tbuckley/cabot-search huggingface dataset:
Visceral disease site to predict clinical outcome of metastatic castration-resistant prostate cancer (mCRPC) patients (pts) treated with abiraterone acetate (AA): Results of the Italian compassionate use named patient program (NPP).
Authors: Vincenza Conteduca, Orazio Caffo, Lucia Fratino, Giovanni Lo Re, Umberto Basso, Alessandro D'Angelo, Maddalena Donini, Francesco Verderame, Raffaele Ratta, Giuseppe Procopio, Enrico Campadelli, Francesco Massari, Donatello Gasparro, Paola Ermacora, Caterina Messina, Monica Giordano, Daniele Alesini, Francesca Maines, Ugo De Giorgi
Journal: Journal of Clinical Oncology (2015)

e16045 Background: Results of clinical trials have shown that the presence of visceral disease does not preclude clinical benefit from abiraterone (AA) in metastatic castration-resistant prostate cancer (mCRPC) after docetaxel (DOC). We sought to analyze the impact of the site of visceral metastases (mets) in the patients treated with AA within the Italian named patient program (NPP). Methods: For the purposes of this study, we reviewed the patients' clinical records of all patients treated with AA for mCRPC by NPP in our Institutions. All patients have been previously treated with a DOC-based first line chemotherapy and received the standard AA dose of 1,000 mg orally daily plus prednisone 10 mg orally daily. The safety data recorded in the patients' clinical records were analyzed using the National Cancer Institute's Common Terminology Criteria for Adverse Events (CTCAE) v.4.0. We consider liver and lung mets as visceral. Results: Among the overall population of 265 mCRPC patients, median age was 73 yrs (range 51-88), 49 patients had visceral mets (18 liver, 28 lung, 3 lung and liver). The median progression-free survival (PFS) in patients with or without visceral mets was 4.6 and 7.0 months (p = n.s.), respectively. In the group of pts with visceral mets, the PFS was 4.4 months in patients with liver mets vs 6.5 months in patients with lung mets (p = n.s.). The median overall survival (OS) in patients with or without visceral mets was 12.4 and 18.5 months (p = 0.01), respectively. The median OS of patients with liver only disease vs other sites was 10.5 vs 18.5 m (p = 0.006), respectively. The median OS of patients with lung only disease vs other sites was 14.1 vs 18.5 months (p = n.s.). The incidence of grade 3/4 adverse events was similar between the groups. Conclusions: The visceral metastatic site appears as an important predictor of clinical outcome in mCRPC treated with AA in a community setting like NPP.
TV comedian writes off $15m in US medical debt
Authors: Michael McCarthy
Journal: BMJ (2016)

In a television show highlighting the practices of the US debt buying industry, the comedian John Oliver wrote off nearly $15m (£10.3m; €13.2m) in medical debt owed by nearly 9000 people.1

The British comedian said that the move was the largest television giveaway in history, almost doubling that by Oprah Winfrey, the daytime talk show host who, in 2004, gave a new car to everyone in her studio audience at an estimated cost of $8m.

Medical debt is common in the United States, where 20% of working age people …
Rat Mammary Tumor Classification: Notes on Comparative Aspects&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;
Authors: D Komitowski, B Sass, W Laub
Journal: JNCI Journal of the National Cancer Institute (1982)

Mammary tumors (170 spontaneous and 1,613 induced with 7,12-dimethylbenz[a]anthracene) in inbred SD rats were classified histologically. The neoplasms were divided into three main categories: fibroepithelial, epithelial, and connective tissue. In the fibroepithelial category, compound tumors showing a wide range of histologic structures with variation in the arrangement of both epithelial and connective tissue elements that differ among lobules occurred in 44 (25.9%) spontaneous and 1,027 (63.7%) induced neoplasms, whereas fibroadenomas occurred in 41 (24.1%) untreated and 175 (10.9%) treated rats. Uncommon fissured tumors were found in 1 (0.7%) untreated and 6 (0.4%) treated animals, whereas carcinosarcomas were found in only 10 untreated animals. In the epithelial category, tubular adenomas occurred in 48 (28.2%) untreated and 164 (10.2%) treated animals. Cystadenomas, duct papillomas, intraductal carcinomas, and anaplastic carcinomas were found less frequently. Adenoacanthomas occurred in only 12 (0.8%) of the treated animals. Among tumors with a fibrous component only, fibromas occurred in 22 (13%) untreated and 97 (6.0%) treated animals, Fibrosarcomas were less frequent, occurring in 4 untreated (2.4%) and 54 (3.4%) treated animals.
Oncogenic Effect of Tissue-Culture Preparations of Polyoma Virus on Fetal Mice
Authors: Mearl F. Stanton, Sarah E. Stewart, Bernice E. Eddy, Robert H. Blackwell
Journal: JNCI Journal of the National Cancer Institute (1959)

