tbuckley/cabot-search huggingface dataset:
Paraneoplastic ataxic syndrome with anti-Yo antibodies in breast and ovarian cancer: A retrospective analysis.
Authors: Akshjot Puri, Usman Khan, Polly Ann Niravath
Journal: Journal of Clinical Oncology (2020)

e18089 Background: Paraneoplastic cerebellar syndrome is a rare immunological reaction caused most commonly by Anti-Yo or Purkinje cell cytoplasmic antibody type 1(PCA1) to cerebellar degeneration protein 2(CDR2), found in the cerebellum and ectopically produced by tumor. Most cases are reported in women with HER2+ breast and ovarian cancers with underlying breast cancer patients having relatively better prognosis. Treatment initiation within one month of symptom onset has shown better outcomes. Methods: A retrospective analysis was conducted using a clinical database at a single institution and included 3 patients with a cancer diagnosis and ataxic symptoms diagnosed between 2016 and 2020. Data collection included age, gender, performance status, site of disease, pathology, diagnostic work up, treatment and overall survival (OS). Results: The study included 3 patients who presented with new onset ataxic symptoms with the median time of cancer diagnosis from onset of symptoms being 5 months (range 4-7). Median age was 62 years (range 59-83), all 3 patients were females and functionally independent before symptom onset. Out of 3 patients 2 had HER2+ breast cancer (one with IHC 3+ and one with equivocal IHC but 20 HER2 signals/nucleus) and the third had ovarian carcinoma. All 3 patients had stage IIIA disease as per AJCC 8 th edition and presented with bilateral extremity weakness, ataxia, visual disturbances, vertigo and nausea/vomiting. Extensive neurological work up including MRI brain, CSF analysis, EEG were inconclusive except for high titres of anti- Yo antibodies in all patients. All patients were treated with cancer directed therapy and immunomodulation with plasma exchange, IVIG and steroids. The median OS being 22 months (range 12-28) with 2 patients with underlying breast cancer alive at the time of the analysis albeit there has been no neurological recovery, despite IVIG, steroids, and plasma exchange. Conclusions: The anti-Yo associated paraneoplastic ataxic syndrome most commonly associated with breast and pelvic tumors in women has a very poor prognosis despite anti-tumor and immunomodulating therapies, leaving most patients bed-ridden. The neurologic damage is irreparably incurred once the antibodies attack cerebellar cells. Thus, it is critical for clinicians to recognize the potential signs and symptoms as early as possible, so that treatment can be started, and long term symptoms are minimized. Further studies are needed to know the exact mechanism of this syndrome and provide evidence based treatment options.
Application of dizziness handicap inventory in evaluation of benign paroxysmal positional vertigo
Authors: Chong Wang, Jianming Wang, Wei Yang, Lei Song
Journal: BMJ (2016)

Thirty patients with objective benign paroxysmal positional vertigo (BPPV) (objective group) and 30 patients with subjective BPPV (subjective group) visiting Department of Neurology from January 2014 to June 2015 were enrolled in the study. There were no significant differences in semicircular canal, gender, age, related factors of secondary onset (P>0.05). Patients were evaluated with dizziness handicap inventory (DHI) before and after the maneuver therapy. The average DHI subscale scores before treatment of all patients were higher than those after treatment (11.8±2.8 vs. 2.5±1.8, P<0.05); there was 11.9±3.0 vs. 2.5±2.1 (P<0.05) for objective group and 11.6±2.6 vs. 2.5±1.6 (P<0.05) for subjective group. The scores of P1, F5, P11, P13, P25 (mean rank order value) after treatment were decreased compared to corresponding initial scores in two groups(objective group: 21.30 vs. 39.70, 19.55 vs. 41.45, 19.00 vs. 42.00, 18.65 vs. 42.35, 15.90 vs. 45.10, respectively, subjective group: 20.93 vs. 40.07, 18.07 vs. 42.93, 19.77 vs. 41.23, 18.57 vs. 42.43, 16.47 vs.44.53, respectively; all P<0.05). The results indicate that maneuver therapy is effective both for objective and subjective BPPV patients; and subscale of DHI can be used to evaluate the degree of illness in patients with BPPV.


