tbuckley/cabot-search huggingface dataset:
Long-term financial outcomes and quality of life in partners of colorectal cancer survivors.
Authors: Christine M Veenstra, Paul Abrahamse, Arden M. Morris, Sarah T. Hawley
Journal: Journal of Clinical Oncology (2020)

7048 Background: Many patients with colorectal cancer face financial toxicity, but little is known about financial outcomes among their partners. Moreover, virtually nothing is known about associations between partners’ quality of life and their financial outcomes. Methods: In 2019 we surveyed patients who, in 2014-18, underwent resection of Stage III colorectal cancer and were seen at a community oncology practice, an academic cancer center, or reported to Georgia SEER (current RR 46%). Patients gave a separate survey to their partner. 254 partners (68% RR) completed surveys. Partners were asked about financial impacts of the patient’s cancer. Partners’ quality of life (QOL) was measured with the PROMIS global health scale. Multivariable regression analyses of 3 partner-reported outcomes (1. Perception that their financial status is worse off, 2. Substantial worry about finances, 3. Debt related to patients’ cancer) were generated to assess associations between each outcome and key partner and patient variables, and associations between partners’ QOL and financial outcomes. Results: Among partners, 55% were &lt; age 65, 64% female, 86% white, and 27% had &lt; high school education. 61% were employed at time of patient’s diagnosis; 38% of those missed 7-30 days work and 13% missed &gt; 1 month work due to the patient’s cancer. 66% patients were employed at diagnosis. Among those, 34% were no longer working at the time of survey. In 14% dyads only the patient was working at diagnosis and among those, 50% were no longer working at the time of survey. 32% partners reported their financial status is worse off, 36% reported substantial worry about finances, and 28% reported current debt, all due to the patient’s cancer. After adjustment for partner and patient variables, partners of patients further out from diagnosis and partners of patients who were working at diagnosis were more likely to report substantial worry. Partners &lt; age 50, with &lt;high school education, with &gt;1 comorbid condition, and partners of patients who were working at diagnosis were more likely to report debt (all p &lt; 0.05). Endorsing each of the 3 financial outcomes was associated with lower QOL among partners, after adjustment for partner and patient variables (all p &lt; 0.01). Conclusions: Nearly 1/3 of partners of survivors of colorectal cancer reported long-term adverse financial outcomes due to the patient’s cancer. Partners of patients working at the time of diagnosis were more likely to report substantial worry and debt, perhaps because many patients who were working at diagnosis are no longer working in the survivorship period.
急性有机磷中毒患者血清酶学测定及临床意义
Authors: 李岩, 邹莉, 秦菲
Journal: BMJ (2006)

测定360例急性有机磷中毒患者血清肌酸激酶(CK)、乳酸脱氢酶(LDH)及乳酸脱氢酶同工酶(LD1)水平.结果表明,重度中毒患者血清CK、LDH、LD1均明显升高;轻度及中度中毒患者中有部分患者血清CK、LDH、LD1也明显升高.中毒程度与血清酶学变化存在不平行关系,认为急性有机磷中毒患者血清酶学变化缺乏心肌特异性,其中CK升高的主要原因可能是骨骼肌损伤。
Disease profile of inpatients in general practice department of a Grade A tertiary hospital
Authors: Rongying Wang, Feng Li, Zhenyin He, Weijie Wang, Yan Wang, Xiao Zhi, Jinyan Wang
Journal: BMJ (2016)

Objective
To analyze the disease profile of inpatients from general practice department in a Grade A tertiary hospital.


Methods
Information of 3 963 inpatients admitted in general practice department of the Second Hospital of Hebei Medical University from November 2013 to March 2016 was retrospectively analyzed.


Results
Inpatients were admitted from emergency department(10.8%), specialist departments(2.9%) or general practice department(80.3%). The most frequent diagnosis was headache, dizziness or syncope of unknown origin (29.3%), followed by fever of unknown origin (22.4%), cerebrovascular diseases (7.5%). Undifferentiated diseases accounted for 84.2% of all conditions; the diagnostic categories included common diseases, multiple diseases and chronic diseases of all systems. In the discharged patients, 10.9% had one single diagnosis, 23.6% had one comorbidity of chronic diseases, the remaining had two and more comorbidities of chronic diseases. Most inpatients of general practice department were discharged with improvement or cure; the other outcomes included transferred to specialist departments(6.1%), referred to higher level hospitals(2.8%), auto-discharge (0.9%) and death (0.1%).


