tbuckley/cabot-search huggingface dataset:
Is rising BMI associated with an increased rate of clinically relevant pancreatic fistula after distal pancreatectomy for pancreatic adenocarcinoma?
Authors: Evan Scott Glazer, Yixuan Zhou, Justin Drake, Jeremiah Lee Deneve, Stephen W Behrman, Paxton Vandiver Dickson, David Shibata
Journal: Journal of Clinical Oncology (2019)

360 Background: Clinically relevant pancreatic fistula (CR-POPF), following distal pancreatectomy (DP) remains a clinical challenge. Prior studies investigating the relationship between body mass index (BMI) and CR-POPF have yielded conflicting results. We examined this relationship utilizing our institutional database and hypothesized that BMI is associated with CR-POPF in patients having DP for pancreatic ductal adenocarcinoma (PDAC). Methods: Patients who underwent DP for PDAC at a single institution from 2007 to 2018 were retrospectively reviewed. A CR-POPF was defined as ISGPS grade B or C fistula. Uni- and multi-variable logistic regression analysis to assess factors associated with CR-POPF following DP was performed, controlling for factors such as gland texture, operative drain placement, gender, and smoking status. Results: 78 patients met the inclusion criteria. 51% were female, 51% were Caucasian, and the average age was 59 ± 15 years. The median BMI was 26 (interquartile range 24 to 29). Overall, 19% (n = 15) of patients had a CR-POPF. With a mean follow up 2.8 ± 2.5 years, the presence of a CR-POPF was not associated with long-term survival (P = 0.17). On univariable logistic regression, older age was associated with a decreased risk of CR-POPF (OR = 0.95, P = 0.015) while increasing BMI was associated with an increased risk of CR-POPF (OR = 1.1, P = 0.044). After controlling for multiple factors on multivariable logistic regression analysis, BMI (OR = 1.12, P = 0.035) was the only factor associated with development of a CR-POPF while older age (OR = 0.94, P &lt; 0.001) was slightly protective of CR-POPF development. Conclusions: For patients undergoing DP for PDAC, increasing BMI is associated with an increased risk of CR-POPF, independent of other factors. These findings should be considered during preoperative counseling. Although there is no specific cut-off for the association between BMI and CR-POPF, efforts to diminish the risk of CR-POPF should be focused on patients with higher BMI based on this data.
Gemcitabine/nab-paclitaxel (G/A) alternating with 5-FU/leucovorin/irinotecan (FOLFIRI) in first-line metastatic pancreatic cancer (MPC): Updated results.
Authors: Vincent J. Picozzi, Bruce Shih-Li Lin, Margaret T. Mandelson
Journal: Journal of Clinical Oncology (2019)

314 Background: Both gemcitabine- and 5-FU-based chemotherapy (chemoRx) have demonstrated efficacy in MPC. Alternating these two regimens may 1) decrease toxicity 2) slow emergence of resistant cancer biology, and 3) provide a broader platform for addition of other (non)chemotherapeutic (CT) agents to the base regimen. The strategy using alternating G/A and FOLFIRI in MPC was first tested in the SEENA-1 trial (Picozzi et.al. GI Cancer Symposium 2017) and further suggested to be of benefit both at our own institution (Picozzi et.al. ASCO 2018 ) and elsewhere (Assenat et.al. ASCO 2018). We extend and update our observations here. Methods: Eligible patients (pts) had the following characteristics: 1) bx proven de novo MPC, 2) chemoRx naive, 3) ECOG PS 0/1, and 4) bi-dimensionally measurable disease. Treatment (Rx) consisted of 1) gemcitabine 1000 mg/m 2 and nab-paclitaxel 125 mg/ 2 d 1,(8),15 alternating every 8 weeks (2 cycles) with FOLFIRI. Pts were radiographically restaged every 8 weeks. Rx was continued for up to 48 weeks, at which time additional Rx was given per physician/patient decision. Results: As of 9/2018, 61 pts have been treated at our institution via this method. Median age is 67; ECOG PS 0/1 58/42%. Disease site involvement included liver, lung, peritoneum 79%, 39%, and 23% respectively. Toxicity is less than typical with either individual regimen (e.g. no ≥ grade 3 neuropathy or diarrhea has been seen to date). Of pts followed for ≥ 4 months , 45/51 (88%) received ≥ 4 cycles Rx. Median number Rx cycles received was 9; 15/34 (44%) pts followed for &gt; 1 year completed 48 weeks Rx. Disease control rate at 16 weeks in 45 evaluable patients is 89% (47% PR, 42% SD, 11% PD). 27/61 pts (44%) are currently on Rx (4 transferred care from region, 30 deceased). Currently, median f/u is 11.8 mo; median OS is 14.1 mo ( 95% CI 10.6-20.3 mo) 6,12, 18 and 24 mo OS are 88%,57 %, 34%, and 15% respectively. Conclusions: 1) Alternating G/A and FOLFIRI in MPC appears to have a more favorable toxicity profile than either individual regimen. 2) Median OS in MPC using this Rx is at least competitive with other reports. 3) The above method has potential to integrate other therapeutic agents/ treatment approaches.
