tbuckley/cabot-search huggingface dataset:
P1-11-01: Strong Socioeconomic Disparities in Breast Cancer Quality of Care in Switzerland.
Authors: E Rapiti, A Blanc, S Benhamou, H Schubert, G Vlastos, R Schaffar, C Bouchardy
Journal: Cancer Research (2011)

Abstract Background Despite substantial research on socioeconomic disparities in breast cancer prognosis, important gaps remain concerning the causes of over mortality among socially deprived patients. In this population-based study, we identify disparities by socioeconomic status (SES) in diagnosis assessment and management of breast cancer in Geneva, Switzerland, where the average income and the health care system cost are among the highest in the world. Methods We included in the study all 1110 women reported with invasive breast cancer at the Geneva Cancer Registry between 2003 and 2005. SES was regrouped in three levels: low (manual employees, skilled and unskilled workers), middle (nonmanual employees and administrative staff) and high (professionals, executive administrators, entrepreneurs) based on the patient's last occupation or, if unemployed, that of the spouse. We compared patients, tumour, treatment characteristics, surgeon caseload and delay of diagnosis as well as some of the management quality indicators established by the European School of Mastology among SES classes by heterogeneity tests. To assess the independent effect of each factor we used multivariate logistic regression, comparing women of high vs. low SES. Results Compared with patients of high SES, low SES patients were older, more often born outside Switzerland and treated in the public system. Low SES women had less often screen detected cancers (29% vs. 41%; OR multi-adjusted for breast self-examination vs. mammography: 1.7, 95%CI: 1.1−2.6, p=0.020), and less frequently magnetic resonance imaging to assess tumour size/focality (4% vs. 15%; OR multi-adjusted for breast MRI vs. ultrasound: 0.2, 95%CI: 0.1−0.5, p=0.001). They had more often a delay longer than 4 weeks between diagnosis and treatment (53.8% vs. 32.7%; OR multi-adjusted for 4 weeks and more vs. less: 2.6, 95%CI: 1.7−4.1, p&amp;lt;0.000). Also, women of low SES were more frequently operated by surgeons with a lower caseload (&amp;lt;5 new breast cancer operations per year) (55% vs. 30%; OR multi-adjusted for surgeon's caseload of 5–15 vs. &amp;lt;5: 0.4, 95%CI: 0.1−0.9, p=0.020), had more often positive surgical margins (11.4% vs. 5.4%; OR multi-adjusted for negative vs. positive margins: 0.4, 95% CI 0.2−1.0, p=0.057) and lower access to anti-aromatase treatments (29.6% vs. 43.6%). In particular, the probability to receive anastrozole vs. tamoxifen was 70% lower (OR multi-adjusted for anastrozole vs. tamoxifen: 0.3, 95%CI: 0.2−0.6, p&amp;lt;0.000). Conclusions: This study shows strong SES differences all along the continuum of breast cancer management, even in the highly medicalized county of Geneva. Only by improving the quality of care provided to women of low SES we will be able to prevent the excess breast cancer mortality observed among these women. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P1-11-01.
Ingested Nitrate and Breast Cancer in the Spanish Multicase-Control Study on Cancer (MCC-Spain)
Authors: Nadia Espejo-Herrera, Esther Gracia-Lavedan, Marina Pollan, Nuria Aragonés, Elena Boldo, Beatriz Perez-Gomez, Jone M. Altzibar, Pilar Amiano, Ana Jiménez Zabala, Eva Ardanaz, Marcela Guevara, Antonio J. Molina, Juan Pablo Barrio, Ines Gómez-Acebo, Adonina Tardón, Rosana Peiró, Maria Dolores Chirlaque, Margarita Palau, Montse Muñoz, Laia Font-Ribera, Gemma Castaño-Vinyals, Manolis Kogevinas, Cristina M. Villanueva
Journal: Environmental Health Perspectives (2016)

Ingested nitrate leads to endogenous formation of N-nitroso compounds that are breast carcinogens in animals, but human evidence is limited.
AB0686 Can Fatigue BE Used as A Unique Disease Activity Marker in Ankylosing Spondylitis Patients?
