tbuckley/cabot-search huggingface dataset:
Listeria in Europe: The need for a European surveillance network is growing
Authors: C Hedberg
Journal: Eurosurveillance (2006)

Four years ago, Henriette de Valk and colleagues determined both the need for and feasibility of a European network on Listeria infections in humans. The network was envisioned as a way to strengthen surveillance in individual countries by harmonising microbiological methods and providing epidemiologic tools for investigations. The results of their survey were clear: respondents felt that such a network would aid in the detection and investigation of outbreaks, and that it could be based on existing national surveillance systems. There has been considerable institutional support for developing a European Listeria network, and in response to planning efforts, Listeria surveillance has improved in several countries. However, the network has yet to be realised.
High-dose carboplatin, etoposide, and cyclophosphamide for patients with refractory germ cell tumors: treatment results and prognostic factors for survival and toxicity.
Authors: R J Motzer, M Mazumdar, G J Bosl, D F Bajorin, A Amsterdam, V Vlamis
Journal: Journal of Clinical Oncology (1996)

PURPOSE The efficacy and toxicity of high-dose carboplatin, etoposide, and cyclophosphamide with autologous bone marrow transplantation (AuBMT) was investigated in a prospective trial for patients with cisplatin-refractory germ cell tumor (GCT). Prognostic factors for survival and treatment-related toxicity were identified. PATIENTS AND METHODS Fifty-eight patients with refractory GCT were treated with high-dose carboplatin, etoposide, and cyclophosphamide plus AuBMT. Prognostic factors for toxicity and survival were examined in multivariate analyses. RESULTS Twenty-three patients (40%) achieved a complete response and 12 (21%) are alive and free of disease at a median follow-up time of 28 months. Myelosuppression was severe and there were seven (12%) treatment-related deaths. Independently predictive factors that resulted in faster blood count recovery were the use of granulocyte colony-stimulating factor (G-CSF) for the number of days to neutrophil count recovery (P = .013) and prior treatment with cisplatin limited to six cycles or less for the number of days to platelet count recovery (P = .0012). Both were predictive for the number of days of hospitalization (P = .04 and .03, respectively). The two independently predictive variables for survival were pretreatment level of HCG; human chorionic gonadotrophin (HCG; &lt; or = 100 times the upper limit of normal [xnl] v &gt; 100 xnl, P = .02) and the presence of retroperitoneal metastases (yes or no, P = .04). Patients grouped by HCG &lt; or = 100 xnl with retroperitoneal metastases, HCG &lt; or = 100 xnl without retroperitoneal metastases, and all patients with HCG more than 100 xnl had median survival times of 14, 11, and 3 months, respectively (P = .04). CONCLUSION High-dose carboplatin, etoposide, and cyclophosphamide is an effective therapy for patients with refractory GCT, and results in a complete response proportion of 40% and a 2-year survival rate of 31% at a median follow-up time of 28 months. This was accomplished in a group of patients with a dismal prognosis to conventional-dose therapy.
Abstract 18590: The Underutilization of Guideline Recommended Antihypertensive Agents is Associated with a High Prevalence of Uncontrolled Hypertension in Urban Community Dwelling Older Adults
Authors: Sanjum S Sethi, Richard Bordowitz, Kimberly B Morland, Evelyn Granieri, Michael E Farkouh
Journal: Circulation (2012)

