tbuckley/cabot-search huggingface dataset:
The adequacy of pain treatment in advance stage non-small cell lung cancer: A longitudinal study
Authors: T. Mendoza, X. Wang, G. Mobley, G. Palos, C. Cleeland
Journal: Journal of Clinical Oncology (2007)

17016 Background: Pain is a prevalent symptom in advance stage non-small- cell lung cancer (NSCLC). Previous studies have shown these patients to be at risk for inadequate pain management. This longitudinal study evaluated pain and analgesic management in this patient population. Patients were treated at a major tertiary cancer center. Methods: Data from 102 patients receiving chemotherapy were used. Their pain was assessed weekly using the pain item from the M.D. Anderson Symptom Inventory, administered through an interactive voice response system. Analgesic orders were collected three times every two cycles of chemotherapy across 18 weeks (T1, T2 and T3). Adequacy of pain management was evaluated by the Pain Management Index (PMI). Chi-square tests were used to test for differences in proportions. Results: This analysis was based on all available data, as sensitivity analyses of pain trajectory by dropout as a function of time did not show differences. At baseline, 60% of 102 patients reported pain (ratings of 1 or greater on a 0- 10 scale) with the following distributions: 39% mild, 14% moderate and 7% severe. The proportions of patients with moderate to severe pain were 21%, 15%, 17% and 20% at baseline, T1, T2 and T3, respectively. The proportion of patients with moderate to severe pain did not increase over time. According to the PMI, there were 21%, 18%, 15% and 21% of patients who were inadequately treated at baseline, T1, T2 and T3, respectively. The percentages of patient receiving orders for strong opioids were 19%, 25%, 26% and 41% at baseline, T1, T2 and T3, respectively. Conclusions: About 80% of patients seen in a major tertiary cancer center were adequately treated for pain, while about 20% of patients experienced moderate to severe pain. Both these percentages were seen over time and did not significantly change during the course of their cancer treatment. These may be accounted for by a significant increase in the prescription orders for strong opioids by twice as much during the latter stage of their treatment. No significant financial relationships to disclose.
Comparing recist and Choi’s criteria to evaluate radiological response to chemotherapy in patients with advanced pancreatic cancer.
Authors: Silvia Vecchiarelli, Marina Macchini, Elisa Grassi, Fabio Ferroni, Federica Ciccarese, Lucia Calculli, Claudio Ricci, Riccardo Casadei, Raffaele Pezzilli, Guido Biasco, Mariacristina Di Marco
Journal: Journal of Clinical Oncology (2013)

e15069 Background: Assessment of response after chemotherapy (CTH) for pancreatic cancer (PC) is currently based on RECIST criteria. In 2007 Choi et al. published a new classification system.The purpose of this study was to evaluate the accuracy of these classification systems for radiological response to CTH in patients with advanced PC. Methods: From 2006 to 2012, 66 untreated patients with advanced PC underwent palliative CTH. Fourty (60 %) had a locally advanced PC and 26 (40%) a metastatic disease. All patients were treated with a GEM-based CTH or FOLFIRINOX. We assessed radiological response after three months of first-line therapy applying both RECIST criteria, which evaluate differences in CT size, and Choi’s criteria, which consider changes both in size and in density at CT. We evaluated the accuracy in restaging, comparing the class of response with overall survival (OS). OS was calculated with Kaplan-Meier method. The accuracy in restaging was assessed through log rank test and multivariate analysis with Cox Regression. Results: At restaging, using RECIST criteria, we registered 7 (10.6 %) patients with partial response (PR), 32 (48.5 %) with stable disease (SD), and 27 (40.9 %) with disease progression (PD). Instead Choi’s criteria assessed 19 PR (28.8 %), 12 SD (18.2%) and 35 PD (53.0%). Comparing each classification with OS, we observed that patients with different prognosis were better stratified with Choi’s criteria. Using RECIST criteria we found a borderline significant difference in OS between patients with PR (13.47 months), SD (13.67 months) and PD (9.97 months) (p=0.05). Instead we found a significant statistical difference in OS using Choi’s criteria between patient with PR (14 months), SD (16.37 months), PD (9.7 months; p=0.004). Multivariate analysis showed a statistically significant difference in OS between Disease Control Rate (DCR, PR+SD) and PD patients (14.47 vs. 9.67 months, p=0.02), only using Choi’s criteria. Conclusions: In our experience, Choi’s criteria seem to better assess radiological response of CTH in PC patients than RECIST criteria. Due to the small number of patients, larger prospective studies are needed.
Screening for Hepatitis C Virus Infection
Authors: Jill Jin
Journal: JAMA (2020)

