tbuckley/cabot-search huggingface dataset:
International randomized phase III study of capecitabine (Cap), bevacizumab (Bev), and mitomycin C (MMC) in first-line metastatic colorectal cancer (mCRC): Final results of the AGITG MAX trial
Authors: N. C. Tebbutt, V. Gebski, K. Wilson, M. Cummins, Y. Chua, B. Robinson, A. Broad, D. Cunningham, J. Simes, T. Price
Journal: Journal of Clinical Oncology (2009)

4023 Background: The addition of Bev to oxaliplatin or irinotecan based doublet chemotherapy has shown benefit in mCRC. Cap± MMC are alternate chemotherapy regimens suitable for patients (pts) who are either unfit for or who do not require initial oxaliplatin/irinotecan. This phase III study compared Cap with Cap Bev and Cap Bev MMC. The aim was to develop a low toxicity regimen suitable for a broad population of pts with mCRC. Methods: Previously untreated pts with unresectable mCRC considered suitable for Cap monotherapy were randomised to arm A Cap (Cap 2000mg/m 2 /d or 2500mg/m 2 d1–14 q21d), arm B Cap Bev (Bev 7.5mg/kg q3w) or arm C Cap Bev MMC (MMC 7mg/m 2 q6w). Primary endpoint: PFS, secondary endpoints: RR, toxicity, OS, QoL . Randomisation was stratified by age, PS, centre and Cap dose. Response was assessed every 6w. The study was designed to detect an increase in the median PFS from 5.5m (arm A) to 8m (arm B or C) at p&lt;0.025 with 80% power. Results: A total of 471 pts were randomised from July 2005-June 2007. Outcomes were evaluated on an intention to treat basis and included 15 ineligible pts. Baseline demographics were well balanced between arms with median age 67y (range 31–86y). Toxicity was reported: ASCO 2008 abstr 4029. The most common grade 3/4 toxicities were PPE (16%, 26%, 28%) and diarrhoea (11%, 17%, 16%) for arms (A,B,C). However, adjusted rates per cycle were similar as arms B &amp; C received more cycles of Cap (A8.3, B10.8, C10.5). Other toxicity rates were generally &lt;10%. The study achieved its primary endpoint with a highly significant improvement in PFS for arms B &amp; C. RR and OS are summarized ( Table ). Conclusions: All treatment regimens were well tolerated in a relatively elderly patient cohort. The addition of Bev±MMC to Cap significantly improved PFS without significant additional toxicity. OS was similar for all arms. Cap Bev±MMC is an active, low toxicity regimen that may be considered as a treatment option for pts with mCRC. [Table: see text] [Table: see text]
Down's Syndrome (Mongolism), Other Congenital Malformations and Cancers among the Sibs of Leukemic Children
Authors: Robert W. Miller
Journal: New England Journal of Medicine (1963)

ABNORMALITIES of somatic-cell chromosomes have been associated with some cases of leukemia, with Down's syndrome (mongolism) and with certain other congenital defects (reviewed by Ford1). Furthermore, leukemia has been reported to be three to fifteen times more common in children with Down's syndrome than in the general population.2 3 4 5 Thus, leukemia and Down's syndrome, which individually have cytogenetic defects, are in turn associated with one another. These relations suggest that by epidemiologic study of sibship histories of children with leukemia or with Down's syndrome, one may recognize a spectrum of childhood ailments related to one another and to chromosomal abnormalities. . . .
Diagnosis of the Alk-Eml4 Translocation with Fish, Immunohistochemistry, and Real Time-Polymerase Chain Reaction in Patients with Non-Small-Cell Lung Cancer: the Latin American Experience
Authors: G. Cruz-Rico, V. Morales-Oyarvide, A. Aviles-Salas, A.M. Espinosa-García, V.A. Maldonado-Laguna, C. Rojas-Enriquez, A.F. Cardona, O. Arrieta
Journal: Annals of Oncology (2014)
Case 25-1993
Authors: Richard C. Cabot, Robert E. Scully, Eugene J. Mark, William F. McNeely, Betty U. McNeely, Frederick L. Mansfield, John X. O'Connell
Journal: New England Journal of Medicine (1993)

