tbuckley/cabot-search huggingface dataset:
Abstract 15938: Disaggregating Cardiovascular Disease Mortality Among Hispanic Subgroups
Authors: Fatima Rodriguez, Katherine G Hastings, Elsie Wang, Derek Boothroyd, Mark R Cullen, Sandra E Echeverria, Latha Palaniappan
Journal: Circulation (2015)

Background: Hispanics are currently the largest minority group in the US and face a disproportionate burden of cardiovascular disease (CVD) risk factors. Hispanics paradoxically experience lower mortality rates as compared to their non-Hispanic white (NHW) counterparts. This phenomenon has been largely observed in Mexicans and it is unknown whether this holds true for other Hispanic subgroups, and if these favorable trends persist over time. Methods: We examined data from the National Center for Health Statistics U.S. Mortality Multiple Cause-of-Death data from 2003-2011 to identify CVD deaths for the three largest Hispanic subgroups in the U.S. (Mexicans, Puerto Ricans, and Cubans). CVD deaths were extracted from mortality records using the underlying cause of death based on ICD-10 coding (I00-I09, I11, I13, I20-I51.9, I60-I69). Race/ethnicity was recorded on death certificates by the funeral director using state guidelines. Population estimates were calculated using linear interpolation from 2000 and 2010 U.S. Census. Results: The study sample consisted of all-cause deaths for the three largest Hispanic subgroups in the U.S.: Mexicans (n=689,162), Puerto Ricans n=154,402), and Cubans (n=117,751), compared to NHWs (n=17,699,740). Cubans and Mexicans were, on average, younger at time of incident CVD death as compared to NHWs (73 vs. 79, respectively). Overall, CVD mortality trends decreased from 2003-2011 for all groups (p&lt;0.001), but rate differences between groups vary substantially, with Puerto Ricans exhibiting similar mortality patterns to NHWs and Mexicans experiencing the lower mortality (Figure 1). Conclusions: Significant differences in CVD mortality rates and trends were found between the three largest Hispanic subgroups in the US. These findings suggest that the current aggregate classification of Hispanics masks heterogeneity in CVD mortality reporting, leading to an incomplete understanding of health risks and outcomes.
非酒精性脂肪性肝病诊断与治疗推荐意见(2006年11月修订)
Authors: 亚太地区非酒精性脂肪性肝病工作组
Journal: BMJ (2007)

非酒精性脂肪性肝病(nonalcoholic fatty liver disease,NAFLD)为西方发达国家最常见的肝病,成人受累20%～30%.众多研究表明,脂肪肝亦已成为亚太地区的重要肝病,成人患病率10%～45%.尽管NAFLD的患病率因调查对象的年龄、性别、种族组成以及诊断标准的不同而有差异,但在过去的15年间,亚太地区NAFLD患病率增长的趋势与当地营养过剩、肥胖、糖尿病以及代谢综合征患病率增加趋势相一致。
献血人群中梅毒感染情况调查
Authors: 孙爱农, 冯志广, 陈永灵, 廖艳婷, 何锐洪, 詹宗伟, 葛峰
Journal: BMJ (2005)

梅毒是由梅毒螺旋体(TP)引起的慢性性传播疾病.我国解放初期通过政府干预使包括该病在内的多种性病得到了全面控制,但近年来性病流行呈上升趋势,梅毒患者也日渐增加.为了解献血者中梅毒感染状况,本文总结并分析了广东省中山市红十字中心血站近几年在献血者中的梅毒筛查结果。
Novel methylated DNA markers in plasma detect distant recurrence of colorectal cancer.
Authors: Hao Xie, Douglas W. Mahoney, Patrick H. Foote, Kelli Burger, Karen A Doering, William R. Taylor, Xiaoming Cao, Maria McGlinch, Calise K. Berger, Joleen Marie Hubbard, Hatim T. Allawi, Graham P. Lidgard, David A. Ahlquist, John B. Kisiel
Journal: Journal of Clinical Oncology (2020)

