tbuckley/cabot-search huggingface dataset:
Association of Extending Hospital Length of Stay With Reduced Pediatric Hospital Readmissions
Authors: James C. Gay, Matt Hall, Jessica L. Markham, Jessica L. Bettenhausen, Stephanie K. Doupnik, Jay G. Berry
Journal: JAMA Pediatrics (2018)

Discussion | A sizeable proportion of adolescent marijuana users reported experiencing paranoia or anxiety or hallucinations in association with their marijuana use, with rates higher among those who used cannabis more regularly, met criteria for cannabis use disorder, or experienced symptoms of depression.Marijuanarelated psychotic symptoms may become more common if rates of regular or heavy marijuana use continue to rise. 5 The association between marijuana use during adolescence and poor adult outcomes has been well documented, and there is a strong association between its use and the development of mental health problems and psychotic disorders. 6Marijuana use is also associated with psychotic symptoms related to intoxication.The association between these phenomena is poorly understood.Experiencing acute psychotic symptoms while using marijuana may be a marker of risk for developing a psychotic disorder in the future.Because some adolescents with psychotic disorders report first experiencing symptoms acutely with marijuana use, these experiences may represent prodromal symptoms in some individuals.A future longitudinal study could examine these questions.A limitation of our study was self-report, which is subject to recall and social desirability biases that could lead to underreporting and hence underestimation of the true nature of the phenomenon.The mental health burden of adolescent marijuana use may be challenging to accurately estimate because adolescents do not always seek treatment for mental health problems.Our findings suggest that experience of marijuana-related acute psychotic symptoms may be considerable.
Tyrosine kinase inhibitors as a first-line treatment in patients with newly diagnosed chronic myeloid leukemia in chronic phase: A mixed-treatment comparison.
Authors: Belal Firwana, Maria Diab, Mohamad Bassam Sonbol, Ibraheem Yousef, Rim Hasan, Shahzad Raza, Donald C. Doll
Journal: Journal of Clinical Oncology (2014)

7054 Background: Chronic myeloid leukemia (CML) is a myeloproliferative disorder of blood stem cells. After the introduction of tyrosine kinase inhibitors (TKi), patients with CML have had substantially improved responses compared with previous therapies. We sought to summarize the evidence of TKi efficacy and safety in patients with newly diagnosed CML in chronic phase (CML-CP). Methods: We included all randomized clinical trials evaluating first-line treatment with a TKi (imatinib, dasatinib, bosutinib or nilotinib) in adults with CML-CP. Staudies of patients with accelerated- or blast-phase CML as well as those on IFN-α or stem cell transplantation were excluded. Main outcomes are complete cytogenetic response (CCyR) and major molecular response (MMR) at 12-month follow-up period. Safety and tolerability outcomes were pooled. A comprehensive literature search was conducted. Bayesian mixed-treatment method was used to rank TKi in terms of effectiveness. Results: Eighteen peer reviewed papers and conference abstracts reporting on seven studies were identified involving 2842 patients with CML-CP who were enrolled for initial treatment. At 12-month follow-up, mixed treatment comparison analysis demonstrated superiority of each TKi treatment family over imatinib, except bosutinib and nilotinib, which were not statistically different for CCyR and MMR respectively. Nilotinib ranked first among other TKi in terms of efficacy for CCyR; dasatinib ranked first in terms of MMR. Among second generation TKi, nilotinib had the superior tolerance and the least discontinuation rate from drug-related toxicity, followed by dasatinib then bosutinib. Hematological adverse events were highest for high dose imatinib followed by dasatinib. Conclusions: Second generation TKi are associated with a deeper and faster CCyR and MMR compared to imatinib. At 12-month follow-up period, nilotinib ranked first to achieve CCyR and had the lowest treatment discontinuation rate, while dasatinib ranked first to achieve MMR. Long term follow up is required to determine the impact of difference in the response patterns to the overall survival.
Evaluation of an online, skill-building, group intervention for cancer patients and caregivers: Pillars4Life.
Authors: Jonathan David O'Donnell, Amy Pickar Abernethy, Greg Samsa, Tina Staley, Kristin MacDermott, Sophia Smith
Journal: Journal of Clinical Oncology (2014)

