tbuckley/cabot-search huggingface dataset:
An attempt to correlate “comprehensive geriatric assessment” (CGA), treatment assignment and clinical outcome in elderly cancer patients: Preliminary results of a phase II open study
Authors: G. Mantovani, G. Astara, E. Massa, C. Madeddu, F. M. Tanca, E. Sanna, C. Spiga, L. Deiana, F. Saba
Journal: Journal of Clinical Oncology (2006)

18599 Background: The aim of our study was to verify the feasibility of using the CGA as an effective instrumental tool for treatment assignment and verify its influence on clinical outcome in elderly cancer patients (pts). Methods: The study design was a prospective Phase II open study. Elderly (age ≥65 years) cancer pts were assigned to 3 different CGA categories (“Fit”, “Intermediate” and “Frail”): accordingly, an appropriate treatment was administered and the clinical outcome was assessed. “Fit” pts were assigned standard chemotherapy, “intermediate” pts tailored (chemo) therapy, “frail” pts monochemotherapy (as “supportive” therapy) or only “supportive” therapy. The primary endpoint of the study was to correlate CGA with treatment and clinical outcome which was based on: objective clinical response (RECIST), ECOG PS, toxicity (NCI CTC v.3), survival, quality of life. Patients who completed at least 3 months of treatment were evaluable. Results: At January 2006, 72 pts were enrolled (mean age 74.4 years, range 65–91, M/F 39/33), 35 of whom (34 stage IV) were evaluable: 5 were “fit”, 16 “intermediate” and 14 “frail”. At baseline no difference was found between the CGA categories in the clinical characteristics (M/F ratio, stage, tumor site) except for ECOG PS which was significantly higher in frail pts (ANOVA test). The objective clinical response to the assigned treatment was: 1 PR, 1 SD and 3 PD for “fit” pts; 1 PR, 9 SD and 6 PD for “intermediate” pts; 4 PR, 4 SD and 6 PD for “frail” pts. Comprehensively, the ORR was 17.1% and the median survival was 4.15 months; 25 out of 35 pts are alive. As for the correlation of CGA categories with treatment and clinical outcome, no difference was found in the clinical outcome variables after 3 months of treatment (ANOVA test). Our results are preliminary as the study is still in progress: the required accrual is at least 32 pts for each CGA category. Conclusions: The CGA assessment is strongly recommended as an essential component of the clinical evaluation of elderly pts. Large prospective clinical trials in this field are awaited. Work Supported by: MIUR, Rome, Italy: NRP No. 2004067078. No significant financial relationships to disclose.
Features of HIV-TB co-infection in children
Authors: Sergey Skornyakov, Natalia Kamaeva, Yuriy Chugaev
Journal: European Respiratory Journal (2014)

Background.  Among all the children born in Sverdlovsk region from HIV-positive mothers, about 6,7% were perinatally HIV-infected. That was confirmed by immune blotting which helped to detect the HIV-antibodies and RNA viruses in blood. 5% of children developed tuberculosis (TB).   Objective:  to display the epidemiological and clinical features of TB in HIV-infected children.   Material and methods.  22 cases of TB in HIV-positive children in Sverdlovsk region were studied. TB was diagnosed by standard research methods.   Results.  In 63.6 % of cases, we found that children had contact with people diagnosed with TB (n = 14), in 80% of cases the contact was between children and their parents. 54.5 % of children (n = 12) developed TB at an early age. 45.5% of children in the age of 3 and older (n = 10) developed the TB disease as well. 9 out of 22 children were vaccinated with BCG (40.9%).  The process have been localized in all cases, for example, in the respiratory system; two children were diagnosed with generalizable process, in which one of them was identified with BCG ethiology with verification by PCR of operational biopsy material from axillary lymph node. 57.1% of children had complicated TB with the development of lung tissue destruction, dissemination or atelectasis. All children were treated with polychemotherapy and were dismissed from hospital after recovery.   Conclusion.  In the presence of HIV and TB prevalence among the young people, there is an extremely high risk of co-infection of HIV-TB among children.
Liver capsule: Molecular‐based signatures in hepatocellular carcinoma
Authors: Amanda J. Craig, Augusto Villanueva
Journal: Hepatology (2016)

