tbuckley/cabot-search huggingface dataset:
Photodynamic Therapy in Daylight for Actinic Keratoses
Authors: Hans Christian Wulf
Journal: JAMA Dermatology (2016)

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A new print<i>BMJ</i>for all UK doctors
Authors: Fiona Godlee
Journal: BMJ (2015)

If you have access to the UK print version ofThe BMJ you'll notice some changes.We hope you like what you see.Over the past six months we've talked to quite a few of the readers of our weekly UK magazine and surveyed more.We heard that they were busy and didn't always have time to read articles in depth.We heard that they wanted something in print that was easier to digest, something they could dip into quickly to find the information they needed: fewer words, more pictures, lots of clinical education, a good dose of debate, quick briefings on important topical issues.And, because they mainly read the print BMJ at home or on the move, they asked for some lighter pieces to make them think and raise a smile.
Upregulation of procalcitonin in cancer patients with venous thrombosis is independent of sepsis
Authors: J. Fareed, O. Iqbal, D. Fareed, D. Hoppensteadt, C. Adiguzel, J. Cunanan
Journal: Journal of Clinical Oncology (2008)

20583 Background: Procalcitonin (PCT) represents a prohormone which is converted into calcitonin and is involved in calcium homeostasis. Sepsis associated inflammatory response results in a marked increase in PCT (> 100 ng/ml). Circulating PCT has a long plasma half life ranging from 25–40 hours. Cancer patients with venous thrombosis have associated complications with complex pathogenesis involving inflammatory responses. Methods: To test the hypothesis that PCT levels may be altered in cancer patients, baseline plasma samples were retrospectively analyzed from an open label clinical trial which recruited 110 pateints with cancer and associated venous thrombosis. Aged and sex matched plasma samples from a group of normal healthy individuals (n=94) served as a control. PCT levels were measured utilizing a commercially available immunoluminescence method (BRAHMs, Berhn, Germany). This method is based on the use of two specific monoclonal antibodies which bind to PCT at two distinct sites. One of the antibodies is luminescence labeled (tracer) and the other is fixed to the inner wells of the coated tubes. The intensity of luminescence signaling is directly proportional to the PCT levels in plasma samples. Results: PCT levels in normal healthy volunteers ranged from 0.18–0.46 ng/ml, (0.17±0.11 ng/ml), whereas in cancer patients these ranged from 0.25–2.25 ng/ml (0.70±0.48 ng/ml). Of the 110 cancer patients 16 had PCT levels > 1.0 ng/ml. None of these 16 patient exhibited any signs and symptoms of infections. The fact that the averaged baseline value of cancer patients without pre- existing infection exhibited a higher average mean PCT level suggests that PCT levels are upregulated in cancer due to multiple pathogenesis involving inflammation. Conclusions: These results suggest that PCT levels may be upregulated in cancer independent of any infections. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Expert Testimony Other Remuneration sanofi-aventis
Dose Escalation of Tamoxifen in Patients with Low Endoxifen Level: Evidence for Therapeutic Drug Monitoring—The TADE Study
Authors: Peter Fox, Rosemary L. Balleine, Clara Lee, Bo Gao, Bavanthi Balakrishnar, Alexander M. Menzies, Shang Heng Yeap, Sayed Sahanawaz Ali, Val Gebski, Pamela Provan, Sally Coulter, Christopher Liddle, Rina Hui, Richard Kefford, Jodi Lynch, Mark Wong, Nicholas Wilcken, Howard Gurney
Journal: Clinical Cancer Research (2016)

