tbuckley/cabot-search huggingface dataset:
Bone mineral density in men with <i>de novo</i> metastatic castration-sensitive prostate cancer treated with or without abiraterone plus prednisone in the PEACE-1 phase 3 trial.
Authors: Guilhem Roubaud, Marie Kostine, Raymond S. McDermott, Alice Bernard-Tessier, Xavier Maldonado, Marlon Silva, Aude Flechon, Dominik R. Berthold, Philippe Ronchin, Bertrand F. Tombal, Loic Mourey, Gwenaelle Gravis, Anne Escande, Sophie Abadie Lacourtoisie, Antoine Thiery-Vuillemin, Miguel Angel A. Climent Duran, Hélène Ribault, Alberto Bossi, Stéphanie Foulon, Karim Fizazi
Journal: Journal of Clinical Oncology (2022)

19 Background: Addition of abiraterone plus prednisone (AAP) to androgen deprivation therapy (ADT) with or without docetaxel (D) improved overall survival in men with de novo metastatic castration sensitive prostate cancer in PEACE-1 trial. An analysis of bone mineral density (BMD) was planned by an amendment in the last randomized patients to assess whether addition of AAP increases bone loss. Methods: Patients (pts) were randomized to receive either ADT + D + AAP or ADT + D (and also randomized for radiotherapy given to the prostate). BMD (g/cm 2 ) of the lumbar spine (L), femoral neck (F) and total hip (H) were measured by dual x-ray absorptiometry at baseline, M6, M12 and M24 in both arms. Mean percent change in BMD values from baseline to the different time points were calculated. T-Scores were also assessed. Results: Among the 210 pts with BMD data, 182 (87%) had available data at baseline, 109 (52%) at M6, 94 (45%) at M12, and 109 (52%) at M24: 97 pts were treated with AAP and 98 without. In both arms, the median age was 65 years and 69 pts (71%) were ECOG PS 0. Median body mass index (BMI) was 25.6 and 26.5 kg/m 2 in pts treated with or without AAP, respectively. BMD, T score and mean percent change in BMD values are summarized in the Table. Conclusions: This is the first prospective assessment of BMD in a randomized trial, according to an experimental treatment with AAP. Despite a bone loss increase in both arms over time, addition of AAP to ADT+D was associated with no or modest difference in bone loss during the first 2 years, compared to ADT+D. Data including fractures will be presented. Main limitations include the difficulty to reliably assess BMD in men with bone metastases, the limited sample size and the short follow-up (i.e. 2 years). Clinical trial information: NCT01957436. [Table: see text]
Tuberculosis Undefeated
Authors: J. Crofton
Journal: BMJ (1960)

I account it a great privilege to be asked to give this lecture in memory of my friend Marc Daniels.From him I first learnt about the epidemiology of tuberculosis and much about the scientific approach to its study.But.for him, tuberculosis was not merely an intellectual interest.He had a passionate concern for the welfare of the men and women behind the facts and figures.It was this underlying passion, coupled with a high and sane intelligence, which enabled him to contribute so much in this field in the course of his short life.First of all I must excuse the somewhat sententious title of my lecture.I believe that we now have the weapons to defeat tuberculosis finally and completely, but that we could be using these weapons more exten- sively, more intensively, and more intelligently than at present.In economically developed countries we have certainly made progress, but might not this progress be much more rapid ?In this lecture I intend to review the weapons at our disposal and make some suggestions about their better use.The World Health Organization calculates that at the present time between 0.5 and l % of the world's popula- tion are coughing up tubercle bacilli (Holm, 1959).That is to say, there may be 12 to 25 million infectious cases throughout the world.An estimate based on a large- scale sample survey (Indian Council of Medical Research, 1959) suggests that in India alone there are four to eight million active or probably active cases.Logan and Benjamin (1957) calculate that in England and Wales there are probably about 375,000 cases of respiratory tuberculosis, of which about 45,000 are infectious.Confronted with such an astronomical computation of distress, it is clear that tuberculosis is very far from being defeated, even in economically developed countries.Indeed, in underdeveloped countries it is often said that
Smallpox.
