tbuckley/cabot-search huggingface dataset:
Preoperative Testing in Patients Undergoing Cataract Surgery
Authors: Catherine L Chen, Adrian W Gelb, R Adams Dudley
Journal: New England Journal of Medicine (2015)

the range observed in the general population. 4 Thus far, data from more than 2000 propranolol-treated infants in clinical studies and a compassionate-use program in France have been reassuring, but we agree that there is a need for large studies assessing longer-term outcomes.To date, propranolol is by far the best-studied beta-blocker in infants.We believe that any assessment of its benefits and potential risks should take into account that the efficacy and safety profiles of alternative drugs used for this condition are not as well documented.
Real-world efficacy of epoetin zeta for chemotherapy-induced anemia in patients with solid tumors: A sub-analysis of the SYNERGY study.
Authors: Florian Scotte, Christian Gisselbrecht, Kamel Laribi, Isabelle Laure Ray-Coquard, Emna Kasdaghli, Dominique Spaeth
Journal: Journal of Clinical Oncology (2016)

e21614 Background: The management of chemotherapy-induced anemia (CIA) by erythropoiesis-stimulating agents is well established, with EU and US guidelines advising their use to reduce red blood cell transfusions and improve quality of life. The SYNERGY study investigated the use of epoetin zeta (Retacrit, Hospira, a Pfizer company) in current clinical practice in France. Methods: This observational, longitudinal, prospective, multicenter study was conducted in France, from a representative, random sample of oncologists and hematologists. The primary aim was to assess anemia response to epoetin zeta with and without iron supplementation; secondary objectives included current practice in management of CIA, monitoring of iron status and iron supplementation. The study included adults with CIA, with solid tumors or hematological malignancies, eligible for treatment with epoetin zeta, followed up at 12–16 weeks. Results: Most patients had solid tumors (79.8%; 1657/2076). Common types included breast, lung, colorectal and pancreatic cancers. Patients with solid tumors had a median age of 68.0 years (44% ≥70); the breast cancer patient sub-group had a median age of 61.5 years (28.6% ≥70). Most patients were having chemotherapy for metastases (72.1%). Median hemoglobin at inclusion was 9.7 g/dL. Response rates to epoetin zeta varied between tumor types (Table). Iron supplementation did not significantly affect the response, though there was a trend for improvement of fatigue with iron supplementation of epoetin zeta in breast cancer patients. Conclusions: Epoetin zeta is effective and well tolerated for treating CIA, regardless of solid tumor type. Iron supplementation did not appear to affect anemia response in this population, possibly due to patients without iron deficiency, who are less likely to benefit from iron supplementation, comprising part of the study. Clinical trial information: NCT02158169. Anemia response (%) Improvement of fatigue (%) No iron Iron p No iron Iron p All solid tumors (N=1657) 67.6 70.1 0.308 55.0 56.8 0.520 Breast (N=238) 71.1 77.3 0.315 63.6 76.4 0.059 Lung (N=334) 60.1 63.4 0.574 52.0 45.5 0.283 Colorectal (N=233) 75.0 77.1 0.728 61.5 56.8 0.501 Pancreatic (N=166) 77.2 73.1 0.582 52.9 50.0 0.743
Results of a multicenter pilot study of weekly nab-paclitaxel, carboplatin with bevacizumab, and trastuzumab as neoadjuvant therapy in HER2+ locally advanced breast cancer with SPARC correlatives
Authors: D. A. Yardley, E. Raefsky, R. Castillo, A. Lahiry, R. LoCicero, D. Thompson, M. Shastry, V. Trieu, D. Knauer, N. Desai
Journal: Journal of Clinical Oncology (2009)

