tbuckley/cabot-search huggingface dataset:
Can sentinel node biopsy be considered in early breast cancer with axillary nodal disease?
Authors: P. May-Miller, M. Zaidi, S. Helme, L. Mansfield, C. Yiangou, A. Agrawal
Journal: Annals of Oncology (2019)

Background: Biopsy proven axillary disease in breast cancer is a contraindication for sentinel node biopsy and is considered a predictor of heavier nodal disease. This may not hold true for early breast cancer with clinically negative axilla with a positive ultrasound biopsy. Our study aimed to identify a group of such patients with minimal involvement of 1-2 lymph nodes, who may benefit from sentinel lymph node biopsy and avoid axillary clearance based on Z11 criteria. Methods: Ten years prospectively collected data of patients with clinically T1-2 N0 breast cancer was reviewed. All patients underwent axillary dissection for positive ultrasound biopsy. Primary outcomes were involvement of 1-2 lymph nodes or > 3 lymph nodes on final histology. Clinico-pathological and radiological factors including tumour characteristics and number of lymph nodes on ultrasound were recorded and analysed with binomial logistic regression model to predict higher lymph node disease of 3 or more lymph nodes on final histology. Results: One hundred and fourteen patients underwent axillary clearance for cT1-2N0 disease and positive ultrasound guided lymph node biopsy. Forty seven (41%) had only 1-2 lymph nodes positive in the final histology. None of the tested variables were found to have a predictive significance on binary logistic regression model. Conclusions: It was noted that a substantial number of early breast cancer patients with ultrasound positive axillae show only 1-2 involved lymph nodes. We were unable to find any significant predictors for higher nodal disease. A larger prospective study and consideration of sentinel lymph node biopsy with ultrasound as an adjunct can be the next step forward to avoid axillary clearance in such patients. Legal entity responsible for the study: Local Audit and Research Department. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
Mortality Among Professional American-Style Football Players and Professional American Baseball Players
Authors: Vy T. Nguyen, Ross D. Zafonte, Jarvis T. Chen, Kalé Z. Kponee-Shovein, Sabrina Paganoni, Alvaro Pascual-Leone, Frank E. Speizer, Aaron L. Baggish, Herman A. Taylor, Lee M. Nadler, Theodore K. Courtney, Ann Connor, Marc G. Weisskopf
Journal: JAMA Network Open (2019)

Studies of American-style football players have suggested lower overall mortality rates compared with general populations, but with possibly increased neurodegenerative mortality. However, comparisons with general populations can introduce bias. This study compared mortality between US National Football League (NFL) and US Major League Baseball (MLB) players, a more appropriate comparison group of professional athletes.To compare all-cause and cause-specific mortality between NFL and MLB players.In this retrospective cohort study, the setting was US mortality from January 1, 1979, through December 31, 2013. The dates of analysis were January 2016 to April 2019. Participants were 3419 NFL and 2708 MLB players with at least 5 playing seasons.Participation in the NFL compared with the MLB.Vital status and causes of death from the National Death Index from 1979 through 2013 were obtained. Cox proportional hazards regression models using age as the timescale were used to calculate hazard ratios (HRs) and 95% CIs to examine all-cause and cause-specific mortality among NFL players compared with MLB players, adjusted for race and decade of birth.By the end of follow-up, there were 517 deaths (mean [SD] age, 59.6 [13.2] years) in the NFL cohort and 431 deaths (mean [SD] age, 66.7 [12.3] years) in the MLB cohort. Cardiovascular and neurodegenerative conditions, respectively, were noted as underlying or contributing causes in 498 and 39 deaths in the NFL and 225 and 16 deaths in the MLB. Compared with MLB players, NFL players had significantly elevated rates of all-cause (HR, 1.26; 95% CI, 1.10-1.44), cardiovascular disease (HR, 2.40; 95% CI, 2.03-2.84), and neurodegenerative disease (HR, 2.99; 95% CI, 1.64-5.45) mortality. Comparing hypothetical populations of 1000 NFL and 1000 MLB players followed up to age 75 years, there would be an excess 21 all-cause deaths among NFL players, as well as 77 and 11 more deaths with underlying or contributing causes that included cardiovascular and neurodegenerative conditions, respectively.This study found that NFL players had elevated all-cause, cardiovascular, and neurodegenerative mortality rates compared with MLB players, although the absolute number of excess neurodegenerative deaths was still small. Factors that vary across these sports (eg, body habitus and head trauma) as opposed to those common across sports (eg, physical activity) could underlie the differences.
Degenerative protein modifications in the aging vasculature and central nervous system: A problem shared is not always halved
Authors: Xavier Gallart-Palau, Le Min Tan, Aida Serra, Yonggui Gao, Hee Hwa Ho, A. Mark Richards, Nagaendran Kandiah, Christopher P. Chen, Raj N. Kalaria, Siu Kwan Sze
Journal: Ageing Research Reviews (2019)
EVALUATION OF OUR TRAINING PROGRAM OF ENDOSCOPIC SUBMUCOSAL DISSECTION FOR GASTRIC CANCER IN EUROPE; TEACHING BY JAPANESE MENTOR
Authors: J Hamanaka, M Campanale, F Barbaro, G Costamagna, S Maeda
Journal: Endoscopy (2019)

