tbuckley/cabot-search huggingface dataset:
Utilization of support services, emergency department, and hospital in advanced cancer patients with severe disease in a community cancer institute.
Authors: Caitlyn McNaughton, Emily Gehron, Shanthi Sivendran, Rachel Holliday, Michael Horst, Kristina Braine Newport
Journal: Journal of Clinical Oncology (2017)

112 Background: Patients with advanced cancer are at high risk for emergency department (ED) and hospital utilization, which is distressing and costly. Palliative care consultation and symptom management clinics have been shown to decrease ED and hospital utilization, but the frequency and composition of these interventions is still being delineated. More evaluation is needed to determine practical approaches to implementing interdisciplinary management of distress for patients with advanced cancer in the community setting. This retrospective review evaluates healthcare utilization with respect to support services provided in our community based cancer institute. Methods: 157 patients with advanced cancer of lung, gastrointestinal, genitourinary or gynecologic origin diagnosed January 2015-December 2015 were reviewed retrospectively. Descriptive data including demographics, disease characteristics, palliative care consultation, support services utilized and ED visits/hospitalizations were collected for 12 months, or to date of death. Support services included physician assistant–led symptom management, nurse navigator, social worker, nutrition, financial counselor, chaplain, and oncology clinical counselor. Support service referrals were made based on identified needs. Severe disease was defined as death within 6 months of diagnosis. Results: Patients with severe disease had a mean of 6 ED visits per year, significantly greater than patients with non-severe disease (p &lt; 0.001). Patients with severe disease also had more contacts with support services per year (30.3 vs 9.1, p &lt; 0.001). A palliative care consult was placed in 50% of patients with severe disease, and 23% in patients with non-severe disease (p &lt; 0.001). Conclusions: Patients with advanced cancer have evidence of significant needs as reflected by high healthcare utilization in the last 6 months of life. As needed involvement of support services correlated with severity of disease but did not result in decreased ED utilization or hospitalization. This suggests that availability of support services alone is not a feasible strategy to impact unplanned hospitalizations and ED visits.
El impacto de la prueba de ácidos nucleicos (NAT) en Italia de 2001 a 2003
Authors: C Velati, L Fomiatti, L Baruffi, L Romanò, A Zanetti
Journal: Eurosurveillance (2005)

En Italia, el uso de la prueba de acidos nucleicos (NAT) en las donaciones sanguineas es obligatorio desde el 28 de Junio de 2002, aunque esta tecnica se utilizaba desde 2001 de modo experimental. Durante el periodo de transicion, tambien estaba permitido el uso de pruebas enzimaticas (EIA) para la deteccion del antigeno del core del virus de la hepatitis C (Ag HBc). Considerando el gran numero de centros de transfusion sanguinea en Italia, fue necesario reorganizar la validacion biologica de las hemodonaciones con una centralizacion parcial del cribado por el NAT. El “Gruppo Italiano per lo Studio delle Malattie Trasmissibili con la Trasfusione” (Grupo Italiano de Estudio de Enfermedades Transmisibles por Transfusion) ha realizado un estudio nacional para evaluar el NAT basado en la recogida anual de datos por medio de un cuestionario enviado a todos los centros. Durante los tres primeros anos, 219 centros de transfusion respondieron a la encuesta. 
Entre Enero de 2001 y Diciembre de 2003, fueron testadas para el virus de la hepatitis C (VHC) 3.894.894 donaciones sanguineas y 2.186.468 para el VIH. Doce pruebas dieron positivas para el VHC y cuatro para el VIH, lo que representa un rendimiento para el NAT comparado con las pruebas de anticuerpos de 3,1 por millon de donaciones para el VHC y de 1,8 por millon de donaciones para el VIH. Cinco de los 12 donantes VHC positivos y anti-VHC negativos tenian valores de TLA anormales; estas donaciones hubieran sido rechazadas incluso sin NAT. Asi, la ganancia final del NAT para el VHC no es mas que 1,79 por millon de donaciones. En Italia, desde la implementacion del NAT, el riesgo residual de transmision del VHC o del VIH por transfusion sanguinea es extremadamente escaso.
Associating retinal drug exposure and retention with the ocular toxicity profiles of Hsp90 inhibitors.
Authors: Dan Zhou, Florentina Teofilovici, Yuan Liu, Josephine Ye, Weiwen Ying, Luisa Shin Ogawa, Takayo Inoue, William Lee, Alfred Adjiri-Awere, Lev Kolodzieyski, Noriaki Tatsuta, Yumiko Wada, Andrew J Sonderfan
Journal: Journal of Clinical Oncology (2012)

