tbuckley/cabot-search huggingface dataset:
Desmoplastic small round-cell tumor: prolonged progression-free survival with aggressive multimodality therapy.
Authors: B H Kushner, M P LaQuaglia, N Wollner, P A Meyers, K L Lindsley, F Ghavimi, T E Merchant, F Boulad, N K Cheung, M A Bonilla, G Crouch, J F Kelleher, P G Steinherz, W L Gerald
Journal: Journal of Clinical Oncology (1996)

PURPOSE To test intensive alkylator-based therapy in desmoplastic small round-cell tumor (DSRCT). PATIENTS AND METHODS Patients received the P6 protocol, which has seven courses of chemotherapy. Courses 1, 2, 3, and 6 included cyclophosphamide 4,200 mg/m2, doxorubicin 75 mg/m2, and vincristine (HD-CAV). Courses 4, 5, and 7 consisted of ifosfamide 9 g/m2 and etoposide 500 mg/m2 for previously untreated patients, or ifosfamide 12 g/m2 and etoposide 1,000 mg/m2 for previously treated patients. Courses started after neutrophil counts reached 500/microL and platelet counts reached 100,000/microL. Tumor resection was attempted. Post-P6 treatment options included radiotherapy and a myeloablative regimen of thiotepa (900 mg/m2) plus carboplatin (1,500 mg/m2), with stem-cell rescue. RESULTS Ten previously untreated and two previously treated patients have completed therapy. The male-to-female ratio was 11:1. Ages were 7 to 22 years (median, 14). The largest masses were infradiaphragmatic (n = 11) or intrathoracic (n = 1). Other findings included serosal implants (n = 11), regional lymph node invasion (n = 8), ascites or pleural effusion (n = 7), and metastases to liver (n = 5), lungs (n = 4), distant lymph nodes (n = 3), spleen (n = 2), and skeleton (n = 2). Tumors uniformly responded to HD-CAV, but there were no complete pathologic responses. One patient died at 1 month from tumor-related Budd-Chiari syndrome. Of seven patients who achieved a complete remission (CR), five remain in CR 9, 12, 13, 33, and 38 months from the start of P6, one patient died of infection at 12 months (autopsy-confirmed CR), and one patient relapsed 4 months off therapy. Of four patients who achieved a partial remission (PR), one remains progression-free at 34 months and three developed progressive disease. Five patients received local radiotherapy: three were not assessable for response, but in two patients, antitumor effect was evident. Four patients received thiotepa/carboplatin: two were in CR and remain so, and two patients had measurable disease that did not respond. CONCLUSION For control of DSRCT, our experience supports intensive use of HD-CAV, aggressive surgery to resect visible disease, radiotherapy to high-risk sites, and myeloablative chemotherapy with stem-cell rescue in selected cases.
Abstract 12264: A Risk Score for the Prediction of Atrial Fibrillation in the Japanese Community: The Suita Study
Authors: Yoshihiro Kokubo, Makoto Watanabe, Aya Higashiyama, Yoko M Nakao, Takuya Watanabe, Misa Takegami, Kengo Kusano, Shiro Kamakura, Yoshihiro Miyamoto
Journal: Circulation (2015)

