tbuckley/cabot-search huggingface dataset:
Predicting Persistent Opioid Use, Abuse, and Toxicity Among Cancer Survivors
Authors: Lucas K Vitzthum, Paul Riviere, Paige Sheridan, Vinit Nalawade, Rishi Deka, Timothy Furnish, Loren K Mell, Brent Rose, Mark Wallace, James D Murphy
Journal: JNCI Journal of the National Cancer Institute (2019)

Abstract Background Although opioids play a critical role in the management of cancer pain, the ongoing opioid epidemic has raised concerns regarding their persistent use and abuse. We lack data-driven tools in oncology to understand the risk of adverse opioid-related outcomes. This project seeks to identify clinical risk factors and create a risk score to help identify patients at risk of persistent opioid use and abuse. Methods Within a cohort of 106 732 military veteran cancer survivors diagnosed between 2000 and 2015, we determined rates of persistent posttreatment opioid use, diagnoses of opioid abuse or dependence, and admissions for opioid toxicity. A multivariable logistic regression model was used to identify patient, cancer, and treatment risk factors associated with adverse opioid-related outcomes. Predictive risk models were developed and validated using a least absolute shrinkage and selection operator regression technique. Results The rate of persistent opioid use in cancer survivors was 8.3% (95% CI = 8.1% to 8.4%); the rate of opioid abuse or dependence was 2.9% (95% CI = 2.8% to 3.0%); and the rate of opioid-related admissions was 2.1% (95% CI = 2.0% to 2.2%). On multivariable analysis, several patient, demographic, and cancer and treatment factors were associated with risk of persistent opioid use. Predictive models showed a high level of discrimination when identifying individuals at risk of adverse opioid-related outcomes including persistent opioid use (area under the curve [AUC] = 0.85), future diagnoses of opioid abuse or dependence (AUC = 0.87), and admission for opioid abuse or toxicity (AUC = 0.78). Conclusion This study demonstrates the potential to predict adverse opioid-related outcomes among cancer survivors. With further validation, personalized risk-stratification approaches could guide management when prescribing opioids in cancer patients.
Olutasidenib (FT-2102), an IDH1m Inhibitor As a Single Agent or in Combination with Azacitidine, Induces Deep Clinical Responses with Mutation Clearance in Patients with Acute Myeloid Leukemia Treated in a Phase 1 Dose Escalation and Expansion Study
Authors: Justin M. Watts, Maria R. Baer, Jay Yang, Thomas Prebet, Sangmin Lee, Gary J. Schiller, Shira Dinner, Arnaud Pigneux, Pau Montesinos, Eunice S. Wang, Karen Seiter, Andrew H. Wei, Stephane De Botton, Montserrat Arnan Sangerman, William B. Donnellan, Brian A Jonas, Paul Brent Ferrell, Kim-Hien Dao, Patrick Kelly, Jennifer Sweeney, Sanjeev Forsyth, Sylvie Guichard, Julie Brevard, Patrick Henrick, Hesham Mohamed, Jorge E. Cortes
Journal: Blood (2019)
Frequent HER2/neu gene amplification and overexpression in esophageal cancer
Authors: Uta Reichelt, Peer Duesedau, Alexander Quaas, Bjoern-Chritian Link, Paulus G. Schurr, Ronald Simon, Jakob R. Izbicki, Guido Sauter
Journal: Cancer Research (2006)

