tbuckley/cabot-search huggingface dataset:
Retrospective analysis of pulmonary neuroendocrine/carcinoid tumors at Ohio State University
Authors: E. M. Ort, P. Confer, G. A. Otterson
Journal: Journal of Clinical Oncology (2007)

18176 Background: Neuroendocrine tumors are a unique malignant neoplasm which can arise from the respiratory tree. Bronchial neuroendocrine tumors account for 25% of all neuroendocrine tumors, but only about 1–2% of all lung cancers. The epidemiology, clinical behavior, treatment, and prognosis of carcinoid tumors differ from other lung malignancies in significant ways. Located most often in the major bronchi, these tumors secrete neuroendocrine granules such as serotonin, histamine, and prostaglandins. Classic carcinoid syndrome (diarrhea, flushing, palpitations, wheezing), however, is rare in these patients. Treatment is primarily surgical resection for cure. The purpose of our study was to identify the experience with these malignancies at our institution and compare it to other series. Methods: A total of 64 patients were identified using diagnostic codes via our institutional cancer registry from 1980–2006. Poorly-differentiated neuroendocrine tumors and small cell lung cancer cases were excluded from analysis. Data collected included survival after diagnosis, staging, epidemiologic characteristics, and treatment. Additional variables included smoking history, laterality, and tumor staging. Results: The patient age distribution ranged from 17 years old to 82 years old, with a median age of 57 years old. Most of the patients were female (73%). Tobacco use is variable in carcinoid - 54% of our patients were never smokers, whereas 17% were previous smokers, 20% were current smokers, and history was unknown in 7%. Staging was unknown in over half of the patients. Treatment was generally surgical; lobectomy (40%) was the most common intervention, followed by wedge resection (17%), radiation therapy (14%), bronchial sleeve resections (3.5%), and pneumonectomies (3.5%). Survival was generally good - at the time of last contact, 50 patients (78%) were still alive with a median follow up of 39 months since diagnosis. Conclusion: Neuroendocrine tumors of the bronchial tree remain a unique and uncommon malignancy among lung cancers. The findings at our medical center are consistent with reported series as far as epidemiologic characteristics, treatments, and outcomes. The future direction of non-surgical therapy in this malignancy remains investigational. No significant financial relationships to disclose.
Immunochemical faecal occult blood testing to screen for colorectal cancer: can the screening interval be extended?
Authors: Ulrike Haug, Esmée J Grobbee, Iris Lansdorp-Vogelaar, Manon C W Spaander, Ernst J Kuipers
Journal: Gut (2016)

Objective Colorectal cancer (CRC) screening programmes based on faecal immunochemical testing for haemoglobin (FIT) typically use a screening interval of 2 years. We aimed to estimate how alternative FIT strategies that use a lower than usual positivity threshold followed by a longer screening interval compare with conventional strategies. Methods We analysed longitudinal data of 4523 Dutch individuals (50–74 years at baseline) participating in round I of a one-sample FIT screening programme, of which 3427 individuals also participated in round II after 1–3 years. The cohort was followed until 2 years after round II. In both rounds, a cut-off level of ≥50 ng haemoglobin (Hb)/mL buffer (corresponding to 10 µg Hb/g faeces) was used, representing the standard scenario. We determined the cumulative positivity rate (PR) and the numbers of subjects diagnosed with advanced adenomas (N_AdvAd) and early stage CRC (N_earlyCRC) in the cohort over two rounds of screening (standard scenario) and compared it with hypothetical single-round screening with use of a lower cut-off and omission of the second round (alternative scenario). Results In the standard scenario, the cumulative (ie, round I and II combined) PR, N_AdvAd and N_earlyCRC were 13%, 180% and 26%, respectively. In alternative scenarios using a cut-off level of respectively ≥11 and ≥22 ng/HbmL buffer (corresponding to 2 and 4 µg Hb/g faeces), the PRs were 18% and 13%, the N_AdvAd were 180 and 162 and the N_earlyCRC ranged between 22–27 and 22–26. Conclusions The diagnostic yield of FIT screening using a lowered positivity threshold in combination with an extended screening interval (up to 5 years) may be similar to conventional FIT strategies. This justifies and motivates further research steps in this direction.
Biologic Manifestations of Oncogenesis In Vitro: A Critique1
Authors: Katherine K. Sanford
Journal: JNCI Journal of the National Cancer Institute (1974)

