tbuckley/cabot-search huggingface dataset:
Hematology and oncology patient perceptions of inpatient care coordination at an urban academic teaching center.
Authors: Christopher Chen, Sara DeGregorio, Margaret Soriano, Inga Tolin Lennes, Ryan Thompson, Timothy Ferris
Journal: Journal of Clinical Oncology (2017)

109 Background: Outpatient doctors increasingly defer inpatient care to hospital-based physicians. At academic medical centers, inpatient care coordination is further complicated by frequent handoffs between resident teams. Breaks in inpatient care continuity may disproportionately affect hematology and oncology patients, given their often complicated longitudinal histories and specialized problems. We sought to understand hematology and oncology patient perceptions of inpatient care coordination at Massachusetts General Hospital (MGH). Methods: Between July 2014 and June 2015, patients admitted to any MGH service were randomly selected to complete a survey about their perception of inpatient care coordination. In total, 1,783 patients responded. Of these, 158 were admitted to hematology or oncology. Hematology and oncology patient responses were compared to all MGH patient responses using chi-squared analysis, with p values less than or equal to 0.05 used as the threshold for statistical significance. Responses reflect the percentage of patients who chose the “top box” option. Results: Compared to all MGH patients, hematology and oncology patients were significantly more likely to recognize a clearly identified doctor responsible for their care while in the hospital (85% vs 74%, p = 0.003) and to perceive the presence of a responding clinician at all times (79% vs 66%, p = 0.001). Hematology/oncology patients were also much more likely to report seeing their longitudinal MGH doctors while admitted (77% vs 57%, p &lt; 0.001). However, despite more frequent in-person visits by outpatient physicians, significantly fewer hematology/oncology patients reported perceiving that their outpatient doctor receives discharge information (47% vs 64%, p = 0.005). Conclusions: MGH hematology and oncology patients reported stronger inpatient care coordination and higher frequency of outpatient physician visits than MGH patients overall. Nevertheless, patients perceived less frequent coordination of discharge information with outpatient physicians. More research is needed to understand whether patient perceptions of care coordination correlates with clinical and utilization outcomes.
Pembrolizumab KEYNOTE-001: an adaptive study leading to accelerated approval for two indications and a companion diagnostic
Authors: S P Kang, K Gergich, G M Lubiniecki, D P de Alwis, C Chen, M A B Tice, E H Rubin
Journal: Annals of Oncology (2017)

The landscape of cancer treatment has undergone a vast change over the past four decades [1,2]. Discovery of the heterogeneous molecular features of tumors and the associated microenvironment has led to the development of novel classes of targeted therapeutics [3–5], the two main types of which are small-molecule inhibitors and monoclonal antibodies (mAbs) [1–3]. These targeted drugs have furthered the development of personalized therapeutic regimens in oncology.
Fire Simulation and Cardiovascular Health in Firefighters
Authors: Amanda L. Hunter, Anoop S.V. Shah, Jeremy P. Langrish, Jennifer B. Raftis, Andrew J. Lucking, Mairi Brittan, Sowmya Venkatasubramanian, Catherine L. Stables, Dominik Stelzle, James Marshall, Richard Graveling, Andrew D. Flapan, David E. Newby, Nicholas L. Mills
Journal: Circulation (2017)

Rates of myocardial infarction in firefighters are increased during fire suppression duties, and are likely to reflect a combination of factors including extreme physical exertion and heat exposure. We assessed the effects of simulated fire suppression on measures of cardiovascular health in healthy firefighters.
Predictors of vitality (energy/fatigue) in early stage Hodgkin's disease (HD): Results from Southwest Oncology Group (SWOG) Study 9133
Authors: P. A. Ganz, C. M. Moinpour, S. McCoy, D. K. Pauler, O. W. Press, R. I. Fisher
Journal: Journal of Clinical Oncology (2004)

