tbuckley/cabot-search huggingface dataset:
Symptom distress and symptom clusters in underserved Chinese-American cancer patients.
Authors: Lara Dhingra, Kin Y. Lam, William Cheung, Theresa H. Shao, Zujun Li, Sandra Van de Maele, Victor Tsu-Shih Chang, Jack Chen, Huiyan Ye, Rhoda Wong, Wan Lam, Selina Chan, Marilyn Bookbinder, Nathan Dieckmann, Russell Portenoy
Journal: Journal of Clinical Oncology (2014)

27 Background: Cancer is prevalent in the rapidly-growing Chinese-American community, yet little is known about symptom burden to guide comprehensive treatment planning. We evaluated symptom distress and symptom clusters in a large sample of Chinese-American patients with cancer. Methods: Patients were consecutively recruited from four oncology practices and completed a translated cancer symptom scale. Latent class cluster analysis explored symptom distress clusters in patients. Results: Of 1,436 patients screened, 94.4% were non-English speaking and 45.1% were undergoing active cancer therapy. The most common cancer sites were breast (32.6%), lung (14.8%), head and neck (12.5%), and hematologic (10.1%). Overall, 1,289 (89.8%) patients had &gt; 1 symptom and 1,129 (78.6%) patients had &gt; 2. The most prevalent symptoms were lack of energy (57.0%), dry mouth (55.6%), feeling sad (49.3%), worrying (47.5%), and difficulty sleeping (46.8%). Symptoms causing “quite a bit” or “very much” distress included: difficulty sleeping (37.9%), lack of appetite (37.2%), feeling nervous (35.8%), pain (35.2%), and worrying (34.0%). Four symptom distress clusters were identified: very low physical and psychological symptom distress (49.5%); very low physical and moderate psychological symptom distress (25.2%); moderate physical and psychological symptom distress (17.4%), and high physical and psychological symptom distress (7.8%). Patients in the last group reported lack of energy, difficulty sleeping, pain, feeling sad, and worrying. Conclusions: Symptom prevalence is high in community-dwelling, Chinese-American cancer patients and half experience moderate to high distress from clusters of physical symptoms, psychological symptoms, or both. These data have important implications for the development of effective interventions for symptom control.
Time to onset of progression after imatinib interruption and outcome of patients with advanced GIST: Results of the BFR14 prospective French Sarcoma Group randomized phase III trial.
Authors: A. Le Cesne, I. Ray-Coquard, N. Bin Bui, A. Adenis, M. Rios, F. Duffaud, F. Bertucci, S. Chabaud, J. Emile, J. Blay
Journal: Journal of Clinical Oncology (2010)

10033 Background: We previously demonstrated that IM must not be interrupted after 1 and 3 years (yr) in responding patients (pts) and has to be given continuously until disease progression (PD) or intolerance. The impact of the IM-free interval and pattern of GIST mutations on the subsequent outcome of patients remains unknown. Methods: Fifty-seven responding pts to IM (400mg/d) were randomized in the interruption arms of the BFR14 randomized phase III trial. IM was reintroduced in case of PD (same dose). The median PFS after IM rechallenge was analyzed according to the duration of treatment interruption (>6 months (m), 6 to 12 m, >12 m) and the patterns of GIST mutations. Results: As of January 2010, 434 pts were included in this trial. Thirty-two and 25 pts were randomized in the interruption arm after 1 and 3 yrs of IM 400mg/day respectively. The outcomes of pts were similar in the two cohorts of pts: 69% and 69% of patients relapsed one year after treatment stopped, median time to progression of 7 months, 10 pts within the 3m following IM interruption, 12 between 3 to 6m, 10 between 6 to 9m, 7 between 9 to 12m and 10 after 12m. IM reintroduction was performed in all but 2 PD pts. The median follow-up from randomization is 66 m and 35 m at 1 and 3 yrs respectively. A second PD was observed in 63% of pts who relapse in the first 6m after IM interruption (2-yr PFS: 45%, CI95: 23-65) vs 35% and 30% of pts for those experiencing a PD between 6 to 12m (2-yr PFS: 68%, CI95: 40-86) and after 12m (2-yr PFS: 64%, CI95: 24-87) respectively. All but 1 pt with a 557- 558 deletion of KIT exon 11 remain free of secondary resistance to IM. In contrast all pts with a mutation involving only 557 or 559 experienced a secondary resistance after IM. Conclusions: Mutational status of GIST and the kinetic of progression after IM interruption seem to influence the time to secondary resistance to IM. Pts progressing rapidly after interruption had a dismal prognosis comparing to those exhibiting a PD after 6m or more. Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration GlaxoSmithKline, Novartis, Pfizer, PharmaMar GlaxoSmithKline, Novartis, Pfizer, PharmaMar Novartis
Abstract 15721: Coronary Artery Calcium Scoring Effectively Stratifies Long-Term Mortality Risk in Smokers and Non-Smokers
Authors: Taylor A Lebeis, Pratik Sandesara, Joseph Knapper, Michael J Blaha, Daniel S Berman, Arshed Quyyumi, Matthew J Budoff, James K Min, Ashley E Giambrone, Tracy Q Callister, Leslee J Shaw
Journal: Circulation (2014)

