tbuckley/cabot-search huggingface dataset:
Optimal chemotherapy utilization rate in cancer care: Setting an evidence-based benchmark for quality improvement.
Authors: W. L. Ng, S. Jacob, G. Delaney, M. Barton
Journal: Journal of Clinical Oncology (2010)

6099 Background: A wide variation in the utilization rates of chemotherapy exists in cancer care in Australia and internationally. We developed an evidence-based utilization model to estimate the optimal proportion of new cases of cancer where chemotherapy is indicated at least once as a benchmark for measuring and improving the quality of care. Methods: We constructed an optimal chemotherapy utilization model using indications for chemotherapy identified from evidence-based treatment guidelines. Population-based data on the proportion of patient and tumor-related attributes for which chemotherapy was indicated were obtained from Australian cancer registries where possible. Treatment indications and epidemiological data were merged using TreeAge Pro 2007 to calculate the optimal rate. Monte Carlo simulations and sensitivity analyses were used to assess the impact of controversial chemotherapy indications and variations in epidemiological data on our model. Results: Chemotherapy was indicated at least once in 50.8% (95% CI 50.6-51%) of all new cancer patients. The optimal chemotherapy utilization rates by tumor sites ranged from a low of 13% in thyroid cancers to a high of 94% in myeloma. Conclusions: Our model generates an optimal chemotherapy utilization rate that can function as a valuable evidence-based benchmark against which patterns of care data on chemotherapy utilization may be compared. The actual chemotherapy utilization rate appears to be substantially lower than the optimal rate in most tumor sites (except for liver cancer) suggesting that chemotherapy may be underutilized in cancer treatment. Optimal and actual chemotherapy utilization rates by tumor site Tumor site Optimal rate (%) Actual rate (%) Breast 68 29-42 Colon 55 28-32 Lung 73 21-41 Rectum 64 42-54 Prostate 15 NA Melanoma 19 NA Head and neck 36 12-17 Unknownprimary 65 5-49 Lymphoma 85 NA Leukemia 85 NA Pancreas 35 19-31 Stomach 83 10-34 Urinary bladder 66 10-28 Kidney 33 3-7 Thyroid 13 1-2 Brain 72 NA Endometrium 20 2-12 Esophagus 79 38-52 Gallbladder 80 22-24 Liver 27 22-37 Testis 70 NA Myeloma 94 76 Ovary 84 52-79 Cervix 51 NA Abbreviation: NA, not available. No significant financial relationships to disclose.
Assessment of LV Systolic Dyssynchrony in Heart Failure Beyond a Snapshot⁎⁎Editorials published in JACC: Cardiovascular Imaging reflect the views of the authors and do not necessarily represent the views of JACC: Cardiovascular Imaging or the American College of Cardiology.
Authors: Cheuk-Man Yu, Qing Zhang
Journal: JACC. Cardiovascular imaging (2011)
The Risk of Cancer in Patients With Psoriasis
Authors: Zelma C. Chiesa Fuxench, Daniel B. Shin, Alexis Ogdie Beatty, Joel M. Gelfand
Journal: JAMA Dermatology (2015)

