tbuckley/cabot-search huggingface dataset:
Point: Sentinel Lymph Node Biopsy Is Indicated for Patients With DCIS
Authors: Hiram S. Cody, Kimberly J. Van Zee
Journal: Journal of the National Comprehensive Cancer Network (2003)

Sentinel lymph node (SLN) biopsy, a new standard of care for staging invasive breast cancer, remains controversial for ductal carcinoma in situ (DCIS). Although DCIS has a natural history in which long-term distant disease-free survival (DDFS) is 98% to 99% and axillary node metastases are historically rare, three recent DCIS series have found SLN metastases in a surprising 6% to 13% of patients. The strongest argument for SLN biopsy in DCIS is the diagnostic uncertainty and inherent sampling error of conventional pathologic techniques. Definitive surgery (excision or mastectomy) reveals invasive cancer in 10% to 21% of patients with a preoperative core needle or surgical biopsy diagnosis of DCIS, all of whom become conventional candidates for SLN biopsy. In the absence of proven invasion, most positive SLN in DCIS are micrometastases detected by hematoxylin and eosin– and immunohistochemical-stained serial sections. An increasing body of evidence suggests that these are prognostically significant, not artifactual. We propose that DCIS patients with positive SLN have occult invasive cancers, and that the same may have been true for the 1% to 2% of DCIS patients who go on to develop distant metastasis, either after an invasive local recurrence or as a first event. We further suggest that the diagnosis of DCIS encompasses two patient populations: 1) a majority (perhaps 90%) with true in situ disease (or prognostically insignificant invasion), negative SLNs, and an expected DDFS of 100%; and 2) a minority (perhaps 10%) with occult invasion, positive SLNs, and an expected DDFS of perhaps 90%. Pending the development of predictive models for preoperative identification of this SLN-positive minority of DCIS patients, SLN biopsy is indicated in any DCIS patient who may have an underlying invasive cancer, especially those who require mastectomy. In DCIS, SLN biopsy may ultimately prove to be a more sensitive screening test for occult invasion than examination of the breast itself.
AB0577 Mean Platelet Volume is Associated with Behcet's Disease Activity
Authors: H.J. Ryu, M.K. Lee, K.H. Lee, M.R. Seo, H.J. Choi, H.J. Baek
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> Mean platelet volume (MPV) has been known to be a marker of platelet activity and influenced by inflammation.The correlations of MPV with disease activities were reported in several rheumatic diseases such as rheumatoid arthritis, ankylosing spondylitis, and psoriasis. However MPV is controversial as a marker of their disease activities. Furthermore, the association of MPV with disease activity in Behcet9s disease (BD) is not determined yet. <h3>Objectives</h3> The aim of this study is to investigate the association of MPV with clinical manifestations and disease activity in BD. <h3>Methods</h3> We sequentially retrieved data on 193 patients with BD who visited to our rheumatic clinic from 1999 to 2013 by reviewing of medical records. BD was diagnosed according to International Criteria for BD. The data on demographics, clinical manifestations, and laboratory results including MPV, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were collected. Active BD was defined as it needed prednisolone of more than 0.5 mg/kg/day or to add immunosuppressive agents. Infection was demonstrated by culture or clinical improvement with antibiotic treatment. Statistical analysis was made by t-test and Pearson9s correlation. A value of <i>p</i>&lt;0.05 was considered as statistically significant. <h3>Results</h3> The ratio of female to male was 2:1 and the age of symptom onset was 32.2±11.1 years. The age at diagnosis of BD was 40.9±10.0 years and the follow-up duration was 4.7±3.8 years. Fifty-one patients (26.4%) had major organ involvements such as eye (17.6%), gastrointestinal (7.8%), vascular (4.7%) and nervous system (3.1%). MPV at diagnosis was 8.2±1.2 fl. MPV was not related with clinical manifestations, ESR and CRP. During follow-up, 79 patients had active BD and 12 patients had infections such as pulmonary tuberculosis and pyelonephritis. MPV in active BD (8.1±1.4 fl) was lower than that in inactive disease (8.9±1.3 fl; (p&lt;0.0001). MPV significantly increased when the patients were infected (9.5±1.6 fl; p&lt;0.0001) <h3>Conclusions</h3> MPV was not related with clinical manifestations of BD. However, there was an association of active BD with lower MPV and of infection with higher MPV. Thus, MPV level may be used as a marker of BD activity and to differentiate infection from active BD. <h3>References</h3> Are platelet volume indices of clinical use? A multidisciplinary review. Ann Med. 2012 Dec;44(8):805-16. Mean platelet volume in recurrent aphthous stomatitis and behcet disease. Angiology. 2014 Feb;65(2):161-5. Increased mean platelet volume in Behçet9s disease with thrombotic tendency. Tohoku J Exp Med. 2010 Jun;221(2):119-23. <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.5121
Case 27-2009
Authors: Jeremy S. Abramson, Subba Digumarthy, Judith A. Ferry
Journal: New England Journal of Medicine (2009)

