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Month: September 2015

Background.Conflicting data exist regarding the prognostic impact of the isocitrate dehydrogenase (IDH) mutation in intrahepatic cholangiocarcinoma (ICC), and limited data exist in patients with advanced-stage disease. Similarly, the clinical phenotype of patients with advanced IDH mutant (IDHm) ICC has not been characterized. In this study, we report the correlation of IDH mutation status with prognosis and clinicopathologic features in patients with advanced ICC.Methods.Patients with histologically confirmed advanced ICC who underwent tumor mutational profiling as a routine part of their care between 2009 and 2014 were evaluated. Clinical and pathological data were collected by retrospective chart review for patients with IDHm versus IDH wild-type (IDHwt) ICC. Pretreatment tumor volume was calculated on computed tomography or magnetic resonance imaging.Results.Of the 104 patients with ICC who were evaluated, 30 (28.8%) had an IDH mutation (25.0% IDH1, 3.8% IDH2). The median overall survival did not differ significantly between IDHm and IDHwt patients (15.0 vs. 20.1 months, respectively; p = .17). The pretreatment serum carbohydrate antigen 19-9 (CA19-9) level in IDHm and IDHwt patients was 34.5 and 118.0 U/mL, respectively (p = .04). Age at diagnosis, sex, histologic grade, and pattern of metastasis did not differ significantly by IDH mutation status.Conclusion.The IDH mutation was not associated with prognosis in patients with advanced ICC. The clinical phenotypes of advanced IDHm and IDHwt ICC were similar, but patients with IDHm ICC had a lower median serum CA19-9 level at presentation.Implications for PracticePrevious studies assessing the prognostic impact of the isocitrate dehydrogenase (IDH) gene mutation in intrahepatic cholangiocarcinoma (ICC) mainly focused on patients with early-stage disease who have undergone resection. These studies offer conflicting results. The target population for clinical trials of IDH inhibitors is patients with unresectable or metastatic disease, and the current study is the first to focus on the prognosis and clinical phenotype of this population and reports on the largest cohort of patients with advanced IDH mutant ICC to date. The finding that the IDH mutation lacks prognostic significance in advanced ICC is preliminary and needs to be confirmed prospectively in a larger study.
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[Source: The Oncologist Subject Collection: Precision Medicine]

Looking for a sponsor to a Credit Union

Looking for a sponsor to a Credit Union

Hey guys I am looking to set up an account at a credit union and am in need of someone who already banks there. I don't have friends or family here so I am turning to you guys to see if you could help. I don't have much to compensate for your time but I can offer tickets to my small plate crawl at the end of the month.

submitted by denton757
[link] [4 comments]

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[Source: Triangle: RTP/Raleigh/Durham NC]

Moving to Durham, is area near Duke Regional Hospital OK?

Moving to Durham, is area near Duke Regional Hospital OK?

Coming from out of state, I don't know the area at all, is the area just north of Duke Regional Hospital an OK place to live? Google says it's Braggtown.

I'm talking about between N Duke St and N Roxboro St, not the main Duke University Hospital

submitted by AMoreExcitingName
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[Source: Triangle: RTP/Raleigh/Durham NC]

The Reese by Drees Homes: Plan to be Built $381,900

The Reese by Drees Homes: Plan to be Built $381,900

Durham, NC — This to-be-built home is the Reese by Drees Homes, and is located in Brightleaf at the Park, in Durham, NC. The home has 4 beds, three bathrooms, one half baths, and is 3199 sq-ft. Listing and description provided by newhomes.move.comThis Durham property is 4 bedrooms / 3.5 bathroom for $381900.00. Call (919) 596-9513 to arrange a viewing.