Swiss mice inoculated late in fetal life with tissue-culture preparations of SE polyoma virus died earlier and had a higher incidence of tumors than animals inoculated shortly after birth. No histologic types of tumors were seen in the mice treated in utero that had not been seen previously in mice treated as newborns. Some of the treated mice were the offspring of mothers bred near mice that had been inoculated previously with polyoma-virus preparations. The incidence of salivary-gland tumors and renal lesions was significantly lower in mice from those mothers that had been indirectly exposed to inoculated animals than in mice from unexposed mothers. A comprehensive morphologic analysis of the tumors indicated interrelated patterns of development and behavior which are unique among murine neoplasms. Initially in organs where tumors developed, epithelial cells hypertrophied, formed intranuclear inclusion bodies, and degenerated. The tumors were composed of hyperplastic epithelial elements and proliferating undifferentiated cells that were limited in their capacity to invade adjacent tissues or metastasize. Some tumors regressed, while other caused death of the animal only by local growth in vital organs.
Effect of Mengo Encephalitis Virus on the Ehrlich Ascites Tumor of the Mouse&lt;xref ref-type="fn" rid="fn1"&gt;2&lt;/xref&gt;
Authors: I KOPROWSKA, H KOPROWSKI
Journal: JNCI Journal of the National Cancer Institute (1953)