9573 Background: Psychosocial distress is common for those with cancer; new interventions are needed. Pillars4Life is an online educational program that teaches coping skills in a group format. What is the relationship between participation in the LiveStrong-funded Pillars4Life program and personal psychosocial outcomes? Methods: This was a longitudinal observational cohort study. Cancer patients and caregivers participating in the Pillars4Life program were recruited from the 20 hospitals that received the LiveStrong Community Impact Award. Consenting participants participated in 10 weekly sessions and completed electronic surveys at baseline and 3 months. Patient reported measures included: distress [Distress Thermometer (DT), Patient Care Monitor (PCM)], depression [Patient Health Questionnaire 9 (PHQ9)], anxiety [Generalized Anxiety Disorder 7 (GAD7)], posttraumatic stress [PTSD Checklist-Civilian (PCLC)], quality of life and despair (PCM), fatigue [Functional Assessment of Chronic Illness Therapy (FACIT)], and cancer-related wellbeing [Functional Assessment of Cancer Therapy-General (FACTG)] outcomes. Results: Participants (n=80) were: mean age 55.5±11.1 years; 90% female; 87% white; 58% married; 46% employed; and 91% cancer patients, of which 54% had breast cancer and 72% were receiving treatment. Mean scores significantly improved from baseline to month 3 on all patient-reported outcome measures: DT (-0.8, p=.01); PCM Distress (-2.9, p=.01); PHQ9 (-2.7, p<.001); GAD7 (-2.2, p<.001); PCLC (-4.9, p<.001); PCM Quality of Life (3.8, p<.001) and Despair (-3.6, p<.001); FACIT-Fatigue (3.7, p=.004); and FACT-G (5.7, p=.002). Patient participants who reported distress at baseline (DT≥4; n=43) had clinically significant improvements (moderate to strong effect sizes ranged from 0.5 to 1.0 standard deviation units) in DT; PCM Distress, Quality of Life, and Despair; PHQ9; GAD7; PCLC; FACTG, among others. Conclusions: Participation in Pillars4Life was associated with statistically and clinically significant improvements on key psychosocial and quality of life patient-reported outcomes measures. Importantly, distressed patients experienced meaningful improvement.
PET imaging in patients with brain metastasis—report of the RANO/PET group
Authors: Norbert Galldiks, Karl-Josef Langen, Nathalie L Albert, Marc Chamberlain, Riccardo Soffietti, Michelle M Kim, Ian Law, Emilie Le Rhun, Susan Chang, Julian Schwarting, Stephanie E Combs, Matthias Preusser, Peter Forsyth, Whitney Pope, Michael Weller, Jörg C Tonn
Journal: Neuro-Oncology (2019)

Brain metastases (BM) from extracranial cancer are associated with significant morbidity and mortality. Effective local treatment options are stereotactic radiotherapy, including radiosurgery or fractionated external beam radiotherapy, and surgical resection. The use of systemic treatment for intracranial disease control also is improving. BM diagnosis, treatment planning, and follow-up is most often based on contrast-enhanced magnetic resonance imaging (MRI). However, anatomic imaging modalities including standard MRI have limitations in accurately characterizing posttherapeutic reactive changes and treatment response. Molecular imaging techniques such as positron emission tomography (PET) characterize specific metabolic and cellular features of metastases, potentially providing clinically relevant information supplementing anatomic MRI. Here, the Response Assessment in Neuro-Oncology working group provides recommendations for the use of PET imaging in the clinical management of patients with BM based on evidence from studies validated by histology and/or clinical outcome.
Abstract 19477: Obesity is More Strongly Associated With Incident HFpEF than HFrEF: The Atherosclerosis Risk in Communities (ARIC) Study
Authors: Kavita Sharma, Keith Bernis, Lucia Kwak, Kuni Matsushita, Amil M Shah, Laura R Loehr, Vijay Nambi, Roberta Florido, Patricia P Chang, Stuart D Russell, Christie Ballantyne, Josef Coresh, Chiadi E Ndumele
Journal: Circulation (2016)

Background: Obesity is associated with both diastolic and systolic dysfunction. However, it is unknown whether heart failure (HF) with preserved ejection fraction (HFpEF) or HF with reduced ejection fraction (HFrEF) is the predominant form of HF associated with obesity in the population. Hypothesis: We hypothesized that obesity is more strongly associated with incident HFpEF than incident HFrEF. Methods: We followed 10,239 participants in ARIC, a community-based cohort, with body mass index (BMI) ≥18.5 kg/m2 and no CVD at baseline (Visit 4, 1996-99). We categorized BMI (kg/m2) as normal (18.5-24.9), overweight (25-29.9), obese (30-34.9) and severely obese (≥35). We constructed Cox regression models with successive adjustment for confounders (Model 1) and traditional CVD mediators (Model 2), to estimate the association of higher BMI with incident HFpEF and HFrEF during the period of ARIC HF adjudication (2005-2012). Seemingly unrelated regression, which is used to compare the magnitude of different risk as...
Disparities of surveillance for hepatocellular carcinoma in high-risk patients in eastern North Carolina.
Authors: Hemant S. Murthy, Sirish Sanaka, Humdum Pasha Durrani, Punam Punja, Salini Sathya Naidu, Prashanti Atluri
Journal: Journal of Clinical Oncology (2014)