Endoscopic submucosal dissection (ESD) has become established as a minimally invasive treatment for early gastric cancer (EGC) in Asian countries. Although training system has been reported in Asian countries, little was known about the training of European countries for ESD. The most important thing is to prevent a decline in clinical outcome during the introductory period. The aim of this study was to assess the learning curve for ESD of EGC in European countries.
Abstract 15639: Stage-specific Effects of Apolipoprotein (apo)A-I Raising in Atherosclerosis: ApoA-I Suppresses Plaque Size and Preserves High-density Lipoprotein Function in Apo E-/- Mice With Early Stage But Not Late-stage Disease
Authors: Jamie Morton, Shisan Bao, Laura Z. Vanags, Tania Tsatralis, Anisyah Ridiandries, Chung Wah Siu, Kwong Man Ng, Joanne Tan, David Celermajer, Martin K C Ng, Christina Bursill
Journal: Circulation (2017)

Introduction: Pre-clinical studies show high-density lipoproteins (HDL) and apolipoprotein A-I (apoA-I) are atheroprotective in early-stage disease, however, HDL-raising has not yet translated succ...
Murine neonatal skin mast cells are phenotypically immature and minimally sensitized with transplacentally transferred IgE
Authors: Yuki Honda, Sachiko Ono, Tetsuya Honda, Tatsuki R. Kataoka, Gyohei Egawa, Akihiko Kitoh, Atsushi Otsuka, Saeko Nakajima, Takashi Nomura, Teruki Dainichi, Kenji Kabashima
Journal: Journal of Allergy and Clinical Immunology (2019)
Five-Year Outcomes of Gastric Bypass in Adolescents as Compared with Adults
Authors: Thomas H. Inge, Anita P. Courcoulas, Todd M. Jenkins, Marc P. Michalsky, Mary L. Brandt, Stavra A. Xanthakos, John B. Dixon, Carroll M. Harmon, Mike K. Chen, Changchun Xie, Mary E. Evans, Michael A. Helmrath
Journal: New England Journal of Medicine (2019)