Authors: C. Mogosan, C. Zainea, D. Marculescu, A. Radulescu, C. Codreanu
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> Fatigue is a major symptom in ankylosing spondylitis (AS). Clinical trials revealed its correlation with mental health and disease activity [1]. <h3>Objectives</h3> Evaluation of fatigue in relation with efficacy parameters in a population of AS patients treated with biologics in outpatient care. <h3>Methods</h3> Cross – sectional study over a sample of 55 patients. Data were gathered from the medical files of the patients (outpatient department). <h3>Results</h3> 55 patients with AS, treated with biologics, with a mean age of 43.78 yrs (±11.11), 67.3% males, 80% living in urban areas, 65.5% profesionally active, with mean AS duration of 12.24yrs (±9.48), 72.7% having peripheral arthritis. Mean duration of the TNF-alfa blockers therapy was 3.42yrs (±1.44), and the persistance time on a certain biological product was 2.13 yrs (±1.18). 45.5% of the AS patients were treated with etanercept, 30.9% infliximab, and 23.6% adalimumab. After 2 years of unchanged biological treatment, mean BASDAI score was 1.68 (±2.13), mean ASDAS score was 1.71 (±1.20). Mean ESR 17.75 (±14.95), mean CRP 9.47 (±18.59); self reporting BASDAI domains, common to ASDAS domains, on visual analog scale (VAS) were: back pain =23.27 (±26.80); peripheral pain =9.64 (±21.34); vertebral stiffness =19.45 (±25.19). Patient global-health (GH) evaluation (on a 0-10 VAS) was 2.50 (±2.59) and fatigue score was 22.55 (±27.90). There were no associations between demography characteristics, disease type, the biological product and the treatment efficacy. BASDAI has a a significant positive correlation with ESR (r =0.5, p&lt;0.01), CRP (r =0.6, p&lt;0.01) and ASDAS (r =0.9, p&lt;0.01) and a negative association with treatment duration (r = - 0.4, p&lt;0.01). Linear regression revealed that the most predictive parameter of BASDAI domains for CRP and ESR was fatigue (B=0.4, Rsquare =0.32, p&lt;0.01, CI95%: 0.23-0.53). We proceeded into insert fatigue (from BASDAI) on GH place in a <i>modified AS DAS score.</i> The results were calculated using the standardized formula. Mean <i>modified AS-DAS</i> score was 1.68 (±1.23). There was a high significant positive association between <i>modified AS-DAS</i> and BASDAI (r =0.88, p&lt;0.001), as well as with classic AS-DAS (r =0.99, p&lt;0.001). BASDAI and <i>modified AS-DAS</i> have a reciprocal highly prediction value (B =1.53, R square =0.8, p&lt;0.001, CI 95%:1.31-1.75). <h3>Conclusions</h3> Cantitative evaluation of self-reporting fatigue (rapid and cheap test) can be used as a unique marker of disease activity, being a usefull tool in monitoring AS patients. <h3>References</h3> Dagfinrud H, Vollestad NK, Loge JH et all Fatigue in patients with ankylosing spondylitis: A comparison with the general population and associations with clinical and self-reported measures. Arthritis Rheum. 2005 Feb 15;53(1):5-11 <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.4767
A randomized phase III trial comparing S-1 versus UFT as adjuvant chemotherapy for stage II/III rectal cancer (JFMC35-C1: ACTS-RC)
Authors: E. Oki, A. Murata, K. Yoshida, K. Maeda, K. Ikejiri, Y. Munemoto, K. Sasaki, C. Matsuda, M. Kotake, T. Suenaga, H. Matsuda, Y. Emi, Y. Kakeji, H. Baba, C. Hamada, S. Saji, Y. Maehara
Journal: Annals of Oncology (2016)

Preventing distant recurrence and achieving local control are important challenges in rectal cancer treatment, and use of adjuvant chemotherapy has been studied. However, no phase III study comparing adjuvant chemotherapy regimens for rectal cancer has demonstrated superiority of a specific regimen. We therefore conducted a phase III study to evaluate the superiority of S-1 to tegafur-uracil (UFT), a standard adjuvant chemotherapy regimen for curatively resected stage II/III rectal cancer in Japan, in the adjuvant setting for rectal cancer.The ACTS-RC trial was an open-label, randomized, phase III superiority trial conducted at 222 sites in Japan. Patients aged 20-80 with stage II/III rectal cancer undergoing curative surgery without preoperative therapy were randomly assigned to receive UFT (500-600 mg/day on days 1-5, followed by 2 days rest) or S-1 (80-120 mg/day on days 1-28, followed by 14 days rest) for 1 year. The primary end point was relapse-free survival (RFS), and the secondary end points were overall survival and adverse events.In total, 961 patients were enrolled from April 2006 to March 2009. The primary analysis was conducted in 480 assigned to receive UFT and 479 assigned to receive S-1. Five-year RFS was 61.7% [95% confidence interval (CI) 57.1% to 65.9%] for UFT and 66.4% (95% CI 61.9% to 70.5%) for S-1 [P = 0.0165, hazard ratio (HR): 0.77, 95% CI 0.63-0.96]. Five-year survival was 80.2% (95% CI 76.3% to 83.5%) for UFT and 82.0% (95% CI 78.3% to 85.2%) for S-1. The main grade 3 or higher adverse events were increased alanine aminotransferase and diarrhea (each 2.3%) in the UFT arm and anorexia, diarrhea (each 2.6%), and fatigue (2.1%) in the S-1 arm.One-year S-1 treatment is superior to UFT with respect to RFS and has therefore become a standard adjuvant chemotherapy regimen for stage II/III rectal cancer following curative resection.
