tbuckley/cabot-search huggingface dataset:
Adjuvant CCRT for locally advanced rectal cancer: Uracil-tegafur? Or intravenous fluorouracil?
Authors: C. H. Hsieh, Y. J. Chen, K. H. Chang, H. H. Hsu, C. K. Liu, S. K. Hung, H. W. Chen, Y. L. Lai, T. C. Hsu
Journal: Journal of Clinical Oncology (2006)

13582 Background: This prospective, nonrandomized study was conducted to compare the efficacy and toxicity of postoperative concurrent chemoradiation therapy (CCRT) using daily oral uracil-tegafur plus leucovorin (UFUR/LV) vs. weekly intravenous fluorouracil plus leucovorin (5-FU/LV) in patients with locally advanced rectal cancer. Methods: From November 1996 through December 2004, 30 patients with stage II or III rectal cancer were enrolled. Seventeen received oral UFUR/LV regiment and thirteen with intravenous 5-FU/LV regiment during CCRT. A weekly infusion of 400 to 450 mg/m 2 of 5-FU plus a bolus injection of 80 to 100 mg/m 2 of LV and 250 to 300 mg/m 2 /d of oral UFUR plus 30 to 45 mg /m 2 /d of oral LV were given separately during RT and for an additional 42 weeks thereafter. Forty-five Gy of whole-pelvis irradiation was followed by a local boost of 5.4 to 14.4 Gy to the tumor bed delivered in 33 fractions. Analytical method was Kaplan-Meier method. Results: Mean survival in the UFUR/LV group was 36 months compare with 30 months in the 5-FU/LV group. The 2-year OS, DFS and LCR were 68.1% vs. 65.8%, 54.9% vs. 50.4%, and 79.4% vs. 83.9%, (p &gt; 0.05), respectively. There were no treatment-related deaths and grade 4 toxicity in both groups. Grade 3 of dermatitis, gastrointestinal, and hematologic toxicity was noted in the 5-FU/LV group. Conclusions: Postoperative CCRT with oral UFUR/LV in locally advanced rectal cancer provides an alternative way for those who have difficulty with an intravenous regimen due to it was more tolerable and less toxicity and has similar survival rate. No significant financial relationships to disclose.
WITHDRAWN: Evaluation of materno-fetal permeability of various compounds by fetus uptake index (FUI) method
Authors: Tomoya Akashi, Tomohiro Nishimura, Takashi Asada, Hideki Ozawa, Yuichiro Sano, Akira Katsube, Masatoshi Tomi, Emi Nakashima
Journal: Asian Journal of Pharmaceutical Sciences (2015)

This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at http://www.elsevier.com/locate/withdrawalpolicy.
The incidence of pulmonary embolism after gynecologic oncologic surgery
Authors: E. Williamson, M. A. Martino, M. S. Hoffman, T. Boren, S. Siegfried, W. Roberts, A. Cantor, J. Fiorica
Journal: Journal of Clinical Oncology (2005)

5089 Background: Pulmonary embolism is a major morbidity following surgery for malignancy. The purpose of this study was to determine the risk of developing a pulmonary embolism in patients having major abdominal surgery during the peri and post-operative period (6 weeks) and to compare cancer and benign subgroups. Methods: The H. Lee Moffitt Cancer Center database was reviewed retrospectively to identify gynecologic oncology patients who had surgery between July 2001-June 2003. These patients were sorted by major or minor procedure, and further by malignant versus benign diagnosis. Pulmonary embolism in post-operative patients was determined from the time of surgery through 6 weeks post-operatively. The diagnosis of pulmonary embolism was confirmed by either a CTPA or V/Q scan. All patients received prophylaxis with sequential compression devices (SCD) and early ambulation. Benign and malignant groups were compared with chi square analysis. This study was IRB approved. Results: A total of 1374 patients were identified between July 2001-June 2003. Chart review identified 1009 major cases and 365 minors. Of the 1009 major surgical cases 836 were exploratory laparotomies with 523 cancer cases and 313 benign cases. In patient with a diagnosis of cancer, 23/523 (4.4%) were diagnosed with pulmonary embolism. In patients with a benign diagnosis, 1/313(0.3%) were diagnosed with a pulmonary embolism. The difference between those with and without cancer was determined to be significant. (p=.0006) Conclusion: We determined the rate of post-operative pulmonary embolism in patients with cancer who have major abdominal surgery to be 4.4%. This rate persisted despite vigorous use of SCD’s and early ambulation. Preventative measures are needed in this subgroup of patients to attempt to decrease this high rate of post-operative pulmonary embolism. No significant financial relationships to disclose.
Web-based standard-regimen selection (SRS) and cancer-care registry (CCR) systems of a nationwide network in Japan: An attempt to improve breast cancer treatment.
Authors: Kazuhiko Sato, Nobuaki Shinozaki, Masaru Iwai, Yoshio Mizuno, Rai Shimoyama, Noriyuki Takahashi, Yoshiro Niitsu
Journal: Journal of Clinical Oncology (2012)

