tbuckley/cabot-search huggingface dataset:
Teledermatology for the Diagnosis and Management of Skin Cancer
Authors: Anna Finnane, Kathy Dallest, Monika Janda, H. Peter Soyer
Journal: JAMA Dermatology (2016)

<h3>Importance</h3> As technology becomes more commonplace in dermatological practice, it is essential to continuously review the accuracy of teledermatology devices and services compared with in-person care. The last systematic review was conducted over 5 years ago. <h3>Objective</h3> To synthesize and assess the quality of the evidence to address 3 research questions: (1) How accurate is teledermatology for skin cancer diagnosis compared with usual care (face-to-face [FTF] diagnosis)? (2) Does teledermatology save clinician and/or patient time, compared with usual care? (3) What are the enablers and barriers to adoption of teledermatology in clinical practice for the diagnosis of skin cancer? <h3>Evidence Review</h3> The review protocol was registered in the PROSPERO database. Six databases (Cochrane, PubMed, Medline, Science Direct, Embase, and Web of Science) were searched for studies investigating the diagnostic accuracy and concordance, management accuracy and concordance, measures of time (waiting times, delay to diagnosis), and enablers and barriers to implementation. Potentially eligible articles were screened by 2 reviewers. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool was used to evaluate the risk of bias and applicability of individual studies assessing diagnostic accuracy. <h3>Findings</h3> Twenty-one studies were reviewed. The diagnostic accuracy (defined as agreement with histopathology for excised lesions or clinical diagnosis for nonexcised lesions) of FTF dermatology consultation remains higher (67%-85% agreement with reference standard, Cohen κ, 0.90) when compared with teledermatology (51%-85% agreement with reference standard, κ, 0.41-0.63), for the diagnosis of skin cancer. However, some studies do report high accuracy of teledermatology diagnoses. Most studies of diagnostic accuracy and concordance had significant methodological limitations. Studies of health service outcomes found teledermatology reduced waiting times and could result in earlier assessment and treatment. Patients reported high satisfaction and were willing to pay out of pocket for access to such services. <h3>Conclusions and Relevance</h3> Robust implementation studies of teledermatology are needed, paying careful attention to reducing risk of bias when assessing diagnostic accuracy. Teledermatology services consistently reduced waiting times to assessment and diagnosis, and patient satisfaction was high.
Treating intermediate-risk prostate cancer with hypofractionated external beam radiotherapy alone.
Authors: A. Dal Pra, S. Faria, F. L. Cury, M. David, M. Duclos, G. Shenouda, L. Souhami
Journal: Journal of Clinical Oncology (2011)

93 Background: A wide range of therapeutic alternatives is available for the treatment of intermediate-risk prostate cancer (IRPC). The use of hypofractionated external beam radiotherapy (HypoRT) in this group of patients appears to be an attractive option. Non-randomized institutional results have provided similar outcomes to conventional fractionation. For health-systems such as we have in Canada, where many patients live far, it significantly shortens treatment duration and impacts favorably in health costs. We report our results using HypoRT alone in IRPC. Methods: Between October/2002 and July/2009, 82 men with IRPC (T2b-T2c, or PSA 10–20 ng/dL, or GS=7) were treated with HypoRT, without any androgen deprivation. Ultrasound image guidance was used daily to confirm setup. The dose was 66 Gy in 22 daily fractions of 3 Gy (BED=79.4Gy/44) prescribed at the isocenter. PTV was the prostate (+/− 1cm seminal vesicles) with 7-mm margin in all directions. GI and GU toxicity were prospectively assessed every 4–6 months using the CTCAE v3 scoring system. Biochemical failure was defined as nadir PSA + 2 ng/dL. Results: 60% of patients had Gleason score 7; 43% had stage T2; median initial PSA=9 ng/ml; median age 71 years. With a median follow-up of 43 months (range: 7–89), only three patients (4%) have developed biochemical failure. All three showed metastatic disease few months after biochemical failure. Actuarial biochemical recurrence free survival (bNED) is 95.4%. There was no death related to prostate cancer. Three patients died from other causes without biochemical failure. The 5-year overall survival was 93%. At the last follow up visit, grade ≥ 2 late GI and GU toxicity rates were 2% and 7%, respectively. No grade 4 or 5 has occurred. Conclusions: Men with IRPC treated with 66Gy/22 fractions and without androgen deprivation have experienced excellent 5-year biochemical control rate with acceptable late toxicity. This regimen is very convenient because the duration of the treatment is half of the time used with conventional fractionation. Whether the addition of short-term androgen deprivation would further improve outcome remains unclear. No significant financial relationships to disclose.
Sickle cell trait is not associated with an increased risk of heart failure or abnormalities of cardiac structure and function
Authors: Natalie A. Bello, Hyacinth I. Hyacinth, Nicholas S. Roetker, Samantha R. Seals, Rakhi P. Naik, Vimal K. Derebail, Abhijit V. Kshirsagar, Nigel S. Key, James G. Wilson, Adolfo Correa, Robert J. Adams, Leonard D. Egede, W. T. Longstreth, Gaurav Choudhary, Beatrice E. Gee, Austin L. Hughes, Amil M. Shah, JoAnn E. Manson, Matthew Allison, Gregory L. Burke, Aaron R. Folsom, Cara L. Carty, Alexander P. Reiner, Scott D. Solomon, Suma H. Konety
Journal: Blood (2016)
Probabilistic simulation framework for EEG-based BCI design
Authors: Umut Orhan, Hooman Nezamfar, Murat Akcakaya, Deniz Erdogmus, Matt Higger, Mohammad Moghadamfalahi, Andrew Fowler, Brian Roark, Barry Oken, Melanie Fried-Oken
Journal: Brain-Computer Interfaces (2016)