<h3>Importance</h3> The risk of cancer in patients with psoriasis remains a cause of special concern due to the chronic inflammatory nature of the disease, the use of immune-suppressive treatments and UV therapies, and the increased prevalence of comorbid, well-established risk factors for cancer, such as smoking and obesity, all of which may increase the risk of carcinogenesis. <h3>Objective</h3> To compare the overall risk of cancer, and specific cancers of interest, in patients with psoriasis compared with patients without psoriasis. <h3>Design, Setting, and Participants</h3> Population-based cohort study of patients ages 18 to 89 years with no medical history of human immunodeficiency virus, cancer, organ transplants, or hereditary disease (albinism and xeroderma pigmentosum), prior to the start date, conducted using The Health Improvement Network, a primary care medical records database in the United Kingdom. The data analyzed had been collected prospectively from 2002 through January 2014. The analysis was completed in August 2015. <h3>Exposures of Interest</h3> Patients with at least 1 diagnostic code for psoriasis were classified as having moderate-to-severe disease if they had been prescribed psoralen, methotrexate, cyclosporine, acitretin, adalimumab, etanercept, infliximab, or ustekinumab or phototherapy for psoriasis. Patients were classified as having mild disease if they never received treatment with any of these agents. <h3>Main Outcomes and Measures</h3> Incident cancer diagnosis. <h3>Results</h3> A total of 937 716 control group patients without psoriasis, matched on date and practice visit, and 198 366 patients with psoriasis (186 076 with mild psoriasis and 12 290 with moderate-to-severe disease) were included in the analysis. The adjusted hazard ratios (aHRs) with 95% CIs for any incident cancer excluding nonmelanoma skin cancer (NMSC) were 1.06 (95% CI, 1.02-1.09), 1.06 (95% CI, 1.02-1.09), and 1.08 (95% CI, 0.96-1.22) in the overall, mild, and severe psoriasis group. The aHRs for incident lymphoma were 1.34 (95% CI, 1.18-1.51), 1.31 (95% CI, 1.15-1.49), and 1.89 (95% CI, 1.25-2.86); for NMSC, 1.12 (95% CI, 1.07-1.16), 1.09 (95% CI, 1.05-1.13), and 1.61 (95% CI, 1.42-1.84); and for lung cancer, 1.15 (95% CI, 1.03-1.27), 1.12 (95% CI, 1.01-1.25), and 1.62 (95% CI, 1.16-2.28) in the overall, mild, and severe psoriasis groups, respectively. No significant association was seen with cancer of the breast, colon, prostate, or leukemia. <h3>Conclusions and Relevance</h3> The association between psoriasis and cancer, albeit small, was present in our cohort of patients with psoriasis. This association was primarily driven by NMSC, lymphoma, and lung cancer.
A repeated short educational intervention improves asthma control and quality of life
Authors: Vicente Plaza, Meritxell Peiró, Montserrat Torrejón, Monica Fletcher, Antolín López-Viña, José María Ignacio, José Antonio Quintano, Santiago Bardagí, Ignasi Gich
Journal: European Respiratory Journal (2015)

We assessed the effectiveness of an asthma educational programme based on a repeated short intervention (AEP-RSI) to improve asthma control (symptom control and future risk) and quality of life. A total of 230 adults with mild-to-moderate persistent uncontrolled asthma participated in a 1-year cluster randomised controlled multicentre study. The AEP-RSI was given in four face-to-face sessions at 3-month intervals, and included administration of a written personalised action plan and training on inhaler technique. Centres were randomised to the AEP-RSI (intervention) group or usual clinical practice group. Specialised centres using a standard educational programme were the gold standard group. A significant improvement in the Asthma Control Test score was observed in all three groups (p&lt;0.001), but improvements were higher in the intervention and gold standard groups than in the usual clinical practice group (p=0.042), which also showed fewer exacerbations (mean± sd ; 1.20±2.02 and 0.56±1.5 versus 2.04±2.72, respectively) and greater increases in the Mini Asthma Quality of Life Questionnaire scores (0.95±1.04 and 0.89±0.84 versus 0.52±0.97, respectively). The AEP-RSI was effective in improving asthma symptom control, future risk and quality of life.
Family violence and child adjustment: a comparative analysis of girls' and boys' behavioral symptoms
Authors: P Jaffe, D Wolfe, S K Wilson, L Zak
Journal: American Journal of Psychiatry (1986)

The authors compared behavior problems and social competence in 126 boys and girls (age 6-11) from violent and nonviolent families, on the basis of maternal ratings on the Achenbach Child Behavior Checklist. Girls from violent families were reported as showing more internalizing behavior problems and a lower level of social competence than their nonviolent comparison group. Boys from violent families were reported as demonstrating both internalizing and externalizing behavior problems, in addition to having a lower level of social competence. For boys, the level of exposure to violence between parents was significantly associated with greater adjustment problems.
Feasibility of using quinine, a potential multidrug resistance-reversing agent, in combination with mitoxantrone and cytarabine for the treatment of acute leukemia.
Authors: E Solary, D Caillot, B Chauffert, R O Casasnovas, M Dumas, M Maynadie, H Guy
Journal: Journal of Clinical Oncology (1992)

