tbuckley/cabot-search huggingface dataset:
Percutaneous needle biopsy preceding preoperative chemotherapy in the management of massive renal tumors in children.
Authors: U M Saarinen, S Wikström, O Koskimies, H Sariola
Journal: Journal of Clinical Oncology (1991)

While the National Wilms' Tumor Study (NWTS) Group in the United States puts an emphasis on accurate staging and histology before any therapy is given for Wilms' tumor, the International Society of Pediatric Oncology (SIOP) in Europe focuses on preoperative therapy and safer surgery. Our current approach combines the benefits of both policies in the management of massive renal tumors in children. In seven consecutive patients we first obtained a percutaneous posterior needle biopsy to obtain adequate tissue for histology, and proceeded with preoperative chemotherapy with vincristine and dactinomycin until tumor shrinkage was sufficient. Tumor removals were feasible and uneventful. At the time of operation, two tumors were found to be totally or almost totally necrotic. In the others, which still included viable tumor, the histology corresponded well to the needle biopsy findings. One case with unfavorable histology and one with rhabdoid sarcoma would have been missed and given suboptimal therapy without the primary needle biopsy. As possible biopsy-related complications, subcapsular intratumoral bleeding was recognized in two patients. We conclude that percutaneous posterior needle biopsy is safe and yields definite, detailed histology in massive renal tumors in children. Preoperative chemotherapy facilitates surgery in these patients.
KRAS mutation analysis in cetuximab-treated advanced stage non-small cell lung cancer (NSCLC): SWOG experience with S0342 and S0536
Authors: P. C. Mack, W. S. Holland, M. Redman, P. N. Lara, L. J. Snyder, F. R. Hirsch, W. A. Franklin, E. S. Kim, R. S. Herbst, D. R. Gandara
Journal: Journal of Clinical Oncology (2009)

8022 Background: KRAS mutations occur in NSCLC with a frequency of 15–25% and have been associated with a poor response to EGFR tyrosine kinase inhibitors. In colorectal cancer, benefit from the EGFR-targeted monoclonal antibody cetuximab is largely limited to patients (pts) whose tumors are KRAS wild-type (WT). However, in cetuximab-treated NSCLC, a predictive role for KRAS mutations has not been established. We evaluated KRAS status in specimens from two cetuximab-based front-line multicenter SWOG phase II trials in advanced NSCLC. Methods: DNA extracted from archival tumor and plasma specimens from S0342 (carboplatin-paclitaxel plus sequential vs. concurrent cetuximab) and S0536 (carboplatin-paclitaxel-cetuximab-bevacizumab) was analyzed for KRAS mutations by micro-dissection/sequencing and/or Scorpion-ARMS (DxS LTD). Results: For S0342, 45 archival tissues and 90 plasma specimens were analyzed. Combined, KRAS mutations were detected in 24% of pts. No differences between mutant and WT tumors were observed for response rate (p=0.62) or progression-free survival (PFS; p=0.65). Overall survival (OS) was non-significantly higher for pts with WT vs. mutant KRAS [median OS: 11 vs. 8 mo.; p=0.39]. When evaluated with EGFR copy number analysis conducted previously (JCO 10:3351, 2008), pts with both low EGFR copy number and mutant KRAS trended towards a worse OS [7 mo. vs. 17 mo. for all others, p=0.08, n=31]. For S0536, 6/26 pt specimens (23%) harbored KRAS mutations. In the limited sample set available from S0536, no associations were observed between KRAS status and clinical outcome [response rate: p=0.83; PFS: p=0.93; OS p=0.89]. Conclusions: These data suggest that KRAS mutations may not play a significant predictive role for cetuximab-based therapy in NSCLC, contrary to colorectal cancer. KRAS analysis in recently completed phase III trials of chemotherapy ± cetuximab will be of interest to confirm these observations. Trends in favorable OS in pts with WT KRAS may reflect prognostic effects of KRAS mutations. [Table: see text]
A systematic review and meta-analysis of the efficacy and safety of<i>N</i>-acetylcysteine in preventing aminoglycoside-induced ototoxicity: implications for the treatment of multidrug-resistant TB
Authors: Katharina Kranzer, Wael F Elamin, Helen Cox, James A Seddon, Nathan Ford, Francis Drobniewski
Journal: Thorax (2015)

