tbuckley/cabot-search huggingface dataset:
Dietary Intake of Omega-3 Fatty Acids From Fish and Risk of Diabetic Retinopathy
Authors: Emily Y. Chew
Journal: JAMA (2017)

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Annals Graphic Medicine - Draw the Line
Authors: Vun Peng Chang, Ben Mitchell
Journal: Annals of Internal Medicine (2017)

Web Exclusives6 June 2017Annals Graphic Medicine - Draw the LineFREEVun Peng Chang Dr, MBBS, FACEM and Ben Mitchell, BA (Hons)Vun Peng Chang Dr, MBBS, FACEMSearch for more papers by this author and Ben Mitchell, BA (Hons)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/G16-0028 SectionsAboutVisual AbstractPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Download figure Download PowerPoint Download figure Download PowerPoint Download figure Download PowerPoint Download figure Download PowerPoint Download figure Download PowerPoint Download figure Download PowerPoint Comments0 CommentsSign In to Submit A Comment Michael ColeLocum Tenens Intensivist13 June 2019 If only... If only... we had more ER docs with this kind of attitude/approach... we had more families with this degree of expectations and acceptance... we would all talk to our family membersabout these things long before they are necessary. Author, Article, and Disclosure InformationAffiliations: Disclosures: The authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=G16-0028.Author/Illustrator Information: Vun Peng Chang, MBBS, is an emergency medicine physician at John Hunter Hospital, Newcastle, Australia, with an interest in graphic medicine. Ben Mitchell, BA(Hons), is an illustrator and comic artist from Newcastle, Australia, currently completing a PhD in visual communication focusing on graphic narrative. He currently produces a comic book series named "Storm Clouds" and lectures at the University of Newcastle.Author Contributions: Conception and design: V.P. Chang, B. Mitchell.Drafting of the article: V.P. Chang, B. Mitchell.Critical revision of the article for important intellectual content: V.P. Chang.Final approval of the article: V.P. Chang.Written by Vun Peng Chang, MBBS, and illustrated by Ben Mitchell, BA(Hons). PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 6 June 2017Volume 166, Issue 11Page: W57-W63KeywordsConflicts of interestDisclosureEmergency medicineHealth careHospital medicineStorms ePublished: 6 June 2017 Issue Published: 6 June 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Major stressful life events and risk of developing lung cancer.
Authors: Syed Hasan Raza Jafri, Faisal Ali, Arash Mollaeian, Syed Mojiz Hasan, Rahat Hussain, Bindu H Akkanti, Jessica T Williams, Shailesh M Advani, Hazem Edmond El-Osta
Journal: Journal of Clinical Oncology (2017)

1575 Background: Lung cancer is the leading cause of cancer-related mortality linked with smoking, though only 6-18% of heavy smokers die of lung cancer. We hypothesized that major stressful life events are a risk factor for developing lung cancer. Methods: In our matched case-control study, cases (CA) were lung cancer patients diagnosed within past 12 months. Controls (CO) were patients without a prior history of malignancy. CA and CO were matched for age, gender and smoking status. Smokers had at least 10 packs/years history of smoking. Data was collected using standardized research questionnaire on 11 major stressful life events using Holmes and Rahe stress scale. The primary endpoint was odds of having a major stressful life event. A sample of 360 patients (120 CA and 240 CO), was needed to achieve 80% power to detect an odds ratio (OR) of 2.00 using Chi-Square test with a P = 0.05 significance. The study was IRB approved at each institution. Results: Between May 2015 and December 2016, 324 patients were enrolled (23 were excluded due to prior cancer history or incomplete information). 301 (CA = 102; CO = 199) were included in the final analysis. The two groups were well matched in median age (CA = 64.4 years; CO = 63.9years), gender (CA-Male = 48%; CO-Male = 49.2%) and smoking status (ever smoker, CA = 86%; CO = 85%). There was no difference in lifetime stressful life event between CA and CO (95% vs 93.9% P = 0.68%). However, CA were significantly more likely to have had a major stressful life event within the past 5 years than controls (CA = 77.4% vs CO = 65.8%, P = 0.03, (OR = 1.78). Serious life-threatening illness of an immediate family member (P = 0.04) and retirement (P = 0.07) within the past 5 years were noticeably more common among CA. Holmes-Rahe stress score in the last 5 years was higher in men (86.3 vs 63.3, P = 0.07) and those &gt; 65 years old (82.4 vs 57.2,P = 0.04) as compared with CO and in those with squamous histology than with adenocarcinoma (115.6 vs 63.4, P = 0.005). Conclusions: Patients with lung cancer (CA) were significantly more likely to have had a major stressful life event within the past 5 years than the matched controls (CO), especially in older men with squamous histology. Major stressful life events should be considered a risk factor for developing lung cancer.
A multicenter phase II study of S-1 combined with bevacizumab after platinum-based chemotherapy in patients with advanced non-squamous non-small cell lung cancer.
Authors: Takaaki Tokito, Kazuhiko Yamada, Masao Ichiki, Kazuhisa Takahashi, Yasushi Hisamatsu, Koichi Azuma, Hidenobu Ishii, Takehito Shukuya, Hiroaki Takeoka, Kazuo Nishikawa, Tomoaki Hoshino
Journal: Journal of Clinical Oncology (2015)