Persistence and clinical relevance of Zika virus in the male genital tract
Authors: Fábio A. Kurscheidt, Cristiane S. S. Mesquita, Gabrielle M. Z. F. Damke, Edilson Damke, Analine R. B. de A. Carvalho, Tamy T. Suehiro, Jorge J. V. Teixeira, Vânia R. S. da Silva, Raquel P. Souza, Marcia E. L. Consolaro
Journal: Nature Reviews Urology (2019)
The impact of psychosocial distress on survival in patients diagnosed with gastrointestinal (GI) malignancies.
Authors: Zamzam Salam Al-Hashami, Cheryl Ho, Sara Moore, Bonnie Leung, Howard John Lim, Alan Bates
Journal: Journal of Clinical Oncology (2019)

654 Background: A cancer diagnosis can cause psychological distress that adversely affects patients’ emotional, social, spiritual and physical capabilities. The aim of this study is to identify factors associated with increased risk for psychosocial distress and to evaluate the influence of anxiety and depression on survival of GI cancer patients. Methods: All patients with GI cancer referred to BC Cancer from 2011-2015 who completed a prospective Psychosocial Screen for Cancer – Revised within 6 months of cancer diagnosis were included in the study. Baseline characteristics were collected from the BC Cancer registry. Patient groups were compared using the Chi-squared Fisher’s exact test. OS was calculated using the Kaplan Meier method, compared using the log rank test and Cox proportional hazards model. Results: 8722 patients were included in the analysis. Baseline characteristic: median age 67, male 60% , metastatic disease 29%. Colorectal/anal cancers (60%) were the most common followed by pancreatic cancer (11%). Patients with anxiety and depression were more likely to be younger (aged 64 and less), female and have metastatic disease. Patients with anxiety were more likely to get chemotherapy. Depression was associated with less chemotherapy use. Anxiety and depression were associated with increased psychosocial needs including emotional, informational, physical, spiritual, social/family concerns (p &lt; 0.001). Psychological distress was not influenced by the patient’s geographic location or socioeconomic status. Median OS for patients with anxiety was 20 m vs no symptoms 27 m (p &lt; 0.001) and depression 17 m vs no symptoms 27m (p &lt; 0.001). The impact on OS remained significant for anxiety and depression in a multivariate model that included age, sex, metastatic status and chemotherapy use. Conclusions: Patients with GI malignancies who are female, younger than 64 and have metastatic disease are at risk for psychological distress. Anxiety and depression were associated with poorer survival outcomes even when controlling for age, sex, metastatic status and chemotherapy. Mobilizing resources to meet patients’ needs is important and should be implemented as part of patients’ comprehensive care.
