tbuckley/cabot-search huggingface dataset:
NeoFLOT: Multicenter phase II study of perioperative chemotherapy in resectable adenocarcinoma of the gastroesophageal junction or gastric adenocarcinoma.
Authors: Christoph Schulz, Frank Kullmann, Volker Kunzmann, Wolfgang Schepp, Michael Geissler, Ursula Vehling-Kaiser, Heribert Stauder, Axel Wein, Salah-Eddin Al-Batran, Thomas Kubin, Claus Schaefer, Swantje Held, Sebastian Stintzing, Stefan Hubert Boeck, Michael Haas, Roswitha Forstpointner, Karsten Ridwelski, Volker Heinemann
Journal: Journal of Clinical Oncology (2012)

4072 Background: The rationale of the NeoFLOT-trial was the intensification of neoadjuvant chemotherapy (NACT) by prolongation of preoperative treatment. This strategy is based on the notion that while perioperative treatment is notably beneficial in locally advanced gastroesophageal cancer (GEC), postoperative chemotherapy can only be applied in a fraction of patients (pts). Methods: Pts with T3, T4 and/or N+ adenocarcinoma (GEC) were eligible for this multicenter phase II trial. NACT consisted of 6 cycles of oxaliplatin 85 mg/m 2 , leucovorin 200 mg/m 2 , fluorouracil 2600 mg/m 2 and docetaxel 50 mg/m 2 (FLOT) applied q 2 wks. Staging was performed after 3 cycles to select pts with progressive disease (PD) for immediate surgery. Primary endpoint was the R0-resection rate. Secondary endpoints included the pathological complete response rate (pCR), histologic tumor regression grade (Becker 2003), safety, and progression-free survival (PFS). Results: From 10/2009 to 06/2011, 59 pts were enrolled of whom 58 pts were assessable for safety. Median age was 61 years (range: 32-79), 58.6% (34/58) had tumors of the gastroesophageal junction. 50 pts underwent surgery and were assessable for the primary endpoint. R0-resection rate was 86.0% (43/50). pCR was achieved in 20.0% (10/50) of pts. During NACT, 6.9% (4/58) of pts developed progressive disease. Dose reduction was performed in 43.1% (25/58) of pts resulting in a median dose intensity of 89.2%. Grade 3/4 neutropenia was observed in 29.3% (17/58) of pts, febrile neutropenia grade 3/4 in 1.7% (1/58). Common grade 3/4 non-hematologic adverse events were diarrhea (13.8% (8/58)) and mucositis (6.9% (4/58)). Treatment related mortality was 3.4% (2/58) with 2 cases of sepsis. After a median follow-up of 9.1 months, median PFS and OS have not been reached. Conclusions: These data indicate that NACT with 6 cycles FLOT is well-tolerated and highly effective in resectable GEC.