Presentation of CaseA 67-year-old man was admitted to the hospital because of increasing back pain and osteolytic changes in the 11th and 12th thoracic vertebras.There was a history of coronary artery disease with multiple subendocardial infarcts, which had led to coronary-artery bypass surgery 19 years earlier.During the year before admission the patient experienced mild, intermittent low dorsal pain. Ten months before entry an electronic pacemaker was implanted because of the sick sinus syndrome. The alkaline phosphatase was 224 U per liter.Seven months before admission the patient returned to the hospital because of recurrent anterior chest pain. . . .
QOL-20LOW-DOSE NALTREXONE IN NEWLY DIAGNOSED HIGH-GRADE GLIOMA: PLACEBO-CONTROLLED, DOUBLE-BLIND, RANDOMIZED PILOT STUDY
Authors: Katherine Peters, Mary Affronti, Sarah Woodring, Eric Lipp, Patrick Healy, Frances McSherry, James Herndon, Charlene Flahiff, Elizabeth Miller, Maria Freeman, Janet Minchew, Ben Zalutsky, Bonnie Taylor, Susan Boulton, Dina Randazzo, Annick Desjardins, Gordana Vlahovic, Darell Bigner, Henry Friedman
Journal: Neuro-Oncology (2015)

At diagnosis and throughout disease course, patients with high-grade glioma (HGG) experience a diminished quality of life (QoL), increase in fatigue, and reduction in cognition. Naltrexone, an orally semisynthetic opiate antagonist, is FDA-approved for treatment of heroin/ alcohol addiction, and low dose naltrexone (LDN) has been observed to improve QoL and lower fatigue in other neurological illnesses, such as multiple sclerosis. LDN is believed to function as a partial agonist and can lead to shifts in neurochemicals that reduce fatigue. Based on this, we sought to study whether LDN has an impact on QoL, fatigue, sleepiness, and cognition in patients with HGG. In a placebo-controlled, double-blind, randomized study, 110 HGG patients were randomized to receive placebo (N = 56) or LDN 4.5 mg orally at night (N = 54). Treatment was initiated at day 1 of concurrent radiation and temozolomide and continued for 16 weeks. Change from baseline was evaluated in all study assessments including patient-reported outcomes of QoL (Functional Assessment of Cancer Therapy-Brain), fatigue (Functional Assessment of Chronic Illness Therapy-Fatigue), sleepiness (Epworth Sleepiness Scale), depression (Beck Depression Inventory II), and cognitive testing. Safety of LDN was monitored with standard laboratory testing and adverse event reporting. Demographics were WHO grade IV (85%), male (56%), KPS 90-100 (51%), grossly resected (55%) and mean age of 56 years. For all QoL, fatigue, depression, and cognition measures, change from baseline at 16 weeks was not significantly different in patients receiving LDN or placebo. At 16 weeks, LDN patients reported a significantly greater increase in sleepiness from baseline compared to placebo (p = 0.0088). Adverse events were seen in similar frequencies for LDN and placebo. Of note, overall survival did not significantly differ between treatment groups. While LDN is safe to administer, LDN has no effect on QoL, fatigue, cognition, or survival, but may increase sedation, in HGG patients.
P92 Real-time online analysis of volatile organic compounds in the exhaled breath of preschool children
Authors: KA Holden, SF Hussain, D Roland, TJ Coats, EA Gaillard
Journal: Thorax (2015)

