tbuckley/cabot-search huggingface dataset:
Factors Associated With Rates of False-Positive and False-Negative Results From Digital Mammography Screening: An Analysis of Registry Data
Authors: Heidi D. Nelson, Ellen S. O'Meara, Karla Kerlikowske, Steven Balch, Diana Miglioretti
Journal: Annals of Internal Medicine (2016)

Background: Women screened with digital mammography may receive false-positive and false-negative results and subsequent imaging and biopsies. How these outcomes vary by age, time since the last screening, and individual risk factors is unclear. Objective: To determine factors associated with false-positive and false-negative digital mammography results, additional imaging, and biopsies among a general population of women screened for breast cancer. Design: Analysis of registry data. Setting: Participating facilities at 5 U.S. Breast Cancer Surveillance Consortium breast imaging registries with linkages to pathology databases and tumor registries. Patients: 405 191 women aged 40 to 89 years screened with digital mammography between 2003 and 2011. A total of 2963 were diagnosed with invasive cancer or ductal carcinoma in situ within 12 months of screening. Measurements: Rates of false-positive and false-negative results and recommendations for additional imaging and biopsies from a single screening round; comparisons by age, time since the last screening, and risk factors. Results: Rates of false-positive results (121.2 per 1000 women [95% CI, 105.6 to 138.7]) and recommendations for additional imaging (124.9 per 1000 women [CI, 109.3 to 142.3]) were highest among women aged 40 to 49 years and decreased with increasing age. Rates of false-negative results (1.0 to 1.5 per 1000 women) and recommendations for biopsy (15.6 to 17.5 per 1000 women) did not differ greatly by age. Results did not differ by time since the last screening. False-positive rates were higher for women with risk factors, particularly family history of breast cancer; previous benign breast biopsy result; high breast density; and, for younger women, low body mass index. Limitations: Confounding by variation in patient-level characteristics and outcomes across registries and regions may have been present. Some factors, such as numbers of first- and second-degree relatives with breast cancer and diagnoses associated with previous benign biopsy results, were not examined. Conclusion: False-positive mammography results and additional imaging are common, particularly for younger women and those with risk factors, whereas biopsies occur less often. Rates of false-negative results are low. Primary Funding Source: Agency for Healthcare Research and Quality and National Cancer Institute.
Brief Communication: Possible Carcinogenic Effects of Cedar Shavings in Bedding of C3H-Avy fB Mice
Authors: George Vlahakis
Journal: JNCI Journal of the National Cancer Institute (1977)

C3H-AvyfB female mice were tested on bedding consisting only of low-resin pine and on bedding of pine plus cedar shavings. Tumor occurrences were similar in both groups of animals, with a slightly lower incidence and slightly higher average age for mammary gland tumors in the females on bedding of pine plus cedar. From these results, the high incidence of cancer in the C3H-AvyfB strain could not be attributed to the routine use of cedar shavings in the bedding material.
Primary health care: is it poor care for poor people?
Authors: Burkhart S
Journal: BMJ (1983)

3 misconceptions about primary health care (PHC) that were clarified by the World Health Organizations regional officer for PHC in Europe during a recent conference in Britain attended by health professionals and administrators are that the concept of PHC was invented by the WHO that it applies only to developing countries and that it is the same as primary medical care which general practitioners provide in Britain.  The Alma Ata Declaration of 1978 which stated the goal of health for all by the year 2000 has received little publicity in Britain and the conference was organized to examine the problems and possibilities of health for all by 2000 in Britain.  Health care systems should be community-based and acceptable to the community and should provide services needed and wanted by the people.  Encouraging people to take greater responsibility for their health is a vital element of PHC.  Comments on PHC in Britain by a general practitioner a nurse/health visitor and a voluntary worker indicated the difficulty of defining a community in highly mobile areas the importance of accessiblity of health care facilities the possible reluctance of professionals trained to provide curative care to sick people to change their focus the difficulty of cooperation among health teams which is exacerbated by discrepancies in the status and remuneration of doctors and nurses and the attitude changes needed in working with lay people.  Further discussion elaborated on these difficulties and it was concluded that much more should be known about what was being done at the community level before any plans were made for implementation of PHC in Britain.
Bitemporal Versus High-Dose Unilateral Twice-Weekly Electroconvulsive Therapy for Depression (EFFECT-Dep): A Pragmatic, Randomized, Non-Inferiority Trial
Authors: Maria Semkovska, Sabine Landau, Ross Dunne, Erik Kolshus, Adam Kavanagh, Ana Jelovac, Martha Noone, Mary Carton, Sinead Lambe, Caroline McHugh, Declan M. McLoughlin
Journal: American Journal of Psychiatry (2016)