Heparin like effect increases risk of mortality and bleeding tendency in patients with severe alcoholic hepatitis during systemic Inflammatory Response (SIRS) and sepsis
Authors: M. Premkumar, P. Saxena, R. Mirza, P. Jain, P. Bhatia, G. Kumar, S. Sukriti, C. Bihari, A. Choudhury, S.K. Sarin
Journal: Journal of Hepatology (2018)
Transfer Factor For Carbon Monoxide In Patients With COPD And Diabetes : Results From The German Cosyconet Cohort
Authors: K. Kahnert, T. Lucke, F. Biertz, A. Lechner, P. Alter, R. Bals, H. Watz, Jürgen Behr, R. Holle, R. M. Huber, S. Karrasch, B. Stubbe, M. Wacker, S. Sohler, E. F. M. Wouters, C. Vogelmeier, R. Jorres
Journal: American Journal of Respiratory and Critical Care Medicine (2017)
Accuracy of Skin Cancer Diagnosis by Physician Assistants Compared With Dermatologists in a Large Health Care System
Authors: Alyce M. Anderson, Martha Matsumoto, Melissa I. Saul, Aaron M. Secrest, Laura K. Ferris
Journal: JAMA Dermatology (2018)

Physician assistants (PAs) are increasingly used in dermatology practices to diagnose skin cancers, although, to date, their diagnostic accuracy compared with board-certified dermatologists has not been well studied.To compare diagnostic accuracy for skin cancer of PAs with that of dermatologists.Medical record review of 33 647 skin cancer screening examinations in 20 270 unique patients who underwent screening at University of Pittsburgh Medical Center-affiliated dermatology offices from January 1, 2011, to December 31, 2015. International Classification of Diseases, Ninth Revision code V76.43 and International Classification of Diseases and Related Health Problems, Tenth Revision code Z12.83 were used to identify pathology reports from skin cancer screening examinations by dermatologists and PAs.Examination performed by a PA or dermatologist.Number needed to biopsy (NNB) to diagnose skin cancer (nonmelanoma, invasive melanoma, or in situ melanoma).Of 20 270 unique patients, 12 722 (62.8%) were female, mean (SD) age at the first visit was 52.7 (17.4) years, and 19 515 patients (96.3%) self-reported their race/ethnicity as non-Hispanic white. To diagnose 1 case of skin cancer, the NNB was 3.9 for PAs and 3.3 for dermatologists (P < .001). Per diagnosed melanoma, the NNB was 39.4 for PAs and 25.4 for dermatologists (P = .007). Patients screened by a PA were significantly less likely than those screened by a dermatologist to be diagnosed with melanoma in situ (1.1% vs 1.8% of visits, P = .02), but differences were not significant for invasive melanoma (0.7% vs 0.8% of visits, P = .83) or nonmelanoma skin cancer (6.1% vs 6.1% of visits, P = .98).Compared with dermatologists, PAs performed more skin biopsies per case of skin cancer diagnosed and diagnosed fewer melanomas in situ, suggesting that the diagnostic accuracy of PAs may be lower than that of dermatologists. Although the availability of PAs may help increase access to care and reduce waiting times for appointments, these findings have important implications for the training, appropriate scope of practice, and supervision of PAs and other nonphysician practitioners in dermatology.
Correlation between overall survival and other endpoints in clinical trials of second-line chemotherapy for patients with advanced gastric cancer.
Authors: Kohei Shitara, Keitaro Matsuo, Kei Muro, Atsushi Ohtsu
Journal: Journal of Clinical Oncology (2012)

4067 Background: The correlation between progression-free survival (PFS) or time to progression (TTP) and overall survival (OS) has been evaluated in patients with advanced gastric cancer (AGC) who received first-line chemotherapy (Shitara, K et al. Invest New Drug 2011; Shitara K and Burzykowski T, et al, ASCO 2011). However, no corresponding analysis had been done in patients who underwent second-line chemotherapy for AGC. Methods: We evaluated the potential of PFS, TTP, response rate (RR), or disease control rate (DCR) to act as surrogates for OS in phase II and III trials of second-line chemotherapy for AGC by comprehensive literature-based analysis. Correlations between each endpoint and OS were evaluated by Spearman rank correlation coefficient (ρ). Subgroup analyses by trial region or type of failure to previous chemotherapy were also conducted. Results: Fifty-six trials, including four randomized studies, were selected for analysis and covered a total of 61 treatment arms and 3,038 patients; 34 studies were conducted in Asia, 20 studies in Non-Asian countries, and two studies in both regions. Median PFS were similar in Asian and Non-Asian trials (3.0 vs. 3.3 months). In contrast, median OS tended to be longer in Asian vs. Non-Asian trials (8.0 vs. 6.0 months; p&lt;0.01). Median PFS/TTP and OS showed a moderate correlation with ρ of 0.51 (95% CI, 0.31-0.73). Correlation tended to be higher in PFS (ρ = 0.62) than TTP (ρ = 0.29) and higher in non-Asian trials (ρ = 0.73) than Asian trials (ρ = 0.32). Correlation between PFS/TTP and OS among the trials in which eligibility required failure to previous fluorouracil and cisplatin also showed low correlation (ρ = 0.48). The RR and DCR also did not show high correlation with OS (ρ = 0.30 for RR; 95% CI 0.04-0.56; ρ = 0.53 for DCR; 95% CI 0.31-0.75). The hazard ratio (HR) of PFS and OS in each arms of the four randomized studies showed a low correlation with ρ of 0.10. Conclusions: Our results indicate that PFS/TTP, RR, and DCR did not correlate sufficiently with OS to be used as surrogate endpoints in patients with AGC who underwent second-line chemotherapy. Further research is needed based on individual patient data from ongoing randomized trials.
