tbuckley/cabot-search huggingface dataset:
Potential economic impact of the 21-gene recurrence score in Brazil.
Authors: CE Bacchi, ED Saad, FM Carvalho, EB Ojopi, FE Prisco
Journal: Cancer Research (2009)

Abstract Abstract #6102 Objective: The 21-gene recurrence score (RS) may be useful for decisions regarding the use of chemotherapy (CT) in patients with lymph-node-negative (LNN), estrogen-receptor (ER)+ early breast cancer (BC). We investigated the potential impact of using RS in private practice in Brazil, from the perspective of third-party payers, in terms of main direct medical expenses.&amp;#x2028; Methods: We conducted a web-based survey with 30 (of a total of ∼700) Brazilian medical oncologists, who were stratified by State according to the proportion of patients with BC and private insurance. Such physicians represented States and cities in which approximately 80% of new BC cases are diagnosed each year. The questionnaire evaluated the treatment of first choice for patients with LNN, ER+ BC, regardless of menopausal status. Interviewees were initially invited by telephone and were not aware of the objective of the study. The responses allowed a quantitative assessment of the patterns of care regarding CT regimen according to disease stage (T1b, T1c, T 2-4 cm, T &amp;gt; 4 cm), type of premedication, use of G-CSF and in-hospital treatment for febrile neutropenia (rates taken from the literature). Medication costs were calculated using the manufacturer's recommended prices, and the cost for RS testing, which is currently available in Brazil, was set at BR$ 3,900.00 (US$ 2,294.00). Other direct medical expenses, indirect medical costs, and non-medical costs were not considered. We estimated costs for two hypothetic cohorts of patients (without and with RS), whose stage distribution and RS results followed those reported by Paik et al (NEJM 2004). The model assumed that patients with access to RS testing would receive CT if their RS was intermediate or high, whereas patients with a low RS would receive no CT.&amp;#x2028; Results: For a hypothetic cohort of 100 patients with no access to RS testing, the survey showed that 84 patients would receive CT (of note, 43% of patients with T1b tumors and adverse features would not receive CT). Reclassifying patient eligibility to CT according to RS would bring this number to 49. For a hypothetic cohort of 100 patients, BR$ 134,958.00 (∼US$ 79,400.00) would be saved in main direct medical expenses.&amp;#x2028; &amp;#x2028; Conclusion: Considering the current price for the exam, our economic analysis suggests that RS testing is cost-saving in Brazil, from the perspective of third-party payers. Prospective studies are awaited for validating CT decisions based on the RS. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 6102.
Tendering out general practice is bad for doctors--and patients
Authors: Katy Gardner
Journal: BMJ (2012)

I have been a general practitioner (GP) for 34 years, and I was a GP principal long ago. In 1998, while working in an inner city practice in Toxteth, Liverpool, my colleagues and I were finding it increasingly difficult to recruit GPs, and we decided to become a pilot salaried practice. We were a group of dedicated and enthusiastic GPs but did not excel at business and were not always comfortable with our independent contractor status. Initially, we chose to be employed by our local community mental health organisation, North Mersey Community NHS Trust. Immediately we could attract high quality salaried GPs who wished to work in the inner city, who recognised that providing a high quality service in a deprived diverse area did not always attract money through the general medical services contract, and who were keen to be part of an exciting new way of working.