Objective: ECT is the most effective treatment for severe depression. Previous efficacy studies, using thrice-weekly brief-pulse ECT, reported that high-dose (6× seizure threshold) right unilateral ECT is similar to bitemporal ECT but may have fewer cognitive side effects. The authors aimed to assess the effectiveness and cognitive side effects of twice-weekly moderate-dose (1.5× seizure threshold) bitemporal ECT with high-dose unilateral ECT in real-world practice. Method: This was a pragmatic, patient- and rater-blinded, noninferiority trial of patients with major depression (N=138; 63% female; age=56.7 years [SD=14.8]) in a national ECT service with a 6-month follow-up. Participants were independently randomly assigned to bitemporal or high-dose unilateral ECT. The primary outcome was change in the 24-item Hamilton Depression Rating Scale (HAM-D) score after the ECT course; the prespecified noninferiority margin was 4.0 points. Secondary outcomes included response and remission rates, relapse status after 6 months, and cognition. Results: Of the eligible patients, 69 were assigned to bitemporal ECT and 69 to unilateral ECT. High-dose unilateral ECT was noninferior to bitemporal ECT regarding the 24-item HAM-D scores after the ECT course (mean difference=1.08 points in favor of unilateral ECT [95% CI=−1.67 to 3.84]). There were no significant differences for response and remission or 6-month relapse status. Recovery of orientation was quicker following unilateral ECT (median=19.1 minutes versus 26.4 minutes). Bitemporal ECT was associated with a lower percent recall of autobiographical information (odds ratio=0.66) that persisted for 6 months. Conclusions: Twice-weekly high-dose unilateral ECT is not inferior to bitemporal ECT for depression and may be preferable because of its better cognitive side-effect profile.
Complex effects of inhibiting hepatic apolipoprotein B100 synthesis in humans
Authors: Gissette Reyes-Soffer, Byoung Moon, Antonio Hernandez-Ono, Marija Dionizovik-Dimanovski, Jhonsua Jimenez, Joseph Obunike, Tiffany Thomas, Colleen Ngai, Nelson Fontanez, Daniel S. Donovan, Wahida Karmally, Stephen Holleran, Rajasekhar Ramakrishnan, Robert S. Mittleman, Henry N. Ginsberg
Journal: Science Translational Medicine (2016)

Targeting apoB synthesis with mipomersen (KYNAMRO) can be effective for lowering plasma levels of apoB lipoproteins without reducing the secretion of VLDL.
Impact of HIV on the burden and severity of influenza illness in adults in Malawi: a cohort and case-control study
Authors: Antonia Ho, Stephen Aston, Hannah Jary, Tamara Mitchell, Maaike Alaerts, Mavis Menyere, Jane Mallewa, Mulinda Nyirenda, Dean Everett, Robert S Heyderman, Neil French
Journal: The Lancet (2016)
The simple calculated osteoporosis risk estimation (SCORE) does not allow identification of Belgian women with a high risk of osteoporosis
Authors: Wafa Ben Sedrine, Jean-Pierre Devogelaer, Jean-Marc Kaufman, S. Goemaere, G. Depresseux, Olivier Bruyère, Jean-Yves Reginster
Journal: Annals of the Rheumatic Diseases (2000)
A phase 3, randomized, double-blind, placebo-controlled study evaluating the efficacy and safety of idelalisib (GS-1101) in combination with bendamustine and rituximab for previously treated indolent non-Hodgkin lymphomas (iNHL).
Authors: Myron Stefan Czuczman, Hans Knecht, Rebecca Auer, Joseph James McKendrick, Neil Sun Chua, Kim Linton, Graham Collins, Sven De Vos, Leanne Holes, Esteban Abella, Gilles A. Salles
Journal: Journal of Clinical Oncology (2014)