527 Background: The addition of targeted therapies to standard chemotherapy has resulted in improved outcomes in metastatic, neoadjuvant and early stage breast cancer. A phase III study in MBC demonstrated improved efficacy with nab paclitaxel (nab-P) compared with standard solvent-based paclitaxel. The secreted protein acidic rich in cysteine (SPARC) is a poor prognostic factor for survival and may mediate enhanced intratumoral accumulation of nab-P via an interaction with albumin. This multicenter phase II pilot study was designed to evaluate the feasibility, safety, and preliminary efficacy of dual VEGF and HER-2 monoclonal antibodies of bevacizumab (B) and trastuzumab (T) administered in with neoadjuvant nab-P and carboplatin (C) with SPARC tumor correlatives. Methods: Eligibility: clinical T1c-T4d and/or N0–3, M0 (T1N0M0 excluded) chemo naive, ECOG PS 0–2, normal LVEF, adequate organ function. Treatment: nab-P 125 mg/m 2 D1, 8, 15 with C AUC 6 D1 q28 days plus T 4 mg/kg load followed by 2 mg/kg/wk and B 5 mg/kg/wk x 6 cycles followed by surgery. Post surgery T and B continued for 52 wks. SPARC tumor expression was measured by immunohistochemistry. Results: 29 pts are enrolled and evaluable for safety. Median age: 52 years (29–76), ECOG PS 0–93%, median tumor size 3.2 cm, 54% ER-/PR-, 72% node positive. G3/4 neutropenia was 38% with no febrile neutropenia. Nonheme toxicity: G3/4 hyperglycemia 10%, proteinuria and hypertension, each in 7%. 8 pts were hospitalized (infection-4, ↓LVEF-1, wound dehiscence-1 pt, other-2). 5 pts did not complete neoadjuvant therapy (↓LVEF-1, noncompliance-1, pt request-3) and 10 pts did not complete post op therapy ((pt request-2, toxicity-3, wound-2, unk-3). Pathologic responses are available for 20 pts. pCR was noted in 13/20 pts (65%) and PR was noted in 7/20 pts (35%). 77% of the pCR pts (10/13) and 86% of the PR pts (6/7) were positive for SPARC. Conclusions: Neoadjuvant B, T with nab-P and C is feasible and highly active with a remarkable pCR of 65%. SPARC tumor correlations with pathologic response data reveal a concordance between the high response rate and high incidence of SPARC positivity. [Table: see text]
Acute Poisonings from Synthetic Cannabinoids — 50 U.S. Toxicology Investigators Consortium Registry Sites, 2010–2015
Authors: Anne M. Riederer, Sharan L. Campleman, Robert G. Carlson, Edward W. Boyer, Alex F. Manini, Paul M. Wax, Jeffrey A. Brent
Journal: MMWR Morbidity and Mortality Weekly Report (2016)

Recent reports suggest that acute intoxications by synthetic cannabinoids are increasing in the United States (1,2). Synthetic cannabinoids, which were research compounds in the 1980s, are now produced overseas; the first shipment recognized to contain synthetic cannabinoids was seized at a U.S. border in 2008 (3). Fifteen synthetic cannabinoids are Schedule I controlled substances (3), but enforcement is hampered by the continual introduction of new chemical compounds (1,3). Studies of synthetic cannabinoids indicate higher cannabinoid receptor binding affinities, effects two to 100 times more potent than Δ(9)-tetrahydrocannabinol (the principal psychoactive constituent of cannabis), noncannabinoid receptor binding, and genotoxicity (4,5). Acute synthetic cannabinoid exposure reportedly causes a range of mild to severe neuropsychiatric, cardiovascular, renal, and other effects (4,6,7); chronic use might lead to psychosis (6,8). During 2010-2015, physicians in the Toxicology Investigators Consortium (ToxIC) treated 456 patients for synthetic cannabinoid intoxications; 277 of the 456 patients reported synthetic cannabinoids as the sole toxicologic agent. Among these 277 patients, the most common clinical signs of intoxication were neurologic (agitation, central nervous system depression/coma, and delirium/toxic psychosis). Relative to all cases logged by 50 different sites in the ToxIC Case Registry, there was a statistically significant association between reporting year and the annual proportion of synthetic cannabinoid cases. In 2015, reported cases of synthetic cannabinoid intoxication increased at several ToxIC sites, corroborating reported upward trends in the numbers of such cases (1,2) and underscoring the need for prevention.
Regulating psychiatric practice
Authors: P R Fleischman
Journal: American Journal of Psychiatry (1977)