e19040 Background: The additional effects of bevacizumab (B) as first-line chemotherapy for non-squamous non-small cell lung cancer (Non-sq NSCLC) have been established. However, the efficacy of B in a second-line setting or further has not been clarified. It has recently become clear that S-1 (S), an oral fluoropyrimidine, is effective for advanced NSCLC, and S is now used with platinum as one of the standard forms of first-line chemotherapy. Furthermore, preclinical findings have suggested that the combination of S plus B is a promising treatment option. Methods: Non-sq NSCLC patients with an ECOG performance status of 0-2, and who had undergone prior platinum-based chemotherapy regardless of the use of B, were eligible for the study. S (80 mg/m2) was administered orally twice daily for 14 days, and B (15 mg/kg) on day 1 every 3 weeks until disease progression or unacceptable toxicity occurred. The primary endpoint was progression-free survival (PFS), and the planned sample size was 28 patients. Results: Between March 2012 and June 2014, 28 patients (14 males and 14 females; median age 62 years; PS 0/1/2: 21/7/0; Ad/Other: 26/2, EGFR mutation positive/wild type 12/16) were accrued from 4 centers in Japan. All 28 patients were included in analysis of efficacy and toxicity. With a median follow-up of 9.3 months, the median PFS was 3.2 months (95% CI: 2.2-4.0 months). Patients who had not received prior pemetrexed or who had shown a good response to prior chemotherapy tended to have a longer PFS (5.3 and 5.0 months, respectively), although this was not statistically significant. An objective response was observed in 4 patients (PR; 4, SD; 20, PD 4), the response rate and disease control rate being 14.3% and 85.7%, respectively. The treatment was well tolerated, the most common treatment-related side effects being anorexia (75%) and fatigue (68%). Conclusions: This is the first report to evaluate the efficacy and safety of SB. Although SB seems to have a higher tumor reduction effect than S alone for previously treated Non-sq NSCLC, this study failed to meet its primary endpoint. SB is well tolerated and no new toxicities were observed. Clinical trial information: UMIN000007386.
Asymptomatic Pigmented Lesions of the Gingiva
Authors: Eric T. Stoopler, David Ojeda, Faizan Alawi
Journal: JAMA Dermatology (2017)

