tbuckley/cabot-search huggingface dataset:
Starting a tumor board meeting at a public sector hospital – problems faced and its impact on patient care: A lower middle income country experience
Authors: A. Malik, M. Afzal
Journal: Annals of Oncology (2018)

Introduction: The importance of tumor board meeting in care or cancer patients cannot be ignored. No dedicated tumor boards are held in any public sector hospital in Lahore. We decided to start a regular tumor board in a public sector hospital in Pakistan. We will discuss the problems faced in conducting these meetings and how they affected patient management. Methods: Department of Surgery at Lahore General Hospital has started conducting Tumor board meetings on monthly basis since Jan 2017. We share our one year experience of the meetings done and problems faced in conducting those meetings. Results: A total of 9 MDT Meetings were conducted in which 26 patients suffering from different malignancies were discussed for a better treatment plan. Patients discussed included 10 pre operative and 16 post operative patients respectively. Specialty wise 12 patients were from colorectal, 09 patients were from Hepatobiliary, 02 patients were suffering from Endocrine tumors, 01 patient with malignancy of neuromuscular origin and 02 with CA Esophagus. The biggest issue faced by us was getting all the departments on board for conducting the meetings. We lack a dedicated oncology department at LGH and had to request involvement of personnel from INMOL for decision making. Unfortunately only 5 out of 9 meetings were attended by an oncologist. Similarly pathologist was present in 8 out of 9 meetings. Radiology and surgery had a 100 attendance at the tumor board meetings. Pathological slides were not available for any patients and discussion was done on the basis of the available report of histopathology only in all of the discussed patients. Radiological images were not available on CDs and had to be discussed on films. 2 out of 20 patients didn't even have films available. Management decisions were unaffected in 17 patients and were changed in 09 patients. Conclusion: Although we are faced with multiple problems in conducting tumor board meetings at a public sector hospital regularly but it is mandatory for all cancer patients and we believe that with persistence we can achieve a management goal where all patients presenting with cancer will be discussed and managed through a tumor board meeting.
The impact of primary tumor location in patients with resected colorectal liver metastasis
Authors: V. Pacheco-Barcia, O. Donnay, R. Mondéjar Solís, R. Serrano, E. Martin, L. del Campo, J. Rogado, B. Vera, A. Ballesteros, R. Colomer
Journal: Annals of Oncology (2018)

Introduction: Recent prospective studies suggest that the primary tumor site in patients with metastatic colorectal cancer correlates with evolution. However, it is unclear whether there is an association between the side of the primary tumor and survival in patients with resected colorectal liver metastasis. The aim of our study is to evaluate the clinical outcome of patients with resected colorectal liver metastasis according to the side of the primary tumor. Methods: All patients with resected colorectal liver metastasis between 2008 and 2016 who underwent perioperative chemotherapy and completed hepatectomy were reviewed retrospectively. It is considered right colon (RC) from cecum to transverse colon and left colon (LC) from the splenic flexure to rectum sigma. Differences in clinical characteristics were assessed by the Chi-square test and overall survival (OS) with the log-rank test. Results: 34 cases were included. 21 (63.6%) were male. Median age was 64 years. 25 patients (74%) had the primary tumor in LC and 9 (26%) had RC. From the total number of patients, the RAS status was: 17 (50%) native, 16 (47%) mutated and 1 (3%) unknown. There were no differences in RAS status between LC and RC. Chemotherapy regimens: 29 (85%) received fluoropyrimidine doublet + oxaliplatin and 5 (15%) doublet with irinotecan. Patients with native RAS status: 14 (82%) received anti-EGFR therapy, 1 (6%) anti-VEGF and 2 patients (12%) did not receive a biological target. Patients in the RAS mutated group: 8 (50%) received anti-VEGF, 5 (30%) had a contraindication to anti-VEGF and the other patients had no indication. Median OS was 36 months. Regarding the median OS according to the primary tumor location, in the LC it was 45 months compared to 16 months on the RC (chi-square 3.925, p = 0.04). The Kaplan-Meier study shows a statistically significant difference in survival according to the location of the primary colon tumor in the first 12 months after resecting colorectal liver metastasis (log Rank 8.253, p = 0.004). Conclusion: In patients with resected colorectal liver metastasis the primary tumor location showed an impact on survival. Our study suggests that patients with right-sided primary tumor location have a worse prognosis.
Impact of adding oxaliplatin to fluoropyrimidines in the adjuvant therapy in stage II in colon cancer: Experience in Ramon y Cajal Universitary Hospital
Authors: R. Martín Huertas, J. Serrano Domingo, E. Corral de la Fuente, A. Barquín García, M. Villamayor Delgado, C. Saavedra Serrano, O. Martínez Saez, F. Longo Muñoz, V. Pachón Olmos, M. Rodriguez Garrote, M. Vaz, A. Carrato, P. Reguera Puertas, R. Fuentes, R. Ferreiro Monteagudo
Journal: Annals of Oncology (2018)