Authors: A B Christie
Journal: BMJ (1973)

patient under anaesthesia before the diagnosis is established.Although eight patients (24%) in the series gave a history of previous anal disorder and treatment it was only in three patients (9%) that this occurred less than two years before the symptoms of intersphincteric abscess developed.In ad- dition 76% of the patients had no previous anal symptoms.Hence if previous anal disorder is an aetiological factor in the development of intersphincteric abscess, it is rare.The initial symptoms, however, might be those of a fissure which had healed.The treatment by laying open the abscess is effective provided that the subsequent treatment is designed to pre- vent "pocketing".It is important to remember that a fissure associated with an intersphincteric abscess will not respond to treatment by a lateral sphincterotomy.It is recommended, therefore, that before an anal fissure is treated operatively it is palpated bidigitally for induration and its base very gently examined for the presence of an opening.We are grateful to the surgical staff of St. Mark's Hospital for allowing us access to the records of patients under their care.
Malaria Prophylaxis
Authors: N. H. Fairley
Journal: BMJ (1954)

BUTImiMEDICAL JOURNMI the first group the average dose was 88 mg. and in the second group it was 96 mg.Very few of my patients have had more than 50 mg.;most have had 30 to 40 mg.This may account for the higher incidence of muscle pains encoun- tered by Dr.
Abstract 248: Geographic Variability in Population Outcomes for Out-of-Hospital Cardiac Arrest
Authors: Alexis Zebrowski, Douglas J Wiebe, David Karp, David G Buckler, Manqing Liu, David F Gaieski, Benjamin S Abella, Brendan G Carr
Journal: Circulation (2018)

Introduction: Significant work has described patient and hospital level variability in survival after out-of-cardiac arrest (OHCA). OHCA requires a population based systems response in order to optimize regional outcomes, but no regional or systems level incentives exist. We used population based claims data to empirically describe geographic utilization patterns for OHCA and then benchmarked and compared population level outcomes. Methods: OHCA cases were identified from the Healthcare Cost and Utilization Project’s State Emergency Department Databases and State Inpatient Databases for 2011 in 3 states, (NY, NE, FL). Patient cohorts were identified using an ICD-9-CM code of 427.5 for the principal (outpatient) or admitting (inpatient) diagnosis. Exclusion criteria included living outside of the study area and no valid residential ZIP code. Geographic clusters were identified based on hospital utilization patterns at the ZIP code tabulation area level using hierarchical clustering. Boundary zip codes could belong to more than one regional cluster. Adjusted survival was calculated using multi-level logistic regression controlling for demographic, hospital, and community-level variables for each cluster. Results: In 2011, there were 17,086 OHCA treated in the study region, with a mean survival rate to admission of 18.2%; 5.1% to discharge. Hospitals and ZIP codes were grouped into 26 regions (OHCA cases per region: range 7-4,698). Regional unadjusted survival to admission ranged from 0-26.6% and adjusted from 2.8-25.0%. Crude survival to discharge rates ranged from 0-12.8%, and adjusted rates ranged from 1.7-7.6% (Figure 1). Conclusions: This novel approach demonstrates a method by which to measure regional variability in OHCA survival. Because the region is determined empirically based on a utilization based attribution method, population based incentives (or penalties) could be created by payers.
Food Poisoning
Authors: J. Burnford
Journal: BMJ (1938)

~~~~~~~~~~~~~~~~~~~~~~~~~~NIEDICAL JOU!RNALE be nullified by persistence in the use of tobacco.We thlerefore insist that our patients should stop smoktng.Summary 1.A further series of cases treated by intermittent venous occlusion has yielded encouraging resuilts.2. The treatment is especially suitable in cases of obliter- ative arterial disease with a poor collateral circulation.We are again indebted to Professors D. M. Dunlop and Sir John Fraser for their interest and help, and
Social justice: what’s in it for gender equality and health?
Authors: Sarah Hawkes, Jennie Gamlin, Kent Buse
Journal: BMJ (2022)

Social justice framing and approaches can help accelerate progress towards gender equality and reducing health and wellbeing inequities. Yet in addition to promoting action on the inequitable distribution of power and privilege, campaigners need to make a case for a state that proactively promotes and upholds collective wellbeing, say Sarah Hawkes, Jennie Gamlin, and Kent Buse
SWOG S1314: A randomized phase II study of co-expression extrapolation (COXEN) with neoadjuvant chemotherapy for localized, muscle-invasive bladder cancer with overall survival follow up.
