tbuckley/cabot-search huggingface dataset:
Counterpoint: Hyperthermia with Radiation Therapy for Chest Wall Recurrences
Authors: Beryl McCormick
Journal: Journal of the National Comprehensive Cancer Network (2007)

The 2007 National Comprehensive Cancer Network Breast Cancer Clinical Practice Guidelines in Oncology include a consideration for hyperthermia (HT) and radiation for women with recurrent locoregional advanced breast cancers after first-line surgery or radiation failed. Although HT in this setting has been used for several decades, recent reports are few. This article reviews the data from several recent studies, selected because they included at least 100 patients. Unresolved issues of radiation dose, optimal temperature and timing of HT, and quality assurance problems with thermometry are apparent from these studies. Although clearly an effective treatment option in this clinical scenario, more research on HT and radiation is needed before this treatment combination can be considered standard care.
Identification and Clinical Management of Persons with Chronic Hepatitis C Virus Infection — Cherokee Nation, 2012–2015
Authors: Jorge Mera, Claudia Vellozzi, Susan Hariri, Hélène Carabin, Douglas A. Drevets, Anna Miller, Brigg Reilley, Whitney Essex, David Gahn, Lisa Lyons, Jessica Leston, John W. Ward
Journal: MMWR Morbidity and Mortality Weekly Report (2016)

An estimated 3.5 million persons in the United States are living with hepatitis C virus (HCV) infection, resulting in approximately 20,000 deaths each year, primarily from cirrhosis or hepatocellular carcinoma (1,2). American Indian/Alaska Native (AI/AN) populations have the highest incidence of acute HCV infection among all U.S. racial/ethnic groups and are at greater risk for HCV-related mortality compared with the general population (3). In 2013, new antiviral drugs became available that make possible 8-12 week treatment regimens with fewer adverse events and are able to achieve sustained virologic response (SVR) in >90% of treated patients (4), equivalent to a cure of HCV infection. Also of note, HCV testing recommendations were expanded in 2012 by CDC and in 2013 by the U.S. Preventive Services Task Force to include one-time testing of persons born during 1945-1965 (the "baby boomer" cohort) in addition to anyone at increased risk for HCV infection (5,6). Given the availability of new HCV drugs, expanded testing recommendations, and high incidence of HCV infection in AI/AN populations, in October 2012, Cherokee Nation Health Services (CNHS) implemented a tribal HCV testing policy.* As part of the policy, CNHS added a reminder in the electronic health record (EHR) for clinical decision support and provided HCV education to primary care clinicians. From October 2012 to July 2015, among 92,012 persons with at least one CNHS clinic encounter, the cumulative number who received HCV screening for the first time increased from 3,337 (3.6%) to 16,772 (18.2%). The largest percentage of HCV screening was among persons born during 1945-1965. Of 715 persons who tested positive for HCV antibodies, 488 (68.3%) were tested for HCV RNA; among those 488 persons, 388 (79.5%) were RNA positive and were thus confirmed to have chronic HCV infection. Treatment was initiated for 223 (57.5%) of the 388 with chronic infection; 201 (90.1%) completed treatment, of whom 180 (89.6%) achieved SVR. CNHS has successfully increased HCV testing and treatment and is now collaborating with CDC and other external partners to develop an HCV elimination program for the Cherokee Nation that might serve as a model for similar settings.
Prevalence and factors associated with diabetes mellitus among tuberculosis patients: a nationwide cohort
Authors: João Cordeiro da Costa, Olena Oliveira, Luís Baía, Rita Gaio, Margarida Correia-Neves, Raquel Duarte
Journal: European Respiratory Journal (2016)

