tbuckley/cabot-search huggingface dataset:
Phase I and pharmacokinetic (PK) study of lenalidomide (LEN) in pediatric patients with relapsed/refractory solid tumors or myelodysplastic syndrome (MDS): A Children's Oncology Group Phase I Consortium study
Authors: S. L. Berg, H. Russell, M. Cairo, A. M. Ingle, P. C. Adamson, S. M. Blaney
Journal: Journal of Clinical Oncology (2009)

10023 Background: LEN, which has immunomodulatory, antiangiogenic, and antiproliferative effects, is indicated for the treatment of adults with MDS and multiple myeloma. We report the final results of a phase 1 and PK study of LEN in children with recurrent or refractory solid tumors (ST) or MDS. Methods: LEN was administered by mouth once daily for 21 of 28 days. Cohorts of 3 to 12 children with ST were enrolled at 15, 25, 40, 55 and 70 mg/m2/d dose levels. Children with MDS received a fixed dose of 5 mg/m2/d. PK and correlative biology studies were performed in cycle 1. Results: 49 patients (23 female), median age 16 years (range, 1–21) were enrolled and received a median of 1 cycle (range 1–11). 39/46 ST patients and 3/3 MDS patients were fully evaluable for toxicity. 0/3 patients with MDS had DLT. At 15 mg/m2/d, 1/6 ST patients developed DLT (Gr 3 hypercalcemia). At 25 mg/m2/d 1 patient had a cerebrovascular ischemic event of uncertain relationship to LEN; future subjects were screened for thromboembolic risk factors prior to enrollment. At 40 mg/m2/d 3/12 patients developed DLTs (Gr 3 hypophosphatemia/hypokalemia; Gr 4 neutropenia delaying the start of the next cycle for &gt; 7 days; Gr 3 somnolence); at 55 mg/m2/d 1/6 patients developed DLT (Gr 3 urticaria). At 70 mg/m2/d 0/6 patients had DLT. No further dose escalation was attempted. No objective responses were observed. LEN enhanced IL-2 and IL-15 concentrations; NK expansion and activation; and NK and LAK cytotoxicity (Ayello, ASH, 2008). The median apparent LEN clearance and half-life were 135 ± 45 ml/min/m2 and 2.3 ± 1.1 hr. Conclusions: LEN is well tolerated at doses up to 70 mg/m2/d x 21d of 28 days in children with recurrent or refractory ST. Enhancement of immune function is significant. PK parameters in children are similar to those in adults. No significant financial relationships to disclose.
Abstract 12192: Improving Care of ST Segment Elevation Myocardial Infarction in the United States 2008 to 2012: A Report From Mission: Lifeline
Authors: Christopher B Granger, Eric R Bates, James G Jollis, Elliott Antman, Graham Nichol, Robert E O'Connor, Chris Bjerke, Tammy Gregory, S. A Peng, Gray Ellrodt, Timothy D Henry, William J French, Alice Jacobs
Journal: Circulation (2013)

Care guidelines recommend regional systems to optimize reperfusion for patients with ST segment elevation myocardial infarction (STEMI). But such treatment is often delayed or not given at all. Mis...
Type 1 gastric carcinoids: Efficacy and safety of endoscopic management.
Authors: E. Merola, A. Sbrozzi-Vanni, F. Panzuto, G. D'Ambra, E. Di Giulio, G. Capurso, E. Lahner, C. Bordi, B. Annibale, G. Delle Fave
Journal: Journal of Clinical Oncology (2010)

