tbuckley/cabot-search huggingface dataset:
The association of smoking and socioeconomic status on melanoma skin cancer
Authors: J.A.G. Gibson, T.D. Dobbs, R. Griffiths, J. Song, A. Akbari, S. Whitaker, A. Watkins, S.M. Langan, H.A. Hutchings, R.A. Lyons, I.S. Whitaker
Journal: British Journal of Dermatology (2020)

Skin cancer is the most common cancer type in Western populations and melanoma is the most dangerous form of the disease. In recent years, a link between ‘social determinants’ and melanoma has emerged. Social determinants encompass both socioeconomic factors (including income, education, poverty level, area of residence, occupation and social status) and lifestyle factors (including exposure to UV light, marital status, hobbies, smoking, obesity). This study carried out by a team of investigators based in Swansea and London in the UK was designed to re‐examine the relationship between people's smoking habits, as well as socioeconomic status, and the occurrence and progression of melanoma. In order to achieve this, the team used a population database that held details of patients diagnosed and treated in Wales. The investigators were able to analyse data from more than 9,000 patients diagnosed with melanoma over the five years included in this study, and in addition they reviewed information on 26,000 people without melanoma. They found that smoking was associated with a decreased occurrence of melanoma and that it had no effect on death rates caused by melanoma itself, although death rates due to other causes were higher amongst smokers than non‐smokers. There was also a higher rate of melanoma in people of higher socioeconomic status, but these individuals also had a higher chance of survival from melanoma than those of lower socioeconomic status. The explanation for these findings needs to be clarified, as the differences may be due to a direct effect of smoking on the development and progress of melanoma, or may be related to other factors such as sun exposure rates amongst smokers and non‐smokers. This is a summary of the study: The association of smoking and socioeconomic status on cutaneous melanoma: a population‐based, data‐linkage, case‐control study.
Metastatic chromophobe renal cell carcinoma treated with target therapies: A Renal Cross Chanel Group (RCCG) study.
Authors: Emeline Colomba, Laurence Albiges, Gwenael Le Teuff, Tim Eisen, Grant Stewart, Kate Fife, Anandagopal Srinivasan, James M. G. Larkin, Andrea Biondo, Lisa M. Pickering, Helen Jane Boyle, Lisa Derosa, Christy Ralph, Carolina Saldana, Jean-Christophe Bernhard, Philippe Barthelemy, Federica Recine, Bernard Escudier
Journal: Journal of Clinical Oncology (2015)

4561 Background: Metastatic Chromophobe renal cell carcinoma (mChRCC) is a rare entity with no specific targeted therapy recommended. We aim to assess the outcome of targeted therapy (TT) in a large cohort of mChRCC patients (pts). Methods: RCCG collected data from 27 centers in France, UK and Italy. Patients’ characteristics, treatments, best response and outcomes were collected. Time to treatment failure (TTF) for first-line treatment was calculated from the initiation of first-line treatment (t0) until failure (progression disease, toxicity, death). Overall survival (OS [95%CI]) was calculated from t0 until death. Survival outcomes were described using Kaplan-Meier method with 95% confidence interval. Results: Overall, 91 mChRCC pts were collected. Among these, 63 were treated with TT with a median follow-up of 3 years (range: 0.1-14). Median age at diagnosis was 58 years with a majority of men (62%, n = 39). Most pts had nephrectomy (92%, n = 58). International Metastatic RCC Database Consortium (IMDC) prognosis groups were good: 4% (n = 2), intermediate: 74% (n = 35), poor: 21% (n = 10), or unknown (ukn) = 16. Patients were treated either with anti-angiogenic (AA) (79%, n = 50), mTORi (17%, n = 11) or other (3%, n = 2) as first line. Most pts (84%) received sunitinib as AA. Best overall response with AA was CR+PR: 36% (n = 16), SD: 33% (n = 15), PD: 31% (n = 14), ukn = 5. Median TTF in first line in the entire population was 7 months [4-9]. Median TTF with AA was 8 months [5-10]. Median TTF was 7.9 [3.8-13.6], and 2.4 [0.7-8.0] months for intermediate and poor IMDC prognosis groups respectively. Second line treatment was administered in 30 pts (48%) and third line in 9 (14%) pts. Median OS was 23 [12-36], 30 [12-46] and 9 [2-NR] months for overall, AA and mTORi, respectively. Median OS was NR [11.6-NR], 22 [9.8-35.9] and 9 [1.1-35.1] months for good, intermediate and poor IMDC prognosis group respectively. Conclusions: We report the largest cohort of patients with mChRCC treated with targeted therapy. TTF and OS with VEGF/VEGFR inhibitors are similar to outcomes in patients with clear cell RCC. Integration of newly characterized biological insights in ChRCC will be the next step to improve outcomes of patients with mChRCC.
Interactive Case Study Companion to Robbins Pathologic Basis of Disease, 6th edition, CD-ROM, Vinay Kumar, Herbert K Hagler, in: System requirements: Windows 95, 98, NT, Macintosh, or UNIX. W B Saunders Company, Philadelphia (1999), $49·95, ISBN: 0-7216-8462-9
Authors: J Andrew Carlson
Journal: The Lancet (1999)
Cancer burden of major cancers in China: A need for sustainable actions
Authors: Maomao Cao, He Li, Dianqin Sun, Wanqing Chen
Journal: Cancer Communications (2020)

