tbuckley/cabot-search huggingface dataset:
The eSexual Health Clinic system for management, prevention, and control of sexually transmitted infections: exploratory studies in people testing for Chlamydia trachomatis
Authors: Claudia S Estcourt, Jo Gibbs, Lorna J Sutcliffe, Voula Gkatzidou, Laura Tickle, Kate Hone, Catherine Aicken, Catherine M Lowndes, Emma M Harding-Esch, Sue Eaton, Pippa Oakeshott, Ala Szczepura, Richard E Ashcroft, Andrew Copas, Anthony Nettleship, S Tariq Sadiq, Pam Sonnenberg
Journal: The Lancet Public Health (2017)

BackgroundSelf-directed and internet-based care are key elements of eHealth agendas. We developed a complex online clinical and public health intervention, the eSexual Health Clinic (eSHC), in which patients with genital chlamydia are diagnosed and medically managed via an automated online clinical consultation, leading to antibiotic collection from a pharmacy. Partner notification, health promotion, and capture of surveillance data are integral aspects of the eSHC. We aimed to assess the safety and feasibility of the eSHC as an alternative to routine care in non-randomised, exploratory proof-of-concept studies.MethodsParticipants were untreated patients with chlamydia from genitourinary medicine clinics, untreated patients with chlamydia from six areas in England in the National Chlamydia Screening Programme's (NCSP) online postal testing service, or patients without chlamydia tested in the same six NCSP areas. All participants were aged 16 years or older. The primary outcome was the proportion of patients with chlamydia who consented to the online chlamydia pathway who then received appropriate clinical management either exclusively through online treatment or via a combination of online management and face-to-face care. We captured adverse treatment outcomes.FindingsBetween July 21, 2014, and March 13, 2015, 2340 people used the eSHC. Of 197 eligible patients from genitourinary medicine clinics, 161 accessed results online. Of the 116 who consented to be included in the study, 112 (97%, 95% CI 91–99) received treatment, and 74 of those were treated exclusively online. Of the 146 eligible NCSP patients, 134 accessed their results online, and 105 consented to be included. 93 (89%, 95% CI 81–94) received treatment, and 60 were treated exclusively online. In both groups, median time to collection of treatment was within 1 day of receiving their diagnosis. 1776 (89%) of 1936 NCSP patients without chlamydia accessed results online. No adverse events were recorded.InterpretationThe eSHC is safe and feasible for management of patients with chlamydia, with preliminary evidence of similar treatment outcomes to those in traditional services. This innovative model could help to address growing clinical and public health needs. A definitive trial is needed to assess the efficacy, cost-effectiveness, and public health impact of this intervention.FundingUK Clinical Research Collaboration.
Pharmacologic Therapy for Type 2 Diabetes: Synopsis of the 2017 American Diabetes Association Standards of Medical Care in Diabetes
Authors: James J. Chamberlain, William H. Herman, Sandra Leal, Andrew S. Rhinehart, Jay H. Shubrook, Neil Skolnik, Rita Rastogi Kalyani
Journal: Annals of Internal Medicine (2017)

The American Diabetes Association (ADA) annually updates the Standards of Medical Care in Diabetes to provide clinicians, patients, researchers, payers, and other interested parties with evidence-based recommendations for the diagnosis and management of patients with diabetes.For the 2017 Standards, the ADA Professional Practice Committee updated previous MEDLINE searches performed from 1 January 2016 to November 2016 to add, clarify, or revise recommendations based on new evidence. The committee rates the recommendations as A, B, or C, depending on the quality of evidence, or E for expert consensus or clinical experience. The Standards were reviewed and approved by the Executive Committee of the ADA Board of Directors, which includes health care professionals, scientists, and laypersons. Feedback from the larger clinical community informed revisions.This synopsis focuses on recommendations from the 2017 Standards about pharmacologic approaches to glycemic treatment of type 2 diabetes.
