tbuckley/cabot-search huggingface dataset:
Paclitaxel in patients (pts) with advanced angiosarcomas
Authors: M. Schlemmer, P. Reichardt, J. Verweij, J. T. Hartmann, I. Judson, A. Thyss, J. Y. Blay
Journal: Journal of Clinical Oncology (2007)

10033 Background: Angiosarcomas represent a heterogenous group of rare sarcomas with specific clinical behaviour and risk factors. Paclitaxel has been suggested to induce tumor control in a proportion of pts with angiosarcoma while being inactive in other soft tissue sarcomas subtypes. The objective of this retrospective study was to investigate the antitumor activity of this compound in a larger series and a multicenter setting. Patients and Methods: Data from pts with angiosarcoma treated with paclitaxel in centers of the EORTC Soft Tissue and Bone Sarcoma Group were collected using a standardized data collection form. Results: Data from 32 pts were collected from 10 centers. There were 17 males and 15 females with a median age of 60.4 years (range 24–91). Eight pts (25%) had angiosarcomas of the face and scalp, 24 pts (75%) at other primary sites. Ten (31 %) pts had a previous cancer history, 7 of whom had been irradiated for breast cancer. Ten (31 %) pts had received 1 st line chemotherapy (ctx) and 3 pts 2 nd line ctx prior to treatment with paclitaxel. All 13 (40%) pretreated pts had doxorubicin, 5 pts in combination with ifosfamide as 1 st line and 3 pts ifosfamide as 2 nd line ctx. 21 (66 %) pts received paclitaxel 175 mg/m 2 every 3 weeks, and 11 (34 %) received 75–100 mg/m 2 weekly. The overall response rate (RR) was 62.5 % [including 1 CR (3%) and 19 PR (59%)]; in pts with face and scalp primary sites the RR was 75% (1CR, 5 PR), whereas pts with angiosarcoma at other sites achieved a response in 58% (14 PR). PFS was 7.6 months for all 32 pts. Conclusion: Paclitaxel was an active agent in angiosarcoma in this retrospective multicenter study, also in angiosarcoma originating at other sites than scalp and face. These results need to be confirmed in a controlled, prospective phase II study. No significant financial relationships to disclose.
Abstract 9459: Mitral Valve Prolapse-Related Cardiomyopathy
Authors: Eduard Malev, Eduard Zemtsovsky, Asiyet Pshepiy, Svetlana Reeva, Aleksandra Korshunova
Journal: Circulation (2012)

Purpose: In some inherited connective tissue diseases with involving of the cardiovascular system, e.g. Marfan syndrome has been reported early impairment of LV function, which has been described as Marfan-related cardiomyopathy. Our aim was to evaluate the LV function in young adults with mitral valve prolapse (MVP) without significant mitral regurgitation using two-dimensional strain imaging and the possible role of transforming growth factor-β (TGF-β) pathway in its deterioration. Methods: We studied 78 asymptomatic young subjects (mean age 19.7±1.6, 72% male) with MVP in comparison with 80 sex- and age-matched healthy subjects. Longitudinal strain and strain rate (SR) were determined from three apical views, using spackle tracking (Vivid 7 Dimension, EchoPAC’08) with grey-scale frame rate 50-55/sec. Concentrations of TGF-β 1 and β 2 in serum were determined by enzyme-linked immunosorbent assay using a test system Human Platinum ELISA. Results: During the k-means clustering we have identified two clusters of subjects with MVP: first cluster (17 subjects, 28% of the MVP group) and second cluster (61 subjects, 72%). In 1st cluster observed a significant reduction of global systolic strain compared with the control group (-15.5±2.9% vs. -19.6±3.4%; p=0.00001) and the 2nd cluster (-15.5±2.9% vs. -20.6±3.8%; p=0.00001). Diastolic global SR was also decreased compared with the control group (1.3±0.25/s vs. -1.62±0.25/s; p=0.0001) and the 2nd cluster (1.3±0.25/s vs. 1.62±0.25/s; p=0.00001). Global strain in the second cluster did not differ significantly from the control group (p=0.1), but there are significant decrease of local longitudinal systolic strain (-17.1±3.2% vs. -20.7±3.1%; p=0.001) and diastolic SR (1.38±0.25/s vs. 1.55±0.22/s; p=0.00001) in interventricular septum. In first cluster high TGF-β 1 serum level (&gt;14.75 ng/ml) was detected in 2 subjects, TGF-β 2 (&gt;2.0 ng/ml) in 11, and both TGF-β 1 /β 2 in one subject. In 2nd cluster high TGF-β 2 level observed only in 10 subjects (χ 2 =41.1; p=0.00001). Conclusions: These changes of deformation may be the first signs of deterioration of the LV function in young adults with MVP, which may be caused by increased TGF-β signaling and myocardial fibrosis.
Sexual function in male lymphoma survivors versus matched controls: Relationship to age, gonadal hormones, and quality of life
Authors: C. E. Kiserud, L. R. Schover, A. Fossaa, A. A. Dahl, J. H. Loge, T. Bjoero, H. Holte, Y. Yuan, S. D. Fossaa
Journal: Journal of Clinical Oncology (2009)

