tbuckley/cabot-search huggingface dataset:
Pharmacist assistance for patients on oral oncologic therapy: Impact on adherence and costs.
Authors: Munir Murad Junior, Suellen Pegnolato, Luiz Adelmo Lodi, Milena Marcolino, Roberto Porto Fonseca
Journal: Journal of Clinical Oncology (2020)

e19198 Background: Oral cancer treatment has becoming progressively more frequent and its costs are rising. To implement strategies that monitor adverse effects, adherence and manage financial resources is of utmost importance. Our goal is to develop an intervention based on pharmaceutical monitoring that promotes the correct use of medication through the early identification of adverse events, as well as to describe an economic analysis of this intervention. Methods: Quasi-experimental study, which included consecutive patients from a private oncologic clinic in Belo Horizonte, Southeast Brazil, who were taking oral medications for the treatment of cancer. Patients had regular consultations with pharmacists, at the beginning of each treatment cycle. The consultation consisted of the assessment of adherence (if they took at least 80% of the pills on a specific period of time) and adverse effects. The number of pills dispensed in the new cycle was adjusted by the number of pills remaining in the previous cycle. Prices were calculated using Brasindice and the dollar price of Feb/2020. Follow-up period was from Oct/2018 to Nov/2019. Results: Throughout the study, 1224 patients were included: 86% female, mean age 63 years, 37% had at least 7 years education. Breast cancer accounted for 77% and prostate cancer for 6% of the patients, and 23% of all patients were treating stage IV cancer. The most used treatments were tamoxifen (44%) anastrazole (34%) and capecitabine (3%). In total, 10.640 pharmacists consultations were performed, which corresponds, on average, 887 consultations per month and 8.7 per patient. On average, 88.6% were adherent to the medication. In 50% of those consultations, patients reported adverse effects (hot flashes 42%, musculoskeletal syndrome 22%, fatigue 14%, cramps 7%). In that scenario, pharmaceutical care has resulted in total savings of 4067 pills or $ 136,854.89 (Table). Conclusions: Pharmaceutical care was responsible for high rates of adherence, despite the high frequency of adverse effects, and also promoted cost savings. [Table: see text]
Hypotensive efficacy of short-term continuous positive airway pressure therapy for obstructive sleep apnea/hypopnea syndrome patients complicated with hypertension
Authors: Hongyu Sheng, Nanfang Li, Keming Zhou, Lei Wang, Yu Zhang, Guoliang Wang, Duiyimuhan Gulinuer, Wen Jiang, Yunwei Bi, Jing Hong
Journal: BMJ (2015)

Objective
To investigate the hypotensive effects of short-term continuous positive airway pressure (CPAP) therapy on obstructive sleep apnea/hypopnea syndrome (OSAHS) patients complicated with hypertension.


Methods
One hundred OSAHS patients complicated with hypertension admitted in department of hypertension at the People′s Hospital of Xinjiang Uygur Autonomous Region from November 2012 to May 2013 were enrolled in the study, including 13 mild cases (5≤apnea/hypopnea index, AHI 6 h/night) on the basis of antihypertensive medications. The daily blood pressure was monitored, and the blood pressure was compared before and after treatment in three groups of patients.


Results
In severe OSAHS group the morning systolic blood pressure [(133.7±14.2)mmHg vs. (139.0±15.6)mmHg(1 mmHg=0.133 kPa), P<0.05], diastolic blood pressure [(84.8±10.0)mmHg vs.(92.0±12.6)mmHg, P<0.05] and mean blood pressure [(101.1±10.4)mmHg vs.(107.5±12.3)mmHg, P<0.05)] was significantly decreased after treatment; the extent of mean blood pressure decrease [(8.9±12.9)mmHg vs.(3.7±10.1)mmHg, P<0.05] at day 7 was significantly greater than that at day 1, the normalization rates of systolic blood pressure and diastolic blood pressure after treatment were significantly higher than those before treatment (82.0% vs. 54.1%, P<0.05 and 86.9% vs. 36.1%, P<0.05). In moderate OSAHS group the morning diastolic blood pressure [(87.1±9.9)mmHg vs.(92.5±10.1)mmHg, P<0.05], mean arterial pressure [(104.2±8.7)mmHg vs.(109.3±10.8)mmHg, P<0.05] were significantly lowered at day 7 of treatment, the normalization rates of systolic blood pressure and diastolic blood pressure at day 7 were higher than those before treatment (80.8% vs.30.8%, P<0.05 and 77.0% vs. 30.8%, P<0.05). Whereas there were significant differences in those indexes of mild OSAHS group before and after treatment.


