tbuckley/cabot-search huggingface dataset:
Incidence and pregnancy outcomes of premature rupture of membranes in pregnant women in Beijing region
Authors: Haili Jiang, Chang Lu, Liying Zou, Xin Wang
Journal: BMJ (2015)

Objective
To investigate the incidence and pregnancy outcomes of premature rupture of membranes(PROM) in pregnant women in Beijing.


Methods
A retrospective multicenter study of 18 534 cases delivered in Beijing Obstetrics and Gynecology Hospital, Beijing Friendship Hospital, Daxing MCH Hospital and Tongzhou MCH Hospital from January 2011 to December 2011, was conducted.


Results
Among 18 534 cases, PROM occurred in 4 504 cases(24.30%), including 3 910 cases of in term PROM(21.10%) and 594 cases of preterm PROM(3.20%). The incidence of premature delivery was 6.17%(1 144/18 534), and among 1 144 cases of premature delivery 547 cases were PROM(47.81%); the incidence of PROM was 22.75%(3 957/17 390) in term delivery. The overall cesarean section(CS) rate was 48.50%(8 989/18 534) and that in pregnant women with PROM was 35.55%(1 601/4 504), but the CS rate in pregnant women without PROM was 52.66%(7 388/14 030). The rate of postpartum hemorrhage was 13.12%(210/1 601)in CS cases and 4.17%(121/2 903)in vaginal delivery cases(χ2=121.361, P=0.000). The mean hospital stay for PROM was(5.3±2.9) d in CS cases and(4.3±2.3) d in vaginal delivery cases(t=-12.136, P=0.000).


Conclusions
Without severe maternal or fetal complications, the incidence of PROM is relatively high in Beijing region and PROM may not increase the maternal or fetal complications. Vaginal delivery is the main mode of delivery for PROM. Cesarean section may not cause less neonatal complications, but may lead to more postpartum hemorrhage and longer hospital stay.


Key words: 
Fetal membranes, premature rupture; Parturition; Cross-sectional studies; Pregnancy outcome
Application of Four in One model for diabetes management in hospital consortium
Authors: Haijiao Wang, Peng Fu, Lei Zhu, Baochang Shi, Hong Miao
Journal: BMJ (2019)

In 2017, the Diabetes Management Center was founded in Shandong Third Provincial Hospital. On the basis of the center, a network was established which integrated the tertiary hospital, district hospitals, community health service institutions and family of patients forming the Four in One model of diabetes management. This article introduces the background, application, and preliminary accomplishments in individualized and standardized diabetic management of this internet plus model. The challenges and suggestions for future development of theFour in One model are also discussed.


Key words: 
Disease management; Diabetes; Computer communication networks; Progressive patient care; Hospital shared services
Abstract 15666: Prognostic Impact of Left Ventricular Mass Regression After Aortic Valve Replacement in Patients With Severe Aortic Stenosis
Authors: Shunsuke Nishimura, Chisato Izumi, Tomohiko Taniguchi, Takeshi Morimoto, Makoto Miyake, Masashi Amano, Maiko Kuroda, Takeshi Harita, Suguru Nishiuchi, Jiro Sakamoto, Yodo Tamaki, Soichiro Enomoto, Hirokazu Kondo, Toshihiro Tamura, Takeshi Kimura, Yoshihisa Nakagawa
Journal: Circulation (2017)

Background: Left ventricular (LV) hypertrophy is common in patients with severe aortic stenosis (AS). LV mass regression (LVMR) usually occurs within 1-2 years after aortic valve replacement (AVR)....
Choosing Wisely Africa: 10 low-value or harmful practices that should be avoided in cancer care.
Authors: Fidel Rubagumya, Gunita Mitera, Sidy Ka, Achille Van Christ Manirakiza, Phillipa Kibugu-Decuir, Susan Citonje Msadabwe, Ablavi Ahoefa Adani-Ife, Emmanuella Nwachukwu, Naomi Oyoe Ohene Oti, Hirondina Borges, Miriam Claire Mutebi, Dafalla Abuidris, Verna D. Vanderpuye, Christopher M. Booth, Nazik Hammad
Journal: Journal of Clinical Oncology (2020)

