tbuckley/cabot-search huggingface dataset:
Comparison of the Value of Nursing Work Environments in Hospitals Across Different Levels of Patient Risk
Authors: Jeffrey H. Silber, Paul R. Rosenbaum, Matthew D. McHugh, Justin M. Ludwig, Herbert L. Smith, Bijan A. Niknam, Orit Even-Shoshan, Lee A. Fleisher, Rachel R. Kelz, Linda H. Aiken
Journal: JAMA Surgery (2016)

The literature suggests that hospitals with better nursing work environments provide better quality of care. Less is known about value (cost vs quality).To test whether hospitals with better nursing work environments displayed better value than those with worse nursing environments and to determine patient risk groups associated with the greatest value.A retrospective matched-cohort design, comparing the outcomes and cost of patients at focal hospitals recognized nationally as having good nurse working environments and nurse-to-bed ratios of 1 or greater with patients at control group hospitals without such recognition and with nurse-to-bed ratios less than 1. This study included 25 752 elderly Medicare general surgery patients treated at focal hospitals and 62 882 patients treated at control hospitals during 2004-2006 in Illinois, New York, and Texas. The study was conducted between January 1, 2004, and November 30, 2006; this analysis was conducted from April to August 2015.Focal vs control hospitals (better vs worse nursing environment).Thirty-day mortality and costs reflecting resource utilization.This study was conducted at 35 focal hospitals (mean nurse-to-bed ratio, 1.51) and 293 control hospitals (mean nurse-to-bed ratio, 0.69). Focal hospitals were larger and more teaching and technology intensive than control hospitals. Thirty-day mortality in focal hospitals was 4.8% vs 5.8% in control hospitals (P < .001), while the cost per patient was similar: the focal-control was -$163 (95% CI = -$542 to $215; P = .40), suggesting better value in the focal group. For the focal vs control hospitals, the greatest mortality benefit (17.3% vs 19.9%; P < .001) occurred in patients in the highest risk quintile, with a nonsignificant cost difference of $941 per patient ($53 701 vs $52 760; P = .25). The greatest difference in value between focal and control hospitals appeared in patients in the second-highest risk quintile, with mortality of 4.2% vs 5.8% (P < .001), with a nonsignificant cost difference of -$862 ($33 513 vs $34 375; P = .12).Hospitals with better nursing environments and above-average staffing levels were associated with better value (lower mortality with similar costs) compared with hospitals without nursing environment recognition and with below-average staffing, especially for higher-risk patients. These results do not suggest that improving any specific hospital's nursing environment will necessarily improve its value, but they do show that patients undergoing general surgery at hospitals with better nursing environments generally receive care of higher value.
Omalizumab in patients with severe and refractory solar urticaria: A phase II multicentric study
Authors: François Aubin, Martine Avenel-Audran, Michel Jeanmougin, Henri Adamski, Jean-Louis Peyron, Marie-Claude Marguery, Fabienne Léonard, Marc Puyraveau, Manuelle Viguier
Journal: Journal of the American Academy of Dermatology (2016)
A Randomized Controlled Trial of Mindfulness-Based Cognitive Therapy for Treatment-Resistant Depression
Authors: Stuart J. Eisendrath, Erin Gillung, Kevin L. Delucchi, Zindel V. Segal, J. Craig Nelson, L. Alison McInnes, Daniel H. Mathalon, Mitchell D. Feldman
Journal: Psychotherapy and Psychosomatics (2016)

Due to the clinical challenges of treatment-resistant depression (TRD), we evaluated the efficacy of mindfulness-based cognitive therapy (MBCT) relative to a structurally equivalent active comparison condition as adjuncts to treatment-as-usual (TAU) pharmacotherapy in TRD.This single-site, randomized controlled trial compared 8-week courses of MBCT and the Health Enhancement Program (HEP), comprising physical fitness, music therapy and nutritional education, as adjuncts to TAU pharmacotherapy for outpatient adults with TRD. The primary outcome was change in depression severity, measured by percent reduction in the total score on the 17-item Hamilton Depression Rating Scale (HAM-D17), with secondary depression indicators of treatment response and remission.We enrolled 173 adults; mean length of a current depressive episode was 6.8 years (SD = 8.9). At the end of 8 weeks of treatment, a multivariate analysis showed that relative to the HEP condition, the MBCT condition was associated with a significantly greater mean percent reduction in the HAM-D17 (36.6 vs. 25.3%; p = 0.01) and a significantly higher rate of treatment responders (30.3 vs. 15.3%; p = 0.03). Although numerically superior for MBCT than for HEP, the rates of remission did not significantly differ between treatments (22.4 vs. 13.9%; p = 0.15). In these models, state anxiety, perceived stress and the presence of personality disorder had adverse effects on outcomes.MBCT significantly decreased depression severity and improved treatment response rates at 8 weeks but not remission rates. MBCT appears to be a viable adjunct in the management of TRD.
Interstitial lung disease associated with amrubicin in the treatment of patients with small cell lung cancer
Authors: K. Yoh, Y. Nishiwaki, H. Kemmotsu, Y. Yamaguchi, K. Kubota, H. Ohmatsu, K. Goto, S. Niho, N. Saijo
Journal: Journal of Clinical Oncology (2009)

