tbuckley/cabot-search huggingface dataset:
Abstract MP64: Heart to Heart Connections Benefit Behavior Change
Authors: Jo-Ann Eastwood, Nabil Alshurafa, Joy Toyama, Debra K Moser
Journal: Circulation (2015)

Cardiovascular disease is the number 1 killer of women. Substantial racial disparities compound the problem for Black women (BW) who are particularly vulnerable with higher rates of CVD mortality and morbidity compared to other women. BW exhibit risk factors (RFs) at younger ages and have a higher prevalence and greater clustering of multiple CVD RFs. The consequences of untreated CVD RFs for black women are more severe, with increased disability, decreased QOL, and higher mortality rates. The purpose of this community - based pilot was to test the feasibility of a program combining self-care education with wireless individualized feedback via a unique smartphone designed to appeal specifically to young YBW.   Methods:  Using church-based recruitment, 62 young BW (aged 25-45) were randomized to treatment (TX)(n=39) and control groups (n=23) by church site. The TX group participated in 4 interactive self-care classes on CVD RF reduction. Each participant set individualized goals. RF profiles (waist circumference (WC), BP, lipid panel by Cholestech [Alere]), medical history and the Medical Outcomes Study Adherence Scale were assessed prior to classes and 3 months later. Participants were given smartphones with embedded accelerometers and WANDA-CVD, an application that delivered prompts and messages specifically for this pilot. Participants obtained and transmitted BP measurements wirelessly. To identify the effects of the intervention over time (baseline-3 months), a longitudinal mixed model was used that included treatment by time interaction for outcomes.   Results:  Significant differences in time x treatment interactions favoring the TX group occurred in TC, LDL and adherence. (see graphs).   Conclusion:  These interim pilot data validate the feasibility of implementing a risk reduction program of combined education/wireless monitoring and feedback in YBW. Further testing in a large randomized trial is warranted to determine long-term effects on behavior change and cardiac RFs in this high risk population.
Adjuvant temozolomide therapy at continuous low dose after first relapse in patients with glioblastoma multiforme treated initially with radiation plus standard-dose temozolomide: report of two cases
Authors: M. Bjeljac, U. Huber, S. Kollias
Journal: Journal of Clinical Oncology (2005)

1581 Background: Recurrent glioblastoma multiforme (GBM) is resistant to most therapeutic endeavors, with low response rates and survival rarely exceeding six months. Temozolomide is an effective agent in the treatment of recurrent malignant gliomas. The standard dosage is 150–200 mg/m2 per day for 5 days in a 28-day cycle. Actual findings established a continuously administered daily temozolomide dose (75 mg/m2 per day, 2 weeks on, 1 week off) that suggested a superior response rate. Methods: We report here two cases of high-grade glioma treated with surgery, radiotherapy and subsequent temozolomide chemotherapy after first surgical intervention. After tumor relapse and second surgery, treatment was followed by continuous low-dose temozolomide over long time-period. Results: The first patient is a 29-year-old woman who presented with high-grade glioma localized in the right postcentral gyrus. The tumor was surgically subtotal removed, followed by radiotherapy and subsequent standard temozolomide chemotherapy (4 cycles total). Six months after the first intervention occured relapse of the tumor. Continuous low-dose treatment with temozolomide was initiated after the second tumor resection. Subsequent controls of the patient 23 months after the 1st relapse showed no further relapse. The second patient is a 52-year-old male who had a GBM localised in the left medial temporal gyrus. After nearly total tumor resection the patient was subsequently treated with radiotherapy and standard temozolomide chemotherapy (3 cycles total). Relapse of the tumor occurred seven months after the first surgical intervention. After exstirpation of a relapsing tumor a continuous low-dose temozolomide treatment combined with thalidomide was initiated. Twenty six months after relapse, still no signs of tumor recurrence were noticed. Conclusions: In both cases, temozolomide was well tolerated without any signs of hematological toxicity. The two patients presented here treated with extended low-dose schedule of temozolomide appear to have a clear clinical benefit and show a notably prolonged survival time. No significant financial relationships to disclose.
A multicenter phase II study of docetaxel, gemcitabine and trastuzumab administration as first-line treatment in patients with advanced breast cancer (ABC) overexpressing HER-
Authors: A. Polyzos, D. Mavroudis, J. Boukovinas, E. Tsiakopoulos, N. Malamos, G. Milaki, C. Kouroussis, A. Kotsakis, A. Pallis, V. Georgoulias
Journal: Journal of Clinical Oncology (2004)