e14577 Background: Type I gastric carcinoids (TIGC) are “rare” neuroendocrine neoplasms arising from ECL cells in the background of atrophic body gastritis, due to gastrin growth effects. Diagnosis is often accidental, as patients may be asymptomatic, and these tumors are usually indolent. Data regarding their evolution in prospective series are scanty, and thus treatment and follow-up programs are not codified. Our aim was to assess clinical outcome and recurrence in a series of TIGC patients managed by endoscopic approach. Methods: We enrolled in this prospective study consecutive patients with TIGC (diagnosis of gastric well-differentiated endocrine tumor associated with atrophic body gastritis) who had at least one gastroscopy after the first diagnosis. Exclusion criteria were treatments other than endoscopical resection (polypectomy or mucosectomy). Results: 33 patients (24 females), median age 65 (23-81), 75.7% with anemia (40% pernicious). 7 tumors (22.2%) were microcarcinoids, 26 polyps (median diameter: 5 mm; 2-20) multiple in 17 (65.4%) patients. Associated severe atrophy in 21 cases (63.6%), mild in 18.2%. During 46-month median follow-up, survival was 100% and no local/distant invasion occurred. 21 patients (63.6%) had recurrence after a median of 8 months, 12 of these (57.1%) had second recurrence after a median of 7 months from previous TIGC removal. Median recurrence-free survival was 15 months. Nor clinical neither biochemical factors predicting for recurrence were found. Conclusions: Although about 60% of TIGC patients underwent recurrence after endoscopic resection, no tumor progression was observed during follow-up. In patients with TIGC, endoscopic management may be considered safe and effective, while radiological stadiation is not mandatory. No significant financial relationships to disclose.
Phase I study of OSI-906, dual tyrosine kinase inhibitor of insulin-like growth factor-1 receptor (IGF-1R) and insulin receptor (IR) in combination with erlotinib (E) in patients with advanced solid tumors.
Authors: V. M. Macaulay, M. R. Middleton, S. G. Eckhardt, R. A. Juergens, A. W. Stephens, S. Poondru, S. P. McCarthy, S. M. Gadgeel
Journal: Journal of Clinical Oncology (2010)

3016 Background: OSI-906 is an inhibitor of IGF-1R and IR, which are often upregulated in tumors. Compensatory cross-talk between IGF-1R and EGFR contributes to resistance to agents targeting either pathway, supporting evaluation of dual receptor inhibition. Methods: Patients (pts) with advanced solid tumors received escalating doses of OSI-906 plus continuous E (100/150 mg/d). Objectives included determination of MTD, safety, pharmacokinetics (PK), and tumor response (RECIST). Results: To date, 30 pts were enrolled (17M/13F, median age 59 yrs) and 26 treated. Two OSI-906 dosing schedules were investigated, combined with 100 mg/day E. Intermittent OSI-906 (S1) was administered QD 1-3 q7 d to dose cohorts (mg/pt) of 50 (3 pts), 75 (3); 150 (3), 300 (4); 450 (3) and 600 (3), and continuous OSI-906 (S2) QD to dose cohorts 50 (4) and 100 (3). Median number of weeks on trial was 6 (range 0-23+). DLTs of g4 elevated ALT/AST and g3 fasting hyperglycemia occurred in 2 pts at OSI-906 S1 600 mg + E 100 mg. Transient g1-2 hyperglycemia (12 pts, 46%) and elevation of insulin levels (9 pts, 35%) were consistent with IR inhibition. E-related skin rash occurred in 22 (85%) pts (g1/2/3: 27/54/4%). Other adverse events related to OSI-906 and E in ≥2 pts were of g1-2 severity: fatigue (31%), diarrhea (31%), anorexia (12%), nausea (15%), dyspepsia, dysgeusia and vomiting (8% each). Preliminary PK data indicate that exposure of OSI-906 was not altered significantly after co-administration with E. Exposure of E and its main metabolite OSI-420 appears similar to previous studies, suggesting lack of PK interaction between OSI-906 and E. Stable disease of 12-23+ weeks was seen in 4/7 pts on S2 including cases of adrenocortical carcinoma, Ewings sarcoma, chordoma and adenocarcinoma of unknown primary. Conclusions: Intermittent OSI-906 with 100mg E had minor toxicity up to 450 mg, with DLTs at 600 mg. Preliminary data indicate that continuous OSI-906 with E is also well-tolerated, and is capable of inducing disease stabilization. Dose escalation continues including a continuous BID dosing schedule, aiming to define MTDs using E at 150 mg QD. Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration OSI Pharmaceuticals OSI Pharmaceuticals OSI Pharmaceuticals OSI Pharmaceuticals OSI Pharmaceuticals
구연 : 당원병 제1형의 장기적 예후로서 간선종, 간세포암에 대한 고찰
Authors: 양혜란, 김유정, 서정기
Journal: Clinical and Molecular Hepatology (2003)