e15130 Background: HCC is the third leading cause of cancer mortality worldwide. Incidence rates are increasing in the United States. According to the Center for Disease Control and Prevention Morbidity and Mortality Weekly Report, rates of HCC increased from 2.7 cases per 100,000 people in 2001 to 3.2 cases per 100,000 people in 2006. In order to establish effective prevention programs for HCC patients we need to characterize the patient population in Eastern North Carolina. Monitoring incidence, survival, and mortality rates within our at-risk population can help implement these programs. Methods: Retrospective chart analysis was performed on all patients treated at the Leo Jenkins Cancer Center for HCC between the years of 2006-2012. Data analyzed included race, hepatitis C status (HCV), alcohol use, and whether they had an evaluation by a gastroenterologist preceding diagnosis of HCC. Results: 52 patient charts were reviewed. 44% of patients were African American, 56% Caucasian. Median survival for African American patients was 314 days compared to Caucasian patients, which was 1,308 days (p=0.042). 34 out of 52 patients reported heavy alcohol abuse prior to HCC diagnosis and had a median survival of 320 days versus 1308 days for non-alcoholic patients (p= 0.145). 37 patients (71%) were infected with HCV and had a median survival 547 days compared to 725 in HCV negative (p=0.91). 69% of patients with HCC were seen by gastroenterology prior to HCC diagnosis (69%), and those with GI evaluation had a median survival 964 days compared to 314 days not previously evaluated (p=0.29). Conclusions: At our institution race was found to have a statistically significant impact on median survival for HCC patients. In addition alcohol use, HCV status and prior GI evaluation all trended towards improvement in median survival, although statistical significance was limited due to the power of this study. These data suggest that access to primary care for evaluation of alcohol use/cirrhosis and access to specialists for evaluation and management of HCV all impact the survival of HCC patients in Eastern North Carolina. In the prevention of HCC, programs which facilitate access to specialty care are important.
Abstract 12963: More Than 1 in 10 Centres Caring for Patients with Myocardial Infarction Consistently Perform Badly: Results from Nationwide Assessment of Quality of Discharge Prescription after AMI in France
Authors: Francois Schiele, Frederic Capuano, Nicolas Danchin, Christian Zicarelli, Linda Banaei-Bouchareb, Jean-Francois Thebaut, Armelle Desplanques-Leperre, Catherine Grenier
Journal: Circulation (2013)

Background: We report results from 4 consecutive years of a nationwide assessment of quality indicators (QI) at discharge after acute myocardial infarction and the categorization of centres accordi...
Comparison VEGF-pathway elements and EMT markers in patients with sarcomatoid metastatic renal cell carcinoma and risk-matched controls.
Authors: Jeremy Jones, Tommy Tong, Miaoling He, Huiqing Wu, Xueli Liu, Courtney Carmichael, Xiwei Wu, Jose A. Karam, Sabina Signoretti, Toni K. Choueiri, Sumanta Kumar Pal
Journal: Journal of Clinical Oncology (2014)

