tbuckley/cabot-search huggingface dataset:
A unique community-based family cancer registry.
Authors: N. Y. Gabrail, C. L. Smith, J. Fox
Journal: Journal of Clinical Oncology (2010)

1550 Background: The prevalence of a positive family cancer history in a community oncology practice is not well defined. It has been estimated that approximately 25% of cancer patients may have an inherited basis for the development of cancer. We report on a detailed family cancer history in a community oncology practice that has been diligent and systematic in collecting this information for the last 16 years, which may represent a seminal documentation of the incidence of a genetic basis for cancer in this setting. Methods: The family cancer history of all cancer patients from Jan. 2007 to Oct. 2009 were verified and further explored via telephone, email or personal communications with patients and/or family members. We limited the study to 2 years for accuracy of information and to establish an accurate incidence of family cancer history. The families studied included patients diagnosed before Jan. 2007 as long as they were alive and followed up at the cancer center. Results: As of October 30, 2009, charts of 560 families were reviewed. A total of 116 patients were identified as having a strong family history of cancer. The average age at initial cancer diagnosis was 55 years. Fifty seven families (47%) had a profile suggestive of BRCA 1 and 2 mutation. Sixteen families (14%) met the clinical criteria of Lynch syndrome. One family has familial polyposis coli. Twenty eight ( 24%) of families had a pattern of cancer inheritance that did not comprise any of the known cancer syndromes. The average number of relatives affected per family was 5.23. Genetic testing for BRCA 1 and 2 was performed on 26 probands with suspected mutations, 7 tested positive for BRCAI and 4 for BRCAII mutations. Ten of the families showed patterns of both paternal and maternal inheritance. Conclusions: Detailed family history and formal pedigrees are an essential part of community oncology services. The suspicion of a genetic basis for cancer should prompt a detailed family history and pedigree construction. Proper counseling of patients and their family members is critical in prevention and early cancer detection. No significant financial relationships to disclose.
Prevalence, codetection and seasonal distribution of upper airway viruses and bacteria in children with acute respiratory illnesses with cough as a symptom
Authors: K.F. O'Grady, K. Grimwood, T.P. Sloots, D.M. Whiley, J.P. Acworth, N. Phillips, V. Goyal, A.B. Chang
Journal: Clinical Microbiology and Infection (2016)
Cost-effectiveness of scaling up mass drug administration for the control of soil-transmitted helminths: a comparison of cost function and constant costs analyses
Authors: Hugo C Turner, James E Truscott, Fiona M Fleming, T Déirdre Hollingsworth, Simon J Brooker, Roy M Anderson
Journal: The Lancet Infectious Diseases (2016)

The coverage of mass drug administration (MDA) for neglected tropical diseases, such as the soil-transmitted helminths (STHs), needs to rapidly expand to meet WHO's 2020 targets. We aimed to compare use of a cost function to take into account economies of scale to the standard method of assuming a constant cost per treatment when investigating the cost and cost-effectiveness of scaling up a STH MDA programme targeting Ascaris lumbricoides.We fitted a cost function describing how the costs of MDA change with scale to empirical cost data and incorporated it into a STH transmission model. Using this cost function, we investigated the consequences of taking into account economies of scale on the projected cost-effectiveness of STH control, by comparison with the standard method of assuming a constant cost per treatment. The cost function was fitted to economic cost data collected as part of a school-based deworming programme in Uganda using maximum likelihood methods. We used the model to investigate the total reduction in the overall worm burden, the total number of prevalent infection case-years averted, and the total number of heavy infection case-years averted. For each year, we calculated the effectiveness as the difference between the worm burden or number of cases and the number in absence of treatment.When using the cost function, the cost-effectiveness of STH control markedly increased as the programme was scaled up. By contrast, the standard method (constant cost per treatment) undervalued this and generated misleading conclusions. For example, when scaling up control in the projected district from 10% to 75% coverage of at-risk school-age children, the cost-effectiveness in terms of prevention of heavy burden infections was projected to increase by over 70% when using the cost function, but decrease by 18% when assuming a constant cost per treatment.The current exclusion of economies of scale in most economic analyses must be addressed if the most cost-effective policies for the control of neglected tropical diseases are to be formulated. These findings are also relevant to other large-scale disease interventions.GlaxoSmithKline, Bill & Melinda Gates Foundation, Partnership for Child Development, and Wellcome Trust.
Suppression of Glucose Utilization of Murine Peritoneal Exudate Macrophages by Body Fluids From Cancer Patients and Identification of the Susceptible Enzyme
Authors: K Nakamura, Y Nakajima, Y Nakamura
Journal: JNCI Journal of the National Cancer Institute (1986)