We distinguished between oncogenesis in vitro and cell transformation and suggestedthatthe term “transformed” be restricted to those cells demonstrated to grow as malignant neoplasms in vivo or be qualified to indicate the type of change observed. We have selected, from the many responses of cells to oncogenic viruses and carcinogens, those that appear to be associated with acquisition of neoplastic potential. These include alterations in cell and colony morphology and changes in growth properties. The changes in growth pmperties include the capacity for growth in fluid or agar suspension, loss of densitydependent inhibition of growth, and enhanced growth under conditions of reduced serum concentration. These criteria of neoplastic transtormatlen must be used cautiously and cannot completely replace the in vivo assay for tumor production. We interpreted certain of the morphologic changes and the reduced sensitivity of neoplastic cells to inhibition of growth at high cell density as resulting from reduced cytoplasmic spreading associated with diminished adhesiveness to substrate and to adjacent cells. Loss of surface substrate dependence and changes in dynamic morphology, rather than loss of contact inhibition of locomotion or mitosis, seem to characterize the neoplastic transformation of cells in vitro.
Routine screening of children returning home from the tropics
Authors: B. Genton, M. Gehri, E. Okereke, R. Gelletlie, J. J M Tolboom, M. L Brouwer, J. H J Hardeman
Journal: BMJ (1999)

Editor—Information on routine screening of children coming back from the tropics is scarce, but we do not agree with Brouwer et al’s conclusion that routine screening of children without symptoms is worth while.1

Firstly, their definition of asymptomatic children (those seen at their scheduled appointment) is not the one usually accepted (those without symptoms). Parents of children with symptoms or signs not severe enough to seek immediate medical advice may have waited for their scheduled appointment to have the complaint investigated. In fact, 71 (28%) of the 253 so called asymptomatic children had symptoms. If a diagnosis was made in all these children, a diagnosis would have been found in only 28 (99−71) (15%) of the 182 (253−71) truly asymptomatic children; if a diagnosis was made in only half of the “asymptomatic” children with symptoms, a diagnosis would have been found in 64 (99−35) (35%) of the 182 truly asymptomatic children—still less than the figure given (39%). Only 98 (74%) of the 132 cases in which a diagnosis was made were treatable, which further decreases the value of screening.

Secondly, to assess the usefulness of a standard protocol for routine screening it would be necessary to estimate the positive predictive values of clinical criteria and laboratory variables for finding a diagnosis. As the authors state, the clinical examination was not very helpful. We doubt that the urea and creatinine concentrations led to any of the diagnoses found. We find that a thick smear in truly asymptomatic children is useless.

More careful analysis is needed before routine screening is advised for all children without symptoms returning from the tropics. The need for a specialised medical consultation before departure should be reinforced; children should be given vaccines for preventable diseases, including hepatitis A and B, and parents advised to seek medical help for any abnormality identified in their children. Children returning with symptoms should be investigated with laboratory tests. In this context the positive predictive values of the tests are much higher.

For truly asymptomatic children the problem is not yet solved; Brouwer et al give some background, but their proposed screening protocol is too extensive and in Switzerland would cost about Sw fr550 (£220) a child. Before routine screening for all asymptomatic children is recommended, cost efficacy and cost benefit analyses must be performed and different options compared.
Treatment of Chronic Pain
Authors: M. Fischer-Williams
Journal: BMJ (1956)

Pain is the most prominent symptom and its treatment the central problem in the management of many cases, whatever may be the underlying abnormality.However much these cases may vary on account of the diversity of the underlying pathological processes, they will show important similarities because the mechanisms by which pain is produced, appreciated, and alleviated, as well as the physical and psychological effects of pain, are to some extent independent of the underlying disease.It is the policy of those in charge of the Department of Neurology, Oxford, to admit to hospital for assess- ment and treatment patients with obscure or intractable pain, since the successful handling of these cases requires not only the careful study of the reaction to nerve blocks.etc., but also an assessment of the emotional reaction of the patient to the pain when it appears.The present study presents some personal experiences and impressions gained from handling 77 such patients during 1953 and 1954.Table I gives the types of case treated, and Table II lists some of the various measures used in stuLdying and treating the cases.Peripheral Nerve Blocks Peripheral nerve blocks are useful in a wide variety of conditions, such as post-herpetic neuralgia, atypical Diagnosis Painful amputation stump and phantom limb .. Facial pain, excluding trigeminal neuralgia Brachial neuritis Headache not associated with gross neurological disease or hypertension Sciatica.Post-herpetic neuralgia.
Arginase-1–dependent promotion of T <sub>H</sub> 17 differentiation and disease progression by MDSCs in systemic lupus erythematosus
Authors: Hao Wu, Yu Zhen, Zhanchuan Ma, Huimin Li, Jinyu Yu, Zhong-Gao Xu, Xiang-Yang Wang, Huanfa Yi, Yong-Guang Yang
Journal: Science Translational Medicine (2016)