Key words: 
Vertigo; Semicircular canals
Multivariate analysis on risk factors for hepatitis B virus infection
Authors: Qiang Ou, Yu-xia Lu
Journal: BMJ (2012)

To explore the major risk factors for hepatitis B (HBV) in Shanghai Jinshan district.A one-to-two matched case control study was performed among the residents of Shanghai Jinshan district in 2010.The data were analyzed by single factor and multivariate analysis performed with SAS 9.13.Single factor analysis showed that the risk factors for hepatitis B were family member with hepatitis B,no vaccination history of hepatitis B virus vaccine and oral treatment.Muhivariable analysis showed that family member with hepatitis B (OR =1.91),no vaccination history of HBV vaccine (OR =0.49) and oral treatment (OR =2.06) were independent risk factors for HBV infection in Shanghai Jinshan district.Strengthening health education for HBV prevention,modifying unhealthy living habits and standardizing the treatment of oral diseases are important measures for lowering infectious rate of HBV.

Key words: 
Hepatitis B virus; Risk factors
Cri-du-chat syndrome: a case report and literature review
Authors: Xiao-yan Tang, Zheng-hong Li
Journal: BMJ (2013)

A neonatal girl with overextended knees admitted to NICU of our hospital was diagnosed as cri du chat (cat cry) syndrome. We collected 34 cases of cri du chat reported in journals since 2000, the clinical features of total 35 cases were retrospectively analyzed. Among 35 cases 12 were boys and 23 girls. The most common clinical manifestations were characteristic face features (100%), difficult feeding (100%) and typical sound of cry (94%). The main complains at hospital visit were typical cry, difficult feeding and cyanosis in the neonatal period, while in childhood period were recurrent respiratory infection, developmental retardation and other abnormalities. Most cases were diagnosed in the neonatal phase, while 85.3% were in the first year. The diagnosis was based on karyotype analysis; chromosome 5 short arm deletion (5P-) was the most significant genetic variation and clinical features were associated with the position of deletion.


Key words: 
Cri-du-chat syndrome; Diagnosis
Safety and efficacy of gemtuzumab ozogamicin and venetoclax in patients with relapsed or refractory CD33+ acute myeloid leukemia: A phase Ib study.
Authors: Saad Arain, Sonia Christian, Pritesh Rajni Patel, Karen Sweiss, Brian Parkin, Gregory Sampang Calip, John G Quigley
Journal: Journal of Clinical Oncology (2020)

TPS7566 Background: AML is predominantly a disease of the elderly, yet outcomes remain dismal, especially for relapsed/refractory (R/R) AML patients (pts). Gemtuzumab Ozogamicin (GO) is a monoclonal antibody targeting CD33–commonly expressed on AML blasts, and, critically, AML stem cells (LSC)–that is linked to the cytotoxin calicheamicin. Recognized mechanisms of GO resistance include decreased (or aberrant) blast CD33 expression, upregulation of p-glycoprotein (re-exports calicheamicin), and decreased mitochondrial apoptosis. GO-induced apoptosis depends on pro-apoptotic Bax and Bak and is inhibited by overexpression of anti-apoptotic BCL-2 and BCL-XL. Venetoclax (VEN) is a BH3 mimetic, binding BCL-2, dislodging its binding to Bak/Bax, thus facilitating apoptosis. LSC uniquely overexpress BCL-2, however VEN resistance develops rapidly. Hypothesis: VEN targeting of BCL-2 proteins that protect LSC from GO-induced apoptosis will synergistically increase GO efficacy. Correlative studies include pre-treatment AML blast BH3 profiling and CD33 expression (&amp; sequencing for isoforms), MRD measurement at post-therapy timepoints using digital drop PCR technology, and quality of life assessments (EORTC QLQ-C30, FACT-Fatigue). Methods: Single arm, open-label, multi-center (BTCRC), dose-escalation phase Ib study of combination of VEN and GO in R/R AML pts (18-75y), using a 3+3 design. Major eligibility: ECOG 0-2, adequate organ function, CD33+ in ≥ 20% AML blasts, ≤2 lines of prior therapy, no prior use of GO or VEN, no previous VOD, no BMT within 2 months, no CNS disease, and no history of HIV. Induction: 3-day VEN ramp-up to the target dose of 200 (cohort i), 400 (ii), or 600 (iii) mg daily x 28 d, with GO 3mg/m 2 infused d 1, 4, and 7. If CR/CRi achieved, pts proceed to BMT if applicable, otherwise, if in CR/CRi (provided ANC &gt; 1000, plts 100K) or PR (regardless of counts), they are consolidated with VEN at the prescribed dose x 28d and GO 3mg/m 2 on days 1 and 4 (Cycle 2). If BMT not applicable, and then in CR/CRi or PR (as above), proceed to VEN alone as Maintenance in cycles 3+ until progression or toxicity. The primary endpoint is MTD of VEN with GO. Secondary endpoints include ORR, anti-leukemic activity, characterization of AEs, and estimates of RFS, EFS, and OS. This study is currently open and has to date enrolled 2 pts. Clinical trial information: NCT04070768 .
Current status of age-related eye diseases in elderly population and their visual function and visual-related quality of life
Authors: Yuhong Shao, Xiao Chen, Hailan Zhao
Journal: BMJ (2015)

Objective
To explore the prevalence of age-related eye diseases (AREDs) among people aged 70 years or above in Hangzhou and evaluate the impact of AREDs on visual function (VF) and visual-related quality of life (QOL) in elders.