76 Background: Tokushukai group has a nation-wide network of 67 affiliated hospitals, and has started an “oncology project” to improve the quality of cancer care using web-based SRS and CCR systems. Methods: Every institution has been introduced the same electric-medical-record (EMR) to share the unified code to order chemotherapy regimens, and patient data could be collected on a database in the central office. 141 recommended regimens for 15 types of solid tumor have been approved in the cancer committee consisting of working-group and program-evaluation members. In breast cancer, 31 recommended regimens (7 for adjuvant and 24 for metastatic settings) were selected from the NCCN guidelines and approved by the committee. Not only recommended but also non-recommended regimens have their own specific codes in EMR, and the patterns of care in the selection of chemotherapy regimen were examined. Results: In 2011, 21 of 67 hospitals utilized these systems. 71.8% of 2,676 patients with cancer including 753 with colorectal, 317 with breast, 273 with gastric, 144 with non-small cell lung, 123 with pancreatic, and 73 patients with esophageal cancer had received 97 types of recommended therapies (11,022 cycles). In terms of breast cancer, 86% of 388 patients had been treated with recommended regimens (1,994 cycles). Among 71 patients received non-recommend therapies, only 6 patients (1.5%) had been treated with three regimens which were not regarded as standard regimens. Conclusions: The introduction of web-based SRS and CCR systems in a large medical group could facilitate standard chemotherapy regimen by an accurate examination of current treatment patterns.
Examining Infertility Treatment and Early Childhood Development in the Upstate KIDS Study
Authors: Edwina H. Yeung, Rajeshwari Sundaram, Erin M. Bell, Charlotte Druschel, Christopher Kus, Akhgar Ghassabian, Scott Bello, Yunlong Xie, Germaine M. Buck Louis
Journal: JAMA Pediatrics (2016)

An increasing percentage of births are conceived with assisted reproductive technology (ART) and other infertility treatment. Despite findings that such treatments may be associated with diminished gestation and birth size, scarce data exist regarding infertility treatments and children's development in the United States.To assess the use and type of infertility treatment in relation to children's development through age 36 months.Prospective cohort study (conducted 2008-2014) that sampled based on infertility treatment and plurality. Included in the study were infants born between 2008 and 2010 in New York state (excluding New York City) whose parents completed developmental screening instruments through 36 months of age. A total of 4824 mothers (97% of 4989) completed 1 or more developmental screening instruments for 5841 children, including 1830 conceived with infertility treatment and 2074 twins.Maternal self-report of any infertility treatment was further categorized into ART and ovulation induction/intrauterine insemination. Assisted reproductive technology use was previously validated by linkage with the Society for Assisted Reproductive Technology-Clinical Outcome Reporting System.Five developmental domains (fine motor, gross motor, communication, personal-social functioning, and problem-solving ability), as measured by the parental completion of the Ages and Stages Questionnaires at 4, 8, 12, 18, 24, 30, and 36 months of age. Generalized linear mixed modeling techniques estimated adjusted odds ratios (aORs) and 95% CIs for use and type of infertility treatment in relation to failing a developmental domain. Data were stratified by plurality and weighted for the sampling scheme.There were 1422 mothers (29.5%; mean [SD], age, 34.1 [5.2] years) who underwent infertility treatment. Infertility treatment was not associated with risk of their children failing any developmental domain (aOR, 1.33; 95% CI, 0.94-1.89). Assisted reproductive technology was associated with increased risk for failing any developmental domain but only when singletons and twins were evaluated together (aOR, 1.81; 95% CI, 1.21-2.72). Adjustment for birth weight further attenuated this estimate (aOR, 1.26; 95% CI, 0.82-1.93). After stratifying by plurality, type of treatment also was not significantly associated with failing any developmental domain for ovulation induction/intrauterine insemination (aOR, 1.00; 95% CI, 0.57-1.77 for singletons and aOR, 1.30; 95% CI, 0.76-2.21 for twins) or ART (aOR, 1.38; 95% CI, 0.78-2.43 for singletons and aOR, 1.58; 95% CI, 0.94-2.65 for twins).After considering plurality, children's development through age 3 years was similar irrespective of infertility treatment or specific type. To our knowledge, these findings are among the first to focus on non-ART treatments in the United States.
Adjuvant chemotherapy in patients with hepatocellular carcinoma After orthotopic liver transplantation
Authors: W. Sun, S. S. Sonnad, E. E. Furth, K. Timmons, M. Caparro, B. J. Giantonio, D. Vaughn, D. G. Haller, A. Shaked, K. M. Olthoff
Journal: Journal of Clinical Oncology (2005)

