tbuckley/cabot-search huggingface dataset:
Comparison of treatment patterns, health care utilization, and direct costs in elderly patients with distant-stage small cell lung cancer (SCLC) versus non-small cell lung cancer (NSCLC) using the SEER-Medicare database.
Authors: Sudeep Karve, Gregory Price, Keith L. Davis, Gerhardt Pohl, Emily Nash Smyth
Journal: Journal of Clinical Oncology (2012)

7101 Background: Limited data exist on real-world treatment patterns, healthcare utilization, and associated costs of advanced SCLC among elderly patients in the US, and there are no recent comparisons between patients with advanced SCLC and advanced NSCLC. Methods: We retrospectively analyzed administrative claims data for elderly patients (≥65 years) from the linked Surveillance, Epidemiology and End Results (SEER)-Medicare database for 2000-2008. Patients with a new diagnosis of distant stage lung cancer receiving cancer-directed therapy (ie, surgery, radiation, biologics, and/or chemotherapy) were grouped by tumor type (SCLC [n=5,855] vs NSCLC [n=24,090]). Survival was compared using Kaplan-Meier Log-rank; categorical measures with Chi-square statistics; and continuous measures with t-tests. Results: Compared to SCLC patients, a significantly greater proportion of patients with NSCLC received radiation therapy (75.6% vs 65.4%; p&lt;0.001) and surgery (13.6% vs 7.8%; p&lt;0.001). Chemotherapy was received by 85.5% of SCLC patients and 60.3% of NSCLC patients (p&lt;0.001). Significantly higher proportions of SCLC patients also received red blood cell (20.7% vs 10.9; p&lt;0.001) and platelet transfusions (5.6% vs 1.8%; p&lt;0.001) as well as growth factor support (58.9% vs 39.5%; p&lt;0.001). Survival did not differ significantly between groups (p=0.424), with the mean (10.4 months vs 11.1 months) and median (7.4 months vs 5.9 months) survival for SCLC and NSCLC noted accordingly. Total lifetime lung cancer-related costs ($44,167 vs $37,932; p&lt;0.001) and all-cause costs ($70,548 vs $67,175; p&lt;0.001) per patient for SCLC exceeded those for NSCLC. The primary drivers of cost included resource utilization across 3 care settings: hospitalizations, office visits, and hospital outpatient visits. Conclusions: Overall total lifetime and disease-related costs per advanced SCLC and NSCLC patient were high, and costs for SCLC exceeded those for NSCLC. Survival estimates coupled with per patient costs for both cancers underscores the unmet medical need for patients with distant stage SCLC and NSCLC.
CHARACTERISTICS AND OUTCOMES OF MARFAN PATIENTS WITH NONISCHEMIC CARDIOMYOPATHY
Authors: Arooj R. Khan, Erika Hutt, Jean-Pierre Iskandar, Divyang Patel, Anirudh Kumar, Jose Aguilera, Kevin Chen, Brian P. Griffin, Eric Roselli, Chadi Ayoub, Milind Y. Desai, Vidyasagar Kalahasti, Lars G. Svensson
Journal: Journal of the American College of Cardiology (2020)
Retrospective study of febrile neutropenia.
Authors: Nieves Martinez Lago, Maria Vieito, Urbano Anido, Sonia Candamio, Rafael Lopez, Francisco J. Barón, Yolanda Vidal, Santiago Aguin Losada, Marta Carmona Campos, Carmela Rodriguez Lopez, Luis Leon, Rafael Varela Ponte
Journal: Journal of Clinical Oncology (2012)

e19505 Background: Although its mortality has decreased in the last years, neutropenic fever is still one of the most important oncological emergencies. Methods: We have assessed the epidemiological data on patients admitted or evaluated for neutropenic sepsis in a third level cancer center from January 2009 to December 2010. Results: We have found 68 patients who had at least one episode of febrile neutropenia, of them 66% were male and 34% female, and the mean age was 59 years. The performance status was 0 and 1 in 80% of patients and only 19% percent had serious comorbilities such as renal dysfunction, cirrhosis, diabetes mellitus or chronic pulmonary disease. 36% of our patients had a high risk neutropenic fever per MASCC criteria. The majority of patients were lung cancer (31%) breast cancer (22%); and gastrointestinal cancer (28%) and 53% where treated with palliative intention. The episodes of febrile neutropenia were more frequent in patients in first line of treatment (72%) and first cycle of any treatment (42%). 8% of patients were treated with chemorradiation and 35% of the patients were receiving prophylaxis with GCSF. There was no found the source of the infection in 45% of patients. 25% had positive cultures. The porcetaje of infections with gram-positive and-negative was very similar. Patients were treated with a combination of amikacine and ceftacidime in 63% of times, further addition of vancomicine or antifungical therapies were only needed in minority of patients, 88% percent of patients received granulocyte stimulating factors. The mean duration of the neutropenia was of 2 days. Following chemotherapy treatment doses were reduced in 44% of patients and delayed in 26%. Thirteen percent of patients received secondary prophylaxis with GCSF, treatment regimen changed was changed in only 2% of patients and 29% received no further treatment. Conclusions: The mortality rate was of 3%, and the time of hospitalization was short (mean of 7 days). Febrile neutropenia remains a serious complication that we have to decrease.