Bariatric surgery results in weight loss and health improvements in adults and adolescents. However, whether outcomes differ according to the age of the patient at the time of surgery is unclear.We evaluated the health effects of Roux-en-Y gastric bypass in a cohort of adolescents (161 patients enrolled from 2006 through 2012) and a cohort of adults (396 patients enrolled from 2006 through 2009). The two cohorts were participants in two related but independent studies. Linear mixed and Poisson mixed models were used to compare outcomes with regard to weight and coexisting conditions between the cohorts 5 years after surgery. The rates of death and subsequent abdominal operations and selected micronutrient levels (up to 2 years after surgery) were also compared between the cohorts.There was no significant difference in percent weight change between adolescents (-26%; 95% confidence interval [CI], -29 to -23) and adults (-29%; 95% CI, -31 to -27) 5 years after surgery (P = 0.08). After surgery, adolescents were significantly more likely than adults to have remission of type 2 diabetes (86% vs. 53%; risk ratio, 1.27; 95% CI, 1.03 to 1.57) and of hypertension (68% vs. 41%; risk ratio, 1.51; 95% CI, 1.21 to 1.88). Three adolescents (1.9%) and seven adults (1.8%) died in the 5 years after surgery. The rate of abdominal reoperations was significantly higher among adolescents than among adults (19 vs. 10 reoperations per 500 person-years, P = 0.003). More adolescents than adults had low ferritin levels (72 of 132 patients [48%] vs. 54 of 179 patients [29%], P = 0.004).Adolescents and adults who underwent gastric bypass had marked weight loss that was similar in magnitude 5 years after surgery. Adolescents had remission of diabetes and hypertension more often than adults. (Funded by the National Institute of Diabetes and Digestive and Kidney Diseases; ClinicalTrials.gov number, NCT00474318.).
Controversies on the endoscopic and surgical management of pain in patients with chronic pancreatitis: pros and cons!
Authors: Asbjørn Mohr Drewes, Marinus A Kempeneers, Dana K Andersen, Lars Arendt-Nielsen, Marc G Besselink, Marja A Boermeester, Stefan Bouwense, Marco Bruno, Martin Freeman, Thomas M Gress, Jeanin E van Hooft, Bart Morlion, Søren Schou Olesen, Hjalmar van Santvoort, Vikesh Singh, John Windsor
Journal: Gut (2019)

Pain is the dominating symptom of chronic pancreatitis (CP) causing impairment of quality of life, decreased activity, unemployment and major healthcare costs.1 Opinions differ on the best strategy to treat CP-related pain. These differences are fuelled by the lack of a clear correlation between the severity of complaints and the presence and extent of morphological abnormalities, lack of a comprehensive pain assessment tools, deficiency in the knowledge about the natural course of CP and the presence of (changes in) both peripheral and central nervous system pain mechanisms.

Analgesics are the cornerstone of pancreatic pain management, but when opioids are used, it may lead to dependency and opioid-induced hyperalgesia.2 When analgesic therapy fails, invasive treatments including endoscopic pancreatic duct clearance (with or without extracorporeal shock wave lithotripsy (ESWL)) or pancreatic duct stenting and surgery (resection and/or ductal decompression) are used. The rationale for invasive treatments is that reducing ductal pressure by restoring pancreatic juice flow and/or resecting an inflammatory pancreatic mass will result in pain relief. However, there is also a neuropathic basis for pain in most patients, for which invasive treatments may not be effective or even harmful. While there are many clinical studies that support invasive treatments, there is a paucity of high-quality randomised controlled trials (RCTs). As a result, the current guidelines for endoscopic and surgical treatments for painful CP are inconsistent and tend to reflect a specialty bias.3 For example, the German guidelines4 recommend surgery as the most effective treatment of pain, whereas the European Society of Gastrointestinal Endoscopy5 and the international evidence-based (HaPanEU) guidelines1 advice a ‘step-up approach’ incorporating both conservative, endoscopic and surgical treatment. These contradictions allow historic bias and a significant variation in clinical practice. Gut received a review article on the treatment of pain in CP that …
Perceptions of Patients With Breast and Colon Cancer of the Management of Cancer-Related Pain, Fatigue, and Emotional Distress in Community Oncology
Authors: Tenbroeck G. Smith, Alyssa N. Troeschel, Kathleen M. Castro, Neeraj K. Arora, Kevin Stein, Joseph Lipscomb, Otis W. Brawley, Ryan M. McCabe, Steven B. Clauser, Elizabeth Ward
Journal: Journal of Clinical Oncology (2019)