Introduction: Atrial fibrillation (AF) is the most common chronic arrhythmia and is a strong risk factor for all-cause mortality and stroke. However, there is no risk score for incident AF in non-Westerners. Aim: We aimed to develop and validate a risk score for AF incidence in a Japanese general population. Methods: A total of 6,906 participants (30-84 years old) initially free of AF were prospectively followed up for incident AF in the Suita Study. Standard 12-lead ECGs were obtained from all subjects in the supine position. Each record was coded independently by 2 well-trained physicians. Participants were diagnosed with AF if AF or atrial flutter was present on ECGs obtained during a biannual routine health examination or if AF was indicated as a present illness by either annual questionnaires responses or participants' medical records during follow-up. Cox proportional hazard ratios were analyzed after adjusting for cardiovascular risk factors at baseline. The model discrimination was evaluated by the area under the receiver operating characteristic curve. Results: In 88,663 person-years of follow-up, 253 incident AF events occurred. Age, sex, body mass index, valvular disease and/or heart murmur, systolic blood pressure, ischemic heart disease, smoking, and excessive drinking were associated with incident AF (C-statistic 0.73; 95% confidence intervals, 0.70-0.75). The risk scores for participants in their 30s, 40s, 50s, 60s, and 70s, sex (women), smoking 1~19 and ≥20 cigarettes/day, excessive drinking (4 units/day or more of alcohol), systolic prehypertension with overweight or obesity, systolic hypertension with normal weight/overweight or obesity, ischemic heart disease, and valvular disease and/or heart murmur were -6, 0, 6, 18, 27, -6, 2, 5, 5, 6, 5, 10, 7, and 12, respectively. Individuals scoring ≤19 and ≥40 points, for example, had ≤3.5% and ≥8.5% predicted probability of developing AF in 10 years, respectively. Conclusions: We developed a risk score to predict 10-year incident AF risk using variables that are easily available in healthy examination in Japan. This risk score can be useful for a person with higher risk of AF in order to consult a doctor and encourage lifestyle improvements before onset of AF.
Lesson of the Week: Hyperkalaemic cardiac arrest successfully treated with peritoneal dialysis
Authors: M A Jackson, R Lodwick, S G Hutchinson
Journal: BMJ (1996)

Prostate spesific membrane antigen (PSMA) is a type II transmembrane protein. It has been shown to be expressed in the various of solid malignant neoplasm. We report a-case of prostate cancer patient who underwent Ga-68 PSMA PET/CT imaging. There is a large thyroid nodule in right thyroid gland which has intense PSMA accumulation. Follicular thyroid lesions can be seen Ga-68 PSMA PET/CT imaging.
Variable density of CD8+ and CD25+ programmed cell death-1 (PD-1) ligand (PD-L1) CD4+ T cells within the tumor microenvironment causes differential responses to the PD-1/PD-L1 blockade
Authors: Si-Pei Wu, Yi-Long Wu
Journal: Journal for ImmunoTherapy of Cancer (2015)

Meeting abstracts The programmed cell death-1 (PD-1)/programmed cell death-1 ligand (PD-L1) pathway has been shown to play a pivotal role in tumor evasion. Inhibition of PD-1 and its ligand PD-L1 using an immune checkpoint inhibitor has emerged as a promising immunotherapy for the treatment of
Type 2 Diabetes as a Risk Factor for Dementia in Women Compared With Men: A Pooled Analysis of 2.3 Million People Comprising More Than 100,000 Cases of Dementia
Authors: Saion Chatterjee, Sanne A.E. Peters, Mark Woodward, Silvia Mejia Arango, G. David Batty, Nigel Beckett, Alexa Beiser, Amy R. Borenstein, Paul K. Crane, Mary Haan, Linda B. Hassing, Kathleen M. Hayden, Yutaka Kiyohara, Eric B. Larson, Chung-Yi Li, Toshiharu Ninomiya, Tomoyuki Ohara, Ruth Peters, Tom C. Russ, Sudha Seshadri, Bjørn H. Strand, Rod Walker, Weili Xu, Rachel R. Huxley
Journal: Diabetes Care (2015)