Conclusion
Short-term CPAP therapy can effectively lower blood pressure for moderate and severe OSAHS patients complicated with hypertension.


Key words: 
Sleep apnea, obstructive; Hypertension; Continuous positive airway pressure
Abstract 15056: Global Prevalence of Cardiogenic Shock in Patients With Takotsubo Cardiomyopathy: A Systematic Review and Meta-Analysis of 77,537 Patients
Authors: Rupak Desai, Tarang Parekh, Ankit Vyas, Constance Owens, Mir Z Khan, Nazia Farheen, Abhimanyu Ravalani, Kishor Gangani, Rajesh Sachdeva, Gautam Kumar
Journal: Circulation (2019)

Background: Cardiogenic shock (CS) remains the most dreaded complication in patients with takotsubo cardiomyopathy (TC) and has been linked to higher in-hospital mortality. The first systematic rev...
Clinical pathology and analysis of treatment and follow-up for 165 patients with sarcoidosis
Authors: Chun Pu, Yimeng Yang, Ping Zeng, Jingzhi Miao
Journal: BMJ (2014)

Objective
To explore the clinical characteristics, relationship between treatment and prognosis of sarcoidosis and relationship of relapse to prednisone.


Methods
The clinical data of 165 patients with sarcoidosis were collected. The clinical characteristics, treatment process and prognosis, relationship of relapse with prednisone maintenance dose and course of treatment were retrospective analyzed.


Results
Among them, the most common involved systems were lung and lymph nodes. The involvement rates of lung, extra-thorax lymph nodes, cutaneous, ocular, salivary glands, liver & spleen, kidney and nervous system was 87.3%, 51.5%, 6.7%, 6.1%, 6.1%, 4.2%, 1.2% and 1.2% respectively. Unilateral tonsil, breast, ovary and bone involvement was seen in only 1 patient respectively with an involvement rate of 0.6%. A retrospective analysis was made for 114 cases with complete follow-up data. The mean follow-up period was (11.7±5.7) (5-32) years. And 46 cases had no symptom on routine medical examinations. The most common consulted departments were respiratory, dermatological and general surgery departments. Among 74 patients on prednisone, 48 patients (64.9%) were cured while 13 patients (17.6%) relapsed. Whereas in the observation group, 25/38 patients (65.8%) remitted spontaneously and only 1 patient (2.6%) had recurrence. Relapse occurred more often in prednisone therapy group than in observation group (P<0.05). Longer prednisone 10-15 mg daily maintenance and a longer total course of treatment were associated with fewer recurrence(P<0.05).


Conclusions
The clinical manifestations of sarcoidosis vary and many patients have a self-limiting course. The most common involved systems are lung and lymph nodes. Stage Ⅰ/Ⅱdisease should be observed before prednisone therapy. Prednisone 10-15 mg daily for at least 6 months and a total course of treatment over 18 months may prevent relapse.


Key words: 
Sarcoidosis; Retrospective studies; Follow up
Pembrolizumab for previously treated advanced anal squamous cell carcinoma: Pooled results from the KEYNOTE-028 and KEYNOTE-158 studies.
Authors: Aurelien Marabelle, Philippe Alexandre Cassier, Marwan Fakih, Steven Chuan-Hao Kao, Dorte Nielsen, Antoine Italiano, Tormod Guren, Marloes Van Dongen, Kristen Renee Spencer, Giovanni M. Bariani, Paolo Antonio Ascierto, Armando Santoro, Sandrine Hiret, Patrick Alexander Ott, Sarina Anne Piha-Paul, Chih-Chin Liu, Melanie A. Leiby, Kevin Norwood, Jean-Pierre Delord
Journal: Journal of Clinical Oncology (2020)