<h3>Introduction</h3> Investigating airway inflammation and pathology in preschool children is challenging from both a technical and ethical standpoint and as such we urgently need to identify and validate novel, non-invasive techniques. Analysis of exhaled volatile organic compounds (eVOC) has been successfully employed using conventional, offline mass spectrometry in preschoolers (van de Kant 2013). However, real-time, instant analysis of eVOC in this age group would be an important advance in the field of ‘breathomics’. We sought to assess whether real-time online analysis of eVOC was feasible in preschool children attending our hospital. <h3>Methods</h3> Breath samples were taken from preschool children (aged between 1 and 6 years) attending the emergency department or an acute medical ward at our hospital. Children breathed room air tidally via a facemask and eVOC were analysed instantly by Proton-Transfer-Reaction time-of-flight mass spectrometry (PTR-Tof-MS) coupled to Loccioni breath collection apparatus. Capnography data was simultaneously recorded. The mass spectra were analysed using a Matlab programme coded for adult patients and the spectra for mass channel (m/z) 59 (acetone) were inspected. Total counts for all mass channels were summated. <h3>Results</h3> Eight children (median age 42 months, range 14–59 months) participated, of which five (median age 40 months) were able to produce analysable results. The total median count from the summation of all mass channels was 157,465 ncsp (number of counts per second) ranging from 4,831 to 200,319 ncps. The Figure 1 below demonstrates a spectrum for m/z 59 and capnography trace from one of the participants. The patterns of both traces are comparable. <h3>Discussion</h3> The comparability of the traces for the spectrum of m/z 59 and capnography suggests that real-time PTR-ToF-MS is detecting eVOC which relate to end-tidal breathing. The traces are likely offset due to the lag between end-tidal exhalation and the sample reaching the apparatus. This feasibility study has demonstrated that real-time analysis of eVOC is possible in preschool children in an acute setting. Further work is needed to determine the most accurate way of analysing the spectra to be able to apply this novel, non-invasive method of investigating airway inflammation and pathology in preschool children. <h3>Reference</h3> 1 van de Kant KD, van Berkel JJ, Jöbsis Q. <i>et al.</i> Exhaled breath profiling in diagnosing wheezy preschool children.<i> Eur Respir</i>. 2013;<b>41</b>:183–8
The Effects of Antihypertensive Therapy on Left Ventricular Mass in Elderly Patients
Authors: Steven P. Schulman, James L. Weiss, Lewis C. Becker, Sidney O. Gottlieb, Kathleen M. Woodruff, Myron L. Weisfeldt, Gary Gerstenblith
Journal: New England Journal of Medicine (1990)

Left ventricular mass sometimes decreases during treatment of hypertension, but this response is inconsistent and its effects on left ventricular function are unknown. In a six-month randomized trial, we studied the ability of verapamil and atenolol to reduce left ventricular mass in 42 elderly patients with hypertension and the effects of this reduction in mass on cardiac function.
Fertility and Outcome of Pregnancy in Women Exposed in Utero to Diethylstilbestrol
Authors: Ann B. Barnes, Theodore Colton, Jerome Gundersen, Kenneth L. Noller, Barbara C. Tilley, Thomas Strama, Duane E. Townsend, Paul Hatab, Peter C. O'Brien
Journal: New England Journal of Medicine (1980)

Fertility and outcome of pregnancy were examined in women participating in the National Cooperative Diethylstilbestrol Adenosis (DESAD) Project. We compared 618 subjects who had prenatal exposure to DES with 618 control subjects. Fertility, measured in terms of pregnancies achieved, did not differ between the women exposed to DES and the controls. An increased risk of unfavorable outcome of pregnancy was associated with DES exposure (the relative risk of any unfavorable outcome of pregnancy was 1.69; P less than 0.001). Speculation on biologic mechanisms that might produce this difference is premature, since additional data about these subjects must be collected. Among DES-exposed women who became pregnant, 81 per cent had at least one full-term live birth.
The Arietta Study: Exploring Severe Asthma Biomarkers in a Real-World Setting
Authors: Nicola A. Hanania, Stephanie Korn, Andrew Menzies-Gow, Michel Aubier, Kenneth R. Chapman, Giorgio Walter Canonica, Cesar Picado, Nicolas Martin, Ramón A. Escobar, Stephan Korom, Roland Buhl
Journal: Journal of Allergy and Clinical Immunology (2016)
Disparities in Use of Human Epidermal Growth Hormone Receptor 2–Targeted Therapy for Early-Stage Breast Cancer
Authors: Katherine Reeder-Hayes, Sharon Peacock Hinton, Ke Meng, Lisa A. Carey, Stacie B. Dusetzina
Journal: Journal of Clinical Oncology (2016)

