tbuckley/cabot-search huggingface dataset:
Late relapse in triple negative breast cancer
Authors: Z. Tomasevic, L. Radosevic-jelic, Z. M. Tomasevic, S. Jelic, Z. Milovanovic
Journal: Journal of Clinical Oncology (2009)

e12022 Background: Approximately 10%-15 % breast cancer (BC) are classified as triple negative. Although triple negative status carries grave prognosis, recent data suggests that it is mostly due to high relapse rate in first 2–3 years following initial diagnosis. Late relapses are less explored. The aim of this paper is to determine the percentage of triple negative BC among patients with late relapses, and to record relapse site in this subgroup of pts. Late relapse is determined as contra-lateral BC, loco-regional relapse, or any distant metastases at least 5 years after initial diagnosis of BC. Methods: Among 2,234 patients with various stages of BC registered during one year at the Institute for Oncology and Radiology of Serbia (March 2005-March 2006), 256 (11, 4%) had late relapse. Median time to relapse was 7 years (range 5–34 yrs). Median follow-up was 9 years. Results: IHC HER-2 status was retrospectively determined on 189 paraffin embedded primary BC specimen. HER-2 3 + is recorded in 17 specimen (8.9%); HER-2 2+/1+ in 86 (45.5%); and HER-2 0+ in 86 (45.5%) Among patients with HER-2 0+ only 10 also had ER score 0 and PGR score 0 (5.3%). Time to late relapse in this subgroup was 7.24 years (range 5–17 yrs). Relapses were resectable in 6 pts with local recurrence (4/10 pts) and contra-lateral BC (2/10). Three pts had bone metastases (3/10) and only 1 pt had pleural relapse (1/10). Median time to resectable relapse was 8.75 yrs (5–17). Median time to non-resectable relapse was 5.75 yrs (5–8 ). Conclusions: According to our results it seems that late relapse of triple negative BC is rare representing only 5.3% of late relapses. None of these pts had liver, lung, or brain metastases. Most relapses (6/10) could be resected, and therefore could potentially be cured. No significant financial relationships to disclose.
Smoking and risk of myocardial infarction
Authors: T. V Perneger, J.-L. Tang, J. A Dickinson, P. J Woll, E. Prescott, M. Hippe
Journal: BMJ (1998)

Further studies of heroin treatment are neededEditor-On the basis of a trial in Switzerland, 1 Farrell and Hall conclude that medically prescribed heroin is likely to have only a limited role in the future. 2 It is hard to know how any judgment can be made about this approach after only one randomised control trial, 3 one case-control study, 4 and the large but uncontrolled study that the authors commented on. 1 Farrell and Hall are right to emphasise the difficulty of disentangling the contribution of comprehensive social and psychological inventions in the impressive results obtained in this population. 1After more than three decades of research evaluating the effectiveness of methadone maintenance treatment it is safe to conclude that such interventions improve outcomes but difficult to be much more precise than this.Social and psychological interventions probably improve results of virtually all interactions between patients and the healthcare system.The authors say that the proposal to conduct a heroin trial in Australia damaged support for harm reduction.This is arguable.The mood in Australia has generally been more conservative over the past two years.The controversy over the heroin trial in Australia probably contributed to major improvements in a local methadone programme and certainly led directly to a commitment and funding for research on an expanded range of pharmacological treatments for heroin dependence.The authors question whether Australia is in the middle of a national heroin crisis.If a sixfold increase in mortality from drug overdose during the past 16 years 5 is not a crisis it is hard to know what would be.The Swiss heroin trial may have been more expensive than routine prescription methadone.But trials of new treatment are invariably more costly than providing well established treatments as a routine.Heroin
A phase I trial of taxol given by a 6-hour intravenous infusion.
Authors: T Brown, K Havlin, G Weiss, J Cagnola, J Koeller, J Kuhn, J Rizzo, J Craig, J Phillips, D Von Hoff
Journal: Journal of Clinical Oncology (1991)

