tbuckley/cabot-search huggingface dataset:
Abstract 17808: Perceived Health Predicts Risk of Hospitalizations and Death in Adults with Heart Failure
Authors: Ruth M Masterson Creber, Barbara Riegel
Journal: Circulation (2011)

Background: Hospitalization and death are common in adults with heart failure (HF). The purpose of this study is to determine whether overall perceived health can predict all-cause hospitalization or death in HF patients. Methods: A secondary analysis was conducted using data collected on 280 Stage C HF patients from three U.S. northeastern sites. Perceived health was measured at enrollment with the question, “In general would you say your health is, excellent, very good, good, fair, or poor?” Data on hospitalization and death were obtained from the medical record or US death records. We compared the rate of events among patients with poor or fair perceptions of health to those with good or excellent perceptions of health. A Cox proportional hazards model was used to examine the association between perceived health and event rates. Kaplan-Meier survival estimates were compared between groups. Results: The sample was older (mean=62 SD 12.5 years), 64.3% male, 76.4% NYHA class III/IV, 69% with systolic HF (ejection fraction 35.4% SD 17%), and 39% ischemic etiology. Few patients (13.2%) rated their health as being poor. During a 180-day follow-up period, 6 deaths and 91 hospitalizations occurred as first events. Among patients with events, 64.9% perceived their health as poor and 33.9% perceived their health as fair. Controlling for 8 confounders (site, age, race, gender, NYHA class, HF type, HF knowledge, Charlson Comorbidity Index), patients with poor perceived health had over double the rate of dying or being hospitalized (hazard ratio (HR): 2.5; 95% confidence interval (CI): 1.3 to 4.7; p=0.007). CONCLUSION: Perceived health is a powerful indicator of impending events. Asking HF patients how they perceive their health can be a simple and quick tool for prioritizing patients who are at highest risk of death and hospitalization.
Absolute BCR-ABL Transcript Levels At 3 Months but Not At Diagnosis Predict Survival of Chronic Myeloid Leukemia (CML) Patients On Imatinib Therapy
Authors: Benjamin Hanfstein, Valeria Shlyakhto, Michael Lauseker, Philipp Erben, Susanne Saussele, Alice Fabarius, Ulrike Proetel, Susanne Schnittger, Hans-Jochem Kolb, Stefan W. Krause, Joerg Schubert, Hermann Einsele, Mathias Hänel, Jolanta Dengler, Christiane Falge, Lothar Kanz, Andreas Neubauer, Michael Kneba, Frank Stegelmann, Michael Pfreundschuh, Cornelius F. Waller, Karsten Spiekermann, Gabriela M. Baerlocher, Markus Pfirrmann, Joerg Hasford, Wolf-Karsten Hofmann, Rüdiger Hehlmann, Andreas Hochhaus, Martin C. Müller
Journal: Blood (2012)
Allogeneic transplantation for myelofibrosis: Final analysis of a prospective study after a median follow up of 5 years.
Authors: Uday R. Popat, Roland L. Bassett, Julianne Chen, Amin Majid Alousi, Paolo Anderlini, Stefan O. Ciurea, Chitra Hosing, Roy B. Jones, Partow Kebriaei, Issa F. Khouri, Sergej Konoplev, Marcos J.G. De Lima, Yago Nieto, Betul Oran, Muzaffar H. Qazilbash, Gabriela Rondon, Elizabeth J. Shpall, Srdan Verstovsek, Borje Andersson, Richard E. Champlin
Journal: Journal of Clinical Oncology (2015)