TLR6 polymorphism associated with overall survival in metastatic colorectal cancer (mCRC) patients treated with FOLFIRI/bevacizumab enrolled in FIRE3.
Authors: Satoshi Okazaki, Sebastian Stintzing, Volker Heinemann, Shu Cao, Wu Zhang, Dongyun Yang, Yan Ning, Yu Sunakawa, Stefan Stremitzer, Satoshi Matsusaka, Rita Elkhoueiry, Angela Mendez, Anish Parekh, Heinz-Josef Lenz
Journal: Journal of Clinical Oncology (2015)

11039 Background: Toll-like receptors (TLRs) play crucial roles in carcinogenesis and evolution of tumor microenvironment. Recent studies have shown that TLR6 dependent stimulation of the mesenchymal stem cells promotes angiogenesis. We tested the hypothesis that genetic variations of TLR6 will predict outcome in patients treated with bevacizumab based chemotherapy. Methods: Genomic DNA was isolated from tissue samples from 543 mCRC patients enrolled in the FIRE3 trial and treated in first-line with either FOLFIRI+bevacizumab (n = 265) or FOLFIRI+cetuximab (n = 278) was obtained from tissue samples. Two single nucleotide polymorphisms (SNPs) in the TLR6gene, rs5743810 G/A and rs3821985 G/C, were analyzed by PCR-based direct sequencing. These SNPs were tested for the association with tumor response, progression free survival (PFS) and overall survival (OS). Subgroup analyses by gender, tumor location, and Kras status were also analyzed. Results: In the FOLFIRI+bevacizumab treated patients, TLR6rs3821985 G/G variant showed a trend toward longer PFS (10.5 vs. 10.0 months, HR: 1.24, logrank p = 0.11) and OS (24.8 vs 24.7 months, HR: 1.28, logrank p = 0.10) compared to other variants (C/G and C/C). In the subgroup of Kras-wild type patients treated with FOLFIRI+bevacizumab, the same variant was significantly associated with longer PFS (10.7 vs. 9.9 months, HR 1.34, logrank p = 0.046) and OS (26.1 vs. 23.8 months, HR: 1.45, logrank p = 0.026) which remained significant (HR: 1.42, p = 0.041,) in a multivariate analysis. In the FOLFIRI+cetuximab treated patients, there was no association with outcome. Conclusions: This is the first report showing that TLR6SNP is associated with outcome in patients with wild type Kras mCRC treated with bevacizumab based chemotherapy.
Characteristics of patients with endometrial stromal sarcoma
Authors: C. Amin, B. Hemphill, T. Sittisomwong, A. Malpica, W. Hunt, C. Verschraegen
Journal: Journal of Clinical Oncology (2004)

5145 Background: Endometrial stromal sarcoma (ESS) is by definition a low grade sarcoma, accounting for less than 1% of all tumor malignancies. The prevalence is approximately 2 per million women. By comparison, the prevalence of endometrial cancer is 700 per million women. Because of its rarity, the natural history of the disease and the optimal therapy have not been well established. Methods: After IRB approval, the charts of 78 patients diagnosed for the first time with ESS and treated at the University of Texas MDACC were reviewed, with emphasis on patient demographics, therapies, recurrence, and survival. Patients with stromal nodule, high grade ESS (undifferentiated sarcoma), or other sarcomas were excluded. Results: The median age of 78 patients was 43 (range 20–78), 85% were Caucasian, and 37% had received exogenous hormones before diagnosis. Endometrial FIGO stage was I in 52%, II in 6%, III in 30%, and IV in 12%. The primary site was uterus in 87% and extra-uterine in 13%. The median parity was 2. Among 68 patients, 78% were postmenopausal. The two-year recurrence rate was 25% and the five year recurrence rate was 51%. The five-year survival rate was 81%. Conclusions: Our study represents 36 years of collected data from MDACC. The demographic data has been recorded and tabled. The median age of onset is younger than the one of endometrial cancer, but interestingly about 75% are postmenopausal at diagnosis. The prognosis is usually good. Various treatments including hormonal therapy, chemotherapy, radiation therapy, and hysterectomy with oophorectomy have been used, and we plan to study their impact on this disease, to present at the annual meeting. No significant financial relationships to disclose.