The association between diabetes mellitus (DM) and tuberculosis (TB) has been a matter of study worldwide, since it is assumed that DM triples the risk of TB [1]. Recent studies have found discrepant prevalence of DM among TB patients, ranging from 5.3% in Denmark [2] to 44% in India [3]. There is an urgent need to control both epidemics in order to achieve the World Health Organization (WHO) TB elimination goal [4]. To reach this goal, an integrated approach between TB elimination strategies and control of noncommunicable diseases that perpetuate the risk for TB is fundamental [5]. In a Portuguese TB cohort, diabetes mellitus was associated with older age and no HIV infection or drug consumption <http://ow.ly/10EoN1>
Biodegradable Polymer-Based Sirolimus-Eluting Stents With Differing Elution and Absorption Kinetics
Authors: Bo Xu, Runlin Gao, Yuejin Yang, Xuebin Cao, Lei Qin, Yi Li, Zhanquan Li, Xueqi Li, Hailong Lin, Yong Guo, Yitong Ma, Jian’an Wang, Shaoping Nie, Liang Xu, Eric Cao, Changdong Guan, Gregg W. Stone
Journal: Journal of the American College of Cardiology (2016)
Phase II study of induction therapy with gemcitabine and nab-paclitaxel followed by consolidation with mFOLFIRINOX in patients with metastatic pancreatic cancer.
Authors: Ramesh K. Ramanathan, Peter Lee, John E. Seng, Stephen Patrick Anthony, Peter J. Rosen, Raul R. Mena, Vincent J. Picozzi, Jasgit C. Sachdev, Tim Larson, Ronald Korn, Gayle S. Jameson, Amy C. Stoll, Daniel D. Von Hoff, Joseph W. Leach
Journal: Journal of Clinical Oncology (2014)

224 Background: FOLFIRINOX or NabP-Gem are now standard mPC regimens.The optimal sequence is not known.This phase II study evaluated the feasibility of NabP-Gem followed by FOLFIRINOX. Methods: Eligible pts had evidence of untreated mPC, ECOG 0-1 and adequate organ function. Pts received Nab-P (125 mg/m 2 ) and Gem (1000 mg/ m 2 ) weekly x 3 (Induction ) every 4 weeks for upto 6 cycles. FOLFIRINOX, q2 weeks (Consolidation regimen) was initiated after 6 cycles of the Induction regimen, or earlier in case of progression, and given for a maximum of 6 months (12 cycles). mFOLFIRINOX (NEJM, 364:1817-25: 2011) has been modified with growth factor prophylaxis and omission of bolus 5FU. One endpoint is to increase 1 year survival to &gt; 70%, (n=30, 95% CI is +/- 20%). Results: Accrual goals have been met (n=31). The M/F ratio is 55%/45%, median is 66 years. In 23 pts with elevated baseline CA19-9 levels treated with NabP-Gem, 83% had a &gt; 90% decrease. The response rate with the NabP-Gem regimen is 43%. Selected therapy related Grade &gt; 3 adverse events during the course of both NabP-Gem and FOLFIRINOX therapy are: neutropenia (39%), fatigue (32%), anemia (19%), thrombocytopenia (16%), thromboembolic events (3%), peripheral neuropathy (16%), leukopenia (16%), nausea (3%), vomiting (3%), diarrhea (7%), and neutropenic fever (3%). During the course of NabP-Gem, 14 dose reductions and four dose delays were seen. Two pts had early progression at cycle 4 or less and were switched to the Consolidation regimen. Seventy one % (22/31) of pts went on to receive FOLFIRINOX (4 pts still on study), 4 received FOLFIRI, and one pt received FOLFOX as Consolidation therapy. One-year survival is projected to be 50-60%. Conclusions: The induction NabP-Gem regimen shows evidence of substantial activity similar to published reports (JCO.29:4548-54: 2011). The induction-consolidation strategy is feasible in selected patients. Cumulative side effects predominantly fatigue and neuropathy will require appropriate dose reductions or treatment breaks. (Supported by the Seena Magowitz foundation). Clinical trial information: NCT01488552.
Ebola response in Sierra Leone: The impact on children
Authors: Felicity Fitzgerald, Waheed Awonuga, Tejshri Shah, Daniel Youkee
Journal: Journal of Infection (2016)

