tbuckley/cabot-search huggingface dataset:
Cost-effectiveness of adjuvant capecitabine, Mayo Clinic and de Gramont regimens for stage III colon cancer in the French setting
Authors: P. R. Dufour, J. Douillard, M. Ychou, J. Seitz, G. Perrocheau, P. Tilleul, P. Maes, F. Husseini
Journal: Journal of Clinical Oncology (2006)

13506 Background: The oral fluoropyrimidine capecitabine is as effective but better tolerated than i.v. 5-FU/LV as first-line treatment in patients (pts) with metastatic colorectal cancer. Costs associated with the administration route could vary widely according to national rules and medical practice. We compared costs and outcomes of capecitabine, the Mayo Clinic, and de Gramont regimens as adjuvant treatment for stage III colon cancer. Methods: We assessed the cost-effectiveness of the three regimens using the third-party payer perspective, time horizon and efficacy/safety data (adjusted for indirect comparisons) from two published clinical trials [Twelves et al. N Engl J Med 2005; Andre et al. J Clin Oncol 2003]. The costs of chemotherapy and the treatment of side effects were estimated from the clinical trials and expert opinion. We applied French standard costs to resources consumed and evaluated cost-effectiveness using relapse-free survival (RFS), defined in X-ACT study, as an efficacy indicator. One-way sensitivity analyses were performed varying the cost estimates for each treatment. Results: Capecitabine-treated pts had a mean life duration increase without treatment failure of 1.3 months vs. Mayo (see table). De Gramont was considered as effective as Mayo. In the base-case analysis capecitabine appeared to be dominant, more effective and less costly than either Mayo Clinic or de Gramont. In the sensitivity analyses, capecitabine remained dominant except for the minimum costs scenario vs. de Gramont. In this case, the cost-effectiveness ratio was estimated at 8997.55€ per year without relapse. Conclusions: As adjuvant treatment for colon cancer, capecitabine decreases medical resources consumed, mainly in hospitals. Its approval in this setting is expected to bring cost savings and better outcomes. [Table: see text] [Table: see text]
Pressure Cooking and Vitamin-C Content of Vegetables
Authors: G. M. Chappell, A. M. Hamilton
Journal: BMJ (1949)

HAEMORRHAGEM, Nierenlagers,"' and was later classified into four categories by Ponfick (quoted by Coenen, 1910).Case 3 is an example of Ponfick's haematoma renis extracapsulare.Coenen, who collected 12 cases of perirenal haematoma and reported one of his own, mentions nephritis, renal sarcoma, arteriosclerosis, renal tuberculosis, chronic splenomegaly with gastritis, and haemophilia as the associated conditions.Heilmann (1930), who reported four cases of perirenal haematoma, suggests spasm of the capsulaT vessels as an aetiological factor.Cases of gross suprarenal haemorrhage have been reported in adults (Keele and Keele, 1942; Burnett, 1948).Eleven cases had previously been described.Only three of these cases, including those of Keele and Keele, were unilateral, as was the case under discussion, and in no instance was there a haemoperitoneum.In addi- tion to atheroma and a possible spastic mechanism owing to hypertension, thrombosis of the suprarenal vein as in Keele and Keele's case should be considered as the proximate cause.Sumary' Three cases of intra-abdominal haemorrhage are reported.All three had evidence of hypertension.The first case was one of spontaneous intraperitoneal haernor- rhage with no morbid anatomical source for the bleeding apart from hypertensive changes in the smaller vessels.The second case showed intramuscular haematomata; hyper- tensive arteriolar disease was sufficient to account for the haemorrhage.The third case showed a haemoperitoneum from rupture of a perirenal haematoma.The origin of this is discussed.There was clinical evidence of severe hypertension.Our thanks are due to Dr. W.
Economic guidelines for oncology products: Adaptation of the Canadian Agency for Drugs and Technologies in Health (CADTH) technology assessment guidance document
Authors: N. Mittmann, W. K. Evans, A. Rocchi, C. J. Longo, H. J. Au, D. Husereau, P. K. Isogai, M. Krahn, D. Coyle
Journal: Journal of Clinical Oncology (2009)