Abstract 5350: Enhancer of zeste homolog 2 (EZH2) promotes progression of cholangiocarcinoma by regulating cell cycle and apoptosis.
Authors: Shigeki Nakagawa, Hirohisa Okabe, Yasuo Sakamoto, Hiromitsu Hayashi, Daisuke Hashimoto, Hideyuki Kuroki, Katsunori Imai, Hidetoshi Nitta, Akira Chikamoto, Masayuki Watanabe, Toru Beppu, Hideo Baba
Journal: Cancer Research (2013)

Abstract Background: Enhancer of zeste homolog 2 (EZH2) is a catalytic subunit of the polycomb repressive complex 2 (PRC2). When present in PRC2, EZH2 catalyzes trimethylation on lysine 27 residue of histone H3(H3K27Me3), resulting in epigenetic silencing of gene expression and cancer progression. Here, we investigated the expression and the function of EZH2 in intrahepatic and extrahepatic cholangiocarcinoma (ICC and ECC). Methods: The influence of EZH2 on cell growth and apoptosis was assessed by knockdown experiments using siRNA in cholangiocarcinoma cell lines, RBE and TFK-1. Target genes of EZH2 in cholangiocarcinoma cell lines were searched by real time PCR. The clinical significance of EZH2 in 84 cholangiocarcinoma patients (ICC and ECC in 45 and 41, respectively) who underwent a curative surgery was examined by immunohistochemistry. Results: In vitro analysis, a knockdown of EZH2 reduced cell growth and induced G1 arrest, and induced apoptosis confirmed by Annexin V staining and increasing sub-G1 population of two cholangiocarcinoma cell lines. Moreover, a knockdown of EZH2 increased the expression of p16INK4A and p27KIP1, in real time PCR. In immunohistochemical study, The upregulation of EZH2 was correlated with tumor diameter (P = 0.0103) in ICC, lymph node metastasis (P=0.0292) in ECC, and Ki67 index in both ICC (P=0.0364) and ECC (P=0.0017). In addition, EZH2 expression was correlated with the poor prognosis in both ICC (P=0.0447) and ECC (P=0.0227). Conclusion: The current study demonstrates that the high expression of EZH2 results in acceleration of cell cycle and anti-apoptosis in vitro analysis, and is related to poor prognosis in patients with ICC or ECC by IHC study. These results suggest that EZH2 is a potential target for cholangiocarcinoma therapeutics. Citation Format: Shigeki Nakagawa, Hirohisa Okabe, Yasuo Sakamoto, Hiromitsu Hayashi, Daisuke Hashimoto, Hideyuki Kuroki, Katsunori Imai, Hidetoshi Nitta, Akira Chikamoto, Masayuki Watanabe, Toru Beppu, Hideo Baba. Enhancer of zeste homolog 2 (EZH2) promotes progression of cholangiocarcinoma by regulating cell cycle and apoptosis. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 5350. doi:10.1158/1538-7445.AM2013-5350
AB0308 Delay in referral and diagnosis of rheumatoid arthritis in a community medical center in japan
Authors: M. Kimura, K. Yoshida, H. Oshikawa, T. Kobayashi, H. Nakano, M. Utsunomiya, M. Kishimoto, K. Matsui
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Much emphasis has been placed on early diagnosis and treatment of rheumatoid arthritis (RA)<sup>1</sup>. In order to achieve the better outcome, the timing of referral and diagnosis of early arthritis should be optimized<sup>2</sup>. <h3>Objectives</h3> To examine the time to referral of patients with early arthritis, and diagnosis delay of RA in a rural community medical center in Japan. <h3>Methods</h3> A total of 296 who visited Kameda Medical Center from January 2009 to December 2010 with at least one swelling joint without any previous treatment were included. In the patients diagnosed as RA, the time intervals from the onset of symptom to primary care physician (PCP) (patient delay), from PCP referral to a rheumatologist (PCP delay), from the onset of symptoms to rheumatology visit (total delay) were determined. <h3>Results</h3> Ninety-four patients were diagnosed as having RA. The median patient, PCP, total delays [interquartile range [IQR]] were 8.8 weeks [3.4-30.1], 5 weeks [1.9-20.1], 26.9 weeks [10.9-69.4] respectively. The patient delay was significantly longer than PCP delay (p=0.046). Twenty-seven (29%) RA patients were assessed within 12 weeks from onset. At baseline, these patients had less bone erosion on radiograph, as compared with those assessed after≥12 weeks (7% vs 30%, p=0.03). <h3>Conclusions</h3> In a rural community medical center in Japan, the patient delay is longer than the PCP delay, which is comparable to earlier reports from Europe<sup>3</sup>. This study indicates the key delay in early arthritis diagnosis in Japan. <h3>References</h3> P, et al. Ann Rheum Dis 2002;61:290-7. Van der Linden MP, et al. Arthritis Rheum 2010;62:3537-46. K.Raza, et al. Ann Rheum Dis 2011;70:1822-1825 <h3>Disclosure of Interest</h3> None Declared
