tbuckley/cabot-search huggingface dataset:
Reliability and validity of Chinese version of the Short Form of Quality of Life Enjoyment and Satisfaction Questionnaire for elderly patients
Authors: Hongyang Gao, Si Li, Lin Chen, Liming Tang, Juan Shou
Journal: BMJ (2018)

Objective
To evaluate the reliability and validity of the Chinese version of the Short Form of Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q-SF) for elderly patients.


Methods
The quality of life of 400 elderly outpatients from Kongjiang community health service center were evaluated by using the Chinese version of Q-LES-Q-SF. The reliability of the Chinese version of Q-LES-Q-SF was tested by the internal consistency reliability (Cronbach′s α coefficient) and the half confidence; the validity was tested by structural validity, convergence validity and distinguish validity and calibration validity.


Results
The Cronbach′s α coefficient of the internal consistency was 0.956; the Spearman-Brown coefficient of the half confidence was 0.894; the Guttman Split-half coefficient of odd even fold half confidence was 0.894. The exploratory factor analysis showed that there were 2 dimensions: the psychological dimension (Q2-8 items) and the physiological dimension (Q1, Q10-14). The confirmatory factor analysis showed that each psychological dimension factor load of Q2-8 was >0.50; each physiological dimension factor load of Q1, Q10-14 was >0.50. In distinguish validity, there was item with Z> 1.96 (P 9.5, RMSEA were all <0.05. In calibration validity, the physiological and psychological dimensions of Q-LES-Q-SF had a good correlation with the corresponding dimensions of the SF-12 (P<0.05), and Pearson correlation value was 0.317 and 0.237, respectively.


Conclusion
The Chinese version of Q-LES-Q-SF has a good reliability and validity for elderly patients.


Key words: 
Community health centers; Elderly; The Short Form of Quality of Life Enjoyment and Satisfaction questionnaire
Clinicopathological characteristics of inflammatory myofibroblastic tumor: analysis of 173 cases
Authors: Qin Xiang, Jun Lin
Journal: BMJ (2012)

The clinicopathological data of 173 cases of inflammatory myofibroblastic tumor (IMT)were retrospectively analyzed.Among them 125 were males and 48 females with a mean age of 47.9 y (5-78 y).The lesions of 117 cases were located in lungs,41 cases in eyes,8 in ileocecum,2 in liver,2 in spleen,1 in abdominal wall,1 in maxillary sinus and 1 in face.The average diameter of lesions were 3.5 cm,ranging from 1.0 cm to 7.0 cm.The clinical manifestations were not specific,depending on the locations of tumor.The imaging examinations were helpful for diagnosis.The prcsence of slender-spindled myofibroblasts and proliferation of fibroblast cells,with infiltration of chronic inflammatory cells were the basic histopathological features of the disease.Combined with the histological characteristics and immunohistochemical staining IMT can be differentiated from other spindle cell tumors.Appropriate surgical resection is the main treatment for IMT.

Key words: 
Inflammatory myofibroblastic tumor; Diagnosis; Treatment
Assessment of ovarian function as an endpoint in breast cancer clinical trials: A systematic review.
Authors: Wanyuan Cui, Prudence A. Francis, Sherene Loi, Martha Hickey, Catharyn Stern, Ann H. Partridge, Sibylle Loibl, Kelly-Anne Phillips
Journal: Journal of Clinical Oncology (2020)

