tbuckley/cabot-search huggingface dataset:
Surveillance of the first 205 confirmed hospitalised cases of pandemic H1N1 influenza in Ireland, 28 April – 3 October 2009
Authors: G Cullen, J Martin, J O’Donnell, M Boland, M Canny, E Keane, A McNamara, A O’Hora, M Fitzgerald, S Jackson, D Igoe, D O’Flanagan
Journal: Eurosurveillance (2009)

From 28 April 2009 to 3 October 2009, 205 cases of confirmed pandemic H1N1 influenza were hospitalised in Ireland. Detailed case-based epidemiological information was gathered on all hospitalised cases. Age-specific hospitalisation rates were highest in the age group of 15 to 19 year-olds and lowest in those aged 65 years and over. Nineteen hospitalised cases (9%) were admitted to intensive care units (ICU) where the median length of stay was 24 days. Four hospitalised cases (2%) died. Fifty-one percent of hospitalised cases and 42% of ICU cases were not in a recognised risk group. Asthma was the most common risk factor among cases; however, people with haemoglobinopathies and immunosuppression were the most over-represented groups.
Cooperative Gene Repression By DNA Methylation and LSD1-Mediated Enhancer Inactivation in Acute Myeloid Leukemia
Authors: Cihangir Duy, Matt Teater, Francine E. Garrett-Bakelman, Tak C Lee, Cem Meydan, Jacob Lowell Glass, Meng Li, Helai Mohammad, Kimberly Smitheman, Alan H. Shih, Omar Abdel-Wahab, Elisabeth Paietta, Martin S. Tallman, Monica L. Guzman, Ryan G. Kruger, Caretha L. Creasy, Ross L. Levine, Martin Carroll, Ari Melnick
Journal: Blood (2016)
Who's psychopathic now? A recent report has few new solutions and calls for more research
Authors: R Bluglass
Journal: BMJ (1994)

improve health service functioning and morale?This could improve existing systems of care, encourage and support those delivering services, and maximise the chance of local and national ownership.But there is a risk of overloading already overworked staff.Conducting large randomised trials with a few relevant outcome measures may be the best way of improving local services.Health workers, by being part of the research process, would be able to see the value of the work.Everyone agrees that it is important to establish that a new intervention has a potentially beneficial effect.But how quickly should researchers then move to implement it through existing services?Researchers and health service providers should be ready to contribute to the debate.
Low grade b-cell non-Hodgkin lymphomas (NHL) involving the central nervous system (CNS): An analysis from the National Cancer Database (NCDB).
Authors: Priyanka Avinash Pophali, Gita Thanarajasingam, Jose Pulido, Patrick B. Johnston, Ronald S. Go
Journal: Journal of Clinical Oncology (2017)

e13083 Background: CNS involvement from low grade B-cell NHL is rare and has only been reported as case series. The distribution, demographics and outcomes of patients with low grade B-cell CNS NHLs have not been well characterized. Methods: The NCDB represents ~70% of cancer cases in the United States. Using the 2004-2013 NCDB extranodal NHL database, we identified all CNS B-cell NHLs based on ICD-O-3 site and histology codes. Primary or secondary CNS involvement could not be determined. Results: Out of 9435 CNS NHL cases, 475 [5.03%] had low grade histologies. In this group, the median age at diagnosis was 58 years [range 19-89]. Majority of the cases were female [56%], White, non-Hispanic [72%], privately insured [53%], with no comorbidities [74%] and treated in academic/research programs [38%]. Site of CNS disease was not specified in 22%. HIV status was known in 318 cases (6.3% positive). The brain [44%] was the most common site of involvement followed by spinal cord [19%] and meninges [15%]. Follicular lymphoma (FL) [48%] was the most common histology overall followed by marginal zone (MZL) [37%], small lymphocytic (SLL) [8%] and lymphoplasmacytic lymphomas (LPL) [7%]. MZL was the most common histology in the brain [44%] and meninges [61%] while FL was most common in the spinal cord [77%] and nervous system, NOS [69%]. Cranial nerves and eye (retina/optic nerve) involvement was very rare [2 and 1 case each- both MZL]. The overall survival (OS) of CNS B-cell NHL was significantly better if histology was low grade vs other [5-year OS 74% vs 32%, P &lt; 0.0001]. Among CNS low grade B-cell NHLs, 5-year OS varied by histology [MZL 83%, FL 75%, LPL 56% and SLL 50%, P = 0.0003] and site of disease [spinal cord 89%, meninges 78% and brain 63%, P = 0.03] in addition to age at diagnosis and co-morbidities on both uni- and multivariate analysis. Survival was not influenced by sex, race, insurance, year of diagnosis, facility type or location. Conclusions: CNS involvement with low grade B-cell NHL is rare but has a relatively good outcome with most patients surviving beyond 5 years. FL and MZL are the more common low grade histologies. Both histology and disease site are important factors affecting survival.
Utilisation de la capsule “patency” avant exploration par vidéocapsule du grêle chez les patients atteints de maladie de Crohn
Authors: N Musquer
Journal: Endoscopy (2016)

