tbuckley/cabot-search huggingface dataset:
Update on Vaccine-Derived Poliovirus Outbreaks — Democratic Republic of the Congo and Horn of Africa, 2017–2018
Authors: Chukwuma Mbaeyi, Mary M. Alleman, Derek Ehrhardt, Eric Wiesen, Cara C. Burns, Hongmei Liu, Raimi Ewetola, Lerato Seakamela, Rennatus Mdodo, Modjirom Ndoutabe, Pierre Kandolo Wenye, Yogolelo Riziki, Peter Borus, Christopher Kamugisha, Steven G. F. Wassilak
Journal: MMWR Morbidity and Mortality Weekly Report (2019)

Widespread use of live attenuated (Sabin) oral poliovirus vaccine (OPV) has resulted in marked progress toward global poliomyelitis eradication (1). However, in underimmunized populations, extensive person-to-person transmission of Sabin poliovirus can result in genetic reversion to neurovirulence and paralytic vaccine-derived poliovirus (VDPV) disease (1). This report updates (as of February 26, 2019) previous reports on circulating VDPV type 2 (cVDPV2) outbreaks during 2017-2018 in the Democratic Republic of the Congo (DRC) and in Somalia, which experienced a concurrent cVDPV type 3 (cVDPV3) outbreak* (2,3). In DRC, 42 cases have been reported in four cVDPV2 outbreaks; paralysis onset in the most recent case was October 7, 2018 (2). Challenges to interrupting transmission have included delays in outbreak-response supplementary immunization activities (SIAs) and difficulty reaching children in all areas. In Somalia, cVDPV2 and cVDPV3 were detected in sewage before the detection of paralytic cases (3). Twelve type 2 and type 3 cVDPV cases have been confirmed; the most recent paralysis onset dates were September 2 (cVDPV2) and September 7, 2018 (cVDPV3). The primary challenge to interrupting transmission is the residence of >300,000 children in areas that are inaccessible for vaccination activities. For both countries, longer periods of surveillance are needed before interruption of cVDPV transmission can be inferred.
Allogeneic stem cell transplantation results in our myelodysplastic syndrome (MDS) patients.
Authors: Gunhan Gurman, Pinar Ataca, Tolga Aydin, Erden Atilla, Sinem Civriz Bozdag, Selami Kocak Toprak, Meltem Kurt Yuksel, Pervin Topcuoglu, Muhit Ozcan, Taner Demirer, Meral Beksac, Osman Ilhan, Hamdi Akan, Nahide Konuk, Onder Arslan
Journal: Journal of Clinical Oncology (2015)

e18088 Background: The only curative treatment for Myelodysplastic Syndromes (MDS) is Allogeneic Stem Cell Transplantation (ASCT). However the timing of ASCT in MDS remains a central question. Therefore we aimed to analyze the efficacy and safety of ASCT transplantation in our MDS patients. Methods: Between Jun 1993 and Dec 2014, 41 patients (29 M; 12F) admitted to Ankara University Department of Hematology were included in the study. We retrospectively evaluated the early toxicity and outcome. Results: Table 1 describes the patient characteristics. In comparison of the toxicities including oral mucositis and diarrhea, we found no difference according to diagnosis, age (< 65 ys vs. ≥ 65 ys), Sorror CI, R-IPSS Score and the intensity of conditioning regimen. In addition, engraftment kinetics were not affected by the diagnosis, age or Sorror Cl. Early-transplant related mortality (TRM) was seen in 7 patients. 3 patients were relapsed and received donor lymphocyte infusion (DLI). The diagnosis, age and Sorror CI were not found to have any impacts on overall survival (OS). Conclusions: Although being diagnosed as RAEB-2, having high/very high R-IPSS score and Sorror-HCl score, age ≥ 65 ys were related to decreased OS; no statistical differences were detected. Due to similar toxicities and engraftment kinetics with low risk patients, ASCT can be a safe option in high risk MDS. Patient characteristics. Diagnosis at ASCT (n=41) RA RARS RCMD RAEB-1 RAEB-2 11 6 13 7 4 Median age (years) 40 (17-62) Median time from diagnosis to the transplantation (months) 19 (2-96) Sorror Comorbidity Index (CI) (%) 0-1 2 %95 %5 R-IPSS Score (n) High/Very High Intermediate Low/Very Low Unknown 18 9 0 14 Conditioning regimen (n) Myeloablative Reduced Intensity Non-myeloablative 33 7 1 Median CD 34 count (x10^6/kg) 5.63 (1.14-11.16) Median neutrophil recovery (days) 18.68 (12-29) Median thrombocyte recovery (days) 18.90 (8-64) Median Overall survival (months) 81.5 (54.3-108.8)
Abstract P057: Lipid Evaluation in a Large Cardiology Practice
Authors: S Kristen Sexson Tejtel, Constance Cephus
Journal: Circulation (2019)