Methods
This study involved a total 2 111 elderly people (≥70 years). All participants received visual acuity and comprehensive eye examinations and complete VF and QoL questionnaires.


Results
The main cause of visual impairment was AREDs. And the causes were age-related cataract (79.82%), AMD (45.64%), glaucoma (10.95%) and diabetic retinopathy (DR, 7.30%). VF and QoL scores declined gradually with age. And the scores declined more rapidly with declined visual acuity among the elders. VF and QoL scores in patients with age-related cataract, AMD, glaucoma and DR were successively lower. After adjusting for age, gender and visual acuity, the elders with AREDs had lower scores across all domains of VF and QoL. Scores for subscales of VF and QoL domains were significantly lower among those with DR and glaucoma compared with those with age-related cataract and AMD.


Conclusion
Age, presenting vision and AREDs are associated with VF and QoL in this elderly population. And senile people with glaucoma and DR have severe declines in VF and QoL, independent of presenting visual acuity.


Key words: 
Elderly population; Eye diseases, age-related; Visual function; Quality of life
腹外疝嵌顿还纳合并急性阑尾炎二例
Authors: 孔庆晨, 朱海英, 丁庆灿
Journal: BMJ (2009)

例1男,46岁.因右腹股沟可复性包块2年,嵌顿还纳后腹痛6 h于2006年5月24日5:00入院.既往无外伤及手术史.查体:生命体征正常,心肺听诊正常,腹平软,右下腹弥漫性压痛、反跳痛,未及包块,肠鸣音亢进,右腹股沟区未及包块,外环口松弛,可容食指尖,嘱患者咳嗽,有冲击感,压迫内环口,冲击感消失.辅助检查:血常规:白细胞(WBC)14.1×109/L,分类中性粒细胞0.77、淋巴细胞0.118;腹部X线透视检查可见肠胀气多量,未见液平;腹部B超示,右下腹肠间少量积液。
局部麻醉下腹膜前间隙无张力疝修补术的应用体会
Authors: 郑学智, 薛立峰
Journal: BMJ (2009)

随着我国逐渐进入老龄化社会,腹股沟疝作为老年常见疾病发生率逐渐增高.传统的手术方式均为有张力的修补,术后易复发.近年来有资料显示,腹膜前间隙腹股沟无张力疝修补术是最符合人体牛理、解剖的手术[1].我院自2006年2月至2008年8月,对26例腹股沟疝患者应用局部麻醉下腹膜前间隙修补术治疗,取得满意效果,现报告如下。
Damage of proximal stomach function in diabetic patients
Authors: Yuexia Zhang
Journal: BMJ (2016)

Fifty four diabetic patients, including 26 cases with dyspepsia and 28 cases without gastrointestinal symptoms, and 21 healthy volunteers were enrolled in this prospective study.To determine the function of proximal stomach, water load test was performed and the area and circumference of gastric corpus were measured by ultrasonography, and the differences between threshold and maximum were calculated.Results showed that the threshold and maximum drinking volumes in diabetic patients with dyspepsia were lower than those without dyspepsia [(638±311) ml vs. (870±225) ml and(1 000±424) ml vs.(1 360±322) ml, t=2.779 and 3.111, P<0.05]. The threshold drinking volume in patients without dyspepsia was significantly higher than that of control group [(870±225) ml vs.(688±225) ml, t=-2.450, P<0.05]. The differences of drinking volume and corpus area in patients with dyspepsia were lower than those of patients without dyspepsia and controls [(362±146) ml vs. (490±150) ml, (550±157) ml, t=2.838, 3.920, (11.76±6.85) cm2vs. (19.78±12.07) cm2, (20.80±10.65) cm2, t=2.769, 3.311, P<0.05]. The difference of circumference in diabetic patients with dyspepsia was lower than in controls [(3.67±2.17) cm vs.(6.22±3.06) cm, t=3.139, P<0.05]. The study indicates that the proximal stomach function is impaired in diabetic patients, presenting a declined sensory threshold and reduced relax function.