e14098 Background: Premature ovarian failure (POF) is an established adverse effect of chemotherapy for breast cancer (BC); little is known about the ovarian toxicity of newer treatments (e.g. PARPi, CDK4/6 inhibitors, immunotherapy, anti-HER2 therapy). This study examined whether contemporary BC (neo)adjuvant clinical trials will provide data on POF. Methods: Eligible studies were phase 3 (neo)adjuvant trials of pharmacologic agents aimed to reduce BC events, that enrolled premenopausal women between June 2008 - Sept 2019. MEDLINE and EMBASE were searched using MESH terms / keywords: “breast neoplasm” or “breast adj2 (cancer* or tumo?r* or carcinoma*)”, “adjuvant chemotherapy” or “neoadjuvant therapy” or “neoadjuvant” or “adjuvant”. Clinicaltrials.gov and EudraCT were searched using the filters “breast cancer”, “interventional studies”, “phase 3”. Data extracted from eligible trial publications, protocols and clinicaltrials.gov/EudraCT summaries, included whether each trial assessed the variables - post treatment pregnancy/birth, attempt at pregnancy, menstrual data, antral follicle count, FSH, LH, estrogen, progesterone and AMH levels. Results: Of 1665 trials screened, 141 were eligible. Investigational treatments included chemotherapy (71%), endocrine (20%), anti-HER2 (26%), immunotherapy (8%), CDK4/6 inhibitor (5%), PARPi (2%). Few trials (28%) assessed quality of life (QOL). Study chairs were from Nth America (19%), Europe (36%), Asia (43%); most (67%) were male. POF and fertility measures were prespecified endpoints in 9 (6%) and 0 trials respectively. Twenty (14%) trials collected POF and/or fertility data; post treatment pregnancy (11/20), amenorrhoea (6/20), estrogen (8/20), FSH (7/20), LH (5/20), AMH (3/20), and progesterone levels (1/20) and antral follicle count (3/20). Assessment of POF was associated with collection of QOL data (p = 0.02) but not with BC phenotype, timing, treatment type, or sex or nationality of study chair. Conclusions: POF measures are rarely prespecified endpoints and are infrequently collected in phase 3 BC (neo)adjuvant trials. Trialists should consider POF, given the potential for this data to enhance informed decision making for premenopausal patients.
Medicare compared with private insurance for the treatment of cancer.
Authors: Phillip Martinez-Knouse, Christie Hancock, Edward Nabrinsky, Timothy M. Lestingi, Jacob D. Bitran
Journal: Journal of Clinical Oncology (2020)

e19033 Background: Insurance status impacts access to cancer care and outcomes of cancer patients. Patients who are uninsured and those who are insured by Medicaid are less likely to receive cancer screening, more likely to present at later stages of disease, and more likely to die from cancer compared to those who are privately insured. It is unclear whether patients insured by Medicare have different outcomes than patients with private insurance. Methods: We undertook a retrospective analysis of patients treated in our practice from January 1, 2019 to March 31, 2019. Outcomes of solid tumor patients were tracked after treatment in the neoadjuvant or metastatic setting. Patients were stratified by their insurance status and we then compared treatment outcomes of patients with private insurance to those with Medicare. Results: We treated 86 patients from January 1, 2019 to March 31, 2019 including 63 women and 23 men with a median age of 62 years (range 22-88 years). Several types of malignancies were represented including 21 gynecologic cancers, 17 breast cancers, 11 lung cancers, 10 melanomas, 10 gastrointenstinal cancers, 7 lymphomas, 5 genitourinary cancers, and 5 other tumor types. Among our population, 48 patients had private insurance and 38 had Medicare. Thirty-four patients achieved either a complete response (CR) or partial response (PR), 24 with CR and 10 with PR. Of those who achieved a CR, 11 had Medicare and 14 had private insurance. Among those who achieved a PR, 5 had Medicare and 5 had private insurance. Conclusions: In this retrospective analysis, insurance type did not predict likelihood of achieving a complete or partial response to treatment. Other investigators have suggested that patients with Medicare have poorer outcomes than those with private insurance. One potential explanation for the discrepancy between their data and ours is that we have dedicated system designed to accelerate pre-certifications. Additional investigation is warranted to better understand these trends.
Novel target discovery in pembrolizumab-resistant gastric cancer using a comprehensive RNA-seq analysis pipeline.
Authors: Jeeyun Lee, Seung Tae Kim, Kyoung-Mee Kim, Eric Schultz, Stan Skrzypczak, Rob Patro, Carl Kingsford
Journal: Journal of Clinical Oncology (2020)