HSR20-082: Use of the NCCN Distress Thermometer to Identify and Address Distress During a Telemedicine Visit With Rural Head and Neck Cancer Survivors
Authors: Pam Baker DeGuzman, Veronica Bernacchi, C. Allen Cupp, B. J. Ferrebee Ghamandi, Ivora D. Hinton, Mark J. Jameson, Debra Lynn Lewandowski, Christi Sheffield
Journal: Journal of the National Comprehensive Cancer Network (2020)

"HSR20-082: Use of the NCCN Distress Thermometer to Identify and Address Distress During a Telemedicine Visit With Rural Head and Neck Cancer Survivors" published on 20 Mar 2020 by National Comprehensive Cancer Network.
Retrospective analysis of gefitinib versus docetaxel in never-smoking patients with previously treated non-small-cell lung cancer (NSCLC)
Authors: Y. Kogure, S. Ueda, Y. Nakamura, M. Ebisawa, G. Asai, T. Takahashi, N. Yamamoto
Journal: Journal of Clinical Oncology (2006)

17154 Background: Docetaxel has been standard for second line treatment of NSCLC. In ISEL study, subgroup analyses showed significantly longer survival in the gefitinib group than the placebo group for never-smokers and Asians. It is not clear whether gefitinib has the clinical advantage in these selected patients with NSCLC. We aimed to compare the clinical benefit of gefitinib with that of docetaxel in never smoker previously treated with chemotherapy, retrospectively. Methods: We reviewed patients from August 2002 to September 2005 in Shizuoka Cancer Center. Patients with following conditions were analyzed: NSCLC, received gefitinib or docetaxel, never-smoker, not chemo-naived. We assessed the response rate, progression free survival (PFS) and over all survival for gefitinib and docetaxel respectively. Survival curves were calculated using the Kaplan Meier-method. Prognostic factors were estimated using multivariate analysis. Results: 108 patinets were selected. 69 patients were treated with gefitinib and 39 patients were treated with docetaxel. 28 patients overlapped each other. The patients treated with gefitinib following docetaxel and those with docetaxel following gefitinib were 17 and 13, respectively. 69 patients with gefitinib: the median age, 62 years (31–79); stage IIIB/IV, 14/55; ad/sq/ others, 61/3/5; PS 0/1/2/3, 19/35/13/2; prior therapy containing platinum regimen, 58. The response rate was 36%. 39 patients with docetaxel: the median age, 63 years (31–76); stage IIIB/IV, 8/31; ad/sq/others, 29/7/3; PS 0/1/2/3, 18/19/1/1; prior therapy containing platinum regimen, 34. The response rate was 10%. Gefitinib was superior in longer median PFS (148 days vs 43 days, p = 0.0002). Over all survivals were not significant between two arms. In multivariate analysis for PFS, following factors were significant: gefitinib therapy (hazard ratio 0.375, p = 0.0002); male (hazard ratio 1.854, p = 0.0011); good performance status (hazard ratio 0.450, p = 0.0057). Conclusions: Our results suggested that gefitinib therapy is very attractive for never smoker in the point of PFS. Many patients received cross-over therapies made difficult to analyze over all survival. No significant financial relationships to disclose.