Le diagnostic et la surveillance des patients atteints de maladie de Crohn (MC) est progressivement devenue l’une des premières indications de la vidéocapsule endoscopique du grêle (VCE). Cet examen, relativement peu invasif, présente comme principale complication une rétention de la VCE en amont d’une sténose, ce risque pouvant atteindre jusqu’à 13 %. Pour limiter ce risque, une capsule test, appelée capsule “patency” (CP) est régulièrement utilisée (Figure 1).
Precut papillotomy – Is it a safe procedure?
Authors: MS Kurrimboccus, P Jambulingham, M Deakin
Journal: Endoscopy (2005)

Aims: Precut papillotomy is a controversial procedure with some endoscopists performing it routinely and others never because of high incidence of complications. We carried out a study to assess the complication rate of this procedure at our institution.
Infection of Ventricular Assist Device Detected and Monitored by 18F-FDG PET/CT
Authors: Sébastien Dejust, Renaud Guedec-Ghelfi, Estelle Blanc-Autrant, Yannick Lepers, David Morland
Journal: Clinical Nuclear Medicine (2017)

We report a case of a 59-year-old man who presented with fever, sepsis, and left cervicothoracic cutaneous inflammation 13 months after implantation of Jarvik 2000 device. Device infection was suspected and 18F-FDG PET/CT showed an intense and homogeneous uptake along driveline cable. Bacteriological local sample showed Staphylococcus aureus. After adapted antibiotherapy, control 18F-FDG PET/CT displays treatment efficacy with no residual uptake in driveline. 18F-FDG PET/CT could be an important tool for early noninvasive detection of left ventricular assist device infection and monitoring antibiotherapy response.
Soundings: The Far Wrong
Authors: Des Spence
Journal: BMJ (2006)

I was a white settler in the first wave of English immigration to northern Scotland in the 1970s. We were different in the way we looked, how we spoke, and the way we behaved. I could never disguise my accent despite trying hard. In casualty, a patient shouted “I not seeing an English ******.” My Asian colleague and I smiled at each other. Discrimination is a multicoloured affair. I love Glasgow and it is my home but I will always think of myself as English.

When the British National Party (BNP) won seats in the council elections last week I felt a sense of disgust and went rummaging for my rusting anti-Nazi league badges.

It's been nearly 30 years since the far right was this active in Britain. In the late '70s, mass unemployment following the closure of many traditional industries saw the splintering of working communities. Resentment spilled over into street confrontations.

Immigrants have few choices and generally end up living in social housing in the inner cities. Even for well educated and hard working immigrants, it can take a generation to climb the social ladder. The problem is that the most disadvantaged and the least well equipped in society end up shouldering problems arising from rapid social change. Lack of understanding, poor communication, and poverty lead to resentment and frustration on all sides.

Is this resentment racism? In my experience of over 10 years in an inner city this is an oversimplification. For all of us in the middle classes who are deeply offended by the BNP, it is important to remember that we are largely spared the pain of social change. Immigration offers us great cultural opportunity and a cheap source of skilled labour, in contrast to the impact on the working classes who may feel their jobs are under threat.

What can be done to prevent the march of the far right? It is important not to dismiss this vote of protest. At the very least, grievances should be heard, whether they are legitimate or not. Doctors and nurses working in the communities affected have an important role in listening and in leading and maintaining the traditions of tolerance that have generally prevailed in the UK.