3086 Background: In clinical trials certain Hsp90 inhibitors, including AUY922, SNX-5422, and 17-DMAG have caused visual symptoms suggesting retinal dysfunction; others, including ganetespib and 17-AAG, have not. Previous animal toxicology experiments have suggested that retinal changes may be linked to photoreceptor degeneration or cell death. Here histopathologic changes and/or exposure profiles of Hsp90 inhibitors with or without clinical reports of ocular toxicity were evaluated to understand the observed differences in toxicity profile between agents in this class. Methods: We reviewed visual symptoms among subjects administered ganetespib, a potent Hsp90 inhibitor currently in phase II trials; evaluated retinal morphology in rats and cyno monkeys given ganetespib; and compared TUNEL-positive photoreceptors and drug exposure profiles in the retina of rats treated with AUY922, 17-DMAG, and 17-AAG. Studies of ganetespib’s retinal pharmacokinetics and photoreceptor toxicity in rats are ongoing. Results: AUY922 and 17-DMAG induce visual disorders in the clinic. Both drugs induced marked photoreceptor cell death (increased TUNEL-positive cells) in rats with a high retina/plasma (R/P) exposure ratio, and a slow elimination rate (at 6 h post-dose, over 54% of AUY922 present at 30 min remained in the retina). In contrast, and consistent with an absence of clinical visual changes, 17-AAG at the maximum tolerated dose did not elicit photoreceptor injury. Further, retinal elimination was rapid (at 6 h post-dose, 94% of 17-AAG had been eliminated from the retina, resulting in a low R/P ratio). Ganetespib given by 1‑hour IV infusion on days 1 and 15 of four 21-day cycles did not cause histopathological changes in the retina of rats or cynos. This finding is consistent with very low rate (~3%) of drug-related visual symptoms observed among over 300 subjects to date that received ganetespib in the clinic. Conclusions: Unlike AUY922 and 17-DMAG, ganetespib is not associated with ocular toxicity in humans, primates, or rodents. The findings suggest that Hsp90 inhibitors may elicit visual disorders when associated with high retina/plasma exposure ratio and lower retinal elimination rate.
Bi-directional exosome-driven intercommunication between the hepatic niche and cancer cells
Authors: Nikolina Dioufa, Amanda M. Clark, Bo Ma, Colin H. Beckwitt, Alan Wells
Journal: Molecular Cancer (2017)

Our understanding of the multiple roles exosomes play during tumor progression is still very poor and the contribution of the normal tissue derived exosomes in distant seeding and tumor outgrowth has also not been widely appreciated. Using our all-human liver microphysiological system (MPS) platform as a model to closely recapitulate the early metastatic events, we isolated exosomes from both tumor cells and liver microenvironment. We observed that while priming of the hepatic niche (HepN) with MDA-231 breast cancer derived exosomes facilitated seeding of the cancer cells in the liver, subsequent tumor outgrowth was diminished; this was consistent with increased entry into dormancy. We found that hepatic niche (HepN) derived exosomes contribute significantly to the exosome pool and are distinguished from cancer derived exosomes based on their size, protein and miRNA content. By Ingenuity Pathway Analysis (IPA) of the miRNA content of the HepN, MDA-231/HepN and MDA-231 cells we showed that the HepN derived exosomes affect the breast cancer cells by suppressing pathways involved in cancer cell proliferation and invasion. More importantly exposure of MDA-231 and MDA-468 cells to purified normal HepN derived exosomes, induced changes in the cells consistent with a Mesenchymal to Epithelial reverting Transition (MErT). miRNA arrays performed on MDA-231 treated with Hum Hep/NPC derived exosomes showed significant changes in the levels of a select number of miRNAs involved in epithelial cell differentiation and miRNAs, such as miR186, miR23a and miR205, from our top and bottom bins have previously been reported to regulate E-cadherin transcription and MErT induction in various cancer types. Consistently HepN derived exosome treatment of breast and prostate cancer lines lead to a transient induction of E-cadherin and ZO-1 at the protein level and a more epithelial-like morphology of the cells. Collectively our data revealed a novel mechanism of regulation of the metastatic cascade, showing a well-orchestrated, timely controlled crosstalk between the cancer cells and the HepN and implicating for the first time the normal tissue/HepN derived exosomes in enabling seeding and entry into dormancy of the cancer cells at the metastatic site.
New options for the anemia of chronic kidney disease
Authors: Daniel W. Coyne, David Goldsmith, Iain C. Macdougall
Journal: Kidney International Supplements (2017)