Cancer is still a major health problem in China although numerous efforts have been made for its prevention and control. Findings from this study showed that lung cancer remains the most common type of cancer diagnosed, and was attributed to nearly 30% of all cancer-related deaths. The incidence of the five most common cancers, in China, in 2015, including cancers of the lungs, stomach, colorectum, liver and breast, accounted for almost 60% of all cancers diagnosed. The high cancer burden in China highlights the need for further improvement in health education, professional training and the building up an anti-cancer network for introducing and implementing sustainable actions for cancer control.
AB1058 Renal Impairment among Postmenopausal Women with Osteoporosis from A Large Health Plan in Israel
Authors: J. Yu, I. Goldshtein, S. Ish-Shalom, O. Sharon, A. Modi
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Objectives</h3> To estimate the proportion of patients with renal impairment among postmenopausal osteoporotic women within a large health plan in Israel. <h3>Methods</h3> This was a retrospective analysis of Maccabbi electronic medical records (EMR) in Israel. Women aged ≥55 years, with a recorded osteoporosis diagnosis or osteoporosis-related fracture (date for 1st such diagnosis was defined as index date) between 1/1/2007 and 12/31/2012, who were enrolled in health plan for ≥1 year prior to and after index were included. Patients9 minimum serum creatinine level (Scr) during one year pre-index to one year post-index was utilized to calculate glomerular filtration rate (eGFR), using Modification of Diet in Renal Disease (MDRD) equation. Stage 1-5 of renal impairment was classified using the MDRD renal impairment staging system by eGFR: normal ≥90; mild 60 – 89; moderate 30– 59; severe 15 – 29, and failure&lt;15 mL/min/1.73 m<sup>2</sup> respectively. <h3>Results</h3> 18,101 patients were included in the analysis. The mean age (± standard deviation [SD]) of these patients was 66.7±9.0 years, and 35.5% of patients had a fracture at index. Patients with renal function of stage 1-5 accounted for 21.7%, 47.3%, 14.3%, 15.9%, 1.0%, and 0.1% respectively of all patients. 2.3% of those patients had eGFR levels &lt;35 mL/min/1.73 m<sup>2</sup>; the rate was 1.5% for patients with osteoporosis diagnosis and 3.9% for patients with fractures; the rate was higher among older patients aged ≥70 (4.3%) than younger patients (0.5%). <h3>Conclusions</h3> This analysis showed that 2.3% of osteoporotic women had renal impairment (eGFR levels &lt;35 mL/min/1.73 m<sup>2</sup>) to a level at which the commonly used bisphosphonates such as alendronate, risedronate and ibandronate are not recommended. This limitation indicates a need for therapeutic alternatives that have been demonstrated to reduce fracture risk in osteoporotic patients with severe renal insufficiency. <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.2053
Inherited Thoracic Aortic Disease
Authors: Alexander J. Fletcher, Maaz B.J. Syed, Timothy J. Aitman, David E. Newby, Niki L. Walker
Journal: Circulation (2020)