Proc Amer Assoc Cancer Res, Volume 47, 2006

1285 

Introduction: HER2 is the target for antibody based treatment of breast cancer (Herceptin) which is highly successful both in advanced disease and in the adjuvant setting. Studies have shown that gene amplification is a superior predictor of response to herceptin than overexpression alone. In this study 259 primary esophagus cancers were analyzed for HER2 amplification and overexpression. Materials and Methods: A tissue microarray (TMA) was constructed from 259 primary esophagus cancers (113 adenocarcinomas and 146 squamous cell carcinomas) and 123 metastases. Slides were analyzed by immunohistochemistry (HercepTest, DAKO) and Fluorescence in situ Hybridization (FISH) for amplification and overexpression (PathVysion, VYSIS/ABBOTT). Results: Amplification/overexpression was seen in 17/113 (15%) of adenocarcinomas and in 7/146 (4,8%) of squamous cell carcinomas. Amplification was typically high-level with more than 20 HER2 copies per tumor cell. Amplification was unrelated to survival, grading, pT or pN stage. No discrepancies were seen between primary tumors and their metastasis. Conclusions: Esophageal carcinomas belong to cancer types with relevant frequency of high-level HER2 gene amplification. Clinical trials or individual case studies investigating the response of HER2 positive esophageal tumors to herceptin are urgently needed. The strong concordance of the HER2 status in primary and metastatic cancers (p<0.0001) may argue for a possible response of metastases from patients with HER2 positive primary tumors to Herceptin.
Movement in the wrong direction: Inaccurate change in prognostic understanding and its predictors.
Authors: Login George, Andrew S. Epstein, Holly Gwen Prigerson
Journal: Journal of Clinical Oncology (2019)

54 Background: Prognostic understanding research has primarily focused on improvements in the accuracy of patient understanding and factors driving such improvements. However, could patients with a terminal prognosis become more inaccurate in their understanding, and what factors predict such change? Methods: In a multi-site prospective study, 184 advanced cancer patients, whom oncologists expected to die within 6 months, were assessed twice (median time 5 weeks apart). Potential predictors were examined at the first assessment: age, gender, education, marital and insurance status, race, ethnicity, geographical region, cancer type, physical and psychological quality of life, and religious beliefs in end-of-life care. The accuracy of prognostic understanding was measured at both assessments using a 4-item index (understanding of terminal illness status, shortened life-expectancy, disease incurability, and advanced stage). Patients with lower prognostic understanding scores at the second assessment compared to the first assessment were categorized as demonstrating more inaccurate understanding. Results: 18.5% ( n = 34) of patients became more inaccurate in their prognostic understanding. Race ( p &lt; .01), geographic region ( p = 0.03), and religious beliefs ( p &lt; .01) emerged as significant correlates. Specifically, being non-white, being from South-Western/Western United States, and holding stronger religious beliefs were associated with higher likelihood of prognostic understanding becoming more inaccurate. Simultaneously examining these three predictors in a logistic regression model showed likely overlap in their predictive ability, with race ( p = 0.45) and geographic region ( p = .32 &amp; .72, dummy coded) becoming non-significant, and religious beliefs retaining marginal significance ( p = .06). Conclusions: Some patients with a terminal prognosis may become more inaccurate in their prognostic understanding, and this may be more likely among those with stronger religious beliefs. The findings additionally raise the potential role of inaccurate prognostic understanding in contributing to the racial, religious, and regional disparities currently found in end-of-life care.
Nivolumab-Induced Subcutaneous Fat Necrosis
Authors: Peeyush Bhargava, Lesley Flynt, Leonardo Marcal
Journal: Clinical Nuclear Medicine (2019)

A 59-year-old woman with history of metastatic melanoma, currently on nivolumab, presents for a restaging FDG PET/CT scan. New subcutaneous hypermetabolic foci are seen in bilateral lower extremities, suggestive of recurrent melanoma. She is referred for percutaneous image-guided biopsy for definitive diagnosis of progressive disease. Ultrasound shows the subcutaneous foci to be hyperechoic (fat density), and biopsy of the right thigh nodule shows fat necrosis with no evidence of tumor. Fat necrosis, an immune-related adverse event, can be FDG-avid and mimic malignancy on PET/CT scan.
Public Awareness for a Sexual Assault Hotline Following a<i>Grey’s Anatomy</i>Episode
Authors: Trevor Torgerson, Jam Khojasteh, Matt Vassar
Journal: JAMA Internal Medicine (2019)

This study examines a rise in telephone calls to the Rape, Abuse, and Incest National Network rape crisis hotline in the wake of an episode of the television show Grey's Anatomy focused on rape and ending with the hotline number.
Efficacy of medical cannabis for cancer-related pain in the elderly: A single-center retrospective analysis.
Authors: Charles Tonderai Mupamombe, Rachel Andrea Nathan, Amy Allen Case, Michelle Walter, Eric Hansen
Journal: Journal of Clinical Oncology (2019)

