tbuckley/cabot-search huggingface dataset:
THIRTY-DAY READMISSIONS AFTER CHRONIC TOTAL OCCLUSION PERCUTANEOUS CORONARY INTERVENTION IN THE UNITED STATES INSIGHTS FROM THE NATIONWIDE READMISSIONS DATABASE
Authors: Mohammad Akram Kawsara, Fahad Alqahtani, Mohamed Alhajji, Mohamad Adnan Alkhouli, Anthony Roda-Renzelli
Journal: Journal of the American College of Cardiology (2020)
Risk factors for fractures in patients on hormonal therapies for breast cancer and DCIS.
Authors: Abdullah Ladha, Josy Mathew
Journal: Journal of Clinical Oncology (2012)

e19627 Background: Hormonal therapy with aromatase inhibitors (AI) or tamoxifen (TAM) is standard of care for hormone receptor positive breast cancer and DCIS. Fractures are a complication of treatment with AI due to accelerated bone loss. Risk factors for fracture in patients on hormonal therapy (HT) for breast cancer and DCIS are poorly defined. Methods: All 71 patients with breast cancer or DCIS seen in the bone and mineral clinic of our institution from 2000 to 2010 were analyzed. Data on demographics, pathology, type and duration of HT, bone mineral density studies (BMD), number and site of fractures were collected. Statistical analysis: t test, chi square test and Fisher’s exact test for categorical data. Results: The age of the patients ranged 40 to 97 years. 65 patients had ER positive breast cancer, 6 patients had DCIS. 9 patients had fractures.41 patients were on an AI alone, 8 were on TAM alone and 14 were on both sequentially. Fractures involved: vertebral compression, femur, hip, distal radioulnar, rib, hand and feet bones. Patients who had osteoporosis at the femur, osteoporosis or osteopenia in the lumbar spine or forearm in the initial BMD study were found to have an increased risk of fracture (P&lt;0.05). Patients who were on TAM and AI sequentially had an increased risk of fracture (P&lt;0.05) compared AI alone. The use of bisphosphonates and the duration of use were significantly associated with fracture (P&lt;0.05) as these patients already had osteoporosis. The age, race, duration of AI use and the use of calcium and vitamin D were not found to be significantly different in patients who had fractures compared to those who did not. In the 24 patients who had two BMD studies, there was no significant change in the BMD overall. Conclusions: Patients with osteoporosis or osteopenia at baseline have an increased risk of fracture with the use of hormonal therapies for breast cancer and DCIS. This risk was not eliminated by the use of bisphosphonates. Sequential use of tamoxifen and aromatase inhibitors increase the risk of fractures. Bone mineral density studies done prior to the initiation of hormonal therapy for breast cancer maybe useful estimating the risk of fracture while on treatment.
RECURRENT MYOCARDIAL INFARCTION AFTER STEMI VS. NSTEMI
Authors: Raunak M. Nair, Mouin S. Abdallah, Chetan Huded, Michael Joseph Johnson, Kathleen Kravitz, Jeevanantham Rajeswaran, Moses Anabila, Eugene Blackstone, A. Lincoff, Venu Menon, Samir Kapadia, Umesh Khot
Journal: Journal of the American College of Cardiology (2020)
Long-term outcomes after local treatments for prostate cancer by functional categories: Late changes, different results
Authors: R. C. Chen, J. A. Clark, S. P. Mitchell, J. A. Talcott
Journal: Journal of Clinical Oncology (2006)

4507 Background: Although patient-reported treatment outcomes have gained wide acceptance, numerical changes in validated instruments are difficult to interpret by patients and physicians. Using functional categories derived from numerical scales, we report 24- and 36-month outcomes after treatments for localized prostate cancer, presented by patients’ baseline (pre-treatment) functional status, to provide more useful prognostic information and to identify further changes in the third year after treatment. Methods: Using validated symptom indices, we prospectively measured sexual, urinary, and bowel functions of 438 men at baseline, and at fixed intervals post treatment. We translated numerical scores into functional categories: good (normal), intermediate, and poor (severe dysfunction). Results: Abnormal baseline function and surgery in men with normal function uniformly produced poor sexual function ( table ), and more external beam radiotherapy (EBRT) and brachytherapy (BT) patients deteriorated between 24 and 36 months. For those with normal urinary continence, NNSRP (non-nerve sparing radical prostatectomy) produced poor outcomes (26%) more frequently than NSRP (9%) at 24 months and 36 months, despite improvement in some NNSRP patients. Severe incontinence was rare after EBRT (1%) and BT (3%), though slightly more frequent in EBRT patients by 36 months. For patients with normal bowel function, EBRT and BT caused worse outcomes than RP; no change occurred after 24 months. Conclusions: Abnormal baseline sexual function and surgery produced uniformly poor sexual function outcomes and poor function increased significantly between 24 and 36 months after radiation therapy. Significant changes in functional category occurred despite unchanged average numerical scores, indicating that stable numerical indices may conceal significant functional changes. [Table: see text] No significant financial relationships to disclose.