7008 Background: We report final results of a prospective phase II clinical trial of busulfan(bu) and fludarabine(flu) conditioning in patients with myelofibrosis(MF). After observing a higher relapse rate in the initial cohort, we increased the intensity of conditioning regimen for subsequent patients. Here we report updated mature results with a median follow up of 5 years. Methods: Patients with advanced MF were eligible if they had adequate organ function and at least 9/10 HLA matched related or unrelated donor. Of the 46 patients, first 15 (bu low group) received IV busulfan 130 mg/m2/day x 2 (day -3,-2). Of the remaining 31 (bu high group), 27 received IV busulfan dose to a target daily AUC of 4000 μmol.min x 4 (day -5 to -2) and 4 patients received a fixed dose of 100 mg/m2/day x 4 (days -5 to -2). All patients received fludarabine 40mg/m2x 4 (day -5 to -2). Results: 23 males and 23 females with a median age of 58 years (27-74) had intermediate (28) or high-risk (18) disease as per DIPSS plus criteria. Donors were matched sibs (19), matched unrelated (23), or mismatched unrelated (4). All patients engrafted with a median time to neutrophil engraftment of 13 (0-27) days and a median time to platelet engraftment of 24 (0-268) days. Cumulative incidence (CI) of grade II-IV, grade III, IV acute GVHD, and Chronic GVHD w 22%, 7%, and 40%, respectively. With a median follow up of surviving patients of 5.1 years (range 1-8.3 years), 3 year overall survival (OS), event-free survival (EFS), cumulative incidence (CI) of non-relapse mortality (NRM), and CI of relapse were 69%, 48%, 13%, and 39%, respectively. Multivariate analysis showed that Bu-high dose (HR 0.44; p = 0.07) was associated with lower relapse rate. Bu-high dose (HR 0.5; p = 0.09), DIPSS plus high (HR 2.69; P = 0.02) and Age (HR 1.05; P = 0.08) were predictors of EFS. DIPSS plus high (HR 5.99; P = 0.001) and Age (HR 1.07; P = 0.03) were adverse predictors of OS. Conclusions: Allogeneic transplantation results in long-term survival in patients with myelofibrosis with better outcome seen in earlier phase of the disease. PK guided myeloablative busulfan (AUC 16,000 μmol.min) appears promising in reducing relapse rate without increasing non-relapse mortality.
Objective Assessment of Surgical Technical Skill and Competency in the Operating Room
Authors: S. Swaroop Vedula, Masaru Ishii, Gregory D. Hager
Journal: Annual Review of Biomedical Engineering (2017)

Training skillful and competent surgeons is critical to ensure high quality of care and to minimize disparities in access to effective care. Traditional models to train surgeons are being challenged by rapid advances in technology, an intensified patient-safety culture, and a need for value-driven health systems. Simultaneously, technological developments are enabling capture and analysis of large amounts of complex surgical data. These developments are motivating a "surgical data science" approach to objective computer-aided technical skill evaluation (OCASE-T) for scalable, accurate assessment; individualized feedback; and automated coaching. We define the problem space for OCASE-T and summarize 45 publications representing recent research in this domain. We find that most studies on OCASE-T are simulation based; very few are in the operating room. The algorithms and validation methodologies used for OCASE-T are highly varied; there is no uniform consensus. Future research should emphasize competency assessment in the operating room, validation against patient outcomes, and effectiveness for surgical training.
Prevention of stomal complications
Authors: M. V. Phadke
Journal: Journal of Clinical Oncology (2009)

e20745 Background: Ileostomy/Colostomy operations are associated with a high rate of infections and complications resulting in increased morbidity, mortality and litigation. Pathogenesis of each complication and role of Nature was observed. Technique of stomal maturation was modified. Surgeon must maintain control over the stoma at all times. Primary maturation of stoma is unnecessary and potentially harmful. Opening stomal lumen in O.R. is unscientific and allows bacteria to contaminate stomal and main wounds. Methods: Concept was evolved by serendipity in April 1986. Since then it has been used on all patients requiring an Ileostomy or Colostomy. Bacterial migration is prevented by keeping the lumen obstructed. Iatrogenic obstruction of small/large intestine has no deleterious effect on post-operative course. Obstructed bowel is brought out of opening at proposed site of stoma. Mesenteric corner of obstructed stoma is always above the skin. Anti-mesenteric surface is pulled out till the anti-mesenteric corner becomes the apex of a conical stoma. Serosa is sutured to a round opening in the rectus sheath. Stoma is covered by an appliance with a transparent pouch. Peristalsis starts in about 48–72 hours. When obstructed stoma bulges, it is opened with electrocautery as a minor bedside procedure. Diet is started. Peristalsis pushes mucosal cuff which protrudes, everts and auto-grafts over angiogenesis. This is based on Delayed-Primary (DP) wound healing. Mucosal cuff comes in contact with dermis of skin opening at stomal site completing Self-Maturation (SM). During SM, mucosal tube separates from serosal tube. Peristalsis continues to exert its effect on serosal tube but not on mucosal tube. Lumen of stoma remains concentric. Results: 65 Colostomies and 15 Ileostomies were performed using DPSM technique. Infection and complications were prevented. Minor complications were handled easily. Patient satisfaction was excellent. Conclusions: Primary maturation of stoma is unnecessary and potentially harmful and should be replaced by DPSM. It can be performed in all types of stoma construction, end or loop, temporary or permanent. It prevents infection and complications in all patients. No significant financial relationships to disclose.
Phase Ib study of sorafenib and vinorelbine as first-line treatment in patients with metastatic breast cancer.
Authors: C. Ferrario, H. Charamis, S. Oyewole-Eletu, C. L. Mihalcioiu, A. Langleben, W. H. Miller, R. Aloyz, L. C. Panasci
Journal: Journal of Clinical Oncology (2010)