<h3>Background</h3> Ototoxicity is a severe side effect of aminoglycoside antibiotics. Aminoglycosides are recommended for the treatment of multidrug-resistant TB (MDR-TB). <i>N</i>-Acetylcysteine (NAC) appears to protect against drug- and noise-induced hearing loss. This review aimed to determine if coadministering NAC with aminoglycoside affected ototoxicity development, and to assess the safety and tolerability of prolonged NAC administration. <h3>Methods</h3> Eligible studies reported on the efficacy of concomitant NAC and aminoglycoside administration for ototoxicity prevention or long-term (≥6 weeks) administration of NAC regardless of indication. Pooled estimates were calculated using a fixed-effects model. Heterogeneity was assessed using the I<sup>2</sup> statistic. <h3>Results</h3> Three studies reported that NAC reduced ototoxicity in 146 patients with end-stage renal failure receiving aminoglycosides. Pooled relative risk for otoprotection at 4–6 weeks was 0.14 (95% CI 0.05 to 0.45), and the risk difference was −33.3% (95% CI 45.5% to 21.2%). Eighty-three studies (N=9988) described the administration of NAC for &gt;6 weeks. Abdominal pain, nausea and vomiting, diarrhoea and arthralgia were increased 1.4–2.2 times. <h3>Discussion</h3> This review provides evidence for the safety and otoprotective effect of NAC when coadministered with aminoglycoside. It represents a strong justification for a clinical trial to investigate the effect of concomitant NAC treatment in patients receiving aminoglycosides as part of MDR-TB treatment.
Abstract 17725: Growth in Non-Emergency PCI at Hospitals Without Surgery-On-Site Since the Completion of the MASS COMM Trial - A Comparison of the MASS COMM RCT and Cohort Study
Authors: Laura Mauri, Robert W Yeh, Ashwin Nathan, Treacy S Silbaugh, Katya Zelevinksy, Sharon-Lise Normand, Alice K Jacobs
Journal: Circulation (2013)
What is the role of coronary angioplasty and stenting in stable angina?
Authors: Rasha Al-Lamee, Justin Davies, Iqbal S Malik
Journal: BMJ (2016)

#### What you need to know Stable angina refers to chest discomfort that is classically retrosternal, triggered by exertion, and relieved by rest or nitrates within minutes. Unstable symptoms, such as those occurring at rest or persisting when activity stops, suggest an acute coronary syndrome and will not be discussed here.1 More than one million people in the United Kingdom live with stable coronary artery disease (CAD), with an annual mortality rate of 1.5%.2 3 It is associated with long term morbidity and has serious effects on quality of life.4 Treatment options include medical therapy, coronary angioplasty with or without stenting (percutaneous coronary intervention; PCI), and coronary artery bypass surgery (CABG), for which guidelines from the UK's National Institute for Health and Care Excellence (NICE) and European Society of cardiology (ESC) exist.5 6 However, patients' and doctors' expectations of potentials benefits of PCI in stable CAD are often overstated.7 This article focuses on the limited evidence base and indications for PCI in stable angina. #### Sources and selection criteria We searched Medline and the Cochrane Library using terms from a previous systematic review of treatment of stable angina ("stable angina", "percutaneous coronary intervention", and "medical therapy"),8 updated to March 2015. We also drew on our experience of coronary angioplasty and medical treatment of patients with stable coronary artery disease and our knowledge of NICE and ESC guidance. ### The two main goals are risk factor modification and symptomatic relief ### Risk factor modification
Myeloblastoma (Chloroma) in Leukemia
Authors: W.Y. Au, T.W. Shek, S.K. Ma, G. Leung, G.C. Ooi, R. Liang, Y.L. Kwong
Journal: Journal of Clinical Oncology (2000)

Article Tools DIAGNOSIS IN ONCOLOGY Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.2000.18.23.3996 Journal of Clinical Oncology - published online before print September 21, 2016 PMID: 11099330 Myeloblastoma (Chloroma) in Leukemia Case 2. Meningeal Granulocytic Sarcoma (Chloroma) in Essential Thrombocythemia W.Y. AuxW.Y. AuSearch for articles by this author , T.W. ShekxT.W. ShekSearch for articles by this author , S.K. MaxS.K. MaSearch for articles by this author , G. LeungxG. LeungSearch for articles by this author , G.C. OoixG.C. OoiSearch for articles by this author , R. LiangxR. LiangSearch for articles by this author , Y.L. KwongxY.L. KwongSearch for articles by this author Show More University of Hong Kong, Queen Mary Hospital, Hong Kong https://doi.org/10.1200/JCO.2000.18.23.3996 First Page Full Text PDF Figures and Tables © 2000 by American Society of Clinical Oncology
Amifostine protects normal tissue in patients receiving radiation therapy to the pelvis
Authors: C. E. Leonard
Journal: Journal of Clinical Oncology (2005)