e19018 Background: Amrubicin is a novel anthracycline agent with significant activity against small-cell lung cancer (SCLC). The adverse pulmonary effects of amrubicin are less well known. We investigated the incidence of acute interstitial lung disease (ILD) in SCLC patients receiving amrubicin. Methods: Medical records were used to retrospectively investigate a total of 100 SCLC patients treated with single-agent amrubicin at the National Cancer Center Hospital East between June 2003 and March 2008. The radiographic records and clinical data of these patients were reviewed to find patients who developed acute ILD after being treated with amrubicin. Results: Seven of 100 SCLC patients subsequently developed pulmonary infiltrates without underlying heart disease after receiving amrubicin, and were identified as cases of acute ILD associated with amrubicin. The median time from the start of amrubicin treatment to the development of ILD was 22 days (15–94 days). Among 7 patients who developed ILD, 6 patients received treatment with corticosteroids and ILD improved in 3 patients. However 3 patients died of respiratory failure. The incidence of ILD was 33% (4/12) in patients with preexisting pulmonary fibrosis and 3% (3/88) in patients without preexisting pulmonary fibrosis, and the difference between the two groups was statistically significant (P = 0.0036). Conclusions: Our findings indicate that amrubicin can cause severe ILD, and that the incidence of ILD might be higher in the patients with preexisting pulmonary fibrosis. Physicians need to be alert to the possibility. No significant financial relationships to disclose.
Comparative Study of Metabolic Profiles of Primary Hepatoma, Regenerating Liver, and Liver in Newborn Swiss Mice
Authors: S. V. Bhide
Journal: JNCI Journal of the National Cancer Institute (1971)

The metabolic properties of primary thioacetamide-induced hepatoma in mice were compared with fast-growing normal tissues such as regenerating liver and liver tissue in newborn mice. Content of glycogen and lactic acid, as well as activities of glucose-6-phosphatase, hexose diphesphatase, fructose diphosphate aldolase, ornithine, and aspartate carbamyl transferase were measured in all three tissues and in their corresponding control tissues. Metabolic properties of hepatoma and regenerating liver are comparable but differ from those of liver tissue from newborn mice.
Gender differences in long-term dexrazoxane cardioprotection in doxorubicin-treated children with acute lymphoblastic leukemia
Authors: S. E. Lipshultz, R. E. Scully, S. R. Lipsitz, S. E. Sallan, L. B. Silverman, T. L. Miller, E. J. Orav, S. D. Colan
Journal: Journal of Clinical Oncology (2009)

