tbuckley/cabot-search huggingface dataset:
PWE-402 The impact of surgeon laparoscopic training on conversion during laparoscopic colorectal surgery
Authors: H Massarotti, FG Rodrigues, S Chadi, SD Wexner
Journal: Gut (2015)

<h3>Introduction</h3> Laparoscopic colorectal resections are currently the focus of colorectal training programs. Conversion rates are similar between inexperienced fellowship-trained surgeons and those with more experience. This study aimed to determine if primarily open or laparoscopoic surgical training influences type of colorectal operations performed and rates of conversion. <h3>Method</h3> Following IRB approval, review of a prospectively maintained database was performed for all patients with a colorectal resection performed by 6 surgeons for all diagnoses from 2010–2014. Surgeons were designated as laparoscopic- or open-trained based on self-declared exposure to laparoscopy during training. Procedures were categorised by type and included if the procedure was performed both open and laparoscopic. Operative technique was recorded as laparoscopic, open, or converted; conversion was re-categorised as preemptive or reactive. Univariate analyses were performed using Chi-squared test for categorical variables. Multivariable logistic regression was performed to adjust for confounding and identify the role of variables on predicting SSI outcome. <h3>Results</h3> 573 patients were included [mean age 57 (±17) years; 49.3% male]. Patients in the laparoscopic-trained group were older (59.8 vs. 55.9 years; p = 0.017). All other demographic variables were equivalent between groups. Laparoscopic-trained surgeons were less likely to perform proctectomy or resections involving anastomosis (p &lt; 0.001 and p = 0.037, respectively). There was no difference in operative time between laparoscopic vs. open groups (p = 0.31). Laparoscopic-trained surgeons more likely performed procedures laparoscopically (76% vs. 65%; p = 0.018). Overall conversion was not significantly different between the groups (p = 0.374). 88% of conversions were pre-emptive and12% were reactive. Procedures with a proctectomy were more likely performed laparoscopically (80%vs. 60%; p &lt; 0.001) and less likely to be converted (7% vs. 15%; p = 0.049). There was no difference in postoperative anastomotic leaks, intra-abdominal abscesses, or mortality between groups (p = 0.57). On multivariate analysis with the outcome of conversion, laparoscopic training was not predictive of conversion whereas procedures with an anastomosis were considered protective against conversion (OR 0.24, 0.07–0.85; P = 0.03). <h3>Conclusion</h3> There is a difference in the types of procedures performed by surgeons who are laparoscopic-trained compared to their open-trained colleagues given that they are earlier in their career. There was no difference in conversion rates between open and laparoscopic-trained surgeons, despite an experiential difference. Larger multi-institutional studies will strengthen our findings. <h3>Disclosure of interest</h3> None Declared.
Cardiac Metastases of Neuroendocrine Tumors Treated With 177Lu DOTATATE Peptide Receptor Radionuclide Therapy or 131I-MIBG Therapy
Authors: William Makis, Karey McCann, Mark Bryanton, Alexander J.B. McEwan
Journal: Clinical Nuclear Medicine (2015)

Neuroendocrine tumors have a propensity to metastasize to the heart, although the reason for this remains unknown. A review of 251 neuroendocrine tumor patients treated with 177Lu DOTATATE peptide receptor radionuclide therapy or 131I-MIBG therapy at our institution since 2003 revealed 2 patients with cardiac metastases (incidence, 0.8%), one treated with 177Lu DOTATATE and one with 131I-MIBG. We present the imaging findings of these 2 patients, as well as their management and responses to therapy.
Recurrence and Survival in Patients With Merkel Cell Carcinoma Undergoing Surgery Without Adjuvant Radiation Therapy to the Primary Site
Authors: Marcus L. Frohm, Kent A. Griffith, Kelly L. Harms, James A. Hayman, Douglas R. Fullen, Christine C. Nelson, Sandra L. Wong, Jennifer L. Schwartz, Christopher K. Bichakjian
Journal: JAMA Dermatology (2016)