PURPOSE We demonstrated previously that sera from quinine-treated patients reversed the multidrug resistance (MDR) of a human leukemic cell line. We now report a phase I and II clinical study that examined the toxicity of the combination of quinine with mitoxantrone and cytarabine (Ara-C). PATIENTS AND METHODS Fifteen adult patients with relapsed or refractory acute leukemia were treated with quinine formiate (30 mg/kg/d in continuous intravenous (IV) infusion from day 1 through day 5 or 6) associated with Ara-C (1 g/m2 in 3-hour IV infusion twice a day for 5 days) and five increasing doses of mitoxantrone (from 8 mg/m2/d for 4 days to 12 mg/m2/d for 5 days). RESULTS The main toxicity was severe myelosuppression: the mean times to leukocyte recovery (&gt; 500/microL), granulocytes recovery (&gt; 500/microL), and platelet count recovery (&gt; 50,000/microL) were 23 days (range, 17 to 29 days), 30.6 days (range, 17 to 48 days), and 35.4 days (range, 14 to 75 days), respectively. The nonhematopoietic toxicity of this regimen was acceptable. Nausea and vomiting were common, but severe mucositis was observed in only two patients. Cardiotoxicity was limited to transient episodes of moderate supraventricular tachycardia and a clinically well-tolerated bradycardia. Tinnitus and vertigo were observed in 10 cases (67%), and mild hearing loss and transient increase of serum bilirubin were observed in six patients (40%). Total quinine serum levels reached a steady-state concentration between 6.4 and 18 mg/L in 24 hours. Complete remission (CR) was achieved in eight of 14 (57%) assessable patients, and partial response (PR) was achieved in two additional patients (14%). P-glycoprotein expression was detected on blast cells from five of 13 studied patients before treatment. A response was observed in all P-glycoprotein-positive cases. CONCLUSION Quinine can be used safely as a potential reversing agent of MDR for the treatment of clinically resistant acute leukemias.
Abstract 20039: Inhibition of the HIF/Ob/ObR Axis Prevents Experimental Pulmonary Hypertension
Authors: Alice Huertas, Ly Tu, Raphael Thuillet, Morane Le Hiress, Carole Phan, Marc Humbert, Christophe Guignabert
Journal: Circulation (2014)

Introduction: Dysfunctional pulmonary endothelial cells (P-ECs) from pulmonary arterial hypertension (PAH) patients secrete excessive amount of leptin (Ob), a HIF-1α-dependent gene. However, the significance of the HIF/Ob/Ob receptor (ObR) axis for PAH susceptibility and/or progression remains unexplored. Hypothesis: Hence, we hypothesized that HIF/Ob/ObR axis may contribute to pulmonary vascular remodeling and perivascular inflammation in PAH. Methods and Results: In human PAH lung tissues, we found a strong Ob immunostaining intensity in dysfunctional endothelium on one hand, and a marked ObR immunostaining in pulmonary smooth muscle cells (P-SMCs) on the other hand, as compared to control subjects. Consistent with our in situ observations, PAH P-ECs overproduce Ob and PAH P-SMCs overexpress ObR as compared to control cells. Interestingly, we are also demonstrating in vitro that: 1) PAH P-SMCs proliferate more in response to Ob than control cells; 2) increased Ob secretion by PAH P-ECs leads to an exces...
O012 : Hepatitis delta virus can survive liver regeneration and is amplified through human cell division both in vitro and in vivo
Authors: K. Giersch, O.D. Bhadra, T. Volz, L. Allweiss, A.W. Lohse, J. Petersen, C. Sureau, S. Urban, M. Dandri, M. Luetgehetmann
Journal: Journal of Hepatology (2015)
Prognostic factors in osteosarcoma: a critical review.
Authors: A M Davis, R S Bell, P J Goodwin
Journal: Journal of Clinical Oncology (1994)