1093 Background: Sorafenib is an oral inhibitor of Raf and VEGFR/PDGFR. In preclinical models, favorable effects were noted combining sorafenib and vinorelbine. Both vinorelbine and sorafenib undergo hepatic metabolism. We aimed to determine the recommended doses in a phase 1b study. Methods: Patients were eligible with HER2-negative metastatic breast cancer, measurable (RECIST), not previously treated with chemotherapy for advanced stage; ECOG PS 0-1, adequate renal, liver and bone marrow functions, and LVEF ≥50%. Treatment was in two subsequent cohorts of 6 patients each: vinorelbine (30 mg/m2 days 1, 8 every 21) + sorafenib 200 mg BID continuously (cohort 1); vinorelbine (same as cohort 1) + sorafenib 400 mg BID continuously (cohort 2). Patients still benefiting after 8 cycles of treatment were allowed to continue on single-agent sorafenib. Results: Six patients in each cohort (n=12) were evaluated. Patients received a median of 8 cycles of treatment. Dose-limiting toxicities with the first cycle included: grade 3 (G3) pancreatitis + cholangitis (n=1, cohort 1; gallstones were also found), and asymptomatic G4 increase in serum amylase/lipase (n=1, cohort 2; spontaneously resolved). With repeated cycles, other significant (G2-4) toxicities included: uncomplicated G3-4 neutropenia (92%); G3 enteritis (8%); G2-3 diarrhea (33%); G2-3 AST/ALT increase (33%); G2 bilirubin increase (25%), fatigue (50%), stomatitis (25%), vomiting (17%), hand-foot syndrome (17%), dyspepsia, nausea, anorexia, dry skin, sensorial neuropathy (8% each); G2 alopecia (17%). One patient discontinued treatment for recurrent G2 LVEF decrease after 8 cycles. Of 12 patients 50% showed a partial response, and 92% had clinical benefit (including stable disease after 4 cycles of treatment). Conclusions: The combination of vinorelbine and sorafenib is feasible, and shows promising efficacy in advanced breast cancer. Toxicity is quite variable, with uncomplicated neutropenia being very common. Full doses of both agents are tolerated in most patients, but patients at high risk for toxicity can more safely start on a lower dose. We recommend close monitoring for the first 2 cycles, including amylase and lipase. No significant financial relationships to disclose.
Exploratory analysis of circulating pro- and antiangiogenic factors in metastatic colorectal cancer (mCRC) patients, treated with GONO-FOLFOXIRI plus bevacizumab (BV).
Authors: C. Cremolini, F. Loupakis, L. Salvatore, M. Schirripa, A. Fioravanti, P. Orlandi, T. Di Desidero, R. Danesi, A. Falcone, G. Bocci
Journal: Journal of Clinical Oncology (2010)