4020 Background: Patients (pts) with anal squamous cell carcinoma (ASCC) have poor outcomes and few treatment options. We report a pooled analysis of pembrolizumab (pembro) antitumor activity and safety in the ASCC cohorts of the multicohort studies KEYNOTE-028 (NCT02054806; phase 1b) and KEYNOTE-158 (NCT02628067; phase 2), providing a robust sample size and longer follow-up. Methods: Eligible pts were aged ≥18 y with histologically/cytologically confirmed metastatic/unresectable ASCC, had prior failure of/intolerance to standard therapy or no standard therapy options, measurable disease (RECIST v1.1), ECOG PS 0/1, and a tissue sample evaluable for PD-L1/biomarkers (KEYNOTE-028 required PD-L1 positivity). Baseline PD-L1 expression was assessed using a prototype IHC assay (QualTek) in KEYNOTE-028 and the PD-L1 IHC 22C3 pharmDx assay (Agilent Technologies) in KEYNOTE-158. Pts received pembro 10 mg/kg Q2W (KEYNOTE-028) or 200 mg Q3W (KEYNOTE-158) for 2 y or until PD/unacceptable AEs. The primary endpoint in both studies was ORR (per RECIST v1.1). Secondary endpoints were duration of response (DOR), PFS, OS, and safety. Results: 137 pts with ASCC were treated in KEYNOTE-028 (n = 25) or KEYNOTE-158 (n = 112) and were included in this analysis (median age, 61 y; 83.2% women; 73.0% had PD-L1–positive tumors). Median follow-up was 11.7 mo; 124 pts (90.5%) had discontinued treatment. ORR (95% CI) was 10.9% (6.3%–17.4%). 8 pts had CR and 7 had PR. ORR (95% CI) by PD-L1 status was 14.0% (7.9%–22.4%) in the PD-L1 positive group and 3.3% (0.1%–17.2%) in the PD-L1 negative group. Among all treated pts, median DOR was not reached (range, 6.0+ to 57.5+ mo). By Kaplan-Meier estimation, 84.6% of responders had a DOR ≥24 mo. Median PFS was 2.1 mo (95% CI, 2.0–2.1) and median OS was 11.7 mo (95% CI, 8.8–14.5). The 12-mo PFS and OS rates were 14.5% and 47.4%. 85 pts (62.0%) had +1 treatment-related AE, 24 pts (17.5%) with grade 3–4 events (no grade 5 events). 32 pts (23.4%) had immune-mediated AEs; 2 pts (1.5%) had infusion related reactions. Conclusions: In pts with previously treated advanced ASCC, pembro showed durable antitumor activity, particularly in pts with PD-L1–positive tumors, and manageable toxicity. Clinical trial information: NCT02054806 (KEYNOTE-028), NCT02628067 (KEYNOTE-158) .
Management of chronic cor pulmonale should start at the grassroots level
Authors: Yuanhua Yang, Chen Wang, Jianguo He
Journal: BMJ (2018)

慢性肺源性心脏病（肺心病）在我国是常见疾病，对其进行有效的管理与预防是基层医务工作者的一项非常重要的任务。我国当前在慢性肺心病的基层管理方面存在着严重不足，存在着重视急性加重期的治疗而轻视缓解期管理的问题。《慢性肺源性心脏病基层诊疗指南（2018年）》突出了基层医疗机构的工作重点，对规范基础治疗和预防方面的重点内容进行了详尽地推荐。该指南的出台将指导基层医务工作者管理慢性肺心病，从而降低肺心病的发病率及病死率，提高患者生命质量。
连花清瘟胶囊过敏反应一例
Authors: 吴中学, 董淑云, 王殿池
Journal: BMJ (2011)

患者男,60岁,2010年11月某日因咽痛、头痛、发热、咳嗽诊断为上呼吸道感染,口服连花清瘟胶囊(石家庄以岭药业股份有限公司,批号091221)4粒/次,一日3次.服药当天咽痛、头痛、发热明显缓解,但于第3次服药2 h后,自觉皮肤瘙痒,次日早晨第4次服药后瘙痒加重,眼睑红肿,躯干、四肢散在大片状红色风团.立即服用泼尼松20 mg和氯雷他定10 mg,1 h后皮肤瘙痒缓解,6 h后皮疹、风团全部消失.患者因服药有效,晚上又再次口服连花清瘟胶囊4粒,服药后1 h后出现全身皮肤瘙痒及红色皮疹,呼吸困难.本院体检:体温36.8℃,心率90次/min,呼吸20次/min,血压120/85 mm Hg(16.0/11.3 kPa),眼睑红肿,躯干、四肢散在大片状红色风团及散在环形红斑,边缘清晰,两肺呼吸音粗糙,无啰音,心脏无杂音,肝脾无异常,神经反射正常.立即口服泼尼松20 mg,氯雷他定10 mg,半小时后呼吸困难消失,6 h后皮疹及风团全部消失.患者有高血压及糖尿病史,否认过敏史。
Iron-Deficiency and Estrogen Are Associated With Ischemic Stroke by Up-Regulating Transferrin to Induce Hypercoagulability
Authors: Xiaopeng Tang, Mingqian Fang, Ruomei Cheng, Zhiye Zhang, Yuming Wang, Chuanbin Shen, Yajun Han, Qiumin Lu, Yingrong Du, Yingying Liu, Zhaohui Sun, Liping Zhu, James Mwangi, Min Xue, Chengbo Long, Ren Lai
Journal: Circulation Research (2020)