728 Background: To evaluate the activity and toxicity of the docetaxel-gemcitabine-trastuzumab combination in the first-line treatment of ABC overexpressing HER-2. Methods: Previously untreated patients with 2+ or 3+ HER-2 overexpressing ABC who had measurable disease received trastuzumab 4 mg/kg loading dose and 2 mg/kg weekly thereafter followed by docetaxel 65 mg/m2 and gemcitabine 1500 mg/m2 every two weeks without prophylactic growth factor support. One cycle equals one biweekly administration. Results: Thirty-four patients have been entered in this study and all were evaluable for toxicity and 30 for response. Median age was 56 years (range 33–75), 25(73%) patients were post-menopausal, 32(94%) had performance status of 0–1 and 20(59%) had previously received adjuvant and/or neoadjuvant chemotherapy. Complete response was observed in 1(3%) and partial response in 18(53%) patients for an overall response rate of 56% (95% C.I. 39.1–72.5). The median duration of response was 12 months (range 1.5–26.5) and the median time to progression 14.6 months (range 1.7–29.6). After a median follow up of 15 months, 4 patients have died of disease progression. Three hundred sixty eight cycles have been administered with a median of 12 cycles per patient. Treatment was delayed in 60(16%) cycles for a median 7 days and dose reduction was performed in 15(4%). Hematologic toxicity included grade 3 and 4 neutropenia in 16(47%) and 6(17%) patients, respectively, febrile neutropenia in 2 (6%), grade 3 thrombocytopenia in 1(3%) and anemia in 2(6%). Non-hematologic toxicity included 1(3%) grade 3 and 1(3%) grade 4 diarrhea and 2(6%) grade 3 asthenia. No symptomatic cardiotoxicity or toxic deaths occurred. Conclusions: The biweekly administration of docetaxel and gemcitabine with weekly trastuzumab is an active and well tolerated regimen in previously untreated patients with ABC overexpressing HER-2. With durable responses and prolonged times to disease progression it deserves comparison with other trastuzumab containing regimens. No significant financial relationships to disclose.
Death rates have risen sharply among middle aged white people in the US, study finds
Authors: Michael McCarthy
Journal: BMJ (2015)

After decades of steady decline, mortality rates among middle aged white people in the United States have risen sharply, driven largely by an increase in deaths from drug and alcohol poisonings, suicide, and liver disease, a study has found.

The rise in midlife mortality has been paralleled by an increase in self reported morbidity, the researchers reported, with more middle aged white people reporting poor health, pain, psychological distress, alcohol use, and difficulties with activities of daily living.

The study, which was conducted by Anne Case and Angus Deaton, both professors of economics at Princeton University in Princeton, New Jersey, was published online on 2 November in the Proceedings of the National Academy of Sciences .1 Deaton was recently awarded the 2015 Nobel Memorial Prize in Economic Sciences.

Case and Deaton analyzed US morbidity and mortality statistics for a fifteen year period from 1999 to 2013. Previous studies found that between 1970 and 2013 the all cause mortality among those aged 45-54 in the US fell by 44%. Similar improvements were seen in other wealthy nations, such as France, Germany, and the United Kingdom.