Integration will come but this will take time. A new type of Britishness will emerge from the inner cities, just as in times gone by. My children will think of themselves as Scottish.
Decitabine Plus Cytarabine for Induction of Remission in Newly Diagnosed Elderly AML or High Risk MDS Patients
Authors: Kelda Gardner, Elihu H. Estey, Weigang Tong, Robert McCroskey, Roland B. Walter, Paul C. Hendrie, Bart L. Scott, Andrea M. Perdue, Mary-Elizabeth M. Percival, Heather A. Smith, Cody Hammer, Pamela S. Becker
Journal: Blood (2016)
Th2 Cytokine Polymorphisms, IL-4 -590 CC Genotype and IL-10RB K47E, Increase the Requirement of Second-Line Treatment for Chronic ITP
Authors: Yuya Kitamura, Takayuki Saitoh, Rumi Ino, Kazuki Honma, Tomomi Nagashima, Noriyuki Takahashi, Nanami Gotoh, Tetsuhiro Kasamatsu, Takuma Ishizaki, Makiko Takizawa, Akihiko Yokohama, Hiroaki Shimizu, Hiroshi Handa, Norifumi Tsukamoto, Hirokazu Murakami
Journal: Blood (2016)
Asparaginase May Affect Mercaptopurine Tolerability in the Context of Multi-Agent Therapy for Acute Lymphoblastic Leukemia
Authors: Chengcheng Liu, Deqing Pei, Cheng Cheng, Jun J Yang, Kristine R Crews, John C Panetta, Xiangjun DeMeter, Sima Jeha, John Sandlund, Raul C. Ribeiro, Jeffrey E Rubnitz, Monika L. Metzger, Ching-Hon Pui, William E. Evans, Mary V. Relling
Journal: Blood (2016)
Povidone iodine in wound healing: A review of current concepts and practices
Authors: Paul Lorenz Bigliardi, Syed Abdul Latiff Alsagoff, Hossam Yehia El-Kafrawi, Jai-Kyong Pyon, Chad Tse Cheuk Wa, Martin Anthony Villa
Journal: International Journal of Surgery (2017)

Of the many antimicrobial agents available, iodophore-based formulations such as povidone iodine have remained popular after decades of use for antisepsis and wound healing applications due to their favorable efficacy and tolerability. Povidone iodine's broad spectrum of activity, ability to penetrate biofilms, lack of associated resistance, anti-inflammatory properties, low cytotoxicity and good tolerability have been cited as important factors, and no negative effect on wound healing has been observed in clinical practice. Over the past few decades, numerous reports on the use of povidone iodine have been published, however, many of these studies are of differing design, endpoints, and quality. More recent data clearly supports its use in wound healing. Based on data collected through PubMed using specified search criteria based on above topics and clinical experience of the authors, this article will review preclinical and clinical safety and efficacy data on the use of povidone iodine in wound healing and its implications for the control of infection and inflammation, together with the authors' advice for the successful treatment of acute and chronic wounds. Povidone iodine has many characteristics that position it extraordinarily well for wound healing, including its broad antimicrobial spectrum, lack of resistance, efficacy against biofilms, good tolerability and its effect on excessive inflammation. Due to its rapid, potent, broad-spectrum antimicrobial properties, and favorable risk/benefit profile, povidone iodine is expected to remain a highly effective treatment for acute and chronic wounds in the foreseeable future.
Prognostic impact of 21 Gene Recurrence Score, IHC4, and central grade in high-risk HR+/HER2- early breast cancer (EBC): 5-year results of the prospective Phase III WSG PlanB trial.
Authors: Oleg Gluz, Ulrike Nitz, Matthias Christgen, Ronald E. Kates, Michael Clemens, Stefan Kraemer, Benno Nuding, Toralf Reimer, Bahriye Aktas, Sherko Kümmel, Marianne Just, Andrea Stefek, Fatemeh Lorenz-Salehi, Petra Krabisch, Cornelia Liedtke, Christer Svedman, Steven Shak, Rachel Wuerstlein, Hans Heinrich Kreipe, Nadia Harbeck
Journal: Journal of Clinical Oncology (2016)