Type 2 diabetes confers a greater excess risk of cardiovascular disease in women than in men. Diabetes is also a risk factor for dementia, but whether the association is similar in women and men remains unknown. We performed a meta-analysis of unpublished data to estimate the sex-specific relationship between women and men with diabetes with incident dementia.A systematic search identified studies published prior to November 2014 that had reported on the prospective association between diabetes and dementia. Study authors contributed unpublished sex-specific relative risks (RRs) and 95% CIs on the association between diabetes and all dementia and its subtypes. Sex-specific RRs and the women-to-men ratio of RRs (RRRs) were pooled using random-effects meta-analyses.Study-level data from 14 studies, 2,310,330 individuals, and 102,174 dementia case patients were included. In multiple-adjusted analyses, diabetes was associated with a 60% increased risk of any dementia in both sexes (women: pooled RR 1.62 [95% CI 1.45-1.80]; men: pooled RR 1.58 [95% CI 1.38-1.81]). The diabetes-associated RRs for vascular dementia were 2.34 (95% CI 1.86-2.94) in women and 1.73 (95% CI 1.61-1.85) in men, and for nonvascular dementia, the RRs were 1.53 (95% CI 1.35-1.73) in women and 1.49 (95% CI 1.31-1.69) in men. Overall, women with diabetes had a 19% greater risk for the development of vascular dementia than men (multiple-adjusted RRR 1.19 [95% CI 1.08-1.30]; P < 0.001).Individuals with type 2 diabetes are at ∼60% greater risk for the development of dementia compared with those without diabetes. For vascular dementia, but not for nonvascular dementia, the additional risk is greater in women.
Prognostic and predictive factors for outcome to first-line ifosfamide-containing therapy (IFM) in patients (pts) with advanced soft tissue sarcomas (STS) treated in EORTC-STBSG studies
Authors: S. Sleijfer, M. Ouali, M. Van Glabbeke, A. Krarup-Hansen, M. G. Leahy, S. Rodenhuis, A. Le Cesne, P. C. Hogendoorn, J. Verweij, J. Y. Blay
Journal: Journal of Clinical Oncology (2008)

10509 Background: IFM is widely used in pts with advanced STS. Since no data on prognostic and predictive factors for outcome are available from large series, an exploratory, retrospective analysis was done on the EORTC STBSG database of pts with advanced STS. Methods: Data on 1,319 chemotherapy-naive pts receiving IFM for advanced STS were analyzed. Endpoints were response rate (RR) and overall survival (OS). Analyzed factors were gender, age, performance status, time between diagnosis and IFM, histologic type (leiomyosarcomas [LMS]; liposarcomas [LIPO]; synoviosarcomas [SYNO]; GIST; others [LMS as reference]), histologic grade, disease sites, and type of IFM (single vs. with doxorubicin [DXR], and IFM dose [< and ≥ 9 gr/m2 per cycle]). For predictive factor analysis, pts treated with DXR alone (n=660) served as comparators. Only multivariate analyses (logistic/COX) are here reported with significance levels <0.01 and <0.05 for prognostic and predictive factors, respectively. Outcomes are reported as odd (RR) or hazard ratios (OS) with 95% CIs for prognostic factors, and as significance level (interaction) for predictive factors. Results: Combination with DXR (3.26 [1.82–5.84]), high grade (1.65 [1.16–2.35]) and histologic type (3.15 [1.44–6.85] SYNO vs. LMS) were associated with improved RR. For OS, good performance (0.74 [0.60–0.89]), low grade (0.72 [0.61–0.85]), nonmetastatic disease (0.68 [0.50–0.93]), female gender (0.72 [0.57- 0.92]), extremity primary (0.66 [0.51–0.86]), and subtype (0.596 [0.394–0.902], LIPO vs. LMS) were identified as favorable prognostic factors. Compared to DXR single agent, predictive factor analyses revealed that pts who benefited less from IFM were LMS (RR: p=S: P=0.025), LIPO (RR: P=0.042) and patients without liver metastases (OS: P=0.071). Conclusions: Favorable prognostic factors for RR to IFM, including histologic type and tumor grade, differ from those for a better OS. Compared to DXR, some WHO STS entities benefit less from IFM. The different prognostic and predictive factors identified from this retrospective analysis may be helpful in selecting pts for IFM and in designing future tailored trials. No significant financial relationships to disclose.
Relapse and Recovery in Addictions
Authors: Wayne Hall
Journal: BMJ (2001)

