tbuckley/cabot-search huggingface dataset:
Imaging evaluation of non-alcoholic fatty liver disease: focused on quantification
Authors: Dong Ho Lee
Journal: Clinical and Molecular Hepatology (2017)

Non-alcoholic fatty liver disease (NAFLD) has been an emerging major health problem, and the most common cause of chronic liver disease in Western countries. Traditionally, liver biopsy has been gold standard method for quantification of hepatic steatosis. However, its invasive nature with potential complication as well as measurement variability are major problem. Thus, various imaging studies have been used for evaluation of hepatic steatosis. Ultrasonography provides fairly good accuracy to detect moderate-to-severe degree hepatic steatosis, but limited accuracy for mild steatosis. Operator-dependency and subjective/qualitative nature of examination are another major drawbacks of ultrasonography. Computed tomography can be considered as an unsuitable imaging modality for evaluation of NAFLD due to potential risk of radiation exposure and limited accuracy in detecting mild steatosis. Both magnetic resonance spectroscopy and magnetic resonance imaging using chemical shift technique provide highly accurate and reproducible diagnostic performance for evaluating NAFLD, and therefore, have been used in many clinical trials as a non-invasive reference of standard method.
Predictive assay for anti-angiogenic agents (AADx) identifies molecular subgroups of RASwt mCRC with differential efficacy of FOLFIRI plus bevacizumab in the FIRE-3 (AIO KRK-0306) trial
Authors: S. Stintzing, B. Price, L. Knight, A. McCavigan, S. Walker, P. Harkin, R. Kennedy, D. Neureiter, S. Held, A. Jung, T. Kirchner, V. Heinemann
Journal: Annals of Oncology (2017)
Phase 1/2 trial of ixazomib, cyclophosphamide, and dexamethasone for newly diagnosed multiple myeloma (NDMM).
Authors: Martha Lacy, P. Leif Bergsagel, Betsy LaPlant, Alese Halvorson, Francis Buadi, Nelson Leung, Ronald S. Go, David Dingli, Prashant Kapoor, Morie A. Gertz, Yi Lin, Angela Dispenzieri, Yi Lisa Hwa, Amie Fonder, Rafael Fonseca, Suzanne R. Hayman, A. Keith Stewart, Joseph Mikhael, S. Vincent Rajkumar, Shaji Kumar
Journal: Journal of Clinical Oncology (2016)

8002 Background: Ixazomib (Ixa) is an oral proteasome inhibitor, approved for treatment of relapsed myeloma (MM) in combination with lenalidomide and dexamethasone (Dex). The combination of bortezomib with cyclophosphamide (Ctx) and Dex is an effective regimen for initial therapy of MM. The combination of Ixa, Ctx and Dex could provide an effective, all oral regimen for initial therapy of MM. Methods: NDMM patients (pts) with measurable disease, adequate organ function, and an ECOG PS >=2 were enrolled. The primary objective of the phase 1 was to determine the MTD of Ctx that can be combined with Ixa and Dex. Pts received Ixa 4 mg on days 1, 8, 15, dex 40 mg days 1, 8, 15, 22 and cyclophosphamide 300 or 400 mg/m2 days 1, 8, 15, 22; cycles were 28 days. Patients could continue on ixa alone after 12 cycles. The phase 2 portion was designed to determine the complete plus very good partial response rate (>=VGPR) of ixazomib to be used in combination with cyclophosphamide and dexamethasone in ND MM. Results: Fifty-one pts were accrued, 10 to phase 1 and 41 patients to the phase 2 part of the trial, 3 pts were ineligible and were excluded. The median age was 64.5 (41-88); 52% were male. High or intermediate risk FISH was seen in 29% pts. Two patients have died, median (range) follow up for live pts was 8.7 months (2.8-28.3). Nineteen pts continue on treatment; of the 29 who have gone off treatment, majority did so for stem cell transplant, 4 had disease progression. RP2D was 400 mg/m2 of cyclophosphamide weekly, the highest dose tested. Best confirmed response included a partial response or better in 78%, including a VGPR rate of 33%; 2 patients had CR. Response rate at 4-cycle was 71%; the median time to a PR was 1.84 months. Dose modification were mostly in ctx and dex arms; 23 and 13% respectively. A grade 3 or higher adverse events (AE), considered possibly related was seen in 73%. Most common AE included cytopenias, fatigue and GI side effects. Conclusions: The combination of Ixa, Ctx and Dex is well tolerated with high response rates. It offers the opportunity to utilize a completely oral regimen, which also is less expensive compared with the lenalidomide combinations. Future studies should assess its efficacy against other proteasome inhibitor combinations. Clinical trial information: NCT 01864018.
TRUST: Trial of radical upfront surgical therapy in advanced ovarian cancer (ENGOT ov33 / AGO‐OVAR OP7).
Authors: Sven Mahner, Florian Heitz, Alexander Burges, Alexander Reuss, Bernhard Kraemer, Barbara Schmalfeldt, Jalid Sehouli, Bjoern Lampe, Andreas Schnelzer, Pauline Wimberger, Christina Fotopoulou, Frederic Guyon, Fabrice Lecuru, Denis Querleu, Stefano Greggi, Nicoletta Colombo, Giovanni Damiano Aletti, Philipp Harter, Andreas Du Bois
Journal: Journal of Clinical Oncology (2017)