e19213 Background: Choosing Wisely Africa, builds on Choosing Wisely (CW) in the USA, Canada and India, and aims to identify low-value, unnecessary, or harmful cancer practices that are frequently used on the African continent. Methods: The CWA Task Force was convened by African Organization for Research and Training in Cancer (AORTIC) and included representatives in surgical, medical and radiation oncology, the private and public sectors and patient advocacy group. Consensus was built through a modified Delphi process shortening a long list of practices to a short list then to a final list. Results: Of the 10 practices on the final list, one is a new suggestion, 9 are revisions or adaptations of practices from previous CW campaign lists. One item relates to palliative care, 8 concern treatment, and 1 relates to surveillance. Conclusions: The success of this campaign will be measured by how the list is implemented across sub-Saharan Africa and whether it improves the delivery of high-quality cancer care. [Table: see text]
Phase I study of TRC102 in combination with cisplatin and pemetrexed in patients with advanced solid tumors/Phase II study of TRC102 with pemetrexed in patients with mesothelioma refractory to pemetrexed and cisplatin or carboplatin.
Authors: Marianna Koczywas, Paul Henry Frankel, Jonathan W. Riess, Anthony B. El-Khoueiry, Liza C Villaruz, Stephen Leong, Christopher Ruel, Timothy W. Synold, Timothy O'Connor, Edward M. Newman
Journal: Journal of Clinical Oncology (2020)

9055 Background: Treatment options remain limited in malignant pleural mesothelioma refractory to pemetrexed +/- platinum. TRC102 (methoxyamine hydrochloride) is a novel biochemical inhibitor of the BER pathway. Available data support the hypothesis that TRC102 bound DNA is a substrate for topoisomerase II, which cleaves TRC102-bound DNA sites to produce strand breaks in cancer cells that cause cellular apoptosis and enhance the cytotoxic effects of chemotherapy. Methods: This was a parallel cohort trial of a Phase I of TRC102 in combination with cisplatin (CDDP) and pemetrexed in patients with advanced solid tumors (Arm A) and a Phase II of TRC102 with pemetrexed in patients with mesothelioma refractory to platinum and pemetrexed (Arm B). Results: In Arm A dose escalation, 16 pts (11M/5F) were treated; 9 evaluable through 3 TRC102 dose levels (50, 75, and 100 mg/day, PO), with CDDP 60 mg/m 2 and pemetrexed 500 mg/m 2 (levels 1- 3); and 5 evaluable at TRC102 100 mg/day PO, CDDP 75 mg/m 2 , pemetrexed 500 mg/m 2 (level 4). Cycles were every 21 days. There were no DLT’s, establishing level 4 as the RP2D. The only grade 4 treatment-related AE was thrombocytopenia on cycle 22 (level 2). Cycle 1 grade 3 AEs were 1 hypophosphatemia (level 1) and 1 leukopenia (level 2). There were 3 PRs (all parotid salivary gland tumors). Median PFS (95%CI) = 7.1% (1.4 – 15.5) mos. Arm B was designed as the first stage of a two stage Gehan design trial of patients with mesothelioma who had progressed on or recurred within 6 months of pemetrexed + platinum frontline treatment. 14 pts were treated with TRC102 50 mg/day D1-4 and pemetrexed 500 mg/m 2 every 21 days. There were 2 PRs (both in epithelioid cancer of which 1 was confirmed), meeting the pre-specified criteria for continued interest ( &gt; 0/14). mPFS (95% CI) was 4.3 (1.4 - 6.8) mos. 8 pts had stable disease for at least 1 cycle (4 stable at cycles 6, 9, 10 and 12). There were 1 grade 4 neutropenia and 5 grade 3 AE’s (1 each – anemia, neutropenia, leukopenia, fatigue, hyponatremia). Conclusions: TRC102 in combination with CDDP and pemetrexed exhibited antitumor activity, particularly in salivary gland tumors, and a tolerable safety profile at the doses tested. The combination of TRC102 and pemetrexed demonstrated activity in malignant mesothelioma that progressed on prior pemetrexed. Additional studies are warranted to confirm preliminary signals of activity. Clinical trial information: NCT02535312.
Point-of-care examinations of lung ultrasonography in neonatal intensive care unit
Authors: Shuiwen Chen, Wei Fu, Jing Liu
Journal: BMJ (2017)

Objective
To study the features of ultrasonography (LUS) of lung diseases in neonatal intensive care unit (NICU).


Methods
Total 1 413 neonates admitted in NICU of Beijing Chaoyang District Maternal and Child Health Hospital, Bayi Children′s Hospital Affiliated to the Chinese PLA General Hospital, Shenzhen Bao′an Maternal and Child Health Hospital from December 2014 to February 2015 were included in this study. All the newborns underwent LUS examination, the ultrasonographic features of neonatal lung diseases were analyzed.