Key words: 
Diabetes mellitus; Proximal stomach
Breast cancer patient reported outcomes, depression, and objective measures of breast cosmesis.
Authors: Shauna McManus, Jolinta Y Lin, Manali A. Bhave, Gabrielle Brown, India Green, Xiaofeng Yang, Tian Liu, Andrew H. Miller, Mylin Ann Torres
Journal: Journal of Clinical Oncology (2020)

569 Background: Patient-reported outcomes (PROs) of cosmesis after breast-conserving therapy (BCT) are increasingly emphasized as meaningful treatment endpoints but little is known about the relationship between objective measures, mood, and PROs following radiation (XRT). We hypothesized that pre-XRT depression, assessed by Inventory of Depressive Symptomatology Self-Report (IDS-SR), would influence PROs of breast cosmesis 1-year post-XRT independent of objective measures of breast asymmetry. Methods: 98 women were enrolled on two prospective longitudinal studies of breast cosmesis. Percentage breast retraction assessment (pBRA) was used as an objective measure of breast asymmetry pre- and 1 year post-XRT. At the same time points, pBRA was measured and compared with two different PRO ratings of cosmetic outcome (0-10 scale): 1) happiness with cosmesis and 2) perceived differences in treated vs. untreated breast. We performed univariate and multivariate analysis to evaluate the relationship between PROs, pBRA, IDS-SR scores, clinical, tumor, and treatment characteristics. Results: Among subjects, 50% were African American. Mean age was 56.45 years. At 1 year, 65.3% of patients were happy with their cosmetic outcome (Score &gt; 8) although 59.5% noted moderate to severe differences in the treated vs. untreated breast (Score &lt; 6). Mean pBRA increased from 7.20 (SD 3.88) pre-XRT to 9.69 (SD 6.22) confirming more breast asymmetry 1-year post-XRT. Prior to XRT, 23% of patients had moderate-to-severe depression (IDS-SR scores &gt; 26). In multivariate analyses, 1 year PROs of happiness with cosmetic outcome did not correlate with pBRA (p = 0.3) but were strongly correlated with pre and post-XRT depression (all p &lt; 0.05). Patients were more likely to perceive differences in breast texture or asymmetry (i.e. lower PRO ratings of asymmetry) if they had higher pBRA measurements at 1 year (all p = 0.004). Neither pre- nor post- XRT depression were associated with specific PRO ratings of breast asymmetry in multivariate analysis. Conclusions: Our study suggests that PROs may not always reflect the effects of cancer treatment. For patients treated with BCT, baseline depression strongly influenced patient reported happiness with overall cosmetic outcome 1 year post-XRT. Perceived differences in the treated vs. untreated breast correlated with objective measures of breast asymmetry. Our data suggests that this PRO may be more indicative of treatment-related toxicities than patient ratings of overall satisfaction and happiness with cosmetic outcome. Clinical trial information: NCT03167359 .
Successful <i>Pseudomonas aeruginosa</i> eradication improves outcomes after lung transplantation: a retrospective cohort analysis
Authors: Benedicte De Muynck, Anke Van Herck, Annelore Sacreas, Tobias Heigl, Janne Kaes, Arno Vanstapel, Stijn E. Verleden, Arne P. Neyrinck, Laurens J. Ceulemans, Dirk E. Van Raemdonck, Katrien Lagrou, Bart M. Vanaudenaerde, Geert M. Verleden, Robin Vos
Journal: European Respiratory Journal (2020)

Long-term survival after lung transplantation (LTx) is hampered by development of chronic lung allograft dysfunction (CLAD). Pseudomonas aeruginosa is an established risk factor for CLAD. Therefore, we investigated the effect of P. aeruginosa eradication on CLAD-free and graft survival. Patients who underwent first LTx between July, 1991, and February, 2016, and were free from CLAD, were retrospectively classified according to P. aeruginosa presence in respiratory samples between September, 2011, and September, 2016. P. aeruginosa -positive patients were subsequently stratified according to success of P. aeruginosa eradication following targeted antibiotic treatment. CLAD-free and graft survival were compared between P. aeruginosa -positive and P. aeruginosa -negative patients; and between patients with or without successful P. aeruginosa eradication. In addition, pulmonary function was assessed during the first year following P. aeruginosa isolation in both groups. CLAD-free survival of P. aeruginosa -negative patients (n=443) was longer compared with P. aeruginosa -positive patients (n=95) (p=0.045). Graft survival of P. aeruginosa -negative patients (n=443, 82%) was better compared with P. aeruginosa -positive patients (n=95, 18%) (p&lt;0.0001). Similarly, P. aeruginosa -eradicated patients demonstrated longer CLAD-free and graft survival compared with patients with persistent P. aeruginosa . Pulmonary function was higher in successfully P. aeruginosa -eradicated patients compared with unsuccessfully eradicated patients (p=0.035). P. aeruginosa eradication after LTx improves CLAD-free and graft survival and maintains pulmonary function. Therefore, early P. aeruginosa detection and eradication should be pursued.
Risk factors for hepatic steatosis in patients with chronic hepatitis B:a case-control study
Authors: Jing Chen, Jing Dong, Hai-duan Lin, Jia-ji Jiang
Journal: BMJ (2010)

