tbuckley/cabot-search huggingface dataset:
Preliminary analysis of genetic counselling activity at Regina Elena Cancer Institute of Rome - Italy
Authors: S. Gasparro, A. Savarese, G. Maggi, F. M. Sega, A. Caruso, F. Ferranti, E. Cossu, G. Simonetti, M. Crecco, F. Cognetti
Journal: Journal of Clinical Oncology (2004)

8232 Background: increasing education and surveillance among high-risk individuals is crucial. However, how subjects experience counselling and screening is under investigation. Methods: cancer pts or suspected at high-risk subjects referred to Regina Elena Cancer Institute were addressed to genetic counselling,and their familial risk was assessed following the Criteria of Modena. Intensive surveillance program,( MRI performed in collaboration with University of Rome Tor Vergata) was proposed to the selected families. Cancer pts who had blood sample collection for mutation test were also invited to participate in a psychological assessment performed by FACES III, HADS and MMP. Results: From April 2002 to November 2003,191 subjects(188 female, 3 males, median age 52 yrs) belonging to 140 families with a history of B/O cancer underwent to genetic counselling. The subjects were mainly induced to genetic counselling by media information(8%, medical doctors or friends suggestion (70 and 8% respectively. Individuals were aimed to counselling because of their risk perception (30%),prevention opportunity (25%) or anxiety and fear (3%). The remaining 42% had no risk perception,and accepted the counselling following the medical doctor indications. Among these families, 47(33%) met the criteria for suspected HBOC and were proposed for genetic BRCA1/2 mutation test. Cancer pts of 43 families (96%) accepted to undergo mutation analysis. Surveillance program was accepted in 50% of cases. However, the remaining 50% preferred to delay the consent and to wait for the result of test. Psychological evaluation showed higher reactive anxiety in 45 % of cases,with affected emotional adjustment. Moreover,1/5 of the sample reports clinically significant levels of depression. Conclusions: People largely accept to be investigated for the familial risk although only 60% have a perception of risk . Anyway, they seem to accept the start of intensive screening after knowing the result of mutation test. Anxiety and depression were found. Additional evaluation and recruitment are ongoing. Partially supported by Ministero della Salute - Italia, and Lega Italiana Tumori. No significant financial relationships to disclose.
Phase I and clinical evaluation of a pharmacologically guided regimen of suramin in patients with hormone-refractory prostate cancer.
Authors: M A Eisenberger, V J Sinibaldi, L M Reyno, R Sridhara, D I Jodrell, E G Zuhowski, K H Tkaczuk, M H Lowitt, R K Hemady, S C Jacobs
Journal: Journal of Clinical Oncology (1995)

PURPOSE This phase I study was designed with the following objectives: (1) to describe the overall and dose-limiting toxicity (DLT) of suramin administered by intermittent short intravenous infusions until DLT or disease progression; (2) to determine the ability of an adaptive control with feedback (ACF) dosing strategy to maintain suramin plasma concentrations within a preselected range; (3) to develop a population model of suramin pharmacokinetics; and (4) to identify preliminary evidence of antitumor activity. PATIENTS AND METHODS Seventy-three patients with advanced, incurable, solid tumors (including 69 with hormone-refractory prostate cancer) received an initial 5- to 7-day daily loading treatment followed by intermittent infusions individually determined by ACF using a Bayesian algorithm and relying on population models of suramin pharmacokinetics. Treatment was given to three cohorts of patients based on target plasma suramin concentration ranges (peak, 30 minutes postsuramin, and trough on morning of the treatment day), as follows: cohort 1, 175 to 300 micrograms/mL (27 patients); cohort 2, 150 to 250 micrograms/mL (23 patients); and cohort 3, 100 to 200 micrograms/mL (23 patients). All patients were to receive suramin until DLT or disease progression. RESULTS The DLT was most commonly seen in cohort 1 and included a syndrome of malaise and fatigue, associated with weight loss, anorexia, and changes in taste. Other reversible toxicities were neurologic, renal, cutaneous, edema, lymphopenia and anemia, ophthalmologic, and alopecia. Forty of 67 assessable patients (60%) had a 50% reduction and 25 of 67 (37%) a 75% reduction in prostate-specific antigen (PSA) levels that lasted more than 4 weeks, seven of 18 (40%) had measurable responses, and 18 of 37 (49%) demonstrated major pain improvement. The overall times to disease progression and survival were 170 and 492 days, respectively. CONCLUSION We have characterized all toxicities with suramin in a pharmacologically guided phase I study designed to maintain plasma suramin concentrations of 100 to 300 micrograms/mL (cohorts 1 to 3). The incidence of grade 3 to 4 neurologic abnormalities was relatively low, particularly in cohorts 2 and 3 (100 to 250 micrograms/mL). Evidence of significant and durable antitumor activity was seen in all three cohorts.
Impact of influenza virus infection on alveolar epithelial cell Na,K-ATPase expression and localization
Authors: Christin Becker, Gregory R.S. Budinger, Werner Seeger, Istvan Vadasz, Jürgen Lohmeyer, Rory Morty, Susanne Herold
Journal: European Respiratory Journal (2013)