Conclusions
The disease profile of inpatients in department of general practice in Grade A hospital includes undifferentiated disease, common diseases, frequently encountered diseases and chronic diseases of all systems, multiple diseases are common, which is similar with the disease profile of community health service center. It's suggesting that general practice department in Grade A tertiary hospital can make up for the shortage of specialist departments and meet the basic medical needs of patients.


Key words: 
Hospitals, general; Inpatients; General practice; Disease spectrum
Pan-cancer analysis of FGFR1-3 genomic alterations to reveal a complex molecular landscape.
Authors: Melanie A. Krook, Ian M. Silverman, Karthikeyan Murugesan, Gabrielle Ernst, Julie Reeser, Michele Wing, Garrett M. Frampton, Robert C Newton, Jeffery Richard Jackson, Lee A. Albacker, Timothy Burn, Sameek Roychowdhury
Journal: Journal of Clinical Oncology (2020)

3620 Background: Activating genomic alterations (GAs) in the fibroblast growth factor receptor (FGFR) gene family occur in many tumor types. FGFR1-3 mutations and rearrangements are of particular interest given evidence of clinical activity of selective FGFR inhibitors in patients (pts) with susceptible alterations. We queried FGFR1-3 GAs in patient tumor samples analyzed using comprehensive genomic profiling (CGP) and performed in vitro characterization of select novel alterations. Methods: Tumor samples were assayed by hybrid capture based CGP on 0.8-1.2 Mb of the genome to identify GAs in exons and select introns in up to 404 genes (Foundation Medicine, Inc, Cambridge MA). Cell lines were stably transduced with alterations of interest and transformation assays and drug sensitivity assays were performed to determine oncogenic potential and sensitivity to FGFR inhibition by pemigatinib. Results: GAs in FGFR1-3 were present in 6314 of 274,694 pt specimens (2.3%), of which 4091 (64.8%) were short variants and 2269 (35.9%) were rearrangements. Tumor types with the highest frequency of FGFR1-3 alterations were bladder cancer (17.9%), cholangiocarcinoma (11.1%), endometrial cancer (7.9%), and glioma (5.5%) (Table). We identified 270 unique FGFR1-3 short-variants, including 144 missense mutations and 94 truncating alterations. Of short variants, the most frequent were FGFR3 p.S249C (18.3%), FGFR2 p.S252W (9.9%) and FGFR1 p.N546K (6.9%). Truncating alterations were largely identified in exon 18, downstream of the kinase domain. We identified 476 unique FGFR1-3 rearrangement pairs ( FGFR1; n=77, FGFR2; n=338, FGFR3; n=61). FGFR3-TACC3 was the most prevalent FGFR rearrangement (29.0%), followed by FGFR2-BICC1 and FGFR2-N/A (both 9.7%). In vitro analysis of the transforming potential and drug sensitivity for select alterations will be reported. Conclusions: FGFR1-3 mutations and rearrangements are highly diverse and present at low to moderate frequencies across many cancers. Therefore, cataloging and characterizing these diverse alterations has the potential to facilitate precision medicine. Tumor-specific and -agnostic trials of selective FGFR inhibitors in pts with susceptible alterations are ongoing. [Table: see text]
Outcomes of rectal cancer patients treated using Polish II neoadjuvant short course radiation therapy and chemotherapy approach in comprehensive cancer center.
Authors: Stephen Haff, Syed Mohammad Ali Kazmi, Nina Niu Sanford, Todd Anthony Aguilera, Muhammad Shaalan Beg, Linda Farkas, Joselin Anandam-Matthews, Javier Salgado Pogacnik, Naga Cheedella, Sirisha Karri, Radhika Kainthla, Amy Little Jones, Udit Verma, Aravind Sanjeevaiah, Michael Ryan Folkert
Journal: Journal of Clinical Oncology (2020)