Background: Hypertension (HTN) is a major risk factor for cardiovascular disease. Despite numerous medication options and clear clinical practice guidelines (JNC 7), uncontrolled HTN disproportionately affects the elderly population. Hypothesis: We hypothesized that blood pressure (BP) control in adult seniors may be affected by their prescribed antihypertensive medication regimen. Methods: Adults 59-99 years old from two New York City boroughs were enrolled in the NHLBI-funded Cardiovascular Health of Seniors and the Built Environment Study from 2009 to 2011 (n=1,453). At the baseline visit, participants brought their medications and had three BP measurements performed. The average of the 2 nd and 3 rd measurements was recorded. Uncontrolled HTN was defined as a measured BP greater than 140/90 mmHg. Medications were grouped by class including thiazide diuretics, beta blockers (BB), calcium channel blockers (CCB), angiotensin II converting enzyme inhibitors (ACEI), and angiotensin II receptor blockers (ARB). All other agents were grouped together. Results: The prevalence of hypertension was 68.7%. Hypertension increased with age, affected more women (71%) compared to men (61%); and was higher among African Americans (75%) compared to Whites (63%) or Hispanics (63%). Nearly 70% of the hypertensive participants were treated with at least one medication, but in those with uncontrolled BPs (41%), only 65% were prescribed an antihypertensive agent. CCBs were prescribed most frequently (23%) followed by BBs (21%), ACEIs (17%), ARBs (17%), thiazide diuretics (14%), and second line agents (7%). Thiazide diuretics remained the least prescribed first line drug class regardless of underlying comorbidities (diabetes, heart disease, renal disease) or BP control. Conclusions: Despite longstanding consensus recommendations, more than a third of participants with uncontrolled HTN in our cohort were not prescribed any antihypertensive medication. Further, thiazide diuretics were prescribed less often than any other first line agent, contrary to the JNC 7 guidelines. Increased attention to the guideline recommended prescription of antihypertensives may have a beneficial population level effect on uncontrolled hypertension.
Phase II Window of Idarubicin in Children With Extraocular Retinoblastoma
Authors: Guillermo L. Chantada, Adriana Fandiño, Gabriel Mato, Sandra Casak
Journal: Journal of Clinical Oncology (1999)

PURPOSE: The aim of this study was to evaluate in an upfront phase II study the response to idarubicin in children with extraocular retinoblastoma. PATIENTS AND METHODS: The starting dose of idarubicin was 15 mg/m 2 /d (days 1 and 2) weeks 0 and 3. After an interim evaluation, the dose was reduced to 10 mg/m 2 /d (days 1 and 2) weeks 0 and 3 because of hematopoietic toxicity. Response was evaluated at week 6. RESULTS: At the Hospital JP Garrahan (Buenos Aires, Argentina), 10 patients (five bilateral) were entered onto the study from 1995 to 1998. A total of 19 cycles were administered. Extraocular sites included orbit (n = 10), bone marrow (n = 3), bone (n = 1), lymph node (n = 1), and CNS (n = 1). The response rate was 60% (95% confidence interval, 30% to 90%). One complete response was achieved, in addition to five partial responses, two cases of stable disease, and two cases of progressive disease. All patients with bone marrow involvement achieved complete clearance of tumor cells. The patient with CNS disease had progressive disease. All patients had severe hematopoietic toxicity (grade 4 neutropenia and grade 3/4 thrombocytopenia after most cycles). Other toxicities included grade 2 diarrhea in 30%. No echocardiographic changes were detected. CONCLUSION: Idarubicin is active in extraocular retinoblastoma. The activity of this drug should be explored in future phase III studies.
Survival after resection of liver metastases from colorectal cancer with poor clinical risk factors using adjuvant systemic plus hepatic arterial therapy
Authors: N. E. Kemeny, M. Capanu, Y. Fong, D. Haviland, W. R. Jarnagin, R. P. DeMatteo, M. I. D'Angelica
Journal: Journal of Clinical Oncology (2008)