e14094 Background: The combination of the anti-VEGF BV with cytotoxic drugs is an efficacious strategy in the treatment of mCRC. It has been hypothesized that the trend over time of circulating levels of pro- and antiangiogenic factors might help to predict treatment's efficacy and to disclose mechanisms of acquired resistance. Methods: Plasma levels of VEGF, placental growth factor (PIGF), soluble VEGF receptor 2 (sVEGFR2) and thrombospondin-1 (TSP-1) were assessed by means of ELISA assay, in a cohort of 25 patients enrolled in a phase II trial of GONO-FOLFOXIRI plus BV as first-line treatment of mCRC. VEGF levels were measured on immunodepleted plasma samples collected at baseline (d1), immediately before the second (d15), the fifth (d57) and the twelfth (d155) cycle of therapy and/or at the time of radiographic progression (PD). PIGF, sVEGFR2 and TSP-1 were assessed on plasma samples, collected at the same time points, except for d15. Comparisons were made by the two-sided, nonparametric Wilcoxon paired test. Results: Treatment with GONO-FOLFOXIRI plus BV produced a reduction in plasma VEGF (d15 vs. d1: p = 0.016). VEGF variation was independent of baseline levels (correlation coefficient: 0,105; p = 0.617). VEGF remained lower than at baseline also at d57 (d57 vs. d1; p = 0.002), at d155 (d155 vs. d1; p = 0.001) and at the time of PD (PD vs. day1: p < 0.0001). PIGF levels increased at d57 (d57 vs. d1: p < 0.001) and at d155 (d155 vs. d1: p = 0.019), compared to baseline; a decrease was observed at the time of PD (PD vs. d155: p = 0.049). sVEGFR2 increased at PD, compared to baseline, with a trend towards significance (PD vs. day1: p = 0.083). TSP-1 significantly increased at the time of PD, compared to d155 (PD vs. d155: p = 0.049). Conclusions: Triplet plus BV modulates circulating angiogenic markers, with a relevant effect on VEGF and PIGF levels. The characterization of the angiogenic profile of each patient at any time point might be a new starting point to better individualize antiangiogenic treatment and to focus on innovative therapeutic targets. At present, the small sample size does not allow correlations with clinical outcome. To this end, wider analyses are currently ongoing. No significant financial relationships to disclose.
Vascular Endothelial Growth Factor (VEGF) Is a Growth and Survival Factor in Waldenstrom’s Macroglobulinemia.
Authors: Oliver Tournilhac, Steven Le Gouill, Daniel Ditzel Santos, Klaus Podar, Lian Xu, Evdoxia Hatjiharissi, Yu-Tzu Tai, Zachary Hunter, Andrew Branagan, Kenneth C. Anderson, Steven P. Treon
Journal: Blood (2004)
A multicenter, randomized, double-blind, placebo-controlled study to evaluate the clinical effects of paclitaxel-carboplatin (TC) alone or with endostatin for advanced non-small cell lung cancer (NSCLC).
Authors: B. Han, Q. Xiu, Y. Luo, C. Bai, S. Guo, W. Liu, Z. Zhuang, Y. Zhang, J. Zhou, X. Jin
Journal: Journal of Clinical Oncology (2010)

7527 Background: Endostatin is one of the most effective inhibitors of tumor angiogenesis. Clinical studies have shown that chemotherapy combined with endostatin could improve response rate and the survival of patients. Methods: Chemotherapy-naive consenting patients with stage IIIB/IV NSCLC, performance status (PS) 0-2, aged 18-75 years and normal organ function, who had stable disease (SD) or above after receiving a first cycle TC, were enrolled in this study. Eligible patients were randomly assigned to the endostatin treatment group (TC + endostatin. T:175 mg/m2 d1, C:AUC = 5 d1, endostatin:7.5 mg/m2, d8-d21,q3w) or the control group (TC + placebo), and received three cycles of chemotherapy. The primary endpoint was time to progression (TTP); secondary endpoints were objective response rate (ORR), progression-free survival (PFS), clinical benefit rate (CBR), and safety. Results: From Jul 2007 to Aug 2008, 126 patients were randomized 1: 1 to the endostatin treatment group (Arm E) and the control group (Arm C).The ORR was 39.3% in Arm E and 23.0% in Arm C. The ORR of patients treated with endostatin plus chemotherapy increased 16.3% over those treated only with chemotherapy (p = 0.078). The CBR was 90.2% in Arm E and 67.2% in Arm C, and there was a significant difference between the two groups (p = 0.004). The median TTP in Arm E and Arm C were 7.1 and 6.3 months, respectively. The 24-week hazard ratio (HR) was 0.416 (95% confidence interval: 0.209-0.827, p = 0.012). The 16-week rates of PFS in Arm E and Arm C were 90% and 75%, respectively (p = 0.033). The 24- week rates of PFS in Arm E and Arm C were 78% and 59%, respectively (p = 0.017). Survival profile need further follow-up. There was no significant difference in the incidence rates of adverse events and serious adverse events between the two groups. Conclusions: In previously untreated advanced NSCLC, treatments with TC plus endostatin could significantly improve the 16-week and 24-week rates of PFS, ORR and CBR. The safety profile was similar. Chemotherapy combined with endostatin might play a role in the improvement of response rate and the survival of patients with advanced NSCLC. No significant financial relationships to disclose.
Outcome of patients with metastatic renal cell carcinoma (mRCC) treated with targeted therapy (TT) without cytoreductive nephrectomy (CN).
Authors: S. L. Richey, S. H. Culp, E. Jonasch, P. G. Corn, L. C. Pagliaro, S. F. Matin, C. G. Wood, N. M. Tannir
Journal: Journal of Clinical Oncology (2010)