Introduction: The addition of oxaliplatin to fluorouracil and leucovorin as adjuvant chemotherapy (AC) for patients with stage II and III colon cancer (CC) has been analyzed in two large, randomized trials, MOSAIC and C-07 trials. The updated results of these studies showed that the addition of oxaliplatin enhances overall survival by approximately 5% in patients with stage III disease but has no effect in patients with stage II disease. Methods: We retrospectively included patients with stage II CC that were operated between 2009 and 2014 in the Ramon y Cajal University Hospital. We perform a multivariable Cox model analysis to estimate the benefit of the chemotherapy stratifying by oxaliplatin. We have analyzed whether receiving AC improves the relapse free survival (RFS) and overall survival (OS) and has been stratified according to the presence of at least one classic high risk factor (HRF). Additionally, it has been evaluated whether the addition of oxaliplatin improves the results. Results: 246 were identified. 151 were men (61%). 117 patients had at least one HRF (47%), 52 received AC (44%) of which 33 with oxaliplatin (63%). Patients without any HRF, 27 received AC (21%) of which 19 with oxaliplatin (70%). The median follow-up was 58.2 months. Globally, adjuvant chemotherapy (either with some HRF or without any) showed no benefit in RFS (Hazard ratio (HR) of 1.48 and 1.36, respectively). The benefit in OS was significant for patients with at least one HRF (HR 0.33, p: 0.007) but not in those patients without any HRF (HR 0.52, p: 0.54). Patients with stage II treated with oxaliplatin and fluoropyrimidines showed no benefit in terms of RFS neither with any HRF (HR 0.58, p: 0.33) nor without any (HR 1.11, p 0.936). In terms of OS, there is only benefit in those patients with some HRF (HR 0.16, p: 0.03). Conclusion: The AC in patients with stage II show benefit in OS in those patients with at least one HRF, especially with the addition of oxaliplatin. In those patients without any HRF, there is no benefit with AC, even with addition of oxaliplatin.
Клинический случай пациентки с синдромом раздраженного кишечника
Authors: Ye.S. Sirchak
Journal: GASTROENTEROLOGY (2018)

Синдром раздраженного кишечника (СРК) занимает одно из лидирующих мест по распространенности среди заболеваний органов пищеварения. В статье представлен клинический случай пациентки М. с диагнозом СРК с преобладанием диареи, установленным в соответствии с Римскими критериями IV 2016 г. Согласно этому документу, B. infantis 35624 (Альфлорекс) обладает способностью значительно уменьшать все симптомы СРК (абдоминальную боль/дискомфорт, вздутие, диарею, запор). С учетом этого пациентке М. назначен препарат Альфлорекс. Альфлорекс показал высокую эффективность в купировании всех симптомов СРК у пациентки уже с первых дней приема. Учитывая высокий уровень безопасности, удобство приема (1 раз/сутки), препарат В. infantis 35624 (Альфлорекс) открывает новые перспективы для пациента и врача в успешном контроле симптомов СРК.
QOL-36. QUALITY OF SURVIVAL IN SIOPE BRAIN TUMOUR CLINICAL TRIALS FOR CHILDREN AGED LESS THAN 5 YEARS: DEVELOPMENT OF A CLINICAL TRIAL PROTOCOL
Authors: Jenny Limond, Sophie Thomas, Kim Bull, Jurgen Lemiere, Thomas Traunwieser, Helen Spoudeas, Hanneke M Van Santen, Liesa Weiler-Wichtl, Peggy Lüttich, Gabriele Calaminus, Mathilde Chevignard
Journal: Neuro-Oncology (2018)