9510 Background: Sexual function in male lymphoma survivors (LS) was examined and compared to age-matched controls from the general population (CTR). Methods: The study includes 294 LSs, diagnosed 1980–2002, treated at the Norwegian Radium Hospital, ≤50 years at diagnosis, with recent gonadal hormone levels [testosterone (T), SHBG, LH, and FSH]. Sexual function was assessed using the Brief Male Sexual Function Inventory (BSFI) consisting of 11 self-report items covering five domains: sexual drive, erectile function, ejaculatory function, problem assessment and overall satisfaction. Lower scores indicate impaired sexual function. A total BSFI score (T-BSFI) was constructed by summing all items except overall satisfaction. Mean and median scores for the BSFI domains and T-BSFI were compared across age groups (21–39, 40–49, 50–59, 60–69 years at survey), gonadal hormone levels [normal (n=144), elevated FSH only (n=60), low T and/or elevated LH (n=90)], cancer treatment intensity, comorbidity, relationship status, fatigue score, mental distress (HADS) and quality of life (SF-36, mental and physical health components). Multivariate linear regression analysis was performed with T-BSFI as the dependent variable including independent variables significant in univariate analyses. Each LS was matched to two CTRs (n=506). Results: Valid T-BSFI scores were available for 253 LSs (86%). Median age at survey was 48 years, median duration of follow-up 15 years, and 78% were in a committed relationship. LSs aged 40–59 years had significantly lower T-BSFIs compared to their CTRs (p≤0.01). All BSFI domain scores and T-BSFI decreased significantly with ageing. LSs with low T and/or elevated LH had the lowest BSFI domain and T-BSFI scores. Survivors with normal hormone levels had the highest scores. Low T and/or elevated LH (p=0.03), age ≥50 years at survey (p≤ 0.001) and mental distress (p&lt; 0.001) were significantly associated with male sexual dysfunction (T-BSFI) in the multivariate analysis. Conclusions: LSs aged 40–59 years reported poorer sexual function than age-matched CTRs. Impaired sexual function was significantly associated with age ≥ 50 years at survey, having low T and/or elevated LH and being distressed. No significant financial relationships to disclose.
Abstract 15783: Diagnostic and Prosnogtic Value of Late Contras-Enhanced Magnetic Resonance in Acute Myopericarditis
Authors: Rosa M Jimenez, Jose M Serrano, Carmen CristObal, Jorge Cabezudo, Pedro L Talavera, Alejandro Curcio, Catherine Graupner, JoaquIn J Alonso
Journal: Circulation (2012)

Cardiac magnetic resonance (CMR) has become the primary non invasive tool for assessment of myocardial inflammation in patients with suspected acute myocarditis (AM). However its role in the prognosis of myocarditis has not yet been investigated. The aim of this study was to evaluate the incremental diagnostic and prognostic value of cardiac magnetic resonance in patients with AM. Methods: Prospective and clinical observational cohort study of 75 consecutive patients (mean age 33±14 years, 84% male) with AM underwent contrast-enhanced CRM within first month after admission, enrolled between June 2006 and 31 December 2011 Results: Mean follow-up was 72±14 months. Areas of late gadolinium enhancement (LE) were observed in 51 patients (68%) with a subepicardial and focal LE pattern. Forty patients (53%) showed LE in the lateral segments of the left ventricular wall. The median troponin I level and median CK level were associated with LE and the percentage of myocardial mass with LE (R spearmen of 0,71; p<0,0...
Chronic antiplatelet therapy is not associated with alterations in the presentation, outcome, or host response biomarkers during sepsis: a propensity-matched analysis
Authors: Maryse A. Wiewel, Sacha F. de Stoppelaar, Lonneke A. van Vught, Jos F. Frencken, Arie J. Hoogendijk, Peter M. C. Klein Klouwenberg, Janneke Horn, Marc J. Bonten, Aeilko H. Zwinderman, Olaf L. Cremer, Marcus J. Schultz, Tom van der Poll
Journal: Intensive Care Medicine (2016)