e16088 Background: Neoadjuvant short-course (SC) radiation (RT) followed by fluoropyrimidine based chemotherapy prior to surgery (Polish II approach) is a less utilized treatment in the United States for rectal cancer. Based on data suggesting equivalent or improved outcomes at lower cost compared to the long course neoadjuvant chemoradiation, our team started utilizing this approach for rectal cancer management at Simmons Comprehensive Cancer Center. We aim to document our experience with Polish II approach at NCI-designated comprehensive cancer center program. Methods: A retrospective review of stage I-IV rectal cancer patients, seen at an academic center or the Dallas County safety net hospital and treated at Simmons Comprehensive Cancer Center from Nov 2017 to Dec 2019. Patients were treated with neoadjuvant SC-RT followed by 3 cycles of FOLFOX prior to surgery and followed by adjuvant FOLFOX. Descriptive data for demographic, radiation, chemotherapy and surgery, hospitalizations, 30 day post-surgery admission, time to relapse, and laboratory parameters was collected. Results: Thirty-nine patients met the inclusion criteria (average age 58 years; 74% men/26% women). Forty-six percent of patients were Hispanic, 28.2% White, 15.4% African American and 7.7% Asian. The majority of patients had stage IIIB (46.2%), followed by IIIC (17.9%), IIA (12.8%), IIIA (7.7%), while rest were stage I, IVA or unknown (5.1%). All patients received 5 x 5 SC-RT, 100% completed 3 cycles of planned neoadjuvant FOLFOX (12.8% received 4-8 cycles) and 36/39 (92%) of patients underwent planned surgery. Median duration from SC-RT to chemotherapy was 12 days, and from chemotherapy to surgery was 37 days. Hospitalization occurred in 3 patients (7.7%) during neoadjuvant therapy, and in 8 patients (20.5%) within 30 days post-surgery. Complete pathological response was seen in 6 patients (16.6%) and near-complete pathological response in 3 patients (8.3%). Relapse occurred in 10.3% patients at time of data acquisition. Grade 3 and 4 neutropenia, anemia, and thrombocytopenia in neoadjuvant phase was observed in 8.6%, 25.7%, and 2.8% patients, respectively. Conclusions: In rectal cancer patients treated at a comprehensive cancer center, neoadjuvant Polish-II approach was feasible and well tolerated. Pathological response rates were comparable to historical data. SC-RT based neo-adjuvant therapy approach should be favored due to lower pelvic radiation dose, tolerance and convenience to patients.
Abstract 226: Increasing Accidental Death in Elderly, Drawing in Bathtub and Foreign Body Airway Obstruction, Should Be Prevent in Japan
Authors: Hiroyuki Hanada, Katsuhiro Ito, Shinya Yaguchi, Yoshiya Ishizawa, Kaoru Kita, Kyoji Saito, Yuta Sato
Journal: Circulation (2019)

Background: Japan is facing upcoming unprecedented population problems, proportion of elderly person is increasing year by year. It is expected that 1 in 2.5 people will be 65 years old and over, and 1 in 4 will be 75 years old and over by 2060. All Japan Utstein style registry of out of hospital cardiac arrest (OHCA) from 2005 to 2014 showed that the percentage of patients with OHCA aged 80 years old and more were increasing from 37.1% in 2005 to 47.8% in 2014 by 1% each year. Although cardiogenic cardiac arrests were more frequent than non-cardiogenic, there are specific problems of non-cardiogenic arrests in Japan. Methods: Data analysis using All Japan Utstein style registry from 2005 to 2014, and mortality statistics from Ministry of Health, Labor and Welfare Japan. Results: During 2014 in an age group 80 years old and more, this Utstein style registry reported that 885 OHCA by traffic accidents and 3594 OHCA by drowning happened, and Ministry of Health, Labor and Welfare Japan reported that 6470 death by air way obstruction (AWO). Because it is not common for Japanese elder people to swimming and very common to taking hot bathing every day at home, drowning commonly occurs in bathtub. Among all 7915 case of OHCA by drowning in all aged groups, 155 case was reported to be alive with good neurological status at one month after OHCA. Initial shockable cardiac rhythms were reported in 266 out of 7915 cases (3.4%). All of good neurological survivors showed shockable rhythm initially. In an aged group 80 years old and more, only 2 cases survived to be a good neurological status at one month after OHCA by drawing. Because Utstein style registry did not show any details about OHCA by AWO, we could not report initial rhythm nor yes or no of bystander CPR Conclusion: As OHCA in bathtub and by AWO could being preventable accidental death, we Japanese should have new campaigns nationwide to prevent.
Patterns of thyroid dysfunctions during treatment with immune checkpoint inhibitors (ICI) in 59 solid cancer patients.
Authors: Yong Jiang, Li Yang, Yin Han, Yongshen Zhang, Feng-Ming Kong
Journal: Journal of Clinical Oncology (2020)

