tbuckley/cabot-search huggingface dataset:
Predictive value of restaging after induction concurrent chemoradiotherapy (CCRT) for locoregionally advanced (LRA) adenocarcinoma (ACA) of the esophagus and gastroesophageal junction (GEJ).
Authors: B. E. Phillips, D. J. Adelstein, T. W. Rice, L. A. Rybicki, C. P. Rodriguez, G. M. Videtic, J. P. Saxton, S. C. Murthy, D. P. Mason, D. I. Ives
Journal: Journal of Clinical Oncology (2010)

4069 Background: CCRT has modest curative potential for LRA esophageal cancer and is commonly used preoperatively to improve surgical outcome. Although this approach can be curative, most patients (pts) experience only limited benefit from the surgery. This retrospective review was undertaken to identify clinical features after induction CCRT that might predict surgical futility. Methods: Between 11/99 and 7/06, 155 pts with T3, N1, or M1a ACA of the esophagus or GEJ were entered on one of two consecutive Cleveland Clinic trials, using CCRT with 96 hour infusions of cisplatin (20 mg/m2/d) and fluorouracil (1,000 mg/m2/d) beginning on day 1 of radiation (30 Gy at 1.5 Gy bid). Surgery followed in 4-6 weeks with identical CCRT planned post- operatively. 75 pts also received 2 years of gefitinib. Initial and post-induction endoscopic (EGD) tumor length and endosonographic (EUS) TNM stage were recorded. Symptomatic response to induction was characterized as resolved or unresolved. Prognostic factors for freedom from recurrence (FFR) and overall survival (OS) were identified. Results: 4 pts were medically unresectable and not analyzed. The remaining 151 pts had a median age of 59 years; 89% were male and 97% Caucasian. Pretreatment stage was II in 34%, III in 42%, and IVa in 24%. 140 pts underwent resection; 11 developed unresectable disease. With a median follow-up of 62 (range 38-105) months (m), 36 m FFR was 31% and OS 32%. Postinduction change in EGD tumor length and EUS TNM stage was not prognostic. Symptomatic resolution, which occurred in 86%, was the strongest predictor for FFR (p < 0.001) and OS (p < 0.001). At 24 m, pts with unresolved symptoms and pretreatment stage III/IVa disease had a recurrence rate (RR) of 100% and OS of 7%. Conversely, stage II pts with symptomatic resolution had a 24 m RR of 45% and OS of 57%. Conclusions: EGD and EUS restaging of locoregional disease after induction CCRT provides little useful information. Only symptomatic response to induction proved important. When coupled with advanced pretreatment stage, persistence of symptoms after induction is ominous and should be factored into surgical decision making. Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration AstraZeneca, sanofi-aventis
Structural Brain Abnormalities in Youth With Psychosis Spectrum Symptoms
Authors: Theodore D. Satterthwaite, Daniel H. Wolf, Monica E. Calkins, Simon N. Vandekar, Guray Erus, Kosha Ruparel, David R. Roalf, Kristin A. Linn, Mark A. Elliott, Tyler M. Moore, Hakon Hakonarson, Russell T. Shinohara, Christos Davatzikos, Ruben C. Gur, Raquel E. Gur
Journal: JAMA Psychiatry (2016)

Structural brain abnormalities are prominent in psychotic disorders, including schizophrenia. However, it is unclear when aberrations emerge in the disease process and if such deficits are present in association with less severe psychosis spectrum (PS) symptoms in youth.
Histogenesis of Squamous Metaplasia in the Hamster Tracheal Epithelium Caused by Vitamin A Deficiency or Benzo[&lt;italic&gt;a&lt;/italic&gt;]pyrene-Ferric Oxide
Authors: Curtis C. Harris, M.D., Michael B. Sporn, M.D., David G. Kaufman, M.D., Joseph M. Smith, B.A., Frank E. Jackson, Umberto Saffiotti, M.D.
Journal: JNCI Journal of the National Cancer Institute (1972)

In the hamster tracheal epithelium, both vitamin A deficiency and multiple intratracheal instillations of benzo[a]pyrene-ferric oxide caused squamous metaplasia. By light microscopy, squamous metaplasia without cell atypia caused by vitamin A deficiency is morphologically similar to that caused by carcinogen administration. However, significant differences at the ultrastructural level were observed. Defects in the basement membrane, enlarged nuclei with cytoplasmic invaginations, and pleomorphic nucleoli were restricted to squamous metaplasia induced by benzo[a]pyrene-ferric oxide.
Setting a National Agenda for Surgical Disparities Research
Authors: Adil H. Haider, Irene Dankwa-Mullan, Allysha C. Maragh-Bass, Maya Torain, Cheryl K. Zogg, Elizabeth J. Lilley, Lisa M. Kodadek, Navin R. Changoor, Peter Najjar, John A. Rose, Henri R. Ford, Ali Salim, Steven C. Stain, Shahid Shafi, Beth Sutton, David Hoyt, Yvonne T. Maddox, L. D. Britt
Journal: JAMA Surgery (2016)