Endoxifen is the major mediator of tamoxifen effect and endoxifen levels <15 nmol/L may be associated with increased risk of breast cancer recurrence. We increased tamoxifen dose in breast cancer patients with low endoxifen levels and assessed the influence of various parameters on reaching 15 nmol/L and 30 nmol/L endoxifen levels.Tamoxifen dose was increased in those with endoxifen levels below 30 nmol/L. Toxicity, including hot flash score, was measured. CYP2D6 metabolizer status was classified as ultra-rapid (UM), extensive (EM), intermediate (IM), or poor (PM) based genotype of somatic DNA.Dosage was escalated in 68 of 122 participants. On 20 mg tamoxifen, 24% had endoxifen levels below 15 nmol/L and this reduced to 6% following dose escalation. In over 50% of cases, there was no identified cause for low endoxifen. Low baseline endoxifen level, and not CYP2D6 metabolizer status, independently predicted reaching threshold targets for both the 15 nmol/L and 30 nmol/L targets (P = 0.04 and 0.003 respectively). The 15 nmol/L target was reached in all UM/EM and IM patients, 63% of PM patients, and 58% of those with baseline endoxifen of <10 nmol/L. There was no correlation between hot flash score and genotype or any tamoxifen metabolite level including endoxifen (R = 0.07).Low endoxifen on standard dose tamoxifen was the only independent predictor of failure to achieve potentially therapeutic levels. Trials examining tamoxifen dose escalation and breast cancer outcome should be guided by endoxifen levels alone, without reference to CYP2D6 genotype or presence of hot flashes. Clin Cancer Res; 22(13); 3164-71. ©2016 AACRSee related commentary by Hertz and Rae, p. 3121.
The benefit of reduced intensity conditioning (RIC) allogeneic stem cell transplantation (allo-SCT) as salvage treatment for relapsing multiple myeloma (MM)
Authors: M. Mohty, H. De Lavallade, C. Chabannon, A. Stoppa, C. Faucher, J. El-Cheikh, S. Furst, J. Gastaut, D. Blaise
Journal: Journal of Clinical Oncology (2007)

8045 Background: The role of RIC allo-SCT in MM is still controversial. This single centre study aimed to evaluate RIC allo- SCT for relapsed MM, using a genetic randomization through a donor vs. no donor comparison. Methods: Between 2002 and 2005, 32 patients with relapsed or refractory MM, and with an identified sibling, were referred to our centre for HLA typing. In all, 19 patients (59%; donor group) had an HLA-identical sibling donor, while the remaining 13 pts (41%; no donor group) had no HLA-identical sibling donor. There were no significant differences between these two groups that were comparable as for demographic, disease and prognosis factors. All pts had previously failed auto-SCT. Results: Among the 19 pts from the donor group, 18 (95%) could proceed to allo-SCT. With a median overall FU of 36 m., 11 patients (85%; 95%CI: 54–98%) from the no donor group had disease progression despite salvage therapy, and only 6 of them are still alive, of whom 5 (80%) in progressive disease at last FU. In contrast, only 5 pts (28%;P=0.001) from the donor group progressed after RIC allo-SCT. In the RIC allo-SCT group, 10 pts (56%;95%CI;33–79%) are still alive, with 4 pts being in CR, and 5 in PR or VGPR. Only one patient is currently experiencing disease progression and receiving salvage therapy. Interestingly, 11 pts (61%;95%CI,39–83%) from the RIC allo-SCT group showed objective disease response, usually concurrent to chronic GVHD. In all, 6 pts died from TRM for an overall incidence of TRM of 33% (95%CI,11–55%) in this population of heavily pretreated and relapsed or refractory MM population. In an intention-to- treat analysis, the KM estimate of progression-free survival was significantly higher in the donor group as compared to the no donor group (P=0.01; 46% vs. 8% at 3 y.). Conclusions: RIC allo-SCT from an HLA-identical sibling is a feasible and potential therapy that should be proposed for refractory or relapsed MM, since a potent graft-vs. -MM effect can be induced despite heavy pretreatments, allowing for significantly longer PFS. Also, the latter results are expected to be further improved with the systematic and early use of maintenance therapies after RIC allo-SCT. No significant financial relationships to disclose.
Survival and prognostic factors in very elderly patients (pts) with diffuse large B-cell lymphoma (DLBCL): a retrospective analysis of 281 patients over 80 years
Authors: S.M. Gobba, A.A. Moccia, A. Conconi, S. Diem, L. Cascione, K. Aprile von Hohenstaufen, W. Gulden-Sala, A. Stathis, F. Hitz, G. Gaidano, E. Zucca, G. Pinotti
Journal: Annals of Oncology (2015)
Primary small-intestinal lymphomas in Taiwan: immunoproliferative small-intestinal disease and nonimmunoproliferative small-intestinal disease.
Authors: L Y Shih, S J Liaw, P Dunn, T T Kuo
Journal: Journal of Clinical Oncology (1994)