Anemia is a common complication of chronic kidney disease. Use of erythropoiesis-stimulating agents (ESA) has been a mainstay of treatment since 1990. A series of large trials demonstrated that ESAs have serious safety problems, including increasing cardiovascular and thrombotic events, and death. Analyses suggest high pharmacologic doses of ESAs, rather than the highly achieved hemoglobin, may mediate harm. Hypoxia-inducible factor (HIF) activators stimulate endogenous erythropoietin production and enhance iron availability. In early clinical trials, these oral agents appear to be capable of replacing ESA therapy and minimizing the need for i.v. iron therapy for chronic kidney disease-related anemia, while having other potentially advantageous actions. Large phase 3 trials are underway with several HIF activators. This commentary reviews trends in anemia management, the safety issues related to our present therapies, the role of HIF in regulating erythropoiesis, and the diverse actions of HIF activators.
Abstract 15857: Risk of Incident Stroke in Aortic Stenosis and Usefulness of the CHA2DS2-VASc Score for Risk Stratification
Authors: Charlotte Andreasen, Jørgen L Jeppesen, Gunnar H Gislason, Lars Koeber, Jawdat Abdulla, Christian Torp-Pedersen, Charlotte Andersson
Journal: Circulation (2016)

Introduction:  Patients with aortic stenosis (AS) are considered to have an increased risk of ischemic stroke, but data are sparse. Current guidelines recognize AS as an independent risk factor for stroke among atrial fibrillation patients and recommend that all patients should be given oral anticoagulant therapy, irrespectively of other risk factor burden. This is in contrast to patients with non-valvular atrial fibrillation, in whom oral anticoagulant therapy is indicated only if CHA2DS2VASc score exceeds 0.   Hypothesis:  We hypothesized that AS confers a risk factor for stroke of comparable magnitude to that observed for non-valvular atrial fibrillation.   Methods and Materials:  We employed the Danish nationwide administrative registers (1997-2012) to investigate the association of AS and non-valvular atrial fibrillation with the risk of ischemic stroke, stratified by the CHA2DS2VASc score, among all Danish individuals aged ≥30 years old who did not receive anticoagulation therapy.   Results:  Total observation time, numbers of ischemic strokes, and hazard ratio per each 1-point increase in CHA2D2SVASc score for patients with atrial fibrillation, AS, or both are given in the Table.   Conclusion:  AS confers a risk factor for stroke of similar magnitude as non-valvular atrial fibrillation and the combination of atrial fibrillation and AS is associated with additionally increased stroke risk. Whether AS patients without atrial fibrillation may benefit from antiplatelet or antithrombotic therapy warrants further studies.
Assessment of biopsy‐proven liver fibrosis by two‐dimensional shear wave elastography: An individual patient data‐based meta‐analysis
Authors: Eva Herrmann, Victor de Lédinghen, Christophe Cassinotto, Winnie C.‐W. Chu, Vivian Y.‐F. Leung, Giovanna Ferraioli, Carlo Filice, Laurent Castera, Valérie Vilgrain, Maxime Ronot, Jérôme Dumortier, Aymeric Guibal, Stanislas Pol, Jonel Trebicka, Christian Jansen, Christian Strassburg, Rongqin Zheng, Jian Zheng, Sven Francque, Thomas Vanwolleghem, Luisa Vonghia, Emanuel K. Manesis, Pavlos Zoumpoulis, Ioan Sporea, Maja Thiele, Aleksander Krag, Claude Cohen‐Bacrie, Aline Criton, Joel Gay, Thomas Deffieux, Mireen Friedrich‐Rust
Journal: Hepatology (2017)

