tbuckley/cabot-search huggingface dataset:
Palliative percutaneous nephrostomy in recurrent cervical cancer: Retrospective analysis of 50 consecutive cases
Authors: C. S. Pinto, I. A. Small, C. G. Ferreira, R. Dienstmann
Journal: Journal of Clinical Oncology (2007)

19609 Background: Cervical cancer is a public health problem in Brazil, with annual incidence rates of 20 to 40 cases/ 100.000 women. Most patients with recurrent disease have local symptoms and develop renal failure. There are no clear guidelines to predict which patients in palliative care derive benefit from percutaneous nephrostomy (PN) in terms of survival and quality of life. This study aims to evaluate the outcome of patients with recurrent cervical cancer in palliative care submitted to PN and thereby identify those who can potentially benefit from this intervention. Methods: Retrospective chart review of all patients assisted in the Palliative Care Unit of Brazilian National Cancer Institute from January 2002 to October 2006 and submitted to PN. Results: Fifty patients received unilateral PN. Median age was 44 years (26 - 67). All patients were previously treated with radiotherapy with or without chemotherapy and brachytherapy. At relapse, 50 presented with locally advanced disease and 7 also had metastatic disease. Twenty-four patients (49%) had improvement of uremic symptoms and/ or lumbar pain after PN and seven (14%) in Performance Status (PS). Median creatinine levels before and after PN were 6.4 and 3.7 mg/dl, respectively (p &lt; 0.05). Twenty-five patients (50%) had improvement in renal function. Until December 2006, 49 patients have died. Median overall survival after PN was 9.1 weeks (95% CI: 8.0 - 10.2). Median survival was 10 weeks (9.0 - 11.0) in 40 patients with baseline PS 1 - 3 and 1.7 weeks (0 - 3.7) in 10 patients with PS 4 (log rank, p = 0.04). Median survival in patients with and without improvement of renal function after PN was 10.7 weeks (8.6 - 12.8) and 8.1 weeks (4.8 - 11.5), respectively (log rank, p = 0.02). Twenty-nine patients (58%) died due to renal failure. Complications of PN were mainly urinary tract infection (n: 10), catheter loss (n: 9) and bleeding (n: 1). Conclusions: These data suggest that PN can be of clinical benefit for patients with recurrent cervical cancer and PS 1 to 3, but not PS 4. In fact, improvement of renal function after PN did prolong survival. Complications of PN are frequent and most patients still die in renal failure. However, our data indicate that carefully selected patients can derive benefit from this procedure. No significant financial relationships to disclose.
Nutrition and Supplement Use Characteristics in the Myeloproliferative Neoplasms: Results from the Nutrient Survey
Authors: Robyn M. Scherber, Blake T. Langlais, Holly Geyer, Amylou Dueck, Heidi Kosoriek, Carol Johnston, Leslie Padrnos, Jeanne Palmer, Angela G. Fleischman, Ruben A Mesa
Journal: Blood (2017)
Prognostic impact of tumor (T) and lymph node (N) status in patients with metastatic non-small-cell lung cancer (NSCLC).
Authors: Siddhartha Devarakonda, Bing Xia, Feng Gao, Ramaswamy Govindan, Daniel Morgensztern
Journal: Journal of Clinical Oncology (2013)

8076 Background: Although commonly reported in databases and clinical trials, T and N status do not affect the final stage or overall treatment plan for patients with metastatic NSCLC. Since there is limited data on the impact of T and N status on outcomes in this population, we conducted a Surveillance, Epidemiology, and End Results (SEER) study to address this question. Methods: The SEER database was searched for patients with stage M1b NSCLC, with known T and N status, diagnosed between 2004 and 2008. Patients with T0 and malignant pleural effusion were excluded. Overall survival (OS) was estimated by the Kaplan-Meier method, while the hazard ratios (HR) were estimated and compared using Cox proportional hazard models. Results: Among the 25,919 patients included, the frequencies of T1, T2, T3, and T4 were 15.8%, 28.2%, 33.6% and 22.4% respectively, whereas N0, N1, N2, and N3 were observed in 28.0%, 9.3%, 47.1% and 15.6% respectively. One-year OS ranged from 21.1% in T4 to 35.8% in T1, and 23.1% in N2 to 33.2% in N0 disease (Table). Both T and N were also identified as independent predictors for OS in multivariable analysis adjusted for age, gender, race, and histology. Conclusions: Both T and N status are important clinical prognostic factors that should be taken into consideration when evaluating patients with metastatic NSCLC. If confirmed in prospective studies, clinical trials and analyses of either clinical or molecular prognostic factors in the future may need to be adjusted according to the complete TNM staging. [Table: see text]
Inflammation without Vascular Leakage. Science Fiction No Longer?
Authors: Niall C. Filewod, Warren L. Lee
Journal: American Journal of Respiratory and Critical Care Medicine (2019)