Rationale: Epidemiological studies have identified an associate between iron deficiency (ID) and the use of oral contraceptives (CC) and ischemic stroke (IS). To date, however, the underlying mechanism remains poorly understood. Both ID and CC have been demonstrated to upregulate the level and iron-binding ability of Tf (transferrin), with our recent study showing that this upregulation can induce hypercoagulability by potentiating FXIIa/thrombin and blocking antithrombin-coagulation proteases interactions. Objective: To investigate whether Tf mediates IS associated with ID or CC and the underlying mechanisms. Methods and Results: Tf levels were assayed in the plasma of IS patients with a history of ID anemia, ID anemia patients, venous thromboembolism patients using CC, and ID mice, and in the cerebrospinal fluid of some IS patients. Effects of ID and estrogen administration on Tf expression and coagulability and the underlying mechanisms were studied in vivo and in vitro. High levels of Tf and Tf-thrombin/FXIIa complexes were found in patients and ID mice. Both ID and estrogen upregulated Tf through hypoxia and estrogen response elements located in the Tf gene enhancer and promoter regions, respectively. In addition, ID, administration of exogenous Tf or estrogen, and Tf overexpression promoted platelet-based thrombin generation and hypercoagulability and thus aggravated IS. In contrast, anti-Tf antibodies, Tf knockdown, and peptide inhibitors of Tf-thrombin/FXIIa interaction exerted anti-IS effects in vivo. Conclusions: Our findings revealed that certain factors (ie, ID and CC) upregulating Tf are risk factors of thromboembolic diseases decipher a previously unrecognized mechanistic association among ID, CC, and IS and provide a novel strategy for the development of anti-IS medicine by interfering with Tf-thrombin/FXIIa interactions.
Clinical analysis of cytomegalovirus infection and detection of its early antigen pp65 in infants
Authors: Feng-ying Duan, Ming-chang Wu, Zong-rong Yan
Journal: BMJ (2009)

Clinical data of six infants with active cytomegalovirus (CMV) infection were analyzed, two congential infection, two pertnatal infection, one postnantal infection and one with both pnumonia and hepatitis caused by CMV.Serum CMV-IgM, CMV early antigen pp65 and CMV DNA were detected positive in the infants with damage in their tissues and organs within two weeks after their birth, thus diagmosis of active CMV infection was established.MCV-pp65 antigrn is more uneful in diagnosis of CMV active infection than CMV-IgM.

Key words: 
Cytomegalovirus infection;  Antigen; pp65 ;  Infant
Association of birth weight with abnormal metabolism during adulthood in Pingliang Community of Shanghai
Authors: 宋晓敏, 伍佩英, 张雪涛, 王新巧, 王爱蓉, 马东礼
Journal: BMJ (2005)

目的 调查不同出生体重儿成年后代谢异常的现患率,探索两者的关系.方法对上海市平凉社区糖尿病流行病学调查中15～74岁有确切出生体重记录的1 010名中国人(男性390例,女性620例)检测体重指数、腰围、臀围、腰臀比、血压、空腹血糖、胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇.以单变量及多变量分析方法观察不同出生体重儿成年后代谢异常的差别及两者的关系.结果低出生体重者(<2.5 kg)56人,高出生体重者(≥4 kg)53人、正常出生体重者901人.低出生体重组成年后BMI均高于正常出生体重组,其中女性体质指数和腰围、腰臀比两组差异有统计学意义(P<0.01).男性高出生体重组成年后腰围和臀围均较正常出生体重组高,两组差异有统计学意义(P<0.05);低出生体重组成年后肥胖、高胆固醇血症、糖尿病及糖尿病合并高血压的患病率均高于正常出生体重组(P<0.05、P<0.01、P<0.05、P<0.01),高出生体重组成年后肥胖发生率和高血压患病率均高于正常出生体重组(P<0.05);低出生体重与成年后超重肥胖、腹型肥胖、高胆固醇血症及糖尿病的发病呈显著性相关.结论低出生体重与成年后肥胖、糖脂代谢异常相关,是成年后发生超重肥胖、高胆固醇血症和糖尿病的危险因素。
Evaluation for disease-specific quality of life in children with sleep-disordered breathing
Authors: Pei-jie He, Kuan-lin Xiao
Journal: BMJ (2008)