MDSCs promote T H 17 differentiation and systemic lupus erythematosus via arginase-1 production in patients and humanized mice.
The Role of Color and Morphologic Characteristics in Dermoscopic Diagnosis
Authors: Shirin Bajaj, Michael A. Marchetti, Cristian Navarrete-Dechent, Stephen W. Dusza, Kivanc Kose, Ashfaq A. Marghoob
Journal: JAMA Dermatology (2016)

<h3>Importance</h3> Both colors and structures are considered important in the dermoscopic evaluation of skin lesions but their relative significance is unknown. <h3>Objective</h3> To determine if diagnostic accuracy for common skin lesions differs between gray-scale and color dermoscopic images. <h3>Design, Setting, and Participants</h3> A convenience sample of 40 skin lesions (8 nevi, 8 seborrheic keratoses, 7 basal cell carcinomas, 7 melanomas, 4 hemangiomas, 4 dermatofibromas, 2 squamous cell carcinomas [SCCs]) was selected and shown to attendees of a dermoscopy course (2014 Memorial Sloan Kettering Cancer Center dermoscopy course). Twenty lesions were shown only once, either in gray-scale (n = 10) or color (n = 10) (nonpaired). Twenty lesions were shown twice, once in gray-scale (n = 20) and once in color (n = 20) (paired). Participants provided their diagnosis and confidence level for each of the 60 images. Of the 261 attendees, 158 participated (60.5%) in the study. Most were attending physicians (n = 76 [48.1%]). Most participants were practicing or training in dermatology (n = 144 [91.1%]). The median (interquartile range) experience evaluating skin lesions and using dermoscopy of participants was 6 (13.5) and 2 (4.0) years, respectively. <h3>Main Outcomes and Measures</h3> Diagnostic accuracy and confidence level of participants evaluating gray-scale and color images. Two separate analyses were performed: (1) an unpaired evaluation comparing gray-scale and color images shown either once or for the first time, and (2) a paired evaluation comparing pairs of gray-scale and color images of the same lesion. <h3>Results</h3> In univariate analysis of unpaired images, color images were less likely to be diagnosed correctly compared with gray-scale images (odds ratio [OR], 0.8;<i>P</i> &lt; .001). Using gray-scale images as the reference, multivariate analyses of both unpaired and paired images found no association between correct lesion diagnosis and use of color images (OR, 1.0;<i>P</i> = .99, and OR, 1.2;<i>P</i> = .82, respectively). Stratified analysis of paired images using a color by diagnosis interaction term showed that participants were more likely to make a correct diagnosis of SCC and hemangioma in color (<i>P</i> &lt; .001 for both comparisons) and dermatofibroma in gray-scale (<i>P</i> &lt; .001). <h3>Conclusions and Relevance</h3> Morphologic characteristics (ie, structures and patterns), not color, provide the primary diagnostic clue in dermoscopy. Use of gray-scale images may improve teaching of dermoscopy to novices by emphasizing the evaluation of morphology.
Effect of a prostacyclin derivative (OP-41483) and a hyperosmotic agent (glycerol) on brain edema and metabolism in cerebral ischemia.
Authors: Yasuo Katayama, Fumihiko Kashiwagi, Hajime Memezawa, Akiro Terashi
Journal: Circulation (1992)

A PGI2 derivative, OP-41483, and a hyperosmotic agent, glycerol, were tested for possible beneficial effects on brain edema, metabolism and pathological changes in cerebral ischemia. Combination treatment with these agents was also tested. Cerebral ischemia was produced in spontaneously hypertensive rats, using bilateral common carotid artery ligation (BLCL). OP-41483 was administered four times, hourly (500 ng/kg×4, i.p.). Ten per-cent glycerol was administered intravenously (6.6ml/kg). And, for the combination treatment, OP-41483 was administered three times, hourly (500 ng/kg×3, i.p.), and 10% glycerol was administered intravenously (6.6 ml/kg) in the same manner as the glycerol treated group. In ischemic controls, saline was administered intravenously (6.6 ml/kg). After 3h of ischemia, brain water content and metabolites were determined and pathological observation was conducted using electron microscopy. OP-41483 treated animals maintained higher levels of ATP concentration and reduced accumulation of lactate, but showed no difference in brain water content compared to saline treated controls. Glycerol treated animals showed significance in terms of reduction of brain water content and accumulation of lactate. Glycerol abated the depletion of ATP concentration. OP-41483+glycerol treated animals showed the most significant effect on the reduction of brain water content and accumulation of lactate. The combination treatment also maintained higher levels of ATP concentration. Additionally, swelling of astrocytic foot processes and mitochondria with destroyed crista were not observed pathologically in the combination treated animals. These results show that OP-41483, glycerol and combination treatment are beneficial in the treatment of cerebral ischemia. They also indicate that the combination treatment significantly enhances the protective effects compared to individual treatment.
Perioperative stromal depletion by PEGPH20 in pancreatic ductal adenocarcinoma.
Authors: Andrew H. Ko, Pelin Cinar, Margaret A. Tempero, Eric K. Nakakura, Benjamin M Yeh, Dimitrios Chondros
Journal: Journal of Clinical Oncology (2016)