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[Source: Real Estate Search – A service of James Kempski]

Objective.There are limited data on the effects of financial distress (FD) on overall suffering and quality of life (QOL) of patients with advanced cancer (AdCa). In this cross-sectional study, we examined the frequency of FD and its correlates in AdCa.Patients and Methods.We interviewed 149 patients, 77 at a comprehensive cancer center (CCC) and 72 at a general public hospital (GPH). AdCa completed a self-rated FD (subjective experience of distress attributed to financial problems) numeric rating scale (0 = best, 10 = worst) and validated questionnaires assessing symptoms (Edmonton Symptom Assessment System [ESAS]), psychosocial distress (Hospital Anxiety and Depression Scale [HADS]), and QOL (Functional Assessment of Cancer Therapy-General [FACT-G]).Results.The patients’ median age was 60 years (95% confidence interval [CI]: 58.6-61.5 years); 74 (50%) were female; 48 of 77 at CCC (62%) versus 13 of 72 at GPH (18%) were white; 21 of 77 (27%) versus 32 of 72 (38%) at CCC and GPH, respectively, were black; and 7 of 77 (9%) versus 27 of 72 (38%) at CCC and GPH, respectively, were Hispanic (p < .0001). FD was present in 65 of 75 at CCC (86%; 95% CI: 76%-93%) versus 65 of 72 at GPH (90%; 95% CI: 81%-96%; p = .45). The median intensity of FD at CCC and GPH was 4 (interquartile range [IQR]: 1-7) versus 8 (IQR: 3-10), respectively (p = .0003). FD was reported as more severe than physical distress, distress about physical functioning, social/family distress, and emotional distress by 45 (30%), 46 (31%), 64 (43%), and 55 (37%) AdCa, respectively (all significantly worse for patients at GPH) (p < .05). AdCa reported that FD was affecting their general well-being (0 = not at all, 10 = very much) with a median score of 5 (IQR: 1-8). FD correlated (Spearman correlation) with FACT-G (r = -0.23, p = .0057); HADS-anxiety (r = .27, p = .0014), ESAS-anxiety (r = .2, p = .0151), and ESAS-depression (r = .18, p = .0336).Conclusion.FD was very frequent in both groups, but median intensity was double among GPH patients. More than 30% of AdCa rated FD to be more severe than physical, family, and emotional distress. More research is needed to better characterize FD and its correlates in AdCa and possible interventions.Implications for PracticeFinancial distress is an important and common factor contributing to the suffering of advanced cancer patients and their caregivers. It should be suspected in patients with persistent, refractory symptom expression. Early identification, measurement, and documentation will allow clinical teams to develop interventions to improve financial distress and its impact on quality of life of advanced cancer patients.
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[Source: The Oncologist Subject Collection: Symptom Management and Supportive Care]

Tonight’s special guests for the cointoss at the Apex High School football game: the officers, including the K9, who tracked down an armed suspect in a robbery near the school this week

Tonight’s special guests for the cointoss at the Apex High School football game: the officers, including the K9, who tracked down an armed suspect in a robbery near the school this week

submitted by rtphokie
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[Source: Triangle: RTP/Raleigh/Durham NC]

Please help support a local Raleigh Startup, Guidebook! (Vote on twitter)

Please help support a local Raleigh Startup, Guidebook! (Vote on twitter)

Hey /r/ Triangle ! Need your help in promoting a local startup called Guidebook in the yearly Event Tech awards. They're a fixture in the local scene and are growing rapidly in downtown Raleigh. They need our help by voting here! Thanks for supporting a local business!

submitted by jachreja
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[Source: Triangle: RTP/Raleigh/Durham NC]

[Request] Looking to hire a local bluegrass/folk music group for graduate school social function?

[Request] Looking to hire a local bluegrass/folk music group for graduate school social function?

The title says most of it. I am in charge of a graduate student group, and we are looking to hire a bluegrass or folk music group to play at a function in mid September (in Durham).

Do any of you know of good groups?