Inherited thoracic aortopathies denote a group of congenital conditions that predispose to disease of the thoracic aorta. Aortic wall weakness and abnormal aortic hemodynamic profiles predispose these patients to dilatation of the thoracic aorta, which is generally silent but can precipitate aortic dissection or rupture with devastating and often fatal consequences. Current strategies to assess the future risk of aortic dissection or rupture are based primarily on monitoring aortic diameter. However, diameter alone is a poor predictor of risk, with many patients experiencing dissection or rupture below current intervention thresholds. Developing tools that improve the risk assessment of those with aortopathy is internationally regarded as a research priority. A robust understanding of the molecular pathways that lead to aortic wall weakness is required to identify biomarkers and therapeutic targets that could improve patient management. Here, we summarize the current understanding of the genetically determined mechanisms underlying inherited aortopathies and critically appraise the available blood biomarkers, imaging techniques, and therapeutic targets that have shown promise for improving the management of patients with these important and potentially fatal conditions.
Balancing evidence and frontline experience in the early phases of the COVID-19 pandemic: current position of the Italian Society of Anti-infective Therapy (SITA) and the Italian Society of Pulmonology (SIP)
Authors: M. Bassetti, D.R. Giacobbe, S. Aliberti, E. Barisione, S. Centanni, F.G. De Rosa, F. Di Marco, A. Gori, G. Granata, M. Mikulska, N. Petrosillo, L. Richeldi, P. Santus, C. Tascini, A. Vena, P. Viale, F. Blasi
Journal: Clinical Microbiology and Infection (2020)

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of coronavirus disease 2019 (COVID-19), which has rapidly become epidemic in Italy and other European countries. The disease spectrum ranges from asymptomatic/mildly symptomatic presentations to acute respiratory failure. At the present time the absolute number of severe cases requiring ventilator support is reaching or even surpassing the intensive care unit bed capacity in the most affected regions and countries.To narratively summarize the available literature on the management of COVID-19 in order to combine current evidence and frontline opinions and to provide balanced answers to pressing clinical questions.Inductive PubMed search for publications relevant to the topic.The available literature and the authors' frontline-based opinion are summarized in brief narrative answers to selected clinical questions, with a conclusive statement provided for each answer.Many off-label antiviral and anti-inflammatory drugs are currently being administered to patients with COVID-19. Physicians must be aware that, as they are not supported by high-level evidence, these treatments may often be ethically justifiable only in those worsening patients unlikely to improve only with supportive care, and who cannot be enrolled onto randomized clinical trials. Access to well-designed randomized controlled trials should be expanded as much as possible because it is the most secure way to change for the better our approach to COVID-19 patients.
Quality of life of children aged 8‐12 years undergoing food allergy oral immunotherapy: Child and parent perspective
Authors: Na'ama Epstein‐Rigbi, Michael R. Goldberg, Michael B. Levy, Liat Nachshon, Arnon Elizur
Journal: Allergy (2020)

Oral immunotherapy (OIT) for food allergy improves the quality of life (QOL) of children from parental perspective but little is known about the child perception.The Food Allergy Quality of Life Questionnaire-Child Form (FAQLQ-CF) was administered to children aged 8-12 years, and the FAQLQ-Parent Form (FAQLQ-PF) was administered to their parents at the start of OIT for milk, egg, peanut, sesame, or tree nuts, at the end of up-dosing, and after 6 months of follow-up. Food-allergic children not undergoing OIT served as controls. Children QOL scores were compared to their parents.The total FAQLQ-CF score of 103 children undergoing OIT improved significantly from start of OIT (median (IQR); 4.8, 3.8-5.7) to end of up-dosing (3.9, 3-5.2) (P < .001). A greater improvement was noted in the 56 children who reached a follow-up visit, from 5.0 (3.7-5.8) at OIT start to 3.1 (1.8-5.0) on follow-up, (P < .001). In contrast, FAQLQ-CF scores of control patients improved mildly and nonsignificantly between the two time points from 5.3 (4.3-5.7) to 4.8 (3.6-6.0), (P = .13). The improvement in the total FAQLQ-CF scores from OIT start to follow-up was significantly greater compared to the change in control patients during observation (P = .015). Parents reported better QOL scores compared to their children at all stages of OIT (start 4.0, 3.2-5, P = .004; end of up-dosing 2.9, 1.9-4.7, P = .04; follow-up 2.2, 1.6-3.6, P = .003).QOL of food-allergic children undergoing OIT improves significantly compared to controls. Parents perceive QOL to be better than the perception of the children.
Sputum microbiome profiles identify severe asthma phenotypes of relative stability at 12 to 18 months
Authors: Mahmoud I. Abdel-Aziz, Paul Brinkman, Susanne J.H. Vijverberg, Anne H. Neerincx, John H. Riley, Stewart Bates, Simone Hashimoto, Nazanin Zounemat Kermani, Kian Fan Chung, Ratko Djukanovic, Sven-Erik Dahlén, Ian M. Adcock, Peter H. Howarth, Peter J. Sterk, Aletta D. Kraneveld, Anke H. Maitland-van der Zee
Journal: Journal of Allergy and Clinical Immunology (2020)
Increased Need for Thyroxine during Pregnancy in Women with Primary Hypothyroidism
Authors: Susan J. Mandel, P. Reed Larsen, Ellen W. Seely, Gregory A. Brent
Journal: New England Journal of Medicine (1990)