Two‐dimensional shear wave elastography (2D‐SWE) has proven to be efficient for the evaluation of liver fibrosis in small to moderate‐sized clinical trials. We aimed at running a larger‐scale meta‐analysis of individual data. Centers which have worked with Aixplorer ultrasound equipment were contacted to share their data. Retrospective statistical analysis used direct and paired receiver operating characteristic and area under the receiver operating characteristic curve (AUROC) analyses, accounting for random effects. Data on both 2D‐SWE and liver biopsy were available for 1,134 patients from 13 sites, as well as on successful transient elastography in 665 patients. Most patients had chronic hepatitis C (n = 379), hepatitis B (n = 400), or nonalcoholic fatty liver disease (n = 156). AUROCs of 2D‐SWE in patients with hepatitis C, hepatitis B, and nonalcoholic fatty liver disease were 86.3%, 90.6%, and 85.5% for diagnosing significant fibrosis and 92.9%, 95.5%, and 91.7% for diagnosing cirrhosis, respectively. The AUROC of 2D‐SWE was 0.022‐0.084 (95% confidence interval) larger than the AUROC of transient elastography for diagnosing significant fibrosis ( P = 0.001) and 0.003‐0.034 for diagnosing cirrhosis ( P = 0.022) in all patients. This difference was strongest in hepatitis B patients. Conclusion: 2D‐SWE has good to excellent performance for the noninvasive staging of liver fibrosis in patients with hepatitis B; further prospective studies are needed for head‐to‐head comparison between 2D‐SWE and other imaging modalities to establish disease‐specific appropriate cutoff points for assessment of fibrosis stage. (H epatology 2018;67:260‐272).
The effect of treatment for sleep apnoea on determinants of blood pressure control
Authors: Raquel Casitas, Elisabet Martínez-Cerón, Raúl Galera, Carolina Cubillos-Zapata, María Jesús González-Villalba, Isabel Fernández-Navarro, Begoña Sánchez, Aldara García-Sánchez, Ester Zamarrón, Francisco García-Río
Journal: European Respiratory Journal (2017)

Our aim was to assess the effect of continuous positive airway pressure (CPAP) on the nocturnal evolution of peripheral chemosensitivity, renin–angiotensin–aldosterone system activity, sympathetic tone and endothelial biomarkers in obstructive sleep apnoea (OSA) patients with isolated nocturnal hypertension (INH) or day–night sustained hypertension (D-NSH). In a crossover randomised trial, 32 OSA patients newly diagnosed with hypertension and without antihypertensive treatment were randomly assigned to 12 weeks of CPAP or sham CPAP. Peripheral chemosensitivity was evaluated before and after sleep using the hypoxic withdrawal test (%Δ V I ). At baseline, D-NSH patients showed higher %Δ V I before sleep and higher levels of aldosterone and diurnal catecholamines. CPAP only reduced the nocturnal increase of %Δ V I in INH patients (6.9%, 95% CI 1.0–12.8%; p=0.026). CPAP-induced change from baseline in %Δ V I after sleep was 7.5% (95% CI 2.6–12.2%, p=0.005) in the INH group and 5.7% (95% CI 2.2–9.3%, p=0.004) in the D-NSH group. In contrast, %Δ V I before sleep only decreased with CPAP in the D-NSH patients (3.0%, 95% CI 0.5–5.6%; p=0.023). In conclusion, CPAP reduces the nocturnal increase of peripheral chemosensitivity experienced by INH patients and corrects the high daytime sensitivity of patients with D-NSH. Differences in response to CPAP between these patients can help better understand the mechanisms of perpetuation of hypertension in sleep apnoea.
Proportion and number of cancer cases and deaths attributable to potentially modifiable risk factors in the United States
Authors: Farhad Islami, Ann Goding Sauer, Kimberly D. Miller, Rebecca L. Siegel, Stacey A. Fedewa, Eric J. Jacobs, Marjorie L. McCullough, Alpa V. Patel, Jiemin Ma, Isabelle Soerjomataram, W. Dana Flanders, Otis W. Brawley, Susan M. Gapstur, Ahmedin Jemal
Journal: CA A Cancer Journal for Clinicians (2017)