Objective To evaluate the impact of sleep-disordered breathing(SDB)on the quality of life(QOL)in children with SDB and investigate the value of tonsillectomy and adenoidectomy in improving their QOL.Methods Questionnaire of disease-specific quality of life for children with obstructive sleep apnea with 18 items(OSA-18)was used to evaluate QOL in 168 children with SDB within four weeks before and six to 12 months after surgical operation,and correlation between OSA-18 scores to apnea hypopnea index(AHI)and minimum oxygen saturation(MiO2)in 62 of them was evaluated with polysomnography(PSG),with 50 healthy children without snoring as controls.Results Overall scores of OSA-18 in children of SDB group before surgical operation were significantly higher than those in children of control group(t=15.12,P＜0.01).and QOL was seriously affected in 30.4 percent of the children with SDB.Scores of OSA-18 correlated to AHI and MiO2 before surgical operation.QOL was improved significantly in 73.8 percent of children with SDB after tonsillectomy and adenoidectomy.Conclusions SDB has obvious impact on pediatric QOL,which can be improved by tonsillectomy and adenoidectomy.There exists significant correlation between OSA-18 scores and objective indicators of PSG,and the former can be used as clinical diagnosis for SDB in children and as quantitative evaluation for the effectiveness of intervention.

Key words: 
Sleep disorder;  Quality of life; Tonsillectomy;  Adenoidectomy
Retzius-sparing robotic-assisted laparoscopic radical prostatectomy: Racial considerations for 250 consecutive cases.
Authors: Rabii Madi, Rashid K. Sayyid, Dalton Sherwood, Zachary William Abraham Klaassen
Journal: Journal of Clinical Oncology (2020)

e17546 Background: To report the functional and oncologic outcomes of a cohort of 250 consecutive prostate cancer patients undergoing a Retzius-sparing approach and to assess for racial differences in continence outcomes. Methods: This was a prospective, single-center, case series of 250 consecutive prostate cancer patients who underwent a Retzius-sparing robotic assisted laparoscopic radical prostatectomy by a single surgeon between May 2015 and April 2019.Our primary objective was to describe post-operative continence outcomes of patients undergoing this technique. Results: Median follow up was 24.0 months [Interquartile range (IQR) 18.0-30.0 months]. Median age and body mass index were 62.0 years (IQR 57.0-67.0) and 29.0 kg/m 2 (IQR 26.0-33.0), respectively. Median PSA was 8.22 ng/ml (IQR 5.74-13.31). 84.8% of patients were intermediate or high-risk pre-operatively. 96.0% had Gleason Score 7 or worse disease on final pathologic analysis. Positive margin incidence was 18.1% and 44.4% in patients with pT2 and pT3 disease, respectively. Immediate continence (i.e. continence achieved within one moth post-operatively) was achieved in 45.0% of patients. One-year continence rate was 92.0%. Caucasian patients experienced earlier return of continence (77% versus 65% at 3 months) compared to African American patients. IPSS scores gradually improved from 8.0 pre-operatively to 4.0 one year later. Median PSA level was 0.01 ng/ml (IQR 0.01-9.01) post-operatively. Conclusions: Retzius-sparing robotic assisted laparoscopic radical prostatectomy is an oncologically safe surgical technique with excellent short and long-term continence outcomes.
Single-cell RNA sequencing reveals the tumor microenvironment and facilitates strategic choices to circumvent treatment failure in a chemorefractory bladder cancer patient
Authors: Hye Won Lee, Woosung Chung, Hae-Ock Lee, Da Eun Jeong, Areum Jo, Joung Eun Lim, Jeong Hee Hong, Do-Hyun Nam, Byong Chang Jeong, Se Hoon Park, Kyeung-Min Joo, Woong-Yang Park
Journal: Genome Medicine (2020)