13 Background: Use of medical cannabis (MC) for cancer-related symptoms is growing, yet many prior studies used formulations not available in the United States (US). Clinical data on formulation, dosing and efficacy for formulations available in the US is limited. Furthermore, though interest is growing in the use of MC for elderly patients, data on safety and efficacy in this population is limited. We aimed to assess the clinical characteristics of elderly people using MC, formulations prescribed, and efficacy for cancer-related pain, insomnia and anxiety. Methods: We conducted a retrospective chart review of patients age 65 and older prescribed MC in the year 2018 in an outpatient palliative care clinic at a tertiary comprehensive cancer center. Pain intensity and anxiety were measured by numerical rating (0-10), and insomnia was assessed by self-reported hours of sleep per night, with data collected at consecutive clinic visits before and after MC use. Results: Eighty-three patients aged 65 and over were included in our analysis. Half of patients were age 65-70, while 12% were age 76 or older. Slightly more than half were male (58%), while the majority were Caucasian (92%). For patients with pain, two thirds were already prescribed opioids; 28% were using gabapentin/pregabalin, 22% duloxetine, and 7% nortriptyline/amitriptyline. Two-thirds (65%) reported never using cannabis previously. The most common MC product used was oil (35%), followed by vape (13%), pill (6%) and powder (3%). The most common initial concentrations were equal THC/CBD (41%) and high THC (43%); 8% of patients used high CBD, and 8% used a combination. The median delta pain score did not change with use of MC (delta pain = 0.0, p = 0.72), nor did anxiety (delta anxiety = -0.2, p = 1.00) nor insomnia (delta hours sleep = -0.1, p = 1.000). Conclusions: In this study of elderly patients prescribed MC, the majority of whom were cannabis naïve and already prescribed opioids, most were initially prescribed high THC or 1:1 THC/CBD, with oil and vape the most common formulations used. Use of MC was not associated with changes in pain, anxiety nor insomnia scores.
Understanding of palliative care among members of the public.
Authors: Joanne Liu Wong, Christopher Blake, Nadia Swami, Ashley Pope, Breffni Hannon, Gary Rodin, Lisa W Le, Camilla Zimmermann
Journal: Journal of Clinical Oncology (2019)

71 Background: The World Health Organization (WHO) defines palliative care (PC) as an approach that improves the quality of life of patients and their families facing life-threatening illness. However, the public may be unaware of this definition. We assessed the Canadian public’s knowledge and attitudes toward PC before and after being provided the WHO definition. Methods: We engaged a health research firm to distribute a cross-sectional survey to members of the Canadian public. Eligible participants were &gt;18 years of age, could comprehend English or French, and were currently residing in Canada. We assessed participants’ knowledge of and attitudes towards PC before and after reading the WHO definition of PC. Results were analyzed using the Wilcoxon Signed-Rank test. Results: Of 1518 participants (52% female), 45% (676/1518) stated they knew what PC was and could explain it, 32% (488/1518) knew about PC but could not explain it, 13% (198/1518) had heard of PC but did not know what it was, and 10% (156/1518) had never heard of PC. Of those who had heard of PC, 58% (784/1362) agreed PC is the last resort when other treatments have failed, 64% (877/1362) agreed PC means being close to death, and 67% (914/1362) believed PC meant being at “the stage that you can no longer take care of yourself”. Before reading the WHO definition, 56% (774/1362) agreed/strongly agreed that referral to PC would make them feel afraid; after reading the definition, this percentage was reduced to 41%, and degree of fearfulness was reduced in 46% (p&lt;0.0001). Fifty-nine percent (898/1518) stated they did not know, prior to reading the WHO definition, that PC could be involved early in the course of illness, and 45% did not know PC could be provided together with other treatments aimed at prolonging life. Eighty-nine percent (1344/1518) felt the PC definition helped them to better understand what PC is, and 91% believed that Canadians should be made aware PC can be included early in the course of a patient’s illness. Conclusions: More than half of respondents had limited knowledge of PC and believed it was synonymous with end-of-life care. Provision of the WHO definition improved understanding and allayed fears of PC. Public educational initiatives may improve understanding and increase acceptance of PC.
Clinical and histopathological characterization of paradoxical head and neck erythema in patients with atopic dermatitis treated with dupilumab: a case series
Authors: L.E.M. Wijs, N.T. Nguyen, A.C.M. Kunkeler, T. Nijsten, J. Damman, D.J. Hijnen
Journal: British Journal of Dermatology (2019)