The clinicopathologic findings in 45 adult Chinese patients with primary small-intestinal lymphoma (PSIL) are described and compared with those in Western countries and in underdeveloped nations. The efficacy of combination chemotherapy is also assessed.Six patients had immunoproliferative small-intestinal disease (IPSID) indicated by the presence of alpha-heavy chain protein (alpha-CP) in body fluids or tumor tissues. Thirty-nine patients had non-IPSID, including one with postrenal transplant lymphoma. Thirty-three non-IPSID patients received a minimum of four cycles of combination chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP).All IPSID patients presented with the clinical and laboratory features of severe intestinal malabsorption, and all had diffuse lymphoplasmacytic infiltration in the mucosa of the small bowel. Lymphomas were localized mainly in the jejunum and mesenteric nodes. The histologic subtypes were diffuse large cell in two, immunoblastic in three, and diffuse mixed in one. All patients responded poorly to chemotherapy, with a median survival duration of 10.5 months. The common presenting symptoms of the 39 non-IPSID patients included abdominal pain (90%), weight loss (31%), abdominal mass (26%), obstruction (26%), and perforation (23%). Diffuse large-cell and immunoblastic lymphomas constituted 82% of cases. Four patients had stage IE, 19 stage II 1E, and 16 stage 112E disease according to the Musshoff's criteria; 22 had bulky tumors and 19 had multiple tumors. The tumors were completely resected in 14 patients. Of 33 patients treated with combination chemotherapy, 73% achieved a complete remission. With a median follow-up duration of 90 months, there have been four relapses, with only one at the primary tumor site. The overall 5-year survival and disease-free survival rates for non-IPSID patients who were treated with chemotherapy were 59% and 54%, respectively.Intensive chemotherapy produces long-term disease-free survival in locally advanced non-IPSID PSIL.
Lead time of rising CA-125 levels less than 35 u/mL predating radiologic confirmation of recurrent ovarian cancer.
Authors: J. Bandyopadhyay, S. A. Ghamande, L. Zhang, L. Lan, M. S. Macfee
Journal: Journal of Clinical Oncology (2010)

e21072 Background: A persistently rising CA-125 level within the normal range (< 35 U/mL) will eventually lead to recurrent disease in patients with epithelial ovarian cancer (EOC) in remission after primary therapy. The lead time from the initial nadir rise of CA-125 to radiological recurrence is currently unknown. Methods: Inclusion criteria for this retrospective study were: elevated CA-125 at diagnosis (> 35 U/mL), EOC, fallopian, and primary peritoneal cancer of any stage; complete response to optimal primary therapy with normalization of CA-125, no evidence of disease on clinical exam or radiology. A rise in CA-125 after a complete response was defined as a successive increase of at least two CA-125 values above the coefficient of variation for the assay (3 U/mL) or a doubling of the nadir CA-125 level. Results: For 52 patients (out of 340, between 2000-9) that met inclusion criteria, a rise in CA-125 predated the positive radiology scan by 120 days (range 0-580 days). For patients who had platinum resistant disease, the lead-time was decreased to 73 days versus 149 days for platinum sensitive disease. Ninety-six percent of observations with a lead-time greater than the median (120 days) were noted to be sensitive to platinum therapy whereas 53% of observations with a lead-time less than 120 days were platinum resistant (p = 0.001). The lead- time was not statistically different in those who responded to second line therapy versus those who continued to progress. Conclusions: A lead time of 120 days from the initial rise of persistently increasing CA-125 levels in the normal range to radiological recurrence is important new information that may help plan new early intervention trials in EOC patients destined to recur. No significant financial relationships to disclose.
Soft Tissue Sarcoma: Apples, Oranges, and Passion Fruit
Authors: Holcombe E. Grier
Journal: Journal of Clinical Oncology (1999)