Background: Elevated lipids are becoming an increasing problem in children particularly with increasing rate of obesity. We undertook an evaluation to determine if the risk factors are similar for children in a pediatric cardiology practice who are evaluated for lipids is similar to those for children without congenital heart disease. Methods: We performed a medical record review from January 2006- January 2018 of all children in a pediatric cardiology practice who had lipids obtained. We evaluated their weight, height, BMI, blood pressure and the lipid results. A descriptive analysis was performed to determine the rate of risk factors for hyperlipidemia in this population. Results: In total, 12,950 children had 38,158 lipid panels obtained. The average age at the time the lipid panel was obtained was 11.4 years and 57% (7,365) were male. Of these children, 4,441 were overweight with a weight over the 90 percentile for age and 3,389 were obese with a weight over 95 percentile. Of these children, 82% (or 30331 labs) had elevated total cholesterol over 130 and 51% (or 19299 labs) were over 160. However, of those with elevated cholesterol, 45% were overweight or obese. In addition to elevated total cholesterols, the HDL level was less than 40 in 32% (or 10,654 labs) and less than 35 in 20% (or 6,508 labs). Sub fractionation of the HDL was rarely performed. Conclusions: We are identifying a large population of patients with elevated cholesterol and low HDL cholesterol. The risk factors however may be different as there is a lower proportion of these patients who are overweight or obese than in a typical population. Further evaluation for other risk factors in the population of children with congenital heart disease is necessary.
Abstract 17607: MicroRNA Expression Profiles in Endomyocardial Biopsies From Patients With Myocarditis - Association With Left Ventricular Function and Clinical Events
Authors: Christian Besler, Daniel Urban, Stefan Watzka, Karin Klingel, Reinhard Kandolf, Gerhard Schuler, Volker Adams, Philipp Lurz
Journal: Circulation (2015)

Background: Myocarditis represents an important cause of chronic dilated cardiomyopathy. Predicting the clinical course of patients with myocarditis is difficult and the prognostic value of current histological markers remains controversial. We tested whether expression of selected microRNAs (miRNAs) in endomyocardial biopsies is related to left ventricular (LV) function and clinical events in patients with myocarditis. Methods: Endomyocardial biopsies were obtained from patients with non-inflammatory dilated cardiomyopathy (n=22) and histologically proven myocarditis (n=81). Based on literature search, we predefined a set of 6 miRNAs implicated in inflammation (miR-155, miR-146b), heart failure (miR-21, miR-133a), endothelial cell (miR-126) and skeletal muscle function (miR-206). Expression of these miRNAs in endomyocardial biopsies was quantified by RT-PCR. Results: Expression of miR-133a, miR-206 and miR-155 was markedly upregulated in endomyocardial biopsies from patients with myocarditis as compared to patients with dilated cardiomyopathy, irrespective of viral or non-viral etiology. Levels of miR-133a (R=0,68, P&lt;0,01) and miR-155 (R=0,65, P&lt;0,01) significantly correlated with CD68 cell count in endomyocardial biopsies from patients with myocarditis. Patients with myocarditis and preserved LV function at study entry displayed higher endomyocardial expression of miR-133a than patients with reduced LV function. Higher expression levels of miR-133a were associated with improved LV function during a mean follow-up of 3,1 years. Importantly, in a Kaplan-Meier estimate, patients with myocarditis and miR-133a levels above median showed longer survival free of death and malignant arrhythmias. Conclusion: The present study demonstrates that in a predefined set of miRNAs, relevant to cardiovascular pathology, endomyocardial miR-133a levels correlate with macrophage infiltration, improved LV function and clinical outcome in a comparatively large cohort of patients with histologically proven myocarditis. miR-133a may serve as a potential novel biomarker and therapeutic target in human myocarditis.
National Comprehensive Cancer Network (NCCN) surveillance guidelines: Characteristics of post-treatment imaging recommendations in solid tumor malignancies.
Authors: Shrujal S. Baxi, Deborah Korenstein
Journal: Journal of Clinical Oncology (2015)