4126 Background: For patients (pts) with hepatocellular carcinoma (HCC) who are not suitable for surgical resection, orthotopic liver transplantation (OLT) is the only potential curative maneuver. Adjuvant chemotherapy may be administered to those pts with high risk of recurrence based on anecdotal analysis for improving the outcome. The presence of microvascular invasion, multifocality with ≥3 tumor nodules, tumor’s size ≥ 5 cm, and poor differentiation of the tumor are considered as risk factors of HCC recurrence. A retrospective analysis was conducted to determine if adjuvant chemotherapy is beneficial to pts with HCC post OLT. Methods: There were 169 HCC pts underwent OLT in our center from 02/1996 to 07/2004. Among the 157 eligible pts, 44 received adjuvant chemotherapy post OLT. All pts who received adjuvant chemotherapy had at least one risk factor. Most pts received doxorubicin, cisplatin and 5-fluorouracil. Other 36 pts with one or more risk factors, who did not receive adjuvant therapy no therapy post OLT were grouped as ‘control’. Results: The average follow-up time, marked by the end of the study or death, was 27.4 months (median = 22.7 months). The overall mortality was 21% (33/157), including 63.6% (21/33) of the deaths resulting from recurrence of HCC. 1-, 3- and 5-year overall survival (OS) rates are 90.2%, 72% and 63.5% respectively. 1-, 3-, 5-year disease free survival (DFS) rates are 86.7%, 67%, and 63%. No statistical differences in mortality was shown in pts who had at least one risk factor with chemotherapy vs. without chemotherapy (p=0.779), nor was a difference shown compared with those no risk factors (p=0.287). It appeared no survival advantage for adjuvant chemotherapy in pts with vascular invasion (p=0.958); with ≥3 tumor nodules (p=0.199) or poorly differentiated histology (p=0.258). There were more than 2/3 patients developed Gr. 3/4 neutropenia. However, with supportive care, the adjuvant therapy was tolerated for the most patients. About 60% of the patients completed their treatment. Conclusions: Larger, prospective randomized studies are needed to better evaluate the role of adjuvant chemotherapy in pts with HCC post OLT. No significant financial relationships to disclose.
Abstract 14929: The Role Of Mitochondrial Permeability Transition In Reperfusion-induced Cardiomyocyte Death Depends On The Duration Of Ischemia
Authors: Marisol Ruiz-Meana, Javier Inserte, Celia Fernandez-Sanz, Victor Hernando, Elisabet Miro-Casas, Ignasi Barba, David Garcia-Dorado
Journal: Circulation (2011)

Mitochondrial permeability transition (MPT) is critical in cardiomyocyte death during reperfusion but it is not the only mechanism responsible for cell injury. Objectives: To investigate the role o...
Phase I study of gefitinib in combination with FOLFIRI as 2nd-/3rd-line treatment in patients with metastatic colorectal cancer
Authors: A. Hochhaus, R. Hofheinz, M. Heike, R. Schlag, C. G. Gahlemann, S. Kubicka
Journal: Journal of Clinical Oncology (2005)