Effect of Mengo Encephalitis Virus on the Ehrlich Ascites Tumor of the Mouse Get access Irena Koprowska, Irena Koprowska Search for other works by this author on: Oxford Academic PubMed Google Scholar Hilary Koprowski Hilary Koprowski Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 14, Issue 3, December 1953, Pages 627–643, https://doi.org/10.1093/jnci/14.3.627 Published: 01 December 1953 Article history Received: 26 June 1953 Published: 01 December 1953
The Brain of Newly Hatched Chicks as A Host-Virus System for Biological Studies on the Rous Sarcoma Virus (RSV)&lt;xref ref-type="fn" rid="fn1"&gt;2&lt;/xref&gt;
Authors: V GROUPE, F J RAUSCHER, A S LEVINE, W R BRYAN
Journal: JNCI Journal of the National Cancer Institute (1956)
AB0053 CD20+CD27+CD43+CD70-Cells, Proposed as Human B-1 Cells Are Increased in Systemic Lupus Erythematosus, But Not Correlated with Disease Activity
Authors: S.E. Kang, H.J. Yoo, J.K. Park, T.J. Kim, H.J. Oh, S.H. Joo, J.M. Lee, S.J. Lee, K.R. Kim, E.Y. Lee, E.B. Lee, Y.W. Song
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by the production of multiple autoantibodies by hyperactive B cells. B-1 cells distinguished from conventional B cell, perform a protective role in defending against microbial pathogens by secreting natural antibodies. Recently, human B-1 cells identified phenotypically according to the characterization of murine B-1 cells, were reported to be increased in peripheral blood of SLE patients. <h3>Objectives</h3> The aim of this study is to investigate the frequency of B-1 cells and its correlation with disease activity in SLE. <h3>Methods</h3> Peripheral blood mononuclear cells were isolated from 21 SLE patients and 16 age/sex matched healthy controls. Frequencies of B-1 cells were analyzed by multicolor flow cytometry using antibodies against CD3, CD20, CD27, CD43, and CD70. Phenotype of human B-1 cells was identified by CD3<sup>-</sup>CD20<sup>+</sup>CD27<sup>+</sup>CD43<sup>+</sup>CD70<sup>-</sup>. Correlation of B-1 cell frequency with the disease activity of SLE was analyzed according to anti-dsDNA antibody, complement level, renal involvement, platelets count, white blood cell count, erythrocyte sedimentation rate (ESR), and SLE disease activity index (SLEDAI) score. <h3>Results</h3> Absolute B cell count was significantly decreased in SLE patients compared to healthy controls (mean ± SE: 29813±8096 cells/ml vs. 62593±10465 cells/ml, <i>p</i>=0.002). Frequencies of B-1 cell in total B cells were significantly increased in SLE patients compared to healthy controls (1.86±0.33 vs. 0.79±0.10, <i>p</i>=0.025). SLE patients with anti-dsDNA antibody tended to have higher frequency of B-1 cells than patients without anti-dsDNA antibody (1.92±0.39 vs. 1.77±0.60). However there was no correlation between complement level, renal involvement, platelets count, white blood cell count, ESR, or SLEDAI score and B-1 cell frequency. <h3>Conclusions</h3> The frequencies of B-1 cell were significantly higher in SLE compared to healthy controls. But there was no correlation between disease activity and B-1 cell frequency. <h3>References</h3> Griffin DO, Holodick NE, and Rothstein TL. Human B1 cells in umbilical cord and adult peripheral blood express the novel phenotype CD20<sup>+</sup> CD27<sup>+</sup> CD43<sup>+</sup> CD70<sup>-</sup>. J. Exp. Med 2011;208:67-80. Griffin DO, and Rothstein TL. Human B1 cell frequency: isolation and analysis of human B1 cells. Front. Immunol. 2012;3:122. Tørring C, Petersen CC, Bjerg L, et al. The B1-cell subpopulation is diminished in patients with relapsing-remitting multiple sclerosis. J Neuroimmunol. 2013;262:92-99. <h3>Disclosure of Interest</h3> None declared
Yttrium 90 therapy for hepatocellular carcinoma: Is it any better than conventional external beam radiotherapy?
Authors: Alan Wigg, Margaret Wallington
Journal: Hepatology (2011)

To the Editor: We read with interest the recent article by Sangro et al.,1 but we wish to highlight our concern about the inhomogeneity of the radiation dose associated with the angiographic delivery of yttrium 90 (90Y) microspheres. Although the authors claim that 90Y emits “a tumoricidal dose of beta radiation (100-1000+ Gy), far in excess of the doses delivered safely with external beam radiotherapy, over a finite range,” the biological effects of the absorbed dose on tumorous and normal tissues are not simple functions of this dose. The way in which the dose is given to each subvolume (voxel) determines the overall biological effect on the treated tissues. For example, a single hot spot may cause unacceptable damage, and a cold spot may result in a failure to sterilize the tumor. During the angiographic injection of 90Y microspheres, the spatial distribution of the microspheres is very irregular, and the resulting dose distribution is highly heterogeneous.2 Furthermore, the biologically effective dose is even more heterogeneous because of the effect of changing the dose rate.3 Therefore, although the overall mean dose distribution may appear satisfactory at a microscopic level, the dose may be highly inhomogeneous, and there may be a considerable risk of small cold spots. Conventional external beam radiotherapy (EBRT) should also be considered in the context of advanced hepatocellular carcinoma (HCC). EBRT for HCC has significantly advanced in recent years because of improved three-dimensional conformal techniques and improved knowledge of radiation dose–volume relationships.4 The efficacy and safety of EBRT for advanced HCC have been suggested by a large number of nonrandomized studies.5 In these studies, EBRT has usually been combined with transarterial chemoembolization for Child A/B patients and has been applied to the tumor thrombus or the primary tumor. Promising nonrandomized data have prompted many calls for randomized studies. Other advantages of EBRT (the dose uniformity, accessibility, cost, noninvasiveness, and outpatient basis) also encourage such studies. The obvious methodological problems of Sangro et al.'s study1 (the retrospective analysis and the lack of a control group or randomization) are further concerns, and although the difficulty of randomized controlled trials in this setting is acknowledged, such evidence is essential before the use of 90Y radioembolization can be recommended outside clinical trials. The importance of such trials needs to be highlighted because of the association of 90Y radioembolization with significant costs and harm (including death, as described in this study), the concerns about radiation dose inhomogeneity, and the availability of alternative methods of radiotherapy. Alan Wigg M.D. Margaret Wallington M.D. * Hepatology and Liver Transplant Medicine Unit, Flinders Medical Centre, Adelaide, South Australia, Australia.
Current Perspectives on Lymphatic Mapping in Carcinomas of the Uterine Corpus and Cervix
Authors: Robert L. Coleman, Michael Frumovitz, Charles F. Levenback
Journal: Journal of the National Comprehensive Cancer Network (2006)