There is international recognition of the need to assess quality of survival (QoS) in children treated for brain tumours. Further to the work of the QoS working group of the European Society of Paediatric Oncology (SIOPE) Brain Tumour group and the Core ‘plus’ model of QoS assessment in clinical trials for children aged 5-18 years (Limond et al., 2015), the group has established a consensus for QoS assessment for children aged <5 years. Similar to older children, areas of assessment discussed include core medical domains (e.g. vision, hearing, mobility, endocrine), emotion, behaviour, adaptive behaviour, and cognitive functioning. Issues highlighted for this younger age group include reliability and validity of infant and young child measures, predictive value of early measures, and compatibility of measures across countries and age groups. Nevertheless the QoS group has agreed a hierarchy of neuropsychological assessments to maximise data collection to enable statistical analyses of these data in a larger number of patients than had previously been possible. As with the 5-18 year consensus, a Core ‘plus’ approach is suggested in which core assessments (direct and indirect tests) are recommended for all clinical trials. The core component is a brief screening assessment that, in most countries, is a sub-component of routine clinical provision and therefore achievable even where specific resources for QoS assessment are unavailable. The ‘plus’ component enables the addition of assessments which can be selected for tumour-, age-, and location-specific groups in order to enhance the overview of specific medical, cognitive and other relevant domains.
Antinuclear antibody as entry criterion for classification of systemic lupus erythematosus: pitfalls and opportunities
Authors: Philippe Willems, Ellen De Langhe, René Westhovens, Steven Vanderschueren, Daniel Blockmans, Xavier Bossuyt
Journal: Annals of the Rheumatic Diseases (2018)

Antinuclear antibodies (ANAs) are helpful to support the diagnosis of ANA-associated systemic rheumatic diseases (AASRD). Pisetsky et al recently reported on the variability of ANA detection, with differences observed between assay platforms (indirect immunofluorescence (IIF) vs solid phase) and kits in patients with established systemic lupus erythematosus (SLE).1 Variation of ANA detection has also been shown for automated IIF systems.2 Initiatives to better understand the variability of ANA tests are needed.3 Pisetsky et al 1 also pointed out that ANA negativity occurs in established SLE, thereby complicating screening for patients for clinical trials.1 Yet, an Italian study reported a high sensitivity of ANA for established SLE.4

Testing for ANAs is complex and accurate interpretation of test results might be difficult. A task force of the European League Against Rheumatism (EULAR) has recently been installed that will address these issues in conjunction with other international committees.5 In this context and of particular interest is that new criteria for the classification of patients with SLE are being developed under the umbrellas of the EULAR and the American College of Rheumatology (ACR).6 In these criteria, a history of ANAs ≥1:80 by HEp-2 IIF will be the entry criterion (ie, must be present to be considered for classification as SLE).6 The ≥1:80 cut-off was chosen in order to ensure …
QOL-19. THE PROMOTE STUDY: PATIENT REPORTED OUTCOME MEASURES ONLINE TO ENHANCE COMMUNICATION AND QUALITY OF LIFE AFTER CHILDHOOD BRAIN TUMOUR
Authors: Kim Bull, Anne-Sophie Darlington, Martha Grootenhuis, Darren Hargrave, Christina Liossi, Christopher Morris, David Walker, Colin Kennedy
Journal: Neuro-Oncology (2018)

The quality of life (QoL) of children and adolescents treated for brain tumours is significantly impaired into adulthood but is not systematically screened by methods appropriate to these patients. In the UK, referral of them for appropriate support is often reactive rather than proactive. We are developing and testing KLIK, an online platform to systematically monitor QoL and psychosocial functioning using patient-reported outcome measures (PROMs) that are meaningful to affected families. This information will then be fed back to/shared with clinicians on-line during follow-up outpatient clinics. There are two phases to this study: the development phase, and the feasibility phase. Children aged 5-17.9 years, receiving outpatient care >6 monthly for a brain tumour diagnosed within preceding 5 years and their parents and clinicians. Three Children’s Brain Tumour Treatment Centres in the UK (SGH, Southampton, GOSH, London, and QMC, Nottingham). (Development phase) Systematic literature review to identify relevant PROMs with promising psychometric properties; translation of KLIK into UK English; views of families on choice of PROMs and development of KLIK. The PedsQL-Core module identified as the most relevant PROM; KLIK translated into English and currently undergoing development with the views of users in an iterative process. The feasibility of using the KLIK feedback process at paediatric neuro-oncology clinics in the three centres will be tested in 2018-19. The PROMOTE study will enable the viability of a future scaled-up trial of the benefit of this feedback process across the UK to be assessed.
HGCSG 1403: Phase I trial of oxaliplatin/irinotecan/S-1 (OX-IRIS) as first line chemotherapy for unresectable pancreatic cancer
Authors: A. Ishiguro, Y. Kawamoto, S. Yuki, S. Nakano, M. Yagisawa, K. Sawada, T. Muranaka, H. Hayashi, H. Nakatsumi, T. Saiki, K. Harada, Y. Kobayashi, I. Iwanaga, K. Hatanaka, Y. Sakata, Y. Komatsu
Journal: Annals of Oncology (2018)