Dupilumab is the first biologic registered for the treatment of atopic dermatitis (AD). We report on seven patients with AD presenting with a paradoxical head and neck erythema that appeared 10–39 weeks after the start of dupilumab treatment. The patients presented with a relatively sharply demarcated, patchy erythema in the head and neck area that showed no or less scaling compared with their usual eczema. Only one patient experienced symptoms of itch and burning, although this was notably different from his pre‐existent facial AD. Except for a notable 'red face', eczema on other body parts had greatly improved in six of the seven patients, with a mean numerical rating scale for treatment satisfaction of 9 out of 10 at the time of biopsy. Treatment of the erythema with topical and systemic drugs was unsuccessful. Despite the presence of this erythema, none of our patients discontinued dupilumab treatment. Lesional skin biopsies showed an increased number of ectatic capillaries, and a perivascular lymphohistiocytic infiltration in all patients. In addition, epidermal hyperplasia with elongation of the rete ridges was observed in four patients, resembling a psoriasiform dermatitis. Additional immunohistochemical stainings revealed increased numbers of plasma cells, histiocytes and T lymphocytes. Interestingly, spongiosis was largely absent in all biopsies. We report on patients with AD treated with dupilumab developing a paradoxical erythema in a head and neck distribution. Both clinically and histopathologically we found a heterogeneous response, which was most suggestive of a drug‐induced skin reaction.
Medical algorithm: Diagnosis and treatment of nonsteroidal antiinflammatory drugs hypersensitivity
Authors: Inmaculada Doña, Natalia Pérez‐Sánchez, Gádor Bogas, Esther Moreno, María Salas, María José Torres
Journal: Allergy (2019)

None of the authors have any conflict of interest, and all authors had full access to the manuscript.
Contemporary Hormonal Contraception and the Risk of Breast Cancer
Authors: Kevin Roberts, Ruth B Merkatz, Carolina S Vieira
Journal: New England Journal of Medicine (2018)

Morch et al. use data from nationwide registries in Denmark to examine contemporary hormonal contraception and the risk of breast cancer. A potential confounder was the age of the women at first birth since the risk of breast cancer is lower among women who give birth for the first time at an early age than among older women who do and a woman’s age at first birth is delayed by contraception. Data on age at first birth were abstracted from the Danish National Birth Register which started in 1973. These data may be missing for older cohort members. Data should be complete for women younger than 35 years of age so Table S7 in the Supplementary Appendix of the article is important. However the authors’ analysis was not adjusted for the women’s age at first birth. An important omission was a discussion of how many women underwent tubal sterilization and whether they were placed disproportionately into the “never used hormonal contraception” category. Information about sterilization is available from the Danish National Health Register; this information is complete from 1977 on. This information again may be incomplete for older cohort members. Evidence that sterilization may lower the risk of breast cancer makes this an important issue. Women may choose to delay childbearing even knowing that it will increase their risk of breast cancer. They should not conclude from this study that this risk can be avoided by choosing “nonhormonal” contraceptive methods of an unspecified type and efficacy. (full text)
Measures of Racism, Sexism, Heterosexism, and Gender Binarism for Health Equity Research: From Structural Injustice to Embodied Harm—An Ecosocial Analysis
Authors: Nancy Krieger
Journal: Annual Review of Public Health (2019)

Racism. Sexism. Heterosexism. Gender binarism. Together, they comprise intimately harmful, distinct, and entangled societal systems of self-serving domination and privilege that structure the embodiment of health inequities. Guided by the ecosocial theory of disease distribution, I synthesize key features of the specified "isms" and provide a measurement schema, informed by research from both the Global North and the Global South. Metrics discussed include (a) structural, including explicit rules and laws, nonexplicit rules and laws, and area-based or institutional nonrule measures; and (b) individual-level (exposures and internalized) measures, including explicit self-report, implicit, and experimental. Recommendations include (a) expanding the use of structural measures to extend beyond the current primary emphasis on psychosocial individual-level measures; (b) analyzing exposure in relation to both life course and historical generation; (c) developing measures of anti-isms; and (d) developing terrestrially grounded measures that can reveal links between the structural drivers of unjust isms and their toll on environmental degradation, climate change, and health inequities.
Natural History of Subclinical Atrial Fibrillation Detected by Implanted Loop Recorders
Authors: Søren Zöga Diederichsen, Ketil Jørgen Haugan, Axel Brandes, Mathias Buus Lanng, Claus Graff, Derk Krieger, Christian Kronborg, Anders Gaarsdal Holst, Lars Køber, Søren Højberg, Jesper Hastrup Svendsen
Journal: Journal of the American College of Cardiology (2019)
Merkel cell polyomavirus in gastrointestinal neuroendocrine tumors.
Authors: Salvatore Lorenzo Renne, Caterina Fumagalli, Nicola Fazio, Giuseppe Viale, Massimo Barberis
Journal: Journal of Clinical Oncology (2012)