4613 Background: CN became a standard procedure in mRCC in the immunotherapy era. Historically, median overall survival (OS) of patients treated with interferon alpha (IFN-α) without CN was 7.8 months. Median OS in patients treated with TT without CN is unknown. Methods: We retrospectively reviewed records of patients with mRCC who received TT without CN. Kaplan-Meier methods and Cox regression analysis were used to estimate median OS and identify prognostic risk factors, respectively. Results: 144 patients were identified. 82 patients (57%) and 62 patients (43%) had intermediate and poor-risk disease, respectively. Median OS for all patients was 11.1 months (95% CI, 9.5-14.1). By multivariable analysis, elevated baseline serum LDH and corrected calcium levels, performance status ≥ 2, retroperitoneal nodal metastasis and constitutional symptoms were independent risk factors for inferior OS. Patients with ≥3 factors had increased risk of death (HR 4.2; 95% CI, 2.7-6.5; p<0.001) and shorter median OS (5.8 vs. 15.3 months). 16 patients (11%) survived for 2+ years. Conclusions: These data highlight the improved OS of patients with mRCC treated with TT without CN, compared to historical IFN-α treatment, and may guide in the design of trials investigating the role of CN in the era of TT. No significant financial relationships to disclose.
Role of thrombospondin 1 (THBS1) expression in peritoneal metastasis of gastric cancer treated with taxanes.
Authors: N. Kurita, M. Shimada, T. Iwata, M. Nishioka, S. Morimoto, K. Yoshikawa, T. Miyatani, C. Mikami, H. Kashihara
Journal: Journal of Clinical Oncology (2011)

57 Background: To clarify the utility of taxanes and to pick up the prognostic factors in the treatment with 5FU- based chemotherapy for peritoneal metastasis of gastric cancer. Methods: Responder analysis: 18 patients with peritoneal metastasis of gastric cancer were enrolled in phase I study. The regimen consists of S-1 (80-120 mg) for 14 days and intraperitoneal infusion of PTX (dose escalation: 40 - 100 mg/m 2 ) at day 1 and 14, which was repeated 2 cycles. To pick up the predictive factors, the 137 genes, which were selected in the viewpoint of sensitivity of 5FU, CPT11 and taxanes, were analyzed using focused DNA microarray for the 12 patients. Role of THBS1 expression: THBS1 expressions were evaluated in immunohistochemical (IHC) staining of surgical specimens of 59 patients with peritoneal metastasis of gastric cancer who were administered 5FU-based chemotherapy. THBS1 positive was defined &gt; 30% of the population stained moderate to strong. Results: Responder analysis: Expressions of THBS1 gene of the 6 patients who had clinical benefits (2: partial response, 2: positive adenocarcinoma cells in peritoneal cytology became negative, 2: remarkable decrease of ascites) were more than 2 folds higher than those of no responders. THBS1 expression was confirmed in 5 (83.3%) using IHC staining, who had significantly higher survival rate compared with that of the negative. Role of THBS1 expression: 17 patients (28.8%) was THBS1 positive and had significantly better prognosis compared with negative patients (1year survival: 64.7% vs 34.7%). 38 patients treated with regimes including taxanes revealed a tendency of improved overall survival rates (p=0.05). Overall survival of 15 patients with THBS1 positive administered taxanes was significantly higher than that of the negative patients. (1 year survival: 66.7% vs 42.4%) Conclusions: PTX could improve the survival of peritoneal metastasis of gastric cancer. THBS1 is a prognostic factor especially in the patients treated with taxanes, which leads to tailor-made therapy. [Table: see text]
Quantifying within-household transmission of extended-spectrum β-lactamase-producing bacteria
Authors: M.R. Haverkate, T.N. Platteel, A.C. Fluit, J.W. Cohen Stuart, M.A. Leverstein-van Hall, S.F.T. Thijsen, J. Scharringa, R.C. Kloosterman, M.J.M. Bonten, M.C.J. Bootsma
Journal: Clinical Microbiology and Infection (2016)
Panel Recommends Mammograms Start at 50
Authors: Janet Colwell
Journal: Cancer Discovery (2016)