4088 Background: Methylated DNA markers (MDMs) are broadly informative for early detection of colorectal cancer (CRC) but have not been extensively studied for post-treatment surveillance and disease monitoring. We aimed to assess the feasibility of novel CRC-associated MDMs for detection of distant recurrent CRC (rCRC) in plasma. Methods: A panel of 13 MDMs previously identified to be discriminant for primary CRC was selected. In a cross-sectional analysis of plasma samples, MDMs were assayed blindly (by target enrichment long-probe quantitative amplified signal assay) from 160 age/sex-balanced patients (60 healthy controls, 60 with resected CRC and no evidence of disease (NED), and 40 rCRC after primary tumor resection). Plasma-derived carcinoembryonic antigen (CEA) was measured on all patients. Random forest modeling was used to derive a prediction algorithm of MDMs (with and without CEA) for the endpoint of rCRC relative to healthy controls. The accuracy of the algorithm was summarized as sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) with 95% confidence intervals (CI) in the test set. Results: Median patient age was 55 (interquartile range: 49-64) years. As shown in the Table below, a single MDM with the highest AUC was significantly better than CEA ( p= 0.02). On cross validation, CEA provided no additional improvement to the performance of the panel of 13 MDMs ( p= 0.2). The cross-validated panel of MDMs detected rCRC liver metastases with 96% (79-100%) sensitivity, lung metastases with 78% (40-97%) sensitivity, and peritoneal/nodal metastases with 57% (18-90%) sensitivity. Lesions with Response Evaluation Criteria in Solid Tumors sum &gt; 4 cm were detected with 94% (73-100%) sensitivity and ≤4 cm with 78% (52-94%) sensitivity. Conclusions: Novel MDMs in plasma detect rCRC with promising accuracy. The clinical utility of MDMs for non-invasive post-treatment surveillance and treatment monitoring in CRC warrants further evaluation in longitudinal studies with sufficient follow-up to exclude sub-clinical recurrence in those with NED. [Table: see text]
Effect of postoperative continuation of antibiotic prophylaxis on the incidence of surgical site infection: a systematic review and meta-analysis
Authors: Stijn W de Jonge, Quirine J J Boldingh, Joseph S Solomkin, E Patchen Dellinger, Matthias Egger, Georgia Salanti, Benedetta Allegranzi, Marja A Boermeester
Journal: The Lancet Infectious Diseases (2020)
Racial disparities in utilization and effectiveness of first-line therapies in metastatic castrate-resistant prostate cancer.
Authors: Mallika Marar, Ronac Mamtani, Vivek Narayan, Neha Vapiwala, Ravi Bharat Parikh
Journal: Journal of Clinical Oncology (2020)

e17541 Background: Prospective evidence suggests that abiraterone use is associated with improved progression-free survival in African-American (AA) men with metastatic castrate-resistant prostate cancer (mCRPC) compared to white men. It is unclear whether race-based differences in treatment utilization and effectiveness exist for men with newly diagnosed mCRPC treated in real-world clinical practice. Methods: In this retrospective cohort study, we used the Flatiron Health electronic health record-derived de-identified database to identify patients with mCRPC who received first-line (1L) systemic therapy between 2012 and 2018. We used multivariable logistic regression analysis to examine differences in utilization of abiraterone, enzalutamide, and docetaxel between AA and white men. We then used Fine-Gray models with death as a competing risk to assess treatment-specific associations between race and time to next therapy (TTNT) – a proxy for progression-free survival. Finally, we used multivariable Cox proportional hazards analyses to assess for treatment-specific racial disparities in all-cause mortality. All analyses were adjusted for age, Elixhauser comorbidity index, baseline steroid or opioid use (a proxy for disease aggressiveness), performance status, insurance status, and (if significant) an interaction term for race and age. Results: Of 3,808 mCRPC patients in the cohort, 2,165 (68.7%) were white and 404 (10.6%) were AA. At time of metastatic diagnosis, AA men were younger (69 vs. 75, p &lt; 0.001) and more likely to have PSA value greater than 50 (57.9% vs. 42.6%, p &lt; 0.001) compared to white men. Median follow up was 15 months. There were no significant racial differences in 1L utilization, TTNT, or all-cause mortality associated with abiraterone, enzalutamide, or docetaxel use (Table). Conclusions: In this large real-world analysis of men with mCRPC who received 1L therapy, we found no significant treatment-specific differences in utilization, TTNT, or all-cause mortality between AA and white men. Long-term prospective evidence is needed to justify differential treatment selection for AA men with mCRPC. [Table: see text]
常见皮肤病诊疗
Authors: 王爱平
Journal: BMJ (2011)