The West African Ebola virus disease (EVD) outbreak is the largest ever seen, with over 28,000 cases and 11,300 deaths since early 2014. The magnitude of the outbreak has tested fragile governmental health systems and non-governmental organizations (NGOs) to their limit. Here we discuss the outbreak in the Western Area of Sierra Leone, the shape of the local response and the impact the response had on caring for children suspected of having contracted EVD. Challenges encountered in providing clinical care to children whilst working in the "Red Zone" where risk of EVD is considered to be highest, wearing full personal protective equipment are detailed. Suggestions and recommendations both for further research and for operational improvement in the future are made, with particular reference as to how a response could be more child-focused.
Secondary Leukemia Responsive to Retinoic Acid With Abnormal Localization of RARα Protein: A Report of Two Cases
Authors: Giuseppe Leone, Simona Sica, Elettra Ortu La Barbera, Ugo Testa, Roberta Riccioni, Catherine Labbaye, Cesare Peschle, Marcella Zollino
Journal: Blood (1998)
Comparison of Test Results for Zika Virus RNA in Urine, Serum, and Saliva Specimens from Persons with Travel-Associated Zika Virus Disease — Florida, 2016
Authors: Andrea M. Bingham, Marshall Cone, Valerie Mock, Lea Heberlein-Larson, Danielle Stanek, Carina Blackmore, Anna Likos
Journal: MMWR Morbidity and Mortality Weekly Report (2016)

In May 2015, Zika virus was reported to be circulating in Brazil. This was the first identified introduction of the virus in the Region of the Americas. Since that time, Zika virus has rapidly spread throughout the region. As of April 20, 2016, the Florida Department of Health Bureau of Public Health Laboratories (BPHL) has tested specimens from 913 persons who met state criteria for Zika virus testing. Among these 913 persons, 91 met confirmed or probable Zika virus disease case criteria and all cases were travel-associated (1). On the basis of previous small case studies reporting real time reverse-transcription polymerase chain reaction (RT-PCR) detection of Zika virus RNA in urine, saliva, and semen (2-6), the Florida Department of Health collected multiple specimen types from persons with suspected Zika virus disease. Test results were evaluated by specimen type and number of days after symptom onset to determine the most sensitive and efficient testing algorithm for acute Zika virus disease. Urine specimens were collected from 70 patients with suspected Zika virus disease from zero to 20 days after symptom onset. Of these, 65 (93%) tested positive for Zika virus RNA by RT-PCR. Results for 95% (52/55) of urine specimens collected from persons within 5 days of symptom onset tested positive by RT-PCR; only 56% (31/55) of serum specimens collected on the same date tested positive by RT-PCR. Results for 82% (9/11) of urine specimens collected >5 days after symptom onset tested positive by RT-PCR; none of the RT-PCR tests for serum specimens were positive. No cases had results that were exclusively positive by RT-PCR testing of saliva. BPHL testing results suggest urine might be the preferred specimen type to identify acute Zika virus disease.
"Duration Certificate"--New Style
Authors: B. D. M. Williams
Journal: BMJ (1975)

Primary sensory cortices respond to crossmodal stimuli, for example auditory responses are found in primary visual cortex (V1). However, it remains unclear whether these responses reflect sensory inputs or behavioural modulation through sound-evoked body movement. We address this controversy by showing that sound-evoked activity in V1 of awake mice can be dissociated into auditory and behavioural components with distinct spatiotemporal profiles. The auditory component began at ∼27 ms, was found in superficial and deep layers and originated from auditory cortex, as shown by inactivation by muscimol. Sound-evoked orofacial movements correlated with V1 neural activity starting at ∼80-100 ms and explained auditory frequency-tuning. Visual, auditory and motor activity were expressed by segregated neuronal populations and during simultaneous audiovisual stimulation, visual representations remained dissociable from auditory and motor-related activity. This threefold dissociability of auditory, motor and visual processing is central to understanding how distinct inputs to visual cortex interact to support vision.
Randomized phase III study of bevacizumab plus FOLFIRI and bevacizumab plus mFOLFOX6 as first-line treatment for patients with metastatic colorectal cancer (WJOG4407G)
Authors: K. Yamazaki, M. Nagase, H. Tamagawa, S. Ueda, T. Tamura, K. Murata, T. Eguchi Nakajima, E. Baba, M. Tsuda, T. Moriwaki, T. Esaki, Y. Tsuji, K. Muro, K. Taira, T. Denda, S. Funai, K. Shinozaki, H. Yamashita, N. Sugimoto, T. Okuno, T. Nishina, M. Umeki, T. Kurimoto, T. Takayama, A. Tsuji, M. Yoshida, A. Hosokawa, Y. Shibata, K. Suyama, M. Okabe, K. Suzuki, N. Seki, K. Kawakami, M. Sato, K. Fujikawa, T. Hirashima, T. Shimura, K. Taku, T. Otsuji, F. Tamura, E. Shinozaki, K. Nakashima, H. Hara, T. Tsushima, M. Ando, S. Morita, N. Boku, I. Hyodo
Journal: Annals of Oncology (2016)
6 vs. 3 cycles of epirubicin/docetaxel + G-CSF in operable breast cancer: results of ABCSG-14
Authors: G. G. Steger, E. Kubista, H. Hausmaninger, M. Gnant, C. Tausch, A. Lang, H. Samonigg, A. Galid, R. Jakesz
Journal: Journal of Clinical Oncology (2004)