Taxol is a unique mitotic inhibitor that has entered phase II investigation. Phase I studies demonstrated hypersensitivity reactions that were related to the cremophor vehicle and to the rate of drug infusion. As a result, the time span of intravenous (IV) infusion of taxol was routinely prolonged to 6 hours or beyond, and premedication with diphenhydramine, dexamethasone, and cimetidine was initiated. Early studies showed antitumor activity, especially against malignant melanoma and ovarian carcinoma. This phase I trial was performed giving taxol, as a 6-hour IV infusion every 21 days, without premedication. The purpose was to study the necessity of premedication and its impact on toxicity and pharmacokinetics. Thirty-one patients received 64 assessable courses of taxol. One patient had a hypersensitivity reaction, which was easily controlled using routine measures. Myelosuppression was dose-limiting, but sporadic, with two fatalities due to sepsis. Nonhematologic toxicity was of grade 1 and 2 except for one patient with grade 3 mucositis and two patients with grade 3 neuropathy. The neuropathy consisted of reversible painful paresthesias, requiring discontinuation of drug in two patients. Four partial responses were seen (three in patients with non-small-cell lung cancer, one in a patient with adenocarcinoma of unknown primary). Pharmacokinetic values were consistent with those previously reported. The occurrence of myelosuppression or neurotoxicity appeared to be associated with the area under the concentration x time curve (AUC) of taxol. The recommended phase II starting dose on this schedule is 225 mg/m2. Taxol merits broad investigation at the phase II level.
An Evolving Role for Oral Fluoropyrimidine Drugs
Authors: Robert B. Diasio
Journal: Journal of Clinical Oncology (2002)

Article Tools EDITORIALS Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.2002.20.4.894 Journal of Clinical Oncology - published online before print September 21, 2016 PMID: 11844808 An Evolving Role for Oral Fluoropyrimidine Drugs Robert B. DiasioxRobert B. DiasioSearch for articles by this author Show More Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL https://doi.org/10.1200/JCO.2002.20.4.894 First Page Full Text PDF Figures and Tables © 2002 by American Society of Clinical Oncology
Use of Cytogenetic Analysis of Body Fluids in Cancer Diagnosis
Authors: Nejat Izadian
Journal: Journal of the Royal Society of Medicine (1982)

Direct chromosome preparations were made from 52 malignant and 21 non-malignant effusions. An effusion was classified as malignant if 2% of the counted cells showed abnormal karyotypes. There was a significant relationship between diversified karyotypes and the pathological nature of tumours: diversity of karyotypes was much higher in undifferentiated adenocarcinoma, anaplastic carcinoma and embryonal cell carcinoma cells than in well-differentiated cancer cells. Diagnosis was positive for 38 of the 52 malignant effusions by cytological examination (73% sensitivity), and positive for 41 of the 52 by cytogenetic analysis (78% sensitivity). There were no false positive results using both cytogenetic and cytologic examinations (92% sensitivity). Particularly in patients with equivocal cytology, cytogenetic analysis appears to be a useful tool in the diagnosis of malignant effusions.
Low-Dose Radiation Is Sufficient for the Noninvolved Extended-Field Treatment in Favorable Early-Stage Hodgkin’s Disease: Long-Term Results of a Randomized Trial of Radiotherapy Alone
Authors: Eckhart Dühmke, Jeremy Franklin, Michael Pfreundschuh, Susanne Sehlen, Norman Willich, Ursula Rühl, Rolf-Peter Müller, Peter Lukas, Anton Atzinger, Ursula Paulus, Bernd Lathan, Ulrich Rüffer, Markus Sieber, Jürgen Wolf, Andreas Engert, Axel Georgii, Susanne Staar, Richard Herrmann, Maria Beykirch, Hartmut Kirchner, Adelheid Emminger, Richard Greil, Esther Fritsch, Peter Koch, Angelika Drochtert, Oana Brosteanu, Dirk Hasenclever, Markus Loeffler, Volker Diehl
Journal: Journal of Clinical Oncology (2001)