Eds Frank M Tims, Carl G Leukefeld, Jerome J Platt    ![][1] 

Yale University Press, £35, pp 420 ISBN 0 300 08383 1

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Giving up drugs is easy, as Mark Twain observed: he'd stopped smoking hundreds of times. The same is true of alcohol, opiate, and cocaine dependence. Staying stopped, once you stop, can be difficult, with a half to two thirds of treated cases relapsing to problem use within a year. Still, many developed countries invest more in “detoxification” and short term treatment programmes than in helping users to stay …

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Second Cancer Risk Up to 40 Years after Treatment for Hodgkin’s Lymphoma
Authors: Michael Schaapveld, Berthe M.P. Aleman, Anna M. van Eggermond, Cécile P.M. Janus, Augustinus D.G. Krol, Richard W.M. van der Maazen, Judith Roesink, John M.M. Raemaekers, Jan Paul de Boer, Josée M. Zijlstra, Gustaaf W. van Imhoff, Eefke J. Petersen, Philip M.P. Poortmans, Max Beijert, Marnix L. Lybeert, Ina Mulder, Otto Visser, Marieke W.J. Louwman, Inge M. Krul, Pieternella J. Lugtenburg, Flora E. van Leeuwen
Journal: New England Journal of Medicine (2015)

Survivors of Hodgkin's lymphoma are at increased risk for treatment-related subsequent malignant neoplasms. The effect of less toxic treatments, introduced in the late 1980s, on the long-term risk of a second cancer remains unknown.We enrolled 3905 persons in the Netherlands who had survived for at least 5 years after the initiation of treatment for Hodgkin's lymphoma. Patients had received treatment between 1965 and 2000, when they were 15 to 50 years of age. We compared the risk of a second cancer among these patients with the risk that was expected on the basis of cancer incidence in the general population. Treatment-specific risks were compared within the cohort.With a median follow-up of 19.1 years, 1055 second cancers were diagnosed in 908 patients, resulting in a standardized incidence ratio (SIR) of 4.6 (95% confidence interval [CI], 4.3 to 4.9) in the study cohort as compared with the general population. The risk was still elevated 35 years or more after treatment (SIR, 3.9; 95% CI, 2.8 to 5.4), and the cumulative incidence of a second cancer in the study cohort at 40 years was 48.5% (95% CI, 45.4 to 51.5). The cumulative incidence of second solid cancers did not differ according to study period (1965-1976, 1977-1988, or 1989-2000) (P=0.71 for heterogeneity). Although the risk of breast cancer was lower among patients who were treated with supradiaphragmatic-field radiotherapy not including the axilla than among those who were exposed to mantle-field irradiation (hazard ratio, 0.37; 95% CI, 0.19 to 0.72), the risk of breast cancer was not lower among patients treated in the 1989-2000 study period than among those treated in the two earlier periods. A cumulative procarbazine dose of 4.3 g or more per square meter of body-surface area (which has been associated with premature menopause) was associated with a significantly lower risk of breast cancer (hazard ratio for the comparison with no chemotherapy, 0.57; 95% CI, 0.39 to 0.84) but a higher risk of gastrointestinal cancer (hazard ratio, 2.70; 95% CI, 1.69 to 4.30).The risk of second solid cancers did not appear to be lower among patients treated in the most recent calendar period studied (1989-2000) than among those treated in earlier periods. The awareness of an increased risk of second cancer remains crucial for survivors of Hodgkin's lymphoma. (Funded by the Dutch Cancer Society.).
Clinical and molecular response to interferon-α therapy in essential thrombocythemia patients with CALR mutations
Authors: Emmanuelle Verger, Bruno Cassinat, Aurélie Chauveau, Christine Dosquet, Stephane Giraudier, Marie-Hélène Schlageter, Jean-Christophe Ianotto, Mohammed A. Yassin, Nader Al-Dewik, Serge Carillo, Eric Legouffe, Valerie Ugo, Christine Chomienne, Jean-Jacques Kiladjian
Journal: Blood (2015)
ObSERvational study for thE moNitoring of not controlled Asthma (SERENA)
Authors: Andrea Rossi, Antonio Corrado
Journal: European Respiratory Journal (2012)

Background 

International guidelines recommend control of asthma as a major goal of therapy. Patients with “well-controlled” asthma present no exacerbations. However, it is well known that implementation of guidelines in real clinical practice may be difficult.