Fourteen years on, were we right? Over the past six months, I have experienced the full downside of this decision. I have been “out to tender” …
SP0177 Management of Secondary Care as Support for Primary Care for People with Hip or Knee Osteoarthritis: The AMS-OA Cohort Study.
Authors: M. Van Der Esch
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Introduction</h3> Reade, Centre for Rehabilitation and Rheumatology, Amsterdam, the Netherlands, started an outpatient clinic for people with knee and/or hip osteoarthritis (OA) in 2009. The main reason behind this is that OA is a heterogeneous disease with different presentations, and as a consequence requires a variety in care options. Knee and/or hip OA is a common condition managed frequently in primary care, but often not in line with national and international guidelines. The ideal consultation for a patient with knee and/or hip OA is not known, but in general, non-complex patients are supposed to be treated in primary care and complex patients in secondary care. Protocols have been established for the diagnosis and treatment of knee and/or hip OA by rheumatologists and specialists in rehabilitation medicine, incorporating medical and functional assessments. Results from assessments provide guidance to referrals in primary of secondary care, whereby data from assessments can be used for scientific research. <h3>Method</h3> The outpatient clinic consists of patients aged 18 years or older with symptoms of the knee and/or hip indicative of OA. The initial step in the diagnostic care-process is to exclude other diseases and to diagnose knee and/or hip OA in accordance with the ACR criteria and supplementary radiology criteria. Limitations in daily activities and several psychosocial and biomechanical variables are assessed. Inclusion criteria for secondary care are disease complexity such as co morbidity, high pain intensity and/or many activity limitations or insufficient treatment results from primary care. <h3>Results</h3> Since February 2009, a total of 500 patients have been included. Most of these patients have a Kellgren &amp; Lawrence score of 2 or more, indicative of mild-to-severe cartilage degeneration. These patients show mild to severe activity limitations with a mean WOMAC score for functioning of 26.9 ±121.9 (range 0-69) and moderate pain with a NRS (during the last week) of 5.2 ±2.2 (range 0-10). In general, most patients show muscle weakness. The OA management in secondary care has been improved; referrals for primary care are more adequate but need to be improved. Results form several studies from the AMS-OA data have been used to improve the assessments and the therapeutically applications <h3>Conclusions</h3> Results show that the population of knee and/or hip patients referred to our outpatient clinic is heterogeneous. The assessments of activity limitations and the determinants behind these limiting factors are important in distinguishing between complex and non-complex knee and/or hip OA patients, guide adequate referrals and further research. <h3>Disclosure of Interest</h3> None Declared
Tc-99m MIBI to Evaluate Children With Ewing’s Sarcoma
Authors: Z Bar-Sever, I J Cohen, L P Connolly, G Horev, T Perri, T Treves, R Hardoff
Journal: Clinical Nuclear Medicine (2000)

Tc-99m MIBI has been used increasingly to evaluate benign and malignant tumors because of its tumor-seeking properties and ability to provide an imaging assessment of multiple-drug resistance. This study investigated the clinical utility of Tc-99m MIBI in the management of Ewing's sarcoma in children.Thirteen Tc-99m MIBI studies in nine (six male, three female) patients ages 6.5 to 20 years (mean, 13.4 years) with Ewing's sarcoma were reviewed. All patients had imaging studies at diagnosis, and four had follow-up studies during or after therapy. Scintigraphy was evaluated for Tc-99m MIBI uptake within the tumor and in metastases, which other imaging modalities had shown to be present in four patients. Scintigraphic results were correlated with the clinical course in all patients and with tumor P-glycoprotein status in six patients.Tc-99m MIBI accumulated in 6 of 9 primary tumors and did not accumulate in one recurrent tumor. No metastases showed Tc-99m MIBI uptake. The presence or absence of Tc-99m MIBI uptake at diagnosis or after therapy carried no prognostic significance. Tc-99m MIBI was present in the two tumors that were P-glycoprotein positive and in only one of four tumors that were P-glycoprotein negative.Tc-99m MIBI imaging does not appear to be useful in Ewing's sarcoma.
Abnormal FDG and MIBG Activity in the Bones in a Patient With Neuroblastoma Without Detectable Primary Tumor
Authors: Wei Zhang, Hongming Zhuang, Sabah Servaes
Journal: Clinical Nuclear Medicine (2016)

Neuroblastoma is among the most common extracranial solid tumors in pediatric patients and typically arises anywhere from the neck to pelvis but most commonly in the adrenal glands. It is extremely rare for a patient to have extensive metastases from neuroblastoma without primary tumor being identified. We present a 3-year-old with widespread bone and bone marrow involvement of the disease revealed on both FDG PET/CT and MIBG scan, which was pathologically proven as neuroblastoma. However, extensive imaging did not detect primary tumor anywhere.
Abstract P4-09-01: Poly (ADP-ribose) Polymerase-1 mRNA Expression in Human Breast Cancer: Correlations with Subtypes and Prognostic Impact
Authors: A Gonçalves, P Finetti, M Gilabert, R Sabatier, J-P Borg, P Viens, D Birnbaum, F. Bertucci
Journal: Cancer Research (2010)