Sepsis is a major health burden worldwide. Preclinical investigations in animals and retrospective studies in patients have suggested that inhibition of platelets may improve the outcome of sepsis. In this study we investigated whether chronic antiplatelet therapy impacts on the presentation and outcome of sepsis, and the host response.We performed a prospective observational study in 972 patients admitted with sepsis to the mixed intensive care units (ICUs) of two hospitals in the Netherlands between January 2011 and July 2013. Of them, 267 patients (27.5%) were on antiplatelet therapy (95.9% acetylsalicylic acid) before admission. To account for differential likelihoods of receiving antiplatelet therapy, a propensity score was constructed, including variables associated with use of antiplatelet therapy. Cox proportional hazards regression was used to estimate the association of antiplatelet therapy with mortality.Antiplatelet therapy was not associated with sepsis severity at presentation, the primary source of infection, causative pathogens, the development of organ failure or shock during ICU stay, or mortality up to 90 days after admission, in either unmatched or propensity-matched analyses. Antiplatelet therapy did not modify the values of 19 biomarkers providing insight into hallmark host responses to sepsis, including activation of the coagulation system, the vascular endothelium, the cytokine network, and renal function, during the first 4 days after ICU admission.Pre-existing antiplatelet therapy is not associated with alterations in the presentation or outcome of sepsis, or the host response.
Chemotherapy-induced nausea and vomiting-associated hospital and ER visits in real-world practice: Palonosetron versus other 5-HT<sub>3</sub>-RA anti-emetic regimens.
Authors: H. T. Hatoum, S. Lin, D. Buchner, D. Cox
Journal: Journal of Clinical Oncology (2010)

9127 Background: Palonosetron (2nd generation 5-HT3-RA) and dolasetron, granisetron, and ondansetron (1st generation 5-HT3-RAs) are indicated to prevent chemotherapy induced nausea and vomiting (CINV). This study compares risk of CINV associated with a hospital or emergency room (ER) event in patients with lung cancer initiated on cisplatin-based chemotherapy (CT) and started and maintained on palonosetron for CINV prevention throughout all cycles of CT vs. any other 5-HT3-RA based strategy for anti-emetic prophylaxis. Methods: Claims data (PharMetrics) of continuously enrolled adult patients diagnosed with lung cancer and treated with cisplatin-based chemotherapy(index CT) between 2005 and 2008 were identified. Patients enrolled for at least 6 months before and after their index CT were stratified into one of two groups based on the 5-HT3-RA regimen: palonosetron throughout all cycles of CT (Group 1) vs. any other 5-HT3-RA based regimen (Group 2). CINV events were identified from ER and hospitals claims with ICD-9 codes of nausea, vomiting, and/or dehydration. The two groups were compared in the 6 month follow-up on risk of CINV using standard statistical 2-sided tests and logistic and Poisson regression models controlling for age, gender, comorbidity, and CT treatment days. Results: 1,692 patients were identified, with 390 (or 23%) in Group 1. All patients received ≥ 1 cisplatin-based chemotherapy cycles and were of comparable age (60 years). Group 1 incurred fewer 5-HT3-RA claims (mean±SD 6.43±4.42 vs. 12.44±6.54, p<0.001), and was less likely to be treated with dexamethasone and/or neurokinin1-receptor antagonists (48.97% vs. 54.45%, Chi-square p=0.057). In the follow-up period, Group 1 was less likely to have CINV (16.41% vs. 22.58%, p<0.01), and had fewer mean hospital/ER days with CINV (p<0.02). Risk for CINV was 31% lower in patients treated with palonosetron (Odds Ratio=0.69, p<0.05). Conclusions: Patients with lung cancer receiving cisplatin-based CT initiated and maintained on palonosetron experienced significantly lower risk for costly CINV than patients receiving any other strategy for 5- HT3-RA-based CINV prophylaxis. Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Eisai Eisai
British Thoracic Society community acquired pneumonia guideline and the NICE pneumonia guideline: how they fit together
Authors: W. S. Lim, D. L. Smith, M. P. Wise, S. A. Welham
Journal: Thorax (2015)

The British Thoracic Society (BTS) guideline for the management of adults with community acquired pneumonia (CAP) published in 2009 was compared with the 2014 National Institute for Health and Care Excellence (NICE) Pneumonia Guideline. Of the 36 BTS recommendations that overlapped with NICE recommendations, no major differences were found in 31, including those covering key aspects of CAP management: timeliness of diagnosis and treatment, severity assessment and empirical antibiotic choice. Of the five BTS recommendations where major differences with NICE were identified, one related to antibiotic duration in low and moderate severity CAP, two to the timing of review of patients and two to legionella urinary antigen testing.
Expanded Evidence for Frozen Fecal Microbiota Transplantation for<i>Clostridium difficile</i>Infection
Authors: Preeti N. Malani, Krishna Rao
Journal: JAMA (2016)