Background: Cigarette smoking is a known risk factor for coronary heart disease (CHD). Studies have shown earlier onset and higher burden of coronary artery calcium (CAC) in smokers compared to non-smokers. However, little long-term follow-up data exists on the potential interaction between cigarette smoking and CAC for the prediction of important clinical outcomes. Hypothesis: In the setting of cigarette smoking, CAC scoring should accurately predict clinical outcomes. Methods: A total of 9,785 (mean age 53±10 years) consecutive asymptomatic individuals, free of known CHD, underwent computed tomography to estimate CAC for cardiovascular risk assessment. CHD risk factors were prospectively obtained by patient interview. Unadjusted and risk-factor adjusted Cox proportional hazard modeling was used to estimate time to all-cause mortality (mean follow-up=13.7 years) by CAC subsets. Results: 3,833 patients (39.2%) were current smokers. Smokers were less likely than non-smokers to have a CAC score of 0 (42.7% vs 54.3%). For smokers and non-smokers, survival rates ranged from 60 to 94% and 73 to 97% by CAC subsets, respectively (see Figure, p&lt;0.0001). Compared to CAC=0, adjusted hazard ratios for CAC scores of 1-10, 11-100, 101-399, 400-999, and ≤ 1000 were 1.8, 2.3, 2.7, 4.1, and 5.4 (p&lt;0.0001) among smokers; and 1.4, 2.2, 4.1, 5.6, and 7.6 among non-smokers (interaction p&lt;0.0001). Higher adjusted mortality was observed for CAC scores &lt;400 among smokers as compared to non-smokers. The relative hazards for CAC scores of 400-999 (p=0.052) and ≥1,000 (p=0.14) were similar by smoking status. Conclusion: CAC scoring effectively stratifies long-term all-cause mortality risk in both smokers and non-smokers. However, smokers are at substantially higher risk and excess mortality is noted for smoking patients with CAC scores &lt;400. High risk CAC scores of 400 or higher carry a high mortality hazard for smokers and non-smokers.
Increase of CD4<sup>+</sup>CD25<sup>high</sup>Foxp3<sup>+</sup> regulatory T cells in peripheral blood in patients with metastatic renal cell carcinoma treated with dendritic cell vaccination and low-dose IL-2
Authors: A. Berntsen, M. K. Brimnes, P. T. Straten, I. M. Svane
Journal: Journal of Clinical Oncology (2008)

16144
Handgrip weakness and mortality risk in COPD: a multicentre analysis
Authors: Chris Burtin, Gerben ter Riet, Milo A Puhan, Benjamin Waschki, Judith Garcia-Aymerich, Victor Pinto-Plata, Bartolome Celli, Henrik Watz, Martijn A Spruit
Journal: Thorax (2015)

Handgrip strength is a simple measure of upper limb muscle function that is associated with mortality in the general population and in patients with COPD.1 ,2 Recently, normative values for handgrip strength have been proposed based on centile scores in >224 000 healthy adults between 39 and 73 years of age, adjusted for age, sex, height and measurement side.3 As an illustration, in a typical 65-year-old male patient 5th and 10th centile of right handgrip strength range 18–28 kg and 20–30 kg, respectively, depending on the patient's height. It is unclear whether the identification of handgrip weakness based on these centiles has prognostic value in addition to known prognostic parameters like FEV1, age, dyspnoea symptoms (combined in the validated ADO index4) and body mass index (BMI).