The trend toward increased regulation of psychiatry and medicine may alleviate some problems but increase others. Some models of practice may achieve monolithic dominance, and maldistribution of practitioners may increase. Covert fantasies about authority, leadership, and peer relations should be borne in mind in the attempt to create an informed, improved regulation of medical practice.
Assessing Therapeutic Potential of Magnetic Mesoporous Nanoassemblies for Chemo-Resistant Tumors
Authors: Lina Pradhan, Bhushan Thakur, Rohit Srivastava, Pritha Ray, Dhirendra Bahadur
Journal: Theranostics (2016)

Smart drug delivery system with strategic drug distribution is the future state-of-the-art treatment for any malignancy. To investigate therapeutic potential of such nanoparticle mediated delivery system, we examined the efficacy of dual drug-loaded, pH and thermo liable lipid coated mesoporous iron oxide-based magnetic nanoassemblies (DOX:TXL-LMMNA) in mice bearing both drug sensitive (A2780(S)) and drug resistant (A2780-CisR) ovarian cancer tumor xenografts. In presence of an external AC magnetic field (ACMF), DOX:TXL-LMMNA particles disintegrate to release encapsulated drug due to hyperthermic temperatures (41-45 ºC). In vivo bio distribution study utilizing the optical and magnetic properties of DOX:TXL-LMMNA particles demonstrated minimum organ specific toxicity. Noninvasive bioluminescence imaging of mice bearing A2780(S) tumors and administered with DOX-TXL-LMMNA followed by the application of ACMF revealed 65% less luminescence signal and 80% mice showed complete tumor regression within eight days. A six months follow-up study revealed absence of relapse in 70% of the mice. Interestingly, the A2780-CisR tumors which did not respond to drug alone (DOX:TXL) showed 80% reduction in luminescence and tumor volume with DOX:TXL-LMMNA after thermo-chemotherapy within eight days. Cytotoxic effect of DOX:TXL-LMMNA particles was more pronounced in A2780-CisR cells than in their sensitive counterpart. Thus these novel stimuli sensitive nanoassemblies hold great promise for therapy resistant malignancies and future clinical applications.
Soundings: Look east
Authors: Trisha Greenhalgh
Journal: BMJ (2004)

I've been in Tokyo, the guest of a thousand Oriental dentists. For some years now, an enthusiast for my work has been translating my books into Japanese. A sophisticated marketing strategy has ensured that I am, in the words of one of the publisher's employees, a “very famous and honourable person in our country.”

The car they sent to pick me up at the airport was large, black, and lined with white lace. I tried to open the thick smoked-glass windows, but the uniformed driver motioned me to leave them closed. Was I really so famous that someone might try to shoot me?

The hotel occupied the top 20 floors of a breathtakingly modern skyscraper development. In-room technologies ranged from wireless internet to an electronic bidet with programmable temperature and jet speed. Also available were traditional Japanese comforts such as origami ornaments, foot massage, and green tea delivered by two women walking on their knees.

The opening conference ceremony featured a dozen celebrity professors in kimonos bashing a crate of sake (pronounced sar'kay) with wooden hammers. They had all been placed on the top table. It turned out I wasn't famous at all, except among a small group of off-beat academics who identify with my fringe ideas and irreverent style. Just like in Britain, then.

I delivered my lectures and fielded questions through two flawless simultaneous interpreters: one processing English into Japanese and the other (through a tiny gadget they had fixed behind my left ear) Japanese into English. In parallel sessions at the same conference, different translation teams were working variously to link delegates with Chinese, Burmese, German, and Dutch speakers.

Later, I was escorted to an exclusive shopping mall packed with boutiques called Tiffany, La Mode, and such like, and handed a delicately patterned envelope containing a generous gratuity. My host supervised while I exchanged my crisp bank notes for parcels of luxury goods.