<h3>Importance</h3> The use of adjuvant radiation therapy (RT) to the primary site in Merkel cell carcinoma (MCC) is not uncommon. However, the need for adjuvant RT to the primary site in patients at low risk for local recurrence is questionable. <h3>Objectives</h3> To examine the occurrence of true local, satellite, in-transit, regional, and distant recurrences in patients undergoing surgery alone without adjuvant RT to the primary site. To establish overall survival (OS), MCC-specific survival (MCCSS), and disease-free survival (DFS) relationships in a cohort of patients with MCC. <h3>Design, Setting, and Participants</h3> Our University of Michigan Multidisciplinary MCC Program database was used to obtain characteristics and outcome measures for 104 patients (105 primary MCCs) with tumors less than 2 cm in diameter. The majority of patients were treated between July 2006 and November 2012. <h3>Main Outcomes and Measures</h3> Outcome measures included the occurrence of true local, satellite, in-transit, regional, and distant recurrences. End points included OS, MCCSS, and DFS. <h3>Results</h3> Overall, information for 55 men and 49 women with 105 primary MCCs was obtained; 19 patients developed recurrent disease, and the mean time to first recurrence was 10.7 months. True local recurrence occurred in 1 patient with concurrent in-transit recurrence. Satellite recurrence occurred in 1 patient with concurrent regional recurrence. Four additional patients developed in-transit metastases. Thirteen patients had a regional recurrence component, 4 patients had distant metastases, and 6 patients developed subsequent regional and/or distant recurrences. Stratified by initial pathologic stage, the OS and MCCSS at 48 months were estimated to be 85.0% (95% CI, 71.8%-92.3%) and 94.4% (95% CI, 83.4%-98.2%) for patients with stage 1A/B disease and 63.2% (95% CI, 36.6%-81.1%) and 78.1% (95% CI, 50.0%-91.5%) for patients with stage 3A disease. The OS and MCCSS at 24 months for patients with stage 3B disease were both 50.0% (95% CI, 5.8%-84.5%). <h3>Conclusions and Relevance</h3> In selected MCC patients with primary tumors less than 2 cm in diameter treated with surgery alone without adjuvant RT to the primary site, we found a low occurrence of true local recurrences and satellite recurrences. This relatively low rate of local recurrence questions the need for adjuvant RT to the primary tumor site in patients with small low-risk lesions.
Genomic Copy Number Dictates a Gene-Independent Cell Response to CRISPR/Cas9 Targeting
Authors: Andrew J. Aguirre, Robin M. Meyers, Barbara A. Weir, Francisca Vazquez, Cheng-Zhong Zhang, Uri Ben-David, April Cook, Gavin Ha, William F. Harrington, Mihir B. Doshi, Maria Kost-Alimova, Stanley Gill, Han Xu, Levi D. Ali, Guozhi Jiang, Sasha Pantel, Yenarae Lee, Amy Goodale, Andrew D. Cherniack, Coyin Oh, Gregory Kryukov, Glenn S. Cowley, Levi A. Garraway, Kimberly Stegmaier, Charles W. Roberts, Todd R. Golub, Matthew Meyerson, David E. Root, Aviad Tsherniak, William C. Hahn
Journal: Cancer Discovery (2016)

The CRISPR/Cas9 system enables genome editing and somatic cell genetic screens in mammalian cells. We performed genome-scale loss-of-function screens in 33 cancer cell lines to identify genes essential for proliferation/survival and found a strong correlation between increased gene copy number and decreased cell viability after genome editing. Within regions of copy-number gain, CRISPR/Cas9 targeting of both expressed and unexpressed genes, as well as intergenic loci, led to significantly decreased cell proliferation through induction of a G2 cell-cycle arrest. By examining single-guide RNAs that map to multiple genomic sites, we found that this cell response to CRISPR/Cas9 editing correlated strongly with the number of target loci. These observations indicate that genome targeting by CRISPR/Cas9 elicits a gene-independent antiproliferative cell response. This effect has important practical implications for the interpretation of CRISPR/Cas9 screening data and confounds the use of this technology for the identification of essential genes in amplified regions.
Prevalence, onset, and clinical recognition of panic states in hospitalized male alcoholics
Authors: D J Johannessen, D S Cowley, R D Walker, C F Jensen, L Parker
Journal: American Journal of Psychiatry (1989)

Alcoholism has been associated with a high prevalence of anxiety and phobic disorders. The authors ascertained the current prevalence of panic disorder and the lifetime prevalence of infrequent panic attacks in 154 male alcoholics in an inpatient alcohol treatment program. Thirteen percent (N = 20) gave a lifetime history of panic attacks and 45% (N = 9) of these had current panic disorder. Panic attacks preceded or coincided with the onset of problem drinking in 50% (N = 9) of the 18 patients with both diagnoses. Only two patients with histories of panic had been previously diagnosed, and none had been treated. Clinical implications of these findings are discussed.
Palliative Care
Authors: Michael H Levy, Anthony Back, Costantino Benedetti, J Andrew Billings, Susan Block, Barry Boston, Eduardo Bruera, Sydney Dy, Catherine Eberle, Kathleen M Foley, Sloan Beth Karver, Sara J Knight, Sumathi Misra, Christine S Ritchie, David Spiegel, Linda Sutton, Susan Urba, Jamie H Von Roenn, Sharon M Weinstein
Journal: Journal of the National Comprehensive Cancer Network (2009)