PURPOSE The purpose of this critical appraisal was to determine the prognostic factors that influence survival in patients with nonmetastatic, high-grade osteosarcoma of the extremities. DESIGN A computerized literature search of reports published from January 1973 to March 1992 was conducted to determine those eligible for inclusion in the review. Reports were reviewed blindly by two of the authors; inclusion and scoring were determined according to preestablished criteria. RESULTS Eight reports were included in the appraisal. The prognostic variables evaluated were age, sex, anatomic tumor location, tumor size, and tumor necrosis. Tumor size and necrosis following preoperative chemotherapy were significant prognostic variables in relation to survival in univariate analysis. However, only tumor necrosis maintained its significance in multivariate modeling. CONCLUSION The most important prognostic variable for patients with osteosarcoma of the extremity was tumor necrosis evident following preoperative chemotherapy. There is no consensus as to any prognostic variable that might be used to stratify patients before the onset of therapy.
Monitor antibody levels after vaccination
Authors: S Obaro, D C Henderson, M Monteil
Journal: BMJ (1994)

EDITOR, - The role of the spleen in protecting against overwhelming sepsis due to encapsulated bacteria has long been established, and animal studies have shown the importance of the spleen in clearing organisms that have been opsonised by complement.1 In animals that have undergone splenectomy the fixed macrophages of the liver take over this function, but high levels of specific capsular antibodies are required to facilitate hepatic clearance.2 Vaccination in patients who have undergone splenectomy aims to maintain high specific antibody levels. …
Transmissibility of 2009 pandemic influenza A(H1N1) in New Zealand: effective reproduction number and influence of age, ethnicity and importations
Authors: S Paine, G N Mercer, P M Kelly, D Bandaranayake, M G Baker, Q S Huang, G Mackereth, A Bissielo, K Glass, V Hope
Journal: Eurosurveillance (2010)

Binary file ES_Abstracts_Final_ECDC.txt matches
Phase Ib/II study to evaluate the safety and antitumor activity of durvalumab (MEDI4736) and tremelimumab as monotherapy or in combination, in patients with recurrent or metastatic gastric/gastroesophageal junction adenocarcinoma
Authors: Ronan J Kelly, Ki Chung, Yu Gu, Keith E Steele, Marlon C Rebelatto, Paul B Robbins, Fatemeh Tavakkoli, Joyson J Karakunnel, Dominic W Lai, Khaldoun Almhanna
Journal: Journal for ImmunoTherapy of Cancer (2015)

Meeting abstracts Despite improvements in diagnosis, surgical techniques, and multidisciplinary approaches to patient care, the median survival of patients with metastatic gastroesophageal adenocarcinoma is less than one year. Chemotherapy is the mainstay of treatment in patients with metastatic
Weaning Failure for Disproportionate Hypoxemia Caused by Paradoxical Response to Positive End-Expiratory Pressure in a Patient with Patent Foramen Ovale
Authors: Guido Tavazzi, Marco Pozzi, Gabriele Via, Silvia Mongodi, Antonio Braschi, Francesco Mojoli
Journal: American Journal of Respiratory and Critical Care Medicine (2015)

Weaning Failure for Disproportionate Hypoxemia Caused by Paradoxical Response to Positive End-Expiratory Pressure in a Patient with Patent Foramen Ovale Guido Tavazzi, Marco Pozzi, Gabriele Via, Silvia Mongodi, Antonio Braschi, and Francesco Mojoli Anesthesia, Intensive Care and Pain Therapy, University of Pavia, Pavia, Italy; and Anesthesia and Intensive Care, Emergency Department, Foundation IRCCS Policlinico San Matteo, Pavia, Italy
Detection and Natural Progression of Early Oesophageal Carcinoma: Preliminary Communication1
Authors: Miao Yanjin, Li Guangyi, Gu Xianzhi, Chen Wenheng
Journal: Journal of the Royal Society of Medicine (1981)