A white woman in her 50s with a medical history of orolabial melanotic macules presented to an oral medicine clinic for evaluation of asymptomatic pigmented lesions affecting the maxillary and mandibular gingiva. What is your diagnosis?
Architecture and functioning of child and adolescent mental health services: a 28-country survey in Europe
Authors: Giulia Signorini, Swaran P Singh, Vlatka Boricevic-Marsanic, Gwen Dieleman, Katarina Dodig-Ćurković, Tomislav Franic, Suzanne E Gerritsen, James Griffin, Athanasios Maras, Fiona McNicholas, Lesley O'Hara, Diane Purper-Ouakil, Moli Paul, Paramala Santosh, Ulrike Schulze, Cathy Street, Sabine Tremmery, Helena Tuomainen, Frank Verhulst, Jane Warwick, Giovanni de Girolamo
Journal: The Lancet Psychiatry (2017)
Brentuximab vedotin or physician's choice in CD30-positive cutaneous T-cell lymphoma (ALCANZA): an international, open-label, randomised, phase 3, multicentre trial
Authors: H Miles Prince, Youn H Kim, Steven M Horwitz, Reinhard Dummer, Julia Scarisbrick, Pietro Quaglino, Pier Luigi Zinzani, Pascal Wolter, Jose A Sanches, Pablo L Ortiz-Romero, Oleg E Akilov, Larisa Geskin, Judith Trotman, Kerry Taylor, Stephane Dalle, Michael Weichenthal, Jan Walewski, David Fisher, Brigitte Dréno, Rudolf Stadler, Tatyana Feldman, Timothy M Kuzel, Yinghui Wang, Maria Corinna Palanca-Wessels, Erin Zagadailov, William L Trepicchio, Wenwen Zhang, Hui-Min Lin, Yi Liu, Dirk Huebner, Meredith Little, Sean Whittaker, Madeleine Duvic, Judith Trotman, David Joske, H. Miles Prince, Kerry Taylor, Ian D. Lewis, Constanze Jonak, Franz Trautinger, Oliver Bechter, Pascal Wolter, Dominique Bron, Vladmir Claudio C. de Lima, Jose Antonio Sanches, Richard Klasa, Martine Bagot, Marie Beylot-Barry, Stephane Dalle, Michel D'Incan, Brigitte Dreno, Florent Grange, Jan Nicolay, Rudolf Stadler, Michael Weichenthal, Marion Wobser, Chalid Assaf, Carmen Loquai, Pietro Quaglino, Michele Spina, Pier Luigi Zinzani, Alberto Bosi, Pier Paolo Fattori, Aleksandra Grzanka, Jan Walewski, Andres Lopez-Hernandez, Pablo L. Ortiz-Romero, Jose Juan Rifon Roca, Silvana Novelli Canales, Reinhard Dummer, Timothy Illidge, Rod Johnson, Sean Whittaker, Stephen Morris, Pam McKay, Julia Scarisbrick, Madeleine Duvic, Tatyana Feldman, Oleg Akilov, Larisa Geskin, Steve Horwitz, Youn H. Kim, Barbara Pro, Timothy Kuzel, Adam Lerner, Herbert Eradat, Lubomir Sokol, David C. Fisher, Sarah Hughey
Journal: The Lancet (2017)
Phase (Ph) 2 stage 1 clinical activity of seviteronel, a selective CYP17-lyase and androgen receptor (AR) inhibitor, in women with advanced AR+ triple-negative breast cancer (TNBC) or estrogen receptor (ER)+ BC: CLARITY-01.
Authors: Ayca Gucalp, Michael A. Danso, Anthony D. Elias, Aditya Bardia, Haythem Y. Ali, David Potter, Nashat Y. Gabrail, Barbara B. Haley, Hung T. Khong, Elizabeth Carloss Riley, Leigh Ervin, Joel Robert Eisner, Edwina Baskin-Bey, M.D., William Richard Moore, Tiffany A. Traina
Journal: Journal of Clinical Oncology (2017)

1102 Background: Seviteronel (Sevi), an oral selective CYP17-lyase and AR inhibitor that blocks testosterone and estradiol production and competitively antagonizes the AR, is in Ph 2 clinical development for BC and prostate cancer. The primary objective of this ongoing Ph 2 study (NCT02580448) is to estimate the activity of once daily Sevi in women with AR+ TNBC and ER+ BC as measured by clinical benefit rate (CBR) at 16 and 24 weeks (wk), respectively. Methods: Patients (pts) with ER+/HER2-normal metastatic BC following progression of ≥1 prior line of endocrine therapy or TNBC were enrolled with no limit of prior therapies in either cohort. Evaluable pts had AR ≥10% via central IHC staining (TNBC only) and 1 post-baseline scan. Sevi was administered at 450 mg oral daily. Scans were performed every 8 wk. Circulating tumor cell (CTC) enumeration was performed by EPIC CTC analysis. A Simon’s 2-stage design was employed to determine activity (≥2 of 13 CBR16 in TNBC and ≥2 of 12 CBR24 in ER+ BC allow for accrual to Stage 2). Results: As of 4 Oct, 2016, 16 pts with AR+ TNBC (6 evaluable) and 14 pts with ER+ BC (11 evaluable) were enrolled. 67% had visceral metastases; 10% had stable brain metastases. 60% had ≥2 lines of prior therapy for advanced disease. 13 of 14 (93%) TNBC pts who underwent central AR testing had AR ≥10%. Four pts in the TNBC cohort and 8 pts in the ER+ cohort remain on therapy. CBR16 (TNBC) and CBR24 (ER+) was 2 of 6 (33%) and 2 of 11 (18%) allowing Stage 2 accrual in both cohorts. 7 of 10 evaluable pts with CTCs present at baseline had a CTC decline at C2D1, including all that met CBR (-94.3% [-27.5, -100] median [range]). The most common adverse events (≥ 25%) were fatigue (50%), nausea (43%) and decreased appetite (33%); all Grade 1/2. Updated CBR data will be presented at the time of presentation. Conclusions: Sevi Stage 1 activity is suggested by CBRs, along with associated CTC declines in heavily pre-treated pts with high disease burden. The observed safety profile is consistent with on-target pharmacology. Stage 2 enrollment is ongoing. Sevi may provide a novel treatment option for women with AR+ TNBC or ER+ BC. Clinical trial information: NCT02580448.
Association of molecular subtype, proliferation, and immune genes with efficacy of carboplatin versus gemcitabine addition to taxane-based, anthracycline-free neoadjuvant chemotherapy in early triple-negative breast cancer (TNBC): Results of the randomized WSG ADAPT-TN trial.
Authors: Oleg Gluz, Cornelia Liedtke, Aleix Prat, Matthias Christgen, Daniel Gebauer, Ronald E. Kates, Eva-Maria Grischke, Helmut Forstbauer, Michael Wilhelm Braun, Mathias Warm, John Hackmann, Christoph Uleer, Bahriye Aktas, Claudia Schumacher, Sherko Kummel, Rachel Wuerstlein, Enrico Pelz, Ulrike Nitz, Hans Heinrich Kreipe, Nadia Harbeck
Journal: Journal of Clinical Oncology (2017)