Case and …
Discovery of a biomarker signature that predicts upgrading or upstaging in patients with low-risk prostate cancer.
Authors: Nicholas Erho, Ismael A. Vergara, Christine Buerki, Mercedeh Ghadessi, Anamaria Crisan, Thomas Sierocinski, Zaid Haddad, Benedikt Zimmermann, Sebastian Harko, Worlanyo Sosu-Sedzorme, Timothy J. Triche, Elai Davicioni
Journal: Journal of Clinical Oncology (2012)

37 Background: More than 90% of patients diagnosed with organ-confined prostate cancer (PCa) choose upfront definitive treatment (e.g., radical surgery) even though many are excellent candidates for delayed therapy (i.e., active surveillance [AS]). Therefore, patients may suffer from the adverse effects of treatment without gaining any benefit. Biomarker signatures that predict tumour aggressiveness are promising tools for identification of patients suited for AS. In this study, we use a transcriptome-wide assay to develop a biomarker signature for patients assessed as low risk at diagnosis who are upgraded or upstaged following radical prostatectomy (RP). Methods: Gene expression data of 56 RP samples from the Memorial Sloan Kettering Oncogenome Project (GSE21034) which met the low risk criteria (i.e., biopsy Gleason score (GS) ≤ 6, clinical stage T1 or T2A, and pre-operative PSA (pre-op PSA) ≤ 10 ng/ml) were used to develop the signature. Of these tumors, 31 underwent upgrading or upstaging (defined by pathological GS ≥ 7 or a pathological tumor stage &gt; T3A). In the training set (n = 29) a median fold difference filter (MFD &gt; 1.4) was applied to select features. The top 16 t-test ranked features were modelled with a K-nearest-neighbor (KNN) classifier (k = 3) which predicts upgrading/upstaging events. Results: The KNN was applied to the test set (n = 27) and achieved an area under the receiver operating characteristic curve (AUC) of 0.93, significantly better discrimination than pre-op PSA (AUC = 0.52) or tumor stage (AUC = 0.63). Compared to the null model’s accuracy of 56%, the KNN correctly predicts 81% (p-value &lt; 0.005) of the upgrading/upstaging events. In multivariable analysis with pre-op PSA, tumor stage, and age at diagnosis, the KNN remained the only significant (p &lt; 0.05) factor with an odds ratio of 2.7. Conclusions: A 16 marker signature was identified from RP specimens and shown to accurately segregate true low risk patients from those which transitioned to higher risk. Validation studies of this signature in prospectively designed cohorts of active surveillance candidates are underway to determine if the molecular signature can improve treatment and management decisions for low risk PCa patients.
Influence of market access conditions on utilization of innovative drugs in Europe: The cases of trastuzumab and cetuximab.
Authors: J. Misset, M. Toumi, L. Krukowski, M. Lamure, S. Aballea
Journal: Journal of Clinical Oncology (2010)

1601 Background: Market access conditions of innovative drugs are expected to affect their utilization. Prices of recently launched monoclonal antibodies are high and their accessibility differs across Europe. In Italy most products are associated to risk-sharing schemes while in France they are approved with no restrictions. Funding process varies: these products are funded on top of diagnostic-related group (DRG) costs in France, but not in the United Kingdom and Germany. Trastuzumab (TRZ) was recommended by payers for early- and late-stage breast cancer (BC) in Europe, with differences in the process and timelines of recommendations. Cetuximab (CTX) for metastatic colorectal cancer (mCRC) was not recommended in the United Kingdom (until June 2009), but accepted under a price volume agreement scheme with prior authorization in Italy, and without restriction in France and Germany. Methods: We reviewed how such differences might affect usage of TRZ and CTX in France, Germany, Italy, and the United Kingdom. Data on drug utilization from June 2006 to July 2009 were extracted from the Synovate Oncology Monitor, an ongoing database tracking prescribing of anticancer therapies. Sample sizes varied between countries and cancer types, from 1,700 to 6,200 patients. Results: Utilization rates from July 2008 to Jun 2009 are shown below (Table). Differences across countries were larger for TRZ than CTX. Utilization of TRZ increased over time in early stage BC (irrespective of HER2 screening) but there was no clear trend in late stage. Utilization of CTX was stable in France, increased in Germany, and decreased in Italy. Dosages and patient profiles were comparable across countries. Conclusions: Funding on top of DRG does not appear to increase drug uptake. Health technology assessment conclusions influence utilization strongly. Even when access is granted, the existence of administrative constraint may reduce first-line utilization to the benefit of second-line. This should be considered when decisions are made about access to innovative medicine. France Germany Italy United Kingdom Trastuzumab—BC Early stage 10% 12% 16% 9% Late stage, 1st-line 19% 16% 12% 14% Late stage, 2nd-line 10% 22% 34% 16% Cetuximab—mCRC 1st-line 7% 13% 3% 0% 2nd-line 17% 16% 19% 2% No significant financial relationships to disclose.
Abstract 15497: Novel Methods of Reducing the Energy Required to Cardiovert Atrial Fibrillation in Ovine Models
Authors: David Brody, Rebecca Di Maio, Allister McIntyre, Paul Crawford, Cesar Navarro, John Anderson, Jennifer Adgey
Journal: Circulation (2011)