Atrial Fibrillation: A Risk Factor for Increased Mortality in Patients with Ventricular Tachyarrhythmias–An AVID Registry Analysis
Authors: J. Martins, D. Wyse, J. Love, Qing Yao, M. Carlson, P. Cassidy, H. Greene, C. Ocampo, M. Raitt, E. Schron, N. Stamato, A. Olarte, Avid Investigators
Journal: Circulation (2001)
Initial and maintenance dose of sorafenib in female patients with advanced hepatocellular carcinoma should be modified to maximize therapeutic effect.
Authors: Kaoru Tsuchiya, Yohei Kubota, Kenta Takaura, Hitomi Takada, Nobuharu Tamaki, Yutaka Yasui, Hiroyuki Nakanishi, Jun Itakura, Masayuki Kurosaki, Namiki Izumi
Journal: Journal of Clinical Oncology (2018)

497 Background: Sorafenib is the only approved first-line agent in patients with advanced HCC and patients who showed progressive disease after sorafenib therapy have an opportunity to receive regorafeib as 2 nd -line agent. Therefore, it is very important to maintain sorafenib therapy until sorafenib resistance occurs. We retrospectively analyzed initial and maintenance dose especially in female patients. Methods: A total of 232 patients with advanced HCC who received sorafenib in our institution from July, 2009 until May, 2017 were enrolled. Overall survival (OS), radiological response evaluated by modified RECIST criteria and dose of sorafenib were analyzed. Results: The 232 patients included 179 males and 53 females, with a mean age of 71 ± 9 years. The majority of patients (N = 131, 56.4%) were HCV Ab positive and HBs Ag was positive in 29 patients. Eighty-six patients had extrahepatic metastasis and 50 patients showed major portal invasion defined as VP3 or VP4 by Liver Cancer Study Group of Japan. The overall survival rates of the 232 patients at 6, 12 and 18 were 72.4%, 53.6% and 41.9%, and MST was 14 months. In all patients no existence of major portal invasion, serum Albumin level ≧3.5g/dl before administration of sorafenib, and post-sorafenib anticancer therapy were independently associated with OS. The mean age of female patients was 75 years and mean body weight was 49kg. In female patients only 5 patients (9.4%) showed over 60kg. The dose reduction of sorafenib was necessary in all female patients and 26 female patients could receive post-sorafenib anticancer therapy including regorafenib. The muscle mass calculated by direct segmental multifrequency bioelectrical impedance analysis method was associated with duration of sorafenib therapy, dose reduction of sorafenib and possibility of post-sorafenib anticancer therapy. Conclusions: The modification of sorafenib dose according to sex and muscle mass is clinically important to improve overall survival in patients with advanced HCC treated with sorafenib. It is associated with duration of sorafenib therapy and the possibility for induction of other therapies after sorafenib failure.
Early‐life secondhand smoke exposure and food hypersensitivity through adolescence
Authors: L. Y. Feldman, J. D. Thacher, M. van Hage, I. Kull, E. Melén, G. Pershagen, M. Wickman, T. To, J. L. Protudjer, A. Bergström
Journal: Allergy (2018)

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Patient characteristics, treatment, and outcomes in recurrent HR+/HER2- advanced breast cancer after adjuvant therapy: A retrospective chart review of community-based practice.
