tbuckley/cabot-search huggingface dataset:
Navigating herbal dietary supplements: Oral chemotherapy drug interactions in a community cancer center.
Authors: Heather F. McCarthy, Bethany F. Gomes, Patrick John Skeffington, Noelle Cordova, Olivia Huber, Kristina Ward
Journal: Journal of Clinical Oncology (2020)

e19239 Background: The number of FDA-approved oral chemotherapy medications has continued to increase as has their incorporation into cancer treatment plans. Oncology pharmacists play an integral role in assessing and navigating drug interactions for patients. At Southcoast Centers for Cancer Care (SCCC), oncology pharmacists meet with patients to review/counsel on newly initiated oral therapy. One of the areas assessed during the visit is the use of herbal nutritional supplements. Pharmacists utilize available institutional resources to assess potential interactions and collaborate with the University of Rhode Island (URI), Drug Information Services (DIS), when information is not readily available. Methods: Patient responses about utilization of herbal dietary supplements during pharmacist-patient counseling sessions were assessed. All positive responses triggered a drug-supplement interaction screen. Number of patients taking herbal dietary supplements was tabulated and their use was characterized. Results: From October 2016-June 2019, 187 patients were counseled. Of these, 44/187 (24%) were taking herbal dietary supplements. SCCC pharmacists consulted the URI DIS on 10/44 (23%) patients to assist in identifying, researching, and recommending a care plan. The most frequently used supplements were melatonin and marijuana/CBD oil. The most frequently used supplements that required further consultation included curcumin. Conclusions: Consistent with findings from the general population taking prescription medications, we found that approximately 25% of patients taking oral chemotherapeutic medications were also actively taking herbal dietary supplements. Little data exists regarding oral chemotherapy agents and herbal dietary supplement interactions. Careful questioning/review/research of potential interactions is needed to prevent interactions and maximize effectiveness of oral chemotherapy.
Etanercept with extracorporeal photopheresis (ECP) for steroid-refractory acute graft versus host disease following allogeneic hematopoietic stem cell transplantation.
Authors: Sunny R K Singh, Sindhu Janarthanam Malapati, Klodiana Neme, Angela Michael, Nancy Mikulandric, Vera Vulaj, Josephine Emole
Journal: Journal of Clinical Oncology (2020)

7543 Background: Acute graft versus host disease (aGVHD) is a well-described complication of allogeneic stem cell transplantation (allo-SCT). Complete response to steroids is achieved in 40-50% of cases, with steroid refractory GVHD requiring second line therapy. Currently, there is no accepted standard of care in this setting. In our study, we assessed the safety and efficacy of etanercept with ECP for steroid refractory aGVHD in a single center tertiary care hospital. Methods: Thirty adult patients who underwent peripheral blood allo-SCT and developed steroid-refractory aGVHD between January 2010 - July 2019 were retrospectively analyzed. Patients were planned to receive etanercept 25 mg subcutaneously twice weekly for at least 4 weeks. Safety was assessed by estimating infection related mortality. For efficacy, we analyzed the change in grade of aGVHD using the Wilcoxon signed-rank test. Results: Median age at the time of allo-SCT was 57.6 years and the most common indication for transplant was Myelodysplastic syndrome. Median time from allo-SCT to steroid initiation was 39.5 days (range 14-183 days). Median time from steroid initiation to etanercept was 6 days, with 7.5 median number of etanercept doses received. A total of 25 patients (83.3%) received ECP. As depicted in the table, there was a significant improvement in severity of aGVHD after etanercept therapy compared to that before its initiation. Overall response rate was 83.3%, while overall mortality was 86.7%. Median overall survival for responders was 306 days (range 59-2005 days) and for non-responders was 181 days (range 89-261 days). Death attributed to infection alone occurred in 28% (n=7), infection along with GVHD in 28% (n=7) and infection with relapsed disease in 1 patient. Active infection within 6 months of transplant occurred in 93.3% patients. Conclusions: The use of Etanercept with ECP resulted in improvement of steroid refractory aGVHD following allo-SCT, with responses noted in the majority of patients. High rates of infection related mortality were also noted and remain a cause of concern. [Table: see text]
Phase II clinical trial of pazopanib for patients with unresectable or metastatic malignant peripheral nerve sheath tumors.
Authors: Yoshihiro Nishida, Hiroshi Urakawa, Robert Nakayama, Toshifumi Ozaki, Keisuke Ae, Yoshihiro Matsumoto, Yuichi Ando, Yachiyo Kuwatsuka, Takafumi Ueda, Akira Kawai
Journal: Journal of Clinical Oncology (2020)