TPS8621 Background: PI3Kδ is critical for activation, proliferation and survival of B cells and plays a role in homing and retention in lymphoid tissues. PI3Kδ signaling is hyperactive in many B-cell malignancies. Idelalisib is a first-in-class, targeted, highly selective, oral inhibitor of PI3Kδ that reduces proliferation, enhances apoptosis, and inhibits homing and retention of malignant B cells in lymphoid tissues (Lannutti et al, 2011). A phase 2 trial demonstrated that idelalisib is highly active in pts with heavily pretreated iNHL: response rate was 57% (6% CR) and median PFS was 11 mos with an acceptable safety profile (Gopal et al, 2014). Methods: A planned 450 pts with recurrent iNHL, who require therapy for iNHL, have received prior anti-CD20-antibody-containing therapy and chemotherapy, and who have iNHL that is not refractory to bendamustine (B) with measurable lymphadenopathy, will be randomized in a 2:1 ratio into Arm A or Arm B of the study. In Arm A, subjects will receive rituximab (R) at 375 mg/m2 every 28 days + B at 90 mg/m2 on days 1 and 2 of each 28-d cycle up to 6 cycles with idelalisib at 150 mg BID continuously until progression. In Arm B, subjects will receive placebo BID instead of idelalisib. Stratification factors include tumor type (follicular lymphoma vs others), tumor burden (high vs low), and time since completion of last prior therapy for iNHL (<18 months vs ≥18 months). The primary endpoint is PFS, and secondary endpoints include CR rate, ORR, lymph node response rate, and OS. This is an event-driven trial and primary endpoint evaluation will be based on independent central review. For the primary efficacy analysis, the difference in PFS between the treatment arms will be assessed in the ITT analysis set using Kaplan-Meier methods and the stratified log-rank test. The study opened for enrollment in Dec 2012. Clinical trial information: NCT01732926.
Knowledge and beliefs about breast cancer in rural women and indigenous population of southern Mexico
Authors: M. Saldana-Tellez, S. Marcial-Toledo, S. Terrazas-Espitia, J. Vazquez-Luna, C. Guzman-Patraca, L. Venegas- Hernandez, J. Perez-Romero, F. Gutierrez-Delgado
Journal: Journal of Clinical Oncology (2009)

1533 Background: Rural and indigenous women are generally considered to be at lower risk of breast cancer than women living in urban environments. However, a rising breast cancer incidence rates among those women has been reported. Moreover, up to 90% of those women are diagnosed as having advanced disease. With the aim to improve preventive programs in that population, this study evaluated socio-demographic factors associated with breast cancer early detection and women's knowledge about this malignancy. Methods: Between March 2008 and November 2008, women attending cancer screening programs in our clinic were asked to answer a questionnaire focusing on socio-demographic issues, breast cancer risk factors, breast self examination (BSE), mammography, and perception of breast cancer risk. Results: 838 consecutive women (median age 40 years, range: 15–85) were evaluated. 443 (53%) of them were 40 years and older. The highest education level was 9 years in 408 (49%), 72 (9%) were illiterates and 721 (86%) have no medical insurance. 104 (12%) women practice BSE. The main source of breast cancer awareness was physicians and media in 270 (32%) and 214 (26%) women, respectively. 285 (34%) women knew about breast cancer risk factors, 255 (30%) identified symptoms and signs, and 460 (55)% of them identified lump as the most common sign. 441 (53%) women recognized mammography as the best diagnostic tool in detecting breast cancer, but only 79 (18%) out of 443 women 40 years and older, reported having had a mammogram. Mammograms were not done in 364 (82%) women because of financial issues and difficulty in accessing facilities that perform mammography. 311 (37%) women thought that they were at higher risk of developing breast cancer. Conclusions: Rural and indigenous women have a poor knowledge about breast cancer. Low level education, lack of medical insurance, financial issues, insufficient mammography facilities, and low perception of breast cancer risk are the most important barriers to increase women´s participation in early breast cancer detection. These factors should be considered to improve preventive breast cancer programs. No significant financial relationships to disclose.
Sharp spike in deaths in England and Wales needs investigating, says public health expert
Authors: Nigel Hawkes
Journal: BMJ (2016)

A sharp rise in the annual number of deaths recorded in England and Wales in 2015 has left public health experts grasping for answers.

Preliminary figures show a 5.4% increase in deaths from 2014 to 2015, the biggest rise for several decades. The Office for National Statistics estimated that, after adjustment for population growth, the crude death rate rose by 4.9% in 2015. Smaller rises recorded in 2012 and 2013 were explained at the time by Public Health England as being due to influenza and cold weather.