Article Tools EDITORIAL Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.1999.17.12.3695 Journal of Clinical Oncology - published online before print September 21, 2016 PMID: 10577840 Soft Tissue Sarcoma: Apples, Oranges, and Passion Fruit Holcombe E. GrierxHolcombe E. GrierSearch for articles by this author Show More Dana-Farber Cancer Institute and Children's Hospital, Boston, MA https://doi.org/10.1200/JCO.1999.17.12.3695 Full Text PDF Figures and Tables "Soft Tissue Sarcoma: Apples, Oranges, and Passion Fruit." Journal of Clinical Oncology, 17(12), pp. 3695–3696© 1999 by American Society of Clinical Oncology
β-Hexosaminidase From Colon and Sera of Dukes-Classified Colorectal Cancer Patients: Activity Levels, Isozyme Patterns, and Kinetic Properties&lt;xref ref-type="fn" rid="FN1"&gt;2&lt;/xref&gt;
Authors: M C Plucinsky, J J Prorok, J A Alhadeff
Journal: JNCI Journal of the National Cancer Institute (1986)

Total activity levels, isozyme patterns, and kinetic properties of beta-hexosaminidase were studied in crude supernatants of malignant and adjacent, uninvolved normal colon tissues and in sera from 28 Dukes-classified colorectal cancer patients. A significant increase (P less than .001) in both beta-hexosaminidase activity and beta-hexosaminidase specific activity and a significant increase (P less than .01) in the relative percentage of activity comprised by the basic thermostable form of beta-hexosaminidase (Hex B) isozyme were found in malignant tissue compared to the activities seen in uninvolved normal colon tissue. No apparent correlations were found between either beta-hexosaminidase activity levels or relative percentage of Hex B and Dukes category. Kinetic analysis indicated that the thermolabile form of beta-hexosaminidase and Hex B from malignant colon were comparable to the corresponding isozymes from normal colon with regard to thermostability after preincubation at 50 degrees C and pH activity curves (optimum between pH 4.0 and 5.0). Significantly decreased (P less than .05) beta-hexosaminidase activity was found in sera of the 28 colorectal cancer patients (17.3 +/- 5.2 U/ml, mean +/- SD) when compared to the activity in 19 controls with nonmalignant diseases (21.4 +/- 8.2 U/ml) and 17 normal controls (21.3 +/- 6.4 U/ml). Isoelectric focusing indicated that a peak of beta-hexosaminidase activity with an isoelectric point value (9.5) comparable to that of the peak found in increased amounts in malignant colon was detectable in the sera of 36% of the colorectal cancer patients and 11% of the controls.
Achievement of asthma control in patients with cold airway hyperresponsiveness at different variants of basic therapy
Authors: Victor P. Kolosov, Aleksey B. Pirogov, Juliy M. Perelman, Svetlana V. Naryshkina, Tatyana A. Maltseva
Journal: European Respiratory Journal (2013)

Background: Cold airway hyperresponsiveness (CAHR) modifies the course of bronchial asthma (BA). Optimal strategy of basic therapy in patients with CAHR remains controversial.

Aim: To estimate the achievement of the BA control in patients with CAHR at the application of monotherapy by beclomethasone or the combined therapy by budesonide/formoterol.

Methods . 59 patients with uncontrolled BA (ACT ≤19 points) at monotherapy with beclomethasone dipropionate more than 4 weeks at the moment of getting into the research were devided into 2 groups: the 1st group included 35 patients with CAHR (ΔFEV1 in response to 3-minute isocapnic cold air hyperventilation was -19.7±1.06%), 2nd group included 24 patients without CAHR (ΔFEV1=-6.3±1.11%).

Results . At the first 12 weeks of treatment the patients in 1st and 2nd groups took beclomethasone in a doses of 610.6±9.3mkg/day and 576.2±11.4 mkg/day, respectively (p<0.05). The part of the patients who achieved asthma control (20-25 points ACT) at the end of the first period was 28% in 1st group and 58% in 2nd group (p<0.05). There was no dynamics of CAHR in the 1st group (ΔFEV1=-18.46±1.02%). Budesonide/formoterol in a stable doze of 320/9 mkg/day was offered to the patients of 1st group at the second 12-week stage of the therapy. As a result the asthma control was achieved in 48% as compared with 50% in 2nd group with the monotherapy with beclomethasone (603.5±12.3mkg/day). After 24 weeks of treatment ΔFEV1 decreased till -16.81±1.12% in the 1st group.

