tbuckley/cabot-search huggingface dataset:
Chemotherapy within the last 30 days of life among patients with metastatic solid tumors.
Authors: Maria Alma Rodriguez, Yvette DeJesus, Lee Cheng, Thomas W. Burke
Journal: Journal of Clinical Oncology (2012)

e16574 Background: Metastatic solid tumors (MST) are rarely curable. However, treatment options for MST (stage IV) are increasing. Thus, discussing realistic therapeutic goals is critical to planning appropriate end of life medical interventions. We analyzed chemotherapy use within 30 days prior to end of life, and DNR orders, among patients with solid tumors (ST) who died at our institution. Methods: We reviewed all adult patients (age&gt;18 years) with a diagnosis of ST who died in hospital at M.D. Anderson Cancer Center from June, 2010 through March, 2011 (excluded: hematologic malignancies). Data on patients’ demographics, chemotherapy within last 30 days (excluded: hormones), inpatient DNR orders, and comorbidities were from the institution’s administrative databases. Statistical analyses were: chi-square test for association between variables; univariate and logistic regression for association of chemotherapy use with age, gender, ethnicity, comorbidities, years of disease diagnosis, and metastatic status; statistical significance is defined as P value &lt; 0.05. Results: 357 ST patients died in hospital: median age 60 years; 41% female; 81% MST; 44% had lung, breast or colorectal cancer. Patients receiving chemotherapy within last 30 days of life: 29% with MST; 18% without metastases (p = 0.06). DNR orders: 90% with MST, versus 79% without metastases (p =0.01). By regression analyses, there were no significant factors for chemotherapy use during the last 30 days of life (age, gender, ethnicity, years from time of disease diagnosis, metastatic status, and co-morbid conditions, each p&gt;0.05). Conclusions: Only a small portion of patients with MST received chemotherapy within the last 30 days of life, while most had DNR orders indicating an end of life discussion. We need to study further the relationship of early discussion of treatment goals to clinical outcomes and end of life planning.
RAPID AORTIC HOMOGRAFT DEGENERATION AND VAD SUPPORT IN A NEONATE WITH SINGLE VENTRICLE HEART DISEASE
Authors: Humera Ahmed, Sharon Chen, Vamsi Yarlagadda, Christopher Almond, Jenna Murray, David N. Rosenthal, Michael Ma, John Dykes, Katsuhide Maeda
Journal: Journal of the American College of Cardiology (2020)
Reducing the Risk of Cardiovascular Disease
Authors: K. Srinath Reddy, Dorairaj Prabhakaran
Journal: Circulation (2020)

araphrasing the opening lines of A Tale of Two Cities by Charles Dickens, these are the best of times and the worst of times for patients with cardiovascular diseases (CVDs) around the world.Tremendous achievements have been observed in high-income countries at both population and individual levels.Most high-income countries achieved a population-level decline in CVD mortality of >50% within 1 generation. 1 Rapid advances in cardiovascular care since the 1970s have resulted in a large decline in both out-of-hospital and in-hospital mortality after acute myocardial infarction. 2,3In high-income countries, population-level cardiovascular risk factors have declined substantially. 3 In contrast, CVD burdens have either risen or only slowly declined in low-and middle-income countries during the same period. 3RICS (Brazil, Russia, India, China, and South Africa), a grouping of upper-and lower-middle-income countries, constitutes close to 44% of the world's population, contributes to 32% of the world's gross domestic product, and has a major influence on global economy. 4The large burden of CVDs in BRICS, particularly in younger and productive age groups, can impair national economic development and adversely affect global economy.There is substantial heterogeneity in CVD mortality and risk factors even within this apparently homogenous bloc of emerging economies.Whereas aging of the population has resulted in a high burden of CVD, age-specific CVD mortality rates are highly variable among these countries.This variation is attributable both to the level and calendar of economic growth and the efficiency with which multisectoral prevention policies combined with health care services to reduce CVD risk across the life course are implemented.Temporal trends in CVD mortality and their ecological associations with risk factor levels have been well-documented, but the roles of cohort and period effects have not been equally well studied.Age-period-cohort analyses can yield valuable insights into the successes and challenges that mark the evolution of the CVD epidemic across the BRICS countries and explain the variations in the course of their CVD epidemics.In this issue of Circulation, Zou et al 5 make good use of data from the Global Burden of Disease study to analyze time trends in BRICS countries over 25 years.The authors derive mortality estimates from the 2017 Global Burden of Disease study and use age-period-cohort modeling to estimate cohort and period effects in CVD between 1992 and 2016.Age-period-cohort models are additive models in which the predictor is a sum of 3 time effects: functions of age, period, and cohort. 6Data for these are drawn from repeated cross-sectional surveys, in which the time effects can be combined with individual covariates.Using this sophisticated analytical model, the authors were able to obtain several outcomes to reflect
Max Rendall: consultant surgeon who became an addiction specialist in retirement
Authors: Colin Brewer
Journal: BMJ (2020)