배경/목적: 당원병 제1형은 어린 소아연령에서 발현하는 가장 심한 형태의 당원병으로, 장기간 관찰시 일부 환자에서 간선종이 발생하고 드물게는 간암이 발생하여 예후에 심각한 영향을 미치는 것으로 알려져 있다. 하지만 아직까지 당원병 제1형에서 발생하는 간선종에 대한 연구가 거의 이루어지지 못하였다. 본 연구에서는 한국의 당원병 제1형 환자들의 추적관찰을 통해 간선종과 간암 발생의 측면에서 당원병 제1형의 장기적인 예후를 살펴보고자 하였다. 대상과 방법: 1982년 3월에서 2003년 2월까지 간조직 검사 및 효소검사를 통해 당원병 제1형으로 진단된 45명의 환자(제Ia형 43명, 제Ib형 2명)를 대상으로 하였다. 복부 초음파, 전산화단층촬영 또는 자기공명영상을 시행하여 간선종의 발생여부를 관찰하였으며, 간의 종괴가 확인된 경우 가능하면 조직검사를 시행하여 간선종 및 간암을 확진하였다. 결과: 1) 전체 45명 중 14명(31.1%)에서 간선종이 발생하였는데, 간선종이 처음 발견된 나이는 평균 14.9세(범위: 10.8∼25.7세)였다. 처음 발견시 다발성 선종인 경우는 10례(71.4%)였다. 간선종은 10세 이후까지 추적관찰이 가능하였던 환자의 41.2%(14/31명), 15세 이후까지 관찰하였던 환자의 64.7%(11/17명), 그리고 20세 이후까지 관찰하였던 환자의 88.9%(8/9명)에서 발생하였다. 2) 간선종이 발생하지 않은 나머지 31명의 마지막 외래추적시 나이는 평균 10.5세(범위: 1.8∼24.3세)였고, 이 중 17명은 10세 이후까지 추적이 가능한 경우였다. 3) 10세 이후까지 추적관찰한 환자들 중에서 간선종이 발생하였던 선종군(n＝14)과 간선종이 안 생긴 비선종군(n＝17)에서의 남녀비는 두 군간에 유의한 차이가 없었고(P＝0.101), 선종군에서 처음 간선종이 발견된 나이와 비선종군에서 마지막 추적관찰시 나이는 유의한 차이가 없었다(P＝0.804). 신장질환이 선종군의 42.9%와 비선종군의 11.8%에서 발생하여 두 군간에 유의한 차이를 보였다(P＝0.018). 4) 25.7세에 간선종이 발견되었던 1명은 26.5세에 간암으로 진단되어 간동맥 항암화학 색전술을 시행 받았다. 결론: 당원병 제1형 환자들을 장기간 추적관찰 하였을 때 10세 이후부터 간선종이 발생하였으며, 간선종의 발생빈도는 환자들의 나이가 증가함에 따라 증가하였다. 이 중 1명에서 조기에 간암이 발생하여 당원병 제1형에서 간선종과 간암의 발생여부가 예후에 매우 중요함을 알 수 있었다. 따라서 당원병 제1형 환자들에서 간선종을 조기에 진단하기 위해 정기적인 검사를 시행하는 것이 장기적인 예후에 도움이 될 것이다.
저중심정맥압 유지 기법에 의한 간절제수술이 술중 출혈 및 술후 합병증에 미치는 영향
Authors: 이상엽, 강구정, 김용훈, 임태진
Journal: Clinical and Molecular Hepatology (2003)