A 56-year-old woman was admitted to this hospital because of fever, rash, and lymphadenopathy. Eleven weeks earlier, fever and a rash had developed, shortly after an ant sting. Her symptoms responded to corticosteroids, but 6 weeks before admission, lymphadenopathy developed, followed by recurrent fever and rash. Evaluation disclosed no evidence of infection, and specimens from lymph-node biopsies did not yield a diagnosis. A diagnostic procedure was performed.
Double-balloon enteroscope-assisted enteral stent placement for malignant afferent-loop obstruction after Roux-en-Y reconstruction
Authors: Takashi Sasaki, Hiroyuki Isayama, Hirofumi Kogure, Atsuo Yamada, Taku Aoki, Norihiro Kokudo, Kazuhiko Koike
Journal: Endoscopy (2014)

A 64-year old man was admitted to our hospital because of acute cholangitis. He had previously undergone pancreatoduodenectomy with Roux-en-Y reconstruction for a pancreatic neuroendocrine carcinoma ([Fig. 1]). A computed tomography (CT) scan revealed afferent-loop obstruction due to lymph node metastases ([Fig. 2]).
Noninvasive Assessment of Subclinical Atherosclerosis in Normotensive Patients with Gestational Diabetes
Authors: Ahmet Engin Atay, Hakki Simsek, Bulent Demir, Mehmet Nafi Sakar, Meki Kaya, Semir Pasa, Surreya Demir, Dede Sit
Journal: Journal of the American College of Cardiology (2013)
SP0079 Self management for OA: The role of the GP
Authors: M. Porcheret
Journal: Annals of the Rheumatic Diseases (2013)

The ongoing management of OA by healthcare professionals is predominantly undertaken in primary care in the UK by GPs. The National Institute for Health and Clinical Excellence (NICE) OA Guideline provides evidence-based recommendations to guide GPs. At the heart of NICE's recommendations is the self-management of OA: access to information, exercise and physical activity, where appropriate weight loss and over-the-counter analgesics. GP management has traditionally focussed on the pharmacological management of pain but with the rising awareness of the need to support patients with long-term conditions, such as OA, in managing their own condition(s) this is starting to change. This is echoed by the patient voice: that they would like help from healthcare professionals in supporting them to self-manage. To provide support for self-management the GP, or other healthcare professional, needs to enter the patient's world to understand how OA affects their life and what they have tried to help the condition. It is then important to identify what support is needed and help the patient set goals and think through how they might achieve them. The aim is to increase patients' confidence and skills in managing their OA, but also to provide evidence-based advice on effective treatments for OA when asked. The talk will provide practical examples of how GPs, and other healthcare professionals, can support the self-management of OA. <h3>Disclosure of Interest</h3> None Declared
TBCRC 003: Phase II trial of trastuzumab (T) and lapatinib (L) in patients (pts) with HER2+ metastatic breast cancer (MBC).
Authors: N. U. Lin, I. A. Mayer, J. S. Najita, T. J. Hobday, C. I. Falkson, E. C. Dees, M. F. Rimawi, R. Nanda, R. S. Gelman, K. Josephs, A. Richardson, L. Flores, A. D. Van Den Abbeele, J. T. Yap, C. L. Arteaga, A. C. Wolff, I. E. Krop, E. P. Winer
Journal: Journal of Clinical Oncology (2011)