Health care disparities (differential access, care, and outcomes owing to factors such as race/ethnicity) are widely established. Compared with other groups, African American individuals have an increased mortality risk across multiple surgical procedures. Gender, sexual orientation, age, and geographic disparities are also well documented. Further research is needed to mitigate these inequities. To do so, the American College of Surgeons and the National Institutes of Health-National Institute of Minority Health and Disparities convened a research summit to develop a national surgical disparities research agenda and funding priorities. Sixty leading researchers and clinicians gathered in May 2015 for a 2-day summit. First, literature on surgical disparities was presented within 5 themes: (1) clinician, (2) patient, (3) systemic/access, (4) clinical quality, and (5) postoperative care and rehabilitation-related factors. These themes were identified via an exhaustive preconference literature review and guided the summit and its interactive consensus-building exercises. After individual thematic presentations, attendees contributed research priorities for each theme. Suggestions were collated, refined, and prioritized during the latter half of the summit. Breakout sessions yielded 3 to 5 top research priorities by theme. Overall priorities, regardless of theme, included improving patient-clinician communication, fostering engagement and community outreach by using technology, improving care at facilities with a higher proportion of minority patients, evaluating the longer-term effect of acute intervention and rehabilitation support, and improving patient centeredness by identifying expectations for recovery. The National Institutes of Health and American College of Surgeons Summit on Surgical Disparities Research succeeded in identifying a comprehensive research agenda. Future research and funding priorities should prioritize patients' care perspectives, workforce diversification and training, and systematic evaluation of health technologies to reduce surgical disparities.
Dangerousness, confidentiality, and the duty to warn
Authors: L H Roth, A Meisel
Journal: American Journal of Psychiatry (1977)

The Tarasoff decision, by imposing on psychiatrists an obligation to warn the intended victim of threats made by a patient, but only under certain vaguely specified circumstances, may stampede psychiatrists into issuing such warnings to avoid possible legal liability no matter how remote the risk of harm may actually be. The authors suggest that the ill effects of such a reaction by psychiatrists--breach of confidentiality and the attendant erosion of trust and harm to the therapeutic alliance--can often be easily avoided by taking less drastic steps, some of which are illustrated by case presentations.
Growth, Metastasis, Immunogenicity, and Chromosomal Content of a Nickel-Induced Rhabdomyosarcoma and Subsequent Cloned Cell Lines in Rats&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;&lt;xref ref-type="fn" rid="FN3"&gt;3&lt;/xref&gt;
Authors: J Pot-Deprun, M F Poupon, F L Sweeney, I Chouroulinkov
Journal: JNCI Journal of the National Cancer Institute (1983)

Karyotype patterns, growth, metastasis, and immunogenicity were compared in a rhabdomyosarcoma induced by a single injection of metallic nickel with those in subsequent tumor-cloned cell lines. The primary tumor was induced in a male WAG rat by im injection of 20 mg nickel powder. The parental cell line (9-4/0) and 8 cell subpopulations (J 9-4) isolated from a primary tumor by cloning on agarose were examined. The tumor cell dose inducing tumors in 50% of the animals after sc injection (TD50) and the in vitro growth characteristics showed a marked heterogeneity between parental and cloned tumor cell lines. In vitro doubling times and saturation densities were also heterogeneous without showing a discernible relationship with TD50. Chromosome patterns of the cell lines exhibited very similar modal numbers, whereas chromosome numbers were somewhat different; neither of these exhibited any correlation with tumorigenicity. Parental cell line 9-4/0 expressed a significant degree of immunogenicity, but it did not protect against pulmonary metastasis in immunized rats. Among 6 clones studied, only clone J 9-4/2 appeared to be immunogenic and reduced metastatic spread. The relevance of the comparison between the different characteristics is discussed.
Early precut sphincterotomy for difficult biliary access to reduce post-ERCP pancreatitis: a randomized trial
Authors: Alberto Mariani, Milena Di Leo, Nicola Giardullo, Antonella Giussani, Mario Marini, Federico Buffoli, Livio Cipolletta, Franco Radaelli, Paolo Ravelli, Giovanni Lombardi, Vittorio D’Onofrio, Raffaele Macchiarelli, Elena Iiritano, Marco Le Grazie, Giuseppe Pantaleo, Pier Testoni
Journal: Endoscopy (2016)