Vascular leakage is a characteristic of critical illnesses such as septic shock and acute respiratory distress syndrome. It results in hypotension and tissue edema and contributes to organ dysfunction. It has long been taught that increased vascular permeability is a natural consequence of inflammation; in particular, many clinicians believe that it occurs inevitably during leukocyte recruitment to a site of infection. In fact, abundant research now indicates that vascular leakage and leukocyte emigration do not necessarily occur together in a blood vessel. The molecular mechanisms underpinning these processes-allowing leukocytes to exit the circulation without increasing vascular permeability-are starting to be elucidated and establish vascular leakage as a viable therapeutic target. Several preclinical studies indicate that vascular leakage can be reduced without impairing cytokine production, leukocyte recruitment, and pathogen clearance. The realization that leukocyte traffic and vascular permeability can be regulated separately should spur development of therapies that decrease vascular leakage and tissue edema without compromising the immune response.
Characterization and Outcomes of Patients With Hansen Disease Treated at the Los Angeles County Hospital
Authors: Maggie Chow, Lisa Shue, Tiffany Sierro, Kristi Tran, Seth Vaccaro, Maria Teresa Ochoa
Journal: JAMA Dermatology (2019)

Hidyanara L. de Paula, RN; Carlos D. F. de Souza, PhD; Sara R. Silva, RN; Paulo R. S. Martins-Filho, PhD; Josafá G. Barreto, PhD; Ricardo Q. Gurgel, PhD; Luis E. Cuevas, MTropMed; Victor S. Santos, PhD
Surgical resection and its relationship to survival for recurrent hepatocellular carcinoma after living donor liver transplantation.
Authors: Toru Ikegami, Ken Shirabe, Tomoharu Yoshizumi, Kazutoyo Morita, Takeo Toshima, Jun Muto, Shohei Yoshiya, Hideaki Uchiyama, Yuji Soejima, Yoshihiko Maehara
Journal: Journal of Clinical Oncology (2012)

e14602 Background: Although liver transplantation offers excellent recurrence-free survivals for treating hepatocellular carcinoma (HCC), cases with recurrent diseases usually result in miserable outcomes. In this study, the indication and efficacy of surgical resection for the recurrent diseases after living donor liver transplantation (LDLT) for HCC. Methods: A total of 153 recipients, who underwent LDLT for HCC between 1997 and 2011, were included. The endpoints analyzed were survivals from time of LDLT and from the time of recurrence. Results: Twenty-three patients had recurrence of HCC after LDLT. The mean period until the initial recurrence after LDLT and the mean duration until death after the initial recurrence were 17.1 months (n=23) and 17.4 months (n=16), respectively. A univariate analysis showed that gender (p&lt;0.01) des-gamma-carboxy prothrombin &lt;300 mAU/ml (p=0.02), interferon therapy (p=0.02), early posttransplant tumor recurrence (p&lt;0.01), and eligibility for a surgical resection (p&lt;0.01) all had a beneficial impact on survival from tumor recurrence. Other factors at LDLT including Milan criteria, tumor number, tumor size or alpha-fetoprotein had no impact on the survival after recurrence. Multivariate analysis showed eligibility for a surgical resection (odds ratio 12.3, p&lt;0.0199 and des-gamma-carboxy prothrombin &lt;300 mAU/ml (odds ratio 5.3, p=0.04) were the independent beneficial factors on survival from tumor recurrence. Surgical resection was performed in 12 patients for the initial recurrences at lung (n=5), peritoneum (n=2) lymph nodes (n=2), liver (n=1), bone (n=1) and adrenal gland. The 2-year survival rate after recurrence in the patients surgery was indicated or not indicated was 72.2% and 18.2%, respectively (p&lt;0.01). Conclusions: Surgical therapy could be useful for patients who experience a recurrence of HCC after LDLT to improve their outcome, when such treatment is available.
A rare case of angina bullosa hemorrhagica of the esophagus
Authors: Flaminia Cavallaro, Gian Eugenio Tontini, Ennio Leggieri, Pavlos Lagoussis, Alberto Prada, Luigi Bonavina, Luca Pastorelli
Journal: Endoscopy (2019)