e23569 Background: Malignant peripheral nerve sheath tumor (MPNST) is a malignant soft tissue tumor that does not respond well to chemotherapy and often develops on the basis of neurofibromatosis type 1 (NF1). The purpose of this study was to examine the effects of pazopanib on MPNST. Methods: This study was designed as a physician-initiated phase II clinical trial of pazopanib in patients with MPNST with unresectable or distant metastases. Eleven large hospitals were selected from the Japanese Musculoskeletal Oncology Group (JMOG), and patients were registered between July 2016 and August 2018. The primary endpoint was set to clarify the clinical benefit rate (CBR, including complete or partial response and stable disease) at 12 weeks for pazopanib according to Response Evaluation Criteria in Solid Tumors (RECIST1.1). Progression-free survival and overall survival were set as secondary endpoints along with the safety of this treatment. The clinical benefit rate based on Choi evaluation at week 12 was also set as the secondary endpoint. Results: The study enrolled twelve patients with MPNST. Grade 2 was 7 and grade 3 was 5 by according to the FNCLCC evaluation. Median follow-up period was 10.60 (1.74-22.85) months. Six were male, and six were female. Median age was 49 (20-76). After 12 weeks of pazopanib treatment, CBR was 50.0% (6 of 12 patients) and 50.0% (6 of 12 patients) at RECIST and Choi criteria, respectively. The median progression-free survival was 5.4 months for both RECIST and Choi. Interestingly, the median progression-free survival was 2.9 months for patients with FNCLCC Grade 2 and 10.2 months for Grade 3 for both RECIST and Choi. The median overall survival was 10.6 months. The adverse events of Grade 4 was neutropenia in one person and lipase elevation in one person. Grade 3 adverse events observed in ≥10% of patients were increase of AST and ALT, and decrease of white blood cells. Conclusions: The results of this pazopanib clinical trial were comparable to those of previous doxorubicin-based chemotherapy, and better than those of other molecular targeted therapy. Although accumulation of cases is necessary, pazopanib treatment for MPNST might be a safe and promising treatment, particularly for grade 3 MPNST. Clinical trial information: UMIN000019303 .
变应性鼻炎患者咽鼓管咽口形态和中耳功能的观察
Authors: 付竞云, 陈艳丽, 骆文淑
Journal: BMJ (2009)

变应性鼻炎也称过敏性鼻炎,通常是指由IgE介导的鼻黏膜炎症反应,2001年在丹佛召开的变应性疾病、哮喘和免疫学年会指出变应性鼻炎是系统性炎症反应在鼻部的表现[1].为进一步探讨变应性鼻炎对咽鼓管咽口形态及功能的影响,对在我科门诊就诊的100例患者的咽鼓管咽口形态及中耳功能进行观察分析。
Analysis of trends in race and gender disparities in incidence-based mortality in patients diagnosed with soft tissue sarcomas from 2000 to 2016.
Authors: Lakshmi Priyanka Pappoppula, Germame Hailegiorgis Ajebo, Justin Yeh, Picon Hector, Allan N. Krutchik, Achuta Kumar Guddati
Journal: Journal of Clinical Oncology (2020)

e23549 Background: The clinical course of soft tissue sarcomas is often dependent on the grade of the tumor. The incidence of soft tissue sarcomas have been known to be higher in males compared to females and more in African Americans compared to Caucasians (1995 to 2008 SEER data). The variability of incidence-based mortality in low grade and high grade soft tissue sarcomas with respect to gender and race over the past decade has not been well studied. This study analyzes the rates of incidence-based mortality from the years 2000 to 2016 amongst for both the grades, genders and racial groups. Methods: The Surveillance, Epidemiology, and End Results (SEER) Database was queried to conduct a nation-wide analysis for the years 2000 to 2016. Incidence-based mortality for all stages of low grade and high grade soft tissue sarcomas was queried and the results were grouped by race (Caucasian/White vs African American/Black) and gender. All stages and ages were included in the analysis and trend from 2000 to 2016 was analyzed. Results: Incidence-based mortality rates (per 10000) for low grade and high grade soft tissue sarcomas for both races and genders are shown in the table below. The incidence-based mortality rates for Caucasians are similar to African American in both grades and genders. Rates were not analyzed for American Indian and Asian/Pacific Islanders due to small sample size. Mortality rates of high grade soft tissue sarcomas were significantly higher compared to low grade tumors. A higher rate of mortality is noted in Caucasian males compared to African Americans males despite past observations of higher incidence in African Americans. There was no significant change in the rate when trended over the past decade (2007 to 2016). Conclusions: This study highlights the higher rate of incidence-based mortality in Caucasian males compared to African American males in the past 15 years despite a lower incidence reported in the 1995 to 2008 period. With no significant change in mortality rates/year noted during this time period, this study implies that soft tissue sarcomas in Caucasian males have worse outcomes. Further research is needed to understand the mechanism underlying this disparity. [Table: see text]
A follow-up investigation on nonalcoholic fatty liver disease in medical staff at a hospital during 2006-2008
Authors: Li Li, Yu Lan
Journal: BMJ (2010)

