tbuckley/cabot-search huggingface dataset:
Role of an extended pathology exam in risk classification of testicular germ cell tumors (GCTs).
Authors: Mihai Vasile Marinca, Irina Draga Caruntu, Ludmila Liliac, Simona Eliza Giusca, Andreea Marinca, Lucian Miron
Journal: Journal of Clinical Oncology (2012)

e15032 Background: The 1997 IGCCCG Consensus classification provides clinicians with enough information to efficiently choose between treatment options for most GCT patients. Nevertheless, therapy is ineffective in 5-10% of cases (even more in less developed countries), and about the same numbers experience severe side effects. This exploratory study aims to assess the impact of more rigorous and detailed pathology examination on improving the assignation of these patients to prognostic groups and, consequently, making optimal therapeutic decisions. Methods: Predefined features were reviewed on histology slides from 39 GCT patients followed-up for a median of 48.28 months. We designed a uniform pathology protocol, focused on identifying potential new prognostic factors. Categorical and continuous variables were quantified using light microscopy and computer-aided morphometry and, due to the small sample size, their statistical correlation was analyzed by exact tests and Spearman’s rho, respectively. Significant (2-sided p-value &lt;0.05, under sample size reserve) coefficient values were entered in hierarchical cluster analysis (HCA). Results: Favorable IGCCCG group, presence of seminoma, glandular tissue pattern, presence and histoarchitecture of lymphocytic infiltrate associated better survival rates and lower risk of progression. Invasion of the epididymis and spermatic cord, presence of teratoma, choriocarcinoma and yolk-sac elements, papillary pattern and cell pleomorphism predicted poorer outcomes. HCA yielded 2 significantly distinct patient groups in terms of overall survival (p=0.018) and time to progression (p=0.080), but not disease-free survival (p=0.614). Conclusions: Quantification of tumor subtypes and other histology features of GCTs (e.g. necrosis, tissue patterns, inflammation) is feasible and, if standardized, may prove useful in optimal selection of risk groups, when performed by an experienced pathologist.
Annals Consult Guys - Palpitations and Sleep Apnea
Authors: Geno J. Merli, Howard H. Weitz
Journal: Annals of Internal Medicine (2020)

Web Exclusives17 March 2020Annals Consult Guys - Palpitations and Sleep ApneaFREEGeno J. Merli, MD and Howard H. Weitz, MDGeno J. Merli, MDThomas Jefferson University, Philadelphia, Pennsylvania (G.J.M., H.H.W.)Search for more papers by this author and Howard H. Weitz, MDThomas Jefferson University, Philadelphia, Pennsylvania (G.J.M., H.H.W.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/W19-0036 CME/MOC SectionsSupplemental MaterialAboutVisual Abstract ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Annals Consult Guys brings a new perspective to the art and science of medicine with lively discussion and analysis of real-world cases and situations. They address medically relevant topics—whether they be poignant, thought-provoking, or just plain entertaining.For more videos from and information on Annals Consult Guys, visit go.annals.org/ConsultGuys. Comments0 CommentsSign In to Submit A Comment Burton AbramsNo institutional affiliation17 March 2020 Elapsed time to restore heart rhythm Dr. Bravri's statement that if the patient does have sleep apnea (SA), his heart rhythm abnormalities would certainly disappear after resolution of his SA omits something very important, ie, how long after resolution of the SA will the heart rhythm abnormality disappear. One night, one week, one month, one year? If cardiac remodeling is involved, it could take many months. Author, Article, and Disclosure InformationAffiliations: Thomas Jefferson University, Philadelphia, Pennsylvania (G.J.M., H.H.W.)Disclosures: Geno J. Merli, MD, and Howard H. Weitz, MD, report that they have no financial relationships or interests to disclose.Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that her spouse has stock options/holdings with Targeted Diagnostics and Therapeutics. Darren B. Taichman, MD, PhD, Executive Editor, reports that he has no financial relationships or interests to disclose. Cynthia D. Mulrow, MD, MSc, Senior Deputy Editor, reports that she has no relationships or interests to disclose. Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Christina C. Wee, MD, MPH, Deputy Editor, reports employment with Beth Israel Deaconess Medical Center. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Yu-Xiao Yang, MD, MSCE, Deputy Editor, reports that he has no financial relationships or interest to disclose. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 17 March 2020Volume 172, Issue 6Page: CG1KeywordsDiagnostic techniquesDisclosureSleep apnea ePublished: 17 March 2020 Issue Published: 17 March 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.Loading ...
BEHAVIORAL RISK FACTORS AND PREMATURE ATHEROSCLEROTIC CARDIOVASCULAR DISEASE: AN ANALYSIS FROM THE VITAL (VETERANS WITH PREMATURE ATHEROSCLEROSIS) REGISTRY
Authors: Dhruv Mahtta, David Ramsey, Mahmoud Al Rifai, Khurram Nasir, Zainab Samad, Christie M. Ballantyne, Laura Petersen, Salim Virani
Journal: Journal of the American College of Cardiology (2020)
Existence of reprogrammed lymphoma stem cells in a murine ALCL-like model
Authors: Stefanie Kreutmair, Cathrin Klingeberg, Teresa Poggio, Geoffroy Andrieux, Alexander Keller, Cornelius Miething, Marie Follo, Dietmar Pfeifer, Khalid Shoumariyeh, Claudia Lengerke, Irene Gonzalez-Menendez, Falko Fend, Robert Zeiser, Suzanne D. Turner, Leticia Quintanilla-Martinez, Melanie Boerries, Justus Duyster, Anna L. Illert
Journal: Leukemia (2020)
Psychophysical functioning and quality of life in 94 patients affected by oropharyngeal cancer and treated with different therapeutic approaches.
Authors: Fulvia Pedani, Mario Airoldi, Massimiliano Garzaro, Riccardo Torta, Luca Raimondo, Giuseppe Riva, Antonella Varetto, Elisa Bellini, Laura Salonia, Giancarlo Pecorari
Journal: Journal of Clinical Oncology (2013)