e15613 Background: The presence of sarc elements in pts with RCC portends a poor prognosis. Some studies have focused on epithelial-to-mesenchymal transition (EMT) as a driver of sarc ccRCC; however, the potential role of other targetable entities is unknown. Methods: From an institutional database, we identified 13 pts with metastatic sarc ccRCC and 13 pts with metastatic ccRCC lacking sarc elements matched by age and risk group. All patients had available FFPE tissue derived from nephrectomy. For a limited sample of 5 pts with sarc ccRCC, RNA sequencing was performed on microdissected cc, sarc, and benign renal cortical sections from FFPE blocks. Reads were aligned to hg19 genome with Tophat v2.0. IHC was used to explore expression of implicated genes in the entire matched cohort of 26 pts. Results: With respect to RNA sequencing analysis for 5 pts with sarc ccRCC, reads had between 4% and 24% exon coverage. Hierarchical clustering demonstrated that most samples were clustered by patient, not by disease state (i.e., sarc vs non-sarc), suggesting that inter-patient variation is large. However, comparisons between cc and sarc components for these 5 pts demonstrated a significant increase in cell growth pathways, with the most highly enriched gene ontology pathways being M-phase, cell cycle, mitosis and aurora kinase pathways. No EMT-related pathways were found to be enriched. IHC assessments of VEGF and mTOR pathways were performed, given their purported role in RCC cell growth. While no differences were noted in pVEGFR2, higher pS6K staining was noted in both the sarc and non-sarc components of pts with sarc ccRCC relative to pS6K staining in tumor tissue derived from ccRCC pts lacking sarc elements (p<0.05 for both). No differences in EMT marker expression were noted (specifically, E-cad, N-cad and Twist); IHC assessments for aurora kinases A and B will be reported. Conclusions: Although cytotoxic agents and VEGF-directed therapies have been explored in sarc ccRCC, the finding of mTOR pathway activity underscores the need to examine mTOR inhibitors in this disease. Furthermore, emerging agents targeting aurora kinases may have a role in sarc ccRCC.
Multitarget Strategies to Reduce Myocardial Ischemia/Reperfusion Injury
Authors: Sean M. Davidson, Péter Ferdinandy, Ioanna Andreadou, Hans Erik Bøtker, Gerd Heusch, Borja Ibáñez, Michel Ovize, Rainer Schulz, Derek M. Yellon, Derek J. Hausenloy, David Garcia-Dorado
Journal: Journal of the American College of Cardiology (2019)

Many treatments have been identified that confer robust cardioprotection in experimental animal models of acute ischemia and reperfusion injury. However, translation of these cardioprotective therapies into the clinical setting of acute myocardial infarction (AMI) for patient benefit has been disappointing. One important reason might be that AMI is multifactorial, causing cardiomyocyte death via multiple mechanisms, as well as affecting other cell types, including platelets, fibroblasts, endothelial and smooth muscle cells, and immune cells. Many cardioprotective strategies act through common end-effectors and may be suboptimal in patients with comorbidities. In this regard, emerging data suggest that optimal cardioprotection may require the combination of additive or synergistic multitarget therapies. This review will present an overview of the state of cardioprotection today and provide a roadmap for how we might progress towards successful clinical use of cardioprotective therapies following AMI, focusing on the rational combination of judiciously selected, multitarget therapies. This paper emerged as part of the discussions of the European Union (EU)-CARDIOPROTECTION Cooperation in Science and Technology (COST) Action, CA16225.
Treatment with tumor-infiltrating lymphocytes (TIL) in metastatic melanoma and clinical benefit regardless of site of origin, mutation status, or prior checkpoint blockade.
Authors: Isabella Claudia Glitza, Chantale Bernatchez, Roland L. Bassett, Carol Vaughn, Portia Velasquez, Adi Diab, Rodabe Navroze Amaria, Cassian Yee, Scott Eric Woodman, Sapna Pradyuman Patel, Kevin Kim, Michael A. Davies, Nicholas E. Papadopoulos, Agop Y. Bedikian, Wen-Jen Hwu, Laszlo George Radvanyi, Patrick Hwu
Journal: Journal of Clinical Oncology (2014)

9079 Background: In this report we describe the association of specific patient attributes, such as mutation status, prior treatment with checkpoint blockade, and location of primary tumor with treatment response to therapy TIL therapy. Methods: Stage IIIc-IV patients (pts) were enrolled and treated in an ongoing non-randomized phase II TIL trial at MD Anderson Cancer Center. Cox proportional hazards regression (overall survival (OS), progression-free survival (PFS)) and logistic regression (response) were used to assess the association between outcomes and covariates of interest. Results: 56 (19 female, 37 male) pts were enrolled. Most common site of origin was cutaneous (N=45), while a subgroup of pts had melanoma derived of acral (N=7) or mucosal origin (N=3). Staging (69% MIc), mutational status (BRAF V600, NRAS mutations) or the presence of brain metastasis did not significantly impact the odds of response or survival (OS, PFS). Overall response rate was 44% (2 pts CR, 22 pts PR) in 54 pts available for analysis, while stable disease was observed in 20 pts. 22 pts received prior checkpoint blockade with ipilimumab and/or anti-PD1. Among subgroups of pts, 30% of the acral/mucosal melanoma pts, 30% of the pts with previous checkpoint blockade and 53% of patients with BRAF V600 mutations responded. Higher numbers of CD8+ T-cells infused was significantly associated with greater likelihood of response (p=0.03) and longer PFS (p=0.01). PFS was significantly worse (p=0.01) after prior checkpoint blockade (1-year PFS: 14% versus 27%) and with higher pre-treatment LDH level (p= <0.001) and ECOG PS score (p=0.002). OS was not affected by site of origin (1-year OS: 68% acral/mucosal), BRAF V600 status (62%), or prior checkpoint blockade (61%). Higher ECOG PS score (p=<0.001) and LDH level (p=<0.001) were associated with greater risk of death. Conclusions: Patients with BRAF V600 mutations and with mucosal or acral origin do benefit from TIL therapy. Despite shorter PFS, patients that had previously failed checkpoint blockade therapy still experience benefit from TIL therapy, arguing its use in this highly refractory population.
SP0123 Why is the prevalence of knee osteoarthritis increasing?
Authors: D. Felson
Journal: Annals of the Rheumatic Diseases (2018)