Abstract Contemporary information on the fraction of cancers that potentially could be prevented is useful for priority setting in cancer prevention and control. Herein, the authors estimate the proportion and number of invasive cancer cases and deaths, overall (excluding nonmelanoma skin cancers) and for 26 cancer types, in adults aged 30 years and older in the United States in 2014, that were attributable to major, potentially modifiable exposures (cigarette smoking; secondhand smoke; excess body weight; alcohol intake; consumption of red and processed meat; low consumption of fruits/vegetables, dietary fiber, and dietary calcium; physical inactivity; ultraviolet radiation; and 6 cancer‐associated infections). The numbers of cancer cases were obtained from the Centers for Disease Control and Prevention (CDC) and the National Cancer Institute; the numbers of deaths were obtained from the CDC; risk factor prevalence estimates were obtained from nationally representative surveys; and associated relative risks of cancer were obtained from published, large‐scale pooled analyses or meta‐analyses. In the United States in 2014, an estimated 42.0% of all incident cancers (659,640 of 1570,975 cancers, excluding nonmelanoma skin cancers) and 45.1% of cancer deaths (265,150 of 587,521 deaths) were attributable to evaluated risk factors. Cigarette smoking accounted for the highest proportion of cancer cases (19.0%; 298,970 cases) and deaths (28.8%; 169,180 deaths), followed by excess body weight (7.8% and 6.5%, respectively) and alcohol intake (5.6% and 4.0%, respectively). Lung cancer had the highest number of cancers (184,970 cases) and deaths (132,960 deaths) attributable to evaluated risk factors, followed by colorectal cancer (76,910 cases and 28,290 deaths). These results, however, may underestimate the overall proportion of cancers attributable to modifiable factors, because the impact of all established risk factors could not be quantified, and many likely modifiable risk factors are not yet firmly established as causal. Nevertheless, these findings underscore the vast potential for reducing cancer morbidity and mortality through broad and equitable implementation of known preventive measures. CA Cancer J Clin 2018;68:31‐54 . © 2017 American Cancer Society .
P2.07-046 Nivolumab Exerts Remarkable Antitumor Activity in NSCLC After an Immune-Modulating Biochemotherapy Regimen
Authors: P. Pastina, V. Nardone, C. Botta, S. Croci, D. Davì, P. Tini, G. Battaglia, L. Sebaste, T. Carfagno, S.F. Carbone, V. Ricci, R. Giannicola, P. Tagliaferri, L. Pirtoli, P. Correale
Journal: Journal of Thoracic Oncology (2017)
Serum miRNA discriminates treatment-naive localized synovial sarcoma patients from those in follow-up after radical combined therapy
Authors: H. Kosela Paterczyk, M. Mikula, A. Paziewska, M. Kulecka, J. Kaczmarski, M. Dabrowska, A. Kluska, A. Balabas, M. Piatkowska, P. Rutkowski, J. Ostrowski
Journal: Annals of Oncology (2017)
Q-switched 532-nm laser energy causes significant vascular damage in the capillary plexus: how does this affect laser tattoo removal?
Authors: M. J. Murphy
Journal: British Journal of Dermatology (2017)

Tattoos can be effectively removed using Q-switched and picosecond lasers at four wavelengths – 1064, 755, 694 and 532nm1,2,3,4. However, there are two particular problems with the 532nm line. Firstly, it is well absorbed by the melanin in the epidermis, due to its relatively high absorption coefficient5, (μa_mel = 56 cm−1 for typical Caucasian skin). Secondly, 532nm is also strongly absorbed in the haemoglobin located in the capillary plexus5 (μa_HbO = 260 cm−1).

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Improved Assessment of Bolus Clearance in Patients With Achalasia Using High-Resolution Impedance Manometry
Authors: Dustin A. Carlson, Claire A. Beveridge, Zhiyue Lin, Michelle Balla, Dyanna Gregory, Michael Tye, Katherine Ritter, Peter J. Kahrilas, John E. Pandolfino
Journal: Clinical Gastroenterology and Hepatology (2018)
Rehabilitation medicine
Authors: A. Frank
Journal: BMJ (1998)

Rehabilitation is the specialty which seeks to restore and maintain individuals at their maximum level of physical, mental, and social functioning. After the second world war services gradually reduced, a neglect that became appreciated during 1982, the international year of disabled people. A Royal College of Physicians report subsequently found services unevenly distributed and poorly coordinated across the United Kingdom, describing them as an “important if unplanned experiment … to set up an effective care service for physically disabled people without a substantial specialty of rehabilitation.”(1) It failed. Physicians interested in rehabilitation medicine created the Medical Disability Society, which became the British Society for Rehabilitation Medicine (BSRM). Since its inception in 1984, the society membership has grown from 180 founder members to 339 members today. Academic departments of rehabilitation medicine are slowly developing, usually with a special interest such as rheumatological or neurological rehabilitation. Now rehabilitation medicine is one of the fastest growing specialties in medicine. ### Pros and cons of rehabilitation medicine #### Attractions #### Disadvantages