e17572 Background: Economic evaluations (EE) are routinely used by decision-makers in Canada. CADTH's “Guidelines for the Economic Evaluation of Health Technologies: Canada” Third edition, 2006, provide guidance on the conduct of EEs for all therapeutic products. The consistency and quality of oncology EEs are variable and therapeutics in the cancer care environment presented unique challenges in decision making. Several chapters of the CADTH document adequately defined methods for the conduct of an oncology EE. However, some chapters required more specific guidance to improve the quality of oncology EEs. The goal was to provide direction on methods for the conduct of high quality EEs in oncology. Methods: The Working Group on Economic Analysis, NCIC CTG and CADTH jointly initiated this project and formed a working group (WG) of oncologists, health economists, decision makers and economic analysts. The WG identified CADTH chapters where oncology-specific guidance would be required. In-person and teleconference meetings provided content and structure for the document. Formal reviews by external academic experts, cancer agencies, patient groups and the pharmaceutical industry were conducted. Feedback was reviewed by the WG and incorporated as appropriate. Results: Chapters requiring guidance included: target population, comparators, perspective, effectiveness, modeling, type of evaluation, valuing health, time horizon, costs and resources, sensitivity analysis and equity. Guidance included clarity around CADTH methodology and recommendations for oncology products. For example for the effectiveness chapter, there was guidance around the use of intermediate outcomes (progression free survival vs. overall survival) and type of evidence (phase II vs. phase III). Overall recommendations for chapters will be presented. Conclusions: The oncology adapted economic guidelines provide specific guidance on the conduct of EEs for oncology products and will be published as an addendum to CADTH's third edition document. Their use should lead to more consistent application of EE methodologies for anti-cancer drugs and higher quality information for decision-makers at a national and perhaps international level. No significant financial relationships to disclose.
A phase II study of temsirolimus (CCI-779) in patients with metastatic and/or locally advanced recurrent endometrial cancer previously treated with chemotherapy: NCIC CTG IND 160b
Authors: A. M. Oza, L. Elit, D. Provencher, J. J. Biagi, L. Panasci, J. Sederias, J. E. Dancey, M. S. Tsao, E. A. Eisenhauer
Journal: Journal of Clinical Oncology (2008)

5516 Background: Loss of PTEN function occurs in 26–80% of endometrial carcinomas and leads to deregulated PI3K/Akt/mTOR signalling which may provide neoplastic cells with a selective survival advantage by enhancing angiogenesis, protein translation and cell cycle progression. Inhibition of mTOR with temsirolimus, an ester derivative of rapamycin, has demonstrated promising activity, irrespective of PTEN loss, in chemotherapy naïve endometrial cancer with an objective response rate of 21% and prolonged stable disease in 48%. This trial was designed to assess the level of activity in patients who had previously received chemotherapy. Methods: A single stage phase II study of temsirolimus in women with chemotherapy treated, recurrent or metastatic endometrial cancer has been completed, at a dose of 25mg i.v. weekly. 27 eligible patients have been enrolled and archival specimens of tumour have been collected for PTEN immunohistochemistry analysis. Thirteen had received prior radiation and 10 hormonal therapy. Twenty five patients had adenocarcinoma (8 serous carcinoma) and 2 had adeno-squamous carcinoma; 20 patients had grade 2/3 disease, 5 unknown and 2 grade 1. Results: Hematologic toxicity has been mild with 5 episodes of grade 3 lymphopenia and 2 of anemia; 8 patients had grade 3/4 non-hematologic adverse events [pneumonitis, mucositis, fatigue, GI, pain]. Grade 3/4 biochemical toxicities were hypokalemia, hyperglycemia, hypoalbuminemia and hypophosphatemia. Two patients have had a confirmed partial response (PR) (7.4%; 95% CI 0.9–24.3%) and 12 patients had stable disease (SD) (44%), median duration 3.5months (2.4–7.2m) and 10 patients had progressive disease (41.7%). Five of the 8 patients with serous disease had SD and of the 17 with Grade 3 disease, 1 was PR and 7 SD. PTEN assays are underway. Conclusions: The results indicate modest activity for Temsirolimus in women with recurrent endometrial cancer previously treated with chemotherapy. Supported by a grant from the National Cancer Institute of Canada with funds from the Canadian Cancer Society No significant financial relationships to disclose.
The Gray Mouse Lemur: A Model for Studies of Primate Metabolic Rate Depression
Authors: Kenneth B. Storey
Journal: Genomics Proteomics & Bioinformatics (2015)