An oxygenation agent and radiation sensitizer, dodecafluoropentane, for the treatment of glioblastoma multiforme.
Authors: Jason D. Lickliter, David Brown Wilson, Howard Hendrickson, Natarajan Raghunand, Soo-Peang Khor, Olivia Longacre, Evan C. Unger
Journal: Journal of Clinical Oncology (2015)

TPS2078 Background: Post-resected glioblastoma multiforme (GMB) patients were treated with dodecafluoropentane emulsion (DDFPe) to evaluate the pharmacokinetics (PK), safety and potential survival benefit in combination with the current standard of care: radiation therapy (RT) and temozolomide (TMZ). DDFPe is an oxygen transport agent, which carries more than 100x more oxygen than other tested fluorocarbons. Studies in tumor xenografts show that DDFPe increases tumor pO2 by up to 400% and mitigates radiation resistance (J Biomed Nanotechnology, Vol 11, No 2, Feb2015, pp. 274-281). Methods: DDFPe is being dosed using an accelerated escalation design with one patient per dose level. Eligible patients have previously-untreated GBM with residual enhancing tumor on an early post-operative MRI scan, ECOG score 0-2, satisfactory blood counts and adequate renal and hepatic function. Since an increase in the frequency and extent of radiation necrosis is a theoretical risk of increased oxygenation, the location and size of the radiation field must be assessed as having a manageable risk should radiation necrosis occur. NVX-108 is infused intravenously prior to each fraction of radiation (total 60 Gray in 30 fractions), with patients breathing carbogen gas (2% CO2 and 98% O2) concurrently. Blood samples are drawn to evaluate DDFP PK. Objective tumor responses are assessed with serial gadolinium-enhanced MRI scans using RANO criteria. In addition, molecular analysis of tumor biopsies and tissue oxygen level dependent (TOLD) MRI measurement of tumor oxygenation are being used as exploratory predictive and pharmacodynamic biomarkers. The dose escalation schedule will study NVX-108 doses between 0.05 and 0.35 mL/kg in 5 planned dose levels. Dose levels 1 and 2 have been treated without dose-limiting toxicity. Data will be presented summarizing current safety, PK and preliminary efficacy results, as well as our progress in qualifying TOLD MRI as a potential biomarker of tumor hypoxia and re-oxygenation by DDFPe. Clinical trial information: 2014/007283.
Multi-gene panel testing in an unselected endometrial cancer cohort.
Authors: Kari Lassen Ring, Amanda S. Bruegl, Brian Allen, Eric P. Elkin, Nanda Singh, Anne-Renee Hartman, Russell Broaddus
Journal: Journal of Clinical Oncology (2015)

1533 Background: Endometrial carcinoma (EC) is associated with multiple hereditary cancer genes including Lynch syndrome (LS) genes, which are estimated to account for 2-6% of all cases. The role of other cancer predisposition genes in EC is unclear. We aimed to determine in an unselected EC cohort the prevalence of germline mutations in LS and other cancer predisposition genes. Methods: The study cohort was 381 EC patients unselected for age of dx with banked blood samples available for testing. DNA mutations in 25 cancer genes were identified using a next generation sequencing based panel. Germline sequence variations and large rearrangements were classified for pathogenicity. Patients’ clinical data, tumor testing with immunohistochemistry (IHC) for mismatch repair proteins, microsatellite instability, and MLH1 methylation, were abstracted from the medical record. All cases had germline genetic testing regardless of tumor testing status. Results: 35 patients (9.2%) had a deleterious mutation (DM). 