Distress screening and follow-up: Multidisciplinary routine toward a personalized approach.
Authors: Cristiane Decat Bergerot, Marco Murilo Buso
Journal: Journal of Clinical Oncology (2012)

e19504 Background: Cancer care still fails to address psychosocial problems, which can compromise the effectiveness of health care and thereby adversely affect cancer patients. The present retrospective study explores a routine of distress screening, followed by a multidisciplinary discussion, in order to devise strategies for intervention and treatment. Methods: Over two years, 328 patients from a private cancer center, located in Brasilia, the capital of Brazil, participated in a longitudinal study. They were evaluated three times over a 6-month period using the Distress Thermometer and the Hospital Anxiety and Depression Scale. The data of each evaluation were discussed between oncologist assistant and psychologist, establishing appropriate intervention. Descriptive statistics, Pearson’s correlation and a logistic regression were employed to analyze the data. Results: There was a prevalence of female patients (64%). They were between 18 - 86 years (M = 54.7, SD = 15.8). Gastrointestinal (28%), breast (23.8%) and hematologic cancer (22.6%) were the main diagnosis, being 29% with early disease stage and 59.1% with late stage. The distress level progressively decreased along the evaluations: first day (55.8%), middle (27%) and last day of chemotherapy (13.4%). The same decrease occurred in anxiety and depression scale. There was a significant association (p &lt; .001) between distress vs. anxiety and distress vs. depression over phases of evaluation: first day (r = 0.8, t(328) = 21.6; r = 0.8, t(328) = 16.2; R 2 = 0.85), middle (r = 0.8, t(285) = 18.4; r = 0.8, t(285) = 20.9; R 2 = 0.86) and last day of chemotherapy (r = 0.8, t(261) = 14.7; r = 0.8, t(261) = 20.8; R 2 = 0.82). The incidence of distress shows to be related to anxiety, depression, gender, emotional and physical problems. Conclusions: Preliminary results suggest that distress, anxiety and depression scores tends to reduce during the 6-months period of evaluation. This results support the multidisciplinary discussion in order to propose the best intervention and treatment tailored to each case, being more assertive. In our experience we note the importance of distress screening and the health team integration to understand patient's experiences and to improve cancer care.
Living with terminal hepatocellular carcinoma: The patient and family perspective.