e17775 Background: Concern about the rising cost of cancer care has prompted attempts to minimize care variations and optimize value through guideline/pathway adherence. Post-treatment care is increasingly guideline-driven. We characterized imaging recommendations in NCCN guidelines for surveillance of solid tumor malignancies after curative-intent treatment. Methods: We extracted recommendations for surveillance from NCCN guidelines posted on www.NCCN.org. We excluded guidelines for hematologic malignancies, benign conditions, incurable cancers, or cancer syndromes. We extracted post-treatment recommendations regarding imaging. Data were extracted by one investigator and checked by a second, with differences resolved by consensus. Results: We identified 74 recommendations from 31 panels addressing 57 cancers or cancer groups. Guidelines were risk- or stage-based for 11/55 conditions (20%); an additional 3 guidelines (5.5%) described stage- or prognosis-based strategies. Imaging was recommended in 41 guidelines (55.4%); (15/41, 36.6%) did not specify a preferred test and (26/41, 63.4%) offered a range of recommended testing frequencies instead of a single interval. No guideline recommended PET scan. Half (37/74) recommended optional or “if clinically indicated” imaging. Six guidelines recommended against specific tests, 4 of which recommended against PET. Conclusions: NCCN guideline recommendations for surveillance imaging after curative-intent therapy of solid tumors commonly lack specificity; recommendations against testing are uncommon. The lack of guideline specificity likely reflects the paucity of high-quality data to inform surveillance practice, and may contribute to unproductive practice variations and compromise value.
Effect of extended pedigree information on risk estimates for BRCA1/2 mutation by risk assessment models.
Authors: Boyoung Park, Sun-Young Kong, Myong Cheol Lim, Keun-Seok Lee, Eun Sook Lee
Journal: Journal of Clinical Oncology (2015)

e12530 Background: The aim of this study was to investigate the effect of extended pedigree information from first degree relatives to second degree relatives on risk estimates measured by risk assessment models such as BRCAPRO or Myriad II in breast cancer patients. Methods: Total of 105 breast cancer patients who visited genetic counselling clinic at the National Cancer Center, Korea between March 2013 and January 2015 twice or more were recruited. At the first visit, probability of BRCA1/2 mutation carriers and ovarian cancer risk were assessed using their first degree relatives’ history. A clinician asked the patients to bring extended pedigree including second degree relatives’ information at the next visit and estimated risk of BRCA1/2 mutation and ovarian cancer using the extended information. Results: With the extended pedigree information, the probability of BRCA1/2 mutation carriers estimated by BRCAPRO was significantly lower than estimates using first degree relatives’ information (13.0% vs. 9.2%, P = 0.007). However, the decrement was significant in only probability of BRCA2 mutation carriers (P = 0.022) not in that of BRCA1 mutation (P-value = 0.189). Estimates from Myriad II showed similar risk between first degree relatives’ information and extended information (8.5% vs. 8.8%, P = 0.116). 5-year and lifetime ovarian cancer risks were not significantly different between first degree relatives’ information and extended information (P = 0.095 and 0.131). When we estimated the discriminatory power of BRCA mutation carriers from 105 patients including 15 BRCA1 and 6 BRCA2 mutation carriers using first degree relatives’ information and extended information, the area under a receiver operating characteristic curve increased for BRCA2 mutation discrimination by 10% (from 0.64 to 0.74), otherwise, the value became lower for BRCA1 mutation discrimination measured by BRCAPRO. The discriminatory power of Myriad II was very low. Conclusions: BRCAPRO might be better risk assessment tool for estimation of BRCA mutation probability than Myriad II in Korea. The extended pedigree information may decrease the probability of BRCA1/2 mutation carriers but the discrimination power seemed to become higher.
N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP) Is Associated with Both Left Ventricular Diastolic Dysfunction and Myeloma-Related Renal Insufficiency and Robustly Predicts Mortality in Patients with Symptomatic Multiple Myeloma
Authors: Yoshiaki Abe, Tetsuya Kobayashi, Kentaro Narita, Hiroki Kobayashi, Akihiro Kitadate, Masami Takeuchi, Kosei Matsue
Journal: Blood (2018)
The prognostic significance of circulating angiogenesis biomarkers in stage I NSCLC.
Authors: Jeffrey Allen Borgia, Ravi Pithadia, Christopher W. Seder, Imad Tarhoni, Sanjib Basu, Cristina Fhied, Wen-rong Lie, Jehangir Sorabji Mistry, Gary Chmielewski, Philip Bonomi, Michael J. Liptay
Journal: Journal of Clinical Oncology (2015)