1Division of Liver DiseasesLiver Cancer Program 2Division of Hematology and Medical Oncology, Department of MedicineTisch Cancer Institute, Icahn School of Medicine at Mount SinaiNew YorkNY * Corresponding author: [email protected]
Fertility and ageing
Journal: Human Reproduction Update (2005)

The late 20th century trend to delay birth of the first child until the age at which female fecundity or reproductive capacity is lower has increased the incidence of age-related infertility. The trend and its consequences have also stimulated interest in the possible factors in the female and the male that may contribute to the decline in fecundity with age; in the means that exist to predict fecundity; and in the consequences for pregnancy and childbirth. In the female, the number of oocytes decreases with age until the menopause. Oocyte quality also diminishes, due in part to increased aneuploidy because of factors such as changes in spindle integrity. Although older male age affects the likelihood of conception, abnormalities in sperm chromosomes and in some components of the semen analysis are less important than the frequency of intercourse. Age is as accurate as any other predictor of conception with assisted reproductive technology. The decline in fecundity becomes clinically relevant when women reach their mid-30s, when even assisted reproduction treatment cannot compensate for the decline in fecundity associated with delaying attempts at conceiving. Pregnancies among women aged >40 years are associated with more non-severe complications, more premature births, more congenital malformations and more interventions at birth.
Does Her2/neu status affect adjuvant chemotherapy utilization? A population based analysis
Authors: S. Snow, D. Rayson, P. J. Barnes, M. Sellon, K. Thompson, T. Younis
Journal: Journal of Clinical Oncology (2008)

11549 Background: Adjuvant chemotherapy (aC) is a standard treatment for patients with breast cancer (BC) who have a moderate to high risk of cancer recurrence. More recently, adjuvant trastuzumab (aTZ) has also become a standard treatment option for patients with Her2/neu positive BC who are candidates for aC. We conducted a population-based study in Nova Scotia, Canada, to determine if patients with Her2/neu positive BC have a greater chance of receiving aC compared to those with Her2/neu negative BC. Methods: All patients diagnosed with stage I-III BC between October 2005 and September 2006 in NS, Canada, were identified through the provincial cancer registry. A retrospective chart review was performed to abstract relevant clinical and pathological variables including: age, menopausal status, comorbidities, TNM stage, grade, multifocality, lymphovascular invasion, hormone receptor status, Her2/neu status, referral to medical oncology (MO) and receipt of aC and trastuzumab (aTZ). Logistic regression model with multivariate analyses was performed to determine variables associated with MO referral and/or aC treatment. Results: 630 patients were identified; 523 were reviewed and 421 underwent Her2/neu testing (IHC with Tab250 and DAKO A0485 antibodies, and FISH for equivocal IHC results). Of those tested, Her2/neu was positive in 59 (14%) and negative in 362 (86%) with 43 (73%) vs 182 (50%) undergoing aC treatment, respectively (p=0.001). In the Her2/neu positive cohort, 37/59 received aTZ (63%). Patients not tested for Her2-neu were older (median age 71 vs 59) and more likely to be post menopausal with T1 tumors; only 8/102 (8%) received aC. In multivariate analyses MO referral was associated with age <60, premenopausal status, ≥T2 tumor and node-positive disease while receipt of aC was associated with age <60, ≥T2 tumors, node-positive disease, negative hormone receptor status and positive Her2/neu status. Conclusions: Patients with Her2/neu positive BC were more likely treated with aC compared to those with Her2/neu negative disease, even after accounting for patient and disease-risk characteristics. No significant financial relationships to disclose.
Comorbidity and overall survival (OS) in patients with advanced pancreatic cancer (APC): Results from NCIC CTG PA.3-A phase III trial of erlotinib plus gemcitabine (E+G) versus gemcitabine (G) alone.
Authors: M. M. Vickers, E. D. Powell, T. R. Asmis, D. J. Jonker, C. J. O'Callaghan, D. Tu, W. Parulekar, M. J. Moore
Journal: Journal of Clinical Oncology (2010)