Acetylcholine-induced release of nitric oxide is impaired in patients with coronary risk factors
Authors: Y. Kato, Y. Kijima, Y. Matsu-ura, K. Hashimura, T. Yasuda, T. Ueda, I. Mori, T. Minamino, M. Kitakaze, M. Hori
Journal: Journal of the American College of Cardiology (1998)
New insights into immunological responses to infection in bronchiectasis
Authors: Michal Shteinberg, Anand Shah, J. Stuart Elborn
Journal: European Respiratory Journal (2019)

<b>Immunological responses to infection are impaired in bronchiectasis. Autoimmune antibodies to neutrophil components may impair clearance of Pseudomonas and thus contribute to the chronicity of infection.</b>http://ow.ly/MGm230n4AEF
Risk of complications in patients with conservatively managed ovarian tumours (IOTA5): a 2-year interim analysis of a multicentre, prospective, cohort study
Authors: Wouter Froyman, Chiara Landolfo, Bavo De Cock, Laure Wynants, Povilas Sladkevicius, Antonia Carla Testa, Caroline Van Holsbeke, Ekaterini Domali, Robert Fruscio, Elisabeth Epstein, Maria José dos Santos Bernardo, Dorella Franchi, Marek Jerzy Kudla, Valentina Chiappa, Juan Luis Alcazar, Francesco Paolo Giuseppe Leone, Francesca Buonomo, Lauri Hochberg, Maria Elisabetta Coccia, Stefano Guerriero, Nandita Deo, Ligita Jokubkiene, Jeroen Kaijser, An Coosemans, Ignace Vergote, Jan Yvan Verbakel, Tom Bourne, Ben Van Calster, Lil Valentin, Dirk Timmerman
Journal: The Lancet Oncology (2019)
Comorbidity and systemic inflammation are independent prognostic factors in patients with colorectal cancer: A ScotScan collaborative study.
Authors: James Hugh Park, Anniken Fuglestad, Anne Helene Kostner, Antonia K. Roseweir, Joanne Edwards, Campbell SD Roxburgh, Paul G. Horgan, Christian Kersten, Donald C McMillan
Journal: Journal of Clinical Oncology (2019)

707 Background: Although inextricably linked, both comorbidity and systemic inflammatory responses have been shown to determine survival in patients undergoing surgery for colorectal cancer (CRC). The present study examines the interrelationships between comorbidity (ASA grade) and systemic inflammation (modified Glasgow Prognostic Score (mGPS)) in patients from the ScotScan dataset. Methods: Clinicopathological characteristics and outcome of consecutive patients undergoing potentially curative resection of TNM I-III CRC in Glasgow Royal Infirmary (Scotland) and Sørlandet Hospital (Norway) were prospectively collected. ASA grade and mGPS (0-CRP ≤ 10mg/L, 1-CRP &gt; 10mg/L, 2-CRP &gt; 10mg/L and albumin &lt; 35g/L) prior to surgery was recorded and relationship with overall survival (OS) examined. Results: 2,295 patients (Scotland: n = 1,234 , Norway: n = 1,061) were included. Patients from Norway were more likely to be older, female and have higher ASA grade (all P &lt; 0.001), and more likely to have colon cancer (76% vs. 67%, P &lt; 0.001). Patients from Norway were less likely to be systemically inflamed (mGPS = 0: 72% vs. 65%, P &lt; 0.001), even after propensity score matching ( n = 736, OR 0.36 95%CI0.25-0.51, P &lt; 0.001). ASA grade and mGPS were significantly associated; 21% of ASA 1 patients had mGPS ≥ 1 compared to 41% of ASA four patients ( P &lt; 0.001). In the propensity-matched cohort, both increasing ASA (HR 1.98 95% CI1.57-2.49, P &lt; 0.001) and mGPS (HR 1.20 95% CI1.02-1.41, P = 0.027) were associated with OS independent of age, N stage and adjuvant therapy use; results in the whole cohort were similar. The combination of ASA grade and mGPS was examined with respect to OS in patients with stage II-III CRC (Table 1). In patients with stage II disease, 3-year OS was stratified from 96% (ASA 1, mGPS0) to 67% (ASA 3, mGPS2) ( P &lt; 0.001); in patients with stage II disease, 3-year OS was stratified from 84% to 44% ( P &lt; 0.001). Conclusions: Using a large, prospectively collected dataset of patients undergoing resection of CRC in two countries, the results of the present study confirm the independent prognostic value of measures of comorbidity and systemic inflammation prior to surgery.