The glucose consumption of cultured murine (C57BL/6N) peritoneal exudate macrophages is suppressed by pleural effusions, ascitic fluids, and sera from patients with advanced primary lung and gastric cancers. Analysis for the generation of 14C-labeled CO2 after [14C]glucose metabolism revealed the glycolysis pathway to be more susceptible to cancerous body fluids than was the hexose monophosphate shunt. Enzymatic analysis showed that the enzyme susceptible to the cancerous body fluids was D-fructose-6-phosphate 1-phosphotransferase (PFK), the rate-limiting key enzyme in the glycolysis pathway. Other enzymes participating in glycolysis were insensitive to the cancerous body fluids. Suppression of PFK may represent a new tumor marker.
The Patient-Centered Medical Home and Associations With Health Care Quality and Utilization
Authors: Lisa M. Kern, Alison Edwards, Rainu Kaushal
Journal: Annals of Internal Medicine (2016)

Background: Effects of the patient-centered medical home (PCMH) are unclear. Previous studies had relatively short follow-up and may not have distinguished effects of the PCMH (which involves electronic health records [EHRs] plus organizational changes) from those of EHRs alone. Objective: To determine effects of the PCMH on health care quality and utilization compared with paper records alone and EHRs alone, with extended follow-up. Design: Prospective cohort study (2008 to 2012), including 3 years after PCMH implementation. (ClinicalTrials.gov: NCT00793065) Setting: The Hudson Valley, a multipayer, multiprovider region in New York. Participants: 438 primary care physicians in 226 practices, with 136 480 patients across 5 health plans. Intervention: Level III PCMH, as defined by the National Committee for Quality Assurance. Measurements: Claims-based outcomes included 8 quality and 7 utilization measures. Generalized estimating equations were used to compare adjusted differences in rates of change across study groups. Results: Patterns of quality were fairly similar across groups. Utilization patterns were similar across groups from 2008 to 2011 but showed modest differences between the PCMH and control groups on most measures in 2012. For example, hospitalizations were relatively stable from 2008 to 2011 (approximately 3.9 to 5.2 per 100 patients per year) but decreased in the PCMH group in 2012 (incidence rate ratio, 0.79 [95% CI, 0.69 to 0.90] compared with paper records). Emergency department visits were highest for the PCMH group (16.7 per 100 patients at baseline and 15.4 per 100 patients at the end of the study period) and lowest for the paper group (14.3 per 100 patients at baseline and 12.2 per 100 patients at the end of the study period), but the rate of change did not differ across groups. Limitation: Possible unmeasured confounding. Conclusion: The PCMH was associated with modest changes in most utilization measures and provided similar quality compared with EHRs and paper records. Primary Funding Source: The Commonwealth Fund and the New York State Department of Health.
Medical students’ views on the new junior doctor contract
Authors: Sarim Siddiqui, Ibtesham Hossain, Samee Siddiqui, Mohammed Muntasir, Mustafa Franka, Umair Mughal, Bashar Atalla
Journal: BMJ (2016)

Coverage of the junior doctor contract proposals has focused on its immediate impact on those in postgraduate training and has overlooked the perspective of medical students—the junior doctors of tomorrow.1