Authors: Lissi Hansen, Susan J. Rosenkranz, Gina M. Vaccaro
Journal: Journal of Clinical Oncology (2013)

e20702 Background: Hepatocellular carcinoma (HCC) is a growing problem worldwide; incidence of HCC in the U.S. has increased from 1.4 to 2.4 per 100,000 primarily because of people infected by hepatitis B or C. For those diagnosed with intermediate-advanced or terminal HCC, there is no curative treatment, and duration of survival is typically one to two years. Despite a high death rate, no studies were found examining experiences of living with terminal HCC and how it may affect end of life care from perspectives of both patients and family members. Methods: This pilot study used a prospective, longitudinal descriptive design, and qualitative and quantitative methods (mixed methods). Interview and survey (symptoms, quality of life) data were collected once a month for a 6-month period from 20 patient-family member dyads. Two researchers independently coded transcribed interview data into synthesized themes using inductive analysis, and met regularly to establish consensus on coding disagreements. Results: This poster reports on interview data from a convenience sub-sample of 14 patient-family member dyads. The interview data set comprised 56 interviews (14 conducted with patients, 11 with family members, and 31 with patient-family member dyads). Of the 14 patients, 11 were male and 3 were female (mean age=61.5, range=54-68 years). Of the 14 family members, 4 were male and 10 were female (mean age=57.4, range=22-68 years). Eight patients died during the study period. Findings from patient-family member dyad interviews included 5 major themes: 1) comparing diseases—differences and similarities between HCC and other types of illnesses/cancers (e.g., breast cancer), 2) uncertainty about treatments over time, 3) symptom management, 4) lack of support, and 5) family member caregiving struggles. Differences were found between interviews conducted with patients only and family members only, including perceived challenges in patient-family member relationships. Conclusions: From this first step, knowledge gained will serve as the foundation for a larger scale study and test of future interventions to address challenges (e.g., symptom management, caregiver burden) at the end of life for these cancer patients and their family members.
Treatment-associated mortality in head and neck cancer: Analysis of phase III trials.
Authors: Marina Shcherba, Shankar Viswanathan, Dukagjin Blakaj, Madhur Garg, Missak Haigentz
Journal: Journal of Clinical Oncology (2013)

6064 Background: Chemoradiotherapy is an accepted standard for patients with locoregionally advanced squamous cell carcinoma of the head and neck (SCCHN). Although acute and long-term toxicities of this approach are known, little is known about early mortality associated with curative-intent treatment. Methods: We reviewed 45 phase III trials of curative-intent radiotherapy in SCCHN published from 2000-2012 for adequate reporting of early mortality defined as deaths during and within 3 months of therapy, regardless of attribution. We estimated pooled proportions of deaths during prescribed therapy using a random effects model of radiotherapy alone (RT), concurrent chemoradiotherapy (CCRT) and induction chemotherapy (IC) regimens. The relative risk of death during CCRT vs. RT and CCRT/IC vs. RT were estimated. Results: Although all trials reported early mortality statistics, definitions had wide variability, and only 34 trials (75%) met adequate reporting characteristics. Ten trials excluded enrolled patients who died prior to initiating therapy. Of studies reporting early mortality statistics, crude frequency of death during prescribed therapy was 2.7% (308/11362). The pooled estimated rates of death observed during RT alone was 1.7% (SE: 0.3, I 2 =89.2%) from 29 studies, while 2.8% (SE: 0.4, I 2 =64.9%, 19 studies) and 3.1% (SE: 0.5, I 2 =53.5%, 9 studies) for CCRT and IC regimens, respectively. The pooled relative risk for death in CCRT compared to RT treatment was 1.08 (95%CI: 0.78, 1.48, p=0.63, I 2 =0, 15 studies). The relative risk for death in CCRT or IC therapy compared to RT was 1.06 (95%CI: 0.77, 1.45, p=0.72, I 2 =0, 15 studies). When reported, most early deaths were attributed to infectious complications or cardiovascular events. Conclusions: Early death remains an uncommon but important complication of curative-intent radiotherapy in SCCHN that necessitates consistent reporting. Despite strict eligibility criteria and protocol-defined care, treatment-associated death occurs with all regimens, though no clear increase was observed with CCRT/IC regimens over RT alone. Early mortality should be considered during treatment planning, particularly for patients with considerable comorbidities.