Authors: Yanni Hao, Peggy L. Lin, Alexander R. Macalalad, James E. Signorovitch, Eric Qiong Wu, Zhou Zhou, Jinlin Song, Erika Ohashi, Caroline Kelley, Suleiman Alfred Massarweh
Journal: Journal of Clinical Oncology (2014)

e11550 Background: Patients with hormone receptor-positive (HR+), human epidermal growth factor receptor-negative (HER2-) breast cancer (BC) may experience disease relapse after adjuvant therapy. We studied the characteristics, treatment, and outcomes of patients with HR+/HER2- BC who relapsed after adjuvant therapy. Methods: This is a chart review studyof patients with HR+/HER2- advanced breast cancer (aBC) in a network of community-based oncology practices in the US. Patients had disease relapse between 1/1/2004 and 9/30/2010. The study was approved by the jurisdictional Institutional Review Board. Extracted chart data included demographics, disease characteristics, comorbidities, treatment and outcomes following relapse. Kaplan-Meier analysis was used to estimate overall survival. Results: We studied 99 patients with disease relapse after adjuvant therapy. Of these, 69% were white and 30% African American. 69% had private health insurance, 37% had Medicare and 14% had Medicaid. Eighty-seven percent of patients received adjuvant endocrine therapy. Tamoxifen was used in 41% of patients, anastrozole in 25%, letrozole in 12%, and exemestane in 5%. Disease relapse occurred after a median of 34.8 months from the initial diagnosis of breast cancer. Upon relapse, the mean age was 59 years and the median Charlson Comorbidity Index (CCI) was 2. From the start of 1st-line therapy for aBC, median duration of treatment before discontinuation or death within the study period was 35.9 months. Sixty-five percent of patients died during the study period with a median overall survival of 31.8 months. Conclusions: In this retrospective study of patients with HR+/HER2- advanced breast cancer recurrence after adjuvant therapy, median time to recurrence was approximately 3 years from initial breast cancer diagnosis with the majority of patients having received adjuvant endocrine therapy. Following recurrence, and after initiating the first treatment for aBC, median survival was less than 3 years.
Abstract 16865: Long-Term Clinical Outcomes of Patients with Type 4a Myocardial Infarction Following Elective PCI for Stable Ischemic Heart Disease (SIHD): Post Hoc Analysis of the COURAGE Trial
Authors: Marcin S Dada, Koon K Teo, Pamela M Hartigan, Eric R Bates, Steven P Sedlis, G.B. John Mancini, David J Maron, John A Spertus, William J kostuk, Gilbert Gosselin, Jean-Francois Tanguay, Mandeep S Sidhu, Daniel S Berman, Leslee J Shaw, William S Weintraub, Bernard R Chaitman, William E Boden
Journal: Circulation (2012)

Background:  The relevance of peri-PCI (type 4a) myocardial infarction (MI) is controversial, as is the type of biomarker (CK-MB or troponin) and threshold (e.g., 3x or 5x ULN; other?) used to determine prognostically-important clinical events. While the current 2007 Universal MI Definition designates a biomarker (CK-MB or troponin) elevation >3x the 99 th  percentile URL as a type 4a MI, data from recent PCI trials have failed to show a significant independent association between peri-PCI MI and mortality up to 2 years using this definition. Whether type 4a MI is associated with mortality or subsequent type 1 MI during longer-term follow-up is unknown.   Methods:  We performed a post hoc analysis of clinical outcomes (all-cause mortality, spontaneous [type 1] MI, or hospitalization for acute coronary syndrome [ACS]) among 1,371 SIHD patients (pts) from the COURAGE Trial who underwent initial PCI and long-term (2.5-7.0 year [mean 4.6 year]) follow-up. All pts had ≥70% stenosis in at least one major coronary artery that met an AHA/ACC Joint Task Force Class I-II indication for PCI. Type 4a MI was defined as CK-MB ≥ 3x ULN or troponin ≥ 5x ULN plus angina or an angina equivalent within 24 hours post-PCI; type 1 MI was defined as new ECG Q-waves or CK-MB ≥ 1.5X ULN or troponin ≥ 2x ULN plus angina/new ischemia equivalent.   