TPS476 Background: Treatment with PEGylated recombinant human hyaluronidase (PEGPH20) depletes stromal HA in pancreatic tumors, resulting in increased intratumoral perfusion and improved drug delivery. This Phase 2 study evaluates the clinical, biologic, and radiographic effects of neoadjuvant PEGPH20, gemcitabine (GEM) and nab-paclitaxel (NAB) in patients (pts) with borderline resectable pancreatic ductal adenocarcinoma (PDAC). Methods: Therapy-naïve patients aged ≥ 18 years with histologically confirmed PDAC defined as borderline resectable by consensus national guidelines will be eligible. Pts must have ECOG PS of 0-1 and adequate renal, marrow and hepatic function. Co-primary endpoints include incidence of postoperative pancreatic fistula and pathologic complete response rate. The trial uses a 2-stage design. In Part 1 (n = 15), pretreatment endoscopic ultrasound-guided core biopsies and functional MRI (fMRI) will be obtained. After a 1-week run-in with PEGPH20 (3μg/kg on Days [D]1 and 4), pts will undergo repeat biopsy and fMRI. Pts will then receive PEGPH20 (3μg/kg), NAB (125 mg/m 2 ) and GEM (1000mg/m 2 ) on D1, 8 and 15 of a 28-day cycle. Enoxaparin (1mg/kg daily) and dexamethasone (8mg pre- and post- PEGPH20) will be administered prophylactically. CA 19-9 levels will be checked monthly. Restaging CT will be obtained at the end of Cycles 2 and 4, with repeat fMRI performed after Cycle 4. Pts who are judged to be appropriate operative candidates upon multidisciplinary tumor board review will go to surgery at that point. Tissue analyses will be performed on the serially collected tumor samples, including the resected pancreatic specimen, with a focus on HA expression and immune cell infiltrates. Upon recovery, pts will receive 2 adjuvant cycles of GEM and NAB. If the predefined safety threshold is met in Part 1, an additional 21 pts will be enrolled in Part 2, without the one-week PEGPH20 run-in or pre- and post-run-in biopsies. Assuming 25 of the 36 pts are evaluable (i.e., able to go to surgery), a post-operative fistula rate of 11% would be able to be estimated with 95% CI of 3.4%-23.1%. Study initiation has begun as of September 2015. Clinical Trial Information: NCT02487277 Clinical trial information: NCT02487277.
Immediate adverse reactions to chemotherapy: Experience of a large ambulatory treatment center
Authors: C. P. Escalante, J. H. Oh, D. D. Baum, M. Mante, A. Zalpour, S. Spivey, C. Stewart, J. Ensor, T. Grover, R. Freedman
Journal: Journal of Clinical Oncology (2006)