Introduction: In recent years, FOLFIRINOX has become one of the primary standard treatment for unresectable pancreatic cancer (PC) with distant metastasis. OX-IRIS is the combination therapy of oxaliplatin (L-OHP), irinotecan (IRI) and S-1. It is the useful treatment to dispense with a continuous infusion of 5FU by administering S-1 orally. For establishing OX-IRIS therapy as a new standard treatment, we planned this study for evaluating dose limiting toxicity (DLT) and maximum tolerated dose (MTD). Furthermore, we exploratorily considered the efficacy (UMIN ID: 000017002). Methods: This study was carried out as a multicenter phase I study in 6 institutions. Chemotherapy-naïve patients with unresectable PC were included. L-OHP and IRI were administered on day1 and 15, and S-1 was taken twice a day in day1-14, and 14 days were rest for 1 cycle. This study used a standard 3 plus 3 design, and we evaluated safety and tolerability in 3 to 6 cases of each levels. It was assumed until 1 cycle completion for the evaluation period of DLT. MTD was defined as the highest dose beyond a more of one-third within DLT evaluation period. The primary endpoint was the frequency of DLT and MTD. Secondary endpoints were the frequency of adverse events, response rate, progression-free survival (PFS) and overall survival (OS). Results: Between January 2016 and August 2017, 13 cases were enrolled. The patients' backgrounds were median age 62 years old, man/woman; 9/4, the primary tumor sites head/body and tail; 8/5, ECOG PS 0/1; 7/6, UR-LA/UR-M; 4/9. The metastatic sites were lymph nodes/liver/lung/peritoneum; 2/7/1/1. Two of five patients enrolled in level 0 (L-OHP: 85 mg/m2, IRI: 100 mg/m2, S-1: 80 mg/m2) had DLT. In two of eight patients enrolled in level -1 (L-OHP: 65 mg/m2, IRI: 100 mg/m2, S-1: 80 mg/m2), DLT was impossible to evaluate because the treatment of 1 cycle was not accomplished. And one of remaining six cases had DLT. At level 0, 100% of cases had anemia and fatigue, 80% had anorexia, diarrhea, peripheral sensory neuropathy, 60% had platelet count decrease. At level -1, 100% of cases had anemia, 75% had nausea and fatigue, 63% had anorexia. Response rate was 10% and disease control rate was 70% in ten cases with the evaluable lesion. Median PFS was 4.1 months (95%C.I.; 0.0-8.6 months). Conclusion: In this study, MTD was estimated to be level 0, and determined that recommended dose (RD) was level -1 in the planned future study. We are going to evaluate efficacy and the safety in a phase II study.
mRNA Delivery System for Targeting Antigen‐Presenting Cells In Vivo
Authors: Cristina Fornaguera, Marta Guerra‐Rebollo, Miguel Ángel Lázaro, Cristina Castells‐Sala, Oscar Meca‐Cortés, Victor Ramos‐Pérez, Anna Cascante, Núria Rubio, Jerónimo Blanco, Salvador Borrós
Journal: Advanced Healthcare Materials (2018)

Abstract The encapsulation of mRNA in nanosystems as gene vaccines for immunotherapy purposes has experienced an exponential increase in recent years. Despite the many advantages envisaged within these approaches, their application in clinical treatments is still limited due to safety issues. These issues can be attributed, in part, to liver accumulation of most of the designed nanosystems and to the inability to transfect immune cells after an intravenous administration. In this context, this study takes advantage of the known versatile properties of the oligopeptide end‐modified poly (β‐amino esters) (OM‐PBAEs) to complex mRNA and form discrete nanoparticles. Importantly, it is demonstrated that the selection of the appropriate end‐oligopeptide modifications enables the specific targeting and major transfection of antigen‐presenting cells (APC) in vivo, after intravenous administration, thus enabling their use for immunotherapy strategies. Therefore, with this study, it can be confirmed that OM‐PBAE are appropriate systems for the design of mRNA‐based immunotherapy approaches aimed to in vivo transfect APCs and trigger immune responses to fight either tumors or infectious diseases.
Differences in Obesity Prevalence by Demographics and Urbanization in US Children and Adolescents, 2013-2016
Authors: Cynthia L. Ogden, Cheryl D. Fryar, Craig M. Hales, Margaret D. Carroll, Yutaka Aoki, David S. Freedman
Journal: JAMA (2018)