배경/목적: 간 절제수술중 출혈문제는 외과의사의 주된 관심사 중의 하나다. 많은 출혈과 수혈은 술 후 합병증 혹은 사망률과 직접 관련이 있으며 원발병소가 간암인 경우 재발률에도 악영향을 미친다고 알려져 있다. 간을 절제하는 동안 출혈을 줄이기 위하여 간내로 유입되는 문맥혈류와 간동맥혈류를 차단하는 방법(Pringle maneuver)이 간을 절제하는 외과의사들에게 즐겨 사용되어 왔다. Pringle maneuver로 간절제시 출혈은 문맥에서보다 간정맥에서 오히려 더 많이 일어나는 것이 보통이다. 술전 과 주입한 수액이나 혈액제재가 중심정맥압을 상승시켜 간정맥을 팽창시키면서 간절제중 상당히 많은 출혈이 있을 수 있다. 따라서 간절제시에는 간내로 유입되는 혈액을 차단함과 동시에 중심정맥압에 의하여 간정맥에서 역으로 흐르는 혈류(back flow)를 줄여 출혈을 감소시키는 것은 대단히 중요하다고 생각된다. 이것은 중심정맥압을 낮춤으로서 가능해지며 간절제시 낮은 중심정맥압을 유지하는 것이 술중 출혈과 주술기 합병증 빈도에 미치는 영향을 알아보고자 본 연구를 계획하였다. 대상과 방법: Nitroglycerine을 지속적으로 주입하여 중심정맥압을 정상보다 낮게 유지한 체로 간절제수술을 시행한 117명의 성인을 대상으로 술중 출혈, 수혈량 및 신장손상을 포함한 주술기 합병증을 조사하였다. 마취 전처치로 midazolam 0.02 mg/kg, glycopyrrolate 0.2 mg을 근육주사하였고, 통상적인 마취유도와 isoflurane으로 흡입마취를 시행하였으며 환자의 활력징후 감시로는 혈압, 심전도, 중심정맥압, 동맥혈 산소포화도를 지속적으로 관찰하였으며 배뇨량을 매시간 측정하였다. 일반적인 개복수술때에 주입하는 수액주입양의 1/4정도인 100 ml/hr 정도로 주입하면서 중심정맥압을 5 mmHg 이하로 낮추도록 하며 수액주입속도조절만으로 중심정맥압이 목표치에 미달하면 nitroglycerine을 지속적으로 투여(1∼2 μg/kg/min)하여 중심정맥압을 5 mmHg 이하로 유지하였고 간 실질절제가 마무리되고 간 절단면의 지혈이 마무리되는 즉시 수액주입양을 급속히 늘려 중심정맥압을 상승시키고 배뇨량을 증가시켰다. 간실질 절단기간 동안 간내로 유입되는 문맥혈과 간동맥혈은 15분간격의 간헐적 차단법을 사용하였고 간 실질 절단에는 주로 초음파분쇄흡인기(CUSA)를 사용하였다. 결과: 질환별로는 간세포암 57례, 간내 담도 결석증 23례, 말초담관암 5예, 간농양 5례, 전이성 간암 5례, 간문부담관암 4예, 담도의 낭성 선종 3예, 육종성 간세포암 및 담낭암 각각 1례 등이었다. 수술은 표준 간엽이상절제(lobectomy)가 63예(54%), 구역절제술 및 분절절제술이 54예(46%)였다. Nitroglycerin투여전 혈압과 중심정맥압은 128.1 mmHg, 7.0 mmHg였고 nitroglycerine 투여 후 혈압과 중심정맥압은 101.8 mmHg, 3.8 mmHg였다. 평균 출혈량은 607±500ml였다. 84예(71.8%)에서는 수혈을 하지 않았으며 1U 이상의 수혈을 시행한 예는 33예(28.2%)였으며 수혈환자의 수혈량은 평균 2.6U였다. 한 분절(section) 이하의 절제에서 출혈량과 수혈량은 539.5±632ml, 0.9±1.4pint였다. 간경변군과 정상군의 출혈량은 각각 869±691ml, 408.5±3010.3ml였다(p＝0.004). 술 후 가벼운 합병증이 25예(21.4%)에서 합병증이 발생하였으며 3예(2.6%)에서 술후 간기능부전으로 사망하였다. 저중심정맥압으로 인한 신기능장애 예는 없었다. 결론: 간 절제수술시 비교적 짧은 시간동안 nitroglycerine 지속주입에 의한 저중심정맥압 마취방법은 술중 출혈을 줄일 수 있고 술 후 간기능 장애나 신장기능 장애를 초래하지 않으며 합병증을 줄일 수 있는 유용한 수단이라 생각된다.
Should non-anthracycline-based chemotherapy (Non-A) substitute anthracycline-based (A) when combined with taxanes (T) as 1st-line chemotherapy (CT) for advanced breast cancer (ABC)? Meta-analysis of randomized clinical trials (RCTs) balancing efficacy and toxicity
Authors: P. Carlini, E. Bria, F. Cuppone, I. Sperduti, V. Vaccaro, C. Nistico, C. Nuzzo, F. Cognetti, E. Terzoli, D. Giannarelli
Journal: Journal of Clinical Oncology (2008)