Abstract Introduction: Although poly(ADP-ribose) polymerase-1 (PARP1) inhibition is a recent promising therapy in breast cancer, PARP1 expression in this disease is not known. Methods. Using DNA microarray and array-based comparative genomic hybridization (arrayCGH), we examined PARP1 mRNA expression and copy number alterations in 326 invasive breast cancer samples and normal breast samples. A meta-analysis was performed on a large public retrospective gene expression dataset (n= 2,485) to analyze correlation between PARP1 mRNA expression and molecular subtypes and clinico-pathological parameters. Results. PARP1 was overexpressed in 58% of cancers, and its expression was heterogeneous between tumors. ArrayCGH data revealed an association between mRNA overexpression and gain/amplification at the PARP1 locus (p&amp;lt;1.0E-8). Meta-analysis showed that PARP1 expression was higher in basal breast cancers (p&amp;lt;1.0E-72), but overexpression was also found in other subtypes. PARP1 expression correlated with high grade, medullary histological type, tumor size and worse metastasis-free survival (HR=1.12 [1.04-1.22]; p=0.004). In multivariate analysis, PARP1 expression had an independent prognostic value, which was restricted to patients untreated with any adjuvant chemotherapy. Univariate and multivariate analyses in MFS in patients untreated with systemic adjuvant chemotherapy Conclusion. These data demonstrate overexpression of PARP1 in a large number of breast cancers and its association with reduced metastasis-free survival. These results further support the development of PARP inhibitors in basal subtype but also potentially in other breast cancer subtypes. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P4-09-01.
Weight gain among schizophrenic patients treated with clozapine
Authors: J S Lamberti, T Bellnier, S B Schwarzkopf
Journal: American Journal of Psychiatry (1992)

A retrospective chart review was used to assess weight changes in 36 chronic schizophrenic inpatients who were treated with clozapine after being treated with standard neuroleptics. The average weight gain during 6 months of clozapine treatment was 16.9 lb; 75.0% of the patients gained at least 10 lb. The results confirm previous findings of clozapine-associated weight gain.
Identification and Prioritization of Relationships between Environmental Stressors and Adverse Human Health Impacts
Authors: Shannon M. Bell, Stephen W. Edwards
Journal: Environmental Health Perspectives (2015)

There are > 80,000 chemicals in commerce with few data available describing their impacts on human health. Biomonitoring surveys, such as the NHANES (National Health and Nutrition Examination Survey), offer one route to identifying possible relationships between environmental chemicals and health impacts, but sparse data and the complexity of traditional models make it difficult to leverage effectively.We describe a workflow to efficiently and comprehensively evaluate and prioritize chemical-health impact relationships from the NHANES biomonitoring survey studies.Using a frequent itemset mining (FIM) approach, we identified relationships between chemicals and health biomarkers and diseases.The FIM method identified 7,848 relationships between 219 chemicals and 93 health outcomes/biomarkers. Two case studies used to evaluate the FIM rankings demonstrate that the FIM approach is able to identify published relationships. Because the relationships are derived from the vast majority of the chemicals monitored by NHANES, the resulting list of associations is appropriate for evaluating results from targeted data mining or identifying novel candidate relationships for more detailed investigation.Because of the computational efficiency of the FIM method, all chemicals and health effects can be considered in a single analysis. The resulting list provides a comprehensive summary of the chemical/health co-occurrences from NHANES that are higher than expected by chance. This information enables ranking and prioritization on chemicals or health effects of interest for evaluation of published results and design of future studies.Bell SM, Edwards SW. 2015. Identification and prioritization of relationships between environmental stressors and adverse human health impacts. Environ Health Perspect 123:1193-1199; http://dx.doi.org/10.1289/ehp.1409138.
Case 16-2000
Authors: Eric A. Pillemer, Nancy L. Harris
Journal: New England Journal of Medicine (2000)