553 Background: Preoperative chemotherapiy (PROP) for operable breast cancer is established to downstage tumors primarily not suitable for breast conserving surgery. A pathologic complete response (pCR) after PROP might be a surrogate marker for longer overall survival (OS) but the rates of pCR with current treatment regimens are still rather low and a beneficial effect of PROP upon OS remains to be established. In 1999, the ABCSG set out to test the hypothesis whether prolonging the time of the neoadjuvant treatment period by doubeling the number of cycles of the same drugs might raise the rate of pCR after PROP by converting more partial responses into pCR's. Methods: Patients (pts) with biopsy proven breast cancer T1–4a-c,N+/-,M0 were eligible for this prospectively randomized phase III trial. 282 pts (estimated drop-out rate: 5%) were planned to detect a significant difference (one-sided p < 0,05, Fisher's exact test) with a power of 82%. Pts were randomized to receive either 3 cycles of epirubicin 75mg/m2 and docetaxel 75mg/m2 on day 1 + G-CSF 30 MU days 3–10 q 21 days (ED+G) or 6 cycles of the identical regimen. Primary end point was the rate of pCR. The pathological nodal status and the rate of breast conserving surgical procedures served as secondary end points. Results: 292 pts were accrued to the trial between 6/199 and 12/2002 and 288 pts are eligible. Both trial groups were well balanced for tumor size, clinical nodal status, menopausal status, hormone receptor status, HER2-status, and trial center. The results of the primary and the secondary end points are depicted in the table. There was no significant difference in serious adverse events per patient and per cycle and no patient died while on treatment. Conclusions: Doubeling the number of cycles of neoadjuvant chemotherapy (6 vs. 3 x ED+G) results in significantly higher rates for pCR and negative axillary nodal status with with no excess of side effects. Author Disclosure Employment or Leadership Consultant or Advisory Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Aventis
Chronic expression of interferon‐gamma leads to murine autoimmune cholangitis with a female predominance
Authors: Heekyong R. Bae, Patrick S.C. Leung, Koichi Tsuneyama, Julio C. Valencia, Deborah L. Hodge, Seohyun Kim, Tim Back, Megan Karwan, Anand S. Merchant, Nobuyuki Baba, Dechun Feng, Ogyi Park, Bin Gao, Guo‐Xiang Yang, M. Eric Gershwin, Howard A. Young
Journal: Hepatology (2016)