Trastuzumab is a key component of adjuvant therapy for stage I to III human epidermal growth factor receptor 2 (HER2)-positive breast cancer. The rates and patterns of trastuzumab use have never been described in a population-based sample. The recent addition of HER2 information to the SEER-Medicare database offers an opportunity to examine patterns of trastuzumab use and to evaluate possible disparities in receipt of trastuzumab.We examined a national cohort of Medicare beneficiaries with incident stage I to III HER2-positive breast cancer diagnosed in 2010 and 2011 (n = 1,362). We used insurance claims data to track any use of trastuzumab in the 12 months after diagnosis as well as to identify chemotherapy drugs used in partnership with trastuzumab. We used modified Poisson regression analysis to evaluate the independent effect of race on likelihood of receiving trastuzumab by controlling for clinical need, comorbidity, and community-level socioeconomic status.Overall, 50% of white women and 40% of black women received some trastuzumab therapy. Among women with stage III disease, 74% of whites and 56% of blacks received trastuzumab. After adjustment for tumor characteristics, poverty, and comorbidity, black women were 25% less likely to receive trastuzumab within 1 year of diagnosis than white women (risk ratio, 0.745; 95% CI, 0.60 to 0.93).Approxemately one half of patients 65 years of age and older with stage I to III breast cancer do not receive trastuzumab-based therapy, which includes many with locally advanced disease. Significant racial disparities exist in the receipt of this highly effective therapy. Further research that identifies barriers to use and increases uptake of trastuzumab could potentially improve recurrence and survival outcomes in this population, particularly among minority women.
Case 18-2012
Authors: Louis R. Caplan, R. Gilberto Gonzalez, Ferdinando S. Buonanno
Journal: New England Journal of Medicine (2012)

A 35-year-old man was seen in the emergency department of this hospital because of neck pain, hoarseness, and dysphagia that developed during exertion 1 week earlier, recurred intermittently, and then persisted. A diagnostic procedure was performed.
Unilateral Urine Sampling Utilizing External Ureteral Compression
Authors: Lionel M. Bernstein, William M. Hamby
Journal: New England Journal of Medicine (1963)

HYPERTENSION associated with unilateral renovascular disease is receiving an increasing amount of attention. The present technics for the diagnosis of unilateral renal disease are excretory urography, retrograde pyelography, isotope renography, renal biopsy, the "Howard" test and its modifications1 2 3 4 and aortography.A simple, atraumatic procedure for unilateral urine sampling would be of great value. The purpose of this paper is to describe a technic whereby one ureter can be obstructed by external compression, thus allowing collection of urine from the opposite kidney by catheterization of the urinary bladder.5 MethodsTechnic of Ureteral OcclusionThe maximal intraureteral pressure at the distal end . . .
20P Context-dependent role of FGFR4 in lung tumorogenesis
Authors: Á. Quintanal, R. Poveda, R. Meléndez, L. Ojeda-Márquez, Á. Marrugal, M.G. Velasco, I. Ferrer, A. Carnero, L. Paz-Ares, S. Molina-Pinelo
Journal: Journal of Thoracic Oncology (2016)
FRI0451 Unclassifiable Interstitial Lung Disease or Undifferentiated Connective Tissue Disease? A Challenging Differential Diagnosis:
Authors: A. Manfredi, M. Sebastiani, S. Cerri, G. Della Casa, D. Giuggioli, C. Vacchi, M. Colaci, A. Spinella, F. Luppi, C. Ferri
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Interstitial lung disease (ILD) includes a group of disorders of the pulmonary parenchyma including ILD secondary to environmental exposure, to sarcoidosis and connective tissue diseases, idiopathic pulmonary fibrosis, nonspecific interstitial pneumonitis. Unclassifiable-ILD (U-ILD) is defined when ILD cannot be included in one of these subtypes, because of inadequate findings or impossibility to complete diagnostic iter. Undifferentiated connective tissue disease (UCTD) is a systemic autoimmune diseases characterized by clinical and serological features typical of other CTD, but not fulfilling any of the existing classification criteria. It has been recently suggested that UCTD should be responsible for ILD, although the available classification criteria do not consider lung manifestations. Differential diagnosis between U-ILD or ILD secondary to UCTD (UCTD-ILD) can be difficult, but fundamental for therapeutic implications. <h3>Objectives</h3> To evaluate the clinical and serological features of patients with ILD secondary to UCTD compared to unclassifiable ILD, to improve differential diagnosis and identify patients candidate to immuno-suppressive therapy. Secondary outcome was to construct a clinical algorithm, using a priori variables, helpful to predict ILD-UCTD in clinical practice. <h3>Methods</h3> From September 2011 to November 2014, 50 patients referred to our Center were diagnosed for UCTD (26/50) or U-ILD (24/50), after a multidisciplinary discussion according to standard available criteria. <h3>Results</h3> Main features and comparison between UCTD-ILD and U-ILD are reported in the table. An inconsistent with usual interstitial pneumonia (UIP) pattern at high resolution computerized tomography (HRCT) was more frequently detected in UCTD-ILD compared to U-ILD. A predictive model based on Raynaud9s phenomenon, ocular dryness, and antinuclear antibodies showed a predictive value of 85.7% (UCTD-ILD were correctly classified in 90.5% and U-ILD in 78.6%). <h3>Conclusions</h3> Lung involvement is a possible presenting symptom of UCTD; therefore, differential diagnosis with U-ILD is crucial due to the relevant therapeutic implications; a multidisciplinary approach, including rheumatologist, pulmonologist, radiologist, and pathologist, is mandatory. Some clinical-serological features potentially helpful in differential diagnosis should be carefully evaluated <h3>Disclosure of Interest</h3> None declared
Renal cancer complicating acquired cystic kidney disease.
Authors: J T Marple, M MacDougall, A M Chonko
Journal: Journal of the American Society of Nephrology (1994)