Presentation of CaseA 53-year-old woman was admitted to the hospital because of swelling of the right breast and bilateral lymphadenopathy.The patient had been well until five months earlier, when severe bronchitis developed. She received trimethoprim–sulfamethoxazole, but there was no improvement. Soon thereafter, the palmar surface of her right hand swelled and became slightly tender, but the swelling soon receded. During the next few days, her right arm also became tender, with right axillary lymphadenopathy and swelling of the right breast. Three weeks later, a mammographic examination (Figure 1) showed density and trabecular thickening of the right breast, with . . .
FRI0504 Retinotoxicity of hydroxychloroquine; is it possible to demonstrate by spectral domain optical coherence tomography before development? a cross sectional investigation
Authors: H. F. çay, M. K. Erol, D. Turgut Coban, I. Sezer, M. Bulut, T. Cakir, N. F. Toraman
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Hydroxychloroquine is an antimalarial drug, which has been used for the treatment of autoimmune disorders as rheumatoid arthritis, connective tissue disease and Sjögren's syndrome. Potential retinotoxicity of the antimalarial drugs is the main limiting issue of their consumption. <h3>Objectives</h3> To evaluate the alterations of retinal layers in rheumatic patients, who have been treated with hydroxchloroquine without the signs or symptoms of retinopathy by using spectral domain ocular coherence tomography (SD-OCT). <h3>Methods</h3> The retinal layers of patients who have been treated with hydroxychloroquine for rheumatoid arthritis, Sjögren's syndrome and connective tissue diseases and age matched healthy controls were evaluated with SD-OCT. The macular cube protocol, optic disc cube protocol and horizontal and vertical HD five line raster scan protocol were applied. The measured parameters were compared between hydroxychloroquine users and healthy controls and among different diagnostic groups. in addition, correlation of these parameters with drug consumption duration and dose parameters of hydroxychloroquine were performed. <h3>Results</h3> A total of 402 eyes of 201 subjects [114 hydroxychloroquine users;40 RA, 47 SjS, 27 CTD and 87 age-mathced healthy females] were evaluated. The central and perifoveal layers and superior and inferior quadrants of retinal nerve fiber layer (RNFL) of hydroxychloroquine users were thinner than of non-users. Connective tissue disease group had longer duration and higher cumulative dose of hydroxychloroquine than other diagnostic groups. This group had thinner mean RFNL values than the other groups as well. There were significant and negative correlations between cumulative dose of drug and first quadrant of full foveal thickness and inferior quadrant of RFNL. Parafoveal and perifoveal layers were correlated negatively with dose of drug per kg of body weight. <h3>Conclusions</h3> We did not encounter a significant finding consistent with hydroxychloroquine-induced retinotoxicity. This may be the result of relatively short duration and low cumulative dose of consumed hydroxychloroquine as well as the possible safety of the drug. Nevertheless, peroidic screening should not be ommitted in order to be sure of being not-involving by retinotoxicity. SD-OCT may be the golden standard technique for the follow up of antimalarial-induced retinotoxicity in future. We need further investigation concerning the evaluation of retinotoxicity by SD-OCT <h3>Disclosure of Interest</h3> None Declared
Insulin-Infusion-Pump Treatment of Diabetes
Authors: William V. Tamborlane, Raymond L. Hintz, Michael Bergman, Myron Genel, Philip Felig, Robert S. Sherwin
Journal: New England Journal of Medicine (1981)