We report the case of a 52-year-old woman referred for esophagogastroduodenoscopy (EGD) because of a previous episode of transient acute chest pain with a negative cardiology work-up. EGD revealed a 15-mm hemorrhagic purple – red tense bulla in the thoracic esophagus at 26 cm from the incisors. The blister broke following passage of the endoscope, rapidly exposing the submucosal layer and causing transient bleeding ([Video 1]; [Fig. 1]).
Prevalence and Trends of Overweight and Obesity in European Children From 1999 to 2016
Authors: Miriam Garrido-Miguel, Iván Cavero-Redondo, Celia Álvarez-Bueno, Fernando Rodríguez-Artalejo, Luis A. Moreno, Jonatan R. Ruiz, Wolfgang Ahrens, Vicente Martínez-Vizcaíno
Journal: JAMA Pediatrics (2019)

Studies of trends in excess weight among European children throughout the last few decades have rendered mixed results. Additionally, some studies were outdated, were based on self-reported weight and height, or included only a few European countries.To assess prevalence trends in measured overweight and obesity among children across Europe from 1999 to 2016 using a systematic methodology.MEDLINE, Embase, CINAHL, and Web of Science were searched from their inception until May 2018. Moreover, searches were conducted on health institutions' websites to identify studies not published in scientific journals.The inclusion criteria were: (1) studies reporting the population-based prevalence of excess weight (overweight plus obesity) or obesity according to body mass index cutoffs proposed by the International Obesity Task Force; (2) cross-sectional or follow-up studies; and (3) studies including populations aged 2 to 13 years.Literature review and data extraction followed established guidelines. The Mantel-Haenszel method was used to compute the pooled prevalence estimates and their 95% CI whenever there was no evidence of heterogeneity (I2 < 50%); otherwise, the DerSimonian and Laird random-effects method was used. Subgroup analyses by study year, country, or European region (Atlantic, Iberian, Central, and Mediterranean) were conducted. Prevalence estimates were calculated as an aggregate mean, weighted by the sample size and the number of individuals in each study.A total of 103 studies (477 620 children aged 2 to 13 years) with data from 28 countries were included. The combined prevalence of overweight and obesity in the Iberian region tended to decrease from 30.3% (95% CI, 28.3%-32.3%) to 25.6% (95% CI, 19.7%-31.4%) but tended to increase in the Mediterranean region from 22.9% (95% CI, 17.9%-27.9%) to 25.0% (95% CI, 14.5%-35.5%). No substantial changes were observed in Atlantic Europe or Central Europe, where the overweight and obesity prevalence changed from 18.3% (95% CI, 14.0%-23.9%) to 19.3% (95% CI, 17.7%-20.9%) and from 15.8% (95% CI, 13.4%-18.5%) to 15.3% (95% CI, 11.6%-20.3%), respectively.The prevalence of childhood overweight and obesity is very high, but trends have stabilized in most European countries. There are substantial between-country differences in the current levels and trends of overweight and obesity. The rising prevalence in some Mediterranean countries is worrisome.PROSPERO identifier: CRD42017056924.
Gaussian processes for daily demand prediction in the hospitality industry
Authors: Wai Tsang, Dries Benoit
Journal: Eurosurveillance (2018)

In tourism forecasting literature, the majority of the studies relies on econometric models. While econometric models are effective for monthly or yearly data, many machine learning techniques are yet to be explored in the demand literature and it can be beneficial to do so on daily data. This study fills the research gap by predicting daily hotel occupancy rates on a city level in Brussels using booking.com data. A forecasting methodology is proposed with feature extraction and selection, processing steps that are missing in most approaches. Special attention is given to Gaussian Processes to make predictions with credible intervals, an uncertainty measure that is helpful for managers during decision-making. The novel approach uses online data to create a proxy measure for occupancy rate. The new methodology is verified with internal occupancy data from hotels in Brussels and can be extrapolated to cities for which no internal hotel data is available.
Systemic Juvenile Idiopathic Arthritis–Associated Lung Disease: Characterization and Risk Factors
Authors: Grant S. Schulert, Shima Yasin, Brenna Carey, Claudia Chalk, Thuy Do, Andrew H. Schapiro, Ammar Husami, Allen Watts, Hermine I. Brunner, Jennifer Huggins, Elizabeth D. Mellins, Esi M. Morgan, Tracy Ting, Bruce C. Trapnell, Kathryn A. Wikenheiser‐Brokamp, Christopher Towe, Alexei A. Grom
Journal: Arthritis & Rheumatology (2019)