A simulation framework could decrease the burden of attending long and tiring experimental sessions on the potential users of brain computer interface (BCI) systems. Specifically during the initial design of a BCI, a simulation framework that could replicate the operational performance of the system would be a useful tool for designers to make design choices. In this manuscript, we develop a Monte Carlo based probabilistic simulation framework for electroencephalography (EEG) based BCI design. We employ one event related potential (ERP) based typing and one steady state evoked potential (SSVEP) based control interface as testbeds. We compare the results of simulations with real time experiments. Even though over and under estimation of the performance is possible, the statistical results over the Monte Carlo simulations show that the developed framework generally provides a good approximation of the real time system performance.
Endobiliary jumbo forceps biopsy as a technique for diagnosing bile duct malignancies.
Authors: Michael H. Hsu, Rajeev Tummuru, Abhitabh Patil
Journal: Journal of Clinical Oncology (2012)

197 Background: Pancreaticobiliary cancers are difficult to diagnose early and have a high associated mortality. Current methods of obtaining pathologic specimens from a biliary stricture include fine-needle aspiration, brush cytology, and endobiliary forceps biopsy. Among these forceps biopsy is the best, but is frequently limited by its low sensitivity (56%). The goal of this study is to evaluate the diagnostic yield and safety of jumbo forceps biopsies taken from the bile duct. Methods: All patients who presented to a single, tertiary academic referral center from July 2009 to July 2010 with a non-anastomotic biliary stricture were studied. This resulted in 9 patients with common bile duct strictures – 3 male and 6 female (ages 29-83, mean 61). All subjects underwent ERCP by the same gastroenterologist with endobiliary jumbo forceps biopsy using the Boston Scientific Radial Jaw 4 jumbo biopsy forceps. Specimens obtained were compared to available specimens obtained via fine needle aspiration, cytologic brushing or surgical resection. Patients with benign results were followed clinically for 1 year. Results: Three patients had benign biliary strictures as determined by clinical follow-up or surgical resection specimen. Jumbo forceps biopsy diagnosed a benign entity in 100% of these cases. Among the remaining 6 patients with malignant strictures, jumbo biopsy diagnosed a malignancy in 83% of cases. Tissue obtained was deemed adequate for histologic evaluation in 8 of 9 patients. The exception was recognized at the time of the procedure and was attributed to the technical inability to adequately open the biopsy forceps within the bile duct. Of the technically successful cases, 100% yielded an accurate histologic diagnosis as determined by concordant alternative sampling or clinical follow-up. In the 90 days following jumbo forceps biopsy, there were no adverse events such as bleeding, cholangitis, pancreatitis, perforation, peritonitis, or need for hospitalization. Conclusions: In our limited study, the use of jumbo forceps biopsies is safe and, when technically feasible, has a very high yield in evaluating biliary strictures. Larger studies are needed to confirm our findings.
PTH-277 Thirteen year review of how 2-week wait referrals and heightened awareness of colorectal cancer has affected stage at presentation: Abstract PTH-277 Table 1
Authors: K Fairhurst, M Silavant, J Bunni, T Cook, M Scott
Journal: Gut (2015)