e16541 Background: Immune checkpoint inhibition (ICI) has made significant breakthroughs in several tumor types including gastric cancer (GC) in recent years. We recently showed that single agent pembrolizumab demonstrated remarkable and durable response in MSI and EBV GC. However, the response to ICI remains low in MSS and most patients progress after initial response. We explore novel targets in ICI-resistant GC patients by analyzing pre- and post-resistant expression. Methods: Of the 61 patients who were enrolled onto our previously reported phase II pembrolizumab trial (NCT#02589496), whole transcriptome RNA-seq analysis of 10 paired freshly collected tissue samples (all from primary gastric tumors) was performed using TruSeq. All biopsies were performed at progression following stable disease (SD) or partial response (PR) to pembrolizumab. All patients had a MSI status of MSS and EBV negative. Molecular features were extracted using the validated Ocean Genomics, Inc. gene expression analysis pipeline, which trims reads, computes transcript- and gene-level expression, predicts structural variants, assembles novel isoforms, and computes per-sample quality control metrics, among other analyses. Samples that passed quality control, with mapping rates &gt; 88%, were selected for analysis. Differentially expressed (DE) genes between resistant and pre-resistant samples were identified using a statistical test with a study design that accounted for the pairing of samples for each patient. Results: 16 genes (GENCODE v31) had absolute log2-fold expression changes (L2FC) &gt; 2, P-value &lt; 10 −5 and FDR-adjusted P-value &lt; 0.05. Because sex was only partially controlled for, we excluded genes on the X and Y chromosomes. We also excluded non-protein encoding genes and pseudogenes. The 7 remaining genes are in the table. PDL-1 (CD274) was not identified as significantly DE (FDR-adjusted P-value &gt; 0.9999). Conclusions: This is the first study to identify novel targets in pembrolizumab-resistant GC using RNA-seq algorithms beyond PDL-1. [Table: see text]
Association of baseline characteristics and survival in patients with advanced non-small cell lung cancer (NSCLC) treated with immune checkpoint inhibitors (CPIs): Real-world evidence.
Authors: Danielle Crawley, Kerri Beckmann, Saranya Ravindra, Debra Hannah Josephs, James F. Spicer, Ana Montes, Eleni Karapanagiotou, Sharmistha Ghosh
Journal: Journal of Clinical Oncology (2020)

e21625 Background: CPIs including antibodies to programmed death-1 (PD-1) and its ligand anti PD-L1 are associated with superior overall survival (OS) in NSCLC. PDL1 is an imperfect predictive biomarker. We have examined real world data to identify additional factors associated with clinical benefit. Methods: 96 consecutive NSCLC patients (pts) were treated with CPIs at our institution. Multivariate cox proportional hazard regression models were used to examine the associations between OS and baseline characteristics including age, sex, histology, PDL1 status, performance status (PS), steroid use and brain metastases. Results: 93% (89/96) of pts received pembroluzimab, 6 (6%) nivolumab, and 1 (1%) atezoluzimab. All pts had metastatic disease (68% adenocarcinoma). 15% had PS 0, and 70% PS1. 11 of the 96 pts had brain metastases prior to CPI, 4 (37%) had whole brain radiotherapy, 2 (18%) targeted radiotherapy, 2 (18%) resection with radiotherapy and 3 (27%) had no definitive treatment for brain metastases. After multivariate analysis those with PS 1-2 had an increased risk of death (PS = 1 HR 2.74, 95% CI 1.11-6.72; PS = 2 3.61, 95% CI 1.28-10.15) compared with PS 0. Outcomes for pts receiving corticosteroids at the time of initiation of CPI were also inferior (HR 2.29, 95% CI 1.10-4.74) compared to those who were not. Conversely those who had brain metastasis diagnosed prior to commencing CPI had superior OS (HR 0.29 95% CI: 0.11-0.76). No statistically significant association was seen with age, gender, histology, stage at diagnosis, smoking or mutational status. PDL &lt; 50% compared to &gt; 50% was associated with an increased risk of death (HR 1.53 95% CI: 0.90-2.60) though it was not statistically significant. Conclusions: Here we show, using real world data, that PS and use at baseline of oral corticosteroids are associated with inferior OS with CPI treatment for NSCLC, in line with reports from large clinical trials. We show that baseline brain metastases are associated with improved outcomes. This may be explained by survivor bias, in that those who are successfully treated for brain disease, remain PS ≤2 and are able to commence CPI represent a highly selected group.
关于急性早幼粒细胞白血病治疗策略的几点看法
Authors: 乔振华
Journal: BMJ (2005)