Max Rendall, who has died at the age of 85, was a consultant surgeon and superintendent at Guy’s Hospital, London. In retirement, he developed a second career in addiction medicine and wrote a book criticising the century old “noble experiment” of outlawing mood altering drugs other than alcohol and nicotine.

After a year at Harvard, he became a consultant at Guy’s Hospital at 34. Soon, his manifest organisational skills got him elevated to superintendent, where his tact and politeness enabled him to defuse the resistance to change that some older surgeons displayed. Unusually for a London teaching hospital consultant, Max had no private practice. Colleagues and students remember him as a skilled and kindly surgeon and an excellent teacher. He was also an innovator, introducing problem oriented medical records, audit systems, and weekly surgical meetings to discuss treatment failures, as well as successes, and how to learn from them. He wished politicians would adopt the self-examination and self-criticism that are …
A phase II study of temozolomide and bevacizumab in patients with advanced neuroendocrine tumors
Authors: M. H. Kulke, K. Stuart, C. C. Earle, P. Bhargava, J. W. Clark, P. C. Enzinger, J. Meyerhardt, M. Attawia, C. Lawrence, C. S. Fuchs
Journal: Journal of Clinical Oncology (2006)

4044 Background: Inhibitors of the VEGF pathway have been shown to have activity in neuroendocrine tumors (NETs). Temozolomide (TMZ), an oral analog of dacarbazine is also active in this setting. We performed a prospective, phase II study to assess the safety and efficacy of TMZ, administered in combination with bevacizuamb, in patients (pts) with advanced NETs. Methods: Pts received TMZ, 150 mg/m 2 /day po for 7 days every other week, and bevacizumab, 5 mg/kg IV every other week. Due to anticipated lymphopenia, pts received prophylaxis with trimethoprim/sulfamethoxazole (1 DS tablet q MWF) and acyclovir (400 mg po TID). Pts were followed for toxicity, response, and survival. Results: Enrolled patients (n=34) had the following characteristics: M:F = 19:15; median age 61 (range 37–75); ECOG PS 0/1/2 = 12/20/2; carcinoid/pancreatic NET = 16/18. Prior treatments included chemoembolization (n=7) chemotherapy (n=12); and octreotide (n=17); pts on octreotide remained on octreotide at stable doses for the duration of the study. Pts had either well-differentiated tumors (n=27) or moderately/poorly-differentiated NETs (n=7); pts with small cell carcinoma were not eligible for the study. Pts have received treatment for a median of 22 weeks. Grade 3–4 toxicities included: lymphopenia (n=21, 62%), leukopenia (n=2, 6%), thrombocytopenia (n=7, 21%), neutropenia (n=2, 6%), hyponatremia (n=1, 3%), vomiting (n=3, 9%), nausea (n=2, 6%), dehydration (n=1, 3%), fatigue (n=2, 6%), constipation (n=1, 3%), and hypertension (n=1, 3%). 20 pts had elevated CGA levels (&gt;36.4 ng/ml) at baseline; 0/9 (0%) carcinoid and 4/11 (36%) pancreatic NET experienced CGA decreases of &gt;50% from baseline on two consecutive assessments. 29 pts are currently evaluable for radiologic response ( Table ). Conclusions: The combination of TMZ and bevacizumab can be safely administered and shows promising activity in pts with advanced pancreatic NETs. Additional studies with this combination are warranted. [Table: see text] [Table: see text]
UNVEILING OUTCOMES IN COEXISTING SEVERE AORTIC STENOSIS AND TRANSTHYRETIN CARDIAC AMYLOIDOSIS
Authors: Hannah Rosenblum, Ahmad Munir Masri, David Narotsky, Goldsmith Jeff, Nadira Hamid, Rebecca T. Hahn, Susheel K. Kodali, Torsten Vahl, Tamim Nazif, Omar K. Khalique, Sabahat Bokhari, Soman Prem, Joao L. Cavalcante, Mathew Maurer, Adam Castano
Journal: Journal of the American College of Cardiology (2020)
High dose rate post-operative brachytherapy and external beam radiotherapy for uterine sarcomas
Authors: M. A. Maia, P. Novaes, A. C. Pellizzon, R. Ferrigno
Journal: Journal of Clinical Oncology (2006)