In most autoimmune diseases the serologic hallmarks of disease precede clinical pathology by years. Therefore, the use of animal models in defining early disease events becomes critical. We took advantage of a "designer" mouse with dysregulation of interferon gamma (IFNγ) characterized by prolonged and chronic expression of IFNγ through deletion of the IFNγ 3'-untranslated region adenylate uridylate-rich element (ARE). The ARE-Del(-/-) mice develop primary biliary cholangitis (PBC) with a female predominance that mimics human PBC that is characterized by up-regulation of total bile acids, spontaneous production of anti-mitochondrial antibodies, and portal duct inflammation. Transfer of CD4 T cells from ARE-Del(-/-) to B6/Rag1(-/-) mice induced moderate portal inflammation and parenchymal inflammation, and RNA sequencing of liver gene expression revealed that up-regulated genes potentially define early stages of cholangitis. Interestingly, up-regulated genes specifically overlap with the gene expression signature of biliary epithelial cells in PBC, implying that IFNγ may play a pathogenic role in biliary epithelial cells in the initiation stage of PBC. Moreover, differentially expressed genes in female mice have stronger type 1 and type 2 IFN signaling and lymphocyte-mediated immune responses and thus may drive the female bias of the disease.Changes in IFNγ expression are critical for the pathogenesis of PBC. (Hepatology 2016;64:1189-1201).
Basal Cell Skin Cancer, Version 1.2016, NCCN Clinical Practice Guidelines in Oncology
Authors: Christopher K. Bichakjian, Thomas Olencki, Sumaira Z. Aasi, Murad Alam, James S. Andersen, Daniel Berg, Glen M. Bowen, Richard T. Cheney, Gregory A. Daniels, L. Frank Glass, Roy C. Grekin, Kenneth Grossman, Susan A. Higgins, Alan L. Ho, Karl D. Lewis, Daniel D. Lydiatt, Kishwer S. Nehal, Paul Nghiem, Elise A. Olsen, Chrysalyne D. Schmults, Aleksandar Sekulic, Ashok R. Shaha, Wade L. Thorstad, Malika Tuli, Marshall M. Urist, Timothy S. Wang, Sandra L. Wong, John A. Zic, Karin G. Hoffmann, Anita Engh
Journal: Journal of the National Comprehensive Cancer Network (2016)

Basal cell carcinoma (BCC) of the skin is the most common cancer, with a higher incidence than all other malignancies combined. Although it is rare to metastasize, patients with multiple or frequently recurring BCC can suffer substantial comorbidity and be difficult to manage. Assessment of risk is a key element of management needed to inform treatment selection. The overall management of BCC primarily consists of surgical approaches, with radiation therapy as an alternate or adjuvant option. Many superficial therapies for BCC have been explored and continue to be developed, including topicals, cryosurgery, and photodynamic therapy. Two hedgehog pathway inhibitors were recently approved by the FDA for systemic treatment of advanced and metastatic BCC, and others are in development. The NCCN Guidelines for Basal Cell Skin Cancer, published in full herein, include recommendations for selecting among the various surgical approaches based on patient-, lesion-, and disease-specific factors, as well as guidance on when to use radiation therapy, superficial therapies, and hedgehog pathway inhibitors.
Gemcitabine(G)/erlotinib(E) versus gemcitabine/erlotinib/capecitabine(C) in the first-line treatment of patients with metastatic pancreatic cancer (mPC): Efficacy and safety results of a phase IIb randomized study from the Spanish TTD Collaborative Group.
Authors: Manuel Benavides, Javier Gallego Plazas, Carmen Guillen, Ruth Vera, Vega Iranzo, Inmaculada ALES Diaz, Sara Arevalo, Aleydis Pisa, Marta Martin-Richard, Antonieta Salud Salvia, Esther Falco, Alberto Saenz, Jose Luis Manzano, Gema Pulido, Joaquina Martínez-Galán, Roberto A. Pazo Cid, Fernando Rivera, Teresa Garcia, Antonio Irigoyen, Enrique Aranda
Journal: Journal of Clinical Oncology (2014)