Therefore, we performed an a posteriori analysis of prospectively collected multicentre data in patients with stable COPD, followed for a median of 3.9 years.2 ,5–7

Handgrip strength was assessed using …
Evaluation of serum YKL-40 as a prognostic marker for overall survival in patients with metastatic malignant melanoma
Authors: H. Schmidt, J. S. Johansen, J. Gehl, P. Geertsen, K. Fode, H. von der Maase
Journal: Journal of Clinical Oncology (2005)

7520 Background: YKL-40 is secreted by cancer cells, macrophages and neutrophils. YKL-40 is a growth factor for connective tissue cells and stimulates migration of endothelial cells. Its function in cancer is unknown. High serum YKL-40 levels have been associated with a poor prognosis in several solid tumors. We aimed to evaluate the prognostic impact of serum YKL-40 in metastatic malignant melanoma. Methods: YKL-40 was determined by ELISA (Quidel Corporation, Santa Clara, CA) in serum samples from 110 patients (46 females and 64 males, median age 53 years, range 29–74 years) obtained immediately before, during and after interleukin-2 treatment and from 245 healthy subjects (134 females and 111 males, median age 49 years, range 18–79 years). Performance status, number of organ sites, organ site involvement, serum LDH, and serum YKL-40 were tested in univariate analyses. Variables with a P value less than 0.10 were included in a Cox multivariate analysis to identify variables of independent significance. Results: Patients had higher serum YKL-40 values than healthy persons (P<0.001). Serum YKL-40 was elevated in 45% of the patients. An elevated level of serum YKL-40 was correlated to site of metastases (P=0.03) and poor performance status (P=0.002). Multivariate Cox analysis showed that serum YKL-40 (HR=1.8, 95% CI: 1.2–2.7, P=0.007) and serum LDH (HR=2.0, 95% CI: 1.3–3.1, P=0.002) were independent prognostic factors for survival. A combination variable of serum YKL-40 and LDH tripled the risk of death (HR=3.3, 95% CI: 1.7–6.3, P=0.003) after adjusting for the AJCC metastatic stage criteria in a multivariate Cox analysis. Serum samples were available from 12 patients during follow-up. In 8 of 11 patients, an elevated serum YKL-40 was observed in connection to disease progression. In one patient with a lasting complete response, serum YKL-40 remained normal. Conclusions: This is the first study to evaluate serum YKL-40 in patients with metastatic malignant melanoma. Serum YKL-40 was found to be an independent prognostic factor for overall survival. Further studies are required to determine the biological function of YKL-40 and its role as a predictor of relapse in malignant melanoma. No significant financial relationships to disclose.
Salmonella Paratyphi B var Java infections associated with exposure to turtles in Bizkaia, Spain, September 2010 to October 2011
Authors: E Hernández, J L Rodriguez, S Herrera-León, I García, V de Castro, N Muniozguren
Journal: Eurosurveillance (2012)

Between September 2010 and October 2011, the Unit of Epidemiology in the Department of Public Health in Bizkaia, Spain identified eight cases of Salmonella Paratyphi B var Java infection and three cases of infection with its possible monophasic variant 4,5,12:b:- dT+. Six cases reported contact with turtles and S. Java was isolated from three of these turtles' habitats. The isolates from the patients and their respective turtles were indistinguishable by pulsed-field gel electrophoresis (PFGE). Although other reptiles can also carry Salmonella, turtles pose a special risk, as they are commonly kept as pets for children. This emphasizes the need to give recommendations regarding ownership and handling of aquatic turtles and other reptiles. As parents are often not aware of the risk of infection associated with the presence of turtles in the household, it would be appropriate to inform potential buyers at points of sale about the risk of infection and measures they can take to minimise this risk.
Establishing the Clinical Validity of Arrhythmia-Related Genetic Variations Using the Electronic Medical Record
Authors: William Gregory Feero
Journal: JAMA (2016)