Death rates have been falling steadily (with an occasional blip) for the past 30 years, so a change in trend is a concern. Dominic Harrison, public …
Fluorescent false neurotransmitter reveals functionally silent dopamine vesicle clusters in the striatum
Authors: Daniela B Pereira, Yvonne Schmitz, József Mészáros, Paolomi Merchant, Gang Hu, Shu Li, Adam Henke, José E Lizardi-Ortiz, Richard J Karpowicz, Travis J Morgenstern, Mark S Sonders, Ellen Kanter, Pamela C Rodriguez, Eugene V Mosharov, Dalibor Sames, David Sulzer
Journal: Nature Neuroscience (2016)
Brachytherapy: Where Has It Gone…Again?
Authors: Shyamal Patel, Omar Ragab, D. Jeffrey Demanes, Allen M. Chen, Mitchell Kamrava
Journal: Journal of Clinical Oncology (2016)

TO THE EDITOR: The review by Chinn and Myers about the management of oral cavity cancer mentioned available therapeutic options, but there was one significant omission: brachytherapy. Low-dose-rate and high-dose-rate interstitial brachytherapy have historically been used to treat oral cavity cancers, either as monotherapy or in combination with external-beam radiation, and offer high local control rates and low toxicities. It is an effective technique used in centers throughout the world in the definitive, postoperative, recurrent, and salvage settings. In fact, the use of brachytherapy as a boost in the definitive setting can improve local control rates by 20% compared with external beam radiation alone. Both the American Brachytherapy Society and the Groupe Europeen de Curietherapie–European Society for Radiotherapy and Oncology have developed guidelines for the use of brachytherapy for head and neck cancers. Petereit et al appropriately stated in their article “Brachytherapy: Where has it gone?” that it is our responsibility as oncologists to educate patients, insurance companies, and policy makers about the utility of this tool. Brachytherapy has a significant, evidence-based role in the management of oral cavity cancer and should be considered for treatment in appropriately selected patients. A reply to this Correspondence was not provided.
A Global Proteomic Pathway Map In Acute Myeloid Leukemia (AML)
Authors: Chenyu W Hu, Amina A Qutub, Yihua Qiu, Suk Young Yoo, Nianxiang Zhang, Naveen Pammaraju, Courtney D. DiNardo, Kevin R. Coombes, Steven M. Kornblau
Journal: Blood (2013)
Pre-prostatectomy study of the effect of celecoxib versus placebo on androgen receptor (AR) expression in prostate cancer
Authors: M. Garzotto, N. Janeba, K. M. Eilers, H. Sekhon, T. M. Beer
Journal: Journal of Clinical Oncology (2007)

15538 Background: Cyclooxygenase (COX) inhibitor drug use is associated with a reduction in prostate cancer incidence and mortality. Numerous potential mechanisms for the COX-2 inhibitor, celecoxib have been proposed, including a reduction in AR transactivation (Clin Cancer Res 10:7727, 2004). We hypothesized that pre-prostatectomy celecoxib therapy would result in reduced tissue AR levels. Methods: 28 patients with localized prostate cancer were randomized to celecoxib (400 mg bid) or placebo for 4 weeks prior to prostatectomy. Both benign and cancerous tissues were embedded in a tissue microarray. A single blinded pathologist quantified the percent of positive nuclei in benign versus malignant epithelial cells. Results: An increased number of AR-positive nuclei were observed in the malignant versus benign cells (65.9± 35.2% versus 49.9 ± 33.5 %, p &lt;.001). There was no difference in AR expression between treatment and placebo groups in either benign or cancerous tissue (p = .9, .85, respectively). The median serum PSA at baseline was 6.0 and 6.2 ng/ml for the celecoxib and placebo groups. Over the treatment period, there was no detectable effect of celecoxib on serum PSA (p=0.91). Conclusions: Short-term COX-2 inhibitor therapy did not result in a significant change in either tissue AR or serum PSA. If celecoxib has inhibitory effects on prostate cancer, these may occur without an effect of AR activity. No significant financial relationships to disclose.
PARAMOUNT: Final overall survival (OS) results of the phase III study of maintenance pemetrexed (pem) plus best supportive care (BSC) versus placebo (plb) plus BSC immediately following induction treatment with pem plus cisplatin (cis) for advanced nonsquamous (NS) non-small cell lung cancer (NSCLC).
Authors: Luis Paz-Ares, Filippo De Marinis, Mircea Dediu, Michael Thomas, Jean-Louis Pujol, Paolo Bidoli, Oliver Molinier, Tarini Prasad Sahoo, Eckart Laack, Martin Reck, Jesus Corral Jaime, Symantha Melemed, William J. John, Nadia Chouaki, Annamaria Zimmermann, Carla Visseren-Grul, Cesare Gridelli
Journal: Journal of Clinical Oncology (2012)