<h3>Introduction</h3> Colorectal cancer is the third most commonly diagnosed cancer in the UK, and second most common cause of death related to cancer. It is widely acknowledged that the stage of colorectal cancer at presentation has prognostic significance and that earlier stage correlates with improved survival. The introduction of the 2-week wait system for referral of suspected cases of colorectal cancer and campaigns to increase awareness in both primary care and the general public, aim to facilitate earlier diagnosis and treatment. We assessed whether heightened awareness and rapid access to services impacted on the stage of presentation of colorectal cancer in our patient cohort over a 13-year period. <h3>Method</h3> Data was extracted from a prospectively maintained database gathering information on all colorectal cancers at a District General Hospital. Five 12-month periods (2001, 2004, 2007, 2010 and 2013) were analysed specifically for the histopathological stage (American Joint Committee on Cancer), or the stage as assessed by imaging if inoperable or unresected. Data were analysed and presented graphically. <h3>Results</h3> The number of 2-week wait referrals increased from 275 in 2001 to 1291 in 2013 whilst the number of cancers diagnosed increased from 161 in 2001 to 249 in 2013. The trend over a 13-year period is towards an increase in the number of stage I and II cancers (38.9% in 2001 to 43% in 2013) and a decrease in the numbers of stage III and IV cancers (61.1% in 2001 to 49% in 2013) diagnosed. <h3>Conclusion</h3> The number of 2-week wait referrals has increased almost 5-fold over a 13-year period whilst the number of cancers diagnosed has only risen 1.5-fold. However, the number of cancers diagnosed has plateaued out in more recent years, despite the continuing rise in 2-week wait referrals. This perhaps reflects that the prevalence of colorectal cancer is not increasing in the general population. It also suggests that the 2-week wait referral system includes an increasing cohort of patients who may not need urgent investigation, with the consequential workload and financial implications. Similarly, the percentage of patients presenting with a stage III or IV cancer has not decreased further since 2007, when it was at a low of 44% of all colorectal cancers diagnosed. Whilst these results overall support the fast track referral process and campaigns to heighten awareness of colorectal cancer amongst the public and primary care physicians, they suggest that the effect of such measures in Gloucestershire is perhaps now maximised. <h3>Disclosure of interest</h3> None Declared.
Dysfunction of hepatic regulatory T cells in experimental sclerosing cholangitis is related to IL-12 signaling
Authors: Dorothee Schwinge, Franziska von Haxthausen, Alexander Quaas, Antonella Carambia, Benjamin Otto, Fabian Glaser, Benedikt Höh, Nina Thiele, Tanja Schoknecht, Samuel Huber, Niklas Steffens, Ansgar W. Lohse, Johannes Herkel, Christoph Schramm
Journal: Journal of Hepatology (2016)
Nomograms to predict 3-year biochemical recurrence after robotic-assisted laparoscopic radical prostatectomy based on preoperative and perioperative variables of 774 patients.
Authors: P. Sooriakumaran, M. John, A. Srivastava, Y. El-Douaihy, S. Grover, D. Bhagat, S. Rajan, R. Leung, A. Tewari
Journal: Journal of Clinical Oncology (2011)

115 Background: Predictors of biochemical recurrence after robotic-assisted laparoscopic radical prostatectomy (RALP) are not well reported in the literature. We wanted to investigate preoperative predictors as well as the influence of nerve sparing and positive surgical margin status on 3-year biochemical recurrence. Methods: 774 patients with at least 3 year follow up had undergone RALP by a single surgeon at our institution. Biochemcial recurrence was defined as a postoperative PSA &gt;0.2 ng/ml. Multivariable logistic regression models were used to develop the biochemical recurrence predictive nomograms: nomogram 1- age, BMI, PSA density, clinical stage, biopsy Gleason, percent positive cores, perineural invasion; nomogram 2- age, BMI, PSA density, clinical stage, biopsy Gleason, percent positive cores, perineural invasion, nerve sparing, positive surgical margins (none, unifocal, or multifocal). The predictive accuracy of the models was assessed in terms of discrimination and calibration. Results: Both nomograms discriminated well between patients that recurred and those that did not (bootstrap corrected c-indices of 0.766 and 0.806 for nomograms 1 and 2 respectively). Nomogram 1 was well calibrated, but nomogram 2 over- predicted the probability of biochemical recurrence in patients at &gt;30% risk. Conclusions: Our nomogram based on age, BMI, PSA density, clinical stage, biopsy Gleason, percent positive cores, and perineural invasion on preoperative biopsy has a good predictive ability to differentiate between RALP-treated patients that biochemically recur by 3 years from those that do not. Adding nerve sparing and surgical margin status further improved discriminatory ability but at the expense of over-prediction for patients at high risk. These nomograms may be used to guide the use of nerve sparing and the management of positive margins in men undergoing RALP for clinically localized prostate cancer. No significant financial relationships to disclose.
The Addition of Bortezomib to the Combination of Lenalidomide and Dexamethasone Increases Bone Formation in Relapsed/Refractory Myeloma: a Prospective Study in 91 Patients.
Authors: Evangelos Terpos, Dimitrios Christoulas, Efstathios Kastritis, Maria Roussou, Maria Gavriatopoulou, Magdalini Migkou, Maria Gkotzamanidou, Marina Iakovaki, Athanasios Papatheodorou, Meletios A. Dimopoulos
Journal: Blood (2009)
Osimertinib or Platinum–Pemetrexed in <i>EGFR</i> T790M–Positive Lung Cancer
Authors: Tony S. Mok, Yi-Long Wu, Myung-Ju Ahn, Marina C. Garassino, Hye R. Kim, Suresh S. Ramalingam, Frances A. Shepherd, Yong He, Hiroaki Akamatsu, Willemijn S.M.E. Theelen, Chee K. Lee, Martin Sebastian, Alison Templeton, Helen Mann, Marcelo Marotti, Serban Ghiorghiu, Vassiliki A. Papadimitrakopoulou
Journal: New England Journal of Medicine (2016)