527 Background: In heavily pre-treated pts, L+T is associated with improved outcomes compared to L alone (Blackwell et al, 2009). We evaluated the safety and efficacy of L+T in pts with 0-2 prior lines of chemotherapy (CT) for HER2+ MBC. We also explored mechanisms of resistance and predictors of response to anti-HER2 therapy. Methods: Pts with measurable, HER2+ MBC were eligible. Cohort 1: No prior T, L, or CT for MBC, and > 1 yr from adjuvant T, if received. Cohort 2: 1-2 prior lines of CT for MBC, including T, or relapse within 1 yr of adjuvant T. Pts received L 1,000 mg QD + T (2 mg/kg weekly or 6 mg/kg Q3W). Baseline (BL) research biopsy was required. FDG-PET/CT was performed at BL, Wk 1, and Wk 8. Circulating tumor cells and plasma were collected at BL, Wk 4, and off-study. Staging studies were done at BL and every 2 cycles (1 cycle = 4 wks). The primary endpoint was objective response rate (ORR) by RECIST 1.0. The study was designed to distinguish between ORR 25% vs. 45% in Cohort 1 (>/= 5/17 pts to enter 2nd stage; 14 responses in 36 evaluable (eval) pts needed to be promising) and between ORR 10% vs. 25% in Cohort 2 (>/=3/22 pts to enter 2nd stage; responses in 8/40 pts needed to be promising). Secondary endpoints included clinical benefit rate (CBR; CR+PR+SD >/= 6 months), toxicity, and radiologic/biomarker correlates. Results: Enrollment was completed 10/28/2010 (Cohort 1, n=40; Cohort 2, n=47). 14 pts in Cohort 1 remain on protocol therapy. In Cohort 2, all pts have come off study; median number of cycles was 6 (range 1-18). Of the 1st 36 eval pts in Cohort 1, confirmed objective responses were observed in 41.7% (95% CI 23.0%-67.1%; 3 CR, 12 PR; 4 unconfirmed PR). Of the 1st 40 eval pts in Cohort 2, confirmed ORR was 25% (95% CI 11.2%-45.6%; 0 CR, 10 PR; 2 unconfirmed PR). CBR was 47.2% (95% CI 30.4%-64.5%) and 40% (95% CI 24.9%-56.7%), respectively. Grade 3/4 treatment-related toxicities were uncommon (grade 3 diarrhea, 7%; all others < 3%). No biopsy-related SAEs were reported. Conclusions: L+T is an active regimen in HER2+ MBC. The study met its pre-specified primary endpoint in each cohort. Updated efficacy data will be presented. Imaging and tissue-based correlative analyses are underway.
1402 EVEROLIMUS WITH EARLY REDUCTION OR ELIMINATION OF TACROLIMUS: 12 MONTH RESULTS OF A RANDOMIZED, CONTROLLED STUDY IN 719DE NOVO LIVER TRANSPLANT RECIPIENTS
Authors: F. Nevens, L. De Carlis, H. Metselaar, F. Saliba, S. Beckebaum, S. Jonas, D. Sudan, L. Fischer, J. Fung, H. Jiang, G. Junge, P. De Simone
Journal: Journal of Hepatology (2012)
AB0906 Physical Activity in Adolescents with Juvenile Idiopathic Arthritis
Authors: M. Niewerth, J. Klotsche, I. Foeldvari, G. Ganser, A. Hospach, A. Zink, K. Minden
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> Physical activity (PA) is essential for the social, emotional, and cognitive development of children and adolescents. There is limited knowledge on PA in patients with juvenile idiopathic arthritis (JIA). It is of clinical relevance to what degree JIA patients are physically active despite their disease-related functional limitations. <h3>Objectives</h3> To describe PA, to assess the relationship between PA and the burden of illness, and to analyse the trend over time regarding PA of adolescents with JIA. <h3>Methods</h3> Cross-sectional data of adolescents with JIA recorded in the national pediatric rheumatological database in the years 2000 to 2012 were considered for the analyses. PA was defined as doing sport at least three days a week. The data of the year 2012 were used to describe the frequency and duration of PA in adolescents, its influencing factors were analysed by linear regression. Whether PA had changed between 2000 and 2012 was determined using linear mixed models by West, Welch and Galecki. <h3>Results</h3> In 2012 a total of 2,641 adolescents with JIA (females 64%, mean disease duration 4 years) aged 13 to 17 were recorded. About 39% of the participants were physically active (32% girls, 50% boys). Significant differences regarding the frequency of PA were observed among the various JIA categories: patients with enthesitis-related arthritis were more frequently physically active than patients with rheumatoid factor-positive polyarthritis (47% vs 29%). Regardless of the JIA subtype patients who were physically active rated their functional status, intensity of pain, and overall well-being significantly better than physically inactive patients. Multivariate analysis showed that boys, patients with a low burden of disease and patients with an inactive disease did sports more often. Considering the whole cohort, JIA patients were physically active for a median of three hours per week. During the observation period, participation in physical education at school significantly changed. In 2000 only every 4th adolescent with JIA regularly participated in physical education compared to more than 50% in 2012. <h3>Conclusions</h3> The current recommendation [1] which advises daily PA of about 60 minutes is fulfilled only by about 40% of the adolescents with JIA. With regard to participation in physical education, a paradigm change took place, leading to fewer children extempted from school sports. <h3>References</h3> Janssen, LeBlanc (2010). Systematic review of the health benefits of physical activity and fitness in school-aged children and youth. Int. J. Behav. Nutr. Phys. Act. 7:40 <h3>Acknowledgements</h3> Funding: The National Pediatric Rheumatology Database has been funded by the German Children Arthritis Foundation (Deutsche Kinder-Rheumastiftung). <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.2562
Abstract LB-285: Blocking Dll4/Notch signaling inhibits development of chronic colitis-associated colorectal cancer in mice
Authors: Antonio Duarte, Marina Badenes, Alexandre Trindade, Ren Liu, Parkash S. Gill
Journal: Cancer Research (2011)