e18567 Background: Immune checkpoint inhibitors (ICI) have now become the mainstay treatment in patients with many kinds of cancers. Thyroid dysfunction as the most common endocrine toxicity is poorly understood. This study aimed to report hypothyroidism and exam its changing dynamtic in our first series of patients treated with ICI. Methods: This is a retrospective study. Patients received nivolumab or pembrolizumab between July 2018 and December 2019 were considered. Patient must have euthyroidism within the 3 months before immunotherapy and those had previous use of levothyroxine were excluded. They were monitored by thyroid function tests every cycle until stopping ICI. Patients must have received at least 3 cycles of antibody treatment. Results: Among 89 patients treated, 59 met the inclusion criteria. There were 33 males, 26 females, including 26 (44.1%) nivolumab, and 33 (55.9%) pembrolizumab. Median age was 62 years [range: 27-88]). Cancer diagnoses observed were non small cell lung cancer 17(28.8%), small cell lung cancer 4 (6.8%),liver cancer 9 (15.3%), head and neck cancer 5 (8.5%), esophageal cancer4 (6.8%) colon cancer 3 (5.1%), nasopharygeal carcinoma 3 (5.1%) melanoma 3 (5.1%) and other cancers 11(18.6%). There were 9 patients (15.3%) developed a thyroid dysfunction, including 5 females. Four patients had thyrotoxicosis (median onset: 8 weeks) followed by hypothyroidism. There were three types of thyroid dysfunctions: the first type patients 3 (33.3%) had a brief time period of TSH flair (peak 17.4-57.8) after the first cycle of ICI, followed by TSH dramatic drop companied with rising fT4, which usually returned to normal level during 3-4 cycles of . The other 4 patients (44.4%) with thyroid dysfunction presented with remarkably elevated TSH (15.43-125.2) after 3.5-10 months’ treatment, followed by hypothyroidism development with a need of levothyroxine. The remaining 1 patient had a third type of thyroid dysfunction with elevated TSH, elavated more while the treatment continue, the patient should be given levothyroxine as soon as possible. Additionally, 1 patient developed hypopituitarism presented with both low level of TSH and fT4 after 10 month treatment. There was no significant difference in patient characteristics between patients with hypothyroidism and those without. Conclusions: There are heterogeneity in thyroid function and hypothyroidism after ICI. Before more experience is gained, frequent monitoring of thyroid function during ICI is warranted for prompt management of the hypothyroidism.
Multi-station evaluation of comprehensive ability of Shanghai community general practitioner trainers
Authors: Jie Gu, Zhigang Pan, Xiangjie Zhang, Yuan Zhang, Tianhao Wang, Rong Zhou, Limin Lao
Journal: BMJ (2014)

Objective
To assess the comprehensive ability of community general practitioner (GP) trainers in Shanghai by multi-station evaluation.


Methods
Forty one GP trainers from 4 community teaching base in Shanghai were assessed in a half-day multi-station evaluation including comprehensive knowledge, physical examination, auxiliary investigation, clinical skills and teaching knowledge.


Results
The mean score and pass rate of comprehensive knowledge were highest (80.4±6.8 and 97.6%), and those of teaching knowledge were lowest (44.5±15.1 and 14.6%). The mean score of clinical skills of GP trainers whose duration of community teaching was more than or equal to 5 years was higher than those less than 5 years (72.1±12.3 vs. 54.9±21.5, t=2.974, P=0.007). There was no significant difference in mean score of 5 items between GP trainers with different working seniority and professional titles.The mean score of basic medical theories (F=4.550, P=0.008), X-ray (F=5.438, P=0.003), clinical skills (F=3.503, P=0.025), teaching knowledge (F=12.607, P<0.001), basic teaching theories and methods (F=11.558, P<0.001), regulations and demands of training (F=7.281, P=0.001) were statistical different among 4 community teaching bases.