THE IMPACT OF ECONOMIC DISPARITIES ON THE USE OF THE WEARABLE CARDIOVERTER-DEFIBRILLATOR IN PATIENTS POST MYOCARDIAL INFARCTION WITH A REDUCED EJECTION FRACTION
Authors: Jelani Kayode Grant, Rhea Patil, Colin Mackenzie, Gilson Fernandes, Rosario Colombo, Rhea Sancassani
Journal: Journal of the American College of Cardiology (2020)
DIFFERENTIAL EFFECTS OF TOBACCO CIGARETTES AND ELECTRONIC CIGARETTES ON ENDOTHELIAL FUNCTION
Authors: Holly R. Middlekauff, Kacey P. Haptonstall, Yasmine Choroomi, Roya Moheimani, Kevin Nguyen, Elizabeth Tran, Karishma Lakhani, Isabelle Ruedisueli, Jeffrey Gornbein
Journal: Journal of the American College of Cardiology (2020)
A randomized, multicenter, open phase II study of cetuximab with docetaxel, cisplatin as induction chemotherapy in unresectable, locally advanced head and neck squamous cell carcinoma (LA-HNSCC).
Authors: Youngil Koh, Keun-Wook Lee, Sung-Bae Kim, Kyong Hwa Park, Sang Won Shin, Jin Hyoung Kang, Bhumsuk Keam, Se-Hoon Lee, Dae Seog Heo
Journal: Journal of Clinical Oncology (2013)

6069 Background: In this randomized phase II trial, we investigated the efficacy and safety of cetuximab in induction chemotherapy and followed by concurrent chemoradiotherapy (CCRT) in LA-HNSCC. Methods: Patients were randomized to receive 3 cycles of docetaxel (75 mg/m 2 ) and cisplatin (75 mg/mg 2 ) every 3 weeks with or without cetuximab (CDP vs. DP). CCRT was given as a definitive treatment. Patients in CDP arm received CCRT with weekly cetuximab (250 mg/m 2 ) and cisplatin (30 mg/m 2 ), while patients in DP arm received CCRT with weekly cisplatin. Primary endpoint was objective response rate (ORR) after induction chemotherapy. Results: 92 patients were randomized to receive either CDP (48) or DP (44). The median age was 59 years (range 29 – 73 years). The location of primary disease included oropharynx (41), hypopharynx (24), larynx (13) and oral cavity (14). 40 of the 48 patients in CDP arm and 40 of the 44 patients in DP arm completed 3 cycles of chemotherapy. Reason for incompletion in CDP arm included hypersensitivity (1), septic shock (1), skin rash (1), seizure (1), arterial thrombosis (1), unexplained death (1), unsatisfactory response (1), and withdrawal of informed consent (1). ORR to chemotherapy in CDP arm and DP arm was 81% (4 CR and 35 PR) and 82% (4 CR and 32 PR), respectively. 3 patients were not evaluable for response in CDP arm due to unexplained early death (1), septic shock (1), and hypersensitivity reaction after the first dose of cetuximab (1). CCRT completion rate after the completion of CDP and DP was 80% and 85%, respectively. Median PFS and OS were not reached in either arm, with a median follow-up time of 33 months. CDP arm showed 70% and 88% of PFS and OS rate, while DP arm showed 56% and 74% of PFS and OS at 3 years, when intend-to-treat analysis was performed. If we limited to the patients who received 3 cycles of CDP or DP, we saw 78% and 59% of 3-year PFS rate, respectively and 94% and 73% of 3-year OS rate, respectively. Conclusions: Addition of cetuximab during induction and CCRT phase may compromise completion rate of 3 cycles of induction chemotherapy but does not compromise completion of CCRT and shows promising survival data. Clinical trial information: NCT00623558.
GRADE 3 PYROPHOSPHATE SCAN WITH VAL122ILE MUTATION AND NEGATIVE ENDOMYOCARDIAL BIOPSY: A CLINICAL, DIAGNOSTIC AND THERAPEUTIC CONUNDRUM
Authors: Raul A. Garcia, Sadeer Al-Kindi, Babbaljeet Kaur, Safwan Gaznabi, Omar M. Siddiqui, Maria Martinelli, Mary Okorn, Miroslav Sekulic, Oliveira H. Guilherme
Journal: Journal of the American College of Cardiology (2020)
PATENT FORAMEN OVALE SHUNT DIRECTION PREDICTS STROKE OUTCOME IN PATIENTS WITH NON-VALVULAR ATRIAL FIBRILLATION
Authors: Rowlens Melduni, Bernard J. Gersh, Waldemar E. Wysokinski, Zhenzhen Wang, Eddie L. Greene, Jae K. Oh, Hon-Chi Lee
Journal: Journal of the American College of Cardiology (2020)
Inflammatory and nutritional markers as predictors of longer hospital stay and suboptimal residual disease (RD) in ovarian cancer (OVCA).