Results
There were 1 059 cases (74.9%) with lung diseases among 1 413 neonates. Among 354 neonates without lung diseases, the B-lines were observed in 351 cases (99.2%) within 3 day after birth, in 113 cases (31.9%) in 3 day to 1 week after birth, and in 23 cases in 1 to 2 weeks after birth. Among 491 neonates with lung diseases undergoing LUS examination within 48 h after admission, the A-lines disappeared in all patients; the other features included pleural lines abnormalities(n=440, 89.6%), interstitial syndrome (n=353, 71.9%), lung consolidation(n=423, 86.25%), pulmonary edema(n=135, 27.5%) and lung pulse(n=96, 19.6%). The reduction or elimination of above abnormal signs represented the alleviation of lung diseases. Fifty four neonates, in whom the lung diseases were not detected by X-ray, were diagnosed as transient tachypnea of newborn (TTN), respiratory distress syndrome (RDS)and pneumonia by LUS. Fifty five patients, who were misdiagnosed with RDS by X-ray, were confirmed as TTN by LUS. Seventy one neonatal patients with long-term oxygen dependence, in whom no abnormal signs were detected by X-ray, underwent LUS examination and lung atelectasis, pulmonary consolidation and/or interstitial syndrome were diagnosed in 46 cases.


Conclusion
The LUS is practical and effective in diagnosis of neonatal pulmonary diseases, it is a non-irradiative diagnostic procedure and can be applied on bed side; therefore, it should be routinely used in NICU.


Key words: 
Infant, newborn; Lung diseases; Ultrasonography
Efficacy of clavicular hook locking plate combined with Kirschner wire in treatment of comminuted Craig type II and type V distal clavicle fractures
Authors: Feng Zhang, Yuanzheng Song, Fahao Zhu, Feng Lin
Journal: BMJ (2018)

Forty-three patients with comminuted Craig type Ⅱand Ⅴ distal clavicle fractures were treated with clavicular hook locking plate and Kirschner wire from July 2013 to January 2015 in Tengzhou Central People′s Hospital. Patients were followed up for 12-20 months with an average of 18 months. All fractures were clinically healed. In the 3 and 6 months after the operation, the Constant-Murley function score and the visual analogue score (VAS) of the quality of life satisfaction were improved compared with those before operation (75.1±1.4 and 85.6±1.3 vs. 44.3±1.8; 7.02±0.67 and 8.16±0.57 vs. 2.54±0.67, all P<0.05). There were no fracture delayed healing, nonunion, plate fracture and clavicular re-fracture among all patients. It is suggested that the curative effect of the clavicular hook locking plate combined with Kirschner wire is satisfactory and the bone healing rate is high for comminuted Craig type Ⅱ and Ⅴ type distal clavicle fractures.


Key words: 
Fractures, comminuted; Clavicle; Fracture fixation, internal; Craig type Ⅱ; Craig type Ⅴ
Why doctors and their organisations must help tackle climate change
Authors: Chivian Eric, 武思文, 李俊
Journal: BMJ (2014)

医生所扮演的角色能够较理想地提供说服力强且具体的实例，以此阐明气候变化所致的医学后果。Eric Chivian说，医生不仅有能力挽救人类行为对环境所产生的潜在破坏性改变，而且他们也肩负这一职责。
Primary biliary cirrhosis complicated with interstitial lung disease
Authors: Min Shen, Xuan Zhang, Feng-chun Zhang
Journal: BMJ (2008)

Objective To analyze clinical features and prognosis for the patients of primary biliary cirrhosis (PBC)complicated with interstitial lung disease(ILD).Methods Medical records of 139inpatients of PBC were retrospectively analyzed and their clinical features,biochemical parameters,spectrum of autoantibodies and Maye risk score were compared between subgroups with and without ILD.Resuits Among twenty two(16%)patients of PBC complicated with ILD,50 percent had respiratory symptoms such as chest distress,short breath,cough,and so on,and 50 percent had diffusing and obstructive ventilation impairment by pulmonmary function test.Patients of PBC complicated with ILD had a faster erythrocyte sedimentation rate(ESR)than that in those without ILD(P＜0.05).There was no significant difference in other biochemical parameters,positive rates of autoantibodies and Mayo risk score between the two subgroups (P＞0.05).Logistic regression analysis showed that odd ratios(ORs)of Raynoud's phenomenon and other connective tissue diseases(CTD)complication in patients of PBC to develop ILD were 3.54 and 2.56(P=0.03 and P=0.05),respectively,though 46 percent of PBC patients with ILD did not have other CTD complications.Conclusions Half of the patients of PBC complicated with ILD have respiratory symptoms.PBC patients with Raynoud's phenomenon and other CTD complications are more likely to develop ILD,but those without complications can also do.