A retrospective survey wag performed among medical staff in a hospital during 2006-2008 with physical examinations and reviews of medical records.Nonalcoholic fatty liver disease(NAFLD)related factors were compared and analyzed for them.Overall detection rate of NAFLD was 13.9%(230/1655)in 2006 and 18.9%(344/1817)in 2008,with statistically significant difference(χ2=15.549,P＜0. 01 ). Among people surveyed over 30 years old, detection rate of NAFLD was 9.4%, 17. 8% and 21.7% for those aged 30 -39, 40 -49 and 50 years and over, respectively in 2006, while 14. 4%, 28. 2% and 30. 5% , respectively in 2008. Detection rate presented a increasing trend in those of younger age. Relative risk for fatty liver was 1. 859 for those with obesity and overweight. Prevalence of NAFLD in medical staff increases year by year. Medical staff should attend for their own health and take measures to prevent them from its potential risk factors and pay more attention to behavioral intervention for NAFLD.

Key words: 
Nonalcoholic fatty liver disease; Medical staff
Clinically aggressive malignancies associated with STK11 germline mutations (STK11GCa): A comprehensive genomic profiling (CGP) study.
Authors: Ethan Sokol, Natalie Danziger, Dean Pavlick, Julia Andrea Elvin, Jo-Anne Vergilio, Jonathan Keith Killian, Douglas I. Lin, Shakti H. Ramkissoon, Eric Allan Severson, Amanda Hemmerich, Daniel Duncan, Claire I. Edgerly, Richard Huang, Jon Chung, Venkataprasanth P. Reddy, Kimberly McGregor, Jeffrey Venstrom, Alexa Betzig Schrock, Brian Michael Alexander, Jeffrey S. Ross
Journal: Journal of Clinical Oncology (2020)

3558 Background: Germline mutations in the STK11 ( LKB1) mTOR pathway gene are associated with Peutz-Jehger’s Syndrome and a variety of malignancies of variable clinical aggressiveness. Recent evidence also links STK11 inactivation with failure to benefit from anti-cancer immune checkpoint inhibitor (IO) therapy in NSCLC. Methods: Using hybrid capture based CGP on extracted tumor DNA and a published “somatic-germline-zygosity” SGZ data analysis algorithm on 212,470 samples of clinically advanced malignancies, we identified 103 (0.05%) STK11GCa inactivating base substitutions or indels. Tumor mutational burden (TMB) was determined on up to 1.1 Mbp of sequenced DNA and microsatellite instability (MSI) was determined on 114 loci. PD-L1 expression was determined by IHC (Dako 22C3). Results: 57 (55%) STK11GCa cases were NSCLC, 7 (7%) STK11GCa cases each were CRC, breast, pancreatic and unknown primary carcinomas, and 3 (3%) were gynecologic cancers. Amongst all samples included in this analysis, STK11 germline alterations were found in 0.15% NSCLC, 0.03% CRC, 0.03% breast, 0.08% pancreas, 0.06% unknown primary carcinoma and 0.03% of gynecologic cancers. Additional malignancies harboring STK11GCa included melanoma, gastroesophageal, HNSCC, bladder, HCC, lymphoma and mesothelioma. In STK11GCa, the median patient age at sequencing was 61 years (range 2 to &gt; 89 years); gender distribution was 52% female and 48% male. STK11GCa cases had a median of 6.5 genomic alterations (GA)/tumor and KEAP1, another IO resistance gene, was co-altered in 10%. Currently untargetable GA were detected in TP53 (50%), KRAS (38% with 9% in potentially targetable G12C), CDKN2A (32%), CDKN2B (22%), SMARCA4 (19%), MYC (11%), and APC (10%). Potentially targetable GA, which have also been linked in some studies to IO efficacy, included GA in BRAF (10%), EGFR (9%) and PBRM1 (4%). No targetable gene rearrangements or fusions were identified. No MSI High cases were identified. The median TMB was 5 mut/Mb with 23 % &gt;10 mut/Mb and 4% &gt;20 mut/Mb. 15% of 20 evaluated STK11GCA cases were PD-L1 high (&gt;50% tumor cell staining). Conclusions: STK11GCa include a wide variety of primary tumors with a paucity of co-occurring targetable GA. Although these tumors have significant PD-L1 staining and a subset harbor other markers of potential IO efficacy, the inactivated STK11 in these tumors may contribute to IO resistance and lack of responsiveness to immunotherapies.
Hepatic sinusoidal obstruction syndrome induced by Sedum aizoon: case report and literature review
Authors: Haiping Liu
Journal: BMJ (2016)