556 Background: The 21-gene Recurrence Score (RS) assay, nodal status, grade, and ER, PR, Ki67, or IHC4 are recommended for chemotherapy (CT) decision making in HR+/HER2- EBC. The phase III PlanB trial prospectively used RS to define a low-risk subset of pN0-1 EBC patients who could be treated by adjuvant endocrine therapy (ET) alone. Here, we report for the first time a comparison of the prognostic impact of RS, central grade, and IHC4 regarding long-term 5-year outcome. Methods: A central tumor bank was prospectively established within PlanB. Following an early amendment, HR+, pN0-1 patients with RS ≤ 11 were recommended to omit CT. Patients with RS > 12 or pN2-3 or HR-/HER2- BC were randomized to CT: 6xTC vs. 4xEC-4xDoc. Primary endpoint of the study is disease-free survival (DFS), defined here as any relapse, secondary malignancy, or death. Results: From 2009 to 2011, PlanB enrolled 3198 patients (central tumor bank n = 3073); median age was 56 years; 41.1% had pN+ and 32.5% G3 EBC. In 348/404 patients (15.3%), CT was omitted based on RS ≤ 11. After 55 months median follow-up, 5-year DFS in ET-treated patients with RS ≤ 11 was estimated as 94% (in both pN0 and pN1) vs. 94% (RS 12-25) and 84% (RS > 25) in CT-treated patients (p < 0.001); 5-year overall survival (OS) was 99% vs. 97% vs. 93% (p < 0.001), respectively. Nodal status, central and local grade, tumor size, continuous Ki-67, PR, IHC4, and RS were univariate prognostic factors for DFS. In multivariate analysis including all univariate prognostic markers, only pN2-3, both central and local grade 3, tumor size > 2cm, and RS, but not IHC4 or Ki-67 were independent adverse factors. If RS is excluded, then IHC4 or both Ki-67 and PR enter the model. Conclusions: RS seems to provide stronger prognostic impact in addition to clinical-pathological markers (local and central grade, tumor size, and nodal status) vs. IHC4 or Ki-67 in our prospective WSG PlanB trial. The excellent 5-year DFS of 94% and OS of 99% in pN0 and pN1 EBC patients who did not receive adjuvant CT based on RS ≤ 11 support the use of well-validated genomic assays such as RS combined with standardized pathology for adjuvant treatment decisions in HR+ HER2- EBC. Clinical trial information: NCT01049425.
Dermatologic adverse events in breast cancer patients receiving endocrine therapies.
Authors: Azael Freites-Martinez, Viswanath Reddy Belum, Shamir Geller, Anna Skripnik, Kathryn Ciccolini, Jerry Shapiro, Sarah Kitts, Shari Beth Goldfarb, Mario E. Lacouture
Journal: Journal of Clinical Oncology (2017)

e12533 Background: Endocrine therapies are known to cause adverse events including hot flashes, arthralgias, and dyspareunia. Dermatologic adverse events (dAE), including alopecia are infrequently reported, despite their potential impact on quality of life (QoL). This study aims to characterize endocrine therapy-related dAE including alopecia, acne, xerosis, and onychodystrophy. Methods: A retrospective chart review (2005-2015) of patients referred to the dermatology service for dermatologic conditions developing during endocrine therapies was performed. Relevant data was abstracted from each patient’s medical record including demographics, primary cancer diagnosis, and dAEs by grade (CTCAE v4.03). The psychosocial impact of alopecia was assessed in a subset of patients using a QoL questionnaire (Hairdex), which includes the following domains: ‘emotions’, ‘functioning’, ‘symptoms’, ‘stigmatization’ and ‘self-confidence’. Results: A total of 74 breast cancer patients treated with endocrine therapies were included (median age 62yrs. [range, 34-85]). Alopecia was the reason for a dermatologic consultation in all patients, and was attributable to aromatase inhibitors (AI) in 49 patients (66.2%) and tamoxifen in 22 (29.3%). The mean duration of treatment at the time of alopecia diagnosis was 24 months (SD ±14.3). In 93.2% of the patients, alopecia was grade 1 in severity, and in 6.8% it was grade 2 (the latter was attributable to AIs only). All grade xerosis was identified in 34 (45.9%), onychodystrophy in 21 (28.4%) and acne in 9 patients (12.2%). In patients who completed the Hairdex questionnaire (n = 44), a high ‘emotions’ (52.6, p &lt; 0.05) and ‘stigmatization’ (46, p &lt; 0.05) domains score were found, while ‘symptoms’ (22.1, p &lt; 0.05) and ‘functioning’ (24.5, p &lt; 0.05) domains score were lower. Conclusions: Endocrine therapies are associated with alopecia and dAEs, with a greater severity with AIs. A psychosocial impact on emotions was seen in patients with alopecia. Moreover, xerosis, acne, and onychodystrophy were also observed. These findings underscore the need for increased attention to dAE in breast cancer patients receiving endocrine agents, in order to maintain quality of life and adherence to therapies.
Locoregional relapse in BRCA1/2 breast cancer women treated with breast-conserving surgery.
Authors: María José Juan Fita, Isabel Chirivella, Ana Beatriz Sanchez, Carmen Salvador, Isabel Tena, Ana Garcia, Zaida Garcia-Casado, Francisco Gozalbo, Francisco Llopis, Pilar Llombart, Jose Antonio Lopez-Guerrero, Vicente Guillem, Ana Lluch, Dolores Salas, Amparo Ruiz
Journal: Journal of Clinical Oncology (2016)