CORONARY MICROVASCULARDYSFUNCTION IN PATIENTS WITH PSORISASIS
Authors: Brittany Weber, Lourdes M. Perez-Chada, Sanjay Divakaran, Jennifer Brown, Jon Hainer, Courtney Bibbo, Josh Klein, Viviany R. Taqueti, Sharmila Dorbala, Ron Blankstein, Katherine P. Liao, Joseph Merola, Marcelo Di Carli
Journal: Journal of the American College of Cardiology (2020)
CLO20-040: Factors Influencing Survival of Patients Treated for Spinal Metastases at a Regional Cancer Center in Appalachia
Authors: Hassaan Raza Jafri, Isna Batool Khan, Ahmad Abu-Hashyeh, Vivek Yadala, Hassaan Yasin, Todd Gress, Maria Tirona
Journal: Journal of the National Comprehensive Cancer Network (2020)
Novel approach to outpatient endometrial biopsy to detect endometrial cancer.
Authors: Maria B. De Leon, Wu Howard, Giuseppe Del Priore
Journal: Journal of Clinical Oncology (2013)

e16522 Background: Currently there is no consensus on the best device and technique for obtaining endometrial biopsies to rule out cancer. Outpatient methods available include aspiration devices (Pipelle) and disruption devices (Tao brush). This study evaluated a new device which combines Global endometrial Disruption using a brush with a built in suction Process (GDP-Tao). Methods: After IRB approval, endometrial specimens were collected using the GDP-Tao from fresh uteri after completion of hysterectomies. Endometrial pathology results from the new device were compared to the final hysterectomy diagnosis by blinded review. Results: Patients (n = 33) were 29-86 years old (median 56), 67% obese, 52% menopausal. Uterine sounds were 2.5-11cm (median 6.6 cm), weight 45-3500g (median 238g), 15% of cervical os were stenotic but all allowed the device to pass without other instrumentation with overall diagnostic rate of 91% (30/33) 15/15 pathologically confirmed malignant specimens were correctly identified by the new device including 2 GDP-Tao specimens with atypical hyperplasia (AH) and hysterectomy pathology with AH and focal adenocarcinoma. Classifying any atypia from the GDP-Tao as “positive” then the detection rate for malignancy was 100% (PPV). 11/11 samples were benign in GDP-Tao and final pathology. There were 3 non-diagnostic (ND) samples from GDP-Tao with final pathology of benign endometrium. One specimen was ND due to absence of tissue from prior endometrial ablation. There was one device result of “proliferative endometrium” with final pathology of focal complex atypical hyperplasia and one device result of “rare atypical cells” with final diagnosis of endometrial polyp. Sensitivity and specificity were 94% and 92%, and negative predictive value was 82% for the identification of both atypical hyperplasia and malignancy. When stratified by uterine size, benign or malignant, the results were similar. Conclusions: Our validation study showed encouraging data thatthis new endometrial sampling device, which combines tissue disruption and aspiration into a single process, provides a reliable mean of obtaining adequate sample to accurately detect endometrial cancer with a high negative and positive predictive value.
PACEMAKER INDUCED DYSSYNCHRONY AS A CAUSE OF IATROGENIC HEART FAILURE
Authors: Chandra Kanth Ala, John Dawdy, Aditya Sood, Manmohan Singh, Kartik Kumar, Mohit Pahuja, Pramod Savarapu, Randy Lieberman, Nimrod Blank, Luis C. Afonso
Journal: Journal of the American College of Cardiology (2020)
Phase I clinical trial of hybrid cell vaccination in patients with gastrointestinal cancer
Authors: H. Iinuma, K. Okinaga, K. Iwasaki, T. Koide, T. Inaba, R. Fukushima
Journal: Journal of Clinical Oncology (2006)