15027 Background: Uteine sarcoma (US) generally needs an aggressive approach with surgical cytoreduction at the time of initial diagnosis with maximum debulking of tumor. This offers the possibility of prolonged survival or cure. The need for adjuvant radiotherapy is not well established for US. Methods: 25 patients presenting completely ressected US were treated from November, 1992 to June, 2003. All the patients had a multidisciplinary approach with surgery, external beam radiation therapy (EBRT) given in a four- fields “box” technique, and high dose rate brachytherapy (HDRB), using either colpostats or vaginal cylinders with diameters ranging from 2.5 to 4 cm. The entire vaginal length treated with HDRB was 2 cm in all cases. Results: The median age of patients was 62 years (range 39–84). The EBRT dose prescription ranged from 40 Gy to 50,4 Gy (median 48 Gy). HDRB was given concurrent to EBRT in 14 patients (56%). The HDRB for the remaining patients started in median interval of 34 days (range 5–99 days) after the completion of EBRT. The median BED for hole treatment was 91.5 Gy 10 (range 85.6 Gy 10 –97.9 Gy 10 ), with a standard deviation of 3.7. The 10- year actuarial disease free and overall survivals were and 42.2% and 63.4%, respectively. On univariate analysis predictive factors for disease free survival (DFS) were age at initial presentation (p = 0.0268), parity (p = 0.0441), tumor grade (p = 0.0095), cervical or vaginal invasion (p = 0.0014) and node dissection at time of surgery (p = 0.0471). On multivariate analysis the only predictive factor was cervical or vaginal invasion (p = 0.048), hazard ratio of 4.7. Conclusion: Our small and heterogeneous group of patients analyzed precludes any definitive conclusions regarding the impact of HDRB combined to EBRT on recurrence or survival of the patients. As US are aggressive tumors, it is quite likely that neither radiotherapy nor chemotherapy alone will appreciably improve survival. If we assume that adjuvant radiation therapy provides better locoregional tumor control, hematogenous metastases probably will assume an even greater proportion of treatment failures. No significant financial relationships to disclose.
YIA20-001: Targeting TGF-β in Ovarian Cancer Results in Decreased Tumor Burden and Improved T Cell Immune Response
Authors: Rebecca Arend, Brandon M. Roane, Selene Mesa-Perez, Whitney N. Goldsberry, Ashwini Katre, Michael J. Birrer, Lisa A. Norian
Journal: Journal of the National Comprehensive Cancer Network (2020)
Reduction in All-Cause Mortality with Fluticasone Furoate/Umeclidinium/Vilanterol in Patients with Chronic Obstructive Pulmonary Disease
Authors: David A. Lipson, Courtney Crim, Gerard J. Criner, Nicola C. Day, Mark T. Dransfield, David M. G. Halpin, MeiLan K. Han, C. Elaine Jones, Sally Kilbride, Peter Lange, David A. Lomas, Sally Lettis, Pamela Manchester, Neil Martin, Dawn Midwinter, Andrea Morris, Steven J. Pascoe, Dave Singh, Robert A. Wise, Fernando J. Martinez
Journal: American Journal of Respiratory and Critical Care Medicine (2020)