Roger Chou, MD; Tracy Dana, MLS; Rongwei Fu, PhD; Bernadette Zakher, MBBS, MPH; Jesse Wagner, MA; Shaun Ramirez, MPH; Sara Grusing, BA; Janice H. Jou, MD, MHS
Oral and Topical Terbinafine for Fungal Infections in Pregnancy
Authors: Mary Kathryn Abel, Jenny E. Murase
Journal: JAMA Dermatology (2020)

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Leptomeningeal disease from oligodendroglioma: Clinical and molecular analysis
Authors: G. B. Roldán, J. Scott, D. George, J. Easaw, E. Yan, I. Parney, G. Cairncross, P. Forsyth
Journal: Journal of Clinical Oncology (2007)

2019 Background: Leptomeningeal disease (LMD) is a late complication of malignant glioma, mostly of glioblastoma, that usually responds poorly to treatment and is rapidly fatal. A long surviving case led us to review our experience with LMD in patients with oligodendrogliomas. Methods: A 10-year retrospective chart review was performed. Patients with both oligodendroglial tumors and LMD were identified. A single neuro-pathologist reviewed all histological sections, a single neuro-radiologist reviewed all available images and 1p/19q status was assessed. Results: Seven patients with an oligodendroglioma and LMD were identified. Six were male. Median age at tumor diagnosis was 41 years (range, 28–50). None had radiographic or pathological evidence of leptomeningeal or subependymal tumor at initial diagnosis. Most patients had pure anaplastic oligodendrogliomas (4/7); 6/7 had 1p/19q co-deletion. The median time to first relapse was 41 months (range, 19–127). LMD was diagnosed at first relapse in one case and subsequently in six. The median time to LMD was 76 months (range, 19–151) from initial diagnosis and 28 months (range, 0–36) from first relapse, respectively. LMD treatments included spinal radiation and intrathecal and systemic chemotherapy. After progression, some patients with LMD remained stable clinically. The median survival from initial diagnosis was 104 months (range, 19–183) and from LMD diagnosis was 32 months (range, 2–43). Conclusions: LMD is a complication of oligodendroglioma that may occur preferentially in long surviving patients with 1p/19q co-deletion. LMD in patients with oligodendrogliomas appears to be relatively indolent which may have implications for their treatment and be related to 1p/19q status. No significant financial relationships to disclose.
Multilevel Variation in Diabetes Screening Within an Integrated Health System
Authors: Udoka Obinwa, Adriana Pérez, Ildiko Lingvay, Luigi Meneghini, Ethan A. Halm, Michael E. Bowen
Journal: Diabetes Care (2020)

OBJECTIVE Variation in diabetes screening in clinical practice is poorly described. We examined the interplay of patient, provider, and clinic factors explaining variation in diabetes screening within an integrated health care system in the U.S. RESEARCH DESIGN AND METHODS We conducted a retrospective cohort study of primary care patients aged 18–64 years with two or more outpatient visits between 2010 and 2015 and no diagnosis of diabetes according to electronic health record (EHR) data. Hierarchical three-level models were used to evaluate multilevel variation in screening at the patient, provider, and clinic levels across 12 clinics. Diabetes screening was defined by a resulted gold standard screening test. RESULTS Of 56,818 patients, 70% completed diabetes screening with a nearly twofold variation across clinics (51–92%; P &amp;lt; 0.001). Of those meeting American Diabetes Association (ADA) (69%) and U.S. Preventive Services Task Force (USPSTF) (36%) screening criteria, three-quarters were screened with a nearly twofold variation across clinics (ADA 53–92%; USPSTF 49–93%). The yield of ADA and USPSTF screening was similar for diabetes (11% vs. 9%) and prediabetes (38% vs. 36%). Nearly 70% of patients not eligible for guideline-based screening were also tested. The USPSTF guideline missed more cases of diabetes (6% vs. 3%) and prediabetes (26% vs. 19%) than the ADA guideline. After adjustment for patient, provider, and clinic factors and accounting for clustering, twofold variation in screening by provider and clinic remained (median odds ratio 1.97; intraclass correlation 0.13). CONCLUSIONS Screening practices vary widely and are only partially explained by patient, provider, and clinic factors available in the EHR. Clinical decision support and system-level interventions are needed to optimize screening practices.
Covid-19: WHO declares pandemic because of “alarming levels” of spread, severity, and inaction
Authors: Elisabeth Mahase
Journal: BMJ (2020)