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Predictors of independent living status in adult survivors of childhood cancer: A report from the Childhood Cancer Survivor Study.
Authors: A. Kunin-Batson, N. Kadan-Lottick, L. Zhu, V. Bordes, D. K. Srivastava, L. K. Zeltzer, L. L. Robison, K. R. Krull
Journal: Journal of Clinical Oncology (2010)

1576 Background: With increased success of treatments for pediatric cancers, attention has focused on functional outcomes of survivors. This study examines factors that predict independent living in adult survivors of childhood cancer. Methods: Adult survivors of childhood cancers (n = 6047) and siblings (n = 2,326), all of whom were ≥ 25 years of age, completed a long-term follow-up questionnaire that assessed adaptive, neurocognitive, and psychological functioning, as well as demographic information and health status. Survivors were a mean age of 34.2 years (range 25-54) at study. Logistic regression models (expressed as odds ratio [OR] and 95% confidence interval [CI]) were used to predict risk of dependent living based on demographic, neuropsychological, physical functioning and treatment variables. Results: Compared to siblings, survivors were more than twice as likely to live dependently (OR = 2.07, 95% CI 1.77-2.42), adjusted for age, gender and race. In multivariate logistic regression analyses, risk factors for dependent living among survivors included: racial/ethnic minority status (OR = 2.60, 95% CI 2.02-3.36), cranial radiation therapy in dose dependent fashion (> 0 to ≤ 24 Gy OR = 1.35, 95% CI 1.11-1.65; > 24 Gy OR = 3.63, 95% CI 2.82-4.68), attention and processing speed problems (OR = 1.91, 95% CI 1.57-2.33), depression (OR = 1.61, 95% CI 1.23-2.10), poor physical functioning (OR = 1.96, 95% CI 1.53-2.50), and use of neuroleptic, anticonvulsant, or psychostimulant medication (OR=3.05, 95% CI 2.30-4.03). Factors associated with independent living included: older age at diagnosis (6 to < 12 years of age [OR = 0.71, 95% CI 0.58- 0.86], ≥ 12 years of age [OR = 0.43, 95% CI 0.33-0.55] compared to those diagnosed < 6 years), older current age (> 35 years of age; OR = 0.50, 95% CI 0.40-0.62), and having received non-CNS-directed chemotherapy (compared to those with a treatment history of only radiation and/or surgery [OR = 0.69, 95% CI 0.53-0.89]). Conclusions: Adult survivors of childhood cancer are less likely to live independently compared to siblings. Specific neurocognitive, medical and psychological late effects are strongly associated with extended dependency on others in adulthood. No significant financial relationships to disclose.
Induction chemotherapy with cisplatin and epirubicin followed by radiotherapy and concurrent cisplatin in locally advanced nasopharyngeal carcinoma observed in a nonendemic population
Authors: M. Airoldi, M. Garzaro, A. Gabriele, L. Raimondo
Journal: Journal of Clinical Oncology (2009)

e17040 Background: Chemoradiotherapy (CRT) represents the main therapy choice in the treatment of locoregionally advanced nasopharyngeal carcinoma (NPC). Aim of this study was the clinical evaluation of neoadjuvant chemotherapy (NACT) followed by CRT in a non endemic population affected by advanced NPC. Methods: Patients with locoregionally advanced NPC were treated with three cycles of induction chemotherapy (CHT) with cisplatin (100 mg/m 2 ) plus epirubicin (90 mg/m 2 ), followed by cisplatin (100 mg/m 2 ) and concomitant radiotherapy (70 Gy). Results: In 40 patients treated with such protocol, after the completion of induction CHT and CRT we observed the objective response rates of 90% and 100% respectively. Treatment tolerability and toxicity were easily controllable. With a median follow-up time of 54.5 months 3- and 5-years disease-free survival was 75% and 65.4% and 3- and 5-years overall survival was 84% and 77.5%. 3- and 5-years loco-regional control was 82.4% and 70.3%, and 5-years distant metastases-free survival was 75%. Conclusions: NACT with cisplatin and epirubicin followed by concomitant CRT represents a feasible, efficient treatment for patients with advanced NPC. This regimen ensures an excellent locoregional disease control and overall survival with a low incidence of distant metastases. No significant financial relationships to disclose.
The post-inner cell mass intermediate: implications for stem cell biology and assisted reproductive technology
Authors: Margot Van der Jeught, Thomas O'Leary, Galbha Duggal, Petra De Sutter, Susana Chuva de Sousa Lopes, Björn Heindryckx
Journal: Human Reproduction Update (2015)