Rationale: The IMPACT (Informing the Pathway of Chronic Obstructive Pulmonary Disease Treatment) trial demonstrated a significant reduction in all-cause mortality (ACM) risk with fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) versus UMEC/VI in patients with chronic obstructive pulmonary disease (COPD) at risk of future exacerbations. Five hundred seventy-four patients were censored in the original analysis owing to incomplete vital status information.Objectives: Report ACM and impact of stepping down therapy, following collection of additional vital status data.Methods: Patients were randomized 2:2:1 to FF/UMEC/VI 100/62.5/25 μg, FF/VI 100/25 μg, or UMEC/VI 62.5/25 μg following a run-in on their COPD therapies. Time to ACM was prespecified. Additional vital status data collection and subsequent analyses were performed post hoc.Measurements and Main Results: We report vital status data for 99.6% of the intention-to-treat population (n = 10,355), documenting 98 (2.36%) deaths on FF/UMEC/VI, 109 (2.64%) on FF/VI, and 66 (3.19%) on UMEC/VI. For FF/UMEC/VI, the hazard ratio for death was 0.72 (95% confidence interval, 0.53–0.99; P = 0.042) versus UMEC/VI and 0.89 (95% confidence interval, 0.67–1.16; P = 0.387) versus FF/VI. Independent adjudication confirmed lower rates of cardiovascular and respiratory death and death associated with the patient’s COPD.Conclusions: In this secondary analysis of an efficacy outcome from the IMPACT trial, once-daily single-inhaler FF/UMEC/VI triple therapy reduced the risk of ACM versus UMEC/VI in patients with symptomatic COPD and a history of exacerbations.
Lymphoid Tissue Engineering: Thermoresponsive Inverted Colloidal Crystal Hydrogel Scaffolds for Lymphoid Tissue Engineering (Adv. Healthcare Mater. 6/2020)
Authors: Jun‐Goo Kwak, Jungwoo Lee
Journal: Advanced Healthcare Materials (2020)

In article number 1901556 by Jun-Goo Kwak and Jungwoo Lee, thermoresponsive inverted colloidal crystal hydrogel scaffolds with rapid response rate and large volumetric change are reported. These two properties enable selective retrieval of expanded model hematopoietic-lymphoid cells from co-cultures with osteospheroids, via a temperature switch in a repeatable fashion.
Stopping the Spread of COVID-19
Authors: Angel N. Desai, Payal Patel
Journal: JAMA (2020)

An Pan, PhD; Li Liu, MD, PhD; Chaolong Wang, PhD; Huan Guo, MD, PhD; Xingjie Hao, PhD; Qi Wang, MD, PhD; Jiao Huang, PhD; Na He, PhD; Hongjie Yu, PhD; Xihong Lin, PhD; Sheng Wei, MD, PhD; Tangchun Wu, MD, PhD
RIGHT ATRIAL THROMBUS MASQUERADING AS A MYXOMA. SYNERGISTIC EFFECTS OF HORMONAL CONTRACEPTIVES AND ANTI-PHOSPHOLIPID ANTIBODIES
Authors: Zeba Hashmath, Abhishek Bose, Ajay Mishra, Ramses Thabet, Devon McCormick, Mark Kranis
Journal: Journal of the American College of Cardiology (2020)
USE OF A COVERED STENT IN COARCTATION OF AORTA INVOLVING THE LEFT SUBCLAVIAN ARTERY: A SPECIAL CASE
Authors: Rahul Singh, Stephanie C. Fuentes Rojas, Brian A. Karahalios, Akanksha Thakkar, Ahmad Agha, Mikhail Narezkin, Miguel Chavez, C. Huie Lin
Journal: Journal of the American College of Cardiology (2020)
Enhanced physicochemical and biological properties of C/Cu dual ions implanted medical titanium
Authors: Chao Xia, Xiaohan Ma, Xianming Zhang, Kunqiang Li, Ji Tan, Yuqin Qiao, Xuanyong Liu
Journal: Bioactive Materials (2020)