Thank you for your interest in spreading the word about The BMJ.NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address. Username * Your Email * Send To * You are going to email the following Covid-19: WHO declares pandemic because of “alarming levels” of spread, severity, and inaction Your Personal Message CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Epidemiological characteristics of SARS-CoV-2 infections in Shaanxi, China by 8 February 2020
Authors: Yang Yao, Yao Tian, Jing Zhou, Xuan Ma, Min Yang, ShengYu Wang
Journal: European Respiratory Journal (2020)

<b>Patients confirmed with novel coronavirus pneumonia in Shaanxi Province mainly have a history of Wuhan contact. There are characteristics of family aggregation and concealment.</b>http://bit.ly/2x7xs1V
Erratum: Corrigendum: Prolyl 3-hydroxylase 1 deficiency causes a recessive metabolic bone disorder resembling lethal/severe osteogenesis imperfecta
Authors: Wayne A Cabral, Weizhong Chang, Aileen M Barnes, MaryAnn Weis, Melissa A Scott, Sergey Leikin, Elena Makareeva, Natalia V Kuznetsova, Kenneth N Rosenbaum, Cynthia J Tifft, Dorothy I Bulas, Chahira Kozma, Peter A Smith, David R Eyre, Joan C Marini
Journal: Nature Genetics (2008)
Misclassification of Diffuse Gliomas—Letter
Authors: Connor J. Kinslow, Peter Canoll, Simon K. Cheng, Tony J. C. Wang
Journal: Clinical Cancer Research (2020)

We read with interest the article by Iorgulescu and colleagues ([1][1]), which queries the nation's largest cancer registry, the National Cancer Database (NCDB), to determine discordance rates between historically classified diffuse gliomas, based solely on histologic characteristics, with their
Final results of CONFIRM 2: A multinational, randomized, double-blind, phase III study in 2nd line patients (pts) with metastatic colorectal cancer (mCRC) receiving FOLFOX4 and PTK787/ZK 222584 (PTK/ZK) or placebo
Authors: C. Kohne, E. Bajetta, E. Lin, J. W. Valle, E. Van Cutsem, J. R. Hecht, M. Moore, C. J. Germond, G. Meinhardt, C. Jacques
Journal: Journal of Clinical Oncology (2007)

4033 Background: PTK/ZK, a novel, oral, anti-angiogenic compound that inhibits all VEGF receptors has been investigated in two multinational randomized phase 3 studies in 1st (CONFIRM 1) and 2nd line (CONFIRM 2) mCRC. Interim analyses (IA) have been presented at ASCO 2005 and 2006, respectively. Methods: In CONFIRM 2, 855 pts were randomized to FOLFOX4 plus PTK/ZK (1250 mg, qd), or placebo. Eligibility included histologically documented mCRC, pre-treatment for metastatic disease with irinotecan-/fluoropyrimidine- based therapy, measurable disease by RECIST, PS of 0–2 and adequate organ function. Pts were stratified based on PS (0 vs. 1–2) and baseline serum Lactate Dehydrogenase (LDH = vs. &gt;1.5 × ULN). The primary endpoint is overall survival (OS). Secondary endpoints included OS and PFS in high LDH pts (LDH &gt; 1.5 × ULN). Results: At the time of IA in July 2005, OS was 12.1 mo in the PTK/ZK and 11.8 mo in the placebo arm (HR: 0.94; p=0.511). PFS was significantly longer in the PTK/ZK arm (5.5 mo vs. 4.1 mo; HR: 0.83; p=0.026). LDH, a marker for poor prognosis in mCRC, is predictive of the outcome in the PTK/ZK arm. When treated with PTK/ZK, high LDH pts showed a strong improvement in PFS (5.6 mo vs. 3.8 mo; HR: 0.63; p&lt;0.001) and in OS (9.6 mo vs. 7.5 mo; HR: 0.78; p=0.10). Adverse events (AE) were similar to that of the CONFIRM 1 trial. Final analysis for OS, PFS and safety is planned for Feb. 2007 after 732 events (compared to 413 in the IA) and will be presented at the meeting. Conclusions: While the primary endpoint for OS was not met in the IA, PTK/ZK improves PFS significantly in the overall population, and shows strong activity (improved PFS and OS) in patients with high baseline serum LDH. Final results of the study will be presented at the meeting. No significant financial relationships to disclose.
Abstract P143: Methylome-Wide Association Of DNA Methylation And Aircraft Noise Exposure In The Women’s Health Initiative
Authors: Jason M Collins, Rahul Gondalia, Anne E Justice, Katelyn Holliday, James Stewart, Eugenia Wong, Yun Li, Kathleen Hayden, Kristina Jordahl, Themistocles L Assimes, Andrea Baccarelli, Junenette Peters, Eric A Whitsel
Journal: Circulation (2020)