Our budget is as one would expect…not too large.

submitted by rivers31334
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[Source: Triangle: RTP/Raleigh/Durham NC]

Background.This study determined the frequency of drug-related pneumonitis during mammalian target of rapamycin (mTOR) inhibitor therapy in Waldenstrom macroglobulinemia patients and investigated the imaging characteristics and radiographic patterns of pneumonitis.Materials and Methods.A total of 40 patients (23 men, 17 women; 43-84 years old) with Waldenstrom macroglobulinemia treated in 2 trials of the mTOR inhibitor everolimus were retrospectively studied. Chest computed tomography (CT) scans during therapy were reviewed for abnormalities suspicious for drug-related pneumonitis by the consensus of three radiologists, evaluating the extent, distributions, and specific findings. The radiographic patterns of pneumonitis were classified using the American Thoracic Society/European Respiratory Society classification of interstitial pneumonia.Results.Drug-related pneumonitis was noted in 23 patients (58%). The median time from the initiation of therapy to the onset of pneumonitis was 5.7 months. Lower lungs were involved in all 23 patients, with a higher extent than in the other zones (p < .001). The distribution was peripheral and lower in 11 patients (48%) and mixed and multifocal in 10 (44%). The findings were bilateral in 20 patients (87%). Ground glass opacities (GGOs) and reticular opacities were present in all 23 patients, with consolidation in 12, traction bronchiectasis in 2, and centrilobular nodularity in 1. The pattern of pneumonitis was classified as cryptogenic organizing pneumonia (COP) in 16 (70%) and nonspecific interstitial pneumonia (NSIP) in 7 (30%), with overlapping features of COP and NSIP in 7 patients.Conclusion.Drug-related pneumonitis was noted on CT in 58% of Waldenstrom macroglobulinemia patients treated with mTOR inhibitor therapy. Most common findings were bilateral GGOs and reticular opacities, with or without consolidation, in peripheral and lower lungs, demonstrating COP and NSIP patterns.Implications for PracticeThe present study has demonstrated that drug-related pneumonitis during mammalian target of rapamycin (mTOR) inhibitor therapy is highly frequent, occurring in 58% of patients with Waldenstrom macroglobulinemia. The radiographic patterns of pneumonitis demonstrated cryptogenic organizing pneumonia and nonspecific interstitial pneumonia patterns, with overlapping features in 30% of the patients. The present study describes an initial attempt of a radiographic pattern-based approach to drug-related pneumonitis in the era of molecular targeting therapy, with a cohort of patients with Waldenstrom macroglobulinemia receiving mTOR inhibitor therapy as a paradigm, which might contribute to further understanding and in-depth interpretation of lung toxicity during novel cancer therapy.
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[Source: The Oncologist Subject Collection: Symptom Management and Supportive Care]

The Brianna by Drees Homes: Plan to be Built $359,900

The Brianna by Drees Homes: Plan to be Built $359,900

Durham, NC — This to-be-built home is the Brianna by Drees Homes, and is located in Brightleaf at the Park, in Durham, NC. The home has 3 beds, three bathrooms, one half baths, and is 2764 sq-ft. Listing and description provided by newhomes.move.comThis is a 3 bedrooms / 3.5 bathroom property at 300 Plano Dr in Durham for $359900.00. Please call (919) 596-9513 to arrange a viewing.


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[Source: Real Estate Search – A service of James Kempski]

The Buchanan by Drees Homes: Plan to be Built $358,900

The Buchanan by Drees Homes: Plan to be Built $358,900

Durham, NC — This to-be-built home is the Buchanan by Drees Homes, and is located in Brightleaf at the Park, in Durham, NC. The home has 4 beds, two bathrooms, one half baths, and is 2918 square ft. Listing and description provided by newhomes.move.comThis property at 300 Plano Dr in Durham has a 4 bedrooms / 2.5 bathroom and is available for $358900.00. Call us at (919) 596-9513 to arrange a viewing.


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[Source: Real Estate Search – A service of James Kempski]