PURPOSE: To show that radiotherapy (RT) dose to the noninvolved extended field (EF) can be reduced without loss of efficacy in patients with early-stage Hodgkin’s disease (HD). PATIENTS AND METHODS: During 1988 to 1994, pathologically staged patients with stage I or II disease who were without risk factors (large mediastinal mass, extranodal lesions, massive splenic disease, elevated erythrocyte sedimentation rate, or three or more involved areas) were recruited from various centers. All patients received 40 Gy total fractionated dose to the involved field areas but were randomly assigned to receive either 40 Gy (arm A) or 30 Gy (arm B) total fractionated dose for the clinically noninvolved EF. No chemotherapy was given. RT films were prospectively reviewed for protocol violations and recurrences retrospectively related to the applied RT. RESULTS: Of 382 recruited patients, 376 were eligible for randomized comparison, 190 in arm A and 186 in arm B. Complete remission was attained in 98% of patients in each arm. With a median follow-up of 86 months, 7-year relapse-free survival (RFS) rates were 78% (arm A) and 83% (arm B) (P = .093). The upper 95% confidence limit for the possible inferiority of arm B in RFS was 4%. Corresponding overall survival rates were 91% (arm A) and 96% (arm B) (P = .16). The most common causes of death (n = 27) were cardiorespiratory disease/pulmonary embolisms (seven), second malignancy (six), and HD (five). Protocol violation was associated with significantly poorer RFS. Nonirradiated nodes were involved in 42 of 52 reviewed relapses, infield areas in 18, marginal areas in 17, and extranodal sites in 16. CONCLUSION: EF-RT alone attains good survival rates in favorable early-stage HD. The 30-Gy dose is adequate for clinically noninvolved areas. Protocol violation worsens the subsequent prognosis. Relapse patterns suggest that systemic therapy can reduce the 20% long-term relapse rate.
Correlation of Inflammation in Frozen Sections With Site of Nonmelanoma Skin Cancer
Authors: Murad Alam, Misbah Khan, Emir Veledar, Marisa Pongprutthipan, Arthur Flores, Meghan Dubina, Michael Nodzenski, Simon S. Yoo
Journal: JAMA Dermatology (2015)

During Mohs micrographic surgery of nonmelanoma skin cancer (NMSC), inflammation in histologic frozen sections has been found to occasionally presage the detection of tumors in frozen sections of adjacent excision specimens.To quantify the correlation between the location of inflammation without visible tumor in histologic frozen sections and the location of subsequently detected NMSC.A retrospective cohort study of 3148 cases pertaining to frozen sections associated with the staged excision of NMSC was performed from September 8, 2008, to September 18, 2009, at an urban academic medical center, with the collected data analyzed on May 9, 2013.Consecutive cases of Mohs micrographic surgery performed at an academic medical center.For each wedge-shaped tissue segment corresponding with 1 hour of time on a clock face, the proportion of patients with inflammation at the source location of the segment who subsequently had a tumor at this same location; the proportion of patients who had neither inflammation nor subsequent tumor at the source location of the segment; the probability of subsequent tumor at this location given the prior finding of inflammation at the same location; and the probability that a location was without tumor in the absence of preexisting inflammation at that location.Of the medical records of 3148 cases of NMSC that were reviewed, 60 showed inflammation in histologic frozen sections from an excision specimen that was followed by tumor in the subsequent excision specimen. Of these 60, 39 (65%) were b asal cel carcinoma and 21 (35%) were squamous cell carcinomas; 53 (88%) were Mohs stage 1. In 7 of 12 segments, a significant positive correlation was found between the presence of inflammation and the presence of nearby tumor with correlation coefficients ranging from 0.196 to 0.384 (P < .05) . The probability that tumor was absent when inflammation was not seen at a particular location (ie, clock-face segment) in preceding sections from that location was 91%, with segment-specific probability values ranging from 82% to 96%.During Mohs micrographic surgery of NMSC with the examination of frozen sections, histologic inflammation is modestly predictive of adjacent tumor whereas lack of inflammation strongly predicts that no additional tumor will be found.
Spotlight on measles 2010: An ongoing outbreak of measles in an unvaccinated population in Granada, Spain, October to November 2010
Authors: B López Hernández, J Laguna Sorinas, I Marín Rodríguez, V Gallardo García, E Pérez Morilla, J M Mayoral Cortés
Journal: Eurosurveillance (2010)

On 13 October 2010, the Andalusian Epidemiological Surveillance Network was notified of one case of measles. By 15 November 2010, 25 confirmed cases of measles had been reported from Granada, southern Spain, of whom 22 were unvaccinated children under the age of 15 years. This ongoing outbreak involved a subpopulation with low vaccination coverage and parents with ideological objections to vaccination. As of 7 December the number of cases has reached 59.
Effect of a National Cancer Institute Clinical Alert on breast cancer practice patterns.
Authors: T P Johnson, L Ford, R B Warnecke, S G Nayfield, A Kaluzny, G Cutter, D Gillings, E Sondik, H Ozer
Journal: Journal of Clinical Oncology (1994)