这里陆文斌医师所述病例,从治疗的过程、结局回顾性分析可能系维甲酸综合征并细菌、真菌的混合感染.虽然多次未从患者痰中查出细菌和真菌,这也是临床上经常遇到的问题.因此一般在白血病的治疗中要强调及时地进行多种标本、多次培养,力求获得致病菌及明确敏感的药物。
Associations between baseline body composition and cancer-specific mortality following neoadjuvant chemotherapy and radical cystectomy for bladder cancer.
Authors: Leonidas Nikolaos Diamantopoulos, Steven Ngo, Reno Maldonado, Ryan Blair O'Malley, Grace Laidlaw, Florian J. Fintelmann, Sarah K Holt, John L. Gore, George R. Schade, Daniel W. Lin, Petros Grivas, Robert B. Montgomery, Andrew Caleb Hsieh, Heather H. Cheng, Todd Yezefski, Michael Thomas Schweizer, Evan Y. Yu, Jonathan L. Wright, Sarah P. Psutka
Journal: Journal of Clinical Oncology (2020)

e17015 Background: Sarcopenia is a modifiable risk factor independently associated with cancer-specific mortality (CSM) in bladder cancer (BC). Sarcopenic obesity, where obesity is measured by fat mass index [FMI, total body fat (kg)/height(m) 2 ], has been proposed as an additive insult. To date, studies have overwhelmingly been performed in patients treated without neoadjuvant chemotherapy (NAC). Herein, we evaluate associations between baseline skeletal muscle index (SMI), FMI, and CSM in patients treated with NAC and radical cystectomy (RC). Methods: Lumbar SMI (cross sectional area of skeletal muscle/height 2 , cm 2 /m 2 ) was measured on a computed tomography (CT) image at the level of the third lumbar vertebral body, within 60 days prior to NAC. Total body FMI was calculated from visceral and subcutaneous fat cross-sectional areas. Patients were classified as being sarcopenic, according to sex-specific consensus definitions: Male: SMI &lt; 55, Female: SMI &lt; 39, and as obese if Male: FMI &gt; 9, Female: &gt; 13. Cancer-specific survival (CSS) was estimated using the Kaplan Meier method. Associations with CSM were summarized with multivariable Cox proportional hazards models. Results: 143 patients had CT scans of sufficient quality (2005-18). There were no significant differences in clinicopathologic characteristics between the study cohort and patients without available imaging (N = 261). Cisplatin-based NAC was given to 125 patients (87%), and 18 (13%) received other regimens. In total, 86 (60%) patients were sarcopenic, 52 (36%) obese, and 25 (17%) both sarcopenic and obese, while 48 (34%) were sarcopenic with normal FMI. Median follow-up was 2.7 years (IQR 1.2-6.2), and 43 patients died from BC. Three-year CSS was 61% (sarcopenic) vs. 77% (p &lt; 0.05). Sarcopenic patients with normal FMI had the worst 3-year CSS (55%) compared to those with sarcopenia and FMI-obesity (79%), normal SMI with FMI-obesity (69%), and normal body composition (88%, p = 0.03). On multivariable analysis, neither FMI (HR: 0.77, 95% CI: 0.47-1.3, p = 0.3) nor SMI was independently associated with CSM (HR: 0.98, 95% CI: 0.96-1, p = 0.07) after adjustment for ASA score, pathologic tumor, and nodal stage. Conclusions: In patients treated with NAC+RC, pretreatment SMI trended towards independently predicting risk of CSM. Patients with sarcopenia and normal fat demonstrated the worst CSS. Further study is warranted on the impact of NAC on body composition and the role of the latter in risk stratification of this high-risk patient population.
Impact of socioeconomic status on the incidence and mortality of multiple myeloma in the United States.
Authors: Ibrahim Omore, Richard Stephen Sheppard, Stefani Beale
Journal: Journal of Clinical Oncology (2020)