Authors: Michelle Torres, Lynn C. Hartmann, William Cliby, Kimberly Kalli, Aminah Jatoi, Amy Weaver, Matthew Stephen Block, Andrea Mariani
Journal: Journal of Clinical Oncology (2012)

5076 Background: Advanced OVCA should be managed aggressively, and extensive surgery has been the most accepted initial treatment. Medically unfit patients or those with extensive disease, in which complete cytoreduction is unlikely, may not benefit from upfront radical surgery, and neoadjuvant chemotherapy might be an appropriate alternative. Thus, reliable preoperative indicators of surgical outcome are necessary for considering primary surgery vs. neoadjuvant chemotherapy. Our aim is to determine if C-reactive protein (CRP), IL-6, albumin and Glasgow Prognostic Score (GPS – score based on CRP and albumin) correlate with overall survival (OS), length of hospital stay (LOS), surgical morbidity, and suboptimal cytoreduction. Methods: We randomly selected 50 stages III/IV OVCA who underwent surgery as a primary treatment between July 2002 and June 2009 at Mayo Clinic with serum albumin levels and frozen serum available. CRP and IL-6 were measured in stored serum. Univariate and multivariate regression models were fit to evaluate associations with each of the outcomes. Results: Among the 50 patients, the mean age was 67.7 years. 34% had pretreatment albumin &lt;3.5 g/ml, 22.4% had CRP level ≥10 mg/l, 26.5% had IL-6 ≥24 pg/ml and 45% had abnormal GPS score. At 1, 3 and 5 years following surgery, the OS was 75.6%, 49.8% and 36.9%, respectively. RD (0, &lt;1, ≥1cm; p&lt;0.001) was the only independent predictor of OS. Also, IL-6 (p=0.028) and stage (p=0.046) were independently associated with LOS, but no inflammatory or nutritional markers were significant associated with post surgical complications. Stage IV (p=0.019) and elevated CRP (p=0.044) were independent predictors of suboptimal surgery (RD ≥ 1cm). Conclusions: One-third of the patients in our series had low serum albumin at the time of the OVCA diagnosis, and at least one-fourth had elevated inflammatory markers. Advanced stage and elevated inflammatory markers (CRP and IL-6) were independent predictors of longer hospital stay and suboptimal debulking. These pilot data, if confirmed in a larger population, may help in the selection of candidates for neoadjuvant chemotherapy.
The CCND1 c.870G risk allele is enriched in individuals of African ancestry with plasma cell dyscrasias
Authors: Linda B. Baughn, Zhuo Li, Kathryn Pearce, Celine M. Vachon, Mei-Yin Polley, Jonathan Keats, Eran Elhaik, Michael Baird, Terry Therneau, James R. Cerhan, P. Leif Bergsagel, Angela Dispenzieri, S. Vincent Rajkumar, Yan W. Asmann, Shaji Kumar
Journal: Blood Cancer Journal (2020)
AORTIC VALVE MYXOMA: A SYSTEMATIC REVIEW OF PUBLISHED CASES
Authors: Sofia Shamim, Rupak Desai, Sonali Sachdeva, Bishoy Hanna, Pooja Patel, Nazia Farheen, Samarthkumar Thakkar, Rajesh Sachdeva, Gautam Kumar
Journal: Journal of the American College of Cardiology (2020)
A soluble phosphorylated tau signature links tau, amyloid and the evolution of stages of dominantly inherited Alzheimer’s disease
Authors: Nicolas R. Barthélemy, Yan Li, Nelly Joseph-Mathurin, Brian A. Gordon, Jason Hassenstab, Tammie. L. S. Benzinger, Virginia Buckles, Anne M. Fagan, Richard J. Perrin, Alison M. Goate, John C. Morris, Celeste M. Karch, Chengjie Xiong, Ricardo Allegri, Patricio Chrem Mendez, Sarah B. Berman, Takeshi Ikeuchi, Hiroshi Mori, Hiroyuki Shimada, Mikio Shoji, Kazushi Suzuki, James Noble, Martin Farlow, Jasmeer Chhatwal, Neill R. Graff-Radford, Stephen Salloway, Peter R. Schofield, Colin L. Masters, Ralph N. Martins, Antoinette O’Connor, Nick C. Fox, Johannes Levin, Mathias Jucker, Audrey Gabelle, Sylvain Lehmann, Chihiro Sato, Randall J. Bateman, Eric McDade