Differences in childhood obesity by demographics and urbanization have been reported.To present data on obesity and severe obesity among US youth by demographics and urbanization and to investigate trends by urbanization.Measured weight and height among youth aged 2 to 19 years in the 2001-2016 National Health and Nutrition Examination Surveys, which are serial, cross-sectional, nationally representative surveys of the civilian, noninstitutionalized population.Sex, age, race and Hispanic origin, education of household head, and urbanization, as assessed by metropolitan statistical areas (MSAs; large: ≥ 1 million population).Prevalence of obesity (body mass index [BMI] ≥95th percentile of US Centers for Disease Control and Prevention [CDC] growth charts) and severe obesity (BMI ≥120% of 95th percentile) by subgroups in 2013-2016 and trends by urbanization between 2001-2004 and 2013-2016.Complete data on weight, height, and urbanization were available for 6863 children and adolescents (mean age, 11 years; female, 49%). In 2013-2016, the prevalence among youth aged 2 to 19 years was 17.8% (95% CI, 16.1%-19.6%) for obesity and 5.8% (95% CI, 4.8%-6.9%) for severe obesity. Prevalence of obesity in large MSAs (17.1% [95% CI, 14.9%-19.5%]), medium or small MSAs (17.2% [95% CI, 14.5%-20.2%]) and non-MSAs (21.7% [95% CI, 16.1%-28.1%]) were not significantly different from each other (range of pairwise comparisons P = .09-.96). Severe obesity was significantly higher in non-MSAs (9.4% [95% CI, 5.7%-14.4%]) compared with large MSAs (5.1% [95% CI, 4.1%-6.2%]; P = .02). In adjusted analyses, obesity and severe obesity significantly increased with greater age and lower education of household head, and severe obesity increased with lower level of urbanization. Compared with non-Hispanic white youth, obesity and severe obesity prevalence were significantly higher among non-Hispanic black and Hispanic youth. Severe obesity, but not obesity, was significantly lower among non-Hispanic Asian youth than among non-Hispanic white youth. There were no significant linear or quadratic trends in obesity or severe obesity prevalence from 2001-2004 to 2013-2016 for any urbanization category (P range = .07-.83).In 2013-2016, there were differences in the prevalence of obesity and severe obesity by age, race and Hispanic origin, and household education, and severe obesity was inversely associated with urbanization. Demographics were not related to the urbanization findings.
QOL-60. PANACEA: A NOVEL BLACKBERRY 10 BASED, SUPPORT MOBILE APP FOR BRAIN TUMOR AFFECTED PATIENTS
Authors: Abhishek Puri, Amit Garg, P Mohandass
Journal: Neuro-Oncology (2018)

Panacea addresses a yawning gap in clinician-led development for novel use of mobile applications in healthcare delivery for patients. Brain tumour affected patients have difficulty in accessing relevant literature to their clinical condition and reminders for medications. A novel BlackBerry 10 mobile app, Panacea, (final version 1.1.9.1) was conceptualised and developed (using C++ and BlackBerry 10 native SDK) available via BlackBerry World. BlackBerry 10 (OS version 10.3.2.2826) offers a platform with NIAP certification, which ratifies it for security allowing for unrestricted use for regulated healthcare. This app has news section (for patient advocacy), reminders to aid in dispensing of critical medications, ability to add emergency contacts and clinician vetted information for managing common side effects, primarily related to concurrent chemo-radiation therapy. This app also allows for visual theming, reader mode to enhance the readability of web content and sharing of news through various social media. Panacea is securely linked to installed BlackBerry Messenger (BBM), for instant messaging which also allows voice and video interaction with the clinical specialist. Future updates include enhanced heuristics (UI design with emphasis on the visual component), interface with hospital-based information systems, daily log of symptoms experienced and integration with chatbots for measured automated responses to repetitive queries. Porting to Android and Apple iOS platform is being contemplated. Panacea aims to transform information access with clinician vetting to aid in ownership of healthcare, functional independence and remote monitoring of patients.
Multiscale Analysis of Independent Alzheimer’s Cohorts Finds Disruption of Molecular, Genetic, and Clinical Networks by Human Herpesvirus
Authors: Ben Readhead, Jean-Vianney Haure-Mirande, Cory C. Funk, Matthew A. Richards, Paul Shannon, Vahram Haroutunian, Mary Sano, Winnie S. Liang, Noam D. Beckmann, Nathan D. Price, Eric M. Reiman, Eric E. Schadt, Michelle E. Ehrlich, Sam Gandy, Joel T. Dudley
Journal: Neuron (2018)