4122 Background: G and E have shown a survival benefit in the 1st-line setting in mPC. The aim of this study was to assess whether combining C with G+E was safe and effective as compared with G-E in patients(pts) with mPC. Methods: Previously untreated pts with mPC were randomized in a 1:1 ratio to receive G(1000 mg/m2, d1,8,15)+E(100 mg, d1–28)+C(1660 mg/m2, d1-21) or G+E, q4-wk, until progression or unacceptable toxicity. Primary endpoint: progression-free survival (PFS); secondary endpoints: overall survival (OS), response rate (RR), relationship of rash with PFS/OS, and safety. A sample size of 118 pts was required for a hazard ratio(HR) of 0.63, assuming a median PFS of 6 months (m) in pts treated with GEC; unilateral α=0.05; β=0.8. Results: 120 pts were randomized. Median age: 63 years; ECOG status 0/1/2(%), 33/58/8. Median follow-up was 16.5 m (95%CI:13.7-26.2). Median PFS was 4.3 m in the GEC arm and 3.8m in the GE arm (HR:0.88; 95%CI:0.58-1.31; p=0.52). The estimated median OS was 6.8 m in the GEC arm as compared with 7.7 m in the GE group (HR:1.09, 95%CI:0.72-1.63; p=0.69). Neutropenia grade 3/4 (GEC 43% vs GE 15%; p=0.0008) and mucositis (GEC 9% vs GE 0%;p=0.03), were the only statistically significant differences in grade 3/4 adverse events. PFS and OS were significantly longer in pts with rash (grade ≥ 1) vs no rash (grade=0): PFS 5.5 vs 2.0 m; HR=0.39 95%CI:0.26-0.6; p<0.0001 and OS: 9.5 vs 4.0 m; HR=0.51 95%CI:0.33-0.77; p=0.0014). Conclusions: PFS with GEC was not different to that with GE as it did not meet the criterion for statistical significance. Skin rash strongly predicted erlotinib efficacy, deserving further investigation for patient selection. Clinical trial information: NCT01303029.
Outcomes of Citalopram Dosage Risk Mitigation in a Veteran Population
Authors: Thomas S. Rector, Selcuk Adabag, Francesca Cunningham, David Nelson, Eric Dieperink
Journal: American Journal of Psychiatry (2016)

A public safety communication issued by the Food and Drug Administration declared that citalopram dosages exceeding 40 mg/day were no longer considered safe because of a newly recognized risk of dosage-dependent QT interval prolongation. The authors compared the incidence of hospitalizations and mortality when higher dosages of citalopram were or were not reduced to ≤40 mg/day.National electronic medical records compiled by the Veterans Health Administration were used to conduct a retrospective study of a population filling citalopram prescriptions for more than 40 mg/day when the safety communication was first issued in August 2011. Hospitalizations and mortality after dosages of citalopram were or were not reduced to ≤40 mg/day were compared using multivariable Cox regression.The at-risk cohort of 35,848 veterans (mean age, 58 years [SD=11]; 92% male) had citalopram prescriptions for 64 mg/day (SD=8.3), on average. Within 180 days after the safety communication was issued, 60% had filled prescriptions for ≤40 mg/day. All-cause hospitalizations or deaths were found to significantly increase after dosage reductions (adjusted hazard ratio=4.5, 95% CI=4.1-5.0), as were hospitalizations for depression or all-cause death (adjusted hazard ratio=2.2, 95% CI=1.8-2.6). Mortality did not decline (adjusted hazard ratio=1.0, 95% CI=0.8-1.3), and neither did hospitalizations for arrhythmias or all-cause deaths (adjusted hazard ratio=1.3, 95% CI=1.0-1.7).Reduction of prescribed citalopram dosages to a new safety limit was associated with a higher rate of hospitalization in a large patient population who had been treated with substantially higher dosages. Stipulating a safety limit for citalopram dosages before the benefits and risks of doing so were firmly established appears to have had unintended clinical consequences.
Iron Chelation Therapy Could Rapidly Reduce Oxidative DNA Damage In CD34+ Hematopoietic Cells Before Decrease Of Serum Ferritin Level
Authors: Masayoshi Kobune, Shohei Kikuchi, Satoshi Iyama, Kohichi Takada, Kazuyuki Murase, Kaoru Ono, Hiroto Horiguchi, Yusuke Kamihara, Akari Hashimoto, Ayumi Tatekoshi, Tsuyoshi Hayashi, Tsutomu Sato, Koji Miyanishi, Yasushi Sato, Rishu Takimoto, Junji Kato
Journal: Blood (2013)