e13595 Background: Socioeconomic deprivation is known to be associated with poorer survival among cancer patients, but studies has not shown the impacts of socioeconomic status on the Incidence and mortality of multiple myeloma. This article analyzed the socioeconomic inequalities in United States Multiple Myeloma Incidence and Mortality. Methods: We examined national trends in the Incidence and Survival disparities among patients with Multiple Myeloma by race/ethnicity and socioeconomic status. A retrospective cohort of Multiple Myeloma patients diagnosed from 2012 to 2016 belonging to all age groups, genders, income per household and level of education was identified from Surveillance, Epidemiology and End results database, United States Cancer Statistics and Population data from Census Bureau. Results: We found mortality to be higher among African American and in States with low median household income and low level of education. In conclusion our study shows a strong correlation between social deprivation and decreased survival in patients with Multiple Myeloma in all age groups. Also we found that Asians and Pacific Islanders seems to have higher survival compare to African Americans and Other ethnicities. Conclusions: Census‐based socioeconomic measures such as poverty and education levels could serve as important surveillance tools for monitoring trends in cancer‐related health inequalities and targeting interventions.
Clinical behavior and treatment outcomes in angiosarcoma: A 10-year retrospective review.
Authors: Andrea P. Espejo Freire, Philippos Costa, Maryam Alasfour, Yamac Akgun, Andrew Rosenberg, Julio Diaz-Perez, Deukwoo Kwon, Ty Subhawong, Junaid Arshad, Jonathan C. Trent
Journal: Journal of Clinical Oncology (2020)

e23555 Background: Angiosarcoma (AS) is a highly aggressive sarcoma. Five-year overall survival (OS) with local disease is only about 60% despite multimodality treatment. In advanced disease, responses to cytotoxic chemotherapy are common; however, median OS is only 3-12 mos. Targeted therapies (TT) have not been consistently effective. Early results for immune checkpoint inhibitors (ICI) are promising but their efficacy has not been compared to chemotherapy. Here we present the outcome of AS patients by systemic regimen and multimodality approach. Methods: We identified 39 patients with pathologically confirmed AS treated at Sylvester Comprehensive Cancer Center and Jackson Memorial Hospital from 2009 to 2019. Clinical characteristics, treatment, responses and survival were analized. We calculated OS using Kaplan-Meier method and statistical significance with Log-Rank Test and Cox regression to estimate hazard ratio (HR) and 95% confidence interval. Progression-free survival (PFS) was analyzed for different regimens in the palliative setting using same approach as for OS. Results: In our cohort, median follow-up is 2.3 years (95% CI = 2 to 3.3), 48% were women and median age at diagnosis was 63 (range 13-89). At presentation, 16 pts (41%) had local disease and 23 advanced or metastatic (59%). By location, 13 pts (33%) had primary cutaneous AS, 12 pts (31%) visceral AS, 5 pts (13%) primary breast AS, 2 (5%) extremity AS and 7 (18%) radiation associated AS. Multimodality treatment was used in 29 pts (74%). OS in the entire cohort at 3 years was 49% (95% CI = 28 to 67%). OS between local disease was (N = 16) and in advanced disease (N = 23) was not statistically significant (p = 0.485; HR = 1.1 [95% CI = 0.4 to 3.3]). In the neoadjuvant setting, objective response rates trended to favor doxorubicin-based regimen (DBR) over taxane-based regimens (TBR) (80% vs. 40%) but were not statistically different (p = 0.519). In the advanced setting, PFS for DBR was 3.9 mo (95% CI 1.1 to 4.9 mo), 5.9 mo for TBR (95% CI 2.3 to 10.9 mo), 6.1 mo for ICI (95% CI not estimable), and 2.4 mo for targeted therapy (TT) (95% CI 0.8 to 8.8 mo), most common TT agent was pazopanib (71% of TT agents). Conclusions: AS is highly aggressive and most patients with local presentation will relapse translating in similar OS to the advanced cohort. No significant activity was seen for TT. In the advanced setting, chemotherapy with TBR appears slightly superior to DBR. ICIs resulted in similar if not superior PFS despite its use in a later line setting. Studies incorporating ICIs into earlier lines of therapy are warranted.
妇女与糖尿病
Authors: 刘岚
Journal: BMJ (2004)