NCCN Categories of Evidence and ConsensusCategory 1: The recommendation is based on high-level evidence (e.g., randomized controlled trials) and there is uniform NCCN consensus.Category 2A: The recommendation is based on lowerlevel evidence and there is uniform NCCN consensus.Category 2B: The recommendation is based on lowerlevel evidence and there is nonuniform NCCN consensus (but no major disagreement).Category 3: The recommendation is based on any level of evidence but reflects major disagreement.All recommendations are category 2A unless otherwise noted.Clinical trials: The NCCN believes that the best management for any cancer patient is in a clinical trial.Participation in clinical trials is especially encouraged.
Abstract 1452: In vivo TK-NOG liver-humanized model to predict patient pharmacological profile of anti-cancer agents
Authors: Caroline Mignard, Olivier Duchamp, Fariba Nemati, Nathalie Cassoux, Sergio Roman-Roman, Yasuyuki Ohnishi, Hiroshi Suemizu
Journal: Cancer Research (2015)

Abstract To overcome some limitations of existing models, CIEA developed a novel experimental in vivo liver-humanized model. To do this, a herpes simplex virus type 1 thymidine kinase (HSVtk) transgene was expressed within the liver of highly immunodeficient NOG mice (TK-NOG). Mouse liver cells expressing this transgene were ablated after a brief exposure to a non-toxic dose of ganciclovir (GCV), and transplanted human liver cells are stably maintained within the liver (humanized TK-NOG) without exogenous drug. We have shown that the reconstituted liver is mature and functional and could generate: 1)A human-specific profile of anti-cancer drug metabolism. The humanization of the liver of TK-NOG mice modified the pharmacokinetic profile of the sorafenib anti-cancer agent. We were also able to detect the N-oxide metabolite of the sorafenib in humanized mice with a ratio of 8% of the non-metabolized sorafenib, in comparison to a 10% ratio in patients and 0% (not detectable) in non-humanized mice. 2)An efficient environment for metastatic cell homing in patient-derived-xenograft (PDX) model of UVeal melanoma. In two PDX UVeal melanoma models orthotopically xenografted in liver-humanized TK-NOG mice, we were able to detect liver metastasis, ranging from 10 to 50% of animals, whereas metastases have never been detected in non-humanized mice. This novel in vivo system provides an optimized platform for increasing our predictivity of patient anti-cancer drug metabolism, potential toxicology, and efficacy. Citation Format: Caroline Mignard, Olivier Duchamp, Fariba Nemati, Nathalie Cassoux, Sergio Roman-Roman, Yasuyuki Ohnishi, Hiroshi Suemizu. In vivo TK-NOG liver-humanized model to predict patient pharmacological profile of anti-cancer agents. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 1452. doi:10.1158/1538-7445.AM2015-1452
2016 consensus statement of the International Ankle Consortium: prevalence, impact and long-term consequences of lateral ankle sprains
Authors: Phillip A Gribble, Chris M Bleakley, Brian M Caulfield, Carrie L Docherty, François Fourchet, Daniel Tik-Pui Fong, Jay Hertel, Claire E Hiller, Thomas W Kaminski, Patrick O McKeon, Kathryn M Refshauge, Evert A Verhagen, Bill T Vicenzino, Erik A Wikstrom, Eamonn Delahunt
Journal: British Journal of Sports Medicine (2016)

The Executive Committee of the International Ankle Consortium presents this 2016 position paper with recommendations for information implementation and continued research based on the paradigm that lateral ankle sprain (LAS), and the development of chronic ankle instability (CAI), serve as a conduit to a significant global healthcare burden. We intend our recommendations to serve as a mechanism to promote efforts to improve prevention and early management of LAS. We believe this will reduce the prevalence of CAI and associated sequelae that have led to the broader public health burdens of decreased physical activity and early onset ankle joint post-traumatic osteoarthritis. Ultimately, this can contribute to healthier lifestyles and promotion of physical activity.
Statistical basis for exploring schizophrenia
Authors: J J Bartko, W T Carpenter, J S Strauss
Journal: American Journal of Psychiatry (1981)

The authors illustrate the use of multivariate statistics as a tool for exploring diagnostic factors in schizophrenia in two areas: the derivation and replication of the 12-point flexible diagnostic system and the definition of schizophrenic subtypes. They suggest an interactive approach between clinician and statistician to ensure the optimal combination of clinical judgment and systematic data analysis. Statistical concepts are presented with a minimum of statistical terminology.
Stress factors and breast cancer outcome.
Authors: J E Talmadge, W G Alvord
Journal: Journal of Clinical Oncology (1987)