Pain, fatigue, and distress are common among patients with cancer but are often underassessed and undertreated. We examine the prevalence of pain, fatigue, and emotional distress among patients with cancer, as well as patient perceptions of the symptom care they received.
Abstract 16552: hHO-1 Overexpression is Cardioprotective After Acute Myocardial Infarction - Differences Between Pigs and Mice
Authors: Rabea Hinkel, Elena Gottlieb, Björn Petersen, Di Qin, Lange Philipp, Seungmin Lee, Philip Wenzel, Heiner Niemann, Christian Kupatt
Journal: Circulation (2013)

Heme oxygenase-1 (HO-1) responds to stress by increased production of bilirubin, carbon monoxide and free iron. These reaction products attenuate oxidative stress, inflammation and apoptosis, all o...
RISK STRATIFICATION AT THE FRONT DOOR FOR NON-VARICEAL GI BLEEDS AND ITS EFFECT ON GI REFERRAL AND ENDOSCOPIC ASSESSMENT
Authors: M Grzelka, AR Robertson, KA Lockman
Journal: Endoscopy (2019)

Upper gastrointestinal bleeding (UGIB) has high inpatient mortality and so early risk-stratification is essential. We seek to establish the impact of non-specialist risk stratification with Glasgow-Blatchford score (GBS) on timing of specialist referral and endoscopy. An electronic proforma had been introduced to the emergency and medical departments to improve this process.
PREDICTORS OF FAILURE OF EN BLOC RESECTION OR PERFORATION IN ENDOSCOPIC SUBMUCOSAL DISSECTION FOR ESOPHAGEAL NEOPLASIA
Authors: Y Nagami, M Ominami, T Sakai, S Fukunaga, H Yamagami, T Tanigawa, T Watanabe, Y Fujiwara
Journal: Endoscopy (2019)

Endoscopic submucosal dissection (ESD) is accepted as the standard treatment for early-stage esophageal neoplasia. However, esophageal perforation may occur, leading to mediastinitis and pneumothorax, which sometimes require emergency surgery. In addition, failure of en bloc resection causes local recurrence. Until now, few studies have reported on predictors of failure of en bloc resection or perforation during ESD. Thus, we evaluated the predictors of failure of en bloc resection or perforation in ESD for esophageal neoplasia.
Comparison of HER2, estrogen and progesterone receptor expression profiles of primary tumor and synchronous axillary lymph node metastases in 159 breast cancer patients - indicating tumoral heterogeneity
Authors: L. Weydandt, L.-C. Horn, B. Aktas
Journal: Annals of Oncology (2019)

Background: Several studies have shown that there may be change in the expression of steroid hormone receptors (ER and PR) as well as Her-2 as possible therapeutic relevant targets during disease progression (primary tumor versus metastatic disease). However, it is rarely considered into primary therapy that there can be already differences between the primary tumor and synchronous lymph node metastases (LMN). The aim of the present study was to compare the HER2/ER/PR expression profiles of primary tumors and synchronous LNM. Methods: 159 patients with breast cancer and LNM who underwent surgery (either SLNB or ALND) between 2008 and 2016 at the university hospital of Leipzig were included in this study. Formalin-fixed and paraffin-embedded (FFPE-material) were routinely examined immunohistochemically according to the ASCO/CAP guidelines using Ventana-platform. The results for ER, PR and Her-2 were analysed cay-by-case comparing results from the primary tumor within the breast and axillary lymph nodes. Proliferative activity was determined by MIB-1 immunohistochemistry and according to well established guidelines, the tumors were grouped into the different intrinsic subtypes as luminal A and B, Her2-enriched and triple-negative by the different immunohistochemical staining results. Results: The discordance rates between primary tumors and axillary LNM were 14% (22/159) for HER2, 10% (16/159) for ER and 23% (36/159) for PR. The subtypes between primary tumor and LNM were different in 35% of all cases (56/159 patients); gain of HER2 in 5/56, activation of HRs in 6/56, loss of HER2 in 19/56 and loss of HRs in 37/59 cases. Conclusions: Our results imply the high frequency of subtype differences between primary tumor and LNM. Subtype changes should be taken into account for an optimal and individual treatment. Larger studies are necessary to validate these data and gain further information. Legal entity responsible for the study: B. Aktas. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
A CRITICAL EVALUATION OF THE HAZEWINKEL CRITERIA FOR THE OPTICAL DIAGNOSIS OF SESSILE SERRATED LESIONS (SSL) AT THE BEGINNING OF A LEARNING PROCESS
Authors: M Bustamante-Balen, C Satorres, M García-Campos, N García-Morales, N Alonso, M Ponce, C Sanchez-Montes, V Pons
Journal: Endoscopy (2019)