<h3></h3> Invited speaker abstract submission EULAR18-7734 WHY IS THE PREVALENCE OF KNEE OSTEOARTHRITIS INCREASING? D. Felson <b>I will give my lecture on:</b> Friday, 15 June 2018 <h3>Disclosure of Interest</h3> None declared Populations throughout the world are ageing and with ageing comes in increase in knee osteoarthritis. The prevalence of obesity is also rising and this further contributes to an increased risk of disease. Not surprisingly, the demand for knee replacements is rising quickly and is projected to increase further. While the increase in osteoarthritis may be due in part to ageing and obesity of the population, there may be other causes. In a recent study, cadavers whose age and weight at the time of death were known were examined for evidence of knee osteoarthritis. It was found that, after adjustment for age and weight, knee osteoarthritis in our current postindustrial era was twice as common as knee osteoarthritis in the early industrial era. Reasons for this increase include changes in diet or in physical activity. They might also include changes in effects or severity of obesity. Understanding the increase in prevalence might provide new clues to osteoarthritis prevention. <h3>Disclosure of Interest</h3> None declared
Association between CT utilization and radiation therapy at the end of life (EOL) in elderly breast and prostate cancer patients.
Authors: Michaela Ann Dinan, Lesley H Curtis, Soko Setoguchi, Winson Y. Cheung
Journal: Journal of Clinical Oncology (2014)

6529 Background: High cost imaging can inform prognosis for cancer patients and potentially de-escalate unnecessary treatment at the EOL, but it may also be associated with increased health care expenditures. We investigated the association between hospital referral region (HRR)-level utilization of CT imaging and radiation therapy at the EOL. Methods: Retrospective, patient-level analysis of SEER-Medicare patients who died from breast and prostate cancer between 2002 and 2007. HRR-level utilization of CT scans was categorized into tertiles for each cancer type. HRRs were assigned where patients received the majority of inpatient care during the last 6 months of life. Multivariable logistic regression models were constructed to correlate tertile of imaging use with receipt, type, and overall cost of radiation therapy. Results: A total of 5,980 breast and 7,538 prostate cancer patients met study criteria, of which 22.2% and 28.3% received radiation therapy in the last year of life and 3.6% and 4.4% received radiation therapy in the last 30 days, respectively. The average number of CT scans in the last 6 months of life per patient varied by HRR from 0.79 to 1.74 scans for breast and 0.80 to 1.70 for prostate cancer. Treatment within a high vs. low CT utilizing HRR for either cancer type was not associated with increased use of radiotherapy in the last year or 30 days of life. Patients undergoing radiotherapy within high CT utilizing HRRs were more likely to undergo intensity modulated radiotherapy (breast; 4% vs. < 1%; prostate 5.5% vs. 3.8%, both χ2 P < 0.05). Mean costs of direct radiation therapy among patients undergoing radiotherapy in the last year of life were similar across HRR imaging tertiles, and averaged $5,009 in breast and $4,501 in prostate cancer patients. In contrast, overall costs were higher in both breast ($48,705 vs. $32,438) and prostate ($46,283 vs. $32,411) cancer patients in high vs. low CT utilizing HRRs (both P< 0.001). Conclusions: Treatment within a high CT utilizing HRR for EOL patients with breast or prostate cancer was not associated with increased utilization or costs of radiation therapy at the EOL, but was associated with significantly higher overall medical expenditures.