在妇女的任何年龄段均可诊断出糖尿病.并且,不管男性还是女性,糖尿病的病例数均在增加.以前认为2型糖尿病只在成人中发生,但现在由于肥胖的流行,青少年中糖尿病的诊断人数发生了戏剧性的上升。
The influence of food ingredient on the serum level of uric acid in human
Authors: 刘岩, 周道远, 陈辉, 肖笑, 钟小仕
Journal: BMJ (2009)

当降低血尿酸药物别嘌呤醇研发成功并普遍应用之后,高尿酸血症可简单地得到控制,虽然食物疗法在预防和控制高尿酸血症中发挥着非常重要的作用,却仍不能被较好地认知和掌握.严格地限制嘌呤摄入可以有效地降低每天尿中的尿酸排泄约200～400 mg(1.18～2.36 mm01),也可以使血尿酸降低59～mol/L(1 mg/dl)。
PTH-009 Nicevis – results of a randomised controlled trial of simeticone and n-acetylcysteine as a pre-procedure drink to improve mucosal visibility during diagnostic gastroscopy: Abstract PTH-009 Table 1
Authors: PJ Basford, J Brown, L Gadeke, C Fogg, B Haysom-Newport, R Ogollah, B Higgins, R Bhattacharyya, G Longcroft-Wheaton, F Thursby-Pelham, J Neale, P Bhandari
Journal: Gut (2015)

<h3>Introduction</h3> Despite advances in endoscope technology there is still a significant miss rate of neoplastic lesions during gastroscopy. Mucosal views are frequently impaired by residual bubbles and mucus. <h3>Method</h3> We conducted an RCT in 126 patients attending for routine gastroscopy. Subjects were randomised in a 1:1:1 ratio to receive a pre-procedure drink of water, simeticone and n-acetylcysteine (Group A), water alone (Group B) or no preparation (Group C). Study endoscopists were blinded to group allocation. 4 digital images were taken at pre-defined locations during the procedure – lower oesophagus, upper body, antrum and fundus. Images were rated for mucosal visibility (MV) using a 4 point scale (1 = best, 4 = worst) by 4 blinded experienced endoscopists. Primary outcome measure was mean MV score. Secondary outcome measures were procedure duration and volume of flush required to achieve adequate mucosal views. <h3>Results</h3> Groups were well matched for age, gender or indication for endoscopy. Mean MV score for group A was significantly better than for group B and group C (p &lt; 0.001 for both comparisons), with no significant difference between groups B and C (p = 0.541). Interobserver agreement of MV scores was good (mean kappa 0.464). Mean volume of flush required to achieve adequate mucosal views was significantly lower in group A than group B (p = 0.001), and group C (P &lt; 0.001). There was no significant difference in mean flush volume between groups B and C (p = 0.583). Procedure duration did not differ significantly between the groups. Subgroup analysis of MV scores at each location demonstrated significantly better mucosal visibility in group A compared to group B and group C at all locations (p &lt; 0.0025 for all comparisons). <h3>Conclusion</h3> A pre-procedure drink containing simeticone and n-acetlycysteine significantly improves mucosal visibility during routine gastroscopy and reduces the need for flushes during the procedure. This may improve detection of early neoplasia and other pathology during gastroscopy. Subanalysis of separate locations demonstrates significant benefit in the lower oesophagus, demonstrating potential benefit in Barrett’s surveillance procedures. <h3>Disclosure of interest</h3> None Declared.