A phase II study of ipilimumab and nivolumab with radiation in metastatic pancreatic adenocarcinoma.
Authors: Aparna Parikh, Jennifer Yon-Li Wo, David P. Ryan, Jeffrey W. Clark, Ryan David Nipp, Lawrence Scott Blaszkowsky, Colin D. Weekes, Emily Van Seventer, Leilana Ly, Bronwen Foreman, Ryan Bruce Corcoran, Theodore S. Hong
Journal: Journal of Clinical Oncology (2019)

391 Background: Pancreatic ductal adenocarcinoma (PDAC) remains a highly lethal cancer. Immunotherapy (IO) has shown minimal activity. In preclinical models, radiation (XRT) increases likelihood of response to IO via an abscopal effect where local tx (treatment) of a tumor leads to an antitumor response distantly, with synergy between XRT and dual checkpoint blockade. In this study, we assessed CTLA-4 and PD-1 blockade with XRT as a strategy to stimulate an immune response for patients (pts) with PDAC. Methods: In this open-label, single arm phase-2 study, we enrolled 25 metastatic PDAC pts in an exploratory cohort. Eligible pts had histologically-confirmed PDAC, ECOG PS 0-1, and progression on at least 1 line of tx. Tx consisted of Ipilimumab (1 mg/kg every 6 wks), Nivolumab (240 mg every 2 wks) and 3 fractions of 8 Gy of XRT at cycle 2. Tx continued until PD, discontinuation or withdrawal. Endpoints include Disease Control Rate (DCR), ORR, PFS, OS and safety. Radiological evaluations were every 3 months. Response was defined as disease control outside of the radiation field. We obtained serial tumor biopsies pre-tx, during checkpoint blockade alone and 2 weeks after XRT. Intention to treat analysis includes all pts receiving at least one dose of study tx. Results: 22 pts were enrolled and evaluable from 6/2017-6/2018, median age 60 years (32-75), 73% male and 100% MSS. DCR was 27% and ORR was 14% with 1 pt having a complete response. All responses were out of the radiation field. Median PFS was 76 days in the entire cohort; 163 days for pts with disease control vs 62.5 days for pts with PD or who came off study prior to initial imaging. 7 pts did not receive XRT due to clinical progression. Treatment-related adverse events (AEs) were reported in 12/22 pts (54.5%). 8/22 pts (36.4%) experienced grade ≥ 3 toxicities. Elevated lipase, lymphopenia, fatigue, hyperglycemia, mucositis and hepatitis were the most common AEs. 1/22 (4.5%) pt had a grade 5 AE possibly related to tx. Conclusions: Dual blockade of CTLA-4 and PD-1 with XRT is feasible and demonstrates promising activity in pts with metastatic PDAC. We will report the updated efficacy and safety data as well as outcomes from the correlative serial biopsies upon completion. Clinical trial information: NCT03104439.