It is increasingly popular for titanium and its alloys to be utilized as the medical implants. However, their bio-inert nature and lack of antibacterial ability limit their applications. In this work, by utilizing plasma immersion ion implantation and deposition (PIII&D) technology, the titanium surface was modified by C/Cu co-implantation. The mechanical property, corrosion resistance, antibacterial ability and cytocompatibility of modified samples were studied. Results indicate that after C/Cu co-implantation, copper nanoparticles were observed on the surface of titanium, and titanium carbide existed on the near surface region of titanium. The modified surface displayed good mechanical property and corrosion resistance. The Cu/C galvanic corrosion existed on the titanium surface implanted by C/Cu dual ions, and release of copper ions can be effectively controlled by the galvanic corrosion effect. Moreover, improved antibacterial performance of titanium surface can be achieved without cytotoxicity.
Anthropometric change among breast cancer survivors provided a behaviorally based weight loss intervention.
Authors: Kim Dittus, Janice Bunn, Zachary Paul, Jean Harvey-Berino
Journal: Journal of Clinical Oncology (2013)

9591 Background: A majority of women with breast cancer are overweight or obese. Weight gain and loss of lean body mass often accompany chemotherapy. Excess weight is associated with increased risk of recurrence and decreased overall survival. Our aim was to determine the feasibility of a behavioral based weight loss intervention for breast cancer survivors who did and did not receive chemotherapy and to determine if additional resistance training enhances weight loss. Methods: Women with a BMI of 26-50 and stage I-III breast cancer were recruited for a 6 mo weight loss program which included individualized calorie reduction, 300 min of weekly exercise and a weekly online “chat”. Resistance training consisted of 2x/wk 30 min resistance exercises. Anthropometric measures; kcal measured by 24-hr recalls; and physical activity measured by accelerometer were assessed. Results: Seventy-four women were recruited and 52 completed post testing. The average age was 54 and average time since diagnosis was 33 mos. The average BMI at study initiation was 33 kg/m 2 . Overall the survivors lost 5.9 kg (6.7 % of baseline weight). Based on paired t-test evaluation weight, BMI and % body fat were all significantly lower after the intervention for completers and when using intent to treat analysis. There were no differences between groups for anthropometric change. The kcal deficit was significant for the chemo + wt loss + resistance (274kcal) and the no chemo (327kcal) groups but not the chemo+ wt loss group (196kcal). Exercise did not significantly increase between the baseline and post testing. Conclusions: Breast cancer survivors lose significant amounts of weight with a standard behaviorally based weight loss intervention. Receipt of chemotherapy did not influence ability to lose weight. Resistance training may increase weight loss while decreasing amount of fat free mass lost. Supervised exercise may be needed to achieve increases in exercise. Clinical trial information: NCT01482702. [Table: see text]
Analysis of KIT expression and mutations in sinonasal, genital, and acrolentiginous melanomas.
Authors: Christian R F Bull, Nicola L Schoenewolf, Benedetta Belloni, David Holzmann, Sabina Tonolla, Roland Lang, Daniela Mihic, Christian Andres, Reinhard Dummer
Journal: Journal of Clinical Oncology (2012)