6039 Background: The treatment of oropharyngeal squamous cell carcinomas (OSCC) may heavily affect patient’s quality of life (QoL). Aim of our study was the evaluation of the impact of different treatments on physical and psychological functioning and on QoL of patients affected by stage III-IV disease. Methods: The enrolled sample was composed by 94 OSCC patients divided into 3 subgroups based on treatment modalities: surgery + adjuvant radiotherapy (S + RT: 30 patients), exclusive concomitant chemo-radiotherapy (CT + RT: 30 patients) and exclusive chemotherapy (CT) in 34 patients not suitable for surgery and/or radiotherapy. Psycho-oncological assessment included: Hospital Anxiety Depression Scale (HADS), Montgomery-Asberg Depression Scale (MADRS), Mini-Mental Adjustment to Cancer scale (MINI-MAC), EORTC QLQ C-30 questionnaire with the specific module Head and Neck 35 (H&amp;N35). Results: The 60 patients primarily treated with S + RT or CT + RT presented superimposeable clinical and tumour characteristics while those treated with exclusive CT were affected by stage IV disease and in the 90% of cases underwent to previous treatment exclusive or combined treatment such as surgery, radiotherapy and chemotherapy. In the following table, data about physical and psychological functioning and on QoL of the 3 subgroups of patients are summarized. Conclusions: In stage III-IV OSCC treatments have a strong influence on QoL and coping styles. Patients treated with CT + RT were characterized by a lower percentage of self-reported anxiety and depression and higher EORTC Global QoL score. More than one third of patients treated with S + RT had overt symptoms of anxiety and depression. Stage IV patients treated with palliative CT had elevated level of anxiety, depression and low quality of life. Auto-evaluation is less effective in depression assessment. The role of concomitant psychological supportive care should be evaluated in these patients treated with different approaches. [Table: see text]
Lymphatic mapping and parametrial lymph nodes identification in patients with early stage cervical cancer
Authors: B. Li, L. Wu, X. Li, X. Zhang, W. Zhang, J. Gao
Journal: Journal of Clinical Oncology (2006)