To describe how the main characteristics of the Hazewinkel criteria for SS are identified by a group of non-experienced endoscopists
FEASIBILITY, SAFETY, TOLERABILITY AND DOSE-RELATED EFFICACY OF A NOVEL CRYOBALLOON SWIPE ABLATION (CBSAS90) DEVICE IN DYSPLASTIC BARRETT'S ESOPHAGUS
Authors: SN van Munster, A Overwater, GM Raicu, CA Seldenrijk, WB Nagengast, EJ Schoon, JJGHM Bergman, BLAM Weusten
Journal: Endoscopy (2019)

Cryoballoon ablation is endoscopic cryotherapy for Barrett's esophagus (BE), which offers potential advantages over heat-based ablation. Focal CBA has been promising for limited BE, whereas the novel 90 °-swipe CBA (CbSAS90) ablates larger areas (90 ° over 3 cm) in a single-step. The controller software allows for dose adjustment (rate at which the diffuser traverses the 3 cm long catheter axis while emitting cryogen). CbSAS90 has been feasible and safe in animal and pre-esophagectomy studies. This is the first clinical study to assess feasibility, safety and efficacy of CbSAS90 for dysplastic BE.
Association Between Unrecognized Myocardial Infarction and Cerebral Infarction on Magnetic Resonance Imaging
Authors: Alexander E. Merkler, Sigurdur Sigurdsson, Gudny Eiriksdottir, Monika M. Safford, Caroline L. Phillips, Costantino Iadecola, Vilmundur Gudnason, Jonathan W. Weinsaft, Hooman Kamel, Andrew E. Arai, Lenore J. Launer
Journal: JAMA Neurology (2019)

It is uncertain whether unrecognized myocardial infarction (MI) is a risk factor for cerebral infarction.To determine whether unrecognized MI detected by cardiac magnetic resonance imaging (MRI) is associated with cerebral infarction.This is a cross-sectional study of ICELAND MI, a cohort substudy of the Age, Gene/Environment Susceptibility-Reykjavik Study conducted in Iceland. Enrollment occurred from January 2004 to January 2007 from a community-dwelling cohort of older Icelandic individuals. Participants aged 67 to 93 years who underwent both brain MRI and late gadolinium enhancement cardiac MRI were included. Data analysis was performed from September 2018 to March 2019.Unrecognized MI identified by cardiac MRI.Unrecognized MI was defined as cardiac MRI evidence of MI without a history of clinically evident MI. Recognized MI was defined as cardiac MRI evidence of MI with a history of clinically evident MI. Cerebral infarctions on brain MRI were included regardless of associated symptoms. Multiple logistic regression was used to evaluate the association between MI status (no MI, unrecognized MI, or recognized MI) and cerebral infarction after adjustment for demographic factors and vascular risk factors. In addition, we evaluated the association between unrecognized MI and embolic infarcts of undetermined source.Five enrolled participants had nondiagnostic brain MRI studies and were excluded. Among 925 participants, 480 (51.9%) were women; the mean (SD) age was 75.9 (5.3) years. There were 221 participants (23.9%) with cardiac MRI evidence of MI, of whom 68 had recognized MI and 153 unrecognized MI. There were 308 participants (33.3%) with brain MRI evidence of cerebral infarction; 93 (10.0%) had embolic infarcts of undetermined source. After adjustment for demographic factors and vascular risk factors, the likelihood (odds ratio) of having cerebral infarction was 2.0 (95% CI, 1.2-3.4; P = .01) for recognized MI and 1.5 (95% CI, 1.02-2.2; P = .04) for unrecognized MI. After adjustment for demographics and vascular risk factors, unrecognized MI was also associated with embolic infarcts of undetermined source (odds ratio, 2.0 [95% CI, 1.1-3.5]; P = .02).In a population-based sample, we found an association between unrecognized MI and cerebral infarction. These findings suggest that unrecognized MI may be a novel risk factor for cardiac embolism and cerebral infarction.
Abstract 17275: The Natural History of Patients Post-Acute Coronary Syndrome Based on Heart Failure Status - An Analysis of the IMPROVE-IT Trial
Authors: Andrew P Ambrosy, Lucasz P Cerbin, Robert Clare, Yuliya Lokhnygina, Andrew Tershakovec, Matthew T Roe, Michael Blazing
Journal: Circulation (2017)