Abstract Background Tumor cell-intrinsic mechanisms and complex interactions with the tumor microenvironment contribute to therapeutic failure via tumor evolution. It may be possible to overcome treatment resistance by developing a personalized approach against relapsing cancers based on a comprehensive analysis of cell type-specific transcriptomic changes over the clinical course of the disease using single-cell RNA sequencing (scRNA-seq). Methods Here, we used scRNA-seq to depict the tumor landscape of a single case of chemo-resistant metastatic, muscle-invasive urothelial bladder cancer (MIUBC) addicted to an activating Harvey rat sarcoma viral oncogene homolog ( HRAS ) mutation. In order to analyze tumor evolution and microenvironmental changes upon treatment, we also applied scRNA-seq to the corresponding patient-derived xenograft (PDX) before and after treatment with tipifarnib, a HRAS-targeting agent under clinical evaluation. Results In the parallel analysis of the human MIUBC and the PDX, diverse stromal and immune cell populations recapitulated the cellular composition in the human and mouse tumor microenvironment. Treatment with tipifarnib showed dramatic anticancer effects but was unable to achieve a complete response. Importantly, the comparative scRNA-seq analysis between pre- and post-tipifarnib-treated PDX revealed the nature of tipifarnib-refractory tumor cells and the tumor-supporting microenvironment. Based on the upregulation of programmed death-ligand 1 (PD-L1) in surviving tumor cells, and the accumulation of multiple immune-suppressive subsets from post-tipifarnib-treated PDX, a PD-L1 inhibitor, atezolizumab, was clinically applied; this resulted in a favorable response from the patient with acquired resistance to tipifarnib. Conclusion We presented a single case report demonstrating the power of scRNA-seq for visualizing the tumor microenvironment and identifying molecular and cellular therapeutic targets in a treatment-refractory cancer patient.
Mammography adherence among medically underserved women undergoing cancer genetic risk assessment.
Authors: Candice Schwartz, Ifeanyi Beverly Chukwudozie, Silvia Tejeda, Ganga Vijayasiri, Ivy Abraham, Mylene Hernandez Remo, Hiral A. Shah, Carol Estwing Ferrans, Richard Warnecke, Kent Hoskins
Journal: Journal of Clinical Oncology (2020)

1554 Background: Medically underserved women bear a disproportionate burden of breast cancer (BC) mortality. Early detection is vital for reducing BC deaths. Cancer genetic risk assessment (CGRA) provides an opportunity to identify women at highest risk so that risk-adapted screening can be implemented. The effect of CGRA on mammography adherence among underserved women is unknown. Methods: We conducted a study to test the feasibility of performing cancer genetic risk assessment (CGRA) as part of standard primary healthcare at two Federally Qualified Health Centers in Chicago, IL. Racial/ethnically diverse women age 25-69 without a personal history of BC underwent CGRA at the time of an annual well-visit and received the result from their PCP. Medical record review provided data on mammography adherence. Demographic data and measures of perceived BC risk, BC cultural beliefs, fatalism, and BC worry were collected with an enrollment survey. McNemar’s test compared the rate of adherence to screening mammography before and after implementation of CGRA, defined as completing a screening mammogram within 18 months prior to or following CGRA, resp., among women eligible for screening (age &gt; 40 at study enrollment). Logistic regression models tested for associations between mammography adherence and demographic characteristics/health beliefs. Results: Data was available for 90 participants with increased BC risk (IR) who were eligible for screening and 98 eligible, average risk (AR) participants (in total, 61% black and 37% Latina). Overall, adherence improved from 38% at baseline to 49% following CGRA (p = 0.03). Adherence increased from 35% to 51% among IR participants (p = 0.04), and from 40% to 47% among AR participants (p = 0.39). Data on predictors of adherence will be presented. Conclusions: Implementing CGRA as a standard component of primary healthcare improved adherence to screening mammography among racial/ethnically diverse underserved women. The effect was seen primarily in those with increased risk. This intervention could be used to improve uptake of mammography in the subgroup of underserved women who benefit the most from screening.
Some issue about migraine which should be concerned by general practitioners
Authors: 于生元
Journal: BMJ (2007)

偏头痛是全科医生在临床中常见的疾患,各国报道的年患病率不一,西方国家较高,如德国高达28%,美国约为12%.偏头痛可发生于任何年龄,首次发病在青春期左右出现高峰.青春期前的儿童患病率约为4%,男女差别不大,男孩略高.青春期后,女性患病率增高远较男性为著,大约40岁达到高峰.非洲和亚洲略低,如日本为6.0%～8.4%。