TCTAP A-093 Comparative Optical Coherent Tomographic Analysis of In-Stent Neoatherosclerosis Between 1st and 2nd Generation Drug-Eluting Stent
Authors: Mineok Chang, Yu Na Kim, Seung-Jung Park, Seong-Wook Park, Cheol Whan Lee, Young-Hak Kim, Seung-Whan Lee, Duk-Woo Park, Soo-Jin Kang, Jung-Min Ahn, Pil Hyung Lee, Se Hun Kang, Cheol Hyun Lee, Min Soo Cho, Jae Seok Bae, Sung Han Yoon, Do-Yoon Kang
Journal: Journal of the American College of Cardiology (2016)
Overall and Site-Specific Cancer Mortality in Patients on Dialysis and after Kidney Transplant
Authors: Eric H. Au, Jeremy R. Chapman, Jonathan C. Craig, Wai H. Lim, Armando Teixeira-Pinto, Shahid Ullah, Stephen McDonald, Germaine Wong
Journal: Journal of the American Society of Nephrology (2019)

Significance Statement Patients with ESRD experience a substantially increased incidence of cancer, but few studies have examined patterns of cancer mortality among such patients. This population-based cohort study of Australian patients who initiated dialysis or received a kidney transplant from 1980 to 2014 found that the risk of cancer-related death among 52,936 patients on dialysis and 16,820 kidney transplant recipients was 2.5 times higher than that of age- and sex-matched controls in the general population. For patients on dialysis, increased cancer mortality is primarily from cancers that caused ESRD; among transplant recipients, the increase is largely due to de novo cancers. Additional efforts are required to clarify factors and mechanisms involved in increased cancer risk and to improve early detection and management of cancer in this population. Background Patients with ESRD have a substantially increased cancer risk, but few studies have examined the patterns of cancer mortality along a patient's journey from dialysis to transplantation. Methods We identified all Australian patients on dialysis and patients with transplants from 1980 to 2014 from the Australia and New Zealand Dialysis and Transplant Registry. Using standardized mortality ratios (SMRs), we compared cancer mortality among patients on dialysis and patients with transplants versus the general population (overall and by age, sex, year, and site); we also performed a subgroup analysis excluding patients with preexisting cancers. Results We followed 52,936 patients on dialysis and 16,820 transplant recipients for 170,055 and 128,352 patient-years, respectively. There were 2739 cancer deaths among patients on dialysis and 923 cancer deaths among transplant recipients. Overall, cancer SMRs were 2.6 for patients on dialysis and 2.7 for transplant recipients. For patients on dialysis, SMRs were highest for multiple myeloma (30.5), testicular cancer (17.0), and kidney cancer (12.5); for transplant recipients, SMRs were highest for non-Hodgkin lymphoma (10.7), kidney cancer (7.8), and melanoma (5.8). Some 61.0% of patients on dialysis and 9.6% of transplant recipients who experienced cancer death had preexisting cancer. The SMRs for de novo cancer was 1.2 for patients on dialysis and 2.6 for transplant recipients. Conclusions Patients on dialysis and transplant recipients experienced &gt;2.5-fold increased risk of cancer death compared with the general population. This increased risk was largely driven by preexisting cancers in patients on dialysis and de novo cancers in patients with transplants.
Myeloproliferative Neoplasms in Young Patients: The Mayo Clinic Experience with 361 Cases Age 40 Years or Younger
Authors: Natasha Szuber, Mythri Mudireddy, Maura Nicolosi, Domenico Penna, Rangit Reddy Vallapureddy, Terra L. Lasho, Christy Finke, Curtis A. Hanson, Rhett P. Ketterling, Animesh Pardanani, Naseema Gangat, Ayalew Tefferi
Journal: Blood (2018)
Benefits of pulmonary rehabilitation in patients with chronic obstructive pulmonary disease and interstitial lung disease with the same dyspnea severity
Authors: P.I. Pedro, L. Maia Santos, C. Braço Forte, A. Dias, C. Cruz, F. Rodrigues
Journal: Pulmonology (2019)

© 2019 Sociedade Portuguesa de Pneumologia. Published by Elsevier Espana, ˜ S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-ncnd/4.0/).