Objective 

To assess the level of asthma control in real clinical practice in patients treated with inhaled steroids and/or bronchodilators following the GINA guidelines.

Methods 

This 6 months observational study was promoted by AIPO and was carried out in 16 Pulmonary Units. Consecutive patients with asthma, treated after GINA guidelines, attending the outpatients of each center were enrolled (2010). Data on exacerbations and treatments were collected by mean of a web based Case Report Form, and control of asthma was assessed with the Asthma Control Test (ACT) questionnaire.

Results 

The number and characteristics of the patients enrolled are reported in Table 1.

View this table:

Patients characteristics





91% of patients were treated with LABA+ICS, while 9% with ICS and SABA prn. 60% of patients reported 1 exacerbation, 16% 1 Emergency Visit and 44% 1 non programmed visit in the year preceding the study. The data on control of asthma in the 548 patients is reported in Table 2.

View this table:

Control of asthma (ACT score)





Conclusions 

The study shows that an adequate control of asthma following the GINA guidelines is far from being achieved in real life. A significant portion of patients report a not controlled asthma despite guidelines driven treatments.
SAHS and stroke. CPAP compliance and new stroke events
Authors: Beatriz Arias Arcos, Ascensiόn Hernando Sanz, Fernando Gonzalez Torralba, Salvador De la Torre Carazo, Trinidad Díaz Cambriles, Maria Josefa Díaz de Atauri Rodriguez de los Ríos
Journal: European Respiratory Journal (2011)

Aim:  To describe CPAP compliance and new ischemic stroke events in SAHS post stroke patients.   Methods and participants:  Prospective observational study. Inclusion criteria: patients suffered from stroke event from January 2000 until November 2010 and posterior SAHS diagnosis with 3 months follow up. Two groups were defined: group 1, patients with current CPAP use and group 2, patients with no CPAP treatment. All were evaluated for new stroke events. SAHS, was defined as AHI (apnea + hypopnea per hour of sleep/recording) ≥ 10 and severe as AHI >30. Bivariate analysis was performed to evaluate differences between groups, and multivariate of COX proportional risks to review new stroke and variables as sex, age, BMI, neck circumference, Epworth scale, ODI,% time saturation under 90%, AIH, cigarette smoking and hypertension.   Results:  110 patients were included, 85 men (77%), mean age 62±10.7 SD. Group 1 and group 2 were 62 and 48 patients, respectively. New events incidence in group 1 was 16 (26%) and 11 (23%) in group 2, they were no significant statistic differences (p=0.72). The statistically significant variables in multivariate analysis were neck circumference OR [0.87 (IC95% 0.76-0.99; p=0.04)] and BMI OR [0.86 (IC95% 0.75-0.98; p=0.02)]. The survival analysis results are:  The stroke event free time until new event in group 1 was 31.4 months ± 22.6 SD, and in group 2, 25.32 months ±13.9 SD, without statistical significance.   Conclusions:  New stroke development is not associated with CPAP compliance, however it seems to have longer survival probability in CPAP compliant patients.
18F-NaF PET Imaging of Early Coronary Artery Calcification
Authors: Mikaela L. McKenney-Drake, Paul R. Territo, Ali Salavati, Sina Houshmand, Scott Persohn, Yun Liang, Mouhamad Alloosh, Sharon M. Moe, Connie M. Weaver, Abass Alavi, Michael Sturek
Journal: JACC. Cardiovascular imaging (2015)
EGFR mutations are prevalent and independent from K-RAS mutations in lung adenocarcinomas from non-smokers
Authors: Issan Y. S. Tam, Maria P. Wong, W. S. Suen, E. Wang, W. K. Lam, S. W. Chiu, A. Gazdar, John D. Minna, L. P. Chung
Journal: Cancer Research (2005)