1087 Background: A-based CT for ABC has been considered as the standard treatment for clinical practice. Thanks to the larger utilization of A-based CT in adjuvant setting in the last 10 years, several evidences have been produced supporting the activity of new chemotherapeutics such as capecitabine and gemcitabine or old (like carboplatin) combined with taxanes for 1st-line treatment. To better ‘weight’ efficacy and toxicity of such A-free combinations, RCTs have been conducted to compare those regimens with A-based CT. Methods: A literature-based meta-analysis was accomplished, and event-based relative risk ratios (RR) with 95% confidence interval (CI) were derived. A fixed- and a random-effect model according to the inverse variance and the Mantel-Haenszel method were applied. Heterogeneity test was applied as well. Absolute differences (AD) and the number of patients needed to treat (NNT) were calculated. Primary endpoint was median progression-free survival (PFS); secondary endpoints were 2-yrs overall survival (OS), overall response rate (ORR), complete response rate (CR), partial response rate (PR), and WHO-grade 3–4 neutropenia, febrile neutropenia (FN), and diarrhea. Results: Three RCTs were gathered (863 pts); 2 out of 3 combined capecitabine with a taxane (536 pts), and 1 combined carboplatin. Results are reported in the following table. Conclusions: The substitution of A with Non-A chemotherapeutics seem to not compromise efficacy of T-based 1st-line CT for ABC; moreover, neutropenia is significantly reduced with this approach, although extra-hematologic toxicities (such as diarrhea) are increased with capecitabine. Endpoint Pts (#RCTs) RR (95% CI) p Het. (p) AD (%) NNT Median PFS 863 (3) 0.91 (0.81, 1.02) 0.12 0.42 - - 2-yrs OS 327 (2) 0.95 (0.82, 1.09) 0.48 1.00 - - CR 863 (3) 0.88 (0.58, 1.37) 0.58 0.23 - - PR 863 (3) 0.90 (0.75, 1.09) 0.29 0.32 - - ORR 863 (3) 0.95 (0.81, 1.10) 0.50 0.37 - - Neutropenia 863 (3) 0.74 (0.61, 0.91) 0.004 0.43 - 7.4 13 FN 863 (3) 0.63 (0.35, 1.19) 0.15 0.60 - - Diarrhea 536 (2) 4.50 (1.15, 17.50) 0.03 0.74 + 2.6 39 No significant financial relationships to disclose.
NATIVE INFESTATION BY THE BROAD TAPEWORM, DIPHYLLOBOTHRIUM LATUM
Journal: JAMA (1922)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
P53 protein over-expression but not <i>p53</i> gene mutation is a poor prognostic marker and a predictive marker for survival benefit from adjuvant chemotherapy in non-small cell lung cancer (NSCLC) in the JBR.10 Trial
Authors: M. S. Tsao, S. Aviel-Ronen, K. Ding, D. Lau, N. Liu, M. Whitehead, L. Seymour, T. Winton, F. A. Shepherd
Journal: Journal of Clinical Oncology (2007)