6546 Background: Fatigue is often reported by HD survivors. We evaluated health status and quality of life (QOL) prospectively in 247 patients with early stage HD treated on SWOG 9133, comparing subtotal lymphoid irradiation with combined modality treatment [JCO 21:3512, 2003]. Prior to randomization, mean SF-36 Vitality (energy/fatigue) scores were about 0.5 SD below normal and did not improve at 1 yr. Methods: Univariate relationships between baseline medical, demographic, and QOL measures (CARES Physical [CARESPHY], CARES Psychosocial [CARESPSY], Symptom Distress Scale [SDS]) and baseline and 1 yr SF-36 Vitality scores were examined prior to multivariate modeling. Treatment and baseline demographic/medical data were included in the 1 yr model. Results: In univariate analyses increased (worse) performance status (PS), SDS, CARESPSY and CARESPHY were associated with decreased (worse) Vitality at baseline (p=.0006 for PS, <.0001 for rest). Hemoglobin was not associated with Vitality. Multivariate analysis identified increased PS, SDS and CARESPHY as associated with decreased Vitality at baseline (p-values .0472, <.0001 and .0002 respectively). In yr 1 univariate analyses, increased SDS, CARESPSY and CARESPHY at baseline and decreased Vitality at baseline, were associated with decreased (worse) Yr 1 Vitality scores (p <.0001 for all). Marital status, marginally associated with lower Yr 1 Vitality (p=.047), was retained. In a multivariate analysis, lower baseline Vitality score and marital status remained statistically associated with Yr 1 Vitality (p=<.0001 and .001, respectively). Treatment was not a significant predictor of Yr 1 Vitality score. Conclusions: Prior to treatment, decreased Vitality (fatigue) is not associated with medical factors related to disease or hematologic status; however, pre-treatment Vitality is significantly associated with patient-reported symptoms, physical and psychosocial well-being. 1 yr after treatment, decreased Vitality is a problem for HD survivors, is unrelated to the intensity of antineoplastic treatment, and is significantly related to pretreatment Vitality. No significant financial relationships to disclose.
Chest pain in primary care: what happens to the undiagnosed majority?
Authors: Tim Holt
Journal: BMJ (2017)

Pain without a diagnosis may signal higher cardiovascular risk

Acute chest pain is an alarming symptom, and the exclusion of a cardiac or other serious cause is the first priority. Through the process a proportion of patients undergo investigation and in some cases coronary heart disease is confirmed, a definite non-cardiac diagnosis is made, or the cause is unattributed. Assessment of new onset chest pain is typically based on the pattern and characteristics of the pain in the context of background cardiovascular risk. In a linked paper, Jordan and colleagues (doi:10.1136/bmj.j1194) show that most patients are managed without undergoing cardiac investigations.1 The unattributed group, whether investigated or not, have a greater risk of myocardial infarction over the next five years than those with a more definite non-cardiac diagnosis, as we might expect. More surprisingly, their volume in terms of patient numbers is sufficient such that more myocardial infarctions occur over the following five years in this group than those labelled …
A phase I study of BI 853520, an inhibitor of focal adhesion kinase (FAK), in patients with advanced or metastatic solid tumors.
Authors: Alona Zer, Remy Verheijen, Filip Yves Francine Leon De Vos, Sebastien Hotte, Ferry Eskens, Linda Pronk, Lillian L. Siu, David Schnell, Neeltje Steeghs, Marlies HG Langenberg, Hal Hirte, Maja J. De Jonge
Journal: Journal of Clinical Oncology (2015)