Abstract Colorectal cancer (CRC) is one of the most frequent cancers worldwide, often developing as a complication of inflammatory bowel diseases. The Notch pathway plays a central role in intestinal homeostasia and its deregulation contributes to tumor development. Inhibition of Notch signaling through the Dll4 ligand shows anti-tumor activity against a variety of human and rodent tumors grafted in mice. The aim of this work was to analyze Dll4 expression in both normal intestine and intestinal tumors, and determine the effect of Dll4 inhibition by using Dll4 heterozygous mice or administering a pharmacological inhibitor (soluble Dll4-Fc) in the mouse model of chemically induced colo-rectal cancer (CRC). To induce chronic colitis and CRC we combined the administration of azoxymethane, and repeated cycles of the proinflammatory dextran sodium sulfate in the drinking water, as previously described (Neufert et al. Nat Protoc 2: 1998) in either Dll4+/− mice or wild type mice treated with sDll4-Fc at a dose of 5mg/Kg/day, IP, 3x/wk from week 10 of AOM plus DSS treatment to week 14. Dll4 expression was detected in the vascular endothelium as well as in both absorptive and secretive epithelium of the normal intestine and colorectal (CR) polyps. Both genetical (Dll4 allelic deletion, Dll4+/−) and pharmacological inhibition by the soluble extracellular domain of Dll4 (Dll4-Fc) led to significant reductions in the average number (12.5-fold in mutants, 3.7-fold in Dll4-Fc treated), average volume (1.6-fold in mutants, 2.3-fold in Dll4-Fc treated) and overall burden (15.2-fold in mutants, 6.3-fold in Dll4-Fc treated) of CR polyps, by inducing intratumoral apoptosis and disrupting proper tumor angiogenesis., leading to the formation of immature and non-functional blood vessels. Dll4 heterozygous mutants shown a 42.5% increase in tumor vascular density and a 13.9 % decrease in smooth muscle cell vascular recruitment, displaying increased vascular permeability and reduce vascular perfusion. Dll4-Fc treated mice displayed more proeminent vascular disruption, with a 127.5% increase in tumor vascular density and a 53.2% decrease in smooth muscle cell vascular recruitment, showing extensive vascular extravasation and poor perfusion of the tumor blood vessels. In conclusion, Dll4Fc administration in chronic colitis-related CRC appears to constitute a promising therapeutical approach, capable of inhibiting the tumorigenic events as well as targeting the tumour vasculature and preventing tumor development. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr LB-285. doi:10.1158/1538-7445.AM2011-LB-285
High-Dose Vitamin C versus Placebo in the Treatment of Patients with Advanced Cancer Who Have Had No Prior Chemotherapy
Authors: Charles G. Moertel, Thomas R. Fleming, Edward T. Creagan, Joseph Rubin, Michael J. O'Connell, Matthew M. Ames
Journal: New England Journal of Medicine (1985)

It has been claimed that high-dose vitamin C is beneficial in the treatment of patients with advanced cancer, especially patients who have had no prior chemotherapy. In a double-blind study 100 patients with advanced colorectal cancer were randomly assigned to treatment with either high-dose vitamin C (10 g daily) or placebo. Overall, these patients were in very good general condition, with minimal symptoms. None had received any previous treatment with cytotoxic drugs. Vitamin C therapy showed no advantage over placebo therapy with regard to either the interval between the beginning of treatment and disease progression or patient survival. Among patients with measurable disease, none had objective improvement. On the basis of this and our previous randomized study, it can be concluded that high-dose vitamin C therapy is not effective against advanced malignant disease regardless of whether the patient has had any prior chemotherapy. (N Engl J Med 1985; 312:137–41.)
Abstract P5-14-01: The Influence on Upper Limb Function after Sentinel Lymph Node Biopsy or Axillary Lymph Node Dissection
Authors: S Miyajima, T Utsumi, N Kobayashi, M. Hikichi
Journal: Cancer Research (2010)