Authors: Thomas W. Flaig, Catherine Tangen, Siamak Daneshmand, Ajjai Shivaram Alva, M. Scott Lucia, David McConkey, Dan Theodorescu, Amir Goldkorn, Matthew I. Milowsky, Rick Bangs, Gary R. MacVicar, Bruno R. Bastos, Jared Fowles, Daniel Gustafson, Melissa Plets, Ian Murchie Thompson, Seth P. Lerner
Journal: Journal of Clinical Oncology (2022)

536 Background: This trial evaluated COXEN, a gene expression model, as a predictive biomarker in muscle-invasive bladder cancer (BC) patients randomized to Gemcitabine-Cisplatin (GC) or dose-dense Methotrexate-Vinblastine-Adriamycin/doxorubicin-Cisplatin (ddMVAC). Primary results correlating COXEN with pathologic response at surgery have been reported. This secondary analysis includes progression-free (PFS) and overall survival (OS). Methods: Eligibility included Stage cT2-T4a N0 M0, urothelial BC (mixed histology allowed), ≥ 5 mm of viable tumor, cisplatin eligible, with plan for cystectomy. 237 patients were randomized between ddMVAC, given every 14 days for 4 cycles, and GC, given every 21 days for 4 cycles. Cox regression was used to evaluate COXEN score or treatment arm association with PFS and OS, adjusting for stratification factors (stage and PS). Results: 167 patients were included in the primary COXEN analysis all having either at least 3 cycles of chemo and surgery within 100 days of last chemo or having progressed while receiving chemo. The COXEN scores were not significantly prognostic for OS or PFS in their respective arms; the COXEN GC score was a significant predictor for OS in pooled arms. OS and PFS data are shown for both scores in the table. In the intent to treat analysis (n=227), there was no significant difference in OS or PFS for ddMVAC versus GC (for OS, HR =0.87, 95% CI 0.54-1.40), p = 0.57); for PFS (HR= 0.76 95% CI 0.58-1.01, p = 0.055). Association of path response with OS will be presented. Conclusions: The COXEN GC score may be prognostic of survival in those receiving platinum-based neoadjuvant treatment. The randomized, prospective design provides estimates of OS and PFS for GC and ddMVAC that appear comparable, but this phase II trial is underpowered for definitive comparisons. The prospective data and correlative samples from S1314 will allow for further assessment of COXEN and other RNA and DNA based predictive and prognostic biomarkers. Clinical trial information: NCT02177695. [Table: see text]
Editorial: Is the cholera pandemic waning?
Journal: BMJ (1976)

tions.One22 states that: ". . .any propoOals for softening the water supply in any part of the country [UK] should be considered in the light of knowledge about the observed positive relationship between the death rate from ischaemic heart disease and the softness of the local water supply."The second23 states: "Where domestic water softeners are used, it might be prudent for drinking-water to be taken from the mains supply."Both are counsels for inaction, which is the most our present knowledge should allow.
Myocardial Fibrosis Predicts Ventricular Arrhythmias and Sudden Death After Cardiac Electronic Device Implantation
Authors: Francisco Leyva, Abbasin Zegard, Osita Okafor, Paul Foley, Fraz Umar, Robin J. Taylor, Howard Marshall, Berthold Stegemann, William Moody, Richard P. Steeds, Brian P. Halliday, Daniel J. Hammersley, Richard E. Jones, Sanjay K. Prasad, Tian Qiu
Journal: Journal of the American College of Cardiology (2022)
Testing Cholesterol Accuracy
Authors: David D. Koch
Journal: JAMA (1988)

The national emphasis on assessing coronary risk by cholesterol testing mandates that analytical determinations be as accurate and precise as is medically necessary. One goal of the National Cholesterol Education Program is to improve the quality of laboratory tests. Currently, 5% limits of imprecision and 5% of bias vs the nationally accepted Abell-Kendall reference method is recommended, with a goal of reducing these limits to 3% by 1992. Clinicians must be aware of how the cholesterol values are obtained, and especially whether the laboratory's method meets the performance goals. We assayed patients' serum samples for cholesterol using several commercially available, routinely used enzymatic methods and by the Abell-Kendall reference method. Precision of these methods was also assessed using serum-based controls. All instruments were operated precisely according to the manufacturers' instructions. Performance was objectively judged based on the National Cholesterol Education Program goals and on medically allowable total error. In all cases, the DuPont aca, the Kodak Ektachem, the Hitachi 737, and the Cobas FARA determined cholesterol levels acceptably. The precision and accuracy goals of 3% are achievable by these methods. (<i>JAMA</i>1988;260:2552-2557)
Survival outcomes with radical cystectomy (RC) in localized clinically node-positive bladder cancer (CNBC).