肝窦阻塞综合征是由肝窦内皮细胞损害所引起的肝内窦性门脉高压症，临床少见。报道1例服用土三七所致肝窦阻塞综合征患者的临床资料，旨在增加医务人员对土三七的认识，并提高对肝窦阻塞综合征的诊治水平。
Pregravid HbA1c and Glucose Measurement to Rule Out Future Gestational Diabetes Mellitus and Reduce the Need for Oral Glucose Tolerance Testing in Pregnancy
Authors: Ravi Retnakaran, Baiju R. Shah
Journal: Diabetes Care (2020)

The International Association of the Diabetes and Pregnancy Study Groups (IADPSG) has recommended universal screening for gestational diabetes mellitus (GDM) by oral glucose tolerance test (OGTT) in all pregnant women (1). However, concern has been raised that this recommendation may pose a resource challenge for health care systems (2). Recognizing that women who develop GDM have chronic metabolic dysfunction that predates their pregnancy (3), we hypothesized that measurement of pregravid HbA1c or glucose may provide the capacity to rule out GDM in low-risk women and thereby reduce the overall OGTT burden in pregnancy.

To test this hypothesis, we conducted a population-based retrospective cohort study using real-world data for Ontario, the most populous province in Canada. With administrative databases that track health care utilization, we identified all women in Ontario without preexisting diabetes who had pregravid measurement of HbA1c or glucose before singleton live-birth pregnancies between January 2008 and December 2015. Pregravid HbA1c or glucose was measured at median 1.4 years (interquartile range 1.03–2.05 years) before pregnancy in 334,829 women, including 20,221 who developed GDM. For this study, the women were randomly assigned to either derivation ( n = 167,401) or validation ( n = 167,428) cohorts to evaluate the capacity of these pregravid glycemic measurements for predicting GDM. In the derivation cohort, pregravid …
Covid-19: Charities call for clear advice after “utter mess” of shielding texts
Authors: Ingrid Torjesen
Journal: BMJ (2020)

Leading healthcare charities have written to the UK government asking for people who have been told to shield because they are most at risk from the effects of covid-19 to be given “clear, consistent advice” after the “utter mess” caused by incorrect communications.

The British Liver Trust, Asthma UK, and the British Lung Foundation are among nearly 50 charities that signed the open letter, which said that these patients needed to know what to expect and how to protect themselves once shielding was lifted. The wider group of vulnerable people who had not been asked to “shield” but would be at greater risk as lockdown was lifted also needed advice, the letter said.

The call for clarity follows reports from patients in England with conditions such as severe asthma, lung disease, and cancer who said that they had received text messages informing them that they had been removed from the official shielding list without their GP’s knowledge. The problem mirrors that seen when lockdown was imposed in March,1 when some patients at very high risk did not receive messages to shield, while tens of thousands of others who did not need to shield, including some deceased patients,2 did receive them.3

The official texts sent from the Gov.uk website on …
SGN228-001: A phase I open-label dose-escalation, and expansion study of SGN-CD228A in select advanced solid tumors.
Authors: Amita Patnaik, Funda Meric-Bernstam, Caio Max Sao Pedro Rocha Lima, Francisco Robert, Afshin Dowlati, Hedy L. Kindler, Diwakar Davar, Steven Francis Powell, Phillip M. Garfin, Ani Sarkis Balmanoukian
Journal: Journal of Clinical Oncology (2020)