4079 Background: The interaction between comorbidity, age and performance status (PS) in patients with APC receiving chemotherapy has yet to be fully explored, but is of clinical importance. A previous analysis of NCIC CTG PA.3 revealed that venous thromboembolism (VTE) as a comorbidity had a negative impact on survival. We further explored comorbidity (aside from VTE), age and PS as predictors of treatment toxicity and outcome in patients receiving G ± E. Methods: Comorbidity was evaluated retrospectively by 2 physicians (independently) using the Charlson Comorbidity Index (CCI), a previously validated measure of comorbidity based on the presence or absence of index medical conditions (VTE not part of index). CCI was correlated with demographic data (age, gender, race), baseline pain intensity, treatment, PS, and OS by chi-square test or Cox model. Results: 569 patients were included; 47% were ≥ 65 years, 34% had comorbidities and 70% had an ECOG PS ≥ 1 at randomization. In univariate analysis of all covariates, higher ECOG PS (PS > 0) was associated with age ≥ 65 yrs (p = 0.009) and age ≥ 65 yrs was associated with CCI > 0 (p = 0.02). When all patients were combined, neither age nor comorbidity was significantly associated with OS. Erlotinib and gemcitabine significantly improved OS compared with gemcitabine alone for patients < 65 yrs of age (adjusted HR 0.73; 95% CI 0.56-0.94; p = 0.01) and those with CCI > 0 (adjusted HR 0.71; 95% CI 0.52-0.97; p = 0.03). Interaction test trended towards significance for age (p = 0.08), but not for comorbidity (p = 0.2) as predictors of OS benefit from the addition of E to G. Toxicity analysis of the E+G group revealed a higher rate of grade ≥ 3 infections in patients ≥ 65 yrs (p = 0.02) and those with CCI > 0 (p = 0.01). Conclusions: Younger age may, but comorbidity does not predict for OS benefit from the addition of erlotinib to gemcitabine. In the E+G group, age and comorbidity were associated with toxicity. Further investigation is required to determine the prognostic/predictive role of comorbidity in the treatment of solid tumors. Refinement of comorbidity indices for specific tumor sites may also be indicated. Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Amgen, UCB Canada
The Association Between Psychiatric Disorders and Frequent Indoor Tanning
Authors: Aaron J. Blashill, Jessica L. Oleski, Rashelle Hayes, Jonathan Scully, Tad Antognini, Effie Olendzki, Sherry Pagoto
Journal: JAMA Dermatology (2016)

those who screened positive for tanning dependence, 31% were grouped as screening positive for BDD, SAD, and elevated stress, compared with 2% who screened positive for these 3 measures among those without tanning dependence.The study has some limitations.Owing to the small number of participants who screened positive for all 3 variables (n = 11), we could not assess the association between comorbidity and tanning dependence via inferential statistics.Furthermore, the cross-sectional design of the study prevented it from addressing temporal relationships.In addition, assessment of psychiatric disorders was based on validated screening instruments, which may not correspond perfectly with physician-based diagnostic assessment.Results of the present study may have implications for the clinical care of frequent tanners.Given the high level of psychiatric disorders observed among frequent indoor tanners, it may be prudent for dermatologists to screen patients, or at least those who are frequent tanners, for SAD, BDD, and perceived stress.Physicians are encouraged to refer patients who screen positive for 1 or more of these psychiatric disorders to mental health professionals for behavioral or pharmacological interventions or both.Furthermore, interventions to stop tanning dependence may require addressing underlying psychological factors.
North Americans are eating more fat and less carbohydrate, study finds
Authors: Michael McCarthy
Journal: BMJ (2015)

While nutrition experts continue to debate the risks and benefits of dietary fats, consumers seem to have made up their minds, judging by their changing eating habits—consuming more foods rich in saturated and monounsaturated fats and cutting the amount of carbohydrates in their diets, a report by Credit Suisse has concluded.1 The international financial services company prepared the 76 page report to provide guidance for its clients’ investing strategies.