4076 Background: Liver resection for hepatic metastases (mets) from colorectal carcinoma clearly improves survival. However, the 5 year survival varies from 60 to 18% depending on clinical risk score (CRS). CRS uses factors such as number of mets >1, synchronous disease, node positive primary tumor, pre-op CEA levels and positive margins, assigning 1 point for each factor. In 2 different CRS methodologies, 5 year survival is 14–25% in pts with 3–5 points (Fong Y: Ann Surg 1999, Nordlinger B: Cancer 1996). Methods: 4 adjuvant trials using hepatic arterial therapy (HAI) and systemic therapy after liver resection at MSKCC from 1991 to 2007 were updated and analyzed. After liver resection, all pts (n = 236) received HAI with FUDR and dexamethasone via an internal pump, combined with one of four systemic (sys) regimens: 5FU/LV, irinotecan, oxaliplatin/FU/LV, or sys therapy ± bevacizumab. Results: Poor prognostic characteristics for the 236 pts include: > 1 met (65%), CRS 3–5 (41%), synchronous disease (43%), Dukes’ C (61%), and positive margins (13%). The median followup time for all pts is 64.4 months with 62% alive at 5 years. Those pts treated with HAI + sys 5FU/LV or sys irinotecan have a 5 year survival of 61% and 59%, respectively. Since the two remaining trials have a shorter median followup, we can only report the 4 year survival for the HAI + sys oxaliplatin/5FU/LV group, which is 87%. The table below outlines 5 year survival rates for various patient characteristics, including postop CEA, which was not in the CRS. Conclusion: Patients with hepatic mets from colorectal cancer who undergo liver resection can achieve long term survival despite poor clinical characteristics. Even in pts with a CRS of 3–5, the 5 year survival is 52% (70% for pts with CRS of 0–2), when resection is followed by HAI and systemic therapy. Pt Characteristics 5-year overall survival log rank/p-value 5-year PFS survival log rank/p-value Dukes: B 74% 0.003 48% 0.002 C 56% 30% # mets at resection: 1 74% 0.001 51% 0.0005 2 - 4 64% 36% ≥ 5 34% 12% Fong Score (CRS): 0 - 2 70% 0.001 45% 0.0006 3 - 5 52% 26% Synchronous: < 12 mos to hep mets 66% 0.8 41% 0.07 ≥ 12 mos to hep mets 59% 34% Size largest lesion: < 5 cm 63% 0.1 38% 0.7 ≥ 5 cm 62% 35% Resection margins: ≤ 0.1 cm 36% <.0001 18% 0.001 > 0.1 cm 67% 40% Postop CEA: < 5 67% 0.008 38% 0.2 ≥ 5 50% 34% Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Expert Testimony Other Remuneration Genentech, Johnson & Johnson, Pfizer, sanofi-aventis
Abstract 10278: Incretin-Based Treatments Prevent the Development of Atherosclerotic Lesions in Apolipoprotein E-Null Mice
Authors: Takuya Watanabe, Masaharu Nagashima, Michishige Terasaki, Kyoko Nohtomi, Akira Miyazaki, Tsutomu Hirano
Journal: Circulation (2010)

Background: Several lines of evidence suggest that incretin-based therapies suppress the development of cardiovascular disease in type 2 diabetes. Objectives: We investigated the possibility that g...
Higher prevalence and level of IgE, particularly to furry animals, in subjects with asthma in Sweden
Authors: Sigrid Sjolander, Anders Bjerg, Linda Ekerljung, Magnus Rudengren, Malin Berthold, Otti Bengtsson-Gref, Magnus Borres, Eva Rönmark, Jan Lötvall, Bo Lundbäck
Journal: European Respiratory Journal (2014)

Introduction.  Atopic sensitization increases the risk of asthma. Generally, the presence of IgE antibodies (IgE-ab) to furry animals represent a risk factor for developing asthma in temperate areas, while IgE-ab to mites is the main risk factor in tropical and sub-tropical areas.   Aim.  To study patterns of sensitization and the risk of asthma among adults.   Methods.  In the West Sweden Asthma Study a questionnaire targeting asthma issues were sent to 30 000 randomly selected subjects aged 16-75 years. Of the 18 081 responders, a randomly selected sample of 2000 subjects and all reporting asthma, further 1536 subjects, were invited to detailed clinical examinations. Sera were received from 924 subjects with a diagnosis of asthma and from 1011 without, and these 1935 subjects were selected for this study. Sera were analyzed for IgE-ab using three allergen panel tests including inhalant and food allergens (ImmunoCAP). Samples with a level of IgE >0.35 kU A /l were analyzed for IgE-ab against each individual allergen included in the test.   Results.  The risk of being sensitized was significantly higher in the asthma group for the 21 allergens tested (p   Conclusion.  Sensitization, particularly to furry animals, appears in this large sample of adults from West Sweden to be a major risk factor for asthma.
Secondary vs. primary cachexia in patients with advanced cancer
Authors: E. Del Fabbro, S. Dalal, M. Delgado, G. Freer, E. Bruera
Journal: Journal of Clinical Oncology (2007)