TPS5602 Background: Primary cytoreductive surgery (PDS) followed by chemotherapy has been considered as standard management for advanced ovarian cancer patients (pts) over decades. An alternative approach of interval debulking surgery (IDS) following neoadjuvant chemotherapy (NACT) was subsequently reported by two randomized phase III trials (EORTC‐GCG, CHORUS). Owing to important limitations of these studies, especially regarding surgical quality, optimal timing of surgical therapy in advanced ovarian cancer is still unclear. Methods: TRUST is an international open, randomized, controlled multicenter trial investigating overall survival (OS; primary endpoint) after PDS vs NACT and subsequent IDS in pts with FIGO stage IIIB‐IVB ovarian, tubal, and peritoneal carcinoma. Secondary objectives are safety of complete tumor resection, progression‐free survival and quality of life (QoL) as well as surgical morbidity. In order to guarantee adequate surgical quality, participating centers need to fulfill specific quality assurance criteria (e.g. ≥50% complete resection rate in upfront surgery for FIGO IIIB-IV pts, ≥36 debulking-surgeries/year) and agree to independent audits by TRUST Quality committee delegates. A 1:1 randomization to PDS or NACT followed by IDS stratified by center and age‐ECOG combination (ECOG 0 and age ≤65 years vs ECOG &gt; 0 or age &gt; 65 years) is performed. Pts in the PDS arm will undergo surgery followed by 6 cycles of platinum-based chemotherapy, whereas pts in the IDS arm will be treated with 3 cycles of NACT after histologic confirmation of the disease, followed by IDS and subsequently 3 cycles of platinum-based chemotherapy. Intention of surgery for both groups will be complete tumor resection as per guideline recommendations. Health related QoL will be assessed using the EORTC QLQ‐C30, QLQ‐OV28, and EQ‐5D‐3L questionnaires. For sample size planning, we considered a prolongation of median OS from 45 months in the IDS arm to 60 months in the PDS arm (HR 0.75) as clinically relevant. 380 events are needed to obtain a power of 80% in two‐sided log-rank test with significance level of 0.05. The primary analysis will be done in the ITT‐population of 686 randomized pts. By Feb 3 2017, 46 pts were randomized. Clinical trial information: NCT02828618.
Analysis of efficacy and prognostic factors in second-line chemotherapy for BRAF V600E mutant metastatic colorectal cancer
Authors: S. Mitani, H. Taniguchi, K. Honda, T. Masuishi, Y. Narita, S. Kadowaki, T. Ura, M. Ando, M. Tajika, K. Muro
Journal: Annals of Oncology (2017)
Carotid Sinus Massage
Authors: Mathieu Pasquier, Mathieu Clair, Etienne Pruvot, Olivier Hugli, Pierre-Nicolas Carron
Journal: New England Journal of Medicine (2017)

This video reviews the indications and contraindications for and the techniques involved in carotid sinus massage, a noninvasive diagnostic test used to detect carotid sinus hypersensitivity and, in emergencies, to diagnose or treat paroxysmal supraventricular tachycardia.
Unilateral Submandibular Gland Atrophy and Sialolithiasis Diagnosed on 99mTc-MIBI SPECT/CT in a Patient With Primary Hyperparathyroidism
Authors: Puskar Pattanayak, Prasanna Santhanam, Mehrbod Som Javadi, Lilja B. Solnes, Steven P. Rowe
Journal: Clinical Nuclear Medicine (2017)