Lymphatic mapping and sentinel node identification are rapidly becoming the standard of care in managing many malignancies. These procedures have allowed focused evaluation of relevant regional lymphatics, which has led not only to improved precision of nodal pathology, but also to treatment triage and the potential for reduced postoperative morbidity. Given its clinical potential, new cancer primary sites are being evaluated, including those of the female genital tract. Of these, carcinoma of the vulva seems the most apposite; however, it is a rare malignancy and therefore large randomized treatment trials based on sentinel node triage are difficult to perform. Cancers of the uterus–cervix and corpus are more common. Because the physiologic lymphatic drainage from this organ is ambiguous, principle lymphatic basins are located in many different anatomic locales, making sentinel node identification precarious, yet highly relevant and informative. Current experience in carcinoma of the cervix suggests the concept is feasible. A consensus in corpus cancer has not been reached, although both sites are of keen interest with the increasing use of laparoscopy in surgical management. Prospective multi-institutional validation studies are underway.
PTH-258 Effect of opioid medication use on outcome of sacral neuromodulation in patients with slow transit constipation
Authors: SJ Morris, KS Chapple
Journal: Gut (2015)

<h3>Introduction</h3> Sacral Nerve Stimulation (SNM) is an accepted treatment in patients with slow transit constipation (STC). Opioid medication use (which is recognised to prolong colonic transit) is often seen in patients with STC. Whether concurrent use of opioids affects the success, or otherwise, of patients undergoing SNM has not been previously investigated. <h3>Method</h3> All patients with STC undergoing SNM in a 9 year period within a single centre were identified. Patients prescribed two or more opioid drugs at the time of temporary SNM trial were defined as opioid-users. Outcome of the temporary SNM trial and subsequent permanent SNM implantation was determined. <h3>Results</h3> 32 patients (30 female, 2 male; median age [range] 50 [21–70] years) with STC underwent temporary SNM trial. 12/32 [38%] patients were opioid users and 20/32 (62%) patients non-opioid users. Overall, 20/32 (63%) patients had a successful temporary SNM trial. There was no difference in outcome of temporary SNM trial between opioid- or non-opioid users (successful outcome in 6/12 [50%] opioid-users, 14/20 (70%) non-opioid users; <i>P = 0</i>.29, Fishers exact test). 15/20 patients who underwent successful temporary SNM trial progressed to permanent SNM implantation, of which 8/15 (53%) had a successful outcome. There was no difference in outcome of permanent SNM between opioid- or non-opioid users (successful outcome in 3/5 [60%] opioid-users, 8/10 (80%) non-opioid users; <i>P = </i>0.56, Fishers exact test). <h3>Conclusion</h3> Concurrent use of opioid medication in patients with STC does not affect the success rate of either temporary or permanent SNM. <h3>Disclosure of interest</h3> None Declared.
SAT0272 Increased Risk of Vascular Mortality in Axial Spondyloarthritis
Authors: N. Nigil Haroon, M.J. Paterson, P. Li, R.D. Inman, N. Haroon
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Patients with axial spondyloarthritis (AxSpA) are thought to be at increased risk of cardiovascular disease but it is unknown if they have excess vascular mortality. Ontario has 13.5 million residents and aproximately 25,000 patients with prevalent AxSpA. Provincial health databases provide a richource of reliable information to conduct studies on mortality risk in AxSpA. <h3>Objectives</h3> To assess the risk of vascular mortality in AxSpA. To identify the predictive factors of vascular mortlaity in AS. <h3>Methods</h3> We performed a population-based, retrospective cohort study on incident AxSpA patients, age 15 or above, living in Ontario, Canada between April 1995 and March 2011. There were 21,878 SpA cases and 87,504 controls (matched for age, gender and socioeconomic status). The primary outcome was a composite event of cardiovascular or cerebrovascular deaths coded as the primary cause on death certificates. Cox proportional hazards model was used to estimate differences in vascular mortality between cases and controls. Crude and adjusted hazard ratios (HR) were calculated and adjustments were made for coronary and cerebrovascular disease (CAD, CVD), cancer, diabetes, dementia, inflammatory bowel disease, hypertension, chronic kidney disease (CKD) and peripheral vascular disease (PVD). Risk factors for vascular mortality were identified in the SpA cohort. <h3>Results</h3> In the AxSpA cohort 53% were male, with a mean age of 46±16 years, and a follow-up of 169,307 patient-years. Follow-up for controls was 692,499 patient-years. Crude and adjusted HR (95%CI) for vascular deaths were 1.49 (1.26-1.77) and 1.36 (1.14-1.63) respectively, indicating a 36-49% higher risk of vascular mortality in AS. Crude HR (95%CI) in males and females were 1.63 (1.31-2.03) and 1.31 (1.00-1.71) respectively. Cases and controls had similar prevalence of CAD, CVD, PVD, dementia and diabetes, but IBD (6% <i>vs</i> 4%), hypertension (24% <i>vs</i> 18%) and CKD (2% <i>vs</i> 0.8%) were more common in SpA (Figure 1). The predictors of vascular death were CAD and CVD but also included age, male sex, low income, CKD and PVD. <h3>Conclusions</h3> AxSpA is associated with significant risk of vascular mortality. These new findings should prompt a comprehensive strategy to screen and treat modifiable vascular risk factors in addition to optimal control of disease activity in AxSpA patients. <h3>Disclosure of Interest</h3> None declared
Glucocorticoids may increase risk of serious blood infection
Authors: Jacqui Wise
Journal: BMJ (2016)