PURPOSE This study evaluates the effect of the 1988 National Cancer Institute Clinical Alert regarding treatment of early-stage breast cancer on the patterns of treatment provided to patients. PATIENTS AND METHODS Data analyzed were collected from the hospital and outpatient records of 12,534 female patients with a primary diagnosis of breast cancer (stages I and II) initially diagnosed during the years 1983 through 1989. RESULTS Analyses revealed that the proportions of patients with a negative lymph node status diagnosed after the May 1988 Clinical Alert who received adjuvant treatment (tamoxifen and/or multidrug chemotherapy) were significantly greater than predicted from treatment trends established before the Alert's release. Proportions of patients with positive lymph node status receiving adjuvant therapy subsequent to the Alert's release, in contrast, did not fall outside the projected confidence intervals for that group. Additional analyses showed a significant effect of the Clinical Alert among several subgroups of node-negative patients. CONCLUSION Findings suggest that the Clinical Alert mechanism, followed by publication in the peer-reviewed scientific literature, is an effective way to communicate important research findings to practitioners in the community. However, the Alert mechanism is controversial and should be used judiciously to ensure its credibility.
Low Operative Mortality Achieved With Surgical Septal Myectomy
Authors: Barry J. Maron, Joseph A. Dearani, Steve R. Ommen, Martin S. Maron, Hartzell V. Schaff, Rick A. Nishimura, Anthony Ralph-Edwards, Harry Rakowski, Mark V. Sherrid, Daniel G. Swistel, Sandhya Balaram, Hassan Rastegar, Ethan J. Rowin, Nicholas G. Smedira, Bruce W. Lytle, Milind Y. Desai, Harry M. Lever
Journal: Journal of the American College of Cardiology (2015)
Exome sequencing identifies recurrent mutations in NF1 and RASopathy genes in sun-exposed melanomas
Authors: Michael Krauthammer, Yong Kong, Antonella Bacchiocchi, Perry Evans, Natapol Pornputtapong, Cen Wu, Jamie P McCusker, Shuangge Ma, Elaine Cheng, Robert Straub, Merdan Serin, Marcus Bosenberg, Stephan Ariyan, Deepak Narayan, Mario Sznol, Harriet M Kluger, Shrikant Mane, Joseph Schlessinger, Richard P Lifton, Ruth Halaban
Journal: Nature Genetics (2015)
Comparative Effects of Paclitaxel and Docetaxel on the Metabolism and Pharmacokinetics of Epirubicin in Breast Cancer Patients
Authors: M. Esposito, M. Venturini, M.O. Vannozzi, G. Tolino, G. Lunardi, O. Garrone, C. Angiolini, M. Viale, M. Bergaglio, L. Del Mastro, R. Rosso
Journal: Journal of Clinical Oncology (1999)

To investigate whether paclitaxel and docetaxel influence the pharmacokinetics and metabolism of epirubicin.We studied the pharmacokinetics and biotransformation patterns of epirubicin in 27 cycles and 20 breast cancer patients. Four patients received epirubicin alone 90 mg/m(2) by intravenous (IV) bolus; eight patients received the same dose of epirubicin followed immediately by paclitaxel 175 mg/m(2) in a 3-hour infusion; the other eight patients received epirubicin 90 mg/m(2) followed immediately by docetaxel 70 mg/m(2) in a 1-hour infusion. Epirubicin and its metabolites, epirubicinol (EOL) and 7-deoxydoxorubicinone (7d-Aone), were identified by high-pressure liquid chromatography.No pharmacokinetic interaction between the parent compound epirubicin and taxanes was detected. Conversely, a significant effect on epirubicin metabolism by both paclitaxel and docetaxel was found. Epirubicin given with paclitaxel or docetaxel yielded areas under the plasma concentration-time curves (AUC) for 7d-Aone 1. 7-fold and 1.9-fold higher (P <.05), respectively, than epirubicin alone. The appearance of two polar metabolites sensitive to glucuronidase was also significantly greater in both taxane groups. Quantitatively different metabolic rates and patterns for EOL were observed in the paclitaxel and docetaxel combinations. The EOL AUC after paclitaxel treatment (1,521 +/- 150 ng/mL*h) was significantly higher (P <.01) than the corresponding values after epirubicin administered either as a single agent (692 +/- 46 ng/mL*h) or in combination with docetaxel (848 +/- 237 ng/mL*h).There is no apparent pharmacokinetic interaction between the parent compound epirubicin and paclitaxel or docetaxel. A different pattern of interaction between these taxanes and epirubicin metabolism is clearly evident.
Burning of mosquito coils (MCs) produce high levels of indoor PM2.5 and CO, which are associated with adverse respiratory health effects, and are significantly altered by indoor ventilation patterns
Authors: Devashri Salvi, Sneha Limaye, Veena Muralidharan, Jyoti Londhe, Sapna Madas, Archana Rao, Sanjay Juvekar, Shyam Biswal, Sundeep Salvi
Journal: European Respiratory Journal (2014)