A variety of sequelae of elevated calcium levels are encountered in patients with underlying primary hyperparathyroidism, including stone formation such as calculi in the urinary tract and sialoliths in the salivary glands and ducts. We present a case of a 54-year-old woman with fatigue, myalgia, and poor concentration who was found to have hypercalcemia (corrected calcium, 11.2 mg/dL) and elevated parathyroid hormone level (112 pg/mL), laboratory values consistent with primary hyperparathyroidism. She underwent evaluation with a Tc-MIBI parathyroid SPECT scan that included x-ray CT acquisitions for anatomical localization and attenuation correction.
Neoadjuvant treatment with mFOLFOXIRI alone versus chemoradiotherapy in locally advanced rectal cancer: A propensity score analysis from two prospective trials
Authors: J. Zhang, Y. Cai, H. Hu, D. Chen, J. Xiao, W. Wang, P. Lan, M. Huang, L. Wang, X. Wu, L. Kang, J. Wang, Y. Deng
Journal: Annals of Oncology (2017)
Outsourcing review of GP referrals to private companies: who ultimately gains?
Authors: Nick Mann
Journal: BMJ (2017)

We GPs in Hackney had compulsory clinical peer review of our referrals (with payment by results linked to “quality”) imposed on us a few years ago.1 Our referral rates are rising, perhaps more slowly than they otherwise might have done, and cost and quality have not noticeably improved. By preventing some unnecessary referrals and saving money, we might also …
Prognostic value of systemic inflammatory biomarkers in patients with mCRPC treated with abiraterone in pre-docetaxel setting
Authors: R. Ratta, E. Verzoni, F. Pantano, P. Grassi, D. De Lisi, A. Onorato, M. Prisciandaro, R. Montone, F. de Braud, D. Santini, G. Procopio
Journal: Annals of Oncology (2017)
Longitudinal circulating-tumor DNA profiling of EGFR-mutated lung adenocarcinoma patients treated with EGFR-tyrosine kinase inhibitors
Authors: S. Ortiz-Cuaran, A. Swalduz, C. Leonce, S. Martinez, G. Clapisson, S. Marteau, V. Avrillon, E. Green, C. Morris, M. Pérol, P. Saintigny
Journal: Annals of Oncology (2017)
Tumor growth rate analysis of progression-free survival (PFS) and overall survival (OS) for patients with metastatic and/or unresectable gastrointestinal stromal tumors (GIST) receiving placebo or regorafenib in the phase 3 GRID trial
Authors: C. Kappeler, A. Wagner, G.D.S. Demetri
Journal: Annals of Oncology (2017)
Children get over bullying, study shows
Authors: Anne Gulland
Journal: BMJ (2017)

Children who are bullied are likely to develop symptoms of depression and anxiety, however these symptoms dissipate over time, a study has found.1

Exposure to bullying is already associated with poor mental health but establishing a direct detrimental effect has been difficult.

The study, in JAMA Psychiatry , used twins as a way of establishing a control group, accounting for shared environmental and genetic sources, and other mitigating factors.

Some 11 108 twins from the Twins Early Development Study were asked at ages 11 and 16 whether they had been exposed to physical …
Importance of the biologic effective dose in achieving local control of adrenal tumors treated with stereotactic radiosurgery.
Authors: Hema Rai, Amishi Desai, Matthew R. Witten, Jonathan A. Haas, Jeffrey Gary Schneider
Journal: Journal of Clinical Oncology (2012)

e21114 Background: Adrenalectomy achieves long term survival in ~ 25% of patients with solitary adrenal metastasis (SAM). Stereotactic radiosurgery (SRS) represents a potential non-surgical alternative to this same endpoint, but reported local control rates vary from 45% to 96%. SRS delivers a range of biologic effective doses (BED) dependent upon fraction size, number and schedule. We herein review our experience with SRS for adrenal metastasis to evaluate the interaction between BED and local adrenal tumor control. Methods: The Winthrop SRS data base was queried to identify 14 patients undergoing SRS for malignant adrenal tumors from 2006 to 2011. Patients were characterized by their primary tumor site, stage at diagnosis and the time to adrenal involvement. BED was calculated for each patient. Local adrenal tumor control and durability of response were also recorded. Results: Calculated BEDs ranged from 4,667 cGy to13,000 cGy. Of the factors examined, BED was the single most important predictor of local adrenal tumor control. According to best adrenal tumor response, mean BEDs were: 10,053 cGy for radiographic regression of disease; 8,115 cGy for stable disease, and 6,667 cGy for progression of disease (p = 0.0465, by one-tail test). No solid tumor patient responded to SRS with BED &lt; 8,800 cGy and no patient immediately progressed through SRS with BED &gt; 6,667 cGy. Duration of adrenal tumor control also correlated with calculated mean BED which was: 9,676 cGy for never locally failing (n=6) and 7,600 cGy for ever locally failing tumors (n=5). However, eventual local treatment failure was seen in one of three patients receiving even the highest calculated BED (13,000 cGy). Conclusions: Because eventual local failures are observed with SRS even at the highest examined BED, adrenalectomy rather than SRS should remain the standard of care for patients with potentially curable SAM. SRS remains an acceptable alternative to adrenalectomy for palliation of symptomatic adrenal tumors or for the definitive treatment of SAM in non-surgical candidates. When given for these purposes, our data support the use of SRS regimens delivering a minimum BED of 8,800 cGy.
Strengthening early warning function of surveillance in the Republic of Serbia: lessons learned after a year of implementation
Authors: M Valenciano, I Bergeri, D Jankovic, N Milic, M Parlic, D Coulombier
Journal: Eurosurveillance (2004)