Acquired cystic kidney disease (ACKD) occurs in the setting of prolonged azotemia and is therefore common in dialysis patients. It is characterized by epithelial proliferation, and its major complication is the development of renal cancer. The incidence of renal cancer is significantly increased in ACKD patients and is probably increased overall in the ESRD population as well. Those ESRD patients with suspicious symptoms, prolonged predialysis azotemia, or a dialysis duration of longer than 3 yr, or those who are candidates for a renal transplant should be screened for ACKD. Sonography or computed tomographic scanning are useful as initial screening tools. However, although more expensive and requiring contrast administration, the contrast-enhanced computed tomographic scan is the definitive imaging procedure by which to initially evaluate a renal mass. A suspicious renal mass is a patient who is a surgical candidate is an indication for a radical nephrectomy.
Patterns of metastatic (met) disease sites in breast cancer (BrCa): Implications for availability of fresh tumor tissue (FTT) for personalized BrCa treatment (Rx) planning (TP) in met disease
Authors: C. A. Presant, L. Bosserman, F. Howard, B. Emilio
Journal: Journal of Clinical Oncology (2009)

e12004 Background: Personalized Rx for patients (PTs) can improve response. Although archival tissue is available in all PTs, FTT testing of molecular, immunohistochemical, and/or chemosensitivity characteristics may be more optimal for TP than tissues obtained before previous Rx and/or new mets, and archival tissue is inadequate for cell culture information. This study was performed to determine the availability of FTT in a multi-site cancer center. Methods: Pts seen over 22 months were evaluated. PT clinical characteristics were evaluated to determine the prevalence of mets by site, and feasibility of biopsy (bx) for FTT by site. A bx algorithm for FTT was developed and quantified. Results: 26,794 successive PTs were evaluated. BrCa was present in 2043 (7.6%). Median age was 61 (range 27 to 98). Mets were present in only 174 (8.5% of BrCa) who had 256 sites involved (1.47 site per PT). 68% of PTs had multiple sites involved. Of PTs with multiple sites, 96 (81%) had 2, 16 (14%) had 3, and 6 (5%) had 4 sites involved. Single site was the pattern in only 9% of liver, 7% of lung, 32% of bone, 0% of adrenal 6% of skin, but 71% of brain mets. The most frequent sites of mets were bone (50%), lung (31%), liver (26%), brain (10%), skin or soft tissue (11%), lymph node (6%), and effusion/ascites (3.4%). In order to theoretically obtain FTT for development of a personalized TP based on an algorithm preferring in order local bx &gt; para/thoracentesis, &gt; non-osseous needle bx &gt; video-assisted tissue bx &gt; osseous bx, 18% of PTs would have had a local bx, 3% para/thoracentesis, 23% liver bx, 19% lung bx, 17% bone bx, and 12% would not have had a bx because of brain-only mets. Conclusions: Most BrCa PTs in oncology practices have only locoregional disease. Most PTs with mets have multiple sites. FTT acquisition would be feasible for 88% of PTs with mets for personalized TP, and in most the bx would be simple and non-invasive. However, tissue culture tests would necessitate a more invasive video-assisted bx in 42% of PTs. Physicians should consider additional bx to personalize TP when appropriate for improving outcomes. [Table: see text]