e13506 Background: Dysregulation of angiogenesis has been shown to be intimately associated with tumorigenesis and metastatic progression in multiple carcinomas. The objective of this study was to establish the value of circulating angiogenesis biomarker to identify cases of stage I NSCLC at high risk for disease recurrence. We hypothesize differences in angiogenesis biomarker levels will associate strongly with lung cancer progression and may have prognostic value. Methods: We enrolled a total of 147 patients stage I NSCLC in which there was 39 cases of disease recurrence. Histology for these cases were predominately adenocarcinoma (71.2%), followed by squamous cell carcinoma (17.8%) and NSCLC other (11%). Serum from these patients were evaluated for 37 biomarkers associated with angiogenesis were assayed on the Luminex platform including: EGF, Angiopoietin-2, G-CSF, BMP-9, Endoglin, Endothelin-1, Leptin, FGF-1, FGF-2, Follistatin, IL-8, HGF, HB-EGF, PLGF, VEGF-A, VEGF-C, VEGF-D, angiostatin, sAXL, sc-KIT, sEGFR, sHer2, sHer3, E-selectin, HGFR/c-Met, Tenascin C, PDGF-AB/BB, sIL-6Rα, sTie-2, Thrombospondin, sNeutrophilin-1, suPAR, sVEGFR1, sVEGFR2, sVEGFR3, PECAM-1, osteopontin. Biomarkers levels were analyzed using COX regression or log-rank test for progression-free survival (PFS) or overall survival (OS). Results: In our cohort of 147 cases of stage I NSCLC we found 4 biomarkers with significant log-rank p-values (p<0.05) for PFS, including sEGFR, IL-8, sc-KIT, FGF-1. For OS we identified 9 biomarkers with strongly significant a log-rank p-values (p<0.01), including endothelin-1, sHGFR/cMET, VEGF-C, IL-8, angiopoietin-2, sVEGFR-3, PECAM-1, and sc-KIT. Further, an additional 13 angiogenesis biomarkers were found to have log-rank p-values that were significant (p<0.05). Conclusions: We discovered a series of circulating biomarkers of angiogenesis that were significantly associated with prognosis in stage I NSCLC. These angiogenesis biomarkers may provide ideal targets for the establishment of a validated model for predicting lung cancer progression and may have implications for the adjuvant treatment of stage I lung cancer.
The impact of three-dimensional conformal and stereotactic hypofractionated radiotherapy on quality of life of prostate cancer patient.
Authors: Monika Rucinska, Anna Kieszkowska-Grudny, Sergiusz Nawrocki
Journal: Journal of Clinical Oncology (2015)

e16046 Background: The prostate cancer is the second most prevalent solid tumor diagnosed in men. The quality of life (QoL) has become one of the most significant issues in treatment decisions in prostate cancer. The objective of the study was to investigate the quality of life (QoL) after stereotactic hypofractionated radiotherapy (HRT) in comparison with standard three-dimensional conformal radiation treatment (3DCRT) of prostate cancer patients (pts) and the healthy men (HM). Methods: A prospective one-center clinical study was done on clinical localized prostate cancer patients with low- and intermediate-risk adenocarcinoma of prostate T2N0M0 treated by HRT (33.5Gy in 5 fractions). As a standard prostate cancer patients were treated by 3DCRT (70-82Gy in 35-41fractions). Healthy men (without any type of cancer) were used as a control. Subjects filled out EORTC QLQ-C30 (v. 3.0.) and QLQ-PR25. Results: The analysis was performed on 40 men treated by HRT (55-83 years, mean 72, median 73; PSA 5.6-20ng/ml, mean 10.9, median 9.9; Gleason score 5-7, mean and median 6), 42 patients treated by 3DCRT (55-83 years, mean 69, median 70; PSA 2-109ng/ml, mean 19.9, median 10.3; Gleason score 4-9, mean and median 6) and 50 healthy men (55-84 years, median and mean 69). A median follow-up was 21 months (range 18-30) for HRT pts and 28 months (range 8-71) for 3DCRT pts. Univariate analysis of variance ANOVA revealed significant (p < 0,05) difference between groups in general QoL as well as subscales of QoL in physical, emotional, cognitive and social functioning. QoL was associated with general functioning, fatigue, pain, dyspnea, appetite lost, diarrhea and financial problem. Other differences were found in post hoc test. HRT pts had less severe fatigue and pain than 3DCRT pts and HM and had fewer problems with urination than 3DCRT pts. HRT pts demonstrated better general QoL than 3DCRT pts and even HM. Taking into account the age more differences in QoL were found in people aged over 65 years. Conclusions: There are some kinds of prostate cancer treatment and knowledge how they influence patients’ QoL seems to be very important for making therapeutic decision. Subsequent studies on larger groups are necessary.
Using germline variants to estimate glioma and subtype risks
Authors: Jeanette E Eckel-Passow, Paul A Decker, Matt L Kosel, Thomas M Kollmeyer, Annette M Molinaro, Terri Rice, Alissa A Caron, Kristen L Drucker, Corinne E Praska, Melike Pekmezci, Helen M Hansen, Lucie S McCoy, Paige M Bracci, Bradley J Erickson, Claudia F Lucchinetti, Joseph L Wiemels, John K Wiencke, Melissa L Bondy, Beatrice Melin, Terry C Burns, Caterina Giannini, Daniel H Lachance, Margaret R Wrensch, Robert B Jenkins
Journal: Neuro-Oncology (2019)