<b>Background and study aim:</b> Precut sphincterotomy is a technique usually employed for difficult biliary cannulation during endoscopic retrograde cholangiopancreatography (ERCP) for the treatment of bile duct disease. It is a validated risk factor for post-ERCP pancreatitis (PEP), but it is not clear whether the risk is related to the technique itself or to the repeated biliary cannulation attempts preceding it. The primary aim of the study was to assess the incidence of PEP in early precut compared with the standard technique in patients with difficult biliary cannulation. Secondary aims were to compare complications and cannulation success. <b>Patients and methods:</b> In this prospective, multicenter, randomized, clinical trial, patients who were referred for therapeutic biliary ERCP and difficult biliary cannulation were randomized to early precut (Group A) or repeated papillary cannulation attempts followed, in cases of failure, by late precut (Group B). PEP was defined as the onset of upper abdominal pain associated with an elevation in serum pancreatic enzymes of at least three times the normal level at more than 24 hours after the procedure. No rectal indomethacin or diclofenac was used for prevention of PEP. <b>Results:</b> A total of 375 patients were enrolled. PEP developed in 10 of the 185 patients (5.4 %) in Group A and 23 of the 190 (12.1 %) in Group B (odds ratio [OR] 0.35; 95 % confidence interval [CI] 0.16 – 0.78). The incidence of PEP was significantly lower in the early precut group (10/185, 5.4 %) than in the delayed precut subgroup (19/135 [14.1 %]; OR 0.42, 95 %CI 0.17 – 1.07). There were no differences in biliary cannulation success rates, bleeding, perforation, and cholangitis. <b>Conclusions:</b> In patients with difficult biliary cannulation, early precut is an effective technique and can significantly reduce the incidence of PEP. Repeated biliary cannulation attempts are a real risk factor for this complication.
Nipple-sparing mastectomy and immediate reconstruction: Indications, technique, and results of 110 patients with breast cancer
Authors: B. Son, S. Ahn, H. Kim, M. Jang, E. Park, T. Lee, J. Um, S. Kim, J. Ahn, G. Gong
Journal: Journal of Clinical Oncology (2007)

11088 Background: Nipple-sparing mastectomy (NSM) and immediate reconstruction has recently been accepted as a new surgical procedure that provides good cosmetic results, although it is necessary to establish oncological safety. We reported our experience to evaluate indications, technique, results, and complications of NSM. Methods: Between 1999 and 2005, medical records of 113 patients with breast cancer undertaken NSM at the Asan Medical Center were analyzed retrospectively. Median age of the patients was 40 years and complications were assessed 3 months later postoperatively. Results: For preoperative indications of NSM, mulifocal or multicentric cancers were 60 cases (53.1%), diffuse microcalcifications on MMG were 27 cases (23.9%), failure of breast conserving surgery due to tumor involvement of resection margin were 12 cases (10.6%), central located small cancers were 11 cases (9.7%). Immediate reconstruction methods were 85 cases (75.2%) in TRAM and 28 cases (24.8%) in direct implant. Intraoperative frozen section biopsy for evaluation of tumor involvement at the NAC showed accuracy of 100%. Pathologic tumor size were 24 cases (21.2%) in Tis, 56 cases (49.6%) in T1, 33 cases (29.2%) in T2, respectively. Lymph node status showed 81 cases (71.7%) in N0, 24 cases (21.2%) in N1, 7 cases (6.2%), and one case (0.9%) in N3, respectively. During 20 months of the median follow-up, four patients developed recurrences; one local recurrence (subcutaneous), two (lung, brain) distant failures, and one local and distant failure. The rate of major NA necrotic complication was 14.6%, but all cases were improved with conservative management. 91.7% of patients were satisfied with their cosmetic results. Conclusions: Although the presented study does not establish conclusion with regard to oncological safety due to short follow-up period, the procedure of NSM with intraoperative pathologic assessment of the subareola tissue, and immediate reconstruction is a reasonable option for a selected patients. Good candidates for NSM are patients unsuitable for breast conservation either for multicentric or multofocal cancers, or because of extensive microcalcification, or involvement of resection margin during breast conserving surgery. No significant financial relationships to disclose.
A clinical phase II study of cisplatin and vinorelbine followed by docetaxel as first-line treatment in metastatic breast cancer (MBC)
Authors: H. Yassine, M. Khalifeh, N. Bitar, M. Charafeddine, M. Dheiny, A. Chehal, R. Jalloul, A. Dandashi, M. Wehbeh, A. Shamseddine
Journal: Journal of Clinical Oncology (2005)