An estimated 29 billion MCs are used by 2 billion people worldwide annually as mosquito repellents. Laboratory studies have shown that MCs produce high levels of PM2.5 and CO. We aimed to  a.  study the indoor levels of PM2.5 and CO in a simulated bedroom while burning MCs keeping window-closed-door-closed (WCDC), window-open-door-closed (WODC), window-open-door-open(WODO),  b. compare the prevalence of respiratory symptoms and allergic diseases in houses using MCs v/s liquid mosquito repellents (LMRs) in a rural population.  Methods:  I . 3 brands of MCs were burnt 3-times each in a room (2.9x5.8x2.4m) having 1window (1.4x1.3m) & 1door (2.2x0.8m). PM2.5 levels (mcg/m3) were measured online with Thermo PDR 1200 and CO (ppm) with Easylog USB sampler.  II . 465 subjects >18 years of age from 145 randomly selected homes were administered a respiratory health questionnaire.  Results:  See Tables 1 & 2.   Conclusion:  Burning of MCs produced high indoor PM2.5 and CO levels which were markedly altered by keeping the window & door open. Use of MCs was associated with greater respiratory morbidity.
In HIV-1, immediate vs deferred antiretroviral therapy and isoniazid vs no isoniazid reduced severe illness at 30 mo
Authors: Fiona Smaill
Journal: Annals of Internal Medicine (2015)

ACP Journal Club15 December 2015In HIV-1, immediate vs deferred antiretroviral therapy and isoniazid vs no isoniazid reduced severe illness at 30 moFiona Smaill, MSc, FRACP, FRCPCFiona Smaill, MSc, FRACP, FRCPCMcMaster University, Hamilton, Ontario, Canada (F.S.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/ACPJC-2015-163-12-005 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationTEMPRANO ANRS 12136 Study Group, Danel C, Moh R, et al. A trial of early antiretrovirals and isoniazid preventive therapy in Africa. N Engl J Med. 2015;373:808-22. https://pubmed.ncbi.nlm.nih.gov/26193126Clinical Impact RatingsInfectious Disease: Pulmonology: References1. AIDSinfo. Statement by the HHS panel on antiretroviral guidelines for adults and adolescents regarding results from the START and TEMPRANO trials. 28 July 2015. www.aidsinfo.nih.gov/news/1592/statement-from-adult-arv-guideline-panel—start-and-temprano-trials (accessed 24 Sep 2015). Google Scholar2. World Health Organization. Guideline on when to start antiretroviral therapy and on pre-exposure prophylaxis for HIV. September 2015. apps.who.int/iris/bitstream/10665/186275/1/9789241509565_eng.pdf (accessed 6 Oct 2015). Google Scholar3. World Health Organization. Programmatic update. Maximizing the treatment and prevention potential of antiretroviral drugs: Early country experiences towards implementing a treat-all policy. July 2015. apps.who.int/iris/bitstream/10665/183599/1/WHO_HIV_2015.35_eng.pdf (accessed 21 Sep 2015). Google Scholar4. Cohen MS, Chen YQ, McCauley M, et al; HPTN 052 Study Team. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365:493-505. [PMID: 21767103] Google Scholar5. Shah M, Risher K, Berry SA, Dowdy DW. The epidemiologic and economic impact of improving HIV testing, linkage, and retention in care in the United States. Clin Infect Dis. 2015;Sep 11. [Epub ahead of print]. [PMID: 26362321] Google Scholar Author, Article, and Disclosure InformationAffiliations: McMaster University, Hamilton, Ontario, Canada (F.S.)This article was published at Annals.org on 1 December 2015. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoIn early HIV infection, immediate vs deferred antiretroviral therapy reduced serious illnesses at 3 years Fiona Smaill In early HIV infection, immediate vs deferred antiretroviral therapy reduced serious illnesses at 3 years Fiona Smaill Metrics 15 December 2015Volume 163, Issue 12Page: JC5KeywordsAdverse eventsAntiretroviral therapyBacterial diseasesHIVHIV-1IsoniazidMortalityPreventive medicineRelative riskTreatment guidelines ePublished: 15 December 2015 Issue Published: 15 December 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...