Osimertinib is an epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) that is selective for both EGFR-TKI sensitizing and T790M resistance mutations in patients with non-small-cell lung cancer. The efficacy of osimertinib as compared with platinum-based therapy plus pemetrexed in such patients is unknown.
Liposomal Cytarabine in the Central Nervous System (CNS) Prophylaxis of Elderly Patients with Aggressive B-Cell Non-Hodgkin’s Lymphoma (NHL) and Undifferentiated Acute Leukemia (UAL): Preliminary Results of a Single-Center Experience.
Authors: Barbara Anaclerico, Velia Bongarzoni, Anna Chierichini, Maurizio Bartolini, Piero Iacovino, Susanna Fenu, Paola Anticoli-Borza, Luciana Annino
Journal: Blood (2006)
What factors affect the place of end-of-life care for patients with metastatic breast cancer?
Authors: K. Harano, K. Yonemori, K. Hashimoto, M. Yunokawa, C. Shimizu, K. Tamura, N. Katsumata, M. Ando, Y. Fujiwara
Journal: Journal of Clinical Oncology (2011)

218 Background: Despite the early detection and treatment, advanced breast cancer is still impossible to cure. Palliative care has become the standard of care at the time of end-of-life (EOL). However, there are limited data about the degree of access to such care and the factors that affect the choice of place to die. The purpose of this study is to identify factors that affect the place of EOL care in patients with metastatic breast cancer in Japan. Methods: Our study included breast cancer patients who were diagnosed with recurrence or metastatic diseases between 2004 and 2010 at the National Cancer Center Hospital and received EOL care. The following data were obtained: treatments, place of EOL care, and social background such as age, whether patients had young children, whether patients had elderly family members who needed nursing care, whether patients had jobs at the time of recurrence, and where they lived in. Results: Overall, 124 patients met our inclusion criteria. Among them, only 13% of patients received EOL care at home and 43.5% of patients at hospices, while 43.5% of patients died in acute care beds. Patients who had jobs at the time of recurrence were significantly more likely to receive EOL care in acute care beds (odds ratio 2.46; 95% CI 1.04−5.83). Other social backgrounds were not significantly related to the place of EOL care. Conclusions: A sizable proportion of patients, especially patients who had jobs at the time of recurrence, received acute care at the EOL and did not have access to palliative care at home or hospices. Familial backgrounds were not the determinant to choose the place of EOL.
First results of a phase II trial to assess the efficacy of efavirenz in patients with metastatic androgen-independent prostate cancer.
Authors: Nadine Houede, Marina Pulido, Loic Mourey, Florence Joly, Jean Marc Ferrero, Carine Bellera, Franck Priou, Caroline Lalet, Audrey Laroche, Mireille Canal-Raffin, Pier Vi Piazza
Journal: Journal of Clinical Oncology (2012)