3674 Background: Gefitinib (IRESSA) is an orally active epidermal growth factor receptor tyrosine kinase inhibitor. Preclinical studies show that gefitinib potentiates cytotoxic drug activity in xenografts of human tumors (Ciardiello et al, Clin Cancer Res 2000;6:2053–63). This Phase I dose-finding study evaluated the safety and efficacy of gefitinib in combination with a standard FOLFIRI (5-fluorouracil [FU]/folinic acid [FA]/irinotecan) regimen in patients (pts) with metastatic colorectal cancer pretreated with oxaliplatin and FU/FA. Methods: Pts received gefitinib 250 mg/d combined with escalating doses of FOLFIRI (FU/FA/irinotecan mg/m2 iv: Level [L] 1, 1600/500/60; L2, 1600/500/80; L3, 2000/500/80) on days 1, 8, 15, 21, 28, and 36. Duration of each treatment cycle was 6 weeks. Predefined dose-limiting toxicity (DLT) was determined in pts who completed 1 full cycle of combination treatment. DLTs and adverse events (AEs) were assessed by NCI-CTC. Objective tumor assessments were made by RECIST every 9 weeks. Results: 13 pts (10m/3f; median age, 68 yrs, range 53–73) were enrolled. 6 pts received L1 and 7 pts received L2. Recruitment was stopped at L2. The table lists AEs reported during the first treatment cycle. 3 pts had DLTs: L1, 1 pt grade (G) 3 acute psychosis, stroke (unconfirmed); L2, 1 pt G3 diarrhea, 1 pt G3 nausea/vomiting secondary to hemorrhagic cerebral metastasis. Conclusions: Expected side effects of standard FOLFIRI include hematologic effects, diarrhea, nausea/vomiting, and alopecia. Although our preliminary data show the safety profile with combined treatment was similar to that seen with standard FOLFIRI alone, with the addition of skin events, further evaluation of standard FOLFIRI with gefitinib does not seem feasible at these doses. IRESSA is a trademark of the AstraZeneca group of companies. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration AstraZeneca
Activation of Cytotoxic Polymorphonuclear Leukocytes by In Vivo Administration of a Streptococcal Preparation, OK-432&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;
Authors: Shigeru Watabe, Fujiro Sendo
 4, Seishi Kimura, Shigeru Arai
Journal: JNCI Journal of the National Cancer Institute (1984)

Injection ip of a streptococcal preparation, OK-432, into WKA and DONRYU rats induced in vitro cytotoxicity of polymorphonuclear leukocytes (PMN) against tumor cells in terms of their cytostasis and cytolysis. PMN were obtained from peritoneal exudates of WKA and DONRYU rats. Cytotoxicity of activated PMN was immunologically nonspecific, although a certain target selectivity was observed in PMN cytotoxicity. The titer of cytotoxicity of PMN was dependent on the dose of injected OK-432 and on the number of PMN in the cytotoxicity assay. Activated PMN appeared very early (6 hr) after OK-432 injection, and the cytotoxic titer of PMN decreased from 24 hours and disappeared at 96 hours after injection of the reagent. In vitro culture of PMN with OK-432 also evoked cytotoxicity of PMN.
Preliminary experience of high dose rate (HDR) brachytherapy following video assisted thoracoscopic surgery (VATS) based sublobar resection in patients with peripheral non-small cell lung cancer and poor pulmonary functions
Authors: J. C. Yap, N. McCreary, R. Cook, M. Burnison, B. Hakimian, C. Fuller, H. Ward, A. Pickens, R. McKenna
Journal: Journal of Clinical Oncology (2005)

7269 Background: To describe the initial experience of delivering adjuvant radiotherapy following sublobar resection using HDR brachytherapy after VATS resection of lung lesions. Methods: Between March and November 2004, 14 patients were treated with VATS sublobar resection and HDR brachytherapy to 16 peripheral lung lesions that were pathologically proven to be non-small cell lung carcinoma. Intraoperatively, brachytherapy catheters were sutured and anchored over the stapled line and to the chest wall. Brachytherapy planning was done using a CT-based planning system. A remote afterloading HDR unit was used for treatment. A median dose of 2,450 cGy was given at 350 cGy per fraction over 7 fractions twice a day, 6 hours apart, over 4 days as inpatient. Dose was prescribed to 1 cm deep to the stapled line. Biologically, this dose is approximately 5,000 cGy and above (180 cGy per fraction equivalent) at the depth of 5 mm in reference to the resection margin. Results: At median and average followup times of 3 months and 4 months respectively, patients tolerated the postoperative brachytherapy well with no pneumonitis or excess complication. Average hospital stay was one week. There was one case of empyema which may or may not be related to radiation treatment. There were 2 incidents of catheter migration due to inadvertent catheter movement during wound care. Consequently, re-planning was needed in order to continue accurate radiation delivery for these patients. Conclusions: Low dose rate brachytherapy has been described in literature for this subgroup of patients for improving local control rate. This is a first report of using HDR brachytherapy with VATS. In our initial experience, patients tolerate this method of brachytherapy well with no significant acute side effect. HDR technique complements with VATS efficiently and does not prolong hospital stay. Remote afterloading technique allows no radiation exposure to staff members or others. Further data are needed to determine the clinical impact of HDR brachytherapy in this subgroup of patients. No significant financial relationships to disclose.
Chemokine receptor CXCR4 expression and its regulation in gastric cancer cells
Authors: H. Lee, H. Kim, S. Kim, H. Yun, S. Kim, D. Jo
Journal: Journal of Clinical Oncology (2009)