Medical students remain the sole cohort expected to experience the full impact of the contracts, undertaking all future training under the proposed terms. Students currently accrue more debt than ever as a result of …
Effects of adjuvant intra-operative radiation therapy after curative resection in pancreatic cancer patients : Results of a randomized study by 11 institutions in Japan
Authors: T. Kinoshita, K. Uesaka, Y. Shimizu, H. Sakamoto, W. Kimura, S. Sunada, S. Sunada, T. Imaizumi, I. Ozawa, A. Okamoto, T. Oda
Journal: Journal of Clinical Oncology (2009)

4622 Background: To evaluate the benefits of adjuvant intra-operative radiation therapy after curative resection in advanced pancreatic cancer (APC) patients, a multi-center phase III trial was conducted by 11 participating institutions in Japan. Methods: Eligibility included pts with potentially resectable APC (duct cell origin) by image diagnosis. Patients were randomized in a 1:1 ratio to adjuvant IORT or surgery alone less than a week before surgery. Stratification factors were tumor size (TS1/TS2,3,4), location (head/body and tail), and institution. Patients who were assigned to adjuvant IORT arm received IORT after curative resection before reconstruction. IORT consisted of 25Gy with electron beam energies of more than 6MeV and was delivered by the round shaped acrylic cylinder of 6–8cm diameter. The radiation field included the tumor bed and in most cases included the celiac axis, superior mesenteric artery, and the portal vein. The primary endpoint was overall survival. The secondary endpoint was local control rate at 2 years after surgery. Assuming 65 eligible pts in each arm, the study had 0,8 power to detect 20% difference in 2-year survival rate. Results: Between 05/2002 to 12/2006 198 pts were randomized and 153 pts underwent curative resection with assigned treatment. Among the 153 pts with curative resection, seven pts revealed ineligible by the histological examination. Finally full analysis sets were 144 pts. Seventy three pts were in the IORT arm and 71 pts in the surgery alone arm. There was only one hospital death in the IORT arm. Cause of the death was intraabdominal arterial bleeding due to pancreatic fistula. Conclusions: We now are collecting the final follow up data. The final analyses will be presented at the meeting. No significant financial relationships to disclose.
Brief Communication: Hodgkin's Disease Mortality and Occupational Exposure to Wood2
Authors: Gerald R. Petersen, Samuel Milham
Journal: JNCI Journal of the National Cancer Institute (1974)

A study of the Washington State death record files revealed an association between frequency of woodworking- related occupationsand deaths of white males due to Hodgkin's disease. A case-control design and alternatively a proportional mortality ratio analysis were used.
Examining the cost and cost-effectiveness of adding bevacizumab to carboplatin and paclitaxel in advanced non-small cell lung cancer
Authors: P. A. Grusenmeyer, R. J. Gralla
Journal: Journal of Clinical Oncology (2006)

6057 Background: Two-drug platinum-containing regimens are considered the standard of care in advanced non-small cell lung cancer. A recent randomized trial (ECOG 4599) compared carboplatin + paclitaxel (PC) with PC + bevacizumab (PCB). PCB was found to result in a modest improvement in survival (12.5 months vs 10.2 months with PC, p = .007). This finding was exceptional in showing a survival benefit with the addition of a molecularly targeted agent to chemotherapy in a largely unselected population, and doing so in this most common cause of malignant death in the US. Additionally, new therapies can have a major impact on health care costs. Using the known survival data and costs, we analyzed the cost-effectiveness of the addition of bevacizumab to this chemotherapy regimen. Methods: Medicare reimbursement (cost) of the two regimens was developed using the CMS Drug Payment Table and Physician Fee Schedule for January, 2005. Incremental cost effectiveness was calculated. Results: Carboplatin and paclitaxel regimen costs $14,073 for 6 cycles (the number of cycles planned in the clinical trial.) The addition of bevacizumab increases cost by $66,270 to $80,343. Given an increase of 2.3 months in median overall survival over chemotherapy alone, the addition of bevacizumab to chemotherapy costs $345,762 per year of life gained. Conclusions: Adding bevacizumab to chemotherapy is not cost effective even at the $100,000 per Year of Life Gained (YLG) threshold. To be cost effective at the $100,000/YLG level, bevacizumab reimbursement would have to be reduced to $14.70/10 mg. ($1,764/cycle) or 26% of 2005 Medicare reimbursement of $57.08/10 mg. ($6,849/cycle). Prior analyses have examined the impact of chemotherapy on survival and cost-effectiveness. Several factors beneficially influence survival in NSCLC, as shown in meta-analyses, including: chemotherapy vs supportive care, two-agents vs one, and the choice of which platinum agent to use. While all of these may increase costs, some are cost-effective, while others are not. The addition of bevacizumab is the most costly and least cost-effective of any of these interventions. [Table: see text]
Preliminary results of a phase II study to evaluate gefitinib (ZD1839) combined with paclitaxel (P) and carboplatin (C) as second-line therapy in patients (pts) with ovarian carcinoma (OC)
Authors: P. Pautier, F. Joly, P. Kerbrat, P. Bougnoux, P. Fumoleau, T. Petit, F. Ringeisen, O. Rixe, C. Lhommé, S. Kalla
Journal: Journal of Clinical Oncology (2004)