Background: Noise pollution is common and can affect health, but mechanisms underlying this relationship remain incompletely characterized. We therefore examined the novel association between aircraft noise and DNA methylation (DNAm), an environmentally modifiable epigenetic phenomenon that affects gene expression and is associated with cardiovascular and neurological disease. Methods: We conducted a methylome-wide association study in race/ethnicity-stratified subpopulations of 4,535 post-menopausal Women’s Health Initiative participants (mean age: 64.4 years; 59.6% white; 24.7% African American; 15.7% Hispanic/Latina). We estimated DNAm in whole blood as a proportion of methylated cytosines at each Cytosine-phosphate-Guanine (CpG) site using the Illumina 450k BeadChip. In cooperation with the Federal Aviation Administration, we generated day-night-average sound level (DNL) contours around 90 major U.S. airports using the Aviation Environmental Design Tool. The DNL applies a penalty for nighttime exposure and is the primary metric for informing policy in the U.S. We estimated geocoded participant address-specific, annual, DNL aircraft noise exposures in decibels (dB) from the contours on the day of blood draw. We categorized aircraft noise exposures as non-exposed or exposed (DNL &lt; 45 or ≥ 45dB) and used linear mixed-effects models to estimate CpG site-specific DNAm-noise associations adjusted for sociodemographic, behavioral, and technical covariates. We combined site-specific associations across race-ethnicity strata in fixed-effects, inverse variance-weighted meta-analyses and then identified the significant ( P &lt; 1.0x10 -7 ), non-heterogeneous ( P Cochran’s Q &gt; 0.10) associations among them. Results: Overall, DNAm was inversely associated with aircraft noise at cg21525369 (Chromosome 15; P = 6.40x10 -8 ). Cg21525369 is 56 kb upstream from ACAN , a gene encoding an extracellular matrix protein (aggrecan). Aggrecan is expressed in response to ultrasound; forms perineural nets around cochlear hair cells and auditory brainstem neurons; affects afferent extension, synaptic transmission, and neuronal vulnerability; deposits in tympanic membranes of patients with sensorineural hearing loss, and redistributes in auditory brainstem after deafferentation. Conclusions: The biologically plausible DNAm-noise association among postmenopausal U.S. women suggests aircraft noise pollution may affect methylation of DNA near a gene previously associated with hearing, although its cardiovascular, otologic, and neurological implications remain unclear pending sensitivity analysis, external replication, mediation analysis, and functional characterization.
Abstract P430: Educational Attainment, Adherence to Healthy Lifestyle, and Risk of Cardiovascular Diseases
Authors: Xiang Li, Tao Zhou, Hao Ma, Dianjianyi Sun, Yoriko Heianza, JoAnn Manson, Lu Qi
Journal: Circulation (2020)