1666   Lung cancer is common in Hong Kong with an unusually high incidence in female non-smokers (NS). Lung cancers in NS are likely to involve different carcinogenic processes from those in smokers, but the molecular targets are unclear. Epidermal growth factor receptor (EGFR) is a receptor tyrosine kinase that plays a crucial role in cell proliferation, survival and differentiation. It has been observed that non-small cell lung cancer (NSCLC) patients showing improved clinical response to tyrosine kinase inhibitor (TKI) treatment harbour somatic mutations in EGFR tyrosine kinase domain. Activating point mutations in the RAS oncogene has been recognized in adenocarcinomas of different organs including the lung. In order to find out the prevalence and patterns of EGFR and RAS mutations, as well as their relation with clinicopathological profiles of primary NSCLC in Hong Kong, 228 surgically resected primary lung cancers were analyzed. The tumors included 205 adenocarcinomas (AD), 14 squamous cell carcinomas (SCC) and 9 lymphoepithelioma-like carcinomas (LELC) from 97 men (55 current smokers (SM), 17 NS, 24 ex-smokers (EX) and 1 passive smokers (PS)), and 131 women (7 SM, 92 NS, 13 EX and 19 PS) were studied. PCR amplified products spanning the EGFR mutation hot spots (exons 18-21) were sequenced. An overall mutation rate of 49.1% (112/228) was observed, including 52 in-frame deletions, 5 in-frame insertions and 55 amino acid substitutions. Statistically significant associations were found between EGFR mutations and a) NS (79/109) compared with patients with any level of current or previous tobacco exposure (33/119 SM, PS, EX) or with SM only (12/62), P
Complete radiological response of colorectal liver metastases (LM) after chemotherapy: Does it mean cure?
Authors: B. Nordlinger, A. Brouquet, C. Penna, C. Julié, M. El Hajjam, S. Chagnon, E. Mitry, P. Rougier, S. Benoist
Journal: Journal of Clinical Oncology (2006)

3501 Background: Most of patients with colorectal LM receive systemic chemotherapy. Complete response on imaging is considered a good indicator of the efficacy of chemotherapy. Whether complete radiological response is correlated to complete pathological response is not well known. The objective of this study was to determine the significance of complete radiological response of LM after chemotherapy. Methods: Between 1998 and 2004, 586 patients were treated in one institution for colorectal LM. 38 with the following criteria were included in the study: less than 10 LM before chemotherapy, disappearance of one or several LM on helical CT scan and ultrasound after chemotherapy, surgery with liver examination and intraoperative ultrasound within 4 weeks after imaging, no extra-hepatic disease, follow-up at least one year after surgery. Results: Overall, 66 LM disappeared on imaging after chemotherapy (38 patients). In 9 patients, persistent macroscopic disease was observed at surgery at the site of 20/66 (30%) LM although there were considered in complete response on imaging. In 15 patients, with no remnant disease at surgery, the sites of 15 initial LM were resected. Pathological examination of theses sites of LM considered in complete response showed the presence of viable tumor cells in 12/15 cases (80%). In 14 other patients, the sites of 31 initial LM, which were not visible at surgical exploration were left in place during surgery. After one year of follow-up, 23/31 (74%) LM considered in complete response had recurred in situ (11/14 patients). Overall, persistent macroscopic or microscopic residual disease or early recurrence in situ were observed in 55/66 LM (83%) with complete radiological response (32/38 patients). Conclusions: Complete radiological response in patients who have received chemotherapy is a useful tool to evaluate the effect of chemotherapy but it does not mean cure in most patients. This should be taken into account when considering multimodality treatment including chemotherapy and surgery. No significant financial relationships to disclose.