Journal: Nature Medicine (2020)
PATHOLOGY OF CORONARY ARTERY AFTER THIRD-GENERATION DRUG-ELUTING STENT IMPLANTATION IN ATHEROSCLEROTIC PORCINE MODEL AND HUMAN AUTOPSY CASES
Authors: Suguru Migita, Daisuke Kitano, Yuxin Li, Sayaka Yamada, Kumiko Asakura, Toshio Mukaiyama, Akira Onishi, Daiichiro Fuchimoto, Shunichi Suzuki, Yoshiyuki Nakamura, Yasuo Okumura, Hiroyuki Hao
Journal: Journal of the American College of Cardiology (2020)
IMPACT OF SOCIOECONOMIC DISPARITIES ON PATIENT OUTCOMES FOLLOWING TRANSCUTANEOUS AORTIC VALVE REPLACEMENT (TAVR)
Authors: Medhat Farwati, Anas Saad, Mohamed M. Gad, Keerat Rai Ahuja, Manpreet Kaur, Agam Bansal, Vardhmaan Jain, Nicholas Kassis, Essa Hariri, Amar Krishnaswamy, Grant W. Reed, Rishi Puri, Samir R. Kapadia
Journal: Journal of the American College of Cardiology (2020)
PARIS induced defects in mitochondrial biogenesis drive dopamine neuron loss under conditions of parkin or PINK1 deficiency
Authors: Sheila K. Pirooznia, Changqing Yuan, Mohammed Repon Khan, Senthilkumar S. Karuppagounder, Luan Wang, Yulan Xiong, Sung Ung Kang, Yunjong Lee, Valina L. Dawson, Ted M. Dawson
Journal: Molecular Neurodegeneration (2020)

Mutations in PINK1 and parkin cause autosomal recessive Parkinson's disease (PD). Evidence placing PINK1 and parkin in common pathways regulating multiple aspects of mitochondrial quality control is burgeoning. However, compelling evidence to causatively link specific PINK1/parkin dependent mitochondrial pathways to dopamine neuron degeneration in PD is lacking. Although PINK1 and parkin are known to regulate mitophagy, emerging data suggest that defects in mitophagy are unlikely to be of pathological relevance. Mitochondrial functions of PINK1 and parkin are also tied to their proteasomal regulation of specific substrates. In this study, we examined how PINK1/parkin mediated regulation of the pathogenic substrate PARIS impacts dopaminergic mitochondrial network homeostasis and neuronal survival in Drosophila.The UAS-Gal4 system was employed for cell-type specific expression of the various transgenes. Effects on dopamine neuronal survival and function were assessed by anti-TH immunostaining and negative geotaxis assays. Mitochondrial effects were probed by quantitative analysis of mito-GFP labeled dopaminergic mitochondria, assessment of mitochondrial abundance in dopamine neurons isolated by Fluorescence Activated Cell Sorting (FACS) and qRT-PCR analysis of dopaminergic factors that promote mitochondrial biogenesis. Statistical analyses employed two-tailed Student's T-test, one-way or two-way ANOVA as required and data considered significant when P < 0.05.We show that defects in mitochondrial biogenesis drive adult onset progressive loss of dopamine neurons and motor deficits in Drosophila models of PINK1 or parkin insufficiency. Such defects result from PARIS dependent repression of dopaminergic PGC-1α and its downstream transcription factors NRF1 and TFAM that cooperatively promote mitochondrial biogenesis. Dopaminergic accumulation of human or Drosophila PARIS recapitulates these neurodegenerative phenotypes that are effectively reversed by PINK1, parkin or PGC-1α overexpression in vivo. To our knowledge, PARIS is the only co-substrate of PINK1 and parkin to specifically accumulate in the DA neurons and cause neurodegeneration and locomotor defects stemming from disrupted dopamine signaling.Our findings identify a highly conserved role for PINK1 and parkin in regulating mitochondrial biogenesis and promoting mitochondrial health via the PARIS/ PGC-1α axis. The Drosophila models described here effectively recapitulate the cardinal PD phenotypes and thus will facilitate identification of novel regulators of mitochondrial biogenesis for physiologically relevant therapeutic interventions.