Introduction: Atrial fibrillation (AF) is a chaotic breakdown of electrical activity in the upper chamber of the heart with consequent deterioration of atrial mechanical function. AF is the most co...
Response to Crizotinib Observed in Lung Adenocarcinoma with MET Copy Number Gain but without a High-Level MET/CEP7 Ratio, MET Overexpression, or Exon 14 Splicing Mutations
Authors: Yan Zhang, WeiYa Wang, Yan Wang, Yong Xu, Ye Tian, MeiJuan Huang, You Lu
Journal: Journal of Thoracic Oncology (2015)
Abstract 11124: Exogenous AMPK Activation Improves Myofibroblast Maturation and Scar Formation in the Infarcted Aging Heart
Authors: Katarzyna A Cieslik, JoAnn Trial, George E Taffet, Mark L Entman
Journal: Circulation (2012)

We have previously demonstrated that cardiac repair after myocardial infarct (MI) is associated with an endogenous pool of CD44+CD45- multipotential mesenchymal stem cells that rapidly proliferates...
Physicians' perceptions in cancer care of elderly patients: A sociological study by qualitative data in a geriatric oncology programme.
Authors: L. Sifer-Rivière, V. Girre, M. Gisselbrecht, O. Saint-Jean
Journal: Journal of Clinical Oncology (2010)

e19690 Background: This study documents the physicians' perceptions in cancer care of elderly patients in a pilot unit of coordination in oncogeriatrics (UPCOG) in Paris (France). The goal of this study is then to understand how physicians become involved in these new practices, and how they develop new forms of teamwork with aim to “doctoring together.” Methods: Based on various qualitative techniques such as literature review, participant observation of work sessions, and 28 semi-structured interviews with different physicians (surgeon, radiation therapist, organ specialist, oncologist, and geriatrician), the research strategy is set in the methodological perspective of Grounded Theory. The general analysis is based on the model proposed by the sociologists Amselm Strauss and Eliot Freidson to analyze how physicians become involved in these new practices, how they interpret oncogeriatrics in their daily work routines, and what social values influence their perception as their commitment. Results: The analysis starts by an overview of the general perceptions of the geriatric oncology programme: how the oncologists faced new uncertainties and geriatricians with new opportunities and constraints. It then shows various ways of taking the patient's age into consideration: how age emerges as a new working rule, with the implicit competition between “young” and “elderly” patients and “elderly” and “geriatric” patients. Lastly, the survey analyzes the misappreciation of the other's role and the difference between care and cure perception. Conclusions: The data reflects the multiples perspectives on the field, the hierarchical values in the division labor and the differences in working conditions. There are many identities, many values, many interests, many techniques relating to the medical work with the elderly patient, while preserving the specificity of skills, competencies of each one. The nature of the work itself seems not to be thought in terms of sharing and seems to be connected with systematic variation in the characteristics of the workers as well as in the way of the everyday practice. New teamworks have some difficulties to appear durably due to the lack of “shared fate.” No significant financial relationships to disclose.
MRI screening of women at average risk of breast cancer.
Authors: Simone Schrading, Christiane K. Kuhl
Journal: Journal of Clinical Oncology (2013)