Abstract 431: ErbB4 is a novel driver of metastasis and anoikis resistance in Ewing's sarcoma
Authors: Ariadna Mendoza-Naranjo, Daniel H. Wai, Jason E. Farrar, Qingsong Zhu, Priti Mistry, Nikola Lazic, Fernanda Rocha Rojas Ayala, Isabela Werneck da Cunha, Robert J. Arceci, Fernando A. Soares, Timothy J. Triche, Sandra J. Strauss, Poul Hb Sorensen
Journal: Cancer Research (2012)

Abstract Most Ewing family tumor (EFT) related deaths occur as a consequence of metastatic disease. Using high-throughput Affymetrix arrays, and matched primary and metastatic tumor-derived cell line pairs, we have identified ERBB4, a member of the epidermal growth factor receptor (EGFR) family, as a novel driver of metastasis and anoikis resistance in EFTs. Gene expression profiling, mRNA analysis, and immunoblotting revealed a 2 to 4-fold increase in ERBB4 expression in metastatic compared to primary EFT cell lines. SNP profiling failed to show copy number aberrations to explain the increased ErbB4 expression in metastatic cell lines. However, epigenetic mechanisms were found to potentially regulate ERBB4 expression in the paired CHLA-9 primary and in the metastatic/chemoresistant CHLA-10 cell line derived from the same patient. Treatment with 5-aza-2α-deoxycytidine enhanced ErbB4 in CHLA-9 cells, but reduced its expression in CHLA-10, suggesting a potential role for DNA methylation in controlling ERBB4 expression in EFTs. Enhanced protein expression and ErbB4 tyrosine kinase activation were clearly identified in metastatic versus primary cells grown under anchorage independent conditions (as multicellular spheroids), which mimic micrometastases. We next evaluated the clinical relevance of these data using biopsies from EFT patients. We found a direct correlation between ErbB4 expression and reduced disease-free survival (p&amp;lt;0.05), and identified statistically higher ErbB4 expression (p&amp;lt;0.05) in metastatic vs. primary biopsies (80% vs. 56%, respectively). ErbB4 gene knockdown or treatment with the FDA-approved pan-ErbB inhibitor Lapatinib reduced proliferation, blocked cell migration and tumor invasion, and sensitized metastatic/chemoresistant cell lines to EFT standard of care chemotherapeutic drugs. Taken together, our findings identify ErbB4 as a novel driver of metastasis in EFTs. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 431. doi:1538-7445.AM2012-431
LAS PRÓTESIS METÁLICAS CUBIERTAS TRANSMURALES SON LA ESTRATEGIA DOMINANTE PARA EL DRENAJE BILIAR EN LA COLANGIOPANCREATOGRAFÍA ENDOSONOGRÁFICA (CPES)
Authors: I Peñas, N Alcaide, N Alemán, R Sánchez-Ocaña, A Vargas García, F Santos Santamarta, H Núñez, P Gil Simón, C De La Serna Higuera, M Pérez-Miranda
Journal: Endoscopy (2013)

Objetivos: Identificar estrategia dominante de drenaje biliar por CPES. Material y Método: Análisis retrospectivo, datos prospectivos enero-diciembre 2012. CPES en 44 (4.2% CPREs) pacientes (Tabla). Calibre del conducto biliar: 9.1 mm (IQR 6.3 – 15.6) en acceso extrahepático; 5.5 mm (IQR 4.0 – 7.9) en intrahepático. Técnica estandarizada sin needle-knife. Resultados: Éxito técnico, 43 pacientes (97.7%); éxito clínico en 70% (bilirrubina total < 20% del valor basal si ictericia, o resolución síntomas). Complicaciones post-CPES en 6 pacientes (13.6%), 5 leves: sangrado 3, pancreatitis aguda 1, desaturación 1; 1 grave: colecistitis (exitus). Drenaje transpapilar 11 casos (7 anterógrado, 4 rendezvous), 4 combinado transpapilar-transmural y 32 transmural puro (26 Hepaticogastrostomía/yeyunostomía y 10 Coledocoduodenostomía/gastrostomía. Se emplearon stent metálicos cubiertos para drenaje transmural (22 Hanaro; 7 Wallflex), con técnicas de anclaje en 65% (clips, flaps, pig-tails, expansión con balón). Se obtuvieron datos de seguimiento en 35 pacientes. Tras 146 días (SD 141) se registraron disfunciones leves en 5 casos de stent metálico transmural.