Objective Systemic juvenile idiopathic arthritis (JIA) is associated with a recently recognized, albeit poorly defined and characterized, lung disease (LD). The objective of this study was to describe the clinical characteristics, risk factors, and histopathologic and immunologic features of this novel inflammatory LD associated with systemic JIA (designated SJIA‐LD). Methods Clinical data collected since 2010 were abstracted from the medical records of patients with systemic JIA from the Cincinnati Children's Hospital Medical Center. Epidemiologic, cellular, biochemical, genomic, and transcriptional profiling analyses were performed. Results Eighteen patients with SJIA‐LD were identified. Radiographic findings included diffuse ground‐glass opacities, subpleural reticulation, interlobular septal thickening, and lymphadenopathy. Pathologic findings included patchy, but extensive, lymphoplasmacytic infiltrates and mixed features of pulmonary alveolar proteinosis (PAP) and endogenous lipoid pneumonia. Compared to systemic JIA patients without LD, those with SJIA‐LD were younger at the diagnosis of systemic JIA (odds ratio [OR] 6.5, P = 0.007), more often had prior episodes of macrophage activation syndrome (MAS) (OR 14.5, P &lt; 0.001), had a greater frequency of adverse reactions to biologic therapy (OR 13.6, P &lt; 0.001), and had higher serum levels of interleukin‐18 (IL‐18) (median 27,612 pg/ml versus 5,413 pg/ml; P = 0.047). Patients with SJIA‐LD lacked genetic, serologic, or functional evidence of granulocyte–macrophage colony‐stimulating factor pathway dysfunction, a feature that is typical of familial or autoimmune PAP. Moreover, bronchoalveolar lavage (BAL) fluid from patients with SJIA‐LD rarely demonstrated proteinaceous material and had less lipid‐laden macrophages than that seen in patients with primary PAP (mean 10.5% in patients with SJIA‐LD versus 66.1% in patients with primary PAP; P &lt; 0.001). BAL fluid from patients with SJIA‐LD contained elevated levels of IL‐18 and the interferon‐γ–induced chemokines CXCL9 and CXCL10. Transcriptional profiling of the lung tissue from patients with SJIA‐LD identified up‐regulated type II interferon and T cell activation networks. This signature was also present in SJIA‐LD human lung tissue sections that lacked substantial histopathologic findings, suggesting that this activation signature may precede and drive the lung pathology in SJIA‐LD. Conclusion Pulmonary disease is increasingly detected in children with systemic JIA, particularly in association with MAS. This entity has distinct clinical and immunologic features and represents an uncharacterized inflammatory LD.
Metformin Use and Clinical Outcomes Among Patients With Diabetes Mellitus With or Without Heart Failure or Kidney Dysfunction
Authors: Brian A. Bergmark, Deepak L. Bhatt, Darren K. McGuire, Avivit Cahn, Ofri Mosenzon, Ph. Gabriel Steg, KyungAh Im, Estella Kanevsky, Yared Gurmu, Itamar Raz, Eugene Braunwald, Benjamin M. Scirica
Journal: Circulation (2019)