Authors: Stuthi Perimbeti, Changchuan Jiang, Lei Deng, Karan Jatwani, Anahat Kaur, Saby George, Gurkamal S. Chatta, Dharmesh Gopalakrishnan
Journal: Journal of Clinical Oncology (2022)

520 Background: The role of RC in patients with CNBC remains unclear since most prospective clinical trials excluded them. Our study aims to evaluate overall survival (OS) in patients with CNBC treated with systemic chemotherapy (SC) with or without RC. Methods: We queried the National Cancer Database for adult patients who received SC for localized CNBC during the years 2004 to 2018. Patients with distant metastases, including to non-regional nodes, and those treated with radiation to the bladder or pelvic nodes were excluded. Chi-square and Mann Whitney U tests were used to compare frequency distributions. Cox proportional hazards analysis was employed for multivariate analysis of factors associated with OS. Results: A total of 8464 patients were identified – 3565 (42.1%) underwent RC + SC (RC + ), while 4899 (57.9%) received only SC (RC - ). Median age at diagnosis was 65y in the RC + grp vs. 68y in the RC - grp ( P = 0.006). Majority of patients were Caucasian in both grps – 86.9% and 85.1%, respectively. 5y-OS was 34.1% in the RC + grp vs. 36.1% in the RC - grp ( P = 0.06). On multivariate analysis, factors independently associated with OS were RC + status (Hazard ratio (HR) 0.81, 95% CI 0.75-0.88, P &lt; 0.001), advanced age (70-85y vs. 18-35y, HR 1.88, 95% CI 1.18-3.01, P &lt; 0.001), female gender (HR 1.20, 95% CI 1.12-1.28, P = 0.001), African American (vs. Caucasian) race (HR 1.24, 95% CI:1.10-1.40, P = 0.0004), ≥ 2 comorbidities (HR 1.67, 95% CI 1.34-1.92, P = 0.001), annual income ( &lt; $30,000 vs &gt; $45,000, HR 1.24, 95% CI 1.13-1.37, P &lt; 0.001), and insurance status (uninsured vs. private, HR 1.39, 1.15-1.67, P &lt; 0.001). Conclusions: In this large retrospective analysis, among patients with localized CNBC who received SC, 5y-OS rates were comparable with or without RC. However, RC was associated with improved OS on multivariate analysis.[Table: see text]
Epigenetic modification in alcohol‐related liver diseases
Authors: Amir Ajoolabady, Hamid Aslkhodapasandhokmabad, Yuan Zhou, Jun Ren
Journal: Medicinal Research Reviews (2022)

Abstract Alcohol‐related liver disease (ARLD) refers to a spectrum of hepatic damage triggered by excessive alcohol intake, resulting in inflamed and swollen livers, ultimately, liver cirrhosis. Alcoholic liver disease (ALD) is a similar term denoting liver disorders encompassing steatosis, cirrhosis, and hepatocellular carcinoma. Recent evidence has suggested a vital role for epigenetic factors, which modulate gene expression in the absence of changes in DNA sequence, in the onset and progression of liver disorders, to foster hepatic fibrogenesis and cirrhosis. Mounting findings have delineated that alcohol consumption extensively modulates liver epigenetics, thus, prompting the etiology of ARLD and ALD. Alcohol‐induced epigenetic modifications (AIEM) in the liver encompass histone modification, microRNA‐induced genetic modulation, DNA methylation, and alcohol‐evoked cell signaling that alters gene expression. Herein, we aim at summarizing key findings to decipher AIEM and its role in the onset and development of ARLD and ALD from the perspectives of both cellular and animal models of alcohol exposure. Furthermore, we will share our viewpoints on epigenetics‐based therapeutic options in the management of ARLD and ALD.
68ga-PSMA-11 patients with newly diagnosed and recurrent prostate cancer (Firefly).