Abstract 9393: Anxiety and Depressive Symptoms Have Inverse Relationships With Cardiac Depolarization by ECG: MESA Study
Authors: James Peacock, William Whang, Carmela Alcantara, Saman Nazarian, Amit J Shah, Steven Shea, Elsayed Z Soliman, Paul Muntner, Daichi Shimbo
Journal: Circulation (2013)

BACKGROUND: Depression and anxiety are predictors of poor cardiac prognosis. Lower T wave amplitude by resting electrocardiogram (ECG) has been correlated with adverse outcomes such as myocardial infarction, cardiac mortality, and sudden cardiac death. We therefore examined the relationship between depressive and anxiety symptoms and T wave amplitude in the Multi-Ethnic Study of Atherosclerosis (MESA). METHODS: Men and women 45 to 84 years old, free of clinically apparent cardiovascular disease, were recruited between July 2000 and August 2002 from six US communities. Resting 12-lead ECGs were collected, depressive symptoms were measured with the Center for Epidemiologic Studies-Depression scale (CES-D) and anxiety symptoms were measured with the Spielberger Trait Anxiety scale. Linear regression models with maximum T wave amplitude in microvolts as the dependent variable and depression and anxiety scores as independent variables were utilized for analysis. Participant were excluded for any of the following: QRS duration &gt;120 msec, major ECG abnormalities according to the Minnesota Code, or use of antiarrhythmic, antidepressant, or antipsychotic medication. Results: Of 6814 MESA participants, 5388 met the inclusion criteria and were retained for analysis. Depressive symptom scores and anxiety scores were moderately correlated (r=0.55). With simultaneous inclusion in multivariable models that adjusted for cardiovascular disease confounders, depressive symptoms were associated with lower T wave amplitude, while symptoms of anxiety were associated with higher T wave amplitude. CONCLUSION: In this group of men and women without known cardiovascular disease, depressive symptoms were associated with lower T wave amplitude while anxiety symptoms were unexpectedly associated with higher T wave amplitude. Further investigation of the associations of these negative mood states with cardiac repolarization is warranted.
Voruciclib, an Oral, Selective CDK9 Inhibitor, Enhances Cell Death Induced By the Bcl-2 Selective Inhibitor Venetoclax in Acute Myeloid Leukemia
Authors: Daniel A Luedtke, Yongwei Su, Holly Edwards, Lisa Polin, Juiwanna Kushner, Sijana H Dzinic, Hai Lin, Jeffrey W. Taub, Yubin Ge
Journal: Blood (2018)
Immune Mechanism of Desensitization through Rapid Multi-food Oral Immunotherapy
Authors: Monali Manohar, Sandra Andorf, Sheena Gupta, Diane Dunham, Wenming Zhang, Holden T. Maecker, Stephen J. Galli, R. Sharon Chinthrajah, Kari C. Nadeau
Journal: Journal of Allergy and Clinical Immunology (2019)
SF3B1 Mutations Associate with Low CD20 Expression in CLL: Another NOTCH1-Dependent Mechanism?
Authors: Federico Pozzo, Tamara Bittolo, Erika Tissino, Filippo Vit, Elena Vendramini, Riccardo Bomben, Antonella Zucchetto, Michele Dal Bo, Luca Laurenti, Giovanni Francesco D'Arena, Francesco Di Raimondo, Annalisa Chiarenza, Gabriele Pozzato, Francesco Zaja, Giovanni Del Poeta, Valter Gattei
Journal: Blood (2018)
Abstract 19979: Epicardial Delayed Potentials Guided Electrophysiological Study at Ventricular Outflow Tracts in Brugada Syndrome
Authors: Tsuyoshi Urushida, Gaku Matsukura, Tomoaki Sakakibara, Makoto Sano, Hayato Ohtani, Masao Saotome, Yuichiro Maekawa
Journal: Circulation (2017)

Background: Risk stratification for VF with programmed electrical stimulation (PES) has not been established in Brugada syndrome. We measured epicardial delayed potentials (epi-DPs) at left and right ventricular outflow tracts (LVOT and RVOT), and examined the contribution to PES-induced and spontaneous VF. Methods and Results: Forty two cases with Brugada syndrome (41 male, 43±13 years, 17 symptomatic) underwent PES at high right atrium, RV apex, RVOT-endocardial and epicardial (via conus branch of right coronary artery) sites, and LVOT-epicardial site (via anterior inter-ventricular vein). Epi-DPs were defined as local conduction delay and fragmented ventricular waves at epicardial sites of OTs. For VF induction, the minimal coupling interval of extra stimuli was kept > 200 ms. (1) 16 of 42 cases (41%) showed PES-induced VF. Among them, 12 cases with epicardial sites-originated VF had epi-DPs, while 4 cases with endocardial sites-originated VF did not. In 26 cases without PES-induced VF, only two had...