5050 Background: The purpose of this study was to determine the presence, distribution, and metastasis incidence of parametrial lymph nodes (PLN) of patients with cervical cancer, and to investigate the role of lymphatic mapping and topographic section in PLN identification. Methods: Sixty patients with early stage (Ib∼IIa) cervical cancer undergoing radical hysterectomy and pelvic lymphadenectomy were included in the study. Before surgery 4 ml methylene was injected into the cervix around the tumor. The blue-dyed lymph nodes were identified as sentinel lymph nodes (SLN) during operation. An immediate topographic section on uterine specimen was performed to separate the PLNs from parametria for pathologic examination. Results: Ninety five PLNs were presented in 38 (63.3%) of 60 specimens, with a mean size in diameter as (0.67±0.24)cm, and 57 (60.0%) of PLNs were located parallel to the uterine artery through the entire broad ligament. After lymphatic mapping, 69 (72.6%) of PLNs was dyed and found out as SLNs. Parametrial metastasis was found in 12 (20.0%) patients, and parametrium was the only site containing positive nodes in 2 patients with parametrial metastasis. On routine pathologic evaluation, 17 PLNs were found to be positive. Among the remaining 78 PLNs, multilevel sectioning in conjunction with immunohistochemical analysis was carried out and identified 3 other PLNs containing micrometastases. Conclusions: The study showed that PLNs were often found in the parametria, and these nodes often contained metastatic diseases, which were often overlooked. Lymphatic mapping followed by meticulous topographic section is feasible in PLN identification in patients with cervical cancer. No significant financial relationships to disclose.
The impact of estrogen receptor (ER), progesterone receptor (PR), and HER-2 receptor status on treatment of patients with advanced breast cancer.
Authors: Paramjot Bains, Erin Diana Powell
Journal: Journal of Clinical Oncology (2013)

e11580 Background: There are many variables that affect treatment options and outcomes in advanced breast cancer. The expression of ER, PR and HER2 are key in determining prognosis and management. The traditional management of breast cancer did not involve biopsy of metastatic sites. Recent studies indicate that, in a significant number of patients, there is a change in receptor status in the metastasis, and this may alter treatment. There have been many retrospective studies looking at the change in the ER/PR status of the metastatic site. Change in treatment as a result has been less of a focus. Our objective is to document the likelihood of a change in receptor status and the impact of this on treatment. Methods: This is a single center retrospective chart review. Ethics approval has been obtained through Memorial Univeristy of Newfoundland. The Dr. H. Bliss Murphy Cancer Centre database was used to identify 250 patients in Newfoundland who were diagnosed with metastatic breast cancer between January 2006 and November 2011. The review includes patients diagnosed with de novo metastases and those who developed metastases following adjuvant treatment. The information we are collecting includes ER, PR, and HER2 status of original tumour, whether metastases were biopsied and the results of the biopsy. We are also documenting all treatments administered. Results: The percentage of patients who underwent biopsy of metastases, the likelihood of change in receptor status and the likelihood of change in treatment will be calculated. Approximately half of the charts that met our criteria have been reviewed. Of those 125 patients, 35 had a biopsy specimen analyzed for ER/PR and HER2 status. 6 of these 35 patients had a change in their hormone receptor status, and 3 had a change in their HER2 status. The likelihood of change in treatment recommendations will be determined once all the data have been reviewed. These results will be available for the 2013 ASCO meeting. Conclusions: ER, PR and HER2 status may change from initial diagnosis of breast cancer to metastatic disease. This has important implications for treatment and prognosis, suggesting that biopsy of metastatic sites should be routine.
SUDDEN CARDIAC ARREST COMPLICATING ANOMALOUS RIGHT CORONARY ARTERY IN AN ATHLETE
Authors: Mayank Yadav, Carlos Gongora, Saman Setareh-Shenas, Glenmore Lasam, Manoj Bhandari, Jonathan N. Bella, Jacqueline Tamis-Holland, Matthew Tomey
Journal: Journal of the American College of Cardiology (2020)
Abstract ES4-3: The genomic landscape of endocrine-resistant metastatic breast cancer
Authors: P Razavi
Journal: Cancer Research (2020)