Results:  Protocol-defined type 4a MI occurred in only 51 pts (4%). The rate of subsequent all-cause mortality was low and occurred in 6% of patients who had peri-PCI MI (3/51) and in 8% of pts without peri-PCI MI (99/1,320); P=NS. However, pts who sustained an initial type 4a MI had significantly higher rates of subsequent non-fatal events with 16/51 pts (31%) developing a subsequent type 1 MI and 17/51 pts (33%) requiring hospitalization for ACS, as compared with a type 1 MI rate of 9% (118/1,320) and ACS hospitalization rate of 11% (148/1,320 pts) in those without an initial peri-procedural MI (P    Conclusions:  Type 4a peri-PCI MI, as defined above, was associated with an increased rate of type 1 MI and re-hospitalization for ACS during a mean 4.6 year follow-up, the significance of which may be prognostically-important. However, long-term mortality remained low regardless of the presence or absence of initial type 4a MI.
Gender differences in body composition in lean and overweight non-alcoholic fatty liver disease: The Rotterdam Study
Authors: L. Alferink, K. Trajanoska, N. Erler, J. Schoufour, R. de Knegt, A. Ikram, H. Janssen, O. Franco, H. Metselaar, F. Rivadeneira, S.D. Murad
Journal: Journal of Hepatology (2018)
Microsatellite instability in prostate cancer by PCR or next-generation sequencing
Authors: Jennifer A. Hempelmann, Christina M. Lockwood, Eric Q. Konnick, Michael T. Schweizer, Emmanuel S. Antonarakis, Tamara L. Lotan, Bruce Montgomery, Peter S. Nelson, Nola Klemfuss, Stephen J. Salipante, Colin C. Pritchard
Journal: Journal for ImmunoTherapy of Cancer (2018)

Microsatellite instability (MSI) is now being used as a sole biomarker to guide immunotherapy treatment for men with advanced prostate cancer. Yet current molecular diagnostic tests for MSI have not been evaluated for use in prostate cancer.
Abstract 12170: Long-term Clinical Outcomes of Drug-eluting Stent vs Bare Metal Stent for Unprotected Left Main Disease: A Meta-analysis
Authors: Carlos A Gongora, Alejandro Lemor, Abel Casso Dominguez, Alejandro Zulbaran y Rojas, Jacobo Pena, Chirag Bavishi, Shilpkumar Arora, Hafeez Ul Hassan, Farid Gholitabar, Shawn Lee, Franco Vallejo, Seyedhamed Hosseinidehkordi, Edgar Argulian
Journal: Circulation (2016)

Background: The long-term benefits of drug-eluting stents (DES) compared to bare metal stents (BMS) for the unprotected left main (ULM) disease are unclear. We aimed at investigating the long-term clinical outcomes in patients treated with DES vs. BMS for ULM disease. Methods: We performed a meta-analysis of studies examining ULM stenting with a follow-up duration of at least 3 years. We included the following end-points: all cause-mortality, myocardial infarction (MI), and target-lesion revascularization (TLR). In addition, we examined the rates of major adverse cardiac events (MACE) as specified by each individual study. Pooled risk ratios (RR) and their 95% confidence intervals (CI) were calculated for all outcomes using a random-effect model. Results: Thirteen studies were included in the analysis: 12 observational and 1 randomized study, with a total of 4,574 patients. We analyzed separately adjusted and unadjusted data. The adjusted data included a randomized trial and propensity-matched analysis of observational studies. Both analyses showed the benefit of DES for TLR (A p=0.004, UA p&lt;0.001) and MACE (A p=0.02, UA p=0.007). While the unadjusted analysis showed a significant difference for all-cause mortality, the difference was not significant for the adjusted data. Neither of the analyses showed a significant difference for MI (Figure 1a and 1b). Conclusions: The study confirms the benefits of DES for TVR and MACE but there was no significant difference in adjusted all-cause mortality.