Abstract Background Sentinel lymph node biopsy (SLNB) is accepted as a method in patients with clinically negative axillary lymph nodes because it was assumed to be associated with improvement of upper limb morbidity. The purpose of this study was to investigate that SLNB reduces upper limb morbidity of patients with breast cancer compared with axillary lymph node dissection (ALND). Methods The study comprised 362 patients with breast cancer who underwent measuring the upper limb mobility before and after surgery (at discharge, 1 month and 3 months after surgery). 241 patients underwent SLNB, 121 patients underwent ALND. In the SLNB group, 148 patients (48.1%) underwent breast conserving surgery (BCS), 67 patients (18.5%) underwent mastectomy. In the ALND group, 68 patients (18.8%) underwent BCS, 53 patients (14.6%) underwent mastectomy. Upper limb mobility was measured by the difference of the angle of the flexion and the angle of abduction between before and after surgery. The recovery defined that the difference of the angle between before and after surgery, is within 10 degree. The recovery rate was investigated by Kaplan-Meier method, and comparisons were evaluated using the log-rank test. Results The recovery rate of patients in the SLNB group was 85% in measuring flexion, 90% in measuring abduction 3 month after surgery. The recovery rate of patients in the ALND group was 52% in measuring flexion, 58% in measuring abduction. The recovery rate of upper limb function increase by SLNB than by ALND (P&amp;lt;0.001).’ Conclusions SLNB reduces upper limb morbidity of patients with breast cancer compared with ALND. SLNB can improve activity of daily life (ADL) by improving of the upper limb function. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P5-14-01.
Abstract 4081: Sensitivity of gastric cancer cell lines against 2-deoxy-D-glucose is independent of PI3K/mTOR inhibition
Authors: Sandra Eder, Sabine Strommer, Thorsten Füreder, Rene Freitag, Sebastian Dorn, Volker Wacheck
Journal: Cancer Research (2011)

Abstract 2-deoxy-D-glucose (2-DG) is currently studied in Phase I clinical trials as a novel therapeutic strategy for anti-cancer therapy. Several preclinical studies have suggested that the anti-proliferative activity of 2-DG might be linked, amongst others, to the inhibition of the PI3K/mTOR signalling pathway. Blocking the PI3K/mTOR pathway has become a major focus for molecular targeted drug development. In the current study we assessed the biological relevance of PI3K/mTOR signalling for the anti-proliferative activity of 2-DG in gastric cancer cells. The gastric cancer cell lines (N87, MKN-28, MKN-45) were treated with 2-DG and evaluated for cell proliferation, apoptosis induction, cell cycle arrest, and PI3K/mTOR signalling. Everolimus, a specific mTORC1 inhibitor, was employed as positive control. Treatment with 2-DG potently suppressed cell proliferation resulting in an up to 300% reduced IC50 in the gastric cancer cell lines. Cell cycle inhibition and apoptosis induction varied substantially among cell lines. However, the distinct 2-DG sensitivity of gastric cancer cell lines was not reflected by any alteration in the PI3K/mTOR signalling pathway. In all cancer cell lines, no major inhibition of pERK and pAKT was observed, whereas both, 2-DG as well as everolimus strongly inhibited phosphorylation of S6. In contrast to 2-DG everolimus induced also a clear inhibition of 4EBP1 phosphorylation. In conclusion, inhibition of PI3K/mTOR signalling pathway by 2-DG differs from inhibition by everolimus and is not linked with 2-DG anti-proliferative sensitivity in gastric cancer cell lines. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 4081. doi:10.1158/1538-7445.AM2011-4081
CONDUCTANCE CATHETER DERIVED RIGHT VENTRICULAR DIASTOLIC DYSFUNCTION IS EVIDENT AFTER RAPID PACING TEST CAPTURE PRIOR TO TRANSCATHETER AORTIC VALVE REPLACEMENT
Authors: Richard Graham Axell, Paul White, Bushra Rana, Andrew Klein, Michael O’Sullivan, Leonard Shapiro, Cameron Densem, Stephen Hoole
Journal: Journal of the American College of Cardiology (2016)
C-REACTIVE PROTEIN (CRP) LEVELS IMPACT THE ASSOCIATION BETWEEN BODY MASS INDEX (BMI) AND ALL-CAUSE MORTALITY: RESULTS FROM THE NATIONAL HEALTH AND NUTRITION EXAMINATION SURVEY (NHANES)
Authors: Salman Waheed, Daniel Washko, Buddhadeb Dawn, Deepak Parashara, Kamal Gupta
Journal: Journal of the American College of Cardiology (2016)