Authors: Charlotte Manogue, Grant Rauterkus, Malcolm Light, Isabelle P. Sussman, Alex Lieberman, Minqi Huang, Gaynelle Davis, Pedro C. Barata, Jodi Lyn Layton, Brian E. Lewis, Kendra Marie Harris, Hailey Manning, A. Oliver Sartor
Journal: Journal of Clinical Oncology (2022)

TPS189 Background: A primary challenge facing oncologists is the accurate identification of the source of the rising PSA in the recurrent disease setting and the failure of proper staging at the time of initial therapy. Current imaging modalities perform poorly in this regard. PSMA imaging is FDA approved but reimbursement remains a considerable issue for most patients. Methods: This is a phase II expanded access intermediate sized clinical trial using 68 Ga-PSMA-11 (Telix Pharma cold kit) under our own Investigational New Drug (IND) with the FDA. Two cohorts are utilized, recurrent disease with a PSA &gt; 0.2 or &gt; 2.0 post-radiation, and newly diagnosed high risk localized disease and/or oligo-metastatic patients as assessed by conventional imaging. 300 patients will be allowed to enroll and 63 are enrolled to date. Patients will be injected with 1.8–2.2 MBq/kg body weight with 68 Ga-PSMA-11 (per EANM guidelines). The lower and upper limits of the dose are set to 3 to 7 mCi respectively. Primary Objective(s): Utilize 68 Ga-PSMA-11 PET images to define uptake location for localization of prostate cancer metastatic sites in patients prior to initial therapy and to utilize 68 Ga-PSMA-11 PET images to define uptake location for localization of prostate cancer including both local recurrences and metastatic sites in patients with recurrent disease after initial therapy. Secondary Objectives: To assess the therapeutic consequences of 68 Ga-PSMA-11 PET/CT imaging in prostate cancer patients with and without prior treatment. As such the planned therapies after the PSMA scan will be annotated and recorded. In addition, we aim to determine the number of patients with metastatic disease prior to initial therapy that was not diagnosed with conventional imaging and we aim to determine the locations of recurrent disease for those patients who have demonstrated PSA recurrence after curative therapy. Percentage of positive scans will be assessed for PSA values 0.2-0.5 ng/mL, &gt; 0.5-1.0 ng/mL, &gt; 1.0- &gt; 2.0 ng/mL, and &gt; 2 ng/mL. Results will be summarized descriptively with 95% confidence intervals. Localization of all lesions will be performed with regard to lymph nodes (pelvic versus non-pelvis), bones (by location), and other (by site). Treatment planning will be captured and quantified by radiation, surgery, hormonal therapy (type and duration), and/or observation at the time of the initial clinical visit after the PSMA scan and 6 months later. This trial is open and recruiting patients. Data analysis has not been performed. Clinical trial information: NCT04854369.
Effect of PAIP1 on the metastatic potential and prognostic significance in oral squamous cell carcinoma
Authors: Neeti Swarup, Kyoung-Ok Hong, Kunal Chawla, Su-Jung Choi, Ji-Ae Shin, Kyu-Young Oh, Hye-Jung Yoon, Jae-Il Lee, Sung-Dae Cho, Seong-Doo Hong
Journal: International Journal of Oral Science (2022)

Abstract Poly Adenylate Binding Protein Interacting protein 1 (PAIP1) plays a critical role in translation initiation and is associated with the several cancer types. However, its function and clinical significance have not yet been described in oral squamous cell carcinoma (OSCC) and its associated features like lymph node metastasis (LNM). Here, we used the data available from Gene Expression Omnibus (GEO), The Cancer Genome Atlas (TCGA), and Clinical Proteomic Tumor Analysis Consortium (CPTAC) to analyze PAIP1 expression in oral cancer. The publicly available data suggests that PAIP1 mRNA and protein levels were increased in OSCC. The high PAIP1 expression was more evident in samples with advanced stage, LNM, and worse pattern of invasion. Moreover, the in vitro experiments revealed that PAIP1 knockdown attenuated colony forming, the aggressiveness of OSCC cell lines, decreasing MMP9 activity and SRC phosphorylation. Importantly, we found a correlation between PAIP1 and pSRC through the analysis of the IHC scores and CPTAC data in patient samples. Our findings suggest that PAIP1 could be an independent prognostic factor in OSCC with LNM and a suitable therapeutic target to improve OSCC patient outcomes.
A nomogram for decision-making assistance on surgical treatment of chronic osteomyelitis in long bones: Establishment and validation based on a retrospective multicenter cohort
Authors: Hongyi Zhu, Yanchun Gao, Caiming Wang, Zihua Chen, Xiaowen Yu, Xiaodong Qi, Qinggang Sun, Wenjun Zhang, Wenqi Song
Journal: International Journal of Surgery (2022)
Distress Management
Authors: _ _
Journal: Journal of the National Comprehensive Cancer Network (2007)

All patients experience some level of distress at various stages of the diagnosis and treatment of cancer. Physicians' ability to recognize patients' distress has become more challenging as cancer care has shifted to the ambulatory setting, where visits are often short and rushed. Therefore, using clinical practice guidelines for managing psychosocial distress in cancer patients is critical. These guidelines recommend that each new patient be rapidly assessed in the office or clinic waiting room for evidence of distress. For the most recent version of the guidelines, please visit NCCN.org