王爱平:皮肤病是常见病和多发病,约占综合医院门诊量的10%.它可以仅是皮肤的病变,也可以是全身性疾病的先兆或指征,因此,学习皮肤性病学时,一定要有整体观念. 皮肤病大致分以下几大类,感染性皮肤病,如病毒、细菌、真菌感染性皮肤病及性传播疾病等;变态反应相关性皮肤病,如皮炎、湿疹、药疹等;自身免疫性皮肤病,如结缔组织病及获得性大疱性皮肤病;皮肤肿瘤;遗传性皮肤病,如鱼鳞病、掌跖角化病等.本次主要讲解皮炎湿疹类皮肤病及浅部真菌病。
Researches promote the institutional development of urban community health service centers
Authors: Yunfeng Yang, Liping Xu, Wenqin Gu
Journal: BMJ (2017)

Carrying out researches in urban community health service centers can effectively promote the improvement of management system, the cultivation of talents and the formation of characteristic service, leading to the institutional development. This paper summarizes the role and significance of researches in promoting the overall development of urban community health service center in order to provide reference for the relevant medical institutions based on the experiences in Shanghai Fenglin Community Health Service Center.


Key words: 
Community health service; Scientific research
Efficacy of entecavir or adefovir dipivoxil monotherapy in treatment of HBeAg-negative chronic hepatitis B patients with mildly elevated ALT
Authors: Jinghu Qi, Jinchang Ju
Journal: BMJ (2014)

Objective
To evaluate the clinical efficacy of entecavir (ETV) or adefovir dipivoxil (ADV) monotherapy in treatment of HBeAg-negative chronic hepatitis B (CHB) patients with mildly elevated ALT.


Methods
One hundred and seven HBeAg-negative CHB patients with ALT elevated by 1-2-fold of upper limit of normal (ULN) were enrolled in this prospective study. Sixty patients were assigned to receive ETV monotherapy and 47 patients to receive ADV monotherapy for at least 96 weeks. The ALT and HBV DNA levels were measured every 3 months. The liver biopsy was performed in 35 patients prior to therapy. Drug resistance and adverse reactions were documented.


Results
Four cases in ETV group and 2 cases in ADV group were lost in follow-up. Among 35 patients with liver biopsy, 30 (86%) cases had significant fibrosis (stage 2-4) or inflammation (grade 2-4). At weeks 96, serum ALT was normalized in 67% (30/45) cases of ADV group, and 95% (53/56) cases of ETV group(χ2=13.33, P<0.01); the proportion of patients with undetectable HBV DNA in ADV and ETV groups was 78% (35/45) and 100% (56/56) respectively (χ2=13.81, P<0.01). No drug resistance occurred in ETV group, while 2 patients in ADV group were found with virological breakthrough and were confirmed to be of variants associated with ADV resistance. No adverse reactions were observed in either group during the trial.


Conclusion
Present study suggests that most HBeAg-negative CHB patients with mildly elevated ALT have significant fibrosis or inflammation and entecavir monotherapy was more effective than adefovir dipivoxil monotherapy in treatment of the patients.