2579 Background: Vaccination with hybrid cells of dendritic cells (DCs) and tumor cells can induce specific ant-tumor immunity against multiple tumor antigens including those that are unknown. We report the results of phase I study of hybrid cell vaccines comprised of autologous DC and autologous tumor cells in patients with Stage IV or recurrent gastrointestinal cancer. Method: Thirteen patients with Stage IV or recurrent gastrointestinal cancer were enrolled in this study after informed consent was obtained. Tumor cells were cryopreserved following acquisition from the primary or a metastatic site. DCs were induced from mononuclear cells of patients by culture with cytokines (6 days culture with GM-CSF and IL-4, and a further 1 day culture with TNF-α, IL-1 β, IL-6 and PGE2). Fusion of irradiated tumor cells and DC was created with a combination of PEG and electrofusion (two-step fusion method). At 2 week interval, patients received 4 freshly prepared fusion vaccines, with a constant dose range of 1 × 107 to 4 × 107 cells. The endpoints of this study were assessments of safety, anti-tumor immune response and clinical response. Results: Serious adverse events were not observed in any of the enrolled patients and all Common Toxicity Criteria were grade I. Clinical responses are 1 with partial response (PR), 5 with stable disease (SD) and 7 with progressive disease (PD). Delayed skin tests changed to positive in 5 patients. In patients with PR and SD, a shift to Th1 in Th1/Th2 balance of lymphocytes (IFN γ/IL10, IFN γ/IL4) was demonstrated by ELISPOT and cytokine flow cytometry analysis. After vaccination, decrease of immunosuppressive factors (IAP, TGF-β) in serum were shown in patients with PR and SD. There was no significant differences of CD4 + CD25 + cells by vaccination. Conclusion: These results suggests that a strategy of hybrid cell vaccine employing auto-DCs and auto-tumor cells is feasible in patients with gastrointestinal cancer and may show evidence of anti-tumor immune response. No significant financial relationships to disclose.
Dose-modified oral chemotherapy for AIDS-related non-Hodgkin’s lymphoma (AR-NHL) in East Africa
Authors: W. O. Mwanda, J. Orem, P. Fu, C. Banura, J. Kakembo, A. Ness, J. Johnson, J. Black, E. Katongole-Mbidde, S. Remick
Journal: Journal of Clinical Oncology (2006)

7564 Background: Dose-modified chemotherapy for AR-NHL in the pre-HAART era has been shown to be equally efficacious and less myelotoxic [N Engl J Med 1997;336:1641 (mBACOD); J Clin Oncol 2001;19:2171 (mCHOP)]. In resource-constrained settings, intravenous chemotherapy and supportive care of the AIDS/cancer patient are challenging (J Natl Cancer Inst 2002;94:718). Methods: We embarked on a pilot feasibility trial of dose-modified oral chemotherapy [lomustine 50 mg/m 2 D1 (C1 only); VP-16 100 mg/m 2 D1–3; and cyclophosphamide/procarbazine 50 mg/m 2 each D22–26 at 6-week intervals (1 cycle) for 2 cycles] in HIV-infected patients with biopsy-proven AR-NHL in East Africa. Results: A total of 52 pts (23 Uganda; 29 Kenya) were registered to study. The majority of pts were female (56%) with median age 39 yrs (range 18–64); poor PS (2 or 3) - 62%; high grade lymphoma (65%); advanced stage (III or IV) - 67%; and B symptoms (79%). At study entry median CD4 count was 207/μL and HIV-1 viral load 98,857 copies/ml. Nineteen pts (37%) had access to ARV. A total of 74.5 cycles of therapy were administered to 49 pts (median 2; range 0.5–2). The regimen was well tolerated. There were 4 episodes of febrile neutropenia and 3 treatment-related deaths (6% mortality rate). Overall objective response rate is 67% (CR/uCR 49%); median survival 8.2 months (range &lt;1.0 to 52.5+ mos.); and 22 patients remain alive as of 10/7/05. Conclusions: Dose-modified oral chemotherapy is efficacious, has comparable outcome to that in the US in pre-HAART era, an acceptable safety profile, and is pragmatic in the resource-limited setting. Further investigation of the oral regimen vs. mCHOP is warranted. [Supported in part by NIH grants: CA83528, AI36219, CA70081, and TW00011. Bristol-Myers Squibb and Sigma Tau Pharmaceuticals provided the chemotherapy drugs for this trial.] (J. Black, PhD, formerly DCTD, NCI, Bethesda, MD, USA). No significant financial relationships to disclose.