22 patients (5.8%) had a DM in LS genes (3 MLH1, 5 MSH2, 2 EPCAM, 6 MSH6, 6 PMS2) and 13 patients (3.4%) had a DM in non-LS genes (4 CHEK2, 1 each in APC, ATM, BARD1, BRCA1, BRCA2, BRIP1, NBN, PTEN, RAD51C). Compared to patients with no DM, patients with DM in LS genes were younger at diagnosis (mean 51.7 v 61.5, p < 0.01), less likely to be overweight (63.6% v 85.5%, p = 0.01), more likely to have a tumor in the lower uterine segment (30.0% v 7.5%, p < 0.01), and more likely to meet SGO guidelines for genetic assessment referral (59.1% v 24.3%, p = 0.01). 3 patients (13.6%) with DM in LS genes were diagnosed > 60 years. Of 20 patients with DM in LS genes and available tumor results, 2 (10%) had a DM (1 PMS2, 1 MSH6) and IHC results suggestive of sporadic cancer. Patients with DM in non-LS genes were more likely to have serous histology (23.1% v 6.4%, p = 0.02) than those with no DM. 3 patients with non-LS DM and serous histology had mutations in BRCA2, BRIP1, and RAD51C, genes previously linked to hereditary ovarian cancer. Conclusions: Results for EC with DM in LS genes were similar to previous findings. Panel testing to include non-LS genes allowed for the identification of possibly novel genes that may be associated with serous-type EC, the most clinically aggressive form of this cancer.
Ultrasound Elastography: Review of Techniques and Clinical Applications
Authors: Rosa M.S. Sigrist, Joy Liau, Ahmed El Kaffas, Maria Cristina Chammas, Juergen K. Willmann
Journal: Theranostics (2017)

Elastography-based imaging techniques have received substantial attention in recent years for non-invasive assessment of tissue mechanical properties.These techniques take advantage of changed soft tissue elasticity in various pathologies to yield qualitative and quantitative information that can be used for diagnostic purposes.Measurements are acquired in specialized imaging modes that can detect tissue stiffness in response to an applied mechanical force (compression or shear wave).Ultrasound-based methods are of particular interest due to its many inherent advantages, such as wide availability including at the bedside and relatively low cost.Several ultrasound elastography techniques using different excitation methods have been developed.In general, these can be classified into strain imaging methods that use internal or external compression stimuli, and shear wave imaging that use ultrasound-generated traveling shear wave stimuli.While ultrasound elastography has shown promising results for non-invasive assessment of liver fibrosis, new applications in breast, thyroid, prostate, kidney and lymph node imaging are emerging.Here, we review the basic principles, foundation physics, and limitations of ultrasound elastography and summarize its current clinical use and ongoing developments in various clinical applications.
STROKE VOLUME DETERMINED FLOW RESERVE DOES NOT PREDICT THE TRUE SEVERITY OF LOW-FLOW LOW-GRADIENT AORTIC STENOSIS AND IS NOT A ROBUST MARKER OF CONTRACTILE RESERVE IN PATIENTS UNDERGOING LOW-DOSE DOBUTAMINE ECHOCARDIOGRAPHY
Authors: Anastasia Vamvakidou, Navtej Chahal, Reinette Hampson, Nikolaos Karogiannis, Wei Li, Rajdeep Khattar, Roxy Senior
Journal: Journal of the American College of Cardiology (2017)
Is docetaxel (D) less efficient than anthracycline-based chemotherapy (A) in triple-negative breast cancer (TNBC) treated in neoadjuvant setting?