3218 Background: The objective of this study is to evaluate the efficacy of amifostine in reducing the incidence and severity of bowel and bladder morbidity in patients receiving radiation therapy (RT) to the pelvis. Methods: Patients with a diagnosis of pelvic malignancy received amifostine 340 mg/m2 intravenously or 500 mg subcutaneously 3 times a week 15 to 30 minutes before radiation, which was delivered to the pelvis 5 days a week for 5 weeks. Patients undergoing RT to the pelvis but not receiving amifostine served as controls. Results: Data from 19 patients (11 amifostine, 8 controls) were available for analysis. Amifostine-treated patients were predominantly women (70%), with a mean age of 51 years and a diagnosis of rectal (n=6), anal (n=2), cervical (n=1), or ovarian (n=1) carcinoma. Baseline demographic data were missing for 1 patient. Mean cumulative radiation dose was 50.4 Gy (range: 45–54.6 Gy). Toxicities were similar between groups except for nausea, which was more frequent in the amifostine-treated group (P=0.007). Fewer patients taking amifostine reported grade 3 rectal pain compared with control patients (18% vs 50%; P=0.424). Comparisons for bowel (excluding rectum) and bladder toxicity could not be made because of differences between groups in the percentage of bowel and bladder receiving at least 30 Gy. Using logistic regression analysis, the percentage of bowel receiving 30 Gy was a significant predictor of grade 3 bowel, bladder, and rectal toxicity (P=0.03). Conclusions: Among patients given amifostine before radiation of the pelvis, fewer patients reported grade 3 rectal pain compared with controls. These results suggest that amifostine may be effective in raising the threshold for toxicity and in protecting normal tissue in patients with pelvic malignancies undergoing RT. Future studies may be warranted to corroborate these findings. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration MedImmune
Randomized Trial of Reduced-Nicotine Standards for Cigarettes
Authors: Eric C. Donny, Rachel L. Denlinger, Jennifer W. Tidey, Joseph S. Koopmeiners, Neal L. Benowitz, Ryan G. Vandrey, Mustafa al’Absi, Steven G. Carmella, Paul M. Cinciripini, Sarah S. Dermody, David J. Drobes, Stephen S. Hecht, Joni Jensen, Tonya Lane, Chap T. Le, F. Joseph McClernon, Ivan D. Montoya, Sharon E. Murphy, Jason D. Robinson, Maxine L. Stitzer, Andrew A. Strasser, Hilary Tindle, Dorothy K. Hatsukami
Journal: New England Journal of Medicine (2015)

The Food and Drug Administration can set standards that reduce the nicotine content of cigarettes. We conducted a double-blind, parallel, randomized clinical trial between June 2013 and July 2014 at 10 sites. Eligibility criteria included an age of 18 years or older, smoking of five or more cigarettes per day, and no current interest in quitting smoking. Participants were randomly assigned to smoke for 6 weeks either their usual brand of cigarettes or one of six types of investigational cigarettes, provided free. The investigational cigarettes had nicotine content ranging from 15.8 mg per gram of tobacco (typical of commercial brands) to 0.4 mg per gram. The primary outcome was the number of cigarettes smoked per day during week 6. A total of 840 participants underwent randomization, and 780 completed the 6-week study. During week 6, the average number of cigarettes smoked per day was lower for participants randomly assigned to cigarettes containing 2.4, 1.3, or 0.4 mg of nicotine per gram of tobacco (16.5, 16.3, and 14.9 cigarettes, respectively) than for participants randomly assigned to their usual brand or to cigarettes containing 15.8 mg per gram (22.2 and 21.3 cigarettes, respectively; P<0.001). Participants assigned to cigarettes with 5.2 mg per gram smoked an average of 20.8 cigarettes per day, which did not differ significantly from the average number among those who smoked control cigarettes. Cigarettes with lower nicotine content, as compared with control cigarettes, reduced exposure to and dependence on nicotine, as well as craving during abstinence from smoking, without significantly increasing the expired carbon monoxide level or total puff volume, suggesting minimal compensation. Adverse events were generally mild and similar among groups. In this 6-week study, reduced-nicotine cigarettes versus standard-nicotine cigarettes reduced nicotine exposure and dependence and the number of cigarettes smoked. (Funded by the National Institute on Drug Abuse and the Food and Drug Administration Center for Tobacco Products; ClinicalTrials.gov number, NCT01681875.).
PTH-224 A tall order? an audit on the accuracy of recorded and patient-reported height on a university hospital ward
Authors: LN Spillman, ND Gollop
Journal: Gut (2015)