2541 Background: BI 853520 is a potent and highly selective inhibitor of FAK. In the dose-finding part of this study in patients (pts) with advanced or metastatic solid tumors, the maximum tolerated dose (MTD) was determined as 200 mg in a continuous oral daily dosing schedule in 28-day cycles. Dose limiting toxicities included proteinuria grade 3 and fatigue grade 3. Preliminary pharmacokinetic (PK) data support the once-daily dosing schedule. BI 853520 is now evaluated at the MTD in expansion cohorts of selected tumor types. Methods: Pts with metastatic or advancedpancreatic adenocarcinoma (PAC), platinum-resistant ovarian cancer (OC), esophageal cancer (EC) and soft tissue sarcoma (STS) are treated with 200 mg of BI 853520. Selection criteria: radiologically demonstrated progressive disease in 6 months before study entry and consent for tumor biopsies for biomarker assessment. Endpoints include further determination of safety profile (NCI Common Terminology Criteria for AEs (v4.03)), PK, pharmacodynamics (PD) and efficacy, determined according to RECIST v1.1 criteria. Results: To date, 41 pts have been treated: 8 PAC, 11 OC, 8 EC, 14 STS. Male/female ratio: 12/29, median age 62 years (range, 21–78 years), ECOG PS 0/1:10/31. Drug-related adverse events (AEs) in > 10% of pts included proteinuria (58.5%), nausea (58.5%), diarrhea (48.8%), vomiting (36.6%), fatigue (19.5%), decreased appetite (14.6%), dyspepsia and dysgeusia (both 12.2%), in the majority of grade 1–2. Proteinuria grade 3 was reported in 8 pts and reversible upon treatment interruption. Ten pts underwent dose reduction. Three drug-related serious AEs have been reported of which none were fatal. Preliminary PD analysis in fresh tumor biopsies (pFAK) shows target engagement. Preliminary efficacy: of 30 evaluable pts 8 pts had stable disease lasting 2-6 cycles in PAC (3 pts), OC (1 pt), EC (1 pt) and in STS (3 pts), and 22 progressed. Conclusions: The safety profile of BI 853520 is favorable. Preliminary analysis shows anti-tumor efficacy in pts with progressive disease. Recruitment is ongoing and an update on all study endpoints will be provided at the meeting. Clinical trial information: NCT01335269.
Identifying an early indicator of drug efficacy in patients with metastatic colorectal cancer—a prospective evaluation of circulating tumor cells, 18F-fluorodeoxyglucose positron-emission tomography and the RECIST criteria
Authors: B. Ma, A.D. King, L. Leung, K. Wang, A. Poon, W.M. Ho, F. Mo, C.M.L. Chan, A.T.C. Chan, S.C.C. Wong
Journal: Annals of Oncology (2017)
Right patient, right appointment, right provider at the right time.
Authors: Megan Roy, Katie Fanslau, Maria Malloy, Suzanne Sweeney, Eleanor Miller, Margaret Rummel
Journal: Journal of Clinical Oncology (2017)

125 Background: Patients with a suspicious scan or confirmed cancer diagnosis are anxious to be seen by an oncology provider. It’s important that patients are scheduled to see the most appropriate providers in the right order and timing for their clinical needs. At one large academic medical center, where patient volumes are high, the system is complex, and patients often travel. It was identified that patients were being scheduled out of order, had incomplete information, or could have been scheduled with improved timing and with additional support. This occurred in multiple disease sites. Methods: Based on this assessment, a process has been initiated to where the intake forms completed on each new patient scheduled are routed to the oncology nurse navigators via the electronic medical record. The nurse navigators then reach out to the patient prior to their appointment to further triage their needs, identify barriers and provide education and additional resources. Results: This intervention, while in early stages, has improved nurse navigator involvement with the new oncology patients to ensure they are set up appropriately, with accurate information, and has decreased providers scrambling to add patients on the same day. Outcomes from the navigator’s assessment can include any of the following: leave the appointment as is, reschedule it with the same or different provider, coordinate with another provider, or add additional information to the chart as the patient’s story evolves. Regardless, the patient receives an introduction to the nurse navigator, education, and support prior to being seen. Conclusions: By identifying an area where nurse navigators can improve patient care processes, patients are now able to get personalized assessment and appropriate appointments, no matter how they present to the cancer center. Not only are patients able to be seen by the most appropriate provider at correct timing, but the assessment for clinical needs and barriers to care can be addressed proactively. This wouldn’t be possible without the collaboration of staff and providers, willing and eager to improve the process for patient care.
Novel drug visualizing technology in human tumor specimens using mass spectrometry to support/enhance early-phase drug development.
Authors: Kan Yonemori, Shuichi Shimma, Satoko Osawa, Yuko Tanabe, Jun Hashimoto, Makoto Kodaira, Harukaze Yamamoto, Mayu Yunokawa, Chikako Shimizu, Yasuhiro Fujiwara, Kenji Tamura, Akinobu Hamada
Journal: Journal of Clinical Oncology (2014)