Metformin is first-line therapy for type 2 diabetes mellitus, although its effects on the cardiovascular system are unproved.In this post hoc analysis, patients in SAVOR-TIMI 53 (Saxagliptin and Cardiovascular Outcomes in Patients With Type 2 Diabetes Mellitus) with baseline biomarker samples (n=12 156) were classified as ever versus never taking metformin during the trial period. Associations between metformin exposure and outcomes were estimated with inverse probability of treatment weighting Cox modeling for the composite end point of cardiovascular death, myocardial infarction, or ischemic stroke, as well as cardiovascular death and all-cause mortality, with biomarkers included as covariates. Additional sensitivity analyses included propensity score matching and Cox multivariable models.Of the 12 156 patients with baseline biomarker samples, 8971 (74%) had metformin exposure, 1611 (13%) had prior heart failure, and 1332 (11%) had at least moderate chronic kidney disease (estimated glomerular filtration rate ≤45 mL·min-1·1.73 m-2). Metformin use was associated with no difference in risk for the composite end point (hazard ratio for inverse probability of treatment weighting, 0.92 [95% CI, 0.76-1.11]) but lower risk of all-cause mortality (hazard ratio for inverse probability of treatment weighting, 0.75 [95% CI, 0.59-0.95]). There was no significant relationship between metformin use and these end points in patients with prior heart failure or moderate to severe chronic kidney disease.In a cohort of 12 156 patients with type 2 diabetes mellitus and high cardiovascular risk, metformin use was associated with lower rates of all-cause mortality, including after adjustment for clinical variables and biomarkers, but not lower rates of the composite end point of cardiovascular death, myocardial infarction, or ischemic stroke. This association was most apparent in patients without prior heart failure or moderate to severe chronic kidney disease.URL: https://www.clinicaltrials.gov. Unique identifier: NCT01107886.
State-of-the-art for CAR T-cell therapy for chronic lymphocytic leukemia in 2019
Authors: Richard Lemal, Olivier Tournilhac
Journal: Journal for ImmunoTherapy of Cancer (2019)

Experience in the use of CAR T cells to treat CLL is limited, but safety and efficacy data are encouraging, suggesting that it may be possible to use CAR T cells in populations of CLL patients with particularly unfavorable prognoses. Mechanisms intrinsic to the pathophysiology of CLL undoubtedly explain the efficacy reported based on limited data for the first few series, and underlie the rationale of successive modulations in lymphodepletion schemes, transgene constructs, and, finally, the therapeutic association of CAR T cells with ibrutinib, which appears to be particularly promising. This review describes the published results and expected developments.
CAR T-Cell Therapy
Authors: Caron Jacobson, Amy Emmert, Meredith B. Rosenthal
Journal: JAMA (2019)

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Association of breast cancer in men with exposure to 5-α reductase inhibitors: A RADAR report.
Authors: Steven M Belknap, Victoria Godinez-Puig, Robert E Brannigan, Simon M Lin, John Cashy, Rajesh Chowdhary, Michael J Postelnick, Michael A Fotis, Michael Irwig, Seema Ahsan Khan, William John Gradishar, Vishvas Garg, Xian Shen, Dennis W Raisch, Beatrice Nardone, Steven T. Rosen, Beatrice J. Edwards, June M McKoy, Paul R Yarnold, Dennis P. West
Journal: Journal of Clinical Oncology (2012)

2532 Background: Breast cancers in men (BCM) account for &lt;1% of all breast cancers. Dihydrotestosterone (DHT) inhibits proliferation of normal and neoplastic mammary tissue and constrains the effect of estrogens. Finasteride (F) and dutasteride (D) are 5-α reductase inhibitors (5-αRIs) that reduce systemic and local dihydrotestosterone and cause gynecomastia in 1–3% of men. The package inserts for F and D state, “the relationship between long-term use of (finasteride/dutasteride) and male breast neoplasia is currently unknown.” F and D are marketed for treatment of symptomatic benign-prostatic hyperplasia. F is marketed for treatment of androgenetic alopecia. Methods: To detect disproportionality in the FDA MedWatch dataset, we calculated the empiric Bayes geometric mean (EBGM) for association of BCM with F or D. We also calculated the attributable risk of BCM exposed to F or D among men at an urban academic hospital (Northwestern Memorial Hospital) and at a rural healthcare system (Marshfield Clinic). Results: In the MedWatch dataset, we identified 33 reports of F-associated BCM and 5 reports of D-associated BCM. For F–associated BCM, the EBGM was 58.95 (95% CI 24.47-81.76; p=0.0001). For D-associated BCM, the EBGM was 15.79 (95% CI 4.57-35.49; p=0.0001). The mean age for BCM after 5-αRI exposure was 70±11 years; 11/38 (29%) had gynecomastia. There were 38 cases of BCM associated with 5-αRI in the combined Northwestern and Marshfield cohort (see table below). Conclusions: We found a highly significant association between BCM and 5-αRI exposure in each of 6 separate analyses (3 sources X 2 drugs), with an estimated 1 extra BCM per 564 men exposed to 5-αRIs. We now plan to assess BRCA status and other risk factors. Given that 5-αRIs are marketed for control of lower urinary tract symptoms or for cosmetic purposes, it is not immediately obvious that use of finasteride or dutasteride for their labeled indications would provide any net benefit. [Table: see text]