Twenty-three cases of untreated early carcinoma of the oesophagus are described. The detection and observation on the natural progression of these early carcinomas were performed by means of abrasive cytology, barium oesophagography, and/or fibreoptic oesophagoscopy. Eleven cases had developed late carcinoma in a mean of 55.5 +/- 29.0 months after the initial detection of the disease, while in the remaining 12 cases the disease had maintained its early stage of progression for 74.4 +/- 27.3 months without developing into late carcinoma. Further, of the 23 patients, 18 had lived beyond 5 years, making a natural 5-year survival rate of 78.3%. The relatively long period of dormancy at the early stage of oesophageal carcinoma might thus influence the 5-year survival rate of this disease currently treated by surgery.
Abstract 11599: Plasma Amino Acid Profiling Identifies Specific Amino Acid Correlations With Cardiovascular Function in Patients With Systolic Heart Failure: Highlighting the Cardio-Hepatic-Skeletal Muscle Axis
Authors: Daihiko Hakuno, Yasuhito Hamba, Takumi Toya, Takeshi Adachi
Journal: Circulation (2014)

Background: The heart has close interactions with other organs’ functions and concomitant systemic factors such as oxidative stress, nitric oxide (NO), inflammation, and nutrition in systolic heart failure (HF). Recently, plasma amino acid (AA) profiling as systemic metabolic indicator has attracted considerable attention in predicting the future risk of human cardiometabolic diseases, but it has been scarcely studied in HF. Methods: Thirty-eight stable but symptomatic patients with left ventricular ejection fraction (LVEF) &lt;45% and 33 asymptomatic individuals with normal brain natriuretic peptide (BNP) value were registered as the HF and control groups, respectively. We analyzed fasting plasma concentrations of 41 AAs using high-performance liquid chromatography, serum NO metabolite concentration, hydroperoxide and high-sensitivity C-reactive protein measurements, echocardiography, and flow-mediated dilatation. Univariate and stepwise multivariate analyses including potential confounders were subsequently performed in the HF group. Results: (1) In the HF group, 17 AAs and two ratios significantly changed compared with those in the control group. (2) Univariate and multivariate analyses revealed that Fischer ratio and five specific AAs, ie, monoethanolamine, methionine, tyrosine, 1-methylhistidine, and histidine have significant correlation with BNP value, LVEF, LV end-diastolic volume index, inferior vena cava diameter, mitral E/e’, and BNP value, respectively (p&lt;0.05). (3) Unexpectedly, further exploratory factor analysis categorized these AAs into hepatic-related (monoethanolamine, tyrosine, and Fischer ratio) and skeletal muscle-related (histidine, methionine, and 1-methylhistidine) factors. (4) Some categorized AAs showed unique correlations with concomitant systemic factors: monoethanolamine, tyrosine, and Fischer ratio with serum NO concentration (p&lt;0.05); histidine with serum albumin (p = 0.0001); and 1-methylhistidine with flow-mediated dilatation (p&lt;0.05). Conclusions: Plasma AA profiling identified correlations of specific AAs with cardiac function and concomitant systemic factors and highlighted the cardio-hepatic-skeletal muscle axis in patients with systolic HF.
Molecular imaging as a tool to investigate heterogeneity of advanced HER2-positive breast cancer and to predict patient outcome under trastuzumab emtansine (T-DM1): the ZEPHIR trial
Authors: G. Gebhart, L.E. Lamberts, Z. Wimana, C. Garcia, P. Emonts, L. Ameye, S. Stroobants, M. Huizing, P. Aftimos, J. Tol, W.J.G. Oyen, D.J. Vugts, O.S. Hoekstra, C.P. Schröder, C.W. Menke-van der Houven van Oordt, T. Guiot, A.H. Brouwers, A. Awada, E.G.E. de Vries, P. Flamen
Journal: Annals of Oncology (2015)
Phase I study of the DNA minor groove binding pyrrolobenzodiazepine dimer (SJG 136) administered every 21 days in patients with advanced solid tumours
Authors: D. Hochhauser, T. Meyer, P. Loadman, V. J. Spanswick, M. Cobb, R. H. Begent, J. Wu, P. H. Clingen, J. A. Hartley, D. Jodrell
Journal: Journal of Clinical Oncology (2008)