When are studies adequate for regulatory purposes? View of one regulated.
Authors: M Bundy
Journal: Environmental Health Perspectives (1981)

The question of adequacy of studies for regulatory purposes has been debated for years. Nine questions need answers to determine adequacy: (1) Does the study deal with a defined problem or a defined segment of it? (2) Do the study data justify the conclusions drawn? (3) Were appropriate statistical analyses used? Is there evidence of bias versus objectivity in the collection or analysis of data? (4) Does the study support, supplement (or complement) or refute information in the literature? Is the study truly new information? (5) Does the study conform to the Interagency Regulatory Liaison Group (IRLG) guidelines for documentation of Epidemiologic Studies? (6) Does the study stand up to peer review? (7) Have other investigators been able to confirm the findings by duplicating the study? (8) Is the study acceptable or can it be made acceptable for publication in a reputable scientific journal? (9) Is the problem of such magnitude or significance that regulation is required? Because there is no such thing as a risk-free environment or absolute safety and there is no definitive "yes" answer to each of the questions, the regulated would hope--yes, insist--that the regulators exercise judgement with great skill in promulgation of rules or regulations. The application of safety factors and the determination of acceptable levels of risk should be social decisions. A discussion of instances where the "regulated" believes that studies have not been adequate, or others habe been ignored, or misinterpreted for regulatory purposes in included.A method of settling controversial questions to eliminate the litigation route is proposed. Judgment which is so often eliminated by regulation needs to find its way back into the regulatory process. The regulated recognize the need for regulations. However, when these regulations are based on less than good scientific judgment, harm will be done to the regulatory process itself in the long run.
AB0503 Suicide and Suicide Attempts in A Cohort of SLE Patients
Authors: A.C. Araújo, R. Aguiar, D. Isenberg
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> Suicidal intent is believed to be more prevalent amongst systemic lupus erythemathosus (SLE) patients than in the general population. Depression is often present in SLE patients and can be a feature or a consequence of the disease. <h3>Objectives</h3> To assess suicide attempts and fatal events in a cohort of SLE patients. <h3>Methods</h3> A retrospective evaluation of our 650 patients SLE cohort (1978-2013) was performed. Data on disease onset, disease manifestations, immunological profile, time to suicide attempt and disease activity at the event were collected. <h3>Results</h3> In this cohort over a 35 year follow-up period, 9 patients made 11 suicide attempts, 3 of them fatal, resulting in a rate of suicide of 0.46%. Most of the attempts consisted of tablet overdose. Only two patients had previously expressed suicidal intent. Two patients had never had overt neuropsychiatric involvement. Anti-Ro antibodies were identified in 6 patients. At the time of suicide attempt, high anti dsDNA levels were noted in 7 patients and lymphopenia in 8; but the C3 was normal in 8. <h3>Conclusions</h3> Even though SLE patients have a higher risk of suicide than general population, suicide ideation was not mentioned by most patients. Death due to suicide is very uncommon in SLE. <h3>References</h3> Karassa FB, Magliano M, Isenberg DA. Suicide attempts in patients with systemic lupus erythemathosus. Ann Rheum Dis 2003; 62: 58-60. Palagini L, Mosca M, Tani C, Gemignani A, Mauri M, Bombardieri S. Depression and systemic lupus eryhtemathosus: a systematic review. Lupus 2013; 22(5): 409-416 <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.2741