Influenza A viruses (IV) cause primary viral pneumonia resulting in acute lung injury (ALI) associated with a decreased alveolar fluid clearance (AFC), which under normal conditions is driven by the basolateral Na,K-ATPase. Therefore we investigate the regulation of Na,K-ATPase in IV-infection by viral and host factors to characterize the mechanisms affecting AFC.  The effects of IV-infection on Na,K-ATPase have been studied in primary murine and human alveolar epithelial cells (AEC) in monoculture and in coculture with macrophages. Cells were infected with A/PR/8/1934 (PR8) and Na,K-ATPase expression and localization was analysed by qPCR, Western blot, flow cytometry and confocal microscopy.  Na,K-ATPase was not regulated on mRNA levels upon IV-infection in mAEC. Protein levels of Na,K-ATPase α1 were significantly decreased in total cell lysates and surface fractions during IV-infection. Interestingly, Na,K-ATPase α1 surface expression was primarily decreased in non-infected cells, whereas IV-infected cells showed little reduction in Na,K-ATPase α1 expression. Cocultivation of AEC with infected macrophages enhanced the degradation of Na,K-ATPase α1 protein levels, likely by a soluble mediator. Of note, confocal microscopy revealed a mistargeting of Na,K-ATPase α1 to the apical membrane in infected AEC, lungs of infected mice and after transfection of the viral M segment.  We provide evidence that AFC in IV-infection is impaired by viral and host factors affecting Na,K-ATPase expression levels and localization. Defining the underlying molecular pathways might provide targets for new treatments increasing edema clearance in IV-induced ALI.
Acute stress disorder screening in community oncology practice.
Authors: R. E. Nora, K. Burton
Journal: Journal of Clinical Oncology (2010)

e19633 Background: Cancer patients experience psychological symptoms attendant to their diagnosis and treatment. Severe associated symptoms may be diagnostic of acute stress disorder (ASD). Interview and self-reporting tools have been validated to screen for ASD in oncology populations. The prevalence of symptoms and patients' willingness to report ASD symptoms is unknown. Methods: Participants were from a general oncology practice with no selection as to malignancy, therapy, or demographics. An ASD self-reporting screening tool modeled after Bryant was used, with additional questions regarding the patient's understanding, self perception of needs, and willingness to share results with their physician. Patients diagnosed, or receiving first chemotherapy, within 30 days were eligible. RN staff reviewed the consent and questionaire. Participating patients completed the questionaire and scoring of symptom severity. Results were compiled for 1) positive screening question for stress, 2) dissociative cluster (SDC) score, and 3) re-experience, avoidance, arousal cluster (REAAC) score. No specific intervention was prescribed. Results were shared with the treating physician if the patient agreed. Results: 100 patients consented. 96 completed the survey. 20.8% had diagnostic criteria for ASD, 29.3% had SDC and REAAC symptom complexes compatible with ASD, and 51% had REAAC scores consistent with ASD. 64% of patients with ASD criteria or symptomatic criteria but negative screening question requested that the results not be shared with their physician. Eleven nurses assisted patients' participation. Five medical oncologists cared for patients on study. All had patients who agreed and declined sharing results. Conclusions: The prevalence of ASD symptoms in this population is consistent with the rates reported in a more homogenous oncology population, and represents a major supportive care issue. Many patients have significant symptoms that do not fulfill diagnostic criteria for ASD. A substantial portion of symptomatic patients surveyed in this study with this questionnaire did not want to share their symptoms with treating physicians. Screening and multiple means of assessment may be warranted for all new oncology patients. No significant financial relationships to disclose.
Etiological diagnosis of hypersomnia: Which data can we use?
Authors: Inês Franco, Idália Esteves, Ana Antunes, Franco Inês
Journal: European Respiratory Journal (2014)