Abstract Recent efforts to characterize the genomes of metastatic breast cancers hold promise for understanding the evolution of the disease through comparative analyses with primary breast cancers. However, these analyses have proven challenging due to the number of differences including differences in tumor representation and spatial tumor heterogeneity resulting in less accurate representation of metastatic disease, and temporal heterogeneity often due to the selective pressures of treatments, all of which may independently alter the ongoing natural evolution of the tumor containing disrupted DNA and/or DNA repair processes. Advances in genomic analyses and large repositories of samples with detailed clinical annotation have enabled rational deconvolution of these datasets, revealing novel insights into the unique drivers shaping advanced and lethal disease. In particular, large cohorts of patients with exposure to therapy with hormonal therapy has enabled the identification of specific genomic alterations that can promote resistance to hormonal therapy. This classification of genomic mechanisms of endocrine resistance has helped uncover the forces that shape the hormone dependence of ER+ breast cancer while also identifying new therapeutic targets with the promise to treat or even prevent endocrine resistant disease. In this presentation, we will review the genomic features of endocrine resistance metastatic breast cancer, detail evidence for (or against) specific alterations as likely mechanisms of resistance to endocrine therapy and describe next steps for clinical utilization of genomic information for the management of this disease. Citation Format: P Razavi. The genomic landscape of endocrine-resistant metastatic breast cancer [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr ES4-3.
Abstract #1514: BRCA1 orchestrates a novel molecular interplay at the BRCA1 and GADD153 promoters to regulate transcriptional responses to DNA damage
Authors: Paola De Luca, Elba Vazquez, Cristian Moiola, Geraldine Gueron, Florencia Zalazar, Kevin Gardner, Adriana De Siervi
Journal: Cancer Research (2009)

The BRCA1 gene product plays numerous roles in regulating genome integrity. It interacts with crucial proteins and is considered a gene-specific transcriptional co-regulator; however, BRCA1 role in the transcriptional response to DNA damage is poorly understood. By chromatin immunoprecipitation and genome arrays technology (ChIP-chip) we recently determined that BRCA1 is highly enriched at the BRCA1 promoter in cancer cells where it negative influences BRCA1 transcription. Following exposure to genotoxic agents, BRCA1 is released from it own promoter in order to be recruited to other genes or sites of DNA damage, as GADD153 (growth arrest and DNA damage gene). In this study, using Tandem ChIP, we show that the mechanism underlying BRCA1 auto-regulation involves the E2F1 transcription factor. BRCA1 release from its own promoter is accompanied by a reciprocal increase in its occupancy at the GADD153 promoter and an increase in GADD153 transcription. This transcriptional interplay is associated with increases in both BRCA1 and GADD153 transcription and GADD153-mediated apoptosis. Enforced BRCA1 expression enhances GADD153 mediate transcription and BRCA1 depletion silences both active BRCA1 transcription and GADD153 expression. These results describe a novel molecular interplay where BRCA1 and GADD153 show coordinate upregulation through rapid promoter exchange of BRCA1 protein in response to genotoxic stress.  Citation Information: In: Proc Am Assoc Cancer Res; 2009 Apr 18-22; Denver, CO. Philadelphia (PA): AACR; 2009. Abstract nr 1514.
Sequential radioimmunotherapy with tositumomab/Iodine I131 tositumomab followed by CHOP for mantle cell lymphoma demonstrates RIT can induce molecular remissions
Authors: A. D. Zelenetz, A. Noy, N. Pandit-Taskar, M. Scordo, I. Rijo, Y. Zhou, J. A. O’Donoghue, C. Divgi
Journal: Journal of Clinical Oncology (2006)

7560 Background: Mantle cell lymphoma remains a clinical challenge particularly for pts not candidates for consolidation with ASCT or treatment with leukemia induction regimens. Methods: We investigated sequential radioimmunotherapy (RIT) cytoreduction with tositumomab/Iodine I131 tositumomab followed by CHOP chemotherapy as initial therapy for patients either ineligible for or unwilling to undergo high dose therapy and stem cell transplantation. In addition, pts had to have less than 25% of the intratrabecular bone marrow space involved with lymphoma. Results: Twenty-five patients (pts) were enrolled but only 24 were treated with the therapeutic dose of RIT because a manufacturing problem prevented the treatment of one patient. The median age was 66 (45–80), there were 23 men and 2 women. All patients had advanced stage (III/IV) disease and bone marrow was involved in 48% and the GI tract was involved in 48% of the patients. The overall response rate (ORR) to RIT was 83% (CR/CRu 46%; PR 38%). Two pts withdrew consent following the RIT (and are censored from that point); 1 pt with disease progression requiring alternative therapy is included in EFS and OS analyses. Twenty-one pts proceeded to the CHOP consolidation and 19 completed planned therapy (1 pt died of a CVA; 1 pt chose not to complete chemotherapy after two cycles of CHOP). At the completion of delivered therapy the ORR was 86% (CR/CRu 67%, PR 19%). The median follow up is 2.1 years (0.7 to 4.2). The median EFS was 1.4 years though there have been no events beyond 1.7 years with 7 pts at risk; median OS has not been reached (92% at 2.1 years). Minimal residual disease (MRD) was evaluated with a clonotypic PCR (cPCR) capable of detecting about 1:10 5 tumor cells; this assay was informative in 17 pts. Following induction with RIT 6 pts (46%) were molecularly negative in blood and bone marrow. Despite the increase in clinical CR following CHOP consolidation, no additional pts became molecularly negative. Conclusions: RIT with tositumomab/iodine I131 tositumomab is a very active agent in the treatment of MCL; unfortunately, MRD is not effectively eliminated by subsequent CHOP chemotherapy. We are planning to explore chemotherapy induction followed by RIT. [Table: see text]
The effect of continuing therapy for more than one course and CRP level on PFS and OS in the general practice of sunitinib therapy in Japanese patients with metastatic renal cancer.
Authors: Hitoshi Takayama, Atsunari Kawashima, Yasuyuki Arai, Mikio Nin, Go Tanigawa, Yutaka Yasunaga, Hironori Nomura, Masatoshi Mukai, Toshiaki Yoshioka, Motohide Uemura, Yasutomo Nakai, Kazuo Nishimura, Akira Tsujimura, Norio Nonomura
Journal: Journal of Clinical Oncology (2012)