8563 Background: Melanoma is subdivided into molecular defined groups. One major subtype is characterized by a mutation in the BRAF gene. BRAF is less commonly mutated in acrolentiginous (ALM) and mucosal (MM) melanomas, instead these subtypes predominantly show aberrations in the KIT/CD117 gene. KIT aberrations predict the outcome of targeted therapies in ALM and MM patients, however the particular role of KIT expression in these melanoma subtypes remains controversial. To explore the relationship between KIT expression, mutation, and tumor stages, we investigated immunohistochemical KIT expression and mutation status in primary ALM/MM lesions and their metastases. We also compared the frequency of KIT mutations of MM in different anatomic locations. Methods: KIT immunoreactivity and mutation status was assessed in 41 ALM and 25 MM patients, using polyclonal rabbit anti-human KIT/CD117 antibody, and PCR was performed for KIT gene exons 9,11,13,17 and 18. Of these, 19 ALM and 15 MM patients had matched primary and metastatic lesions. Phosphorylated extracellular regulated kinase (P-ERK) was investigated in a subset of 8 ALM and 8 MM matched primary/metastatic pairs by immunohistochemistry. Results: Heterogeneous KIT immunoreactivity was observed in both primary and metastatic lesions. Mutations were present in four of 41 ALM (10%) and five of 25 MM (20%) patients. Only vulvar mucosal samples carried KIT mutations in contrast to sinonasal lesions (p= 0.0109). In KIT-mutated tumors, the mutations were present in KIT expressing as well as KIT negative cells, as shown by Laser Capture Microdissection (LCM). P-ERK expression was preferentially found in metastases. Conclusions: KIT expression is heterogeneous and shows no relationship with disease progression and mutation status, therefore KIT immunoreactivity is not a valuable marker for treatment decisions. In mucosal melanoma patients, KIT mutation frequency is significantly associated with anatomic location. Vulvar melanoma patients are prone to carry activating KIT mutations and thus may be more likely to benefit from KIT-targeted therapies than other subtypes. Therefore, especially vulvar melanoma patients should be screened for activating KIT mutations.
Using Behavioral Economics and Technology to Improve Outcomes in Cardio-Oncology
Authors: Kimberly J. Waddell, Payal D. Shah, Srinath Adusumalli, Mitesh S. Patel
Journal: JACC CardioOncology (2020)

Patients with cancer are often at elevated risk for cardiovascular disease due to overlapping risk factors and cardiotoxic anticancer treatments. Their cancer diagnoses may be the predominant focus of clinical care, with less of an emphasis on concurrent cardiovascular risk management. Widely adopted technology platforms, including electronic health records and mobile devices, can be leveraged to improve the cardiovascular outcomes of these patients. These technologies alone may be insufficient to change behavior and may have greater impact if combined with behavior change strategies. Behavioral economics is a scientific field that uses insights from economics and psychology to help explain why individuals are often predictably irrational. Combining insights from behavioral economics with these scalable technology platforms can positively impact medical decision-making and sustained healthy behaviors. This review focuses on the principles of behavioral economics and how "nudges" and scalable technology can be used to positively impact clinician and patient behaviors.
CLO20-038: Data From Electronic Prior Authorization Supports Real-World Evidence Generation: Contemporary Changes in the Treatment of aNSCLC
Authors: Henry J. Henk, Lindsey R. Sangaralingham, Aaron S. Mansfield
Journal: Journal of the National Comprehensive Cancer Network (2020)

"CLO20-038: Data From Electronic Prior Authorization Supports Real-World Evidence Generation: Contemporary Changes in the Treatment of aNSCLC" published on 20 Mar 2020 by National Comprehensive Cancer Network.
IMPACT OF CATHETER ABLATION FOR ATRIAL FIBRILLATION ON MORTALITY AND HOSPITAL READMISSION RATES IN PATIENTS WITH HEART FAILURE AND REDUCED EJECTION FRACTION
Authors: Shilpkumar Arora, Harsh Patel, Chinmay Jani, Samarthkumar Thakkar, Sopan Lahewala, Abhishek Deshmukh, Juan F. Viles-Gonzalez, Yash Varma
Journal: Journal of the American College of Cardiology (2020)