Background: Acute myocardial infarction complicated by systolic dysfunction and/or signs and symptoms of heart failure (HF) is associated with worse outcomes. However, the natural history of patien...
Carfilzomib-Associated Renal Toxicity Is Common and Unpredictable: An Analysis of 114 Patients
Authors: Efstathios Kastritis, Maria Roussou, Charikleia Gakiopoulou, Erasmia Psimenou, Maria Gavriatopoulou, Magdalini Migkou, Nikolaos Kanellias, Ioanna Dialoupi, Dimitrios C. Ziogas, Evangelos Eleutherakis-Papaiakovou, Despina Fotiou, Aristea-Maria Papanota, Stavroula Giannouli, Anastasia Pouli, Zafeirios Kartasis, Christina Delavinia, Konstantinos Efstathiou, Ioanna Tatouli, Fotios Michas, Sofoklis Kontogiannis, Evangelos Terpos, Meletios A Dimopoulos
Journal: Blood (2018)
Expression of immunomodulatory molecule, programmed death ligand-1 in triple negative invasive breast cancer in the Indian population
Authors: N.B. Gorijavolu, P. Augustine, L. Subhadra Devi, G.R. Antony, J. Kattoor, A. Mathew
Journal: Annals of Oncology (2019)

Background: Triple negative breast cancer (TNBC) account for about 30% of invasive breast cancers in the Indian population. TNBC is an inherently aggressive cancer with limited treatment options. Hence alternative lines of treatment are the urgent need of the day. Immune checkpoint inhibitors are a new class of drugs used in the treatment of various cancers, the advantage being long lasting response and reduced toxicity.PDL-1 is a ligand which is a part of this immunomodulating pathway. Methods: Paraffin blocks of 201 triple negative breast cancer (TNBC) patients are tested for the expression of PDL-1 expression by immunohistochemistry. Clinicopathological features associated with PDL-1 expressing cancers were compared with PDL-1 negative cancers. 5-year Disease free survival (DFS)and pathological complete response (pCR) were compared between PDL-1 positive and negative TNBC patients. Results: 201 blocks of TNBC patients were evaluated for expression of PDL-1 receptor with immunohistochemistry. 48.2% of patients were PDL-1 positive,51.7% were PDL-1 negative. The probability of 5-year disease free survival(DFS) of PDL-1 positive patients was 82% compared to 87.2% in PDL-1 negative patients. There was no statistical significant difference in 5-year DFS between PDL-1 positive and negative patients. There is no statistically significant association between PDL-1 positivity and clinicopathological factors like age, pathological tumor stage, pathological nodal status, grade, lymphovascular invasion and pathological complete response. Conclusions: Expression of PDL-1 was approximately 50% in triple negative invasive breast cancers in the Indian population. Disease free survival is comparable between PDL-1 positive patients and PDL-1 negative patients. Factors like age, histological type, pathological tumor stage, pathological nodal status or lymphovascular invasion and response to chemotherapy were not significantly different between PDL-1 positive and negative patients.PDL-1 expression may serve as a predictive factor for response to treatment with immune check point inhibitors in the future.PDL-1 testing needs further standardization. Legal entity responsible for the study: Scientific Review Committee, Regional Cancer Centre. Funding: Regional Cancer Centre, Trivandrum, India. Disclosure: All authors have declared no conflicts of interest.