Twenty-five single nucleotide polymorphisms (SNPs) are associated with adult diffuse glioma risk. We hypothesized that the inclusion of these 25 SNPs with age at diagnosis and sex could estimate risk of glioma as well as identify glioma subtypes. Case-control design and multinomial logistic regression were used to develop models to estimate the risk of glioma development while accounting for histologic and molecular subtypes. Case-case design and logistic regression were used to develop models to predict isocitrate dehydrogenase (IDH) mutation status. A total of 1273 glioma cases and 443 controls from Mayo Clinic were used in the discovery set, and 852 glioma cases and 231 controls from UCSF were used in the validation set. All samples were genotyped using a custom Illumina OncoArray. Patients in the highest 5% of the risk score had more than a 14-fold increase in relative risk of developing an IDH mutant glioma. Large differences in lifetime absolute risk were observed at the extremes of the risk score percentile. For both IDH mutant 1p/19q non-codeleted glioma and IDH mutant 1p/19q codeleted glioma, the lifetime risk increased from almost null to 2.3% and almost null to 1.7%, respectively. The SNP-based model that predicted IDH mutation status had a validation concordance index of 0.85. These results suggest that germline genotyping can provide new tools for the initial management of newly discovered brain lesions. Given the low lifetime risk of glioma, risk scores will not be useful for population screening; however, they may be useful in certain clinically defined high-risk groups.
<i>Vital Signs:</i>HIV Transmission Along the Continuum of Care — United States, 2016
Authors: Zihao Li, David W. Purcell, Stephanie L. Sansom, Demorah Hayes, H. Irene Hall
Journal: MMWR Morbidity and Mortality Weekly Report (2019)

In 2016, an estimated 1.1 million persons had human immunodeficiency virus (HIV) infection in the United States; 38,700 were new infections. Knowledge of HIV infection status, behavior change, and antiretroviral therapy (ART) all prevent HIV transmission. Persons who achieve and maintain viral suppression (achieved by most persons within 6 months of starting ART) can live long, healthy lives and pose effectively no risk of HIV transmission to their sexual partners.A model was used to estimate transmission rates in 2016 along the HIV continuum of care. Data for sexual and needle-sharing behaviors were obtained from National HIV Behavioral Surveillance. Estimated HIV prevalence, incidence, receipt of care, and viral suppression were obtained from National HIV Surveillance System data.Overall, the HIV transmission rate was 3.5 per 100 person-years in 2016. Along the HIV continuum of care, the transmission rates from persons who were 1) acutely infected and unaware of their infection, 2) non-acutely infected and unaware, 3) aware of HIV infection but not in care, 4) receiving HIV care but not virally suppressed, and 5) taking ART and virally suppressed were 16.1, 8.4, 6.6, 6.1, and 0 per 100 person-years, respectively. The percentages of all transmissions generated by each group were 4.0%, 33.6%, 42.6%, 19.8%, and 0%, respectively.Approximately 80% of new HIV transmissions are from persons who do not know they have HIV infection or are not receiving regular care. Going forward, increasing the percentage of persons with HIV infection who have achieved viral suppression and do not transmit HIV will be critical for ending the HIV epidemic in the United States.