Current users of systemic glucocorticoids experienced 2.5 times higher odds of infection with Staphylococcus aureus bacteria than non-users, a Danish study published in Mayo Clinic Proceedings has found.1

Glucocorticoids are potent immunosuppressive drugs used widely in treating acute and chronic conditions across almost all clinical specialties.

The researchers used medical registries in northern Denmark to analyse …
The Management of Cerebrovascular Disease.
Journal: Annals of Internal Medicine (1969)

crease in the amount of published information on cerebrovascular disease. He is able, in this small volume, to summarize admirably the important advances in the pathophysiology and management of stroke. He utilizes the current classification of cerebrovascular accidents, which includes the completed stroke, the evolving stroke, and the transient ischemic attack. The clinical section deals, in detail, with these three varieties and with the physical findings which may be used to distinguish among them. Particular attention is paid to the transient ischemic attack, for this provides warning of cerebrovascular disease before permanent neurological damage has occurred. The present concepts of the pathophysiology of stroke are well discussed in the section on pathology, written by Drs. T. Crawford and M. R. Crompton. They give an excellent review of the neurovascular pathology of the three major subtypes. Dr. Marshall, emphasizing that cerebral arteriography has come to play a more and more important part in the diagnosis of cerebrovas¬ cular disease, devoted a chapter to the techniques in common use, and the hazards and advantages of each. Because anticoagulants are
A Case of Diabetes Mellitus
Authors: Gerard N. Burrow, Barbara E. Hazlett, M. James Phillips
Journal: New England Journal of Medicine (1982)

A 27-year-old diabetic man was admitted to the Toronto General Hospital in severe ketoacidosis after five days of nausea and vomiting.The patient had had diabetes mellitus for 15 years and had been admitted to the Toronto General Hospital on five previous occasions for control of his disease — once in ketoacidosis and once with severe hypoglycemia.Six days before the most recent admission, he had joint pains, followed by anorexia, nausea, and vomiting. He was unable to retain food or liquids and had decreased his insulin dose from 80 to 40 units in four divided doses daily. He became . . .