Objective To investigate risk factors for hepatic steatosis in patients with chronic hepatitis B (CHB). Methods One hundred and eighty patients with biopsy-proven chronic hepatitis B were included in the study. Those with liver steatosis (61 from 93 cases) and those without it (61 from 87 cases)were matched on gender and age ( ± 3 years). Results Body mass index (BM I) was significantly higher in case group (24 ±3) than that in controls (22 ±3) (P ＜0.01 ). No significant difference was found in fasting plasma glucose, total cholesterol, triglycerides, urine acid, alanine aminotransferase, glutamyl transpeptidase and hepatitis B virus ( HBV ) DNA between the cases and controls ( all P ＞ 0. 05 ).Conditional logistic regression analysis with proportional hazard regression model statement by SPSS software showed that BMI was the only independent correlate to liver steatosis in patient with CHB ( OR = 1. 488, P ＜0. 01 ). Conclusions Liver steatosis in patients with CHB associates with BMI of the hosts, but does not correlate to their HBV DNA level.

Key words: 
Hepatitis B,chronic;  Fatty liver;  Risk factors
Is the toxicity of breast radiotherapy higher in patients with collagen vascular disease? A systematic review of the literature.
Authors: Wei Liu, Aaron Leung, Jane Park, Brandon Liu, Gabriel Boldt, David A. Palma
Journal: Journal of Clinical Oncology (2020)

e12527 Background: Collagen vascular disease (CVD) has been described to be a relative contraindication for radiotherapy (RT) due to increased toxicity. As a result, RT to the breast or chest wall is underutilized in patients with CVD, despite known benefits in local control and overall survival after breast conserving surgery or mastectomy. We sought to characterize the acute and late toxicity rates associated with curative-intent RT for breast cancer patients with CVD. Methods: A systematic review per the PRISMA guidelines was performed using Pubmed database (inception to July 2019), for English-language articles. Key search themes included collagen vascular disease, connective tissue disease, including specific subtypes, along with terms for radiation and cancer. Title and abstract review were followed by full-text review. Inclusion criteria were reports of toxicity of five or more patients with CVD and treatment with curative-intent RT to the breast or chest wall. Data abstracted included: type of study, CVD diagnosis, number of patients who received breast RT, acute grade ≥3, and late grade ≥1, grade ≥3, and grade 5 toxicity. Primary endpoint was late grade ≥3 toxicity for patients with pre-existing CVD. Acute and late toxicity were classified as per CTCAE version 5.0. Results: The initial search yielded 3286 unique abstracts. 34 articles were determined appropriate for full-text review. From these, a final set of 10 articles met all inclusion criteria. All studies were retrospective. In these studies, more than 30 000 patient cases were reported. 184 patients with CVD who underwent curative-intent RT to the breast or chest wall and had available toxicity data were identified, including 128 patients with CVD diagnosed before RT. In the 5 case control studies, 100 patients were matched to 225 controls. Most studies did not report the incidence of all grades of toxicity. Among patients with available data, 7/102 patients (7%) with pre-existing CVD had late grade ≥3 toxicity, including 4/6 (67%) with pre-existing scleroderma and 3/96 (3%) with pre-existing non-scleroderma CVD. 32/88 patients (36%) with pre-existing CVD and available data had late grade ≥1 toxicity. 1/142 (1%) had late grade 5 toxicity, in the form of chronic pericarditis. 6/66 patients (11%) with pre-existing CVD had acute grade ≥3 radiation dermatitis. No patients had acute grade 5 toxicity. Conclusions: Retrospective data suggest that patients with pre-existing CVD, aside from scleroderma, have acceptable acute and late toxicity rates after RT to the breast or chest wall.