Hypersomnia is a frequent reason for sleep consultation request and often the etiologic diagnosis is difficult to make.  The aim of this study was to evaluate whether there is a relation between clinical data, multiple sleep latency test (MSLT) findings and polysomnography (PSG) parameters and the etiological diagnosis of hypersomnia that could aid diagnosis achievement.  Retrospective study of patients observed in our outpatient sleep consultation between 2011 and 2013 with clinical diagnosis of hypersomnia. All patients performed PSG and MSLT. We performed a comparative analysis of gender, age, BMI, Epworth sleepiness scale (ESS), MSLT data (mean sleep latency and SOREM number) and PSG parameters between different hypersomnia diagnoses: idiopathic hypersomnia (IH), insufficient sleep syndrome (ISS), narcolepsy, depressive disorder (DD), sleep-related movement disorders (SRMD), circadian rhythm sleep disorders (CRSD), insomnia and sleep apnea syndrome (SAS).  We included 85 patients, mostly female (n=46, 54.1%), with a mean age of 49.5+12.8 years. More frequent diagnoses were IH (N=20, 23.5%), DD (N=19, 22.4%) and ISS (N=13, 15.3%). We found significant differences respecting gender (IH and DD associated with female gender vs. ISS and CRSD with male, p=0.001); age (insomnia and ISS associated with younger age versus SAS and narcolepsy, p=0.001); sleep efficiency (p=0.007) and No-REM sleep latency (p=0.002), both higher in narcolepsy and ISS and lower in insomnia. No differences were found on the remaining data analyzed between different diagnoses.  Most of the clinical, MSLT and PSG data were not associated with the etiological diagnosis of hypersomnia, being essential the realization of a good medical history.
The frequency of exacerbations in COPD patients and its influence on the effects of pulmonary rehabilitation
Authors: Michael Wittmann, Danijel Jelusic, Michael Schuler, Konrad Schultz
Journal: European Respiratory Journal (2014)

Background: The 2011 GOLD classification requires a history of exacerbations during the previous year. Does this history influence the results of rehabilitation, which is a cornerstone of treating COPD?

Methods: 344 COPD patients in PR with GOLD stage II-IV were asked for the number of exacerbations, defined by the need for oral steroids or antibiotics, and for at least one hospitalization in the last 12 months. We measured the 6MWD, the quality of life (CAT) and the BODE score at the start and at the end of a 3-week inpatient rehabilitation programme and calculated the Standardized Response Mean (SRM)

Results: Patients (57.5±6.8 years, 63.3% male; 38.4% GOLD II, 37.9% GOLD III, 23.7% GOLD IV) were grouped for exacerbation frequency from 0 to at least 4 and additionally the patients with at least one hospitalization. There was no relevant difference between the SRM of all the outcome parameters.

![Figure][1] 



Discussion: With higher frequency of AECOPD the 6MWD, CAT and BODE score slowly deteriorate. Nevertheless, all groups improve to a similar extent from a 3-week inpatient pulmonary rehabilitation. Therefore one or more AECOPD in the last year are not negative predictors of rehabilitation outcome.

 [1]: pending:yes
Pain management at the point-of-care
Authors: K. Darabi, A. Desai
Journal: Journal of Clinical Oncology (2004)

8072 Background: To assure a high level of quality in oncologic pain management, careful assessment of a multitude of clinical parameters and their change over time is necessary, which is usually documented on paper forms. Instead of using a pen and paper-based method, a computer-based method may increase efficiency. However, as pain therapy and its documentation take place at the bedside, a traditional PC application seems not feasible. Our aim was to develop a system which includes a mobile component which would run on PDA computers in addition to PC based software, and assist physicians and other team members to view, enter and assess the condition of the patient's pain and the details of its management. The purpose of this study was to evaluate whether the implementation of this system resulted in improvement of the quality of pain management. Methods: Health care providers using this system have access to several modules. The module on physical examination for example contains various opiate side effects like miosis, pruritus, nausea, hypotension or signs and symptoms of thrombophlebitis in patients on intravenous therapy. Data entered during rounds into the handheld are subsequently synchronized with a PC. The system interfaces to PCA pumps in order to read out pump parameters and events such as delivery, occlusion or denial of a patient controlled bolus. Upon readmission, all previous management parameters and events are available. A pilot questionnaire was developed to evaluate the perceived utility of the PDA-system and the assessment and management results generated by using it compared to the paper-based method. Results: Among the study participants the system was found to be very helpful by 42%, helpful by 39%, somewhat helpful by 17% and not helpful by 2%. Statistically significant results included a higher likelihood of documentation of medication side effects with the PDA-system and a shorter total encounter time (including chart review etc.) when compared with the paper-based method. Conclusions: These results suggest that a PDA-system may enhance the quality of pain management in an inpatient oncology setting by improving the documentation of adverse effects and reducing the amount of time needed for chart review. No significant financial relationships to disclose.
Differential Expression of Metastasis-Associated Genes in Papilla of Vater and Pancreatic Cancer Correlates With Disease Stage
Authors: Helmut Friess, Xiao-Zhong Guo, Adrien A. Tempia-Caliera, Akira Fukuda, Marcus E. Martignoni, Arthur Zimmermann, Murray Korc, Markus W. Büchler
Journal: Journal of Clinical Oncology (2001)