Key words: 
Entecavir; Adefovir dipivoxil; ALT; HBeAg-negative; hepatitis B
Association of Intrauterine Growth Restriction and Small for Gestational Age Status With Childhood Cognitive Outcomes
Authors: Chiara Sacchi, Claudia Marino, Chiara Nosarti, Alessio Vieno, Silvia Visentin, Alessandra Simonelli
Journal: JAMA Pediatrics (2020)

The magnitude of the association of intrauterine growth restriction (IUGR) and small for gestational age (SGA) status with cognitive outcomes in preterm and term-born children has not been established.To examine cognitive outcomes of preterm and term-born children who had IUGR and were SGA compared with children who were appropriate for gestational age (AGA) during the first 12 years of life.For this systematic review and meta-analysis, the Scopus, PubMed, Web of Science, Science Direct, PsycInfo, and ERIC databases were searched for English-language, peer-reviewed literature published between January 1, 2000, and February 20, 2020. The following Medical Subject Heading terms for IUGR and SGA and cognitive outcomes were used: intrauterine growth restriction, intrauterine growth retardation, small for gestational age AND neurodevelopment, neurodevelopmental outcome, developmental outcomes, and cognitive development.Inclusion criteria were assessment of cognitive outcomes (full-scale IQ or a cognitive subscale), inclusion of an AGA group as comparison group, and inclusion of gestational age at birth and completion of cognitive assessment up to 12 years of age.The Meta-analysis of Observational Studies in Epidemiology (MOOSE) reporting guidelines were followed. Data were double screened for full-text articles, and a subset were independently coded by 2 authors. Standardized mean differences (SMDs) and odd ratios from individual studies were pooled by applying random-effects models.Cognitive outcomes, defined as mental, cognitive, or IQ scores, estimated with standardized practitioner-based cognitive tests or as borderline intellectual impairment (BII), defined as mental, cognitive, or IQ scores at least 1 SD below the mean cognitive score.In this study of 89 samples from 60 studies including 52 822 children, children who had IUGR and were SGA had significantly poorer cognitive outcomes (eg, cognitive scores and BII) than children with AGA in childhood. For cognitive scores, associations are consistent for preterm (SMD, -0.27; 95% CI, -0.38 to -0.17) and term-born children (SMD, -0.39; 95% CI, -0.50 to -0.28), with higher effect sizes reported for term-born IUGR and AGA group comparisons (SMD, -0.58; 95% CI, -0.82 to -0.35). Analyses on BII revealed a significantly increased risk in the preterm children who had IUGR and were SGA (odds ratio, 1.57; 95% CI, 1.40-1.77) compared with the children with AGA.Growth vulnerabilities assessed antenatally (IUGR) and at the time of birth (SGA) are significantly associated with lower childhood cognitive outcomes in preterm and term-born children compared with children with AGA. These findings highlight the need to develop interventions that boost cognitive functions in these high-risk groups.
Disparities in the receipt of National Comprehensive Cancer Network (NCCN) guideline adherent care in triple-negative breast cancer (TNBC) by race/ethnicity, socioeconomic status, and insurance type.
Authors: Chimezie Ubbaonu, Jenny Chang, Argyrios Ziogas, Kiran Clair, Sora Park Tanjasiri, Robert E. Bristow, Neha Patel, Rita S. Mehta, Kari Joanne Kansal, Jason A. Zell
Journal: Journal of Clinical Oncology (2020)