9128 Background: Cachexia results in decreased survival and adherence to chemotherapy, and increased treatment toxicity. Primary Cachexia (PC) is characterized by weight loss, anorexia and fatigue and it is the result of tumor-host interactions producing neurohormonal dysfunction and an aberrant pro-inflammatory response. The clinical effects of PC may be exacerbated by complications capable of decreasing energy intake (Secondary Cachexia) such as dysgeusia, anxiety, depression, pain, early satiety, nausea and constipation. The objective of this study was to determine the causes and the frequency of secondary cachexia (SC) in a cohort of patients with PC. Methods: We reviewed the charts of 50 consecutive advanced cancer patients who underwent a structured assessment in a specialized cachexia clinic at a comprehensive cancer center. Results: All patients gathered criteria for cachexia, including a weight loss of &gt;5% within the preceding 6 months. The most frequent causes of SC were early satiety in 40 patients(80%), constipation in 37(74%), depression or anxiety in 30(60%), uncontrolled pain in 31(62%), chronic nausea in 21(42%), dysgeusia in 14(28%),dental problems in 4(8%), dysphagia in 3(6%)chronic aspiration in 2 (4%) and oral candidiasis in 1 (2%).All 50 patients presented with at least 2 secondary causes of cachexia, and 44(88%) presented with = 3. The median number of causes of secondary cachexia was 4 (range 2–5). 211 interventions were used in these patients to treat secondary causes of cachexia. 14(28%) of the patients referred were already on a medication for appetite stimulation (megestrol acetate, dronabinol, corticosteroids). Conclusions: SC should be ruled out in all patients who have PC since the vast majority of patients referred to a cachexia clinic have 2 or more causes of SC. All cancer patients with involuntary weight loss in our series had “mixed cachexia”. Inexpensive effective treatments are available for most of the causes of SC, but they are frequently underused. No significant financial relationships to disclose.
Gemcitabine and irinotecan combination in patients with metastatic bladder cancer: A phase II trial
Authors: U. B. Chaudhary, R. Sawhney, H. Clark, T. Keane, F. Brescia
Journal: Journal of Clinical Oncology (2005)

4753 Background: Gemcitabine and Irinotecan (Irinogem) are newer generation agents with different mechanisms of action, non-overlapping toxicity profiles, and synergistic activity in-vitro. Based on our previous laboratory data, human xenograft in-vivo models confirmed activity of Irinotecan and it’s combinations in human urothelial tumors. We are conducting a phase II trial of Irinogem to evaluate it’s efficacy and toxicity in patients with metastatic bladder cancer. Methods: Thirteen patients have been enrolled to date, of which 10 are evaluable for response. The median age is 65 years (range 55–78). According to Bajorin’s prognostic model for metastatic bladder cancer, 9 patients were classified as having 0 risk factors (KPS ≥80 with no visceral disease), and 4 patients had 1 risk factor (KPS ≥80 with visceral disease). Gemcitabine 1000 mg/m2 and Irinotecan 100 mg/m2 were administered on days 1 and 8 of each 3 week cycle. All patients had histologically proven TCC of the bladder with bidimensionally measurable disease. All but one patient were chemotherapy-naive at enrollment. Results: An average of 4 cycles were delivered per patient. Ten patients have finished therapy, while three patients are currently on treatment, with continued response. One patient was taken off therapy due to grade 4 fatigue, 1 due to stroke, 1 due to grade 4 colitis, 1 due to progressive disease, and 1 declined to participate in the trial after receiving the first cycle of therapy. Among 10 patients evaluable for efficacy, objective radiographic response was documented in 8 patients (two complete and six partial responses). The median time to progression was 8 months (range 3–11 months) among those patients who have progressed. Toxicity, evaluated in all 13 patients, was modest: 2 episodes of febrile neutropenia, grade 3–4 neutropenia in 4 patients, grade 3–4 diarrhea in 2 patients, grade 3–4 fatigue in 1 patient, grade 3–4 nausea/vomiting in 2 patients, grade 3–4 neurologic toxicity in 1 patient, and no grade 3–4 thrombocytopenia. No toxic deaths were noted. Conclusions: This preliminary data suggests that the combination of Gemcitabine and Irinotecan appears active in metastatic bladder cancer, with manageable toxicities. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Lilly Oncology Lilly Oncology
Using clinical algorithms to identify psychosocial distress and other risk factors in cancer survivors.
Authors: Paula A. Lewis-Patterson, Guadalupe R. Palos, Katherine Ramsey Gilmore, Patricia Chapman, Delrose Jones, Weiqi Bi, Maria Alma Rodriguez
Journal: Journal of Clinical Oncology (2015)