10005 Background: Doxorubicin (DOX) causes progressive cardiac dysfunction, particularly in females. Adding dexrazoxane (DZR) to DOX treatment resulted in reduced myocardial injury in children with acute lymphoblastic leukemia (ALL) during Dana-Farber Cancer Institute Protocol 95–01. Methods: We centrally remeasured echocardiograms from childhood high-risk ALL survivors in their first continuous remission who were randomly assigned to treatment with DOX only (n = 66; 30 mg/m 2 /dose for 10 doses) or DOX plus DZR 30 minutes prior (n = 68; 300 mg/m 2 /dose). Results: Demographics and median follow-up (DOX 5.3 vs. DZR/DOX 5.5 y) were similar in both arms. Mean left ventricle (LV) end systolic dimension (ESD) z-score was significantly larger than predicted for body-surface area for DOX (mean = 0.46, P-value [deviation of mean from normal] = 0.01) but not so for DZR/DOX (mean = 0.06, P = 0.74); DOX LV fractional shortening (FS; -0.78, P = .001; DZR/DOX = -0.38, P = 0.11) and thickness to dimension ratio (-0.96, P &lt; .001; DZR/DOX = -0.32, P = 0.08) were also abnormal. LV end diastolic posterior wall thickness (EDPWT) was reduced in both groups, though more so for DOX (-1.19, P &lt; .001) than DZR/DOX (-0.74, P &lt; .001). By gender, 5 years post treatment LVESD z-score was significantly larger than normal for DOX males (mean = 0.48, P = 0.04) but not DZR/DOX males (0.19, P = 0.41) or females (DOX female = 0.38, P = 0.22; DZR/DOX female = -0.17, P = 0.56). LVFS z-score was significantly different from normal in DOX females (mean = -1.29, P &lt; .001), but not DZR/DOX females (-0.22, P = 0.54) or males (DOX = -0.45, P = 0.15; DZR/DOX = -0.52, P = 0.09), as was LV thickness to dimension ratio (DOX female = -1.03, P &lt; .001; DZR/DOX female = 0.02, P = 0.93). DZR/DOX females were the only group with normal LVEDPWT z-score (mean = -0.43, P = 0.07; DOX/female = -1.43, P &lt; .001; DOX male = -1.05, P &lt; .001; DZR/DOX male = -0.94, P &lt; .001). Conclusions: While its impact is seen in all groups, primarily females drive the long-term DZR cardioprotective effect. DZR/DOX females exhibit more normal LV dimensions and more appropriate wall thickness for LV dimension, both of which are consistent with less LV remodeling. DZR/DOX females also have more normal LV function than females who received DOX only or males of either group. [Table: see text]
A Phase III Study of Eagle Comparing Two Doses of Bevacizumab Combined with Folfiri in the Second-Line Setting After First-Line Treatment with Bevacizumab Plus Oxaliplatin-Based Therapy : Kras Subgroup Findings
Authors: Y. Munemoto, S. Iwamoto, T. Takahashi, H. Tamagawa, M. Nakamura, T. Kato, T. Hata, T. Denda, Y. Morita, M. Inukai, K. Kunieda, N. Nagata, K. Kurachi, K. Ina, M. Oshiro, T. Shimoyama, H. Baba, K. Oba, J. Sakamoto, H. Mishima
Journal: Annals of Oncology (2014)
Safety analysis from PACS 04—A phase III trial comparing 6 cycles of FEC100 with 6 cycles of ET75 for node-positive early breast cancer patients, followed by sequential trastuzumab in HER2+ patients: Preliminary results
Authors: M. Spielmann, H. Roché, T. Delozier, G. Romieu, H. Bourgeois, D. Serin, J. Canon, B. Asselain, L. Roca, J. Genève
Journal: Journal of Clinical Oncology (2006)

632 Background: Following the BCIRG 001, PACS 01 and HERA trials, this randomised, multicentre, open-label, Phase III trial was designed to demonstrate the benefit of concomitant docetaxel and epirubicin versus anthracyclines, and evaluate the use of sequential trastuzumab. Methods: Patients (pts) with localised, resectable, unilateral breast cancer who met the following criteria were eligible: age &lt;65 years, ≥1 positive node, M0, adequate heart and organ functions. Pts were randomised to receive either 6 cycles of 5-fluorouracil-epirubicin-cyclophosphamide (FEC100: F and C, 500 mg/m 2 , E 100 mg/m 2 ) (Arm A) or epirubicin-docetaxel (ET75: E 75 mg/m 2 , T 75 mg/m 2 ) (Arm B). Primary prophylaxis with G-CSF was not planned. Radiotherapy was mandatory after conservative surgery and tamoxifen was required in pts with hormone receptor-positive tumours. Pts with HER2-positive disease were then further randomised to observation only or to 1 year of trastuzumab monotherapy (6 mg/kg iv every 3 weeks). In HER2-positive pts receiving trastuzumab, left ventricular ejection fraction (LVEF) was determined at Cycles 2, 4, 8, 13, 18 and after 2 years. Otherwise, LVEF was determined at baseline and at 1 year post-surgery. Results: Of the 3010 pts recruited (2622 evaluable for safety to date), 1518 received FEC100 and 1492 received ET75 after the first randomisation. Haematologic toxicity was the most frequent toxicity in both arms. Grade 3–4 toxicities were similar for Arms A and B, except febrile neutropenia (10.3% and 31.4%, respectively) and nausea/vomiting (13.2% and 7.5%, respectively). Grade 2 clinical cardiac toxicity (decreased LVEF) was observed in 4 pts in Arm A and 5 in Arm B, with median LVEF scores of 63% in both arms at the end of chemotherapy. HER2-positive pts (n=500) were then randomised to either receive trastuzumab (n=259) or observation only (n=241). Conclusions: These preliminary safety data indicate that FEC100 and ET75 were both well tolerated, with acceptable cardiac safety values. The trial is ongoing and further analysis regarding the use of trastuzumab in this setting will be presented. [Table: see text]
LSC 2014 abstract - Alternative macrophage polarization and role during lung epithelium injury and repair in vivo
Authors: Rania Dagher, Valerie Besnard, Sophie Kozelko, Marielle Maret, Fatima Hamidi, Gregory Gautier, Roland Kolbeck, Alison Humbles, Marina Pretolani
Journal: European Respiratory Journal (2014)

In response to various environmental signals, macrophages (MΦ) acquire distinct functional phenotypes that have been classified as classical MΦ and alternatively activated MΦ (AAM). AAM cells sustain tissue repair, whereas their depletion contributes to aberrant wound healing.