PURPOSE: Papilla of Vater cancer has a much better prognosis than pancreatic cancer. It is not known whether this is the result of differences in the tumor biology of the two malignancies. Because metastasis formation is a critical step in tumor progression and a negative prognostic factor, we compared the expression of nm23-H1 and KAI1, two metastasis-suppressing genes, in papilla of Vater cancer and pancreatic cancer. PATIENTS AND METHODS: Analysis was performed in nine normal human papilla of Vater samples, 27 papilla of Vater cancers, 16 normal pancreatic samples, and 29 pancreatic cancers. Expression of nm23-H1 and KAI1 was analyzed by Northern blot analysis and in situ hybridization. In addition, immunohistochemistry was performed to localize the respective proteins. RESULTS: There was no difference in nm23-H1 and KAI1 mRNA expression levels in normal versus cancerous papilla of Vater samples. In contrast, nm23-H1 and KAI1 RNA expression was upregulated in early tumor stages of pancreatic cancer and reduced in advanced tumor stages. When expression of nm23-H1 and KAI1 RNA was analyzed by use of in situ hybridization, normal epithelial cells of the papilla of Vater exhibited mRNA staining intensity similar to that of papilla of Vater cancer cells. Similar levels of nm23-H1 and KAI1 immunoreactivity also were observed in these samples. In contrast, early stage pancreatic cancer samples exhibited stronger nm23-H1 and KAI1 immunoreactivity than normal controls. Furthermore, early pancreatic cancer stages exhibited higher KAI1 and nm23-H1 immunostaining than advanced tumor stages. CONCLUSION: Differences in the expression patterns of the two tumor suppressor genes nm23-H1 and KAI1 may contribute to the different prognoses of papilla of Vater cancer and pancreatic cancer. Our findings support the hypothesis that biologic differences rather than earlier diagnosis influence the different outcomes of these two tumor entities.
Doing More for More: Unintended Consequences of Financial Incentives for Oncology Specialty Care
Authors: Brock O’Neil, Amy J. Graves, Daniel A. Barocas, Sam S. Chang, David F. Penson, Matthew J. Resnick
Journal: JNCI Journal of the National Cancer Institute (2015)

Specialty care remains a significant contributor to health care spending but largely unaddressed in novel payment models aimed at promoting value-based delivery. Bladder cancer, chiefly managed by subspecialists, is among the most costly. In 2005, Centers for Medicare and Medicaid Services (CMS) dramatically increased physician payment for office-based interventions for bladder cancer to shift care from higher cost facilities, but the impact is unknown. This study evaluated the effect of financial incentives on patterns of fee-for-service (FFS) bladder cancer care. Data from a 5% sample of Medicare beneficiaries from 2001–2013 were evaluated using interrupted time-series analysis with segmented regression. Primary outcomes were the effects of CMS fee modifications on utilization and site of service for procedures associated with the diagnosis and treatment of bladder cancer. Rates of related bladder cancer procedures that were not affected by the fee change were concurrent controls. Finally, the effect of payment changes on both diagnostic yield and need for redundant procedures were studied. All statistical tests were two-sided. Utilization of clinic-based procedures increased by 644% (95% confidence interval [CI] = 584% to 704%) after the fee change, but without reciprocal decline in facility-based procedures. Procedures unaffected by the fee incentive remained unchanged throughout the study period. Diagnostic yield decreased by 17.0% (95% CI = 12.7% to 21.3%), and use of redundant office-based procedures increased by 76.0% (95% CI = 59% to 93%). Financial incentives in bladder cancer care have unintended and costly consequences in the current FFS environment. The observed price sensitivity is likely to remain a major issue in novel payment models failing to incorporate procedure-based specialty physicians.
Tumor-associated antigens--an overview.
Authors: J R Zalcberg, I F McKenzie
Journal: Journal of Clinical Oncology (1985)