1080 Background: Breast cancer is the most commonly diagnosed cancer in women in the United States and the second leading cause of cancer mortality in women.TNBC is more likely to present at an earlier age with more advanced and aggressive disease. The overarching goal of treatment recommendations listed in the National Comprehensive Cancer Network (NCCN) guidelines are to improve patient outcomes. Here we examine factors which may contribute to NCCN guideline adherence. Methods: This was a retrospective cohort study of women with triple negative breast cancer using data from the California Cancer Registry (CCR) between 2004-2016 (with follow-up through 11/2018). Indicators for concordance with NCCN guidelines for TNBC was used as the dependent variable in the analysis. A multivariable logistic regression was used to determine the effects of independent variables on adherence to NCCN guidelines. Odds ratios and 95% Confidence Intervals (CI) were calculated. Non-Hispanic Whites, having medical insurance and highest socioeconomic status (SES) were set as references values in the regression models. Disease specific survival was calculated using the Cox regression analysis. Results: A total of 16,858 women were included in this study, 32.5% (n = 5,472) received NCCN adherent care (p &lt; 0.0001). Non-Hispanic Blacks (NHB) and Hispanic patients were less likely to receive guideline adherent care (respectively, OR 0.87, 95%CI 0.79-0.95 and OR 0.87, 95%CI 0.79-0.95). Patients of lowest and lower-middle socioeconomic status (SES) were less likely to receive NCCN guideline adherent care (respectively, OR 0.77, 95%CI 0.68-0.87 and OR 0.88, 95%CI 0.79-0.98). Overall, non-adherent care was associated with an increased disease-specific mortality (HR 1.21, 95%CI 1.11-1.31, p &lt; 0.0001). Hazard ratios were calculated after adjusting for adherent care and NHB patients had an increased disease-specific mortality (HR 1.28, 95%CI 1.16-1.42, p &lt; 0.0001) in addition to patients with Medicare or Medicaid payer status (respectively, HR 1.20, 95%CI 1.08-1.34, p &lt; 0.001 and HR 1.29, 95%CI 1.15-1.43, p &lt; 0.0001). Conclusions: A significant portion of TNBC patients in California continue to receive non-guideline adherent care. Non-Hispanic black patients and lower SES quintile groups were less likely to receive guideline adherent care. Patients with non-adherent care had worse disease specific survival compared to recipients of NCCN-adherent care.
Application and effectiveness of knowledge, attitude and practice assessment scales in self-management of patients with diabetes mellitus
Authors: Shuyu Li, Shanzhu Zhu, Ling Jin, Zhangyan Chen, Hua Yang
Journal: BMJ (2017)

Knowledge-attitude-practice model is widely used in the self-management of type-2 diabetes. Through proper education, patients can gain diabetic knowledge as well as positive attitude on glucose control. By regulating diet, exercise, self glucose monitoring and medication compliance, diabetic patients are able to control blood glucose more effectively, and have less complications and higher quality of life. Researches on the application and effectiveness of various diabetic knowledge, attitude and self-management behavior scales are reviewed in this article.


Key words: 
Diabetes mellitus, type 2; Knowledge-attitude-practice scale; Disease management, patient participation
眼部带状疱疹并发动眼神经麻痹一例
Authors: 马宝峰, 党光福, 段练, 高阳, 杨少远, 边广庆
Journal: BMJ (2008)

患者男,61岁,因右眼睑疼痛、肿胀、水疱伴右侧额部水疱3 d到当地医院眼科就诊.诊为带状疱疹,给予阿昔洛韦滴眼液点眼、阿昔洛韦静脉滴注治疗.3 d后右眼睑肿胀减轻,发现右眼上睑下垂,右眼球运动受限.继续给予阿昔洛韦滴眼液点眼、阿昔洛韦静脉滴注治疗7 d出院.出院时疼痛好转,疱疹部分结痂,右眼上睑下垂,眼球运动受限。
EGFR tyrosine kinase inhibitor therapy continuation with high-dose hypofractionated radiotherapy in EGFR-mutated non-small cell lung cancer (NSCLC) patients with oligoprogressive disease.
Authors: Mariacarmela Santarpia, Maria Rosaria Valerio, Nicolò Borsellino, Andrea Girlando, Gianfranco Mancuso, Giuseppe Altavilla, Vittorio Gebbia
Journal: Journal of Clinical Oncology (2020)