The current study was aimed at determining whether AAM polarization participated in epithelium repair and in lung fibrosis regulation. To this aim, we used the in vivo model of lung epithelium injury induced by the intra-peritoneal injection of naphthalene in mice.

Epithelium repair phase was accompanied by an increased expression in bronchoalveolar lavage (BAL) cells, of mRNAs encoding the AAM markers (CD206, FIZZ-1 and YM1), and the AAM-derived mediators, MMP-12, CCL2 and elastin. FACS analysis on BAL cells demonstrated a significant increase in the number of monocytes and AAM cells, during the phase that proceeded complete epithelium repair (days 6 to 15).

To define the role of AAM in epithelium repair, we depleted MΦ by administering intra-nasally liposome clodronate to naphthalene-injected mice on days 2, 5 and 8. MΦ-depleted mice displayed impaired epithelium repair, excessive production of fibrogenic mediators (IL-6 and CCL2) and lower levels of TIMP-1 in the lung, and enhanced collagen deposition at days 21 and 35, as compared to control mice. Intra-tracheal adoptive transfer of purified AAM to MΦ-depleted mice on day11 after naphthalene administration restored epithelium repair and suppressed lung fibrosis.

We conclude that lung epithelium repair is accompanied by MΦ polarization towards an AAM phenotype, essential for driving epithelium repair and for preventing tissue fibrosis.
Capecitabine (CAP) versus 5-fluorouracil (FU) in combination with oxaliplatin (OX) as 1<sup>st</sup>-line chemotherapy (CT) for advanced colorectal cancer (ACRC): Meta-analysis of randomized clinical trials (RCT)
Authors: F. Cuppone, E. Bria, I. Sperduti, M. Di Maio, P. Carlini, M. Milella, F. Cognetti, E. Terzoli, D. Giannarelli
Journal: Journal of Clinical Oncology (2008)

4056 Background: CAP has proven as effective as, and less toxic than, FU as single agent CT in ACRC. However, the substitution of CAP for FU in combination with OX remains controversial. Thus, we performed a cumulative analysis of available RCT addressing this issue. Methods: All RCT comparing CAP-OX with FU-OX combinations were considered eligible. A literature-based meta-analysis was performed and event-based relative risk ratios (RR) with 95% confidence intervals (CI) were derived, using both fixed- and random-effect models (inverse variance and Mantel-Haenszel methods). Heterogeneity was also taken into account. Absolute differences (AD) and the number of patients (pts) needed to treat (NNT) were calculated. Primary end-points were progression-free survival (PFS) and overall survival (OS). Secondary end-points included response rates and WHO Grade 3–4 toxicities. Results: Six RCT were gathered (3,405 patients); results in terms of RR for CAP vs FU are described in the table. No significant differences in primary outcomes were found. A significant 4% and 30% AD in favor of CAP was found for febrile neutropenia and neutropenia, respectively. Conversely, a significantly higher rate of HFS was found in pts receiving CAP (AD: 4.6%). Conclusions: CAP and FU are equally effective, when combined with OX, as 1st line CT for ACRC. Differences in safety profile should be taken into account when ‘tailoring’ the treatment to individual pts. A cost-analysis taking into account drugs, toxicity management, and the need for infusional devices is warranted. End-point Pts (#RCTs) RR (95% CI) p Het. (p) AD (%) NNT PFS 3,405 (6) 0.98 (0.95, 1.02) 0.46 0.61 - - OS 3,256 (5) 1.02 (0.97, 1.07) 0.37 0.53 - - ORR 3,405 (6) 0.96 (0.88, 1.04) 0.31 0.27 - - CR 2,931 (5) 0.66 (0.39, 1.11) 0.12 0.46 - - PR 2,931 (5) 0.99 (0.90, 1.09) 0.94 0.14 - - Neutropenia 2,931 (5) 0.22 (0.12, 0.39)* <0.0001 0.001 - 29.5 3 FN 2,589 (4) 0.38 (0.23, 0.62) 0.0001 0.28 - 3.7 27 Neurotox 3,405 (6) 0.92 (0.76, 1.12) 0.42 0.18 - - HFS 3,405 (6) 2.84 (1.54, 5.25)* 0.0001 0.04 + 4.6 21 Diarrhea 3,405 (6) 1.16 (0.77, 1,73) 0.47 0.001 - - No significant financial relationships to disclose.
Influence of hyperglycemia on toxicity in older patients receiving chemotherapy
Authors: A. Brunello, R. Kapoor, M. Extermann
Journal: Journal of Clinical Oncology (2007)