2566 Background: This phase I study was undertaken to define dose-limiting toxicity (DLT) and maximum tolerated dose (MTD) of the pyrrolobenzodiazepine dimer SJG-136 in patients with advanced solid tumors. Methods: Good performance patients (PS ≤1) with refractory advanced solid tumors were assigned sequentially to escalating doses of SJG-136 (15 to 240 μg/m2) given as a 10-minute intravenous infusion once every 21 days. An accelerated dose-escalation strategy based on the Simon design was used. Results: 16 patients (11M, 5F) median age 70 years for M (range 41–79) and 56 for F (range 54–58) recruited. Cancer sites included biliary (2), colorectal (5), lung (1), oesophagogastric (2), pancreas (2), sarcoma (1), melanoma (3). Dose levels μg/m2) were 15 (1 pt), 30 (1 pt), 45 (7 pt), 60 (4 pt) 120 (2 pt), 240 (1 pt). 10 pts had grade 1–3 VLS (30–240 μg/m2) with Gr 3 occurring at the top doses at 120 and 240 in 2 pts. DLT were a delayed vascular leak syndrome (DVLS) seen in 4 of 5 pts treated at doses between 30 and 240 μg/m2. DVLS was characterized by hypoalbuminemia, oedema, and other features included pleural effusion, dyspnoea, weight gain and abdominal distension. The dose was reduced to 60 μg/m2 but 2/3 pts developed delayed, prolonged liver toxicity. 7 pts were recruited at a dose level of 45 μg/m2 in combination with dexamethasone, starting 24 hours before treatment to prevent DVLS. Other unexpected adverse events included elevated liver function tests and fatigue. 10 patients had stable disease for > 6 weeks, 2 patients for > 12 weeks. There was no evidence of crosslinking using the single cell gel electrophoresis (comet) assay. Evidence of DNA interstrand cross-linking in peripheral lymphocytes and tumour cells was demonstrated at all dose levels using a sensitive gamma-H2AX assay. SJG-136 demonstrated biphasic clearance and linear pharmacokinetics across the dose range tested. Conclusions: When given as a single injection every 21 days, the MTD for SJG-136 is 45 μg/m2 but a recommended dose for phase II testing was not identified. The major DLT was DVLS, but delayed liver toxicity was also observed. DNA damage was noted at all dose levels studied in circulating lymphocytes and tumour. Alternative clinical dosing strategies are now being evaluated. No significant financial relationships to disclose.
STUDIES ON THE SUPRARENAL CORTEX
Authors: George A. Harrop, William M. Nicholson, Margaret Strauss
Journal: The Journal of Experimental Medicine (1936)

1. The withdrawal of maintenance injections of the cortical hormone from the suprarenalectomized dog during balance experiments, in which a constant meat diet is given, with constant fluid and salt intake, is followed by increased urinary loss of sodium and chloride, and by retention of potassium and nitrogen. 2. Where the water intake is low, a definite diuresis usually accompanies this excretion of sodium and chloride, but where fluids are forced, no diuresis may be observed. 3. The reinjection of the cortical hormone in suprarenal insufficiency causes an active renal excretion of potassium which is greatly in excess of the probable extra accumulation of this component in the extracellular fluids during the period when insufficiency is developing. This potassium excretion is surmised to be sufficient to account for such an accumulation, if diffusible potassium is present in like concentration equally throughout all of the body water, intracellular as well as extracellular. The excretion of potassium is accompanied by a. corresponding excretion of phosphate and of nitrogen. 4. The excretion of electrolytes which is associated with withdrawal and with subsequent reinjection of suprarenal cortical hormone differs from the effects produced with various diuretic agents regarding which data are available. The effects produced by injection of the cortical hormone during suprarenal insufficiency, however, do resemble those produced with pituitrin, particularly in the greatly increased excretion of potassium relative to sodium, and in the coincidental dilution of the circulating blood. They suggest the possibility that the two similar effects may be ascribable to a common cause.