242 Background: Late effects, such as pain and fatigue, increase a cancer survivors' risk to psychosocial distress. Assessment and identification of distress and other risk factors can be integrated into survivorship care. Yet, clinical tools and processes needed to coordinate these efforts are severely limited. Here we describe the processes and metrics used to assess and document distress in the survivorship care plans (SCPs) of survivors diagnosed with colon and rectal cancers (CC and RC). Methods: Eligibility criteria for this longitudinal analysis included being: ≥ 18 years, diagnosed with a primary colon/rectal cancer, no evidence of disease ≥ 5 years, seen between 09/01/2011 - 8/31/2014, and alive at time of data abstraction. 117 survivors met these criteria and the first 50 sequential cases were included in this sub-analysis. Data were collected at Visits 1, 2, and 3 within specific time parameters. Data sources included the SCP, electronic medical records (EMRs), and CC/RC algorithms. Variables included demographic/clinical characteristics and standards of care (SOC) elements embedded in the algorithm related to distress, fatigue, pain, and social support. Compliance with SOC were measured using a “yes/no” response format. Results: Of 50 survivors, 58% were diagnosed with CC and 42% with RC. 52% were male, 64% Caucasian, 54% age 65-89 years, and 68% were 5-9 years from diagnosis. 52% of CC survivors were Stage IIIA-C or IV and 57% of RC were Stage 1-IIB. Documentation and metrics for each element indicated a total of 111 visits over the course of the analysis, 59% were CC and 42% RC. Provider's compliance rates (PCRs) were: distress (65%), fatigue (32%), pain (68%), and social support (46%). The pain element was not included in the CC algorithm. PCRs for each element varied by site. Evidence that providers followed algorithms' recommdendations to assess survivors current risk of distress was found in the EMRs, SCPs. Conclusions: We found cancer survivorship clinical algorithms and care plans can guide assessment, documentation, and monitoring of psychosocial assessment. Screening for risk factors to distress in cancer survivors can be done in real time and help identify at-risk survivors during their visit.
Anti-angiogenic effect of 5-Fluorouracil-based drugs against human colon cancer xenografts
Authors: Akio ooyama, Toshinori Oka, Hong-ye Zhao, Masatatsu Yamamoto, Shin-ichi Akiyama, Masakazu Fukushima
Journal: Cancer Research (2008)