19579 Background: Few data are available concerning how glycemic control can affect outcomes in cancer patients (pts) treated with chemotherapy (CHT), particularly with those regimens that are more likely to cause increases in glycemia. Methods: Charts of non-Hodgkin lymphoma (NHL) and prostate cancer (PC) pts treated at Moffitt Cancer Center from January 1999 to September 2006 were reviewed, and pts who received Cyclophosphamide, Doxorubicin, Vincristine, Prednisone and Rituximab or Docetaxel-based CHT plus steroids were eligible. Demographics, vitals, comorbidity, biochemicals including baseline and average glucose level during chemotherapy, G4 hematological (HemT) and G3-G4 non hematological toxicity (NHemT), progression and death dates were recorded. Upper Limits of Normal for glycemia were set at 100 (fasting) and 140 mg/dL (post-prandial). Results: Three hundred forty-nine pts were eligible (NHL/PC: 62/187). Pts’ characteristics are outlined in Table I . Thirty-three pts in the NHL group and 48 pts in the PC group had received previous chemotherapy. G4 HemT was experienced by 76 (47%) NHL and 9 (5%) PC pts. 79 NHL and 86 PC pts had G3-G4 NHemT: neuropathy (25.3%), fever (not neutropenic, 18.9%), fatigue (15.2%), for NHL and fatigue (22.1%), thrombosis (11.6%) and diarrhea (9.3%) for PC. For NHL pts, G3–4 NHemT was associated with baseline hyperglycemia (p=0.0384, Wilcoxon Rank-Sum test) as well as with average glycemia during CHT (p=0.0048), while there was no significant correlation for HemT. For PC pts, a positive correlation was found between baseline hyperglycemia and G4 HemT (p=0.0241), while correlations between average glycemia during CHT and G4 HemT and between both baseline and average glycemia with NHemT were not significant. Conclusions: In NHL pts receiving CHT, often with a curative intent, hyperglycemia entails greater toxicity. Prospective studies are needed in order to assess whether a better glycemic control can improve the toxicity rate and the outcomes in elderly patients receiving chemotherapy. [Table: see text] [Table: see text]
Novel noninvasive measurement of total tumor glycolysis by PET predicts survival after complete surgical resection of NSCLC
Authors: T. J. Akhurst, R. J. Downey, M. Gonen, A. Vincent, V. W. Rusch, S. M. Larson
Journal: Journal of Clinical Oncology (2004)

7049 Background: Current clinical staging of patients with newly diagnosed non-small cell lung cancer (NSCLC) does not specifically predict prognosis or identify patients most likely to benefit from combined modality therapy. Previously, we showed that pathologic tumor size and SUVmax on FDG PET scan more accurately predicted prognosis after resection of NSCLC than other clinical variables. To extend this work, we developed a novel FDG PET parameter, the total lesion glycolysis (TLG), which integrates noninvasively measured tumor volume and glycolytic activity (unit measurement = gms), and tested this as a prognostic indicator. Methods: Retrospective database review revealed 95 previously untreated consecutive patients who underwent a R0 resection of NSCLC and also had a preoperative FDG PET scan. Parameters evaluated were: resected tumor size, TNM status, histology, SUVmax, and TLG. Survival was analyzed by Kaplan Meier, prognostic factors by log rank. p was significant if <.05. Results: Of 95 patients studied, 29 died during the followup period. The median follow-up of surviving patients was 21 months. TLG had a high rank correlation with the resected tumor volume (74%, p<0.001). By univariate analysis, SUVmax, TLG, nodal status, histology, TNM status, and pathologic tumor diameter all predicted overall survival. However, by multivariable analysis, TLG was the only statistically significant independent predictor of overall survival. Each 10-fold increase in TLG almost doubled the risk of death, hazard ratio=1.9 (p<0.001). At 3 years, 80% of patients with a TLG<125 gms were alive compared to 53% of those with TLG>125 gms (p<0.001). Conclusions: TLG is measurable preoperatively from PET images and is a novel non-invasive predictor of survival after NSCLC resection. TLG can help select poor prognosis tumors for induction therapy. No significant financial relationships to disclose.