e21580 Background: EGFR tyrosine kinase inhibitors (TKIs) represent the standard first-line therapy for advanced non-small cell lung cancer (NSCLC) patients with activating EGFR mutations. However, despite initial marked responses, tumors invariably develop acquired resistance to TKIs. Oligoprogression is commonly observed during treatment with oncogene-directed therapies, including EGFR TKIs, and refers to patients who experience disease progression only in limited sites as a result of heterogeneous mechanisms of resistance. The use of local ablative treatments for these resistant lesions may extend the duration of TKI therapy and potentially improve long-term disease control and survival. We e retrospectively analyzed the efficacy of EGFR TKI therapy continuation with high-dose hypofractionated radiation therapy (RT), in EGFR-mutant NSCLC patients with oligoprogressive disease. Methods: Patients with metastatic EGFR mutant NSCLC who developed oligoprogression during first-line treatment with gefitinib were included in this analysis. We evaluated progression-free survival 1 (PFS 1), defined as the time from initiation of TKI therapy until development of oligoprogression or death, and PFS 2, defined as time of focal progression until further progression of disease or death. Overall survival and safety were also assessed. Results: Thirty-six patients were included in the study. The median PFS 1 was 12.5 (4.0-23.2) months. High-dose hypofractionated RT consisted of intensity-modulated RT in 23 patients (64%) and stereotactic radiotherapy in 13 cases (36%). The median PFS 2 was 6.3 (2-12.5) months. Overall survival was 38.7 months (9.0-46.3). The treatment was well-tolerated and no patient had to discontinue TKI therapy because of adverse events during radiotherapy. Conclusions: Our therapeutic strategy, including high-dose hypofractionated RT in addition to TKI therapy, was feasible in the clinical setting and was associated with significant prolongation of disease control and improvement of survival outcomes, while being associated with manageable side effects. Our study further support the use of definitive therapeutic approaches in oligoprogressive disease, especially in oncogene-driven tumors. Molecular profiling of metastatic sites remains crucial to identify novel biomarkers, involved in the development of acquired resistance and oligoprogression, that may be useful to select patients for local treatments.
Advanced cancer patients' (CP) attitudes and perceptions regarding reasons for outpatient supportive care (SC) referral at a comprehensive cancer center: A randomized controlled study.
Authors: Angelique Wong, Frank V. Fossella, George R. Simon, Rama Maddi, Zhanni Lu, Janet L. Williams, Lisa Thomas, Diane D. Liu, Jimin Wu, David Hui, Eduardo Bruera, Sriram Yennu
Journal: Journal of Clinical Oncology (2020)

e24135 Background: Current ASCO guidelines propose early access to SC in all CP to improve quality of care, quality of life, and symptoms. Very few studies have evaluated patients’ perceived criteria for referral to outpatient SC and perceptions of patients who are referred early in their disease trajectory. Methods: In this study we evaluated CP attitudes and perceptions regarding the role of and access to outpatient Supportive Care clinic (SCC) at a comprehensive cancer center. CP with life expectancy of greater than 6 months (as determined by the oncologist) and who are newly registered at MD Anderson Cancer Center were randomized to either obtain an educational brochure that explained the role of the SCC or no brochure. Both groups then completed a survey regarding the role and access to of outpatient SCC. After completion of the survey, patients were asked if they would like to be seen by the SC team. If so, they were scheduled by their oncologist for a SC consult. Results: 288 patients were evaluable: median age was 63, 43% were female, 84% were Caucasian, and the most common cancer type was lung cancer (39%). Median survival was 15 months. Patients who received a brochure reported more understanding of the role of SC vs those who did not receive a brochure (63% vs 37%, p = 0.04). Both groups felt that SC could help to address physical (47% vs 54%) and psychosocial (50% vs 50%) symptoms. Both groups felt SC could help to address questions regarding prognosis (50% vs 50%) and future care (53% vs 47%). Both groups did not feel that time (50% vs 50%) nor financial concerns (49% vs 51%) would be barriers to access SC. Both groups did not feel that receiving SC would impede their cancer care (60% vs 40%) nor change their oncologists’ perspective of them (25% vs 75%). Both groups felt they could receive SC and cancer care simultaneously (50% vs 50%). Approximately half of the patients in both groups perceived it was not too early for a referral to SC. There were no statistical differences in these groups for these findings. Conclusions: Patients who received a brochure had a better understanding of the role of SC. A very significant proportion in both groups had limited awareness of the value of SC. Oncologist driven referral and education of SC may facilitate better understanding of the value of SC. Further studies are needed.