e22184 Background: Assessment of drug pharmacokinetics in circulating blood is an important component of early-phase drug development, but conventional pharmacokinetic analysis has limitations in providing a comprehensive assessment of spatial drug distribution in tissues.We performed tumor biopsies in patients with solid tumors who were participating in a phase I trial (NCT01813474) of olaparib. The aim of our study was to examine drug distribution in the tumor biopsy specimens by matrix-assisted laser desorption/ionization (MALDI) imaging mass spectrometry (IMS) under a microscope, which provides a sensitive and label-free approach to imaging drugs. Methods: Patients with solid tumors received the tablet formulation of olaparib in dose escalation (200mg BID; 300mg BID) and expansion (300mg BID) cohorts. Biopsies were performed in consenting patients during cycle 2 and/or at the time of progression. MALDI-IMS was performed using a Mass Microscope (Shimadzu, Kyoto, Japan). A detailed procedure was reported previously (Shimma S et al., J Mass Spectrom, 2013). The concentration of olaparib in each tissue sample was determined using a combination of laser-capture microdissection (LCM) and liquid chromatography (LC-MS/MS). Results: In total, 7 tumor biopsies were performed in 6 patients with solid tumors; 3 breast cancer including one BRCA1 mutation positive, 1 ovarian cancer, 1 peritoneal cancer, 1 cervical cancer. One patient had biopsies performed at the time of drug administration and at progression. One patient received olaparib 200mg BID; the remaining patients received olaparib 300mg BID. MALDI-imaging signal levels of olaparib correlated well with the concentration of drug in tumor tissues derived from patients using LCM and LC-MS/MS, a conventional technique used in pharmacokinetic studies. Olaparib was distributed in the tumor region and the signal level in areas of necrosis was higher than that observed in living cell areas. Conclusions: MALDI-IMS can be used to perform the quantitative analysis of olaparib distribution in all human tumor specimens tested. Clinical trial information: 01813474.
An International Collaborative Standardizing a Comprehensive Patient-Centered Outcomes Measurement Set for Colorectal Cancer
Authors: Jessica A. Zerillo, Maartje G. Schouwenburg, Annelotte C. M. van Bommel, Caleb Stowell, Jacob Lippa, Donna Bauer, Ann M. Berger, Gilles Boland, Josep M. Borras, Mary K. Buss, Robert Cima, Eric Van Cutsem, Eino B. van Duyn, Samuel R. G. Finlayson, Skye Hung-Chun Cheng, Corinna Langelotz, John Lloyd, Andrew C. Lynch, Harvey J. Mamon, Pamela K. McAllister, Bruce D. Minsky, Joanne Ngeow, Muhammad R. Abu Hassan, Kim Ryan, Veena Shankaran, Melissa P. Upton, John Zalcberg, Cornelis J. van de Velde, Rob Tollenaar
Journal: JAMA Oncology (2017)

Global health systems are shifting toward value-based care in an effort to drive better outcomes in the setting of rising health care costs. This shift requires a common definition of value, starting with the outcomes that matter most to patients.The International Consortium for Health Outcomes Measurement (ICHOM), a nonprofit initiative, was formed to define standard sets of outcomes by medical condition. In this article, we report the efforts of ICHOM's working group in colorectal cancer.The working group was composed of multidisciplinary oncology specialists in medicine, surgery, radiation therapy, palliative care, nursing, and pathology, along with patient representatives. Through a modified Delphi process during 8 months (July 8, 2015 to February 29, 2016), ICHOM led the working group to a consensus on a final recommended standard set. The process was supported by a systematic PubMed literature review (1042 randomized clinical trials and guidelines from June 3, 2005, to June 3, 2015), a patient focus group (11 patients with early and metastatic colorectal cancer convened during a teleconference in August 2015), and a patient validation survey (among 276 patients with and survivors of colorectal cancer between October 15, 2015, and November 4, 2015).After consolidating findings of the literature review and focus group meeting, a list of 40 outcomes was presented to the WG and underwent voting. The final recommendation includes outcomes in the following categories: survival and disease control, disutility of care, degree of health, and quality of death. Selected case-mix factors were recommended to be collected at baseline to facilitate comparison of results across treatments and health care professionals.A standardized set of patient-centered outcome measures to inform value-based health care in colorectal cancer was developed. Pilot efforts are under way to measure the standard set among members of the working group.
Mitochondrial Patch Clamp of Beige Adipocytes Reveals UCP1-Positive and UCP1-Negative Cells Both Exhibiting Futile Creatine Cycling
Authors: Ambre M. Bertholet, Lawrence Kazak, Edward T. Chouchani, Marta G. Bogaczyńska, Ishan Paranjpe, Gabrielle L. Wainwright, Alexandre Bétourné, Shingo Kajimura, Bruce M. Spiegelman, Yuriy Kirichok
Journal: Cell Metabolism (2017)
Clinical characteristics and prognosis of hepatocellular carcinoma with Lower serum values of AFP and PIVKA-2
Authors: Soung Min Jeon, Do Young Kim, Jun Yong Park, Sang Hoon Ahn, Jung Min Lee, Seung Up Kim, Myoung Ha Lee, Chae Yoon Chon, Kwang Hyub Han
Journal: Clinical and Molecular Hepatology (2009)
Acute myeloid leukemia in the elderly is characterized by a distinct genetic and epigenetic landscape
Authors: P Silva, M Neumann, M P Schroeder, S Vosberg, C Schlee, K Isaakidis, J Ortiz-Tanchez, L R Fransecky, T Hartung, S Türkmen, A Graf, S Krebs, H Blum, C Müller-Tidow, C Thiede, G Ehninger, H Serve, J Hecht, W E Berdel, P A Greif, C Röllig, C D Baldus
Journal: Leukemia (2017)
18F-FDG PET/CT of Tuberculosis Meningitis and Carotid Pseudoaneurysm
Authors: Kasturi Rangan, Mudalsha Ravina, Nitin Yadav, Ajay Singh Suraj, Sanjay Gambhir
Journal: Clinical Nuclear Medicine (2017)