251 Background: This Phase II trial assessed the efficacy of efavirenz, a non-nucleoside reverse transcriptase inhibitor in patients with asymptomatic HRPC [hormone refractory prostate cancer] who progressed, before docetaxel based chemotherapy. Preclinical studies showed that efavirenz, via Line-1 inhibition, could block proliferation and induced re-differentiation of prostate cancer cell line. We then investigated if efavirenz treatment can delay biological and clinical progression. Methods: The primary objective was to assess the efficacy of efavirenz in patients, with no clinical symptom related to disease progression. Each patient received efavirenz 600 mg/day until objective biological progression or study discontinuation. It was possible to increase the dose (up to 1200 mg daily) in case of PSA progression at 3 months. Efficacy was measured in terms of 3-month non-progression. Based on a 2-stage Simon’s design, a total of 16 non-progressions out of 54 eligible patients were required to claim efficacy. Results: 61 patients were enrolled in the study with 53 eligible for the primary endpoint. At baseline, median age was 71 years and median PSA level was 49.6 ng/mL. A total of 15/53 (28%) non-progressions were observed at 3 months. As patients are still being followed, overall survival, PSA progression free survival and symptomatic progression free survival at one year will be presented. Sixty patients were assessable for toxicity. Of these, 9 (15%) experienced at least one grade III/IV toxicity i.e. neuropsychiatric adverse events already reported in efavirenz-treated HIV patients. With regard to pharmacokinetics (PK), preliminary data indicates variability in the 3-month efavirenz concentration. Ongoing preliminary analyses suggest a better response in patients with elevated (&gt;3000ng/ml) plasmatic concentration. Conclusions: Current analyses do not allow to claim efficacy of Efavirenz at the 600 mg dose. The ongoing analysis of the relationship between plasmatic concentration of efavirenz and treatment efficacy could confirm that higher doses of efavirenz may constitute an efficient treatment. A phase I dose escalation study is currently being performed.
Phase I study of imatinib, cisplatin, and fluoruracil in patients with advanced gastric cancer.
Authors: Martina Mayr, Barbara Alberter, Karin Becker, Roland M. Schmid, Matthias Philip Ebert
Journal: Journal of Clinical Oncology (2012)

115 Background: Combination chemotherapies are established as standard treatment in gastric cancer, but prognosis remains poor. Integration of targeted therapies may provide an additional benefit. Imatinib may inhibit platelet derived growth factor (PDGF) mediated tumor growth and amplify effects of chemotherapy. This Phase I study evaluated dose limiting toxicity (DLT) of imatinib in combination with cisplatin and fluoruracil/ capecitabine therapy in gastric cancer. Methods: The study was designed as a 3-patient cohort dose-escalating trial. Patients (pts) received cisplatin (60 mg/m 2 d1 q 21) and capecitabine (1250 mg/m 2 bid d1-14 q 21) or cisplatin (50 mg/m 2 d1, 15, 29 q 50) and leucovorin (500 mg/m 2 ), followed by a 24-hour 5-fluoruracil infusion (2000 mg/m 2 d1,8,15,22,29,36 q 50). Imatinib was started d - 4 and continuously administered with the dose being escalated from 300 to 700 mg QD in 100 mg steps. Results: Characteristics of the 35 enrolled pts: Median age= 61 years (range 39-76). Male: female= 27:8. ECOG 0: 21 pts (60%), ECOG 1: 13 pts (37%), ECOG 2: 1 pt (3%). Localization: carcinoma of the gastroesophageal junction 17 pts (48%), gastric body 18 pts (52%). Histology: intestinal 8 (23%), diffuse 10 (28%), not specified 17 (49%). Metastatic disease: 21 pts (60%). At imatinib dose level 1 (300mg) one DLT was observed and three more pts were enrolled without further DLT. No DLT was encountered up to dose level 4. At dose level 5 (700 mg) two gastric perforations occurred, so 600 mg imatinib emerged as the maximum tolerated dose. Immediate surgery was performed on both with good clinical outcome. Therapy was delivered 14 weeks (range 1- 59) on average. Major grade 3/4 toxicities were nausea (6%), anemia (4%), fatigue (6%) and upper GI hemorrhage (3%). Response evaluation at 6 weeks revealed partial response (PR) in 27%, stable disease (SD) in 43% and progressive disease in 13% of the assessable pts. Conclusions: Combination of imatinib and chemotherapy is a well tolerated therapeutic approach with promising activity. A relationship between study medication and the occurred gastric perforations remains disputable. Further investigations are required to confirm the assumed amplification of chemotherapy effects by imatinib.
Tissue Factor Deficiency Decreases Sickle Cell-Induced Vascular Stasis in a Hematopoietic Stem Cell Transplant Model of Murine Sickle Cell Disease.
Authors: Cheryl A. Hillery, Thomas D. Foster, Sandra L. Holzhauer, J. Paul Scott, Julie A. Panepinto, Narla Mohandas, Nigel Mackman, Nancy J. Wandersee
Journal: Blood (2004)