The use of daily torpor and/or of multi-day torpor bouts during a hibernation season are energy-saving survival strategies that have been well-studied for many years, particularly for small mammals living in seasonally-cold environments.Both phenomena are characterized by a regulated suppression of metabolic rate, a slowing of many physiological processes (e.g., heart and breathing rates, organ perfusion, kidney filtration, and neurological activity), and heterothermy that allows core body temperature (T b ) to fall to near-ambient, often to values close to 0 °C for small hibernators [1][2][3][4].All of these concepts are largely alien to our experience as humans.For example, hypothermia in humans is clinically diagnosed if core T b drops to 34-35 °C and the risk of cardiac arrest and death is very high if core T b is less than about 28 °C [5].The natural capacity for metabolic suppression in humans is quite limited with only small reductions in metabolic rate and T b , when recorded in deep meditative states [6], during starvation [7], or in newborns exposed to hypoxia [8].However, biomedical researchers envision a range of applications that can be derived from a thorough understanding of the natural mechanisms that regulate daily torpor and multi-day hibernation.Chief among these is the development of methods to expand the use of organ transplantation as a medical therapy by using preservation strategies derived from the natural mechanisms of torpor and/or hypothermia tolerance displayed by various mammalian species.Mechanisms to induce whole body torpor
Successful implementation of a comprehensive electronic medical record in pediatric oncology.
Authors: R. Irwin, R. R. Louie, K. Veal, W. Thomas
Journal: Journal of Clinical Oncology (2010)

e16535 Background: Pediatric cancer care requires the integration of multiple team members and treatment locations. For example, a typical boy with standard-risk leukemia will require 19 intrathecal therapies, 1200 oral and 60 IV chemotherapy doses, 72 clinic visits, and 3 admissions. Treatment is delivered in the inpatient, outpatient, infusion clinic, and home health care settings.The electronic medical record (EMR) holds promise for efficient, standardized and flexible care for the subspecialty patient. Methods: We used Epic's Beacon module to generate comprehensive pediatric oncology treatment plans with all medications, notes, laboratory orders, imaging studies, and procedures required by the COG protocols.This process included 5 phases: plan, build, validate, train and optimize. Planning phase included workflow and protocol review, and Beacon functionality assessment. Build was performed by a dedicated pharmacist. Validation was performed throughout. Training consisted of didactic sessions and mentoring. Ongoing optimization includes weekly meetings. A 4 patient 1 month pilot was followed by go-live with the remaining 48 actively treated patients. Results: 145 Beacon protocols were developed for 27 open COG studies and non-study treatment plans. Since go-live, all 28 newly diagnosed patients have been treated with Beacon protocols. 9 were eligible for COG protocols and 7 were enrolled. 242 months of oral chemotherapy was administered without identified error. Pre-EMR: Internal audit revealed deficient home oral medication documentation in 7 of 20 patients, scattered documentation and noting, and COG audit revealed deficient home oral medication documentation in 3 of 8 patients, eligibility deficiencies in 3 of 12 patients. Post-EMR: External audit revealed no medication deficiencies, and a COG audit found no deficiencies or errors in the entire audit. Continuous review identified no chemotherapy errors. Optimization identified 52 functionality issues post go-live, 33 are resolved, and 19 are not Beacon related. Conclusions: We report successful implementation of a comprehensive oncology ordering system. We have maintained good patient care, and been favorably evaluated by outside auditors. No significant financial relationships to disclose.
Elevated soluble c-erbB-2 antigen levels in the serum and effusions of a proportion of breast cancer patients.
Authors: K Leitzel, Y Teramoto, E Sampson, J Mauceri, B C Langton, L Demers, E Podczaski, H Harvey, S Shambaugh, G Volas
Journal: Journal of Clinical Oncology (1992)

PURPOSE An enzyme-linked immunosorbent assay (ELISA) for the extracellular domain of the c-erbB-2 oncogene product was developed and evaluated to determine if soluble c-erbB-2 could be detected in the serum and effusions of cancer patients. PATIENTS AND METHODS Sera from 208 previously untreated or progressing cancer patients and 69 healthy controls were assayed in a double-antibody sandwich ELISA that used two monoclonal antibodies to the native extracellular domain of the c-erbB-2 receptor. Fisher's exact test was used to analyze the statistical significance of the frequency of elevated serum c-erbB-2 levels. Immunoprecipitation and Western blotting were used to characterize further the c-erbB-2 immunoreactivity in the serum of four breast cancer patients. RESULTS Sera from 12 of 53 patients (23%) with metastatic or locally advanced breast cancer, zero of 69 controls, one of 31 patients with ovarian cancer (3%), and two of 124 other cancer patients (2%) had soluble c-erbB-2 values greater than or equal to 5 U/mL. The number of breast cancer patients with elevated serum c-erbB-2 levels was significantly greater than that of the control group (P less than .0001), the ovarian cancer group (P less than .03), and the other cancers group (P less than .0001). Also, two of five effusions (40%) from breast cancer patients had an elevated soluble c-erbB-2 antigen level, compared with zero of 17 effusions from patients with benign diseases. Western blotting of four sera from breast cancer patients with elevated serum c-erbB-2 antigen levels produced bands of approximately 105 kD that seemed to correlate in intensity with increasing ELISA serum levels. CONCLUSION Serum c-erbB-2 levels are elevated in approximately one fourth of patients with locally advanced or metastatic breast cancer.
Effects of nutritional intervention in non-small cell lung cancer patients with different levels of systemic inflammation
Authors: W. Droege, R. G. Tozer, P. Tai, T. Ducruet
Journal: Journal of Clinical Oncology (2008)