A 26-year-old woman presented with a headache, left-sided weakness of the body, and pulsatile swelling above the sternal notch. She was treated for abdominal tuberculosis in the past, two years later she developed miliary tuberculosis and was put on modified regimen of antitubercular drugs in view of drug induced hepatitis. Ultrasound neck revealed saccular aneurysm measuring 4 x 3 cm, located in between common carotid arteries with an eccentric thrombus. MRI brain revealed multiple tuberculoma with thick basal meningeal enhancement. Cerebrospinal fluid was positive for Mycobacterium tuberculosis. F-FDG PET/CT was done to delineate the extent of the disease.
Response assessment parameters in esophageal cancer – conventional and novel techniques
Authors: L. H. Schwartz, J. A. C. Colville, L. Wang, H. Hricak, D. Ilson, G. K. Schwartz
Journal: Journal of Clinical Oncology (2004)

4037 Background: There is great concern that response assessment utilizing RECIST may not be equivalent to methodology previously employed with WHO in the evaluation of esophageal cancer, as has been seen in other tumor types (Cancer 2003 Oct. 15; 98[8]:1611–9). It is our hypothesis that this discordance may be due in part to the inaccurate use of the long dimension (RECIST) in evaluation of metastatic lymphadenopathy, as it is apparent that the short axis of a lymph node is more predictive of malignancy than its long axis. In order to test this hypothesis, we developed a new parameter of response called the “Eccentricity Factor” (EF) and evaluated it in a clinical trial in which responses were measured by RECIST and WHO. Methods: 23 patients with metastatic esophageal cancer involved in a phase II trial of bryostatin-1 and paclitaxel were included in this retrospective study. 93 lesions were assessed at baseline and these were subsequently followed on serial CT scans. Response assessment was calculated with both unidimensional and bidimensional tumor measurements. A new parameter, “EF”, a measure of a tumor shape was calculated (EF = √1-(LPD/MD) 2 where LPD = largest perpendicular diameter, and MD = maximal diameter). Results: There was a 26% disagreement rate in best overall response between unidimensional (RECIST) and bidimensional (WHO) measurements. 3/23 patients categorized as each PR and PD by WHO were SD by RECIST. The average change in the EF was 0.45 for those patients with agreement and significantly greater 0.8 (p<0.001) for time points of disagreement between RECIST and WHO. The greater the change in the EF, the greater the discordance between WHO and RECIST as well as the greater the change in tumor shape. Conclusions: These results indicate a significant difference in response assessment between WHO and RECIST, which may be due in part to the change in eccentricity of tumors as measured by the EF. The greater the change in eccentricity, the greater the discordance between WHO and RECIST as well as the greater the change in tumor shape. The importance of this factor needs to be prospectively validated but could be critical in assessment of overall tumor response in any therapy. No significant financial relationships to disclose.
Efficacy and safety of thromboembolism prophylaxis with fondaparinux in Japanese colorectal cancer patients undergoing laparoscopic surgery: A phase II study
Authors: Katsuji Tokuhara, Hideyuki Matsushima, Yosuke Ueyama, Kazuyoshi Nakatani, Kazuhiko Yoshioka, Masanori Kon
Journal: International Journal of Surgery (2017)