The report said that, although a survey covering six countries had found that most consumers agreed with most current recommendations to lower their intake of …
Abstract P122: Plasma Fatty Acid Binding Protein 4 is Associated with the Incidence of Sudden Cardiac Death in Non-Diabetic Adults in the Cardiovascular Health Study
Authors: Luc Djousse, Marlena Maziarz, Mary L Biggs, Joachim H Ix, Jorge R Kizer, Dariush Mozaffarian, Kenneth J Mukamal, Russell P Tracy, David S Siscovick, Nona Sotoodehnia
Journal: Circulation (2012)

Background: Fatty acid binding protein 4 (FABP4) is an adipokine that plays a role in lipid transport. Previous studies have reported that FABP4 may increase the risk of diabetes and exert negative inotropy on the myocardium. It is unknown whether plasma FABP4 is associated with the risk of sudden cardiac death (SCD). Objective: To test the hypothesis that plasma FABP4 is associated with a higher incidence of SCD in older adults and determine if diabetes status modifies this association. Methods: We prospectively analyzed data on 4,564 men and women aged 65+ years from the Cardiovascular Health Study. FABP4 was measured at baseline using ELISA and SCD events were adjudicated through review of medical records (inter-reviewer agreement of 88% and kappa of 0.74). We used Cox proportional hazards model to examine the association between FABP4 and SCD. Results: During a median follow up of 11.8 years, 146 new cases of SCD occurred. In a multivariable model adjusting for age, sex, race, clinic, education, glomerular filtration rate based on cystatin C, high-sensitive C-reactive protein, leisure time physical activity, hormone replacement therapy, alcohol intake, self-reported general health status, smoking, prevalent coronary heart disease, and prevalent heart failure, each higher standard deviation (SD) of plasma FABP4 was associated with a non-significant 14% (95% CI: -5% to 37%) higher risk of SCD. When stratified by prevalent diabetes status, FABP4 was associated with a higher risk of SCD in non-diabetic participants, [HR per SD of FABP4: 1.37 (95% CI: 1.11-1.67)] but not in diabetic participants [HR per SD of FABP4: 0.77 (95% CI: 0.52-1.15)], p for diabetes-FABP4 interaction was 0.026. Conclusion: A single measure of plasma FABP4 obtained later in life was associated with a higher risk of SCD among older adults without diabetes but not among those with diabetes. If confirmed in other studies, these data may point to novel mechanisms and opportunities for SCD prevention.
Inherited genetic variation in <i>EPHA5</i>, <i>FGD4</i>, and <i>NRDG1</i> and paclitaxel (P)-induced peripheral neuropathy (PN): Results from a genome-wide association study (GWAS) in CALGB 40101.
Authors: D. L. Kroetz, R. M. Baldwin, K. Owzar, C. Jiang, H. Zembutsu, M. Kubo, Y. Nakamura, L. N. Shulman, M. J. Ratain
Journal: Journal of Clinical Oncology (2010)

