos de impacto ambiental, y las agencias estatales y provinciales invirtieron mensualmente en los proyectos, en promedio, 3,681 horas (estatales) y 700 horas (provinciales). La media anual en cuanto al tiempo invertido en definir medidas proactivas, como educación ambiental y ordenamiento de uso de suelo, fue de 1,760 horas (en agencias estatales) y 390 horas (en agencias provinciales). La mayoría de las agencias consideran la evaluación ambiental como muy importante; sin embargo, las agencias generalmente reportan un éxito limitado en cuanto a su influencia sobre los resultados de los proyectos revisados y muchos identificaron esto como un aspecto poco satisfactorio del proceso de evaluación ambiental. Las agencias estatales y provinciales han adoptado una variedad de enfoques para llevar a cabo las evaluaciones ambientales. El examen de estrategias y enfoques alternativos que se emplean entre agencias pudiera brindar una mejor perspectiva y proveer modelos exitosos para desarrollar programas en otras agencias.