e15069 Background: Sunitinib is a multikinase inhibitor used as first- and second-line treatment of metastatic renal cell carcinoma (mRCC). However, there are few reports on the efficacy and adverse events (AE) profile of sunitinib in general practice with Japanese patients. We examined clinical outcomes of sunitinib therapy in a multi-institutional study. Methods: A study population of 98 mRCC patients was eligible for this investigation. Clinical outcomes were evaluated according to clinical features and duration of therapy. Results: he most frequent grade 3/4 laboratory AE were decreased platelet (30.6%) and white blood cell (20.4%) counts. Treatment was discontinued in 20 patients (32.8%) initially receiving a 50-mg/day dose within only one course, and only 2 patients (3.3%) who were initially medicated with 50 mg/day could continue this oral dose. Median PFS time was 2.3 months in patients treated for only one course and 10.8 months in patients treated for more than one course (P &lt; 0.0001). Multivariate analysis showed that duration of treatment, regardless of initial sunitinib dose (50 mg/day or &lt;50 mg/day) was significantly associated with both PFS (HR: 0.120, 95% CI: 0.049-0.294, P &lt; 0.001) and OS (HR: 0.196, 95% CI: 0.082-0.472, P &lt; 0.001). Moreover, C-reactive protein level was significantly associated with PFS and OS times. Conclusions: Sunitinib therapy of 50 mg/day might be an overdose in Japanese patients. Continuing therapy for more than one course and CRP level were very important in the prolongation of PFS and OS times.
CORRELATION OF AVERAGE 4D-CT BASED STRAIN ASSESSMENT (SQUEEZ) WITH GLOBAL LONGITUDINAL STRAIN BY ECHOCARDIOGRAPHY IN INDIVIDUALS WITH SEVERE AORTIC STENOSIS
Authors: Christopher Smitson, Anthony DeMaria, Sachiyo Igata, Gabrielle Colvert, Francisco Contijoch, Ehtisham Mahmud, Ryan Reeves, Elliot McVeigh
Journal: Journal of the American College of Cardiology (2020)
CARDIAC PET GUIDED IMMUNOSUPPRESSION THERAPY IN THE TREATMENT OF CARDIAC SARCOIDOSIS
Authors: Clark Yarber, Mark Travin, Peter Vlismas, Omar Saeed, Sandhya Murthy, Patricia Chavez, Sasa Vukelic, Snehal Patel, Jooyoung Shin, Ulrich Jorde, Daniel Sims
Journal: Journal of the American College of Cardiology (2020)
LONG-TERM ABLATION OUTCOME IN PATIENTS WITH COEXISTENT DIABETES AND ATRIAL FIBRILLATION TREATED WITH INSULIN, ORAL ANTIDIABETIC AGENTS OR LIFE-STYLE CHANGE FOR GLYCAEMIA-CONTROL
Authors: Sanghamitra Mohanty, Alisara Anannab, Chintan Trivedi, Domenico Della Rocca, Carola Gianni, Anu Salwan, Bryan Macdonald, Angel Mayedo, John Burkhardt, Gerald Gallinghouse, Amin Al-Ahmad, Rodney Horton, Andrea Natale
Journal: Journal of the American College of Cardiology (2020)