7577 Background: JBR.10, a phase III inter-group trial randomized 482 patients with resected stage IB &amp; II NSCLC to receive 4 cycles of adjuvant cisplatin + vinorelbine or observation alone. Chemotherapy patients had an overall survival (OS) benefit (Hazard Ratio [HR] 0.69, p=0.04). P53 has important regulatory roles in cell cycle progression, apoptosis, gene transcription and DNA repair. We evaluated the prognostic and predictive value of p53 in JBR.10. Methods: P53 protein expression was evaluated by immunohistochemistry (IHC) on tissue micro-arrays (282 available blocks). We used the DO7 antibody, and defined ≥15% nuclear staining as the cutoff for over- expression. Mutations in exons 5–9 were determined by denaturing high performance liquid chromatography (446 available samples), followed by sequencing of aberrant PCR products. Results: Successful assays: p53 mutation, 403/446 patients; p53 IHC, 254/282 patients. P53 gene mutations were found in 126/403 (31%) patients. In the observation arm, mutations were not prognostic of poorer survival (HR = 1.18, 95% CI 0.77–1.81; p= 0.45). Adjuvant chemotherapy effect was not significantly different in p53 mutated and wild type patients (interaction p = 0.66), the estimated HR was 0.68 (95% CI 0.46–1, p=0.047) for patients with wild type p53, and 0.79 (95% CI 0.47–1.33, p=0.37) for mutated patients. P53 protein over-expression was found in 133/254 (52%) patients. Patients with over-expression in the observation arm had a higher risk of death than patients with low expression (HR 1.89, 95% CI 1.07–3.34, p=0.03). However, the adjuvant chemotherapy effect was significantly better in p53 over-expressing patients (interaction p= 0.018), with an estimated HR of 0.53 (95% C.I. 0.31–0.90, p=0.03) for p53 over-expressing patients, and 1.40 (95% C.I. 0.78–2.52, p=0.26) for low expressing patients. Conclusions: P53 protein overexpression but not p53 gene mutation is both a significant prognostic marker of poorer survival in the JBR 10 population and a significant predictive marker for the benefit of adjuvant chemotherapy. [Table: see text]
Abstract 9463: Clinical and Genetic Evidence for Angiotensin Converting Enzyme Inhibition to Prevent Postoperative Tachyarrhythmias After Congenital Heart Surgery
Authors: Andrew H. Smith, English C. Flack, Kristie Y. Borgman, Jill P. Owen, Frank A. Fish, David P. Bichell, Prince J. Kannankeril
Journal: Circulation (2013)

Andrew H. Smith, 2013 Finalist and Presenting Author
Role of Humoral Antibody and Infecting Dose in the Recovery of Rous Sarcoma Virus From Turkey Tumor Cells in Tissue Culture&lt;xref ref-type="fn" rid="fn1"&gt;2&lt;/xref&gt;
Authors: Victor V. Bergs, Vincent Groupé
Journal: JNCI Journal of the National Cancer Institute (1962)

Rous sarcoma virus (RSV) was consistently recovered in rather high titer from high-infecting-dose tumor cells in culture, and the length of time required for recovery was related to the antiviral antibody titer found in the tumor. Recovery of virus from low-infecting-dose tumor cells was usually late, in low titer, and sometimes intermittent. Similar fluctuations in virus recovery were found in several tumors of the same bird. Cells of the low-infecting-dose tumors were resistant to superinfection with high doses of RSV in vitro. The nature of this resistance is yet unknown but it was overcome by repeated challenges with RSV. This was not achieved by single challenge doses on these cultures at intervals far apart. Transplantation of turkey tumor cells into random-bred turkeys could not be achieved if the cells were noninfective and obtained from turkeys with high levels of circulating antiviral antibody. Consequently, tumors produced in random-bred birds by cell implantation appear to be virus-induced.
NHS ignoring prisoners' health needs, says report
Authors: Zosia Kmietowicz
Journal: BMJ (2001)

The health needs of prisoners are being ignored, says a report criticising the NHS for missing an important opportunity to tackle problems of addiction among prisoners and prevent reoffending.