573 Background: In the ADAPT-TN neoadjuvant trial, 12-week nab-paclitaxel (nab- pac)+carboplatin (carbo) was highly effective and superior to nab-pac+gemcitabine (gem). However, within TNBC, reliable predictive markers for carbo use have yet to be identified. Methods: Patients with early TNBC (centrally confirmed) were treated by nab-pac 125 mg/m2 with either carbo AUC2 or gem 1000 mg/m2 d 1,8 q21 given for 4 cycles. Genomic data (80 genes) and Prosigna (PAM-50) scores were available in 306 pre-therapeutic samples of 331 treated patients. Fisher’s exact test was performed for pCR differences; associations of continuous measurements or scores with pCR were analyzed by the Mann-Whitney statistic. Results: pCR was 44.5% to 28.4% (p=.004) in favor of nab-pac - carbo. Specifically within the carbo- containing arm, immunological (CD8, PD1, PFDL1) genes and proliferation markers (proliferation score and ROR scores, MKI67, CDC20, NUF2, KIF2C, CENPF, EMP3, TYMS) were positively associated with pCR (p&lt;.05 for all). Specifically within the gem-arm, angiogenesis genes were negatively associated with pCR (ANGPTL4: p=.05; FGFR4: p=.02; VEGFA: p=.03). In the whole collective, basal-like (83.3%) was favorable for pCR (38% vs. 20%, p=.015) compared to other subtypes (HER: 6.4%; luminal-A: 1.7%; normal: 8.7%), as was lower HER-2 score (p&lt;.001). Proliferation was positively associated with pCR: i.e., Pam50 proliferation score, ROR scores (all p&lt;.004), and higher Ki67 by central IHC (p&lt;.001) -- though not MKI67 RNA expression, despite their moderate correlation. Conclusions: In early TNBC, basal-like subtype, higher Ki67 (by IHC), and lower HER-2 score were associated with chemo-sensitivity for both neoadjuvant arms. Chemo-resistance pathways differed between the two taxane-based combinations (low proliferation and immune marker gene expression for carbo, high angiogenesis for gem). The positive predictive impact of immunological genes in the nab-pac - carbo arm could influence optimal patient selection for immune-modulative therapy. Clinical trial information: NCT01815242.
Hypofractionated, normofractionated and intraoperative breast irradiation: Long term cosmetic outcome based on photographic evaluation.
Authors: Tarek Ellethy, Grit Welzel, Elena Sperk, Christian Neumaier, Benjamin Tuschy, Sebastian Berlit, Michael Ehmann, Marc Sütterlin, Frederik K. Wenz, Yasser Abo-Madyan
Journal: Journal of Clinical Oncology (2017)