Conclusion . The application of the combined therapy in the stable dose in BA patients with CAHR is associated with the higher frequency of asthma control achievement.
Bronchoscopic injection of absolute ethanol in patients with persistent air leak from chest tube drainage
Authors: Cheol-Hong Kim, Ah-Leum Lim, In-Gye Hyun
Journal: European Respiratory Journal (2011)

Background:  Chest tube drainage (CTD) has indicated for the treatment of pneumothorax, hemothroax and after thoracic surgery. But, in the case of incomplete lung expansion and/or persistent air leak from CTD, medical or surgical thoracoscopy or, if that is unavailable, limited thoracotomy should be considered. We evaluate the efficacy of bronchoscopic injection of absolute ethanolamine to control persistent air leak in patients with CTD.   Methods:  Patients who had persistent or prolonged air leak from CTD were included consecutively. We directly injected 1.0 ml aliquots of ethanolamine into a subsegmental or its distal bronchus where is probably air leakage site, 1 to 20 times using injection needle through a fiberoptic bronchoscope.   Results:  15 patients (all men) were enrolled. There were 14 spontaneous pneumothorax (5 idiopathic, 6 chronic obstructive pulmonary disease (COPD) and 3 post-tuberculosis) and 1 empyema associated with broncho-pleural fistula in the study. Of 14 patients with ethanolamine injection therapies, five had previous surgical therapy, wedge resection for bullae, but the others didn9t have. Twelve were successfully treated by an ethanolamine injection therapy alone. But three (idiopathic, COPD and post-tuberculosis) were failed and followed by a surgery (2 cases) or pleurodesis (1 case). Minor complications such as fever, chest pain and transient pneumonic infiltrations occurred after the therapy. With successful, the time to discharge was about 3 days (median).   Conclusions:  Bronchoscopic ethanolamine injection therapy may be partially useful in controlling air leakage and reducing the hospital stay in patients with CTD.
Abstract 17088: Bleeding Complications After Implantation of Pacemakers and Defibrillators in an Era of Triple Therapy and Novel Antithrombotic Drugs
Authors: Gamze Senel, Lukas Heimbacher, Hendrik Bonnemeier
Journal: Circulation (2013)

Introduction:  Bleeding complications (eg. pocket hematoma) are still common complications after implantation of active cardiovascular implantable devices (CIEDs). We investigated the influence of the type of CIED, the implantation strategy, and the underlying antiplatelet- and anticoagulation-therapy on bleeding complication.   Methods:  Between 2006 and 2012, a total of 3,082 CIEDs (Pacemakers: n=1,689; ICD/CRT/CCM: n= 1393) were implanted at our institution. There was no perioperative anticoagulation in 17.7%, ASA or thienopyridine monotherapy in 33.5%, anticoagulation with phenprocoumon, heparins or novel oral anticoagulants (NOAKs) monotherapy in 16.3%, and a dual- or triple-combination of different antithrombotic drugs in 32.5% of the patients. HAS-BLED-score was >3 in 17.5% of the patients. Bleeding complications were defined as pocket hematoma, pericardial effusion, hematothorax, drop of hemoglobin >2mg/dl, and transfusion of >2 erythrocyte concentrates.   Results:  No patient died due to bleeding complications. The overall incidence of bleeding complications was 7,2%. Reoperation for pocket hematoma or hematothorax was required in 1.26%. Patients with HAS-BLED-Score >3, patients on dual- or triple combination of antithrombotic drugs, patients on low molecular weight heparins (LMWHs), and patients on dabigatran, ticagrelor or prasugrel exhibited a higher incidence for bleeding complications.   Conclusions:  Even in an era of novel antithrombotic drugs and dual-/triple-anticoagulation, the rate of bleeding complications is comparable to published data of the last decade. The use of bridging therapy with LMWHs and especially its combination with ASA/thienopyridine treatment are highly predictive for bleeding complications during or after CIEDs-surgery.