Working conditions in prison medicine are so poor that experienced doctors and nurses are leaving the service in droves, said the BMA's report Prison Medicine: a Crisis Waiting to Break . Of …
Abstract P128: The Association between Stressful Life Experiences and Hyperuricemia in Korean Adults
Authors: Ju-Mi Lee, Hyeon Chang Kim, Hye Min Cho, Sun Min Oh, Dong Phil Choi, Won Joon Lee, Jaelim Cho, Il Suh
Journal: Circulation (2012)

Background: Stressful life events (SLEs) may influence disease intensity and duration. However, the direct association between SLEs and disease manifestations are still controversial and not fully understood. Thus, we evaluated the quantitative associations between number of SLEs and hyperuricemia in a community-based cohort study in South Korea. Hypothesis: Prevalence of hyperuricemia in people with the more SLEs is higher than that in people with less SLEs. Methods: We performed cross-sectional analysis of baseline data of 1758 men and 2826 women (aged 27-87) in the Korean Genome and Epidemiology Study- Kangwha study (2006 to 2010). Life Experience Survey questionnaire was used to measure SLEs during the last 3 months. People who experienced at least five SLEs during the last 3 months were classified as frequent SLE group (N=413, 9.0 %). Blood samples were collected after at least 8-hour fast. Hyperuircemia is defined as serum uric acid level ≥ 6.0 mg/dL in men, and ≥ 7.0 mg/dL in women. Multiple logistic regression was used to assess independent association between SLEs and hyperuricemia. Results: Frequent SLE group had a significantly higher prevalence of hyperuricemia than those who were not (10.9 % versus 5.4 %) : odds ratio (95% CI) was 2.32 (1.59-3.38) when adjusted for age, sex, body weight, blood pressure, pulse rate, serum total billirubin, leukocyte count, smoking status, alcohol consumption, and physical activity. The association was similar in men (OR 2.17, 95% CI 1.45-3.25) and women (OR 3.80, 95%CI 1.38-10.43). Conclusion: These findings suggest that recently experienced SLEs are positively associated with hyperuricemia.
Navelbine (N), leucovorin (L), and fluorouracil (5-FU) (FLN) for triple-negative metastatic breast cancer (TNBC)
Authors: A. Zaniboni, F. Meriggi, A. Rizzi, L. Rota, C. Codignola, B. Di Biasi, M. Mazzocchi, S. Mutti
Journal: Journal of Clinical Oncology (2008)

1127 Background: TNBC (ER, PR, HER2 negative) pts can be treated with conventional chemotherapy only. The combination of 5- FU (350 mg/m2 iv bolus day 1 to 3), L (100 mg/m2 iv day 1 to 3) and N (20–25 mg/m2 bolus on day 1 and 3) every 3 weeks is an active regimen in metastatic breast cancer (MBC) (Nolè et al., Ann Oncol 1997). Methods: Among 137 consecutive MBC pts routinely treated at our Institution with the FLN regimen since 1999, 26 (19%) had TNBC. Median age was 61 yrs, prior adjuvant CT: 88%, one line of CT for MBC: 42%, Visceral involvement: 80%, >2 metastatic sites: 52%. Results: Efficacy data of FLN regimen are reported in Table 1. Response rate, TTF and OS among 105 evaluable non-TNBC pts treated during the same period with FLN were 48%, 7 mos and 19 mos, respectively. Among the 26 TNBC pts, neutropenia was the most frequent toxicity (NCI-CTCv2 grade IV in 32% of pts), with neutropenic fever in 3 cases (one toxic death). Nausea, vomiting and anorexia were mild to moderate in 35% of pts. Grade II ileus occurred in 4 pts, whereas grade II alopecia was reported in 15% of pts. Conclusions: Albeit based on a retrospective analysis, our data suggests that FLN is an effective and reasonably well tolerated combination chemotherapy for the palliative treatment of TNBC pts pretreated with an A±T based regimen. FLN regimen: Results N° Adj CT First line CT CR/PR/NC * RR% TTF (mos) OS (mos) 15 # A(11)A+T(3) 2/6/3 53 8 14 11 § A(8)A+T(1) T(8)Cddp(3) 1/3/3 36 5 11+ Total 26 A(19)A+T(4) 3/9/6 46 6.5 12 # first line for MBC, § second line CT for MBC, A: Anthracycline-based, T: Taxane-based, Cddp: Cisplatin-based, * Recist criteria. No significant financial relationships to disclose.