Abstract The U.S. Preventative Services Task Force issued its final recommendations on breast cancer screening, concluding that women at average risk can wait until age 50 to begin routine biennial mammograms. Screening for women ages 40 to 49 was graded a C recommendation—indicating only a small net benefit—raising concerns that some cancers will be missed at early, potentially curable stages.
Obesity In Young Adulthood Is Associated With Early Onset Multiple Myeloma In African Americans
Authors: Amie E. Hwang, Sikander Ailawadhi, Leon Bernal-Mizrachi, Todd M Zimmerman, Christopher Haiman, David J. Van Den Berg, Karen Pawlish, Ann M. Mohrbacher, Howard Terebelo, Brenda M. Birmann, Daniel O. Stram, David V. Conti, Nalini Janakiraman, Brian E. Henderson, Laurence N Kolonel, Jayesh Mehta, Graham A Colditz, John J. Graff, Cathryn H. Bock, Edward Peters, Brian C-H Chiu, Michael H. Tomasson, Seema Singhal, Carol Ann Huff, Jeffrey A. Zonder, Robert Z. Orlowski, Sagar Lonial, Wendy Cozen
Journal: Blood (2013)
Deep Vein Thrombosis Presenting on Pulmonary Ventilation and Perfusion Scintigraphy
Authors: Malak Itani, Joanna Fair, Zachary Hillman, Fatemeh Behnia, Saeed Elojeimy
Journal: Clinical Nuclear Medicine (2016)

A 52-year-old woman presenting with dyspnea was referred for a ventilation and perfusion scan (VQ). VQ images (with 99mTc-DTPA [diethylene triamine pentaacetic acid aerosol] and 99mTc-MAA [macroaggregated albumin]) initially appeared normal; however, count rates on perfusion images were similar to ventilation images, implying little 99mTc-MAA had reached the lungs. Spot images of the injected extremity demonstrated focal 99mTc-MAA accumulation worrisome for a venous thrombus, subsequently confirmed by Doppler ultrasound. Careful attention to relative radiotracer count rates on VQ scans is crucial to ensure diagnostic utility. In addition, abnormal low perfusion radiotracer counts may unveil other pathology with important clinical implications.
Landscape Of Genetic Lesions In 944 Patients With Myelodysplastic Syndromes
Authors: Yasunobu Nagata, Vera Grossmann, Yusuke Okuno, Ulrike Bacher, Genta Nagae, Susanne Schnittger, Yusuke Shiozawa, Ayana Kon, Tamara Alpermann, Kenichi Yoshida, Masashi Sanada, Andreas Roller, Niroshan Nadarajah, Yuichi Shiraishi, H. Phillip Koeffler, Hans-Ulrich Klein, Martin Dugas, Kenichi Chiba, Hiroko Tanaka, Alexander Kohlmann, Satoru Miyano, Claudia Haferlach, Hiroyuki Aburatani, Wolfgang Kern, Seishi Ogawa, Torsten Haferlach
Journal: Blood (2013)