SCREENING FOR NEWLY DIAGNOSED DIABETES IN YOUNG ADULTS HOSPITALIZED WITH ACUTE MYOCARDIAL INFARCTION-RESULTS FROM THE VIRGO (VARIATION IN RECOVERY ROLE OF GENDER ON OUTCOMES OF YOUNG ACUTE MYOCARDIAL INFARCTION PATIENTS) STUDY
Authors: Qinglan Ding, Erica Spatz, Kasia Lipska, Haiqun Lin, John A. Spertus, Rachel Dreyer, Robin Whittemore, Marjorie Funk, Hector Bueno, Harlan M. Krumholz
Journal: Journal of the American College of Cardiology (2020)
Autoimmune disorders in patients with B-cell chronic lymphocytic leukemia.
Authors: Wei Duan-Porter, Alicia D. Volkheimer, Evan D. Davis, Youwei Chen, Sallie Allgood, J. Brice Weinberg
Journal: Journal of Clinical Oncology (2013)

7103 Background: B-cell chronic lymphocytic leukemia (CLL) results from the accumulation and proliferation of malignant B cells with a predisposition for autoreactivity and autoimmune disease, particularly hematologic disorders such as autoimmune hemolytic anemia (AIHA) and immune thrombocytopenic purpura (ITP). We sought to define the prevalence of autoimmune conditions and associated prognostic factors in our CLL cohort. Methods: We retrospectively reviewed the electronic medical records (EMR) of CLL patients at Duke University Medical Center (DUMC) and Durham VA Medical Center (DVAMC) for known diagnoses of autoimmune conditions, or clinical descriptions matching those disorders. Laboratory data confirming the diagnoses (e.g., Coombs test for AIHA) were verified directly in our EMR. IGVH mutation status, CD38 and ZAP-70 expression were previously determined. Results: We found 92 CLL patients with autoimmune disorders (21.4% prevalence), with higher numbers of both hematologic (58, 11.1%) and non-hematologic(42, 8.1%) conditions than previously published data [Barcellini et al. Haematologica (2006) 91:1689], although one series did show 9.7% of CLL patients with hematologic phenomena [Hamblin et al. J Clin Path (1986) 39:713-6]. CLL patients with AIHA and/or ITP had significantly shorter treatment-free survival [2.1 years (1-3.3)] and overall survival [11.9 years (9.6-15.8)] than those without [6.2 years (5.2-7.3) and 18.0 years (14.0-22.6), respectively]. 52% of CLL patients with autoimmunity had mutated IGVH (41/79 known results), 18% were CD38 positive (16/89) and 49% were ZAP-70 positive(39/80). In CLL patients without autoimmune disorders, the prevalence of mutated IGVH, and CD38 and ZAP-70 positivity were similar at 60% (219/364), 25% (99/395), and 47% (176/377), respectively. Conclusions: There is a higher prevalence of both hematologic and non-hematologic autoimmune disorders in our CLL cohort than previously reported. CLL patients with hematologic autoimmune disorders had shorter time to treatment and survival, compared to those without. There was no difference in frequency of mutated IGVH, CD38 or ZAP-70 expression between those patients with autoimmune conditions and those without.
MYOSIN LIGHT CHAIN DEPHOSPHORYLATION BY PPP1R12C PROMOTES ATRIAL HYPOCONTRACTILITY IN ATRIAL FIBRILLATION
Authors: Mark McCauley, Srikanth Perike, Katherina Alsina, Arvind Sridhar, Dawood Darbar, Xander Wehrens
Journal: Journal of the American College of Cardiology (2020)
NEWLY IDENTIFIED MUTATION OF ABCC9 POTASSIUM CHANNEL IN A PATIENT WITH RECURRENT EXERTION INDUCED POLYMORPHIC VENTRICULAR TACHYCARDIA
Authors: Zackary Tushak, April Shewmake, Jaideep Patel, Ajay Pillai, Jordana Kron, Santosh Kumar Padala, Krishnasree Rao, Allison Goodwin, Antonio Abbate
Journal: Journal of the American College of Cardiology (2020)