AACR Annual Meeting-- Apr 12-16, 2008; San Diego, CA

3340 

In addition to the direct cytotoxic effects of chemotherapy agents on tumor cells, the anti-angiogenic activities attained by these agents by targeting proliferating endothelial cells in tumor blood vessels has attracted much research interest. In this study, we examined the antitumor activity of 5-Fluorouracil (5-FU)-based drugs (S-1 [1M tegafur, 0.4M CDHP and 1M Oxo] and capecitabine) on human colorectal cancer xenografts and evaluated their anti-angiogenic effects. S-1 and capecitabine showed significant antitumor activities against COL-1 xenografts at a semi-toxic dose that was lower than the maximum tolerated dose (S-1: 6.9 mg/kg/day, capecitabine: 360 mg/kg/day). At this dose, a trend towards a reduction in the microvessel number after the administration of 5-FU-based drugs and the enhancement of tumor-associated microvessel endothelial cell apoptosis was seen in xenograft treated with S-1 (P = 0.014). In addition, we found that thrombospondin-1 (TSP-1) mRNA, known to be a mediator of the antiangiogenic effects of metronomic chemotherapy, was significantly up-regulated in xenograft tumor tissues treated with S-1 at a semi-toxic dose (P = 0.006). This induction was reflected at the protein level in tumor tissues and blood plasma. Capecitabine also showed a trend toward the induction of TSP-1 (mRNA: P = 0.079, protein: P = 0.059). These results suggest that 5-FU-based drugs inhibit tumor progression through different modes of action, including cytotoxic activity derived from 5-FU and the inhibition of angiogenesis through the induction of TSP-1.
Intermittent high-dose intravenous interferon alpha 2b (IFNa2b) for adjuvant treatment of stage III malignant melanoma: Final analysis of a randomized phase III DeCOG-trial (NCT00226408).
Authors: Peter Mohr, Axel Hauschild, Uwe Trefzer, Alexander Enk, Wolfgang Tilgen, Carmen Loquai, Helen Gogas, Thomas Haalck, Josef Koller, Dirk Schadendorf, Reinhard Dummer, Ralf Gutzmer, Norbert Brockmeyer, Erhard Hölzle, Cord Sunderkötter, Cornelia Mauch, Anette Stein, Lars Schneider, Maurizio Podda, Michael Weichenthal
Journal: Journal of Clinical Oncology (2012)

8505 Background: Adjuvant high-dose interferon (HDI) treatment of patients (pts) with malignant melanoma (MM) usually consists of 4 weeks initial intravenous (iv) infusion of 20 MU/m² IFNa2b followed by 11 months of 10 MU/m² subcutaneously (sc). It is still unclear, whether both components are necessary for the efficacy of HDI in high-risk MM pts. The adjuvant phase III DeCOG MM-ADJ-5 trial evaluates efficacy, safety, tolerability and quality of life (QoL) of an intermittent (pulsed) high-dose iv IFNa2b regimen as compared to standard HDI. Methods: Patients with stage III (AJCC 2002) resected intransit or lymph node metastasis from cutaneous malignant melanoma were randomly assigned to receive either standard HDI regimen (Arm A), or 3 courses of IFNa2b 20 MU/m² iv on 5 days a week for 4 weeks repeated every 4 months (Arm B). Distant metastasis free survival (DMFS) was the primary endpoint for efficacy analysis. The EORTC QLQ C30 questionnaire was used before and during the study in a standardized way (weeks 0, 4, 16, 24, 40). In addition, patients completed a diary containing global QoL measures every week. Results: Out of 649 patients who were enrolled, 22 patients had to be excluded from the intent-to-treat analysis. The remaining 627 patients were well balanced between both arms according to sex, age, and stage. Median follow-up was similar in both groups (55.4 vs. 55.3 months). Distant metastasis occurred in 138 (Arm A; 44%) vs. 145 (Arm B; 47%) patients without statistical significance (p=0.46). Survival was not significantly different for DMFS (HR 1.1; p=0.39) or OS (HR=1.0; p=0.85). Termination of treatment due to adverse events or QoL related reasons occurred significantly more often in arm A than in arm B (26.0% vs. 14.8%; p&lt;0.001). The pulsed schedule resulted in less cumulative toxicity as compared to the standard regimen, in particular regarding fatigue and neuropsychiatric side effects. Conclusions: The final analysis of pulsed adjuvant HDI treatment showed no significant DMFS or OS differences in comparison to conventional HDI. There is a clearly favorable safety and QoL profile of the pulsed regimen.