4120 Background: Cutaneous Merkel cell carcinoma (MCC) is a high grade neuroendocrine carcinoma potentially induced by Merkel Cell Polyomavirus (MCPyV), a clonally integrated host in the tumor cell genome. Integration of viral DNA and truncating mutations in the helicase domain of the large T (LT) antigen, a protein implicated in the viral life cycle, have been detected in all MCPyV associated MCCs. These results suggest a role of the virus in tumor pathogenesis according to a two step model: a necessary but not sufficient integration of viral DNA followed by LT antigen premature truncations. Gastrointestinal neuroendocrine tumors (GI-NETs) share common phenotypical features with MCCs, therefore we evaluated whether MCPyVs may be present in GI-NET. Methods: Formalin–fixed and paraffin-embedded samples from 14 cases of liver metastases of G2 GI-NETs, 9 small cell lung cancer (SCLCs) and 4 MCCs of the skin were screened for MCPyV-DNA positivity using two PCR primer sets mapping the LT antigen gene. Then to confirm the putative pathogenetic role of the virus, we seeked for premature truncation of LT antigen by sequencing the helicase portion using seven amplicons mapping 1356-2210 region of the MCPyV complete genome (RefSeq: NC_010277.1). Results: Viral DNA was detected in 7/14 GI-NETs, in 0/9 SCLCs and in 4/4 MCCs. We found a premature stop codon truncating the helicase domain in two GI-NETs. Both the patients had a rapid disease progression. We also found previously not reported alterations in MCCs: a single aminoacid deletion in 3 cases and a point mutation causing a single aminoacid substitution in another case. Conclusions: For the first time the potential tumorigenic signature of MCPyV has been detected in GI-NETs, suggesting a possible role in pathogenesis. The study is ongoing to confirm these observations that could support new diagnostic and therapeutical perspectives of a subset of GI NETs. Moreover we have shown that the clonal integration of MCPyV in MCCs produces different genetic alterations with unknown effects on cell biology.
Cancer stem-like phenotypes including immune surveillance and its responsible genes in induced liver cancer stem-like cells
Authors: R. Tsunedomi, K. Yoshimura, Y. Kimura, M. Nishiyama, S. Matsukuma, Y. Tokumitsu, S. Tomochika, M. Iida, N. Suzuki, S. Takeda, S. Yoshino, S. Hazama, H. Nagano
Journal: Annals of Oncology (2019)
Diagnosis and Management of Hyperparathyroidism
Authors: Jean-Philippe Bertocchio
Journal: JAMA Internal Medicine (2019)

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Left atrial structure and function and the risk of death or heart failure in atrial fibrillation
Authors: Riccardo M. Inciardi, Robert P. Giugliano, Brian Claggett, Deepak K. Gupta, Alvin Chandra, Christian T. Ruff, Elliott M. Antman, Michele F. Mercuri, Michael A. Grosso, Eugene Braunwald, Scott D. Solomon
Journal: European Journal of Heart Failure (2019)
Plasticity of the neural coding metaphor: An unnoticed rhetoric in scientific discourse
Authors: Giulia Frezza, Pierluigi Zoccolotti
Journal: Behavioral and Brain Sciences (2019)

Abstract The convincing argument that Brette makes for the neural coding metaphor as imposing one view of brain behavior can be further explained through discourse analysis. Instead of a unified view, we argue, the coding metaphor's plasticity, versatility, and robustness throughout time explain its success and conventionalization to the point that its rhetoric became overlooked.