Background. The CHER-LOB randomized phase II study showed that the combination of lapatinib and trastuzumab plus chemotherapy increases the pathologic complete remission (pCR) rate compared with chemotherapy plus either trastuzumab or lapatinib. A biomarker program was prospectively planned to identify potential predictors of sensitivity to different treatments and to evaluate treatment effect on tumor biomarkers.Materials and Methods.Overall, 121 breast cancer patients positive for human epidermal growth factor 2 (HER2) were randomly assigned to neoadjuvant chemotherapy plus trastuzumab, lapatinib, or both trastuzumab and lapatinib. Pre- and post-treatment samples were centrally evaluated for HER2, p95-HER2, phosphorylated AKT (pAKT), phosphatase and tensin homolog, Ki67, apoptosis, and PIK3CA mutations. Fresh-frozen tissue samples were collected for genomic analyses.Results.A mutation in PIK3CA exon 20 or 9 was documented in 20% of cases. Overall, the pCR rates were similar in PIK3CA wild-type and PIK3CA-mutated patients (33.3% vs. 22.7%; p = .323). For patients receiving trastuzumab plus lapatinib, the probability of pCR was higher in PIK3CA wild-type tumors (48.4% vs. 12.5%; p = .06). Ki67, pAKT, and apoptosis measured on the residual disease were significantly reduced from baseline. The degree of Ki67 inhibition was significantly higher in patients receiving the dual anti-HER2 blockade. The integrated analysis of gene expression and copy number data demonstrated that a 50-gene signature specifically predicted the lapatinib-induced pCR.Conclusion.PIK3CA mutations seem to identify patients who are less likely to benefit from dual anti-HER2 inhibition. p95-HER2 and markers of phosphoinositide 3-kinase pathway deregulation are not confirmed as markers of different sensitivity to trastuzumab or lapatinib.Implications for PracticeHER2 is currently the only validated marker to select breast cancer patients for anti-HER2 treatment; however, it is becoming evident that HER2-positive breast cancer is a heterogeneous disease. In addition, more and more new anti-HER2 treatments are becoming available. There is a need to identify markers of sensitivity to different treatments to move in the direction of treatment personalization. This study identified PIK3CA mutations as a potential predictive marker of resistance to dual anti-HER2 treatment that should be further studied in breast cancer.
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[Source: The Oncologist Subject Collection: Precision Medicine]

Volunteers needed – support Triangle-area survivors of domestic violence!

Volunteers needed – support Triangle-area survivors of domestic violence!

Compass Center (www.compassctr.org) is gearing up for training next month in a number of positions serving individuals in our community who have experienced domestic violence. We would love to see Triangle redditors spread the word about these opportunities with anyone you think might be interested! You can read more about our volunteer positions here – http://compassctr.org/get-involved/volunteer-opportunities/

Compass Center is currently in most need of:

  • Domestic Violence Response Advocates – work directly with survivors in-person and over the phone on our 24-hour hotline providing crisis intervention, emotional support, shelter placement, and community referrals. Compass Center has a great need at this time for Spanish-speaking advocates.

  • Court Advocates – support and advocate for clients in domestic violence court on Thursdays.

  • Spanish Interpreter/Translators – Interpret with clients over the hotline and in-person, and/or translate written materials including educational information and court-related documents.

  • First Response Volunteers – first point of contact for individuals who call or come to our office; FRVs welcome clients, assess their needs and goals, and connect them to Compass Center services and community resources.

  • Domestic Violence Community Educators – facilitate presentations, workshops, and trainings that educate the community about domestic violence and Compass Center services. We have a strong need for bilingual educators.

  • Start Strong Facilitators – School-based program in which facilitators lead interactive presentations on bullying, healthy/unhealthy romantic relationships, red flags for abuse, and bystander intervention.

  • Career Program Volunteers – Assist Compass Center clients in job search, resume/cover letter development, and other career-related needs.

  • Childcare Volunteers – provide childcare for Compass Center clients while they attend our support groups and workshops.

To submit an application, click here -> http://compassctr.org/volunteer-application/

submitted by CCWF
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[Source: Triangle: RTP/Raleigh/Durham NC]

Favorite local camera shops?

Favorite local camera shops?

It's been years – since my 35mm days – since I've stepped into a brick and mortar camera shop, but I'm in need of a few DSLR accessories for an upcoming trip and I'd rather gets some hands-on experience instead of just buying from Amazon. Do you guys have any recommendations for places you'd go for bags, tripods, etc? Thanks!

submitted by Hifi_Hokie
[link] [10 comments]

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[Source: Triangle: RTP/Raleigh/Durham NC]