We examined whether changes in somatomedin accompany those seen in glucose and growth hormone during treatment with the insulin-infusion pump. somatomedin levels in eight insulin-dependent diabetics (13 to 29 years of age) were measured before and after 16 weeks of outpatient insulin-pump treatment, which lowered mean glucose from 245 +/- 21 to 100 +/- 5 mg per deciliter and total glycosylated hemoglobin from 16.2 +/- 1.2 to 9.7 +/- 0.3 per cent (mean +/- S.E.M.). During conventional insulin therapy, both total somatomedin and somatomedin C were within the normal range, despite elevations in growth hormone. Pump treatment resulted in a 70 to 75 per cent increase in both total somatomedin and somatomedin C (P less than 0.05) and a fall in growth-hormone concentrations. In the two growing adolescents, growth velocity doubled during 13 to 15 months of pump treatment. Our data suggest that the improved insulin delivery or metabolic control increases somatomedin levels despite a decrease in growth hormone. Thus, insulin-pump treatment may be useful in optimizing growth in diabetic children.
LOWER INDEXED STROKE VOLUME IS INCREMENTALLY ASSOCIATED WITH LONG-TERM MORTALITY FOLLOWING TRANSCATHETER AORTIC VALVE IMPLANTATION
Authors: Maria I. Drakopoulou, Konstantinos Toutouzas, Styliani Brili, Archontoula Michelongona, George Latsios, Andreas Synetos, Konstantinos Stathogiannis, Antonios Mastrokostopoulos, Pavlos Bounas, Dimitris Tousoulis
Journal: Journal of the American College of Cardiology (2015)
Abstract 5211: Development of a panel of colon cancer cell lines with cancer stem cell properties: a tool for cancer biology and target discovery
Authors: Penny Roberts, Peter Young, Doug Smith, Jeff Hooley, Jonathan Li, Francine Chen, Deryk Loo, Jennie Mather, Paul A. Moore
Journal: Cancer Research (2011)

Abstract The cancer stem cell (CSC) hypothesis provides a foundation for understanding cancer development and carries significant implications relevant to drug discovery. The generation of cell lines with cancer stem cell properties would be an important advancement in the field. If CSC were capable of indefinite self-renewal without immortalization, it should be possible to develop conditions that select this minority population from a tumor for continuous culture as a line. By employing defined serum-free media and conditions that are strongly selective for fetal colon epithelial progenitor cells, we have been able to select a morphologically homogeneous minority population, hereafter we termed cancer stem-like cells (CSLC) from a repertoire of primary and metatstatic colon cancer specimens. Six colon CSLC lines have been generated, some of which have been stably maintained in vitro for over 200 generations. When implanted subcutaneously, under the subrenal capsule, or orthotopically in immune deficient mice, all CLSC form tumors that are morphologically and phenotypically recapitulate the patient's original tumor. Furthermore, some of the lines form distant metastasis with consistent colorectal cancer morphology. All lines express CEA; however, only a fraction expresses elevated levels of “canonical” CSC markers, including CD44 or CD133. Affymetrix U133 micro-array analysis identified a set of transcripts that were elevated in the CSLC lines compared to a series of control cell populations. These included ALDH1A1, a well known colon CSC marker, and OLFM4, a recently identified marker of normal colon crypt stem cells. Whole-cell immunizations of mice with several lines has yielded a panel of CSLC-reactive monoclonal antibodies that recognize broadly expressed colon cancer antigens as well as surface proteins more discreetly represented within colon tumors and possibly representing CSC-specific markers. These lines and their reactive antibodies provide the basis for developing and characterizing novel approaches aimed at targeting and the elimination of the CSC population. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 5211. doi:10.1158/1538-7445.AM2011-5211
Prevalence and Spectrum of Germline Mutations of the p53 Gene among Patients with Sarcoma
Authors: Junya Toguchida, Toshikazu Yamaguchi, Siri H. Dayton, Roberta L. Beaughamp, Guillermo E. Herrera, Kanji Ishizaki, Takao Yamamuro, Paul A. Meyers, John B. Little, Masao S. Sasaki, Ralph R. Weichselbaum, David W. Yandell
Journal: New England Journal of Medicine (1992)

Recent studies have identified germline mutations of the p53 tumor-suppressor gene in families with the Li—Fraumeni syndrome, a rare inherited disorder characterized by a high risk of sarcomas of bone and soft tissue, breast cancer, and other tumors. In this report, we address the possibility that some sporadic sarcomas may be associated with new germline mutations of the p53 gene, which would not be manifested as familial cancer unless the patient survived to reproduce.