Article Tools Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.1987.5.3.333 Journal of Clinical Oncology - published online before print September 22, 2016 PMID: 3819801 Stress factors and breast cancer outcome. J E TalmadgexJ E TalmadgeSearch for articles by this author , W G AlvordxW G AlvordSearch for articles by this author https://doi.org/10.1200/JCO.1987.5.3.333 PDF "Stress factors and breast cancer outcome.." Journal of Clinical Oncology, 5(3), pp. 333–334© 1987 by American Society of Clinical Oncology
PWE-381 Life after prosper: a review of the management of rectal prolapse
Authors: C Gunner, S Brown, J Northover, A Senapati
Journal: Gut (2015)

<h3>Introduction</h3> A questionnaire completed by members of the ACPGBI in 2000 was a precursor to the PROSPER trial. It showed a significant variation in favoured practice for the surgical treatment of rectal prolapse. We repeated the same questionnaire in 2014 to assess how practice has changed. <h3>Method</h3> A 10 question online survey was circulated to all members of the ACPGBI with identical questions to those used in the original in 2000. <h3>Results</h3> Similar numbers of surgeons responded (122 vs. 153). Median operations per surgeon per year is unchanged 6 (0–30) vs. 6 (0–25) and a similar proportion of surgeons have a favoured approach for fit patients (67.2% vs. 64%). More surgeons favour an abdominal approach in 2014 (55.0% vs. 40.1% (p = 0.01)). The most popular abdominal approach in 2014 is a ventral rectopexy (44.1% vs. 5.9% (p &lt; 0.01)) while those favouring a posterior rectopexy has decreased dramatically 45% vs. 92.6% (p &lt; 0.01). Only 5.4% still favour resection rectopexy compared to 39.7% previously (p &lt; 0.01). The use of perineal procedures is unchanged with 59.8% and 21.5% currently choosing Delorme’s and perineal proctectomy respectively compared to 63.4% and 14.9% in 2000. 38.5% prefer perineal approaches in elderly or unfit patients, compared with 39.2% previously and 59.8% had no age preference (61.3%). The use of laparoscopic repair has increased dramatically with 78.7% of surgeons currently choosing this approach compared to 19% previously (p &lt; 0.01). <h3>Conclusion</h3> The surgical approach to management of rectal prolapse is still varied, although more surgeons now favour a laparoscopic abdominal approach. The perineal approach continues to be a favoured option particularly in elderly and unfit patients. <h3>Disclosure of interest</h3> None Declared. <h3>Reference</h3> Senapati A, Gray RG, Middleton LJ <i>et al</i>. PROSPER: a randomised comparison of surgical treatments for rectal prolapse. <i>Colorectal Dis</i>. 2013 Jul;15(7):858–68
PTH-192 Gastric adenocarcinoma of diffuse type develops on a healthy-looking mucosal background, unlike intestinal type gastric adenocarcinoma
Authors: X Zhang, RK Ferrier, C Orange, JJ Going, T Iwata, MH Derakhshan
Journal: Gut (2015)

<h3>Introduction</h3> Intestinal type gastric adenocarcinoma develops in an inflammatory and atrophic background with profound loss of secretory cells. Little is known about background gastric mucosa in diffuse type adenocarcinoma. <h3>Method</h3> Total gastrectomy specimens from non-tumoural body mucosa were selected from 22 patients with diffuse type gastric adenocarcinoma. A frequency-matched group of 22 specimens from patients with intestinal type gastric adenocarcinoma were included as comparison. Well-oriented sections were immunostained for H/K ATPase (parietal cells) and Pepsinogen I (chief cells). Absolute mucosal cell density (per mm<sup>2</sup>) was measured and expressed as mean (±SD). Inflammatory changes were scored by a semi-quantitative method in both groups. <h3>Results</h3> The background densities of parietal cells (PC) and chief cells (CC) were significantly higher in diffuse type than intestinal type cancers, being 665 (±216) vs. 412 (±170) cells/mm<sup>2</sup>, <i>p &lt; 0</i>.001; and 847 (±259) vs. 443 (±206) cells/mm<sup>2</sup>, <i>p &lt; 0</i>.001, respectively. Glandular layer was significantly thicker in diffuse type [811 (±161) µm] vs. intestinal type [610 (±140) µm, <i>P &lt; 0</i>.001]. In contrast, length proportion of intestinal metaplasia was higher in intestinal type than diffuse type [23% (±30) vs 4% (±13), <i>p &lt; 0</i>.005]. Mucosal inflammation was less in diffuse versus intestinal type adenocarcinoma expressed by infiltration score of mononuclear cells (<i>p = 0</i>.011) and reactive changes (<i>p = 0</i>.005), but not in polymorphonuclear cell. Secretory cell densities and inflammation were inversely correlated in both cancer types. <h3>Conclusion</h3> The background mucosa in diffuse type gastric adenocarcinoma is much healthier than that of intestinal type adenocarcinoma, with more functional secretory cells, thicker gastric glands, less atrophy, less inflammation and less intestinal metaplasia. This suggests the existence of separate aetiological pathways leading to these distinct types of gastric adenocarcinoma. <h3>Disclosure of interest</h3> None Declared.
PWE-326 Extending the scope of tem – effect of radiotherapy on outcome in locally excised t2 rectal cancer
Authors: HL Wu, AJ Beveridge
Journal: Gut (2015)