The Republic of Serbia, with WHO support, has implemented an early warning system (ALERT) for priority communicable diseases, to complement the routine surveillance system which notifies individual confirmed cases. The results of its evaluation, conducted one year after implementation is presented here. ALERT relies on notification of 11 syndromes by primary care facilities. Data is analysed weekly at district level and transmitted to national epidemiologists. ALERT is perceived to be a simple and flexible tool. Acceptability is higher at national level than at district level. Some districts perceive ALERT as a parallel system poorly connected to control measures. Sensitivity of ALERT in detecting cases of meningitis is 93%, and 37% for cases of hepatitis. Retrospective analysis of ALERT data identified 9 outbreaks, 5 of which had been recognized by epidemiologists. ALERT was the timeliest system for detecting 4 outbreaks identified by both systems. ALERT was useful for triggering timely investigation and control of outbreaks of hantavirus and salmonellosis and for detecting the start of the influenza season. However, ALERT did not detect clusters of brucellosis and tularaemia targeted by the unexplained fever syndrome. This evaluation underlined the need for a global review of surveillance activities when implementing new components such as ALERT. While control measures based on notification of individual confirmed cases are well understood and implemented, the investigation and verification process that should result from an increase in ALERT syndromes is not fully understood. Field epidemiology training programmes, such as the EPIET programme, are best suited to bring about this change of perspective.
Terminating and episode of overt hepatic encephalopathy: L‐ornithine‐L‐aspartate may have some role
Authors: Sahaj Rathi, Sunil Taneja
Journal: Hepatology (2017)

Potential conflict of interest: Nothing to report. To the Editor: We read with great interest the report on the randomized controlled trial on L‐ornithine‐L‐aspartate (LOLA) in bouts of overt hepatic encephalopathy (HE) by Sidhu et al.1 They have very nicely demonstrated that in patients with bouts of overt HE addition of LOLA to a standard lactulose‐containing regimen shortens the time to resolution of HE. The evidence on the use of LOLA in bouts of overt HE is scant at best. Only two small trials, both from Pakistan, have considered this specific question.2 This trial included a carefully selected cohort of patients with overt HE, without acute‐on‐chronic liver failure or advanced renal failure, thereby explaining the relatively lower 1‐month mortality rate. Studies have shown in‐hospital mortality in over one third of patients having HE at presentation.4 In addition to faster resolution of HE, the LOLA group had a much shorter hospital stay. It was interesting to note that despite only one death in the LOLA group (1%) and resolution of HE by day 5 in >70% of patients, the mean length of hospital stay was 8.4 days in the LOLA group and 11.5 days in the placebo group. It seems unlikely that LOLA plays a role in the reduction of hospital stay once HE resolves. It would be interesting to know the factors responsible for this shortening of hospital stay despite similar time to HE resolution. The investigators implemented a novel approach of administering 120 mL of oral lactulose thrice daily in patients with constipation. Was there a difference in the mean lactulose dose in each group, and did any subject develop diarrhea and dyselectrolytemia because of lactulose therapy in either group? These factors too may affect the resolution of HE. Additionally, patients with grade 3‐4 HE form the more worrisome group, requiring intubation and intensive care. The use of LOLA in grade 3‐4 HE did not reduce the time to resolution or the hospital stay in this group, limiting its potential use in such patients until the availability of further evidence. Overall, this interesting study paves the way for a possible add‐on role of LOLA to the existing lactulose‐based therapy in patients with bouts of overt HE, a problem upon which, despite its frequent occurrence, the literature is rather sparse.
Abstract 16047: Trends in Usage and Outcomes Associated With Ultrafiltration in Hospitalized Patients With Congestive Heart Failure
Authors: Nawfal Al-khafaji, Saurabh Aggarwal, Rohit S Loomba, Gaurav Aggarwal, Venkata Alla
Journal: Circulation (2016)