Key words: 
Liver cirrhosis,biliary; Lung diseases,interstitial; Prognosis
Clinical analysis of oral and maxillofacial spaces infections in diabetic patients:a report of 31 cases
Authors: Jun Cui, Ling Jiang, Ze-qiu Yu, Guang-chun Jin
Journal: BMJ (2008)

The characterization and management of oral and maxillofacial spaces infections in diabetic patients were studied in order to determine the pattern of this clinical condition and formulate a management plan.There were 31 cases with average age of 61 years(s=9);the mean hospitalization time was 14 days(s=6);the average fasting blood glucose level on admission was 10.4 mmol/L.Of the 31 patients 20 were multiple-space infections and 11 were single-space infections.13 patients had major complications during admission.Odontogenic infection was the most common cause of the space infections.Streptococcus viridians and staphylococcus aureus were common organisms(5/19,4/19)identified through pus and/or blood cultures.Early surgical incision and drainage,perfect blood glucose control,intravenous antimicrobial therapy,preventing asphyxia and managing major complications are necessary and effective approaches for the management plan.

Key words: 
Diabetes mellitus; Stomatognathic diseases
Application of protective technique for intercostal nerve in thoracotomy
Authors: Hong-ding Yang, Jun Wang
Journal: BMJ (2013)

To retrospective analyze the clinical profiles of 80 patients undergoing thoracotomy with protection of intercostal nerve versus traditional method. The doses of narcotics of two groups were (12±5) and (43±11) mg respectively. The postoperative levels of visual analogue score (VAS) and such potential complications as pneumonia, atelectasis and paraesthesia were examined (P<0.01). Protective technique of intercostal nerve during thoracotomy could effectively relieve postoperative chest pain, reduce the dosage of narcotics and lower the occurrence of lung complications.


Key words: 
Intercostal nerves; Thoracotomy
Effect of concurrent beta-blocker use in patients receiving immune checkpoint inhibitors for advanced solid tumors.
Authors: Vaibhav G. Patel, Qian Qin, Bo Wang, Mahalya Gogerly-Moragoda, George Mellgard, Xiaobo Zhong, Anish B Parikh, Amanda Leiter, Emily J. Gallagher, William K. Oh, Matt D. Galsky, Che-Kai Tsao
Journal: Journal of Clinical Oncology (2020)

e15068 Background: Stress-induced adrenergic signaling suppresses the immune system. In animal model systems, pharmacological beta-blockade stimulated CD8+ T-cell activity, and further, it improved clinical activity of immune checkpoint inhibitors (ICI) in inhibiting tumor growth. Herein, we investigate the effect of beta blockers (BB) on clinical outcomes of patients receiving ICI in advanced solid tumors. Methods: We retrospectively evaluated patients with solid tumors treated with at least 2 doses of ICI at our institution from December 2010 to April 2017. The primary outcome was disease control rate (DCR), as defined by radiographic complete response, partial response, or stable disease, by RECIST 1.1 criteria. The primary predictor was use of BB (β1-selective BB vs. no BB; non-selective BB vs no BB). The primary predictive variable was analyzed using multivariate logistic regression model controlling for several parameters including patient demographics, co-morbidities, ECOG performance status, and tumor type and location of metastases. All tests were two-sided at the significant level of 0.05. Results: We identified 298 evaluable patients with median age of 66.5 (31-95). Of these patients, 200 (67%) did not use BB, 75 (25%) used β1-selective BB, and 23 (8%) used non-selective BB. In multivariate analysis, use of β1-selective BB was significantly associated with improved DCR compared to no BB (ORR 2.43, 95% CI 1.31-4.51, P = 0.005), while use of non-selective BB was not associated with improved DCR (ORR 1.71, 95% CI 0.65-1.47, P = 0.27). Conclusions: The concurrent use of BB may enhance the clinical activity of ICI, particularly β1-selective BB. Our findings warrant further investigation to understand the interaction of β1- and β2-adrenergic signaling and antitumor immune activity, and potentially explore a combination strategy of ICI and BB.
Projection of cancer incidence and death to 2040 in the US: Impact of cancer screening and a changing demographic.
Authors: Lola Rahib, Mackenzie Wehner, Lynn McCormick Matrisian, Kevin Thomas Nead
Journal: Journal of Clinical Oncology (2020)