Conclusions
The teaching ability of community GP trainers is relatively weak and need relevant special training.Multi-station evaluation can be applied in selection and assessment of GP trainers.


Key words: 
General practitioner; Teacher training; Educational measurement
Symptoms and diagnosis of perimenopause female
Authors: Ruijin Wu
Journal: BMJ (2016)

围绝经期女性卵巢功能减退导致类固醇激素水平降低，从而引起泌尿生殖系统、骨骼系统、心血管系统等一系列临床症状，正确识别女性围绝经期常见症状，及时干预治疗，可提高女性围绝经期的生命质量。
Evaluation of CD22 modulation as a mechanism of resistance to inotuzumab ozogamicin (InO): Results from central CD22 testing on the Children’s Oncology Group (COG) phase II trial of INO in children and young adults with CD22+ B-acute lymphoblastic leukemia (B-ALL).
Authors: Nirali N. Shah, Maureen Megan O'Brien, Constance Yuan, Lingyun Ji, Xinxin Xu, Susan R. Rheingold, Deepa Bhojwani, Joanna Yi, Andrew Harris, Patrick A. Brown, Michael J. Borowitz, Meenakshi Devidas, Elizabeth A. Raetz, Lia Gore, Mignon L. Loh
Journal: Journal of Clinical Oncology (2020)

10519 Background: The COG AALL1621 phase 2 trial evaluated the efficacy of InO in children and young adults with relapsed/refractory CD22+ B-cell ALL. We report results of central surface CD22 expression on ALL and impact on response. Methods: Optional central CD22 testing was performed on bone marrow and/or peripheral blood at the NCI flow cytometry (FC) laboratory pre/post cycle 1. Percentage of blasts with CD22+ expression (CD22%) was measured by multiparameter FC and the BD Biosciences QuantiBRITE system quantified the CD22 site density by measuring CD22 antibody bound per cell (ABC). Comparison of ABC and CD22% between subgroups was based on Wilcoxon rank sum test or signed rank test as appropriate. Post-treatment CD22 assessments could only be performed on those with residual ALL. Results: Amongst 48 patients, 28 (58.3%) achieved a complete response (CR) or CR with incomplete count recovery. The median CD22 ABC, pre and post-cycle 1, was 2688 (range, 290-10715, n = 33) and 1098 (184-6822, n = 15) respectively. Amongst 27 subjects with paired pre/post samples, median pre-treatment CD22 ABC was lower in those with residual ALL (n = 13) than in those without residual ALL (ABC 1005 (290-8848) vs ABC 4123 (762-10715), p = 0.003). Baseline CD22% ranged more widely in those with residual ALL, median 99% (40-100%) vs. 99% (92.9-100%, no residual ALL) p = 0.025; and significant decreases in CD22% were seen compared to baseline in those with residual ALL, with median post-treatment CD22% 82% (1.4%-100%), p = 0.007. Amongst 3 subjects with baseline partial CD22% (40%, 79% and 83% partial CD22+ populations), post-cycle 1 evaluations revealed emergence of predominantly CD22 negative populations (6.5%, 34% and 48% CD22+, respectively), precluding eradication of minimal residual disease. Amongst those with KMT2A rearrangement, 2 of 4 had partial CD22 expression and 4 of 4 had low ABC ( &lt; 1500). Conclusions: Baseline CD22 expression, specifically low CD22 ABC and partial CD22% were significantly associated with response to treatment, emerging as potential biomarkers for poor InO response. This is particularly relevant to patients with KMT2Arearrangement who may be predisposed to CD22 partial positivity and low ABC. Evolution of CD22 negative/dim disease post-therapy suggests CD22 modulation is a mechanism of resistance to InO. Response to InO monotherapy may be limited in those with baseline CD22 negative/dim populations. Clinical trial information: NCT02981628.
腺样体肥大儿童腺样体切除前后免疫水平变化
Authors: 李卫红, 叶京英, 许桂花, 王军, 徐文, 鲁辛辛
Journal: BMJ (2004)