LBA7507 The full, final text of this abstract will be available at abstract.asco.org at 12:01 AM (EDT) on Monday, June 4, 2012, and in the Annual Meeting Proceedings online supplement to the June 20, 2012, issue of Journal of Clinical Oncology. Onsite at the Meeting, this abstract will be printed in the Monday edition of ASCO Daily News.
Elevated preoperative serum level of tumor markers CEA and CA 15–3 in breast cancer patients
Authors: B. Park, H. Kim, J. Oh, S. Kim, K. Kim, J. Sohn
Journal: Journal of Clinical Oncology (2006)

621 Background: Serological tumor markers: Cancer Antigen 15–3 (CA 15–3), Carcinoembryonic Antigen (CEA), have been investigated as useful markers for monitoring of response to treatment and for predicting outcome in breast cancer patients. Methods: A total of 820 breast cancer patients, treated over the period April 1999 through December 2003, had preoperative CA15–3 and CEA concentrations measured. The stage of the primary tumor ranged from 0 to IV. The median age of the patients was 47years (range 20–88 years old). The concentration of markers was investigated with regard to clinico-pathological parameters and patients outcome by both univariate and multivariate analysis. We determined the range of normality by the mean + 2 standard deviations of the markers distribution in populations of healthy females, who took an annual health screening program. Survival curves for disease free survival and death from disease were estimated by the method of Kaplan-Meier method and differences between groups in survival were tested using the log-rank test. All statistical analyses were carried out using SPSS statistics software (ver 10.5). Results: Among 820 patients, elevated preoperative level of CA15–3 and CEA was identified in 100 (12.2%) and 83 (10.1%) patients, respectively. Tumor size (&gt;5cm), lymph node metastases (≥4), advanced stage (stage III and IV) were associated with significantly higher level of both preoperative CA15–3 and CEA. Elevated preoperative values of CA15–3 and CEA were associated with poor disease free survival (DFS, p=0.0019, p=0.0001, respectively) and distant relapse-free survival (DRFS, p=0.011, p=0.0034), but the level was marginal for overall survival (OS, p=0.0848, p=0.0895). By Cox’s multivariate analysis, younger age (&lt;35 years), larger tumor size(&gt;2cm), axillary node metastases, negative ER expression, elevated preoperative values of CA15–3 and CEA were independent prognostic factors for DFS and DRFS. Conclusions: High level of preoperative CA 15–3 and CEA might reflect a tumor burden, and is associated with advanced disease condition and disease-free survival. Measuring preoperative levels of CA 15–3 and CEA might be helpful for predicting the outcome and for planning the adjuvant therapy in breast cancer patients. No significant financial relationships to disclose.
Utilization of plastic dressing clinic: Clinical audit
Authors: J. van der Veen, R. Exton, C. Durrant
Journal: International Journal of Surgery (2015)

Aims    –   The Plastic Department, Queen Alexandra Hospital, Portsmouth has experienced an increasing demand for plastic dressing clinic appointments.   This has resulted in a significant overbooking of appointments. Aim of this audit was to review the current practice in the department and to improve the situation by rationalizing the follow up system for the patients.               Methods    – Two prospective audit cycles were carried out both for the duration of one calendar month period with implementation of changes between cycles. Data collected included diagnosis, reason for the appointment, follow up plan and suitability for an alternative follow up at primary care services.                Results    – First cycle of an audit showed an overbooking of plastic dressing clinic by 37%. This was significantly higher than recommended 10% by Audit Commissioning Group, 2003. During this period 20% of the appointments were recognised as suitable for follow up at primary care services. Data was distributed across the department with the flow diagram created to reinforce the appropriate patients’ pathway. Second cycle of the audit showed a significant improvement in overbooking, which was reduced to 14%.                Conclusions    – Following patients up appropriately can make the health system and services run more efficiently. It can free up the specialist services for caring for the conditions, which require specialist input. It improves patient satisfaction with the service, minimizes the unnecessary travelling of the patients and improves waiting times. It also decreases the high pressure and stress within the working environment, which as a result improves efficiency, quality and job satisfaction of the specialist staff.