The six pillars of Japanese success? (1) Benchmark quality. (2) Capture ideas globally. (3) Reinvest locally. (4) Blend the old with the new. (5) Don't expect something for nothing. (6) Develop machines that can do the dirty jobs efficiently.
Single-duct nipple discharge: How concerned should we be?
Authors: Michelle E. Allan, Simon Thomson, Sanjay Zumberlal Baldota
Journal: Journal of Clinical Oncology (2012)

58 Background: Nipple discharge has a known association with breast cancer, but determining which cases to identify as being at high risk is a complex and controversial task for the clinician. The current policy at West Hertfordshire Hospitals Trust is to offer microdochectomies to all women who present with unilateral single duct discharge, dominant duct discharge or persistent duct discharge and negative cytology and pre-operative imaging. The aim of this study is to determine if a more discriminative approach might be applied to women who present with nipple discharge. Methods: All patients who underwent a microdochectomy over a 4-year period (2006-2011) were assessed. Patient demographics, characteristics, presenting complaint, pre-operative imaging, and pathology results were analysed. Results: Of the 122 patients analysed in this study, only 7 (5.74%) were diagnosed with malignant carcinoma: 4 patients had DCIS; 3 patients had DCIS and IDC. Of these, 2 had bloodstained nipple discharge. Another two women were diagnosed with papillary carcinoma; only one of them presented with bloodstained nipple discharge, although both had single duct discharge only. 42 cases of mammary duct ectasia (34.43%) and 52 cases of papilloma (42.62%) were found. All women with malignant diagnoses were over the age of 55. Although 47 women (38.52%) presented with a history of blood-stained discharge, only 17 of this cohort (36.17%) had positive cytology – one of whom was diagnosed with multifocal intermediate-grade DCIS. The other 16 women were diagnosed with papillomas, duct ectasia, and benign breast disease. Of those 30 women who presented with a history of bloodstained discharge and had negative cytology, only two were diagnosed with carcinoma (DCIS + IDC and papillary Ca); of those 17 with no recorded bloodstained discharge but positive cytology there were no malignant diagnoses. Conclusions: Microdochectomy performed for nipple discharge results in a low rate of malignancy on excision. Our results from this study correspond with other microdochectomy series. It would appear that a cytological diagnosis is an equivocal discriminator for cancer at best. Further work on a prospective study will help to differentiate patient groups who would most benefit from surgical intervention.
Comprehensive Audiometric Analysis of Hearing Impairment and Tinnitus After Cisplatin-Based Chemotherapy in Survivors of Adult-Onset Cancer
Authors: Robert D. Frisina, Heather E. Wheeler, Sophie D. Fossa, Sarah L. Kerns, Chunkit Fung, Howard D. Sesso, Patrick O. Monahan, Darren R. Feldman, Robert Hamilton, David J. Vaughn, Clair J. Beard, Amy Budnick, Eileen M. Johnson, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, Steven E. Lipshultz, M. Eileen Dolan, Lois B. Travis
Journal: Journal of Clinical Oncology (2016)

Purpose Cisplatin is widely used but highly ototoxic. Effects of cumulative cisplatin dose on hearing loss have not been comprehensively evaluated in survivors of adult-onset cancer. Patients and Methods Comprehensive audiological measures were conducted on 488 North American male germ cell tumor (GCT) survivors in relation to cumulative cisplatin dose, including audiograms (0.25 to 12 kHz), tests of middle ear function, and tinnitus. American Speech-Language-Hearing Association criteria defined hearing loss severity. The geometric mean of hearing thresholds (0.25 to 12 kHz) summarized overall hearing status consistent with audiometric guidelines. Patients were sorted into quartiles of hearing thresholds of age- and sex-matched controls. Results Increasing cumulative cisplatin dose (median, 400 mg/m 2 ; range, 200 to 800 mg/m 2 ) was significantly related to hearing loss at 4, 6, 8, 10, and 12 kHz (P trends, .021 to &lt; .001): every 100 mg/m 2 increase resulted in a 3.2-dB impairment in age-adjusted overall hearing threshold (4 to 12 kHz; P &lt; .001). Cumulative cisplatin doses &gt; 300 mg/m 2 were associated with greater American Speech-Language-Hearing Association–defined hearing loss severity (odds ratio, 1.59; P = .0066) and worse normative-matched quartiles (odds ratio, 1.33; P = .093) compared with smaller doses. Almost one in five (18%) patients had severe to profound hearing loss. Tinnitus (40% patients) was significantly correlated with reduced hearing at each frequency (P &lt; .001). Noise-induced damage (10% patients) was unaffected by cisplatin dose (P = .59). Hypertension was significantly related (P = .0066) to overall hearing threshold (4 to 12 kHz) in age- and cisplatin dose–adjusted analyses. Middle ear deficits occurred in 22.3% of patients but, as expected, were not related to cytotoxic drug dosage. Conclusion Follow-up of adult-onset cancer survivors given cisplatin should include routine inquiry for hearing status and tinnitus, referral to audiologists as clinically indicated, and hypertension control. Patients should be urged to avoid noise exposure, ototoxic drugs, and other factors that further damage hearing.
Absence of carbamazepine-induced hyponatremia among patients also given lithium
Authors: V Vieweg, J L Glick, S Herring, R Kerler, L S Godleski, J Barber, G Yank, W Spradlin
Journal: American Journal of Psychiatry (1987)