Association of Skin Examination Behaviors and Thinner Nodular vs Superficial Spreading Melanoma at Diagnosis
Authors: Clio Dessinioti, Alan C. Geller, Aravella Stergiopoulou, Susan M. Swetter, Eszter Baltas, Jonathan E. Mayer, Timothy M. Johnson, John Talaganis, Myrto Trakatelli, Dimitrios Tsoutsos, Gerasimos Tsourouflis, Alexander J. Stratigos
Journal: JAMA Dermatology (2018)

Early melanoma detection strategies include skin self-examination (SSE), physician skin examination (PSE), and promotion of patient knowledge about skin cancer.To investigate the association of SSE, PSE, and patient attitudes with the detection of thinner superficial spreading melanoma (SSM) and nodular melanoma (NM), the latter of which tends to elude early detection.This cross-sectional, questionnaire-based, multicenter study identified patients with newly diagnosed cutaneous melanoma at 4 referral hospital centers in the United States, Greece, and Hungary. Among 920 patients with a primary invasive melanoma, 685 patients with SSM or NM subtype were included.A standardized questionnaire was used to record sociodemographic information, SSE and PSE practices, and patient perceptions in the year prior to diagnosis.Data were analyzed according to histologic thickness, with a 2-mm cutoff for thinner SSM and NM.Of 685 participants (mean [SD] age, 55.6 [15.1] years; 318 [46%] female), thinner melanoma was detected in 437 of 538 SSM (81%) and in 40 of 147 NM (27%). Patients who routinely performed SSE were more likely to be diagnosed with thinner SSM (odds ratio [OR], 2.61; 95% CI, 1.14-5.40) but not thinner NM (OR, 2.39; 95% CI, 0.84-6.80). Self-detected clinical warning signs (eg, elevation and onset of pain) were markers of thicker SSM and NM. Whole-body PSE was associated with a 2-fold increase in detection of thinner SSM (OR, 2.25; 95% CI, 1.16-4.35) and thinner NM (OR, 2.67; 95% CI, 1.05-6.82). Patient attitudes and perceptions focusing on increased interest in skin cancer were associated with the detection of thinner NM.Our findings underscore the importance of complementary practices by patients and physicians for the early detection of melanoma, including regular whole-body PSE, SSE, and increased patient awareness.
Quantification of biliary phosphatidylcholine by non-invasive 31P magnetic resonance spectroscopy imaging suggests differences in cholangiopathies: A pilot study
Authors: E. Halilbasic, L. Pfleger, M. Gajdosik, M. Chmelik, S. Tratting, M. Krssak, M. Trauner
Journal: Journal of Hepatology (2018)
Changes in serum neurotransmitters are associated with changes in patient reported outcomes and neurocognitive performance in patients with hepatitis C virus-genotype 1 who achieved sustained virologic response
Authors: L. Deavila, A.A. Weinstein, M. Curry, P. Golabi, J.M. Estep, C. Escheik, A. Birerdinc, M. Stepanova, L. Gerber, Z. Younossi
Journal: Journal of Hepatology (2018)
Gemcitabine-oxaliplatin plus rituximab (R-GemOx) as first-line treatment in elderly patients with diffuse large B-cell lymphoma: a single-arm, open-label, phase 2 trial
Authors: Qiu-Dan Shen, Hua-Yuan Zhu, Li Wang, Lei Fan, Jin-Hua Liang, Lei Cao, Wei Wu, Yi Xia, Jian-Yong Li, Wei Xu
Journal: The Lancet Haematology (2018)