Women with hypothyroidism have been thought not to require an increase in thyroxine replacement during pregnancy. To evaluate the effects of pregnancy on thyroxine requirements, we retrospectively reviewed the thyroid function of 12 women receiving treatment for primary hypothyroidism before, during, and after pregnancy.
Replacing CAR-T cell resistance with persistence by changing a single residue
Authors: Emily M. Hsieh, Lauren D. Scherer, Rayne H. Rouce
Journal: Journal of Clinical Investigation (2020)

Sustained persistence of chimeric antigen receptor T (CAR-T) cells is a key characteristic associated with long-term remission in patients with hematologic malignancies. Attempts to uncover mechanisms that enhance persistence and thus functionality will have a substantial impact in broadening application of CAR-T cell therapy, especially for solid tumors. In this issue of the JCI, Guedan et al. describe a promising strategy to limit T cell exhaustion and improve persistence by changing a single amino acid in the costimulatory domain of CD28. The authors demonstrated that this single amino acid substitution in CD28-based mesothelin CAR-T cells results in improved persistence and functionality in a xenograft model of pancreatic cancer. Furthermore, reciprocal alteration of the same residue in inducible costimulator-containing (ICOS-containing) CAR-T cells resulted in limited antitumor activity and persistence. These findings suggest that simple alterations in the costimulatory domain may enhance CAR-T cell persistence, warranting future evaluation in other CD28-costimulatory CARs in an effort to improve durable antitumor effects.
The role of affect in feelings of obligation
Authors: Stefen Beeler-Duden, Meltem Yucel, Amrisha Vaish
Journal: Behavioral and Brain Sciences (2020)

Abstract Tomasello offers a compelling account of the emergence of humans’ sense of obligation. We suggest that more needs to be said about the role of affect in the creation of obligations. We also argue that positive emotions such as gratitude evolved to encourage individuals to fulfill cooperative obligations without the negative quality that Tomasello proposes is inherent in obligations.
Reply to the Letter to the Editor: “Comparison of the Safety and Efficacy of Yttrium-90 Radioembolization for Nonalcoholic Fatty Liver Disease-Associated and Hepatitis B Virus-Associated Hepatocellular Carcinoma”
Authors: Clemens Schotten, Heiner Wedemeyer, Jan Best
Journal: Liver Cancer (2020)

difference.The ALBI score, representative of overall liver function, also did not differ significantly between the NALFD and the HBV cohort.Propensity score matching is a well-validated method; however, for our purposes, it would have decreased the statistical power without providing additional insights into NAFLD.The primary aim of our study was to investigate whether NAFLD-associated comorbidities alter the safety and efficacy in selective internal radiotherapy.Using a matching method to overcome the chosen differences between NAFLD and HBV infection was not within the scope of this study.
Ophthalmic examination among adults with diagnosed diabetes mellitus
Authors: R. J. Brechner
Journal: JAMA (1993)

<h3>Objective.</h3> —To assess whether adults with diagnosed diabetes in the United States are receiving recommended eye examinations for detection of diabetic retinopathy and what factors are associated with receiving them. <h3>Design, Setting, and Participants.</h3> —The design was a cross-sectional survey of the civilian, noninstitutionalized US population 18 years of age or older, based on the 1989 National Health Interview Survey. A multistage probability sampling strategy was used to identify a representative sample of 84572 persons. A questionnaire on diabetes was administered to all subjects with diagnosed diabetes (n=2405). <h3>Main Outcome Measure.</h3> —A dilated eye examination in the past year. <h3>Main Results.</h3> —Of all adults with diagnosed diabetes in the United States, only 49% had a dilated eye examination in the past year. This included 57% of people with insulin-dependent diabetes mellitus (IDDM), 55% with insulin-treated non— insulin-dependent diabetes mellitus (NIDDM), and 44% with NIDDM not treated with insulin. Even among diabetics at high risk of vision loss because of retinopathy or long duration of diabetes, the proportion with a dilated eye examination was only 61% and 57%, respectively. By logistic regression, the probability of a dilated eye examination among persons with NIDDM increased with older age, higher socioeconomic status, and having attended a diabetes education class. The probability of a dilated eye examination was not independently related to race, duration of diabetes, frequency of physician visits for diabetes, or health insurance. <h3>Conclusions.</h3> —About half of adults with diabetes in the United States are not receiving timely and recommended eye care to detect and treat retinopathy. Widespread interventions, including patient and professional education, are needed to ensure that diabetic patients who are not receiving appropriate eye care have an annual dilated eye examination to detect retinopathy and prevent vision loss. (<i>JAMA</i>. 1993;270:1714-1718)
Palliative Radiotherapy Versus Esophageal Stent Placement in the Management of Patients With Metastatic Esophageal Cancer
Authors: Emily J. Martin, Andrew R. Bruggeman, Vinit V. Nalawade, Reith R. Sarkar, Edmund M. Qiao, Brent S. Rose, James D. Murphy
Journal: Journal of the National Comprehensive Cancer Network (2020)