568 Background: Photographic documentation of breast changes after breast radiotherapy (RT) is a helpful tool to both subjectively and objectively evaluate cosmesis. The aim of this study was to evaluate cosmesis in breast cancer patients after receiving hypofractionated whole breast RT (HF-WBRT), normofractionated (NF-WBRT), intraoperative RT (IORT) or combined WBRT/IORT. Methods: After excluding cases with missing or inadequate photos from three prospective clinical trials, KOSIMA, TARGIT-A &amp; TARGIT-E, 155 and 205 cases were included in a subjective analysis while 132 and 185 cases were included in an objective analysis postoperatively and after 2 years respectively. Subjective evaluation was done by 9 observers using the Harvard scale. Objective evaluation was done by assessing percentage breast retraction (pBRA). Based on the treatment received, patients were divided into 5 groups: 1. HF-WBRT 40/2,67 Gy ± Boost, 2. NF-WBRT 50/2 Gy ± Boost, 3. NF-WBRT 56/2 Gy, 4. IORT 20 Gy, 5. IORT 20 Gy+WBRT 46/2 Gy. Results: Subjectively, the rate of excellent-good cosmesis was 92% postoperatively and 84% after 2 years while objectively it was around 56% at both time points. At 2 years, no significant difference was observed between the 5 treatment groups with the subjective excellent-good cosmesis being 82%, 80%, 92%, 83%, 85% (p = 0.546) and objective being 56%, 61%, 52%, 53%, 50% (p = 0.883) in groups 1-5 respectively. Factors possibly affecting cosmesis at 2 years were examined. No significant difference was observed with age, smoking, BMI, chemotherapy, hormone therapy or type of axillary surgery. Significantly better cosmesis was observed with upper outer tumor location compared to other quadrants (p &lt; 0.0001) also with a ratio of excised/total breast volume under 20% (p &lt; 0.0294). Conclusions: Cosmetic outcome after hypofractionated and IORT was similar to normofractionated breast RT. After 2 years of treatment, cosmetic deterioration remained acceptable, overall &lt; 10%. Tumor location and excised breast volume were the only factors significantly affecting cosmetic outcome.
Trastuzumab (T) detection in serum using signal amplification strategy for non-faradaic impedimetric sensing quartz crystal microbalance (QCM) based on peptide piezo-immunosensors and its role in breast cancer treatment.
Authors: Mohammad Muhsin Chisti, Juan Liu, Justin Frank Antoni Klamerus, Ishmael A. Jaiyesimi, Syeda Hina Batool, Xiangqun Zeng
Journal: Journal of Clinical Oncology (2017)

e12502 Background: Her2Neu (H) antigen, expressed on 20% of Breast cancers, is an established target for antibody therapy with T. Immunohistochemistry is still the most widely used technique to detect h level which is time consuming and does not reveal any details of interaction between the molecules. We have developed a new innovative biosensor based novel technique to study real time interaction of h antigens with T using QCM Piezo-immunosensor. This quantitative label free peptide based assay can be used to characterize cell surface antigen, to study antigen- antibody interactions and obtain understanding of mechanisms of resistance. Methods: A label free and reagent free peptide mimotope capacitive biosensor is developed for T quantification based on non-Faradaic readout. The low sensitivity issue of capacitive biosensor was overcome with two innovations: peptide mimotope mixed SAM biointerface and dilution of the testing buffer. Signal amplification was achieved through dilution of the PBS buffer to tune C dl to dominate the overall capacitance change upon target binding. After 1000 times dilution, limit of detection is lowered 500 times (0.22 µg/mL) and the sensitivity increased 20 times (0.04192 (µg/mL) -1 ). Results: Binding was very specific. Signal amplification strategy is practical. Further applied to planar electrode for optimizing sensing, response time in less than 1 minute. Conclusions: This is the first report of T detection using electrochemical method based on non-Faradaic impedance. h antigen density and interactions of antigens will help physicians to determine the clinical efficacy and resistance mechanisms to targeted antibodies like T and ado-Trastuzumab.For the first time, we have established a low cost, highly sensitive, fast, synthetic, QCM assay which could be used as a basis for developing a new generation of affinity-based Immunosensor assays. This real time capability and its simplicity of operation are highly suitable for multipurpose studies on living cells including cell immobilization, cytotoxicity of drugs, and the cell action mechanisms
Intense Muscle Activity Due to Polymyositis Incidentally Detected in a Patient Evaluated for Possible Malignancy by FDG PET/CT Imaging
Authors: Xia Bai, Ning Tie, Xuemei Wang, Jianmin Zhao
Journal: Clinical Nuclear Medicine (2017)

A 42-year-old woman suffered shortness of breath and whole-body pain, more prominent in both thighs. After the initial assessment, a paraneoplastic syndrome was considered clinically, and FDG PET/CT was performed to search culprit malignancy. The images did not reveal any focal lesion typical of solid hypermetabolic malignancy. Instead, diffuse increased muscle activity was noted in most musculatures, with some focally intense. The findings were suggestive of polymyositis, which was subsequently confirmed.