Until recently, the temporal events that precede the generation of pluripotent embryonic stem cells (ESCs) and their equivalence with specific developmental stages in vivo was poorly understood. Our group has discovered the existence of a transient epiblast-like structure, coined the post-inner cell mass (ICM) intermediate or PICMI, that emerges before human ESC (hESCs) are established, which supports their primed nature (i.e. already showing some predispositions towards certain cell types) of pluripotency.The PICMI results from the progressive epithelialization of the ICM and it expresses a mixture of early and late epiblast markers, as well as some primordial germ cell markers. The PICMI is a closer progenitor of hESCs than the ICM and it can be seen as the first proof of why all existing hESCs, until recently, display a primed state of pluripotency.Even though the pluripotent characteristics of ESCs differ from mouse (naïve) to human (primed), it has recently been shown in mice that a similar process of self-organization at the transition from ICM to (naïve) mouse ESCs (mESCs) transforms the amorphous ICM into a rosette of polarized epiblast cells, a mouse PICMI. The transient PICMI stage is therefore at the origin of both mESCs and hESCs. In addition, several groups have now reported the conversion from primed to the naïve (mESCs-like) hESCs, broadening the pluripotency spectrum and opening new opportunities for the use of pluripotent stem cells.In this review, we discuss the recent discoveries of mouse and human transient states from ICM to ESCs and their relation towards the state of pluripotency in the eventual stem cells, being naïve or primed. We will now further investigate how these intermediate and/or different pluripotent stages may impact the use of human stem cells in regenerative medicine and assisted reproductive technology.
A clinical comparison of schoolchildren with bronchopulmonary dysplasia and asthma
Authors: Björn Nordlund, Christina Ebersjö, Gunilla Hedlin, Eva Berggren Broström
Journal: European Respiratory Journal (2014)

Background: The clinical presentation of schoolchildren with bronchopulmonary dysplasia (BPD) is not established. The aim of this study was to compare clinical assessments of children with BPD and asthma.

Methods: The study population consisted of 30 schoolchildren with BPD (10.4 years/born at 26.6 weeks´ gestation) and 30 age- and sex-matched children with asthma and atopy, at Astrid Lindgren children's hospital in Stockholm, Sweden. Outcomes were dynamic and static lung volumes, exhaled nitric oxide (FeNO, ppb.), bronchial hyperresponsiveness (BHR) based on increase FEV1% post B2-agonist and challenges of metacholine (PD:20 µmol) and mannitol (PD:15 mg), together with applied asthma control test (C-ACT) and use of control medication.

Results: Lung function parameters of FEV1% (77 vs. 84), FEV1/FVC% (85 vs. 91), FEF50% (61 vs. 80) and diffusion capacity for carbon monoxide (DL%, 81 vs. 88) were all reduced in children with BPD compared to children with asthma (p-values 0.001-0.042). FeNO was significantly lower in children with BPD (12 vs. 23, p=0.019), but static lung volumes and BHR showed no differences between the groups (FEV1% post B2-agonist 5.6 vs. 6.1, p=0.73, PD:20 1.6 vs. 1.5, p=0.94 and PD:15 299 vs. 323, p=0.48). Use of control medication was less frequent (43% vs. 100%, p<0.001) in the BPD-group compared to the asthma-group, as well as less impaired markers of respiratory symptoms in the C-ACT (22.8 vs. 24.8, p=0.003).

Conclusions: In spite of BHR, the clinical presentation of schoolchildren with BPD seems different compared to children with asthma in terms of lower lung function, normal FeNO-levels, fewer asthma-like symptoms and limited use of control medication.