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Abstract 19469: Outcomes in Extended-Criteria Caradiac Transplantation: A 10-Year Experience
Authors: Ashleigh A Owen, Marc Samsky, Chetan Patel, Adrian F Hernandez, Jacob Jentzer, Phillip Schulte, G. M Felker, Paul B Rosenberg, Carmelo A Milano, Joseph G Rogers
Journal: Circulation (2012)

INTRODUCTION: Extended criteria cardiac transplant (ECCT) provides cardiac replacement therapy in patients (pts) with end-stage heart failure who are ineligible for standard criteria transplantation (SCCT). While ECCT provides lower survival, short term outcomes are adequate for pts with advanced age or comorbidities. Long term outcomes after ECCT have not been defined and determining clinical variables associated with improved survival after ECCT will improve risk stratification. METHODS: 454 pts undergoing cardiac transplantation at Duke University Medical Center from January 2000 until December 2009 were retrospectively analyzed. Each patient was identified as either SCCT (n=370) or ECCT (n=84). Baseline clinical variables included demographics, renal function, and need for circulatory support prior to transplant. Comparisons were made between SCCT and ECCT patients pre-transplant and at years 1 and 5. Survival analysis was performed using standard Kaplan-Meier methods. A Cox proportional hazards model was developed to identify predictors of survival. RESULTS: Significant differences (P&lt;0.001) in clinical variables between SCCT and ECCT groups included age (53 y vs 66 y), presence of diabetes (25% vs 46%) and ischemic disease (43% vs 70%). Renal function was worse in the ECCT group when assessed by BUN (19 vs 25, p&lt;0.001) but serum creatinine (Cr) was equivalent (1.2 vs 1.3, p=0.027). Mean follow up was 4.7 years and survival is shown in Figure 1. Only serum Cr prior to transplant had a statistically significant effect on survival regardless of the criteria used (p=0.001, HR 1.7, 95% CI 1.25, 2.30). CONCLUSION: ECCT pts have lower survival than SCCT pts and this risk persists after adjusting for covariates. Serum Cr is an independent predictor of survival in all transplant recipients. Given the detrimental impact of transplant medications on renal function, consideration of Cr should be incorporated in to risk-stratification for patients undergoing ECCT.
Abstract 16399: The Association Between the Volume of Lipid-rich Plaque and the Amount of Debris Captured by a Filter-Type Distal Protection Device in Patients After Coronary Stent Implantation
Authors: Katsuhide Kitagawa
Journal: Circulation (2012)

Background Disruption of atherosclerotic plaque by balloon or stent expansion and distal embolism may be a major cause of periprocedural myocardial injury during percutaneous coronary intervention ...
Building a Rapid Learning Health Care System for Oncology: Why CancerLinQ Collects Identifiable Health Information to Achieve Its Vision
Authors: Alaap Shah, Andrew K. Stewart, Andrej Kolacevski, Dina Michels, Robert Miller
Journal: Journal of Clinical Oncology (2016)

The ever-increasing volume of scientific discoveries, clinical knowledge, novel diagnostic tools, and treatment options juxtaposed with rising costs in health care challenge physicians to identify, prioritize, and use new information rapidly to deliver efficient and high-quality care to a growing and aging patient population. CancerLinQ, a rapid learning health care system in oncology, is an initiative of the American Society of Clinical Oncology and its Institute for Quality that addresses these challenges by collecting information from the electronic health records of large numbers of patients with cancer. CancerLinQ is first and foremost a quality measurement and reporting system through which oncologists can harness the depth and power of their patients’ clinical records and other data to assess, monitor, and improve the care they deliver. However, in light of privacy and security concerns with regard to collection, use, and disclosure of patient information, this article addresses the need to collect protected health information as defined under the Health Insurance Portability and Accountability Act of 1996 to drive rapid learning through CancerLinQ.
Effect of aclidinium bromide on exacerbations in patients with moderate-to-severe COPD: Pooled analysis of phase III studies
Authors: Jadwiga A. Wedzicha, Gavin Donaldson, Ferran Chuecos, Esther Garcia Gil
Journal: European Respiratory Journal (2014)