CYP2D6 pharmacogenetic testing: Beliefs and psychological effects in breast cancer patients treated with adjuvant tamoxifen (T).
Authors: Katia Magnani, Elisa Pezzolo, Milena Gusella, Antonio Bononi, Cristina Falci, Donatella Da Corte, Elisabetta Cretella, Linda Nicolardi, Daniela Menon, Antonella Brunello, Giovanni Rosti, Concetta Raiti, Lisa Montin, Mariella Soraru', Francesca Vastola, Haralabos Koussis, Paola Bozzi, Veronica Parolin, Filippo Greco, Felice Pasini
Journal: Journal of Clinical Oncology (2013)

e20541 Background: Pharmacogenetic tests (PGT) are intended to predict the efficacy and toxicity of a specific treatment. There is a common concern that they may be misunderstood by patients (pts), confused with predictive tests for hereditary disorders and induce psychological distress. Methods: As part of a study aimed at correlating individual T activation capability with disease recurrence, CYP2D6 genotyping was offered to 203 early breast cancer pts. On enrolment, they received complete verbal and written information by their oncologist about the test and its purpose. Six months later they were asked to answer 4 questions concerning the nature and the possible psychogenic stress aroused by PGT. Their level of anxiety was assessed by the Zung-Self-Rating anxiety scale. Results: Anxiety was absent in 39%, within the normal limits in 50% or mild in 9% of pts. Only two pts had a moderate score. Anxiety was not associate with age or time from cancer diagnosis. Although not significantly, its score was higher in pts with larger tumors and positive lymph nodes. All pts agreed on the usefulness of PGT to enable the prediction of differences in drug response and toxicity. Some of them believed that they could predict some disease risks: the misperception was higher among elderly pts (&gt; 70y, 50%) while was infrequent in younger pts (&lt;39y, 12%). There was no association with the anxiety score. PTG related worries, although not generating a clinically detectable anxiety, were reported by 0%, 10% and 16% of all pts &lt;39, 40-69 and &gt;70 years old, respectively. Conclusions: CYP2D6 genotyping to predict tamoxifen activation was welcomed, well understood and was not associated with anxiety in the majority of breast cancer pts on adjuvant treatment. It seems that, when properly informed by their physician, patients show a positive attitude towards PG testing and no psychological distress. Funded by Regione Veneto. Clinical trial information: 532.
PTH-110 Antibodies to infliximaboccur throughout treatment but development is delayed by immunosuppression
Authors: R Downey, G Tun, K Swallow, G Wild, K Robinson, A Wright, L Marshall, M Hale, R Sargur, AJ Lobo
Journal: Gut (2017)

Introduction  Infliximab (IFX) is an important agent in the treatment of inflammatory bowel disease (IBD). However, its use may be limited by the development of antibodies to infliximab (ATI). The aim of this study was to assess the timing and significance of ATI development in clinical practice.  Method  Since May 2016, all IBD patients receiving intravenous IFX for maintenance treatment, at a large, single, referral centre, have undergone therapeutic drug monitoring (TDM). Serum IFX trough levels and ATI were both measured by drug-tolerant enzyme-linked immunosorbent assays (Biohit, UK) from 199 patients at a variable interval following the start of IFX treatment. IFX trough levels were considered undetectable ( 7 mg/L). ATI were considered positive if >10 mg/L. Clinical remission was defined as a Harvey Bradshaw Index or Simple Colitis Activity Index≤4. Risk factors for ATI development were assessed by binary logistic regression model, using 522 sera taken from patients on maintenance therapy. Time to develop ATI, undetectable IFX levels and loss of response to treatment was assessed by Cox regression and Kaplan-Meier analysis.  Results  Male sex (OR=2.1; p  Conclusion  Although IS therapy protects against ATI formation, the risk of antibody development continues throughout treatment. If concomitant IS is aimed at reducing ATI formation, then this also needs to be continued for the duration of IFX therapy.  Disclosure of Interest  None Declared