<h3>Introduction</h3> Local excision of rectal cancers by Endoscopic Microsurgery (TEM) has become accepted as a valid treatment modality for very early rectal carcinomas (stage T1). However its use in the treatment of more advanced carcinomas of stage T2 and above remains more controversial due to the higher rate of local recurrence principally from occult nodal metastases. There has been considerable interest in the use of TEM in combination with radiotherapy in these patients as an alternative to radical rectal resection. We present a review of 12 patients with T2 rectal cancers who have undergone the TEM procedure, 6 of whom had additional radiotherapy and 6 who did not either because they were not fit to undergo this or because they elected for subsequent radical surgery. <h3>Method</h3> The records of all patient who had undergone a TEM procedure for rectal carcinoma at Royal Preston Hospital were reviewed and all those with T2 pathological staging identified. Their treatments and outcomes were recorded. <h3>Results</h3> Out of the 12 patients in the study, 6 did not receive radiotherapy either because they elected for subsequent radical surgery (3 patients) or were unfit for further treatment and underwent close follow-up (3 patients). In the radiotherapy group, 2 patients had pre-op Long-Course Chemo-radiotherapy (LCCRT) with a good partial response, 2 were included in the national TEM and Radiotherapy in Early Rectal cancer (TREC) trial and had pre-op Short Course radiotherapy (SCRT) and 2 had adjuvant LCCRT + Papillon contact radiotherapy following TEM. Median follow-up was 20 months. Patients not undergoing radial surgery had 3 monthly MR and sigmoidoscopy for 1 year and 6 monthly MR and sigmoidoscopy for a further 2 years. In the no-radiotherapy group, 1 of the 3 patients who underwent subsequent radical surgery had involved mesorectal lymph nodes and 1 of those undergoing close follow-up without radical surgery developed mesorectal nodal recurrence. In radiotherapy group 1 patient, in the TREC trial, elected for subsequent radical surgery and had no residual disease and 5 for close follow-up with no recurrences to date. There was no 90 day surgical mortality in either group. <h3>Conclusion</h3> Whilst the numbers in the study where not sufficient for valid statistical comparison, the lack of any tumour recurrence in the group receiving radiotherapy does support the use of TEM with radiotherapy as a promising alternative treatment modality for stage T2 rectal carcinoma particularly in patients who are high risk for radical surgery, have a near-complete response to pre-op radiotherapy or are keen to avoid a permanent stoma. <h3>Disclosure of interest</h3> None Declared.
Leadership in mental health: changing the guard for the 1980s
Authors: S Feldman
Journal: American Journal of Psychiatry (1981)

The author reviews the leadership changes that have taken place in mental health organizations and the factors that have influenced these changes as the mental health field has developed. The administrators of the early mental hospitals were physicians and laymen. By the mid 1840s, the physician-administrator had become dominant, but this changed with the social values of the 1960s and the growth of community mental health centers. Most recent has been the movement into leadership positions by professional administrators without clinical training. The author suggests that the mental health leaders of the 1980s must understand that administration is substantially modified by the subject matter and the values of the mental health field. He feels that the administrator must never lose touch with the experience of being a patient.
Will monoclonal antibodies find a place in our therapeutic armamentarium?
Authors: R Levy
Journal: Journal of Clinical Oncology (1987)

Article Tools Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.1987.5.4.527 Journal of Clinical Oncology - published online before print September 22, 2016 PMID: 3549986 Will monoclonal antibodies find a place in our therapeutic armamentarium? R LevyxR LevySearch for articles by this author https://doi.org/10.1200/JCO.1987.5.4.527 First Page PDF © 1987 by American Society of Clinical Oncology