5015 Background: EGFR expression is increased in 35–70% of primary OC, and often correlates with poor prognosis. Gefitinib (Iressa, ZD1839) is an orally active EGFR-TKI (epidermal growth factor receptor tyrosine kinase inhibitor). Methods: Multicenter, open, non-comparative study in pts with platinum-resistant (relapsed <6 months) or platinum-sensitive (relapsed >6 months) OC, with measurable disease, or non-measurable disease with rising CA125, and after only one line-therapy with cisplatin or C, and P. Pts received gefitinib (500 mg/day), P (175 mg/m2), and C (AUC=5) every 3 weeks, for 6–8 cycles. After which, pts could continue to receive gefitinib. Response was assessed by RECIST or Rustin criteria. Results: Since April 2002, 41 pts (median age: 58 yrs (range 34–71)) and an ECOG performance status (0/1/2) of 27/14/0, were enrolled. In 40 assessed pts, 7 were non-evaluable for efficacy (early withdrawal (1), toxicity (2), no target lesions (4)). The overall response rates (CR and PR) were 25% and 71% in the resistant and sensitive groups, respectively. 182 cycles were administered. Of the 41 pts evaluable for safety, Gr 3/4 pts toxicities were: neutropenia (63%) including 1 febrile neutropenia); thrombocytopenia (10%); anemia (7%); diarrhea (27%); rash (10% ptes). Conclusions: Gefitinib combined with P and C has very promising activity as second-line treatment for OC and is generally well tolerated. Author Disclosure Employment or Leadership Consultant or Advisory Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration AstraZeneca
Myelodysplastic Syndromes: A Multidisciplinary Integrated Diagnostic Work-up for Patients' Risk Stratification
Authors: Elena Ciabatti, Maria Immacolata Ferreri, Angelo Valetto, Alice Guazzelli, Veronica Bertini, Susanna Grassi, Francesca Guerrini, Antonio Azzarà, Maria Rita Metelli, Iacopo Petrini, Paolo Simi, Mario Petrini, Sara Galimberti
Journal: Blood (2014)
The Molecular and Phenotypic Profile of Primary Central Nervous System Lymphoma Identifies Distinct Categories of the Disease and Is Consistent With Histogenetic Derivation From Germinal Center–Related B Cells
Authors: Luigi Maria Larocca, Daniela Capello, Alessandro Rinelli, Simonetta Nori, Andrea Antinori, Annunziata Gloghini, Antonella Cingolani, Anna Migliazza, Giuseppe Saglio, Sophie Cammilleri-Broet, Martine Raphael, Antonino Carbone, Gianluca Gaidano
Journal: Blood (1998)
US Trends for Diabetes Prevalence Among Adults
Authors: Dianna J. Magliano, Paul Zimmet, Jonathan Shaw
Journal: JAMA (2016)

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The reliability of ductal lavage in women at high risk for breast cancer
Authors: K. Visvanathan, D. Santor, S. Ali, A. Brewster, A. Arnold, D. Armstrong, K. Helzlsouer
Journal: Journal of Clinical Oncology (2005)