Authors: Laurence Simon, Christine Belletier, Jean-Francois Rodier, Delphine Weitbruch, Michel Velten, Marc Wilt, Jean-Pierre Ghnassia, Thierry Petit
Journal: Journal of Clinical Oncology (2012)

e11542 Background: BRCA1 mutation is associated with the TNBC phenotype. Loss of BRCA1, due to genetic mutation or post-genomic inactivation, should confer susceptibility to DNA-damaging agents, such as anthracyclines, but resistance to mitotic-spindle poisons such as taxanes. However, optimal adjuvant systemic therapy for TNBC is difficult to define because of a lack of prospective data in TNBC restricted populations. As our neo-adjuvant regimen changed in 2008 (A followed by D before 2008 then D followed by A from 2008); we were able to compare retrospectively A and D efficacy in matched cohorts of TNBC treated in neo-adjuvant setting. Methods: Group 1 includes 24 patients with TNBC treated between 2005 and 2008 with A followed by D (3x 5FU 500 mg/m², epirubicine 100 mg/m², cyclophosphamide 500 mg/m² followed by 3x docetaxel 100 mg/m²). Group 2 includes 24 patients with TNBC treated in NAS between 2008 and 2011 with D followed by A. Characteristics of group 1 and 2 (median age at diagnosis, tumor grade, Ki67, TNM) were similar. All patients had a core-biopsy before chemotherapy. Chemotherapy response was evaluated by CT scan before 1 st cycle, between 3 rd and 4 th cycle then after the 6 th cycle. Surgery was performed 4 weeks after the 6 th cycle. Results: In group 1, objective response rate after 3 cycles was 58% (14/24) (RECIST criteria). There was no progression. Complete pathological response rate (no residual invasive and in-situ tumor in breast, no tumor in axillary nodes) was 25%. In group 2, objective response rate after 3 cycles was 25% (6/24). Progression rate was 13% (3/24). Complete pathological response rate was 29%. The objective response rate after the first three cycles was significantly different between group 1 and group 2 (two-sided p-value = 0,039, Fisher exact test). Conclusions: Our retrospective analysis showed that docetaxel was significantly less efficient than anthracycline-based chemotherapy in chemo-naïve TNBC patients. These data should be taken in consideration for clinical practice and further phase III trials design in TNBC.
ATHERECTOMY IS ASSOCIATED WITH LOWER RATES OF REPEAT INTERVENTION AFTER BELOW KNEE PERIPHERAL VASCULAR INTERVENTION
Authors: Houman Khalili, Haekyung Jeon-Slaughter, Amutharani Baskar, Ehrin Armstrong, Nicolas Shammas, Andrew Shammas, Anand Prasad, Ian Cawich, Gerardo Rodriguez, Mazen Abu-Fadel, Emmanouil Brilakis, Subhash Banerjee
Journal: Journal of the American College of Cardiology (2017)
A Scoring System Predictive of Extensive Chronic Graft-Versus-Host Disease (cGVHD) After Allogeneic Stem Cell Transplantation (allo-SCT)
Authors: Eolia Brissot, Yohann Foucher, Florent Malard, Zinaida Peric, Aline Clavert, Patrice Chevallier, Thierry Guillaume, Jacques Delaunay, Sameh Ayari, Jean-Luc Harousseau, Philippe Moreau, Marianne Coste-Burel, Berthe-Marie Imbert-Marcille, Marc Gregoire, Cécile Braudeau, Régis Josien, Béatrice Gaugler, Mohamad Mohty
Journal: Blood (2011)
Diagnostic Approach to CD5+/CD23+ Leukemic Non-Hodgkin Lymphomas Lacking Lymphnode Histopathology.