<h3>Introduction</h3> Patient height is an important anthropometric measurement essential for nutritional assessment and screening. Often a subjective patient-reported height is used and is not objectively measured and recorded. The aim of this audit is to determine the accuracy of patient-reported height and height recorded in patient notes and whether inaccurate reporting impacts on body mass index (BMI) category and nutritional screening. <h3>Method</h3> The height of patients on the Hepatology ward at a University Hospital on a single day was measured by a Dietitian using an electronic stadiometer. Patient-reported height and height recorded in patient notes were also collected. <h3>Results</h3> A total of 27 patients were included, 52% female, mean age 64 (range 23–87). Height was recorded in the clinical notes for 15 (56%) patients. In all cases patient reported height was recorded in the notes as height was not objectively measured for any patient. 16 (59%) patients were able to stand to have height measured. It was not possible to measure height for 11 (41%) patients as they were unable to get out of bed due to poor mobility. Of the 16 patients who had height measured: 1 (6%) reported the same height as measured height; 12 (75%) reported their height as greater than measured height (range: 1–5 cm; mean: 3 cm); and 3 (19%) reported height as less than measured height (range: 1–2 cm; mean: 1.3 cm). The difference in measured height and reported height altered BMI by 0.2–2.1 kg/m<sup>2 </sup>(mean: 0.86 kg/m<sup>2</sup>) and changed BMI category according to the World Health Organisation categorisation in 4 (25%) patients, including incorrectly categorising one patient as overweight instead of a healthy weight. <h3>Conclusion</h3> This audit identifies the disparity between patient-reported and measured height with 75% of patients over-reporting and 19% under-reporting height. Furthermore, clinical staff may be faced with the challenge of estimating height in patients who are unable to stand. Inaccurate measurement of height may result in inappropriate nutritional advice or mask the risk of malnutrition and prevent the implementation of nutrition support. It is essential that all hospital wards have access to a stadiometer and height is accurately measured and recorded for all patients. As a result of this audit the ward stadiometer has been placed in an area easily accessible to patients and nursing staff. Results of the audit have been disseminated to ward staff and training has been provided to accurately measure and record height and estimate height by measuring ulna length for patients unable to stand. A re-audit is planned for 3 months following this training. <h3>Disclosure of interest</h3> None Declared.
Studies of a Melanoma Tumor-Associated Antigen Detected in the Spent Culture Medium of a Human Melanoma Cell Line by Allogeneic Antibody. I. Purification and Development of a Radioimmunoassay23
Authors: Rishab K. Gupta, Donald L. Morton
Journal: JNCI Journal of the National Cancer Institute (1984)

Journal Article Studies of a Melanoma Tumor-Associated Antigen Detected in the Spent Culture Medium of a Human Melanoma Cell Line by Allogeneic Antibody. I. Purification and Development of a Radioimmunoassay Get access Rishab K. Gupta, Rishab K. Gupta Search for other works by this author on: Oxford Academic PubMed Google Scholar Donald L. Morton Donald L. Morton Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 72, Issue 1, January 1984, Pages 67–74, https://doi.org/10.1093/jnci/72.1.67 Published: 01 January 1984 Article history Received: 14 March 1983 Accepted: 26 July 1983 Published: 01 January 1984
Opioid Modulation With Buprenorphine/Samidorphan as Adjunctive Treatment for Inadequate Response to Antidepressants: A Randomized Double-Blind Placebo-Controlled Trial
Authors: Maurizio Fava, Asli Memisoglu, Michael E. Thase, J. Alexander Bodkin, Madhukar H. Trivedi, Marc de Somer, Yangchun Du, Richard Leigh-Pemberton, Lauren DiPetrillo, Bernard Silverman, Elliot Ehrich
Journal: American Journal of Psychiatry (2016)