Background: Patients with advanced esophageal cancer often experience pain and dysphagia, yet the optimal palliative management remains unclear. This retrospective study evaluated outcomes and adverse effects of palliative radiotherapy (RT) compared with esophageal stenting among a cohort of U.S. veterans with metastatic esophageal cancer. Patients and Methods: We identified 1,957 veterans in the United States with metastatic esophageal cancer who received palliative RT to the esophagus or esophageal stenting, and assessed the risks of severe adverse effects, including esophageal fistula formation, perforation, obstruction, hemorrhage, and esophagitis. We determined palliative efficacy by evaluating pain and dysphagia scores before and after intervention. Multivariable analyses were used to control for potential confounding factors. Results: In our cohort, 1,593 patients underwent RT and 364 underwent esophageal stenting. The cumulative incidence of any severe adverse effect at 6 months was higher among patients who received stents compared with those who received RT (21.7% vs 12.4%; P &lt;.0010). In multivariable analysis, patients who received stents had an increased risk of any severe adverse effect, including fistula, perforation, and hemorrhage (all P &lt;.0500). Multivariable analysis also showed that, compared with stenting, RT was associated with more rapid and durable pain relief ( P &lt;.0010) with no difference in relief of dysphagia over time when accounting for pretreatment dysphagia scores ( P =.1029). Conclusions: Compared with esophageal stenting, RT was associated with a decreased risk of adverse effects, greater pain relief, and equivalent relief of moderate to severe dysphagia over time. Unmeasured patient- or tumor-related factors could have influenced the choice of intervention, thereby impacting our study outcomes. To our knowledge, this is the largest study to date analyzing the comparative risks and benefits of palliative RT and esophageal stenting among patients with metastatic esophageal cancer.
Spinal myxopapillary ependymoma outcomes in patients treated with surgery and radiotherapy at M. D. Anderson Cancer Center
Authors: S. Akyurek, E. L. Chang, T. Yu, D. Little, P. K. Allen, I. McCutcheon, A. Mahajan, M. H. Maor, S. Y. Woo
Journal: Journal of Clinical Oncology (2006)

1547 Background: Myxopapillary ependymomas (MPEs) are a distinctive variant of ependymomas both clinicopathologically and genetically. These tumors usually occur in the lumbosacral/cauda equina region. Most spinal ependymoma series published in the literature included a few patients with MPEs. In this study, we report the outcomes from a single institutional experience with 35 spinal MPEs treated with either surgery alone or with adjuvant radiotherapy (RT). Methods: The medical records of 35 patients with MPE treated at The University of Texas M. D. Anderson Cancer Center between December 1968 and July 2002 were reviewed. The median age of patients in this series was 35 years (range, 14–63 years) and the male to female ratio was 2.5:1. Twenty-one patients (60%) underwent a gross total resection, 13 (37%) a subtotal resection, and 1 (3%) a biopsy only; 22 of these patients (63%) also received adjuvant RT. The endpoints analyzed were progression-free survival, overall survival, and local control. Results: The median follow-up was 10.7 years. The 10-year OS, PFS and LC rates for the entire group were 97%, 62%, and 72% respectively. Twelve patients (34%) had disease recurrence, all in the neural axis; 8 patients had treatment failure at the primary site only, 3 in the distant neural axis only, and 1 at the primary site and in the distant neural axis. Older patient age (≤35 vs. &gt;35 years; p=0.002) and initial treatment modality (surgery vs. surgery + adjuvant RT; p=0.04) showed significant impact on PFS. Conclusions: The long-term patient survival duration for MPE managed with surgery and adjuvant RT is favorable. Regardless of the extent of resection adjuvant RT appears to significantly reduce the rate of tumor progression. Failures in this series occurred exclusively in the neural axis, mainly at the primary site. No significant financial relationships to disclose.