1001 Background: Ductal lavage (DL) is a minimally invasive method used to obtain ductal cells for cytological analysis. It is currently being used as a risk assessment tool to assist with clinical decision making in women at increased risk for breast cancer. Methods: We evaluated the reproducibility and reliability of the DL procedure and cytology at two time points 6 months apart in women at increased risk for breast cancer. Eligible women had a 5 year Gail risk of at least 1.66%, and/or a personal history of breast cancer, and/or were known BRCA1 or 2 mutation carriers. Ducts that produced nipple aspirate (NAF) were cannulated. Kappa statistic was used to evaluate reliability at two time points of NAF production, cellular yield, and cytological diagnosis. Results: 66 women were enrolled over 29 months. Forty one have returned so far for a second visit, and 19 refused but agreed to be followed. The mean age of women is 47 years, 65% are premenopausal. Of the 66 women 28 produced NAF at baseline and underwent DL. There was fair to moderate reliability between the production of NAF at baseline and at 6 months (Kappa 0.49, 95% CI 0.18, 0.80). The mean number of ducts lavaged per individual was 2.5. At 6 months, among the women who had returned, 20 of a potential 33 ducts produced NAF and were cannulated. NAF was also produced by 16 new ducts that were cannulated. There was low repeatability in the mean number of cells collected per lavage over the two time points (weighted Kappa 0.36, 95% CI 0.11, 0.61). There was also low cytological agreement between the two time points (Kappa 0.45, 95% CI 0.15, 0.75). The rate of inadequate cellular material for diagnosis (ICMD, ≤ 10 cells) was 39% for the first visit and 37% for the second visit. Conclusion: The use of DL as a risk assessment tool is limited by low yield of NAF, high rate of ICMD, low reliability of the number of cells collected and cytologic diagnosis at repeated time points. No significant financial relationships to disclose.
Abstract P296: Age-related Differences in Risk Factors for Mortality Among Individuals with Chronic Kidney Disease: The REGARDS Study
Authors: Rikki M Tanner, Barrett Bowling, Monika M Safford, Orlando Gutiérrez, Lisandro D Colantonio, David G Warnock, Paul Muntner
Journal: Circulation (2014)

At younger ages, chronic kidney disease (CKD) is a progressive disorder associated with an increased risk for end-stage renal disease (ESRD). Older individuals with CKD are 10 to 20 times more likely to die than progress to ESRD. We hypothesized that, among individuals with CKD, the association between traditional cardiovascular risk factors with mortality would be weaker and the association between psychosocial risk factors with mortality would be stronger for individuals ≥ 75 years of age compared to those &lt; 75 years of age. We included 5,924 REasons for Geographic And Racial Differences in Stroke (REGARDS) study participants with CKD without ESRD at baseline. CKD was defined as an albumin-to-creatinine ratio ≥ 30 mg/g or an estimated glomerular filtration rate &lt; 60 mL/min/1.73m2. The 12-item Short Form Health Survey (SF-12) was administered and low physical and mental component scores (PCS and MCS) were defined as scores in the lowest quintile. Mortality was assessed through biannual telephone follow-up and contact with proxies provided by the study participant upon recruitment. Date of death was confirmed through death certificates, National Death Index, or Social Security Death Index. Over a median follow-up of 5.0 years, 1,255 deaths occurred. The mortality rate was 30.9 (95% CI: 28.6 - 33.4) and 74.8 (95% CI: 69.2 - 80.8) per 1,000 person-years for individuals &lt; 75 years and ≥ 75 years of age, respectively. Diabetes, history of stroke, and systolic blood pressure were associated with an increased risk for mortality among individuals &lt; 75 years of age but not among those ≥ 75 years of age (Table 1). Low PCS was associated with a higher risk for mortality for both younger and older adults. Symptoms of depression and low MCS were not associated with mortality in either age group. In conclusion, some cardiovascular risk factors are associated with an increased risk for mortality among younger but not older individuals with CKD. These data suggest approaches to reduce mortality risk may differ for younger and older adults with CKD.