TPS3652 Background: SGN-CD228A is an investigational antibody-drug conjugate (ADC) that targets CD228, a cell-surface oncofetal protein with prevalent expression in several types of cancer and limited expression on normal tissues. SGN-CD228A consists of a humanized IgG1 anti-CD228 monoclonal antibody conjugated to an average of 8 molecules of monomethyl auristatin E (MMAE) via a PEGylated β-glucuronidase cleavable linker. MMAE is a well-studied and highly active chemotype with an established safety profile. The proposed mechanism of action involves binding CD228 on cell surfaces, ADC internalization, and trafficking to lysosomes. MMAE is then released through β-glucuronidase cleavage of the glucuronide MMAE linker. MMAE then binds tubulin, which disrupts microtubule networks and causes cell cycle arrest and apoptosis. Methods: SGN228-001 (NCT04042480) is a phase 1, open label, multicenter, dose escalation, and expansion study enrolling up to 240 subjects to evaluate the safety, tolerability, PK, and antitumor activity of SGN-CD228A in select advanced solid tumors. Eligible subjects are ≥18 years of age and have metastatic cutaneous melanoma, malignant pleural mesothelioma, human epidermal growth factor receptor 2-negative metastatic breast cancer, advanced non-small cell lung cancer, metastatic colorectal cancer, or advanced pancreatic ductal adenocarcinoma. Subjects must have relapsed, refractory, or progressive disease, and should have no appropriate standard therapy available. Measurable disease per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1), Eastern Cooperative Oncology Group (ECOG) performance status score of ≤1, and adequate renal, hepatic, and hematologic function are required. The study includes dose escalation and dose expansion, with multiple disease-specific dose expansion cohorts and a biology cohort. Dose escalation will be conducted using the modified toxicity probability interval method (Ji 2010) to evaluate the safety and identify the maximum tolerated dose of SGN-CD228A. Following dose escalation, disease-specific expansion cohorts and a biology cohort (to evaluate exploratory biomarkers) are planned. Response assessments will be conducted every 6 weeks per RECIST v1.1 and all subjects will be followed for safety. Pharmacokinetics and markers of pharmacodynamics will be assessed regularly. Key efficacy endpoints include objective response rate, progression-free survival, and duration of objective response. Enrollment is ongoing in the US and planned in Europe. Clinical trial information: NCT04042480 .
An analysis for status of general practitioners who passed the national qualification examination for medium-level health professional title of general practice
Authors: 全国全科医学专业技术队伍现状研究课题组
Journal: BMJ (2009)

Objective To know basic status of general practitioners (GPs) who passed the national qualification examination for medium-level health professional title of general practice ( GP examination). Methods Distributions of age, gender, educational level, work experience and affiliations of 9613 GPs who passed GP examination in 31 provinces, autonomous regions and municipalities under direct jurisdiction of central government, as well as Xinjiang Production and Construction Corps, during 2001 to 2007 were analyzed. Results During 2001 to 2007, totally 19 295 health professionals took GP examination and 9613 of them passed, accounting for 49.8% of the total. Number of health professionals passed GP examination increased yearly, 533 in 2001,818 in 2002, 776 in 2003, 1218 in 2004, 1330 in 2005, 1809 in 2006 and 3109 in 2007, with an average age decreasing year by year. Most of GPs who passed the examination were from east part of the country, accounting for 63.4%, and the rest were from central and west parts, accounting for 36.6% of the total. Most GPs who passed the examination were graduated from three-year-curriculum medical schools and secondary vocational schools, accounting for 73.1% (7027/9613) of the total, and 47.0% (4521/9613) of them were from primary-care hospitals, community health care centers and township hospitals. Conclusions Number of GPs who passed the examination increased year by year and their force has brought to take shape. However, there still exist some problems in general practice, suchas short in number, obvious discrepancy in geographical distribution, lower educational level of GPs and unreasonable structure of GPs from varied institutions.

Key words: 
Community health services; National qualification examination for medium-level health professional title of general practice; General practitioners
以肾病综合征为表现的原发性甲状腺功能减退11例
Authors: 郑洁, 石义霞
Journal: BMJ (2005)

原发性甲状腺功能减退(primary hypothyroidism)临床上并不少见,它起病隐匿,轻重不一,临床表现各不相同,常以某一系统表现突出,给诊断造成一定困难.其中一部分病例在临床上表现为肾病综合征(nephrotic syndrome,NS),因而易造成误诊,延误治疗,严重者甚至可引起黏液水肿性昏迷危及患者生命.现对我院内科1993至2003年收住院的、临床上以肾病综合征为表现的原发性甲状腺机能减退11例进行回顾分析。