e22173 Background: The chemokine receptor CXCR4 is associated with the biological behavior in several kinds of cancer, but few studies have addressed the expression and regulation of CXCR4 in gastric cancer. Methods: Five gastric cancer cell lines were studied. The expression of CXCR4 was investigated using RT-PCR, Westerning blotting, flow cytometry, and immunofluorescence staining. The regulation of CXCR4 expression by hypoxia, dexamethasone, and the proinflammatory cytokines was evaluated. Results: CXCR4 mRNA and proteins were detectable by RT-PCR and Western blot analysis, respectively, in all five cell lines. However, MKN-28, MKN-45, MKN-74, and SNU 16 cells did not express membrane CXCR4, but had abundant CXCR4 in their cytoplasm, as determined by flow cytometry and immunofluorescence staining. In contrast, a small population of KATO III cells expressed membrane CXCR4. Hypoxia up-regulated CXCR4 proteins and enhanced membrane expression of CXCR4 in human gastric cancer KATO III cells, which constitutively expressed membrane CXCR4 in a steady state, as revealed by Western blotting and flow cytometry, respectively. This hypoxia-induced expression of CXCR4 was mediated via hypoxia-inducible factor (HIF)-1α. In addition, KATO III cells exposed to hypoxia demonstrated enhanced migration in response to stromal cell-derived factor (SDF)-1α, a specific ligand for CXCR4. However, MKN-28, MKN-45, MKN-74, and SNU-16 cells, which lack membrane CXCR4 in a steady state, showed no change in CXCR4 expression in hypoxic condition. Treatment with IFN-γ, TGF-β, TNF-α, and dexamethasone did not induce any change in CXCR4 expression in all five gastric cancer cells. Conclusions: This study suggests that hypoxia up-regulates the membrane expression of functional CXCR4 via HIF-1α in human gastric cancer cells that basally express membrane CXCR4 in a steady state in vitro. No significant financial relationships to disclose.
Margaret McCartney: For better primary care, pay GPs for service
Authors: Margaret McCartney
Journal: BMJ (2015)

How should GPs be paid: by item, or for service?Currently, it's per item, through micromanagement.Not per appointment but by ticking boxes: smoking or not, cardiopulmonary resuscitation or not, blood pressure target or not.But the box may not represent anything useful, appropriate, or kind.Say "every contact counts," and repeat the mantra "GPs are ideally placed to . .."-whether evidence based or not.When GPs achieve many ticks, up the ante: make the hoops smaller and higher.Add items that have not been proved to cut unnecessary admissions or to reduce wasted drugs or identify future suicide bombers.Add accountability-to the Care Quality Commission, contract inspections, commissioning units, patients, and the General Medical Council.Meanwhile, defund social care, wear down district nurses, and allow mental health services to exist in a twilight of waiting lists and CBT-lite.
EARSS activities and results: update
Authors: U Buchholz, S L A M Bronzwaer, P Schrijnemakers, J Monen, J. L. Kool
Journal: Eurosurveillance (2001)

(And with EARSS participants) The latest EARSS results (1990-2000) suggest that the rates of methicillin resistant S. aureus and Penicillin Non Susceptible S. pneumoniae are higher in southern European countries than in the North. Young children, followed by elderly people are the most at risk for an infection by PNSP. The risk to be infected by methicillin resistant S. aureus increases with age, patients hospitalised in intensive care units being more exposed to that risk.