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.1985.3.6.876 Journal of Clinical Oncology - published online before print September 22, 2016 PMID: 2409242 Tumor-associated antigens--an overview. J R ZalcbergxJ R ZalcbergSearch for articles by this author , I F McKenziexI F McKenzieSearch for articles by this author https://doi.org/10.1200/JCO.1985.3.6.876 First Page PDF © 1985 by American Society of Clinical Oncology
Effects of Sodium Warfarin and Sodium Heparin Plus Anticancer Agents on Growth of Rat C&lt;sub&gt;6&lt;/sub&gt; Glioma Cells&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;
Authors: Nancy O. McNiel, Lee Roy Morgan, Jr.
Journal: JNCI Journal of the National Cancer Institute (1984)

The effects of racemic sodium warfarin (warfarin) and sodium heparin (heparin) on brain tumor cells were assessed in the rat C6 glioma cell line. After anticoagulant treatment lasting up to 5 days, cell growth was not inhibited by warfarin at low doses (10−4 to 10−5M), but both cell growth and cellular adherence to culture plates were inhibited at high doses (10−3 to 10−2M). Sodium heparin, even at high doses, did not affect cell growth or adherence. Warfarin (10−3M) significantly decreased and heparin (12.6 U/ml) had no effect on [3H]thymidine and [14C]leucine incorporation after 3- or 24-hour anticoagulant treatment. Colony formation studies examined the effects of 24-hour warfarin (10−3M) or heparin (12.6 U/ml) pretreatment plus a 2-hour incubation with one of seven anticancer agents. Supraadditive toxic effects were produced by warfarin plus chlorambucil, heparin plus chlorambucil, heparin plus carmustine, and heparin plus teniposide. At low doses of warfarin (10−5M) or heparin (0.126 U/ml), heparin plus carmustine and heparin plus teniposide remained synergistic.
Phase I trial of 3-hour infusion of paclitaxel with or without granulocyte colony-stimulating factor in patients with advanced cancer.
Authors: J H Schiller, B Storer, K Tutsch, R Arzoomanian, D Alberti, C Feierabend, D Spriggs
Journal: Journal of Clinical Oncology (1994)

PURPOSE We conducted a phase I trial of a 3-hour infusion of Taxol (paclitaxel; Bristol-Myers Squibb Co, Princeton, NJ) to identify the maximum-tolerated dose of Taxol as a 3-hour infusion with and without granulocyte colony-stimulating factor (G-CSF) support. MATERIALS AND METHODS Thirty-five patients with advanced, untreatable malignancies were treated with a 3-hour infusion of Taxol once every 3 weeks. Groups of three patients were entered at escalating dose levels of Taxol in a traditional phase I design in each of two parallel arms: arm A, without G-CSF, and arm B, with G-CSF. Patients assigned to the G-CSF arm received G-CSF 5 micrograms/kg/d subcutaneously starting on day 2 for 9 to 14 days. All patients were pretreated with dexamethasone, diphenhydramine, and ranitidine, and were monitored continuously for cardiac arrhythmias during the first treatment. RESULTS Dose-limiting myelosuppression with Taxol without G-CSF was observed at the 250-mg/m2 dose level. The dose-limiting toxicity for Taxol with G-CSF was peripheral neuropathy at the 300-mg/m2 dose level. One of 35 patients (2.8%) had a grade 3 anaphylactic reaction at 250 mg/m2. No clinically significant cardiac arrhythmias were documented. Twenty-seven of 111 courses (24%) were associated with grade 3 arthralgias or myalgias requiring narcotics for pain control. Taxol plasma concentrations declined in a triexponential fashion, with a final elimination half-life of 10 to 12 hours. The peak Taxol plasma concentrations and total area under the curve (AUC) increased with increasing doses of Taxol, although this increase appeared to be somewhat nonlinear. CONCLUSION The maximum dose of Taxol recommended for phase II and III studies, when administered as a 3-hour infusion alone and with G-CSF support, is 210 mg/m2 and 250 mg/m2, respectively. No increased incidence of hypersensitivity reactions or other side effects were observed, with the possible exception of arthralgias and myalgias. If ongoing trials demonstrate that a 3-hour infusion is as efficacious as a 24-hour infusion, we conclude that with proper monitoring and premedication, high-dose Taxol can be safely administered in the outpatient setting.