20631 Background: In cancer cachexia systemic inflammation and nutrition-related factors may independently contribute to mortality. Recently treatment with a cysteine-rich protein (CyP) was found to increase body weight and survival in non-small cell lung cancer patients (Tozer et al. Antioxidants & Redox Signaling 2008, 10:395–402). It is not known whether patients with systemic inflammation may also benefit from this nutritional intervention. Methods: The data set from this study has now been analyzed to determine whether patients with high C-reactive protein (CRP) concentrations and/or high white blood cell (WBC) counts, i.e., a subgroup with “strong systemic inflammation” (SSI), may show less benefit than the subgroup with ‘little or no systemic inflammation‘ (LNSI). Sixty-six patients with Stage IIIB-IV non-small cell lung cancer were randomly assigned to CyP or casein, a widely used protein supplement low in cysteine. Included were patients with a previous involuntary weight loss of ≥3%, and Karnofsky status ≥70. Results: All LNSI patients with CyP survived for at least one year and showed a mean increase in Karnofsky status. Survival and Karnofsky status were decreased in both, the SSI subgroup with CyP and the LNSI subgroup with casein. The SSI and LNSI subgroups of the casein group were not significantly different. Conclusions: Poor survival is associated with either condition, systemic inflammation or inadequate nutrition. As CyP and casein are isocaloric and isonitrogenous, their differential effects may be related to the content of cysteine, a precursor of glutathione. Cysteine deficiency and systemic inflammation may be mechanistically related and not necessarily independent factors. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Expert Testimony Other Remuneration Immunotec Inc. Immunotec Inc. Immunotec Inc.
Abstract P394: The Prevalence of Hypertension Among Kazak Individuals of Diverse Occupational Backgrounds In Xinjiang, China
Authors: Jingmei Jiang, Mingtao Zhang, Fang Xue, Yong Tang, Lei Hou, Shaohua Liang, Wei Han, Weizhi Wang, Biao Zhang, Haiyu Pang, Yanhong Wang
Journal: Circulation (2014)

Introduction: Kazak’s hypertension ranks fifth with regard to morbidity among the 56 Chinese ethnic groups. Kazaks, are the main ethnic group in Kazakhstan, and represent a sizable ethnic minority in China and Russia. For thousands of years, China’s Kazak people are mainly active in raising livestock on the prairie grasslands in northwest China, and have developed a unique culture and lifestyle. In order to establish whether this distinct feature affects the prevalence of hypertension in this population, we undertook a population-based study which involved in three occupational backgrounds (herdsman, farmer, non-manual worker) in Xinjiang, China. We hypothesized that any variation in the effect of hypertension is based on the genetic homogeneity. Methods: A prospective cohort design was used, with 1670 participants (aged 30-92 years) from seven villages and town city recruited by a stratified random clustering sampling procedure in Hong-Dun town, Altay region Xinjiang from Jan to Mar 2013. All participants completed the survey and physical examination using standardized procedures. The overall response rate for completing both was 92.5%. Results: Compared with farmers and non-manual workers, herdsmen had the highest prevalence of hypertension and the lower rates of treatment and control (Tab). High-salt diet (air-dried beef and milky-tea) intake and low intake of fruits and vegetables were more common in the nomadic group and a dose-response relationship was observed between hypertension and occupation (Fig). Furthermore, the prevalence of hypertension within each occupational group was more common in lower socioeconomic status based on educational attainment and economic measures. Conclusion: Unlike the previous epidemic of hypertension in developed countries which was driven mainly by urbanization, these data highlight the need for careful monitoring and control of hypertension risk factors in rural residents, especially groups such as the Kazak nomads who have a greater degree of marginalization in modern China.
Generation of T-cells reactive against CT-7 and BCMA peptides: Potential targets for T-cell immunotherapy of multiple myeloma
Authors: L. D. Anderson, D. G. Maloney, S. R. Riddell
Journal: Journal of Clinical Oncology (2006)