Of 33 chronically psychotic patients in a state hospital, 17 received carbamazepine, 13 received carbamazepine and lithium, and three received carbamazepine and then the combination. There was a significant difference in serum sodium level between the patients receiving carbamazepine alone (mean +/- SD = 138.4 +/- 4.3 meq/liter) and those also receiving lithium (141.8 +/- 1.6 meq/liter). (A similar difference was seen for the patients who received the two treatments serially.) Age, sex, diagnosis, age at diagnosis, seizure disorder, antipsychotic drugs, and serum carbamazepine level did not explain this difference. The protection against hyponatremia provided by the carbamazepine-lithium combination occurred despite lithium's tendency to increase polyuria.
MYD88 L265P Mutations Influence Clinical Outcome and Identify a Pathway for Targeted Inhibition in Chronic Lymphocytic Leukemia
Authors: Bethany Tesar, Reina Improgo, Josephine L. Klitgaard, Reuma Magori-Cohen, Lijian Yu, Divya Chaudhary, Wenyan Miao, Stacey M. Fernandes, Kevin Hoang, William F Westlin, Haesook T. Kim, Jennifer R. Brown
Journal: Blood (2015)
Hypopigmented Macules on the Face and Neck of a Man
Authors: Laura Calomarde-Rees, Nancy Rivas-Tolosa, Onofre Sanmartín-Jiménez
Journal: JAMA Dermatology (2016)

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P-152 Observational Cohort Study of 1st line Bevacizumab Combined with Chemotherapy in Metastatic Colorectal Cancer (HGCSG0802): Sub-group Analysis by the Glasgow Prognostic Score (GPS)
Authors: T. Miyagishima, S. Yuki, H. Nakatsumi, Y. Kawamoto, T. Muranaka, K. Sawada, Y. Kobayashi, T. Sasaki, M. Nakamura, A. Sato, I. Iwanaga, M. Tateyama, K. Hatanaka, K. Eto, H. Okuda, O. Muto, M. Abe, A. Oba, S. Kato, K. Miyashita, Y. Sakata, Y. Komatsu
Journal: Annals of Oncology (2016)
Allogeneic hematopoietic cell transplantation in patients ⩾70 years: which patients may benefit?
Authors: S P Haen, M Pham, C Faul, D Dörfel, W Vogel, L Kanz, W A Bethge
Journal: Blood Cancer Journal (2016)

Allogeneic hematopoietic cell transplantation in patients  ⩾ 70 years: which patients may benefit?
Drug‐specific CD4<sup>+</sup>T‐cell immune responses are responsible for antituberculosis drug‐induced maculopapular exanthema and drug reaction with eosinophilia and systemic symptoms syndrome
Authors: Y.‐M. Ye, G.‐Y. Hur, S.‐H. Kim, G.‐Y. Ban, Y.‐K. Jee, D.J. Naisbitt, H.‐S. Park, S.‐H. Kim
Journal: British Journal of Dermatology (2016)

BackgroundA multidrug regimen including isoniazid, rifampicin, pyrazinamide and ethambutol is commonly used as first‐line treatment for tuberculosis. However, this regimen can occasionally result in severe adverse drug reactions, such as drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome and drug‐induced liver injury. The culprit drug and mechanistic basis for the hypersensitive reaction are unknown.