822 Background: Based on our encouraging positive experience with Cisplatin and Vinorelbine combination (PVn) in first and second line for (MBC). Material and Methods: From August 2002 to August 2004, 35 patients (pts) with MBC were recruited of whom 32 were evaluable for response. Median age was 48 years (range: 22–76). 17 (51.5%) pts were premenopausal. 26 (78.8%) of pts had 2 or more sites of metastasis. No previous therapy was allowed except as adjuvant. 11 (33%) pts were chemo naive and 22 (67%) pts underwent previous surgery for breast cancer and received adjuvant anthracycline chemotherapy regimen. 20 (60.6%) pts received locoregional radiotherapy, and 12 (37.5%) pts received hormonal therapy. Chemotherapy consisted of cisplatin 80 mg/m2 given on day 1 of a three week-cycle and vinorelbine 30 mg/m2 on days 1 and 8 for a total of 4 cycles with evaluation every 2 cycles. After the 4th cycle responding pts received docetaxel 75 mg/m2 on day 1 every 21 days for a maximum of 4 cycles. Evaluation of measurable disease was done by physical examination and appropriate radiologic tests. Results: After a median follow up of 8 months (range: 1–24), 24 (75%) pts completed the study, 5 (15.6%) out of 32 pts evaluable for response showed CR, and 14/32 (43.7%) pts showed PR (ORR 59.3%). The median time to disease progression was 9 months (range: 2–9). 73.5% of pts survived for 1 year. The total number of cycles was 186. Dose reduction occurred in 29/186 (15.6%) cycles. Anemia Grade III observed in 3 (9.4%) pts, and Grade IV in 5 (15.6%) pts. Neutropenia Grade III in 2 (6.25%) pts. Febrile neutropenia observed in 4 (12.5%) pts. Thrombocytopenia Grade III in 3 (9.4%) pts, and Grade IV in 4 (12.5%) pts. Neurotoxicity Grade III in 3 (9.4%) pts. Conclusions: PVn followed by docetaxel produces good results in MBC with acceptable toxicity with an ORR 59.3%. Sequential addition of Docetaxel to PVn did not improve ORR. (ORR 62% with 6 cycles PVn [Shamseddine et al. Am J Clin Oncol 1999;22(3): 298–302 and Am J of Clin Oncol in press]) No significant financial relationships to disclose.
CD70 Exacerbates Blood Pressure Elevation and Renal Damage in Response to Repeated Hypertensive Stimuli
Authors: Hana A. Itani, Liang Xiao, Mohamed A. Saleh, Jing Wu, Mark A. Pilkinton, Bethany L. Dale, Natalia R. Barbaro, Jason D. Foss, Annet Kirabo, Kim R. Montaniel, Allison E. Norlander, Wei Chen, Ryosuke Sato, L. Gabriel Navar, Simon A. Mallal, Meena S. Madhur, Kenneth E. Bernstein, David G. Harrison
Journal: Circulation Research (2016)

Rationale: Accumulating evidence supports a role of adaptive immunity and particularly T cells in the pathogenesis of hypertension. Formation of memory T cells, which requires the costimulatory molecule CD70 on antigen-presenting cells, is a cardinal feature of adaptive immunity. Objective: To test the hypothesis that CD70 and immunologic memory contribute to the blood pressure elevation and renal dysfunction mediated by repeated hypertensive challenges. Methods and Results: We imposed repeated hypertensive challenges using either N ω -nitro-L-arginine methyl ester hydrochloride (L-NAME)/high salt or repeated angiotensin II stimulation in mice. During these challenges effector memory T cells (T EM ) accumulated in the kidney and bone marrow. In the L-NAME/high-salt model, memory T cells of the kidney were predominant sources of interferon-γ and interleukin-17A, known to contribute to hypertension. L-NAME/high salt increased macrophage and dendritic cell surface expression of CD70 by 3- to 5-fold. Mice lacking CD70 did not accumulate T EM cells and did not develop hypertension to either high salt or the second angiotensin II challenge and were protected against renal damage. Bone marrow–residing T EM cells proliferated and redistributed to the kidney in response to repeated salt feeding. Adoptively transferred T EM cells from hypertensive mice homed to the bone marrow and spleen and expanded on salt feeding of the recipient mice. Conclusions: Our findings illustrate a previously undefined role of CD70 and long-lived T EM cells in the development of blood pressure elevation and end-organ damage that occur on delayed exposure to mild hypertensive stimuli. Interventions to prevent repeated hypertensive surges could attenuate formation of hypertension-specific T EM cells.
Comparison of Temporal Changes in U.S. and Swedish Lung Cancer, 1950–51 to 1981–822
Authors: Kenneth G. Manton, Hans Malker, Birgitta Malker
Journal: JNCI Journal of the National Cancer Institute (1986)