21 Background: In asymptomatic women at average risk, mammography alone, possibly amended by the US, is recommended for screening. MRI is established for screening women at high risk, but there are no data available to support its use in women at average risk. Methods: Between Jan 2005 and Dec 2012, 1,387 women at average risk, i.e. without personal or family history of breast or ovarian cancer or tissue diagnosis of atypias underwent 1,705 annual MRI screening studies. Mean/median age was 55/56, range 40-79. All women had normal CBE and normal double-read 2-view digital screening mammograms. In women with breast densities, additional US had been performed and women were included if also US was normal. Patients underwent bilateral DCE MRI at 1.5T using a 2D GE pulse sequence. Results: A total of 54 MRIs were rated positive (MR-BI-RADS 4/5) (54/1705; 3.2%). Biopsies performed in these women were positive for breast cancer or DCIS in 18, and revealed high risk lesions in 8 patients, yielding an additional cancer yield of 11/1,000. In 28 women, biopsy revealed benign changes only. This translates into a PPV of 33% (18/54), or 48% (26/54) if high risk lesions are included. Of the 18 cancers, 11 (61%) were invasive and 7 (39%) DCIS. Mean size of invasive cancers was 11 mm (median 10, range 4 -22). Invasive cancers were intermediate or high grade in 9/11, DCIS in 6/7. All invasive cancers were staged pN0, M0. Minimal cancer rate was 13/18 (72%). Distribution of mammographic breast densities in women with MRI-diagnosed cancer was as follows: ACR I in 2 (11%), ACR II in 3 (17%), ACR III in 8 (44%), ACR IV in 5 (28%). This was equivalent to the distribution of breast densities in the entire cohort. Conclusions: In this cohort of heavily pre-screened women at average risk, the additional cancer yield achieved through MRI was high (11/1,000). Although the biologic profile of MRI-only detected additional cancers was indicative of prognostically relevant disease, with a high proportion of high-grade cancers, stage distribution of cancers was favorable. Mammographic breast density did not predict the likelihood with which additional cancers were identified through MRI. In women with dense breasts who underwent screening US in addition to mammography, there is still a significant reservoir of undetected cancers.
The Response of Chronic Lymphocytic Leukemia to Treatment by Extracorporeal Irradiation of the Blood, Assessed by Isotope-labeling Procedures
Authors: E. O. FIELD, K. B. DAWSON, M. J. PECKHAM, P. A. HAMMERSLEY, C. I. COOLING, R. L. MORGAN, D. W. SMITHERS
Journal: Blood (1970)
Impact of body mass index on lymph node dissection and surgical outcomes of patients with gastric cancer
Authors: S. Noh, S. Oh, S. Kim, J. Song, W. Hyung, S. Rha, Y. Lee, S. Choi, H. Chung
Journal: Journal of Clinical Oncology (2008)

15655 Background: There has been a general consensus that increased body mass index (BMI) is correlated with poor surgical outcome. The purpose of this study was to clarify the effects of BMI on surgical outcomes of gastric cancer patients. Methods: A total of 517 patients who underwent curative total gastrectomy with D2 dissection from January 2000 to December 2003 were studied retrospectively from a prospectively designed computer database. The patients were assigned to three groups according to their BMI: group A, BMI < 23 kg/m2 (normal and underweight); group B, BMI 23–24.9 kg/m2 (overweight); group C, BMI ≥ 25 kg/m2 (obesity). The parameters such as operation time, blood loss, packed RBC transfusion, number of retrieved lymph nodes, first time of flatus, start of soft diet, postoperative hospital stay, postoperative morbidity, mortality, recurrence, and prognosis were analyzed. Results: Group C patients had significant longer operation time and higher postoperative complications in comparison to group A and B. However, there were no significant differences regarding blood loss, packed RBC transfusion, number of retrieved lymph nodes, first time of flatus, start of soft diet, postoperative stay, mortality, recurrence, and survival rates among three groups. Logistic regression analysis revealed that tumor size, histological type, serosal invasion, and nodal metastasis were independent risk factors for recurrence while obesity was not. Multivariate analysis showed that age, tumor size, histological type, serosal invasion, and nodal metastasis were independent prognostic factors whereas obesity was not. Conclusions: Although BMI affect somewhat operation time and postoperative morbidity, it does not affect long-term outcomes of patients with gastric cancer. No significant financial relationships to disclose.