Authors: Ilaria Del Giudice, Barbara Anaclerico, Maria Stefania De Propris, Francesca Mancini, Edoardo Pescarmona, Luisa Bizzoni, Anna Levi, Elisabetta Calabrese, Stefano Pileri, Agostino Tafuri, Anna Guarini, Robert Foà
Journal: Blood (2005)
Brain Metastases in Newly Diagnosed Breast Cancer
Authors: Allison M. Martin, Daniel N. Cagney, Paul J. Catalano, Laura E. Warren, Jennifer R. Bellon, Rinaa S. Punglia, Elizabeth B. Claus, Eudocia Q. Lee, Patrick Y. Wen, Daphne A. Haas-Kogan, Brian M. Alexander, Nancy U. Lin, Ayal A. Aizer
Journal: JAMA Oncology (2017)

Population-based estimates of the incidence and prognosis of brain metastases at diagnosis of breast cancer are lacking.To characterize the incidence proportions and median survivals of patients with breast cancer and brain metastases at the time of cancer diagnosis.Patients with breast cancer and brain metastases at the time of diagnosis were identified using the Surveillance, Epidemiology, and End Results (SEER) database of the National Cancer Institute. Data were stratified by subtype, age, sex, and race. Multivariable logistic and Cox regression were performed to identify predictors of the presence of brain metastases at diagnosis and factors associated with all-cause mortality, respectively. For incidence, we identified a population-based sample of 238 726 adult patients diagnosed as having invasive breast cancer between 2010 and 2013 for whom the presence or absence of brain metastases at diagnosis was known. Patients diagnosed at autopsy or with an unknown follow-up were excluded from the survival analysis, leaving 231 684 patients in this cohort.Incidence proportion and median survival of patients with brain metastases and newly diagnosed breast cancer.We identified 968 patients with brain metastases at the time of diagnosis of breast cancer, representing 0.41% of the entire cohort and 7.56% of the subset with metastatic disease to any site. A total of 57 were 18 to 40 years old, 423 were 41 to 60 years old, 425 were 61-80 years old, and 63 were older than 80 years. Ten were male and 958 were female. Incidence proportions were highest among patients with hormone receptor (HR)-negative human epidermal growth factor receptor 2 (HER2)-positive (1.1% among entire cohort, 11.5% among patients with metastatic disease to any distant site) and triple-negative (0.7% among entire cohort, 11.4% among patients with metastatic disease to any distant site) subtypes. Median survival among the entire cohort with brain metastases was 10.0 months. Patients with HR-positive HER2-positive subtype displayed the longest median survival (21.0 months); patients with triple-negative subtype had the shortest median survival (6.0 months).The findings of this study provides population-based estimates of the incidence and prognosis for patients with brain metastases at time of diagnosis of breast cancer. The findings lend support to consideration of screening imaging of the brain for patients with HER2-positive or triple-negative subtypes and extracranial metastases.
BODY FAT PERCENTAGE EVALUATED BY A BIOELECTRICAL IMPEDANCE ANALYSIS PROVIDES PROGNOSTIC VALUE IN ACUTE HEART FAILURE, BEYOND ON THE “OBESITY PARADOX”
Authors: Yoshiyuki Yazaki, Hiroki Niikura, Norihiro Kogame, Masahide Tokue, Nobutaka Ikeda, Raisuke Iijima, Hidehiko Hara, Masao Moroi, Masato Nakamura
Journal: Journal of the American College of Cardiology (2017)
Epidemiology, Risk Factors and Outcome of 282 Bloodstream Infections among Hematological Patients: Results of a 50 Months Prospective Surveillance Study
Authors: Chiara Cattaneo, Francesca Bracchi, Salvatore Casari, Erika Borlenghi, Maria Adele Capucci, Anna Maria Pelizzari, Liana Signorini, Massimiliano De Vecchi, Monica Drera, Alessandro Re, Giampiero Carosi, Giuseppe Rossi
Journal: Blood (2008)
Pacemaker therapy in isolated congenital complete atrioventricular block
Authors: Jmpj Breur, Feau Ten Cate, L Kapusta, MI Cohen, JE Crosson, N Bidlingmaier, AH Friedman, JI Brenner, VL Vetter, N Sreeram, EJ Meijboom
Journal: Circulation (2000)

From the *Departments of Pediatric Cardiology of Wilhelmina Children’ s Hospital/UMC, Utrecht;† Children’ s Heart Center, University Medical Center, Nijmegen, the Netherlands; ‡ Children’ sHospital of Philadelphia, Philadelphia, Pennsylvania; § The Johns Hopkins Hospital, Baltimore,Maryland; \Yale New Haven Hospital, New Haven, Connecticut; and the AAcademic MedicalCenter, Amsterdam, the Netherlands