8558 Background: In recent years there has been a proliferation of Ambulatory Chemotherapy Treatment Centers (ATC). The incidence of hypersensitivity and other immediate adverse drug reactions (IADR) in these ATC units have not been well studied. We aim to describe our experience with IADR in our ATC. Methods: Retrospective chart review was conducted for all patients in the Adverse Drug Reaction Report database (Maxsys II) for the year 2004. Data was abstracted for demographics, risk factors, clinical characteristics, and outcomes of IADR. Overall frequency of different chemotherapeutic and monoclonal agents infused was obtained for the same period through the pharmacy database. Results: In 2004, 81,580 chemotherapy infusions were given and 256 IADR (0.31%) were reported. The mean age was 55 years and 45% were males. The most common drugs used were fluorouracil (12.9%), paclitaxel (9.4%), docetaxel (6.1%), carboplatin (5.9%), and gemcitabine (5.8%). The table shows the most prevalent agents that led to IADR. Common symptoms included flushing (52.3%), dyspnea (27.3%), chest discomfort (27%), pruritus (22.7%), and hypertension (18.4%). Diphenhydramine (85.5%), hydrocortisone (37.1%), and dexamethasone (17.2%) were the most common drugs used for treatment of IADR. Common risk factors included previous allergy to medications (43.4%), previous IADR (19.5%), previous reactions to iodide (7.8%), allergies to seafood (1.6%), allergic rhinitis (1.2%), urticaria (1.2%), and asthma (0.8%). Most patients had their chemotherapy resumed and completed (87.9%) on the same day. Discussion: IADR were rare. Most cases were easily treated and chemotherapy was restarted and completed in the same day. However, they still pose a significant burden to cancer patients. Prospective studies are needed to further evaluate the identified risk factors and most common offending agents in outpatient settings. This will help develop pathways for more effective prevention and treatment of these IADR. [Table: see text] No significant financial relationships to disclose.
AB1242-HPR Fear of Movement Affects Functional Levels and Quality of Life After Total Hip Arthroplasty
Authors: S. Onal, H. Guney, C. Sarial, G.I. Kinikli, I. Yuksel
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Though total hip arthroplasty (THA) is a successful procedure for the late stage of hip osteoarthritis, high pain levels and functional impairment are considerable. In addition, THA patients suffer from psychological symptoms such as kinesiophobia/fear of movement. <h3>Objectives</h3> The purpose of this study was to determine the fear of movement impact on functional levels and quality of life. <h3>Methods</h3> Forty-two patients who underwent unilateral THA were included in the study. Tampa Scale for Kinesiophobia (TSK) was applied to detect fear of movement level. A high value on the TSK indicates a high degree of fear of movement and a score of 37 differentiates between high and low scores. Patients were divided into two groups either to have high scores (Group I; high kinesiophobia, n=22) or low scores (Group II; low kinesiophobia, n=20). Western Ontario and McMaster Osteoarthritis Index (WOMAC) pain, stiffness and activity of daily living questionnaire and Hip Osteoarthritis Outcome Survey-Physical Function Survey (HOOS-PS) were used to determine the functional status. Physical component summary (PCS) and mental component summary (MCS) of Short Form-12 (SF-12) was used to define the quality of life level. Intensity of pain was measured with visual analog scale (VAS). Assessments were applied at least three months after surgery and time after surgery was recorded. Statistical analysis of the data was performed with Mann Whitney-U test. <h3>Results</h3> There were no differences in age (p=0.72), BMI (p=0.31), time from surgery (p=0.11), WOMAC pain (p=0.41), WOMAC stiffness (p=0.87), SF-12 MCS (p=0.57)scores between Group I and Group II (Table I).The pain levels (p=0.02), HOOS-PS (p&lt;0.001) WOMAC-ADL and SF-12 PCS (0.02) scores were better in Group II (low kinesiophobia) when compared to Group I (high kinesiophobia). <h3>Conclusions</h3> Fear of movement has an adverse effect on pain, functional levels and activity of daily living in THA patients. <h3>References</h3> Cheatham SW, Mokha M, Lee M. Postoperative Rehabilitation After Hip Resurfacing: A Systematic Review.J Sport Rehabil. 2015 Jan 22. Peter WF, Dekker J, Tilbury C, Tordoir RL, Verdegaal SH, Onstenk R, Bénard MR, Vehmeijer SB, Fiocco M, Vermeulen HM, van der Linden-van der Zwaag HM, Nelissen RG, VlietVlieland TP. The association between comorbidities and pain, physical function and quality of life following hip and knee arthroplasty. Rheumatol Int. 2015 Jan 14. <h3>Disclosure of Interest</h3> None declared
Thrombosing Arteriosclerosis
Authors: J. Dedichen
Journal: BMJ (1956)

Man lives with arteriosclerosis, and dies of the com- plicating thrombosis.The combination represents a disease entity which should be called " thrombosing arteriosclerosis."The symptoms depend on the seat of thrombosis-giving angina pectoris or coronary infarc- tion, cerebral accidents, or intermittent claudication-
Differential Inhibition of DNA and RNA Synthesis by Neocarzinostatin in Cultured Burkitt Lymphoma Cells
Authors: Yasuo Kawai, Arthur Katoh
Journal: JNCI Journal of the National Cancer Institute (1972)

Neocarzinostatin, a new high molecular weight antibiotic isolated from Streptomyces fermentation, rapidly and differentially affected Burkitt lymphoma cells in culture. At a dose abolishing 90% of DNA synthesis within 1 hour after treatment, RNA synthesis was unaffected. With increasing exposure time, RNA synthesis also approached 90% inhibition. Concomitantly, 90% of the cell population remained viable and protein synthesis continued unchanged.