Background   This analysis investigated the effect of twice-daily aclidinium 400 µg on exacerbation rates in patients with COPD.   Methods   Aclidinium 400 µg and placebo data from five randomised, double-blind, Phase III studies were analysed by GOLD 2013 groups. Prior exacerbation was not an inclusion criterion. Exacerbations (reported and unreported) were assessed by healthcare resource utilisation (symptom increase on ≥2 consecutive days requiring treatment change).   Results   Of 2521 patients, 2459 were classified by GOLD group (A=8.1%; B=47.9%, C=2.6% and D=41.4% [82.5% of D had FEV 1     Conclusion   Aclidinium significantly reduced the rate of moderate-to-severe and exacerbations of any severity vs placebo for all patients and particularly those in GOLD Group B+D.
Pneumonia and Clostridium difficile infection: Hospital acquired infection in a non-ICU department
Authors: Maria Carrabba, Marina Zarantonello, Simone Formica, Luca Mellace, Silvana Castaldi, Maria Domenica Cappellini, Giovanna Fabio
Journal: European Respiratory Journal (2012)

The antibiotic use for pneumonia treatment contributes to the worldwide spreading of Clostridium difficile infection (CDI). Among all hospital acquired infections, CDI is an emerging cause of hospital morbidity, mortality and costs.  We investigated the prevalence of CDI acquisition rates in patients hospitalized with pneumonia and compared all causes of inhospital mortality among patients with and without CDI.  The study considered all patients admitted to Internal Medicine Dept. of a tertiary care university hospital in Milan between 2007 to 2010. Analysis based on aggregated hospital routine data using the ICD-9-codes indicating pneumonia and CDI.  Results  Among 3560 hospital admissions, 17.9% had a diagnosis of pneumonia, 3.9% of CDI. Among overall CDI, pneumonias were 35.5%, while CDI among averall pneumonias were 7.7%. The patients with both illness were older (81.8 yrs) and had a longer lengh-of-stay (30.2 d). In-hospital mortality was 26.5% in the group with both pneumonia and CDI, higher than in the other groups (pneumonia 17.7%, CDI 11.2%).  It is well-known that antibiotic therapy for pneumonia, mainly based on newer fluoroquinolones, b-lactams and macrolides, combined with high-dose or long-term use of proton pump inhibitor drugs increase the risk of CDI. Our data suggest that CDI could be a very common etiology of hospital acquired infection also in non-ICU and non-outbreak setting with low endemic rate.
Smooth Muscle Cell–targeted RNA Aptamer Inhibits Neointimal Formation
Authors: William H Thiel, Carla L Esposito, David D Dickey, Justin P Dassie, Matthew E Long, Joshua Adam, Jennifer Streeter, Brandon Schickling, Maysam Takapoo, Katie S Flenker, Julia Klesney-Tait, Vittorio de Franciscis, Francis J Miller, Paloma H Giangrande
Journal: Molecular Therapy (2016)

Inhibition of vascular smooth muscle cell (VSMC) proliferation by drug eluting stents has markedly reduced intimal hyperplasia and subsequent in-stent restenosis. However, the effects of antiproliferative drugs on endothelial cells (EC) contribute to delayed re-endothelialization and late stent thrombosis. Cell-targeted therapies to inhibit VSMC remodeling while maintaining EC health are necessary to allow vascular healing while preventing restenosis. We describe an RNA aptamer (Apt 14) that functions as a smart drug by preferentially targeting VSMCs as compared to ECs and other myocytes. Furthermore, Apt 14 inhibits phosphatidylinositol 3-kinase/protein kinase-B (PI3K/Akt) and VSMC migration in response to multiple agonists by a mechanism that involves inhibition of platelet-derived growth factor receptor (PDGFR)-β phosphorylation. In a murine model of carotid injury, treatment of vessels with Apt 14 reduces neointimal formation to levels similar to those observed with paclitaxel. Importantly, we confirm that Apt 14 cross-reacts with rodent and human VSMCs, exhibits a half-life of ~300 hours in human serum, and does not elicit immune activation of human peripheral blood mononuclear cells. We describe a VSMC-targeted RNA aptamer that blocks cell migration and inhibits intimal formation. These findings provide the foundation for the translation of cell-targeted RNA therapeutics to vascular disease.
TCT-542 Axial Integrity of Coronary Stents: Evaluation Using Intravascular Ultrasound
Authors: Danny Dvir, Hironori Kitabata, Israel Barbash, Joshua Loh, Rebecca Torguson, Salem Badr, Lowell Satler, Augusto Pichard, Ron Waksman
Journal: Journal of the American College of Cardiology (2012)