Major depressive disorder has been associated with dysregulation of the endogenous opioid system. The authors sought to determine whether opioid modulation achieved through administration of ALKS 5461, a combination of a μ- and κ-opioid partial agonist, buprenorphine, and a μ-opioid antagonist, samidorphan, would exhibit antidepressant activity in patients with major depression.A multicenter, randomized, double-blind, placebo-controlled, two-stage sequential parallel comparison design study was conducted in adults with major depression who had an inadequate response to one or two courses of antidepressant treatment. Participants were randomly assigned to receive adjunctive treatment with 2 mg/2 mg of buprenorphine/samidorphan (the 2/2 dosage group), 8 mg/8 mg of buprenorphine/samidorphan (the 8/8 dosage group), or placebo. Antidepressant effect was measured based on change from baseline to the end of 4 weeks of treatment on the 17-item Hamilton Depression Rating Scale (HAM-D), the Montgomery-Åsberg Depression Rating Scale (MADRS), and the Clinical Global Impressions severity scale (CGI-S).Compared with the placebo group, there were significantly greater improvements in the 2/2 dosage group across the three depression outcome measures (HAM-D: -2.8, 95% CI=-5.1, -0.6; MADRS: -4.9, 95% CI=-8.2, -1.6; CGI-S: -0.5, 95% CI=-0.9, -0.1). There was also evidence of improvement in the 8/8 dosage group, although it did not achieve statistical significance. Overall, the buprenorphine/samidorphan combinations were well tolerated, and there was no evidence of opioid withdrawal on treatment discontinuation.The buprenorphine/samidorphan combination is a novel and promising candidate for treatment of major depressive disorder in patients who have an inadequate response to standard antidepressants.
Double blind, placebo-controlled randomized study of chlorhexidine prophylaxis for chemotherapy-induced oral mucositis with nonblinded randomized comparison to oral cooling (cryotherapy)
Authors: J. Sorensen, T. Skovsgaard, E. Bork, L. Damstrup, S. Ingeberg
Journal: Journal of Clinical Oncology (2006)

8508 Background: Oral mucositis is a frequent complication to many chemotherapy agents in conventional doses. Chlorhexidine prophylaxis has been beneficial in some studies and suggested detrimental in others, but never compared to cryotherapy. Methods: Previously untreatedpatients (pts) with colon or gastic cancer receiving the first course of bolus 5-FU 425 mg/m 2 with leucovorine 20 mg/m 2 daily in five days were randomized, pending informed consent, to either chlorhexidine 0.1% 15 ml mouthrinse one minut TID for 3 wks. (regimen A), or to doubble blind placebo (normal saline with same taste additive as in A) with same dose and frequency (reg. B), or to cryotherapy with crushed ice tips from 10 min. before to 35 min. after start of chemotherapy (reg. C). Pts self-reported on severity (CTC-grading, main end-point) and duration of oral mucositis and side effects on a questionnaire. 75 pts were planned in each arm to detect a 15% difference in grade 3–4 mucositis with a 5% type 1 error and a 20% power. Chi-square test and Mann-Whitney test were used. Results: Among 225 pts randomized, 206 answered the questionnaire (70, 64, and 63 pts in reg.A, reg.B, and reg.C) There were no differences between the regimens with respect to diagnoses, stage, age, gender, smoking habits, or performance status. Mucositis grade 3–4 (impaired oral nutrition/need of artificial nutrition) occurred in 13%, 33%, and 11% in regimens A, B, and C, respectively. Reg. B was significantly worse than A (p&lt;0.01) and C (p&lt;0.005). Median mucositis durations were A: 3 days (0–17), B: 5 (0–20), and C: 1 (0–20). Duration was significantly longer in B than in both A (p=0.035) and C (p=0.003). Pts &lt;40 years had grade 3–4 mucositis in 36% compared to 18% among older pts (p=0.14). Conclusions: Oral mucositis is common with bolus 5-FU,but frequency and duration may be significantly improved by either prophylactic chlorhexidine or by cryotherapy, giving similar results. The latter is an easy and inexpensive treatment which however is drug- and schedule-dependent as it can not be used with infusional 5-FU or with chemotherapy with substantially longer half-lifes than 5-FU. No significant financial relationships to disclose.