1527 Background: Conservative surgery (CS) and radiotherapy (RT) has a 3-5% local recurrence rate in patients with sporadic breast cancer (BC), but offers equivalent survival to mastectomy. For BRCA1/2 mutation carriers women diagnosed with BC this fact remains conflicting. Some studies report higher rates of breast recurrence in BRCA women managed with CS and others do not reveal significant differences. Methods: A multicentric, observational, retrospective case-control study was performed comparing 173 women with stage I-III BC and deleterious germline BRCA1/2 mutations from Valencian Genetic Counselling Centers to 813 women with stage I-III sporadic BC and unknown BRCA mutation status who had the same treatment before January 2010.Primary endpoint was cumulative incidence of ipsilateral-breast tumor recurrence (IBTR) and its characteristics. Secondary endopoints were overall survival (OS), breast-cancer specific OS and disease-free survival. Median follow-up was 130 months for cases and 86 months for controls. Results: Median age was 43 and 56 years for mutation carriers and controls, respectively. Ten-year cumulative incidence of IBTR was 13.3% for mutation carriers and 3.3% for sporadic controls (p = 0.03). Median IBTR for cases appears at 131 months and 39.3 months in controls.We confirm the particular BRCA1-phenotype who is more likely to be grade III (p < 0.001), oestrogen receptor negative (p < 0.001) and her2 negative (p = 0.018). BRCA2 tends to be similar to sporadic tumors. Based on anatomopatologic differences, time time to relapse and different location, relapses appear to be second tumours instead true recurrence from the primary cancer.No significant difference in BC-OS or OS was observed between the two groups. On multivariate analysis, mutation was the most significant predictor for IBTR (p = 0.030). Conclusions: Our data suggest that IBTR risk after BCS is higher in BRCA1/2 mutation carriers than in controls. Hence, the ipsilateral prophylactic mastectomy in these patients could be considered as a safer option to reduce IBTR risk in these women.
Patients in Wales to take control of medical records
Authors: Matthew Limb
Journal: BMJ (2017)

The NHS in Wales has moved closer to adopting a privately developed, online health records system designed to put patients in control of their personal information and care.

The system, called Patients Know Best, has been awarded a national framework contract by the Welsh government. It allows patients with smartphones and other devices to organise their personal records in an internet based account, add information, and share it with others, including hospitals and GPs.

The interactive platform was developed by a for profit, Cambridge based software company, also called Patients Know Best, which is backed by venture capital investors and already has contracts with NHS organisations in England.1

Abertawe Bro Morgannwg University Health Board established the national framework …
Correlation between progression free survival and overall survival in patients with metastatic breast cancer receiving anthracyclines, taxanes or targeted therapies: A trial level meta-analysis.
Authors: Georges Adunlin, George Dranitsaris
Journal: Journal of Clinical Oncology (2016)

1066 Background: Over the past decade, several new drugs have received regulatory approval for metastatic breast cancer (MBC). However, some of these approvals were based on improvement in progression-free survival (PFS), without a concomitant increase in overall survival (OS). This has led some to question the utility of using PFS as a measure for drug approval. To address the uncertainty of using PFS as a surrogate for OS in MBC, a systematic literature review followed by a trial level correlative analysis was conducted in patients receiving anthracyclines, taxanes or targeted therapies. Methods: Electronic databases were searched to identify randomized trials published between January 1990 and August 2015.Data extraction included hazard ratios for PFS (HRPFS ) and OS (HROS ) between comparative arms as well as trial level parameters. Weighted multivariate regression analysis was then used to test the strength of the association between HRPFS and HROS . Results: 72 trials providing 84 comparative arms met the inclusion criteria. HRPFS was a significant predictor of HROS (model coefficient = 0.18, p = 0.04). However, only 31% (i.e. model R2) of the variability between the PFS-OS association was accounted for. When trials were limited to ≥ 2nd line setting, the strength of the association improved (model coefficient = 0.40, p < 0.001) and the model R2 increased to 55%. However, the HRPFS - HROS association was no longer significant when only 1st line trials were considered (p = 0.90). Conclusions: HRPFS is a predictor for HROS in MBC randomized trials. However, the effect was driven by trials in the ≥ 2nd line setting. Therefore, PFS can be a suitable surrogate for OS in trials evaluating new treatments in the 2nd setting and beyond. The use of PFS alone as a primary trial endpoint in the 1st line setting is not recommended.