3021 Background: CALGB 40101 is an ongoing phase III trial comparing the efficacy of standard therapy cyclophosphamide and doxorubicin (AC × 4 or 6 cycles) with single-agent paclitaxel (P × 4 or 6 cycles) as adjuvant therapy for breast cancer in women with 0-3 positive axillary lymph nodes. AC and P are associated with significant toxicities, with peripheral neuropathy being the major toxicity of P. As part of this study, we have collected germline DNA for a pharmacogenetic GWAS to identify genetic predictors of toxicity. Methods: Germline DNA was isolated from 1,040 patients on the P arm of CALGB 40101 and genotyped using the Illumina 610-Quad platform. Following QC analysis, genotypes were available for 520,679 SNPs. Principal component (PC) analysis identified 859 genetic Europeans that were the focus of this analysis. Patients with grade 2 or greater sensory PN during one or more cycles of P (n = 200) were compared to patients with grade 0 or 1 toxicity (n = 610) using an additive logistic regression model incorporating treatment duration and three PCs. Results: Although no SNPs reached genome-wide significance (p <10−8), three of the top ten hits were in genes implicated in congenital or experimental PN. Patients carrying a variant EPHA5 allele had an increased risk of P-induced PN (OR 1.81, p = 2.2 × 10−6). EPHA5 is expressed in the dorsal root ganglion and related genes in the EPH family contribute to neuropathic pain. Risk alleles were also identified in two genes implicated in congenital PN, FGD4 (OR 1.69, p = 1.9 × 10−5) and NDRG1 (OR 0.58, p = 1.9 × 10−5). These findings are further supported by a significant enrichment for SNPs annotated in neuronal development pathways. Conclusions: Heritable variation in EPHA5, FGD4, and NRDG1 may modify a patient's risk of developing P-induced sensory PN. If these findings are replicated, the ability to identify patients at risk of this common toxicity could influence the choice of adjuvant breast cancer therapy. Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration EMD Serono
Incidence of dementia declined in past 30 years in US, study shows
Authors: Susan Mayor
Journal: BMJ (2016)

The incidence of dementia in the United States has declined over the past 30 years, results from the Framingham Heart Study have shown.1

The prevalence of dementia is expected to increase dramatically as the average life expectancy rises, but recent estimates have suggested that the age specific incidence of dementia is actually decreasing in high income countries.

To investigate this further, researchers analysed figures from the Framingham Health Study, which has followed participants for incident dementia as part of regular health checks since 1975.

The study included 5205 people over 60 who were assessed with the …
What have we learned about risk factors for local recurrence after breast-conserving surgery and irradiation?
Authors: J R Harris, R Gelman
Journal: Journal of Clinical Oncology (1994)

Article Tools Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.1994.12.4.647 Journal of Clinical Oncology - published online before print September 21, 2016 PMID: 8151312 What have we learned about risk factors for local recurrence after breast-conserving surgery and irradiation? J R HarrisxJ R HarrisSearch for articles by this author , R GelmanxR GelmanSearch for articles by this author https://doi.org/10.1200/JCO.1994.12.4.647 First Page PDF © 1994 by American Society of Clinical Oncology
Original article: Double-blind, randomized trial for the control of delayed emesis in patients receiving cisplatin: Comparison of placebo vs. adrenocorticotropic hormone (ACTH)
Authors: R. Passalacqua, G. Cocconi, M. Bella, L. Monici, M. Michiara, N. Bandini, M. Bacchi
Journal: Annals of Oncology (1992)
Relapse of breast cancer after adjuvant treatment in premenopausal and perimenopausal women: patterns and prognoses.
Authors: A Goldhirsch, R D Gelber, M Castiglione
Journal: Journal of Clinical Oncology (1988)

Eight hundred eighteen premenopausal or perimenopausal breast cancer patients with axillary node metastases were treated with adjuvant chemotherapy (CMF) with or without endocrine treatment (prednisone, oophorectomy) in two concurrent prospective trials. Three hundred fifty-two (43%) had recurrent disease at a median follow-up time of 6 years. The 2-year survival percentages from time of first relapse were 16% for patients with initial metastases in visceral or multiple sites (including bone and soft tissue), 41% for those with regional metastases or skeletal relapse alone and 70% for patients with isolated local recurrence or contralateral breast cancer. The features that most influenced prognosis within the categories defined by site of first relapse were disease-free interval (less than 24 months v greater than or equal to 24 months), and estrogen receptor content in the primary tumor. These features had clinical importance (identifying patients with at least a 50% 2-year survival percentage) only in those patients with local, contralateral breast, regional, or bony disease alone. The treatment of individual patients after relapse must be directed toward optimized palliation. The results of this study are important for defining groups of patients who relapse after CMF for whom the subsequent therapeutic approach might be differentiated (eg, experimental treatments for dire prognosis, accent on minimal side effect treatment for intermediate prognosis, and investigation of adjuvant systemic therapy for isolated local recurrence).