Introduction: Lower educational attainment is one of the major socioeconomic factors contributing to cardiovascular diseases (CVD); higher education tends to be associated with healthier behaviors and lower risk of CVD. However, whether education plays a causal role in adherence to a healthy lifestyle, and if there is causality, how much of the education-CVD association is mediated by the lifestyle factors, has not been established. Methods: A healthy lifestyle score was constructed on body mass index, smoking status, physical activity, and diet. The causal relations between educational attainment and adherence to a healthy lifestyle was assessed by two-sample Mendelian Randomization analyses using summary statistics for single nucleotide polymorphisms (SNPs) identified from a genome-wide association study (GWAS) of educational attainment (N=1,131,881) and the UK Biobank cohort (N=425,770). We further performed mediation analyses to quantify the effect of educational attainment on the risk of CVD through healthy lifestyle among 386,442 participants in UK Biobank. Results: We found a significant positive causal relationship between years of education and adherence to a healthy lifestyle, independent of age, sex, alcohol intake, and person’s socioeconomic status. In addition, we found that adherence to favorable lifestyle mediated a 42.1%, 40.3%, and 33.5% reduction in the incidence of coronary heart disease (CHD), CVD events, and CVD mortality, respectively (all p &lt;0.05). Conclusions: Our results indicate that educational attainment is causally associated with adherence to a healthy lifestyle, which in turn, mediates a significant proportion of the effect of educational attainment on cardiovascular events.
Anthracycline-containing regimen in early breast cancer: Analysis of toxicity
Authors: A. I. Jagiello-Gruszfeld, A. Lowczak, J. Zbrzezniak-Smilgiewicz, S. Szablowska-Siwik, G. Licznerska, E. Wasilewska-Tesluk
Journal: Journal of Clinical Oncology (2007)

11104 Background: The anthracycline-containing regimens is considered to be more beneficial to patients (pts) with early breast cancer (EBC). However at this moment is not clear which kind of regimen should be used in adjuvant setting. Methods: In our center, from Jan 2004 to Sep 2006, 248 breast cancer pts, who were qualified to the adjuvant chemotherapy received FEC100 (104 pts), AC (126 pts). or sequentially AC- taxans (18). Pts with many poor prognostic factors (N+, T3, G3, HER2/neu 3+) received 6 cycles of FEC100 or AC-taxans. Pts with better prognosis (Intermediate Risk Group according St.Gallen’s guidelines for 2005) received usually 4 cycles of AC. Besides, in most cases, internet access to the adjuvantonline! program was used during making decision. ER-ve or PR-ve positive pts received sequentially hormonal treatment. The radiotherapy (if needed) was delivered at the end of the chemotherapy. Results: During the treatment, toxicity of the chemotherapy was evaluated by NCI CTC v. 3. There was no toxic deaths. Median follow-up period was 19 months (range: 6–36). The febrile neutropenia was observed in 4 pts in FEC100 and in 5 pts in AC group. There was also no significant differences in the grade 3 or 4 neutropenia, anemia, thrombocytopenia and alopecia. In 3 pts treated with FEC100 and 1 with AC, cardiotoxicity grade 2 or 3 was diagnosed. Grade 2 or 3 asthenia was frequent in FEC100 group (44% vs 21% vs11%). In all pts prophylaxis of nausea/vomiting was used. However pts treated with FEC100 needed more 5HT3. Vomiting grade 2 or 3 were observed significantly more often in pts who received FEC100 (58% vs 26% vs 23%). Only at 1 pts in each group the chemotherapy was interrupted due to toxicity (asthenia gr 3, vomiting gr 3 and weight loss gr 2). The relative dose intensities of FEC100 and AC were 87% and 96% of planned doses, respectively. Conclusions: The acute symptoms of toxicity were important for breast cancer pts who received the adjuvant chemotherapy. According the adjuvantonline! 6 cycles of FEC100 were more effective than 4 cycles of AC. Nevertheless tolerability of AC is better. Many pts prefer only the hormonal treatment, even if it is not the optimal option, in fear of nausea or vomiting. The ongoing clinical trials should further define the best choice of anthracycline-containing regimen in the adjuvant setting. No significant financial relationships to disclose.
MRI-Targeted, Systematic, and Combined Biopsy for Prostate Cancer Diagnosis
Authors: Michael Ahdoot, Andrew R. Wilbur, Sarah E. Reese, Amir H. Lebastchi, Sherif Mehralivand, Patrick T. Gomella, Jonathan Bloom, Sandeep Gurram, Minhaj Siddiqui, Paul Pinsky, Howard Parnes, W. Marston Linehan, Maria Merino, Peter L. Choyke, Joanna H. Shih, Baris Turkbey, Bradford J. Wood, Peter A. Pinto
Journal: New England Journal of Medicine (2020)

The use of 12-core systematic prostate biopsy is associated with diagnostic inaccuracy that contributes to both overdiagnosis and underdiagnosis of prostate cancer. Biopsies performed with magnetic resonance imaging (MRI) targeting may reduce the misclassification of prostate cancer in men with MRI-visible lesions.