7615 Background: Multiple myeloma is a malignant plasma cell disorder that is incurable with chemotherapy or autologous stem cell transplantation (SCT), and novel therapies with lower toxicity are needed. There is evidence that T-cells can recognize myeloma and mediate anti-tumor effects, but the lack of defined target antigens other than idiotype has hindered the development of myeloma-specific T-cell therapy. We are investigating cancer-testis antigens and overexpressed “self”-proteins as candidate myeloma antigens, including MAGE-C1 (CT-7), which is expressed by &gt;80% of myelomas, and B-Cell Maturation Antigen (BCMA), a plasma cell differentiation antigen commonly over-expressed in myeloma. Methods: To identify potential T-cell epitopes from CT-7 and BCMA, we scanned the protein sequences with computer algorithms and synthesized peptides predicted to bind to HLA-A2 and A3. CT-7 and BCMA are both “self” proteins to which the T-cell repertoire may be relatively tolerant, so we have utilized culture conditions that facilitate the expansion of rare myeloma-reactive T-cells. CD8 + T cells were stimulated in vitro with autologous dendritic cells pulsed with CT-7 or BCMA peptides in the presence of cytokines that avoid excessive nonspecific expansion of T-cells. Wells were screened for reactivity against peptide-pulsed target cells and myeloma cell lines. Results: A specific CD8 + T-cell response by both ELISPOT and cytotoxicity assays to at least one HLA-A2 peptide from each of the CT-7 and BCMA proteins has been identified in normal donors. CT-7 and BCMA-specific T-cells are being cloned in order to determine their ability to recognize primary myeloma cells. Experiments are also in progress to elicit responses to these peptides in myeloma patient samples and to screen HLA A3-binding epitopes. Conclusions: T-cells recognizing CT-7 and BCMA are detectable in the normal T-cell repertoire and can be isolated and expanded in vitro. We are currently pursuing the identification of additional antigenic epitopes in these proteins to define their potential utility as targets for vaccination or adoptive T-cell therapy. No significant financial relationships to disclose.
Malignancy-associated Sweet's syndrome: review of the world literature.
Authors: P R Cohen, M Talpaz, R Kurzrock
Journal: Journal of Clinical Oncology (1988)

Sweet's syndrome is an acute febrile neutrophilic dermatosis in which approximately 20% of the reported patients have an associated cancer. We review the 79 patients with malignancy-associated Sweet's syndrome documented in the world literature. The most common underlying neoplasm was acute myelogenous leukemia (AML). Lymphomas, chronic leukemias, myelomas, myelodysplastic syndromes, and a variety of solid tumors have also been observed. The onset of Sweet's syndrome either preceded or coincided with the discovery of a previously undiagnosed cancer in greater than 60% of malignancy-associated Sweet's syndrome patients. In contrast to patients with the idiopathic form of the disease, those with a malignancy often presented with more severe cutaneous lesions, cytopenias, and/or immature cells in the peripheral blood. Extracutaneous sites of involvement included the eyes, muscles and joints, kidneys, lungs, and liver. All the manifestations of Sweet's syndrome improved dramatically with corticosteroid therapy, regardless of the response of the associated neoplasm to tumor-directed therapy.
Abstract P315: Epidemiology of Chronic Kidney Disease in Italy: The National Health Examination Surveys 2008-2012
Authors: Chiara Donfrancesco, Luca De Nicola, Amalia De Curtis, Cinzia Lo Noce, Licia Iacoviello, Luigi Palmieri, Barbara Rossi, Simonetta Palleschi, Diego Vanuzzo, Simona Giampaoli
Journal: Circulation (2013)

Background: The epidemic dimensions of non-dialysis chronic kidney disease (CKD) and the associated elevated cardiovascular (CVD) risk as well as the high costs of renal replacement therapy have ma...
Risk factors for the isolation of a third generation cephalosporin resistant strain in patients with community-acquired Enterobacteriaceae bacteraemia
Authors: M. Ortega, A. Soriano, F. Marco, M. Almela, J.A. Martínez, L. Morata, N. Cobos-Trigueros, C. de la Calle, J. Mensa
Journal: Journal of Infection (2015)