Journal Article Comparison of Temporal Changes in U.S. and Swedish Lung Cancer, 1950–51 to 1981–82 Get access Kenneth G. Manton, Kenneth G. Manton Search for other works by this author on: Oxford Academic PubMed Google Scholar Hans Malker, Hans Malker Search for other works by this author on: Oxford Academic PubMed Google Scholar Birgitta Malker Birgitta Malker Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 77, Issue 3, September 1986, Pages 665–675, https://doi.org/10.1093/jnci/77.3.665 Published: 01 September 1986 Article history Received: 21 October 1985 Revision received: 22 April 1986 Accepted: 12 May 1986 Published: 01 September 1986
Prostaglandin E&lt;sub&gt;2&lt;/sub&gt; Regulation of Tumoristatic Factor Production by Macrophage-Like P388D1 Cells&lt;xref ref-type="fn" rid="FN1"&gt;2&lt;/xref&gt;
Authors: M R Young, J A Simmermaker
Journal: JNCI Journal of the National Cancer Institute (1984)

Macrophage-like P388D1 cells, when stimulated with lipopolysaccharide (LPS), produced a factor(s) whose activity was inhibitory to growth of Lewis lung carcinoma cells. Indomethacin, a prostaglandin-synthesis inhibitor, augmented the production of tumoristatic activity by LPS-stimulated P388D1 cells, whereas exogenous prostaglandin E2 (PGE2) suppressed its secretion. These results suggest that P388D1 cells regulate their antitumor abilities by producing PGE2, which inhibits production of soluble factor(s) with tumoristatic activities.
Effects of PCV7 and PCV13 on invasive pneumococcal disease and carriage in Stockholm, Sweden
Authors: Ilias Galanis, Ann Lindstrand, Jessica Darenberg, Sarah Browall, Priyanka Nannapaneni, Karin Sjöström, Eva Morfeldt, Pontus Naucler, Margareta Blennow, Åke Örtqvist, Birgitta Henriques-Normark
Journal: European Respiratory Journal (2016)

The effects of pneumococcal conjugated vaccines (PCVs) need to be investigated. In Stockholm County, Sweden, PCV7 was introduced in the childhood immunisation programme in 2007 and changed to PCV13 in 2010. Over 90% of all invasive isolates during 2005–2014 (n=2336) and carriage isolates, 260 before and 647 after vaccine introduction, were characterised by serotyping, molecular typing and antibiotic susceptibility, and serotype diversity was calculated. Clinical information was collected for children and adults with invasive pneumococcal disease (IPD). The IPD incidence decreased post-PCV7, but not post-PCV13, in vaccinated children. Beneficial herd effects were seen in older children and adults, but not in the elderly. The herd protection was more pronounced post-PCV7 than post-PCV13. PCV7 serotypes decreased. IPD caused by PCV13 serotypes 3 and 19A increased post-PCV7. Post-PCV13, serotypes 6A and 19A, but not serotype 3, decreased. The serotype distribution changed in carriage and IPD to nonvaccine types, also in nonvaccinated populations. Expansion of non-PCV13 serotypes was largest following PCV13 introduction. Serotype diversity increased and nonvaccine clones emerged, such as CC433 (serotype 22F) in IPD and CC62 (serotype 11A) in carriage. In young children, meningitis, septicaemia and severe rhinosinusitis, but not bacteraemic pneumonia, decreased. Pneumococcal vaccination leads to expansion of new or minor serotypes/clones, also in nonvaccinated populations.
Failure of care in mental health trust: Déjà vu in terms of treatment of people with learning disabilities?
Authors: Diane Willis
Journal: BMJ (2016)

Iacobucci’s article asks how the needs of people with learning disabilities are to be met.1 The government now promises ratings on the quality of care offered to this group, yet such commitments in the past have had little impact.

Over five decades there has been a catalogue of failures,2 3 …