为探讨腺样体切除术的最佳手术时机,我们于腺样体切除术前1周检测53例患儿血清IgA、IgG、IgM、IgE水平,血清IgA、IgG、IgM水平≤6岁组患儿高于对照组(P<0.05),＞6岁组患儿与对照组差异无显著性,术后2～4周患儿血清IgA、IgG水平下降(P<0.05)。
慢性疼痛的用药问题
Authors: 杨阳, 樊碧发
Journal: BMJ (2012)

疼痛是各科临床医生最常遇到的一类问题,其中慢性疼痛对患者的生存质量及情感产生明显的影响,有些甚至查不出明确病因,这类疼痛本身就是一种疾病.本文对此类疼痛的药物治疗原则与用药方法进行介绍,以助于用药水平的提高。
Frontline brentuximab vedotin as monotherapy or in combination for older Hodgkin lymphoma patients.
Authors: Christopher A. Yasenchak, Rodolfo Eduardo Bordoni, Dipti Patel-Donnelly, Tim Larson, Jerome H. Goldschmidt, Ralph V. Boccia, Vivian Jean M. Cline, Andres Forero-Torres, Robert Brownell Sims, Trevor Newhook, Jonathan W. Friedberg
Journal: Journal of Clinical Oncology (2020)

8032 Background: Older patients with classical Hodgkin lymphoma (cHL) have poor outcomes relative to younger patients, often due to comorbidities and toxicities related to standard first-line (1L) chemotherapy (5-yr PFS: 30%–45% vs 75%–80%) (Evens 2008; Proctor 2009). Brentuximab vedotin (BV, ADCETRIS ® ), a CD30-directed antibody-drug conjugate, has robust activity in patients refractory to several lines of chemotherapy. Methods: This phase 2, open-label study, SGN35-015 (NCT01716806), evaluated efficacy and tolerability of BV alone or combined with single-agents in treatment-naive cHL patients ≥60 yr. The full-analysis set (FAS) includes all patients who received BV (1.8 mg/kg IV). Patients in Part A received BV monotherapy on Day 1 of every 3-week cycle (n = 26); Part B: BV+dacarbazine (DTIC; 375 mg/m 2 ; n = 19); Part C: BV+bendamustine (benda; 70 mg/m 2 ; n = 20); and Part D: BV+nivolumab (nivo; 3 mg/kg; n = 20). The efficacy evaluable (EE) set includes all patients who had at least 1 post-baseline response assessment (n = 25, 19, 17, 19). Results: Demographic characteristics were generally similar: median age 78, 69, 75, and 72 yr in Parts A, B, C, and D, respectively, and 62% of patients (range 45%–70%) reported impaired physical functioning at baseline. Most patients had disease stage III/IV (62%, 68%, 75%, 80%), were ECOG 0/1 (77%, 74%, 80%, 95%), and male (54%, 68%, 50%, 75%). Median time from diagnosis was 1.2 to 1.5 mo (FAS; 10 Jan 2019 data cutoff). ORR were high (92%, 100%, 100%, 95%) at a median follow-up of 59.4, 58.6, 51.3, and 19.4 mo in the EE data set. Median OS in the FAS set was 77.5 mo with monotherapy; 64.0, 46.9, and not reached in the combination parts. Treatment-related AE ≥ Grade 3 occurred in 50%, 37%, 70%, and 60% of patients; peripheral neuropathy (PN) was most common (35%, 26%, 20%, 35%). Treatment-related SAEs occurred in 12%, 11%, 40%, and 5% of patients. Part C enrollment (BV+benda) closed early due to multiple acute toxicities. There were no treatment-related deaths in any part of the study. The median treatment cycles per patient were 8.0, 12.0, 5.0, and 14.5. Treatment discontinuation due to related AEs occurred in 42%, 42%, 40%, and 30% of patients, most commonly due to PN (38%, 37%, 30%, 20%). Conclusions: Older patients with cHL and multiple comorbidities have very high response rates with BV as monotherapy or combined with other single agents and improved tolerability versus combination chemotherapy. Median overall survival exceeded 6 yr with BV monotherapy. BV+nivo or BV+DTIC appeared to be the most reasonable combination treatment options in this study. Clinical trial information: NCT01716806 .