1566 Background: Coping with the current and future burden of cancer requires an in-depth understanding of cancer incidence and death trends. As of 2020, breast, lung, prostate, and colorectal cancer are the most incident cancers, while lung, colorectal, pancreas, and breast cancer result in the most deaths. Here we integrate observed cancer statistics and trends with observed and estimated US demographic data to project cancer incidences and deaths to the year 2040. Methods: Demographic cancer-specific delay-adjusted incidence and death rates from the Surveillance, Epidemiology, and End Results Program (2014-2016) were combined with US Census Bureau population growth projections (2016) and average annual percentage changes in incidence (2011-2015) and death (2012-2016) rates to project cancer incidences and deaths through the year 2040. We examined the 10 most incident and deadly cancers as of 2020. We utilized Joinpoint analysis to examine changes in incidence and death rates over time relative to changes in screening guidelines. Results: We predict the most incident cancers in 2040 in the US will be breast (322,000 diagnoses in 2040) and lung (182,000 diagnoses in 2040) cancer. Continuing decades long observed incident rate trends we predict that melanoma (173,000 diagnoses in 2040) will become the 3 rd most common cancer while prostate cancer (63,000 diagnoses in 2040) will become the 5 th most common cancer after colorectal cancer (139,000 diagnoses in 2040). Lung cancer (61,000 deaths in 2040) is predicted to continue to be the leading cause of cancer related death, with pancreas (45,000 deaths in 2040) and liver &amp; intrahepatic bile duct (38,000 deaths in 2040) cancer surpassing colorectal cancer (34,000 deaths in 2040) to become the second and third most common causes of cancer related death, respectively. Breast cancer deaths (29,000 in 2040) are predicted to continue to decrease and become the fifth most common cause of cancer death. Joinpoint analysis of incidence and death rates supports a significant past, present, and future impact of cancer screening programs on the number of cancer diagnoses and deaths, particularly for prostate, thyroid, melanoma incidences, and lung cancer deaths. Conclusions: We demonstrate marked changes in the predicted landscape of cancer incidence and deaths by 2040. Our analysis reveals an influence of cancer screening programs on the number of cancer diagnoses and deaths in future years. These projections are important to guide future research funding allocations, healthcare planning, and health policy efforts.
Factors associated with oral chemotherapy adherence in specialty pharmacies.
Authors: Shanada Monestime, Ray D. Page, William M. Jordan, Subhash Aryal, Rafia Rasu
Journal: Journal of Clinical Oncology (2020)

e19137 Background: Specialty pharmacies are expanding in the oncology setting and often favored by payors because of economic and operational benefits. However, challenges exist in coordination of care, patient safety, cost/reimbursement, and operational efficiency. While in-house specialty pharmacies mitigate these challenges due to close proximity of health care providers, these challenges can impact medication adherence. To date, limited data are available on adherence rates and factors associated with oral chemotherapy (OC) adherence in specialty pharmacy settings. Methods: Adult cancer patients who received their first OC between Aug.-Oct. 2018 were analyzed. Pharmacies were contacted to obtain OC pick-up dates over 6 months or until treatment completion. Patients were adherent if the proportion of days covered (PDC) was ≥90%. Descriptive and bivariate logistic regression models were performed to examine demographics, specialty pharmacy type (external vs. internal), distance from pharmacy to home, and chronic comorbidities. Results: Of the 80 patients analyzed, the mean age was 63.59 (SD ±11.8), 51.21% were female, 68.75% were white, 61.25% were married, 82.50% were smokers, 53.75% were on government insurance, 73.75% were using an internal pharmacy, and the mean distance traveled to pharmacy was 17.06 miles (SD±22.66). Thirty-five patients (43.75%) were adherent (mean PDC = 78%, range, 17-100%). Patients who went to an internal pharmacy were 1.81 times likely to be adherent than those who went to an external pharmacy [OR: 1.81, 95% CI (0.64- 5.11)]. We found that males were 1.21 times more likely to be adherent than females [OR: 1.21, 95% CI (0.50- 2.93)] and smokers were 2.21 times more likely to be adherent than non-smokers [OR: 2.21, 95% CI (0.63-7.78)]. Multiple chronic conditions were significantly associated with a decrease in OC adherence, even after controlling for covariates [OR: 0.66, 95% CI (0.66- 0.95); p = 0.02]. Conclusions: Patients with fewer comorbidities receiving OC from specialty pharmacies were significantly more adherent than those with multiple comorbidities. Further studies examining the impact financial toxicity has on adherence for patients with chronic conditions are warranted.