Introduction:  Congestive heart failure is a leading cause of inpatient admissions and readmissions. We sought to analyze the outcomes related to use of ultrafiltration in such patients and assess its effects on length and cost of hospitalization in a large national database.   Methods:  We utilized Nationwide Inpatient Sample database 2005-2012 which is a 20% discharge sample of all hospitalizations across the United States. We divided the patients admitted with congestive heart failure into those underwent ultrafiltration versus those did not. Univariate and multivariate analyses were performed for mortality, length and cost of hospitalization.   Results:  A total of 3,789,452 patients were included in the analysis out of which 1833 (0.05%) patients underwent ultrafiltration. The rates of ultrafiltration have increased significantly from 2005 to 2012 but the overall percentage of patients undergoing ultrafiltration in a year has remained low (0.01% vs 0.1%, p   Conclusion:  The use of ultrafiltration for hospitalized patients with congestive heart failure remains very low. Ultrafiltration is associated with significantly increased length and cost of hospitalization.
Neoadjuvant FOLFOX 4 versus FOLFOX 4 plus cetuximab versus immediate surgery for high-risk stage II and III colon cancers: A phase II multicentre randomised controlled trial (PRODIGE 22)
Authors: M. Karoui, A. Rullier, C. Mariette, E. Maillard, A. Bardier, F. Poizat, A. Luciani, A. Sarran, J.-L. Legoux, C. De Chaisemartin, C. Lecaille, O. Bouche, F. Mauvais, F. Brunetti, M. Prudhomme, J.-F. Seitz, C. Lepage, J. Taieb
Journal: Annals of Oncology (2017)
Infecções recentes por HTLV diagnosticadas na Inglaterra e Gales, 2002-2004
Authors: S Dougan, Alan Smith, J C Tosswill, K Davison, M Zuckerman, G P Taylor
Journal: Eurosurveillance (2005)

Os HTLV (Human T cell lymphotropic viruses) sao retroviruses transmitidos pelo leite materno, as relacoes sexuais, as transfusoes de sangue e o uso de drogas injectadas. Os HTLV sao endemicos no Caribe, certas areas de Africa, no Japao e na America do Sul, com agrupamentos isolados em outras regioes do mundo. A infeccao e cronica. Menos de 5% das pessoas infetadas desenvolvem alguma das doencas ligadas ao virus, mas essas sao debilitantes e frequentemente mortais. 
Na Inglaterra e Gales, as notificacoes microbiologicas e clinicas dos novos diagnosticos de HTLV sao recolhidos em rotina, incluindo as infeccoes identificadas pelo departamento de doacoes de sangue desde a introduccao do despitagem do HTLV em agosto de 2002. 
Entre 2002 e 2004, 273 pessoas foram confirmadas como positivas para o HTLV, das quais 102 (37%) eram do sexo masculino e 169 do sexo feminino (o sexo nao estava notificado para dois casos). Na hora do diagnostico, a idade mediana era de 54 anos para os homens e 50 para as mulheres. A historia clinica era disponivel em 78% (212/273) dos casos. Para aqueles que disponiam da informacao, 58% (116/199) eram negros do Caribe e 29% (57/199) brancos. 87% (128/147) dos casos foram provavelmente infetados por uma relacao heterosexual ou por transmissao de mae a filho ; em 45% (66/146) dos casos, a infeccao ocurreu provavelmente no Caribe, e em 40% (59/146) no Reino-Unido. 
Um numero notavel de infeccoes por HTLV continuam sendo identificadas na Inglaterra e Gales, com um aumento em 2002-2003, devido a despistagem do HTLV nas doacoes de sangue. Embora a maior parte das infeccoes diagnosticadas estejam diretamente associadas com o Caribe, a transmissao das infeccoes por HTLV ocorre no interior da Inglaterra e Gales. As unidades de cuidados especializados para pessoas infectadas pelo HTLV e as suas familias tem melhorando estes ultimos anos, mas a prevencao permanece limitada.