tbuckley/cabot-search huggingface dataset:
Ozone therapy as accompanying treatment for chemoradiotherapy in patients with locally advanced cervical cancer.
Authors: Olga G. Rodionova, Marina A. Gusareva, Vitaliy I. Voshedskiy, Ekaterina O. Vasilyeva, Elena A. Sheiko, Anna A. Solntseva, Pavel G. Sakun, Stanislav G. Vlasov, Ksenia N. Museyko, Alla V. Pustovalova, Tatiana G. Chalabova, Oleg I. Kit
Journal: Journal of Clinical Oncology (2020)

e18030 Background: Chemoradiation therapy (CRT) radiomodified with platinum-based drugs is recommended for patients with inoperable cervical cancer. However, the introduction of chemotherapy medicines increases the number of hematological and non-hematological complications. Prolonged RT significantly decreases survival of patients. This requires more effective methods helping to prevent chemoradiotherapy complications. The purpose of the study was to evaluate the effectiveness of ozone therapy as an accompanying treatment for chemoradiotherapy for cervical cancer (CC). Methods: The study included 20 patients diagnosed with cT3NхM0 CC. The control group (n = 10) received standard CRT with weekly cisplatin radiomodification (40 mg/m 2 ). The main group (n = 10) received CRT with weekly cisplatin radiomodification (40 mg/m 2 ) and additional infusions of 250 ml ozonized solution of 0.9% sodium chloride (a total of 15 infusions). Results: In the main group, CRT did not cause a significant aggravation of gastrointestinal and general symptoms, compared with the initial state. The rate of dyspeptic disorders (nausea, diarrhea, bloating) was 10% in the main group and 100% in controls. In the control group, clinical pain decreased only by the 25th day; 100% of patients developed gastrointestinal toxicity grade 1 (80%) and 2 (20%); 100% of patients complained of weakness during treatment. 7 patients developed leukopenia. Anemia in 5 patients remained at the level of 95g/L, in 3 patients - aggravation up to 80g/L. In the main group, treatment was completed within 7 weeks. In the control group, the duration of CRT was 8 weeks due to toxicity. Conclusions: Ozone therapy in addition to the conventional conservative treatment significantly decreases the severity of CRT-induced complications which allows complete treatment planned, while maintaining optimal treatment duration.
Allergen detection and desensitization treatment for chronic urticaria during recent four years in Xiamen area, Fujian
Authors: Mian Wang, Yi-jin Huang, Ping-e Yang, Tao Shang, Wei-jia Lin, Yi-zhu Zhang
Journal: BMJ (2010)

Effectiveness of allergen detection and desensitization treatment for chronic urticaria during recent four years in Xiamen area, Fujian province were analyzed. Skin tests with intradermal injection were performed for 1250 patients with chronic urticaria by 38 kinds of inhalant and food allergen, with positive results in 93. 76% of them, higher by inhaled allergen than that by food allergen. Effective rate of completed course of desensitization treatment in 535 cases was 70. 65 % (378/535 ).

Key words: 
Urticaria;  Allergens
盲肠部Crohn病误诊为急性阑尾炎一例
Authors: 孟国礼
Journal: BMJ (2010)

患者男,36岁,因转移性右下腹痛3 d入院.3 d前患者不明原因出现脐周疼痛,渐重.12 h后疼痛固定在右下腹,门诊拟诊为阑尾炎.予以头孢噻肟钠5 g/d、甲硝唑250ml/d,静脉滴注2 d,病情无缓解,腹痛进一步加重,并发热。
DNA and RNA next generation sequencing for personalizing cancer treatment: A single-center experience.
Authors: Joseba Rebollo, Manuel Sureda, Ramón González-Manzano, Elena Ma Martínez, Roman Rostagno, Juan José Mata, Elena Monedero, Jose Ortega, Antonio Brugarolas
Journal: Journal of Clinical Oncology (2020)

e13509 Background: Personalized multidrug therapies improve outcomes in patients with drug resistant cancer. For 8 years we have been using microarray-based gene expression profiling (360 procedures) to improve drug selection (Rebollo J et al, 2017; Sureda M et al, 2018). Recently, we have adopted Ion Torrent DNA and RNA Next Generation Sequencing (NGS) to improve the target detection ability. Methods: Since March 2018 DNA (95 analyses) and whole trancriptome RNA (78 analyses) NGS have been performed using Ion Torrent GeneStudio S5 System in fresh-frozen (RNA and DNA sequencing) and paraffin-embedded (DNA sequencing) biopsies obtained from tru-cut or surgical excision procedures from patients with metastatic cancer. Favourable chemotherapy drug profile, treatable (available inhibitory drugs) targets and potentially favourable immunologic signature have been investigated. Results: All biopsies were valid for DNA sequencing but in five patients were invalid (less than 30% viable tumor cells required) for RNA sequencing. Combined DNA and RNA sequencing have been studied in sixty patients with advanced cancer biopsies. Histologies have been NSCLC (12 patents), Breast (9), STS (6), NHL (4), NET (4), Pancreas (4), CRC (4), Ovary/Fallopian tube (3), Prostate (2), Cholangiocarcinoma (2), H&amp;N (2), Esophagus, Bladder, Uterus, Melanoma, SCLC, Anal, Kidney and Cervix (1 each). Most of the patients had been previously treated with systemic therapies. Biopsies have been taken from Lymph nodes (18 patients), Liver (16), Soft Tissues (14), Lung (8), Peritoneum (3) and Adrenal Gland (1). RNA sequencing has predicted favourable chemotherapy drug profile (Median 3 drugs, Range 1-9) in 54 (90%) patients. In addition, treatable targets (Median 3 targets, Range 1-6) have been found in 40 (67%) patients. Favourable immunologic signature has been found in 22 (37%) patients. DNA sequencing has shown treatable (drug available) targets in 14 (23%) patients. In 12 (20%) patients, no targets have been found in any of the sequencing protocols (DNA and RNA). Conclusions: Tumor RNA and DNA sequencing provide potential useful information in personalized cancer treatment decision in a vast majority of advanced cancer patients independent of treatment status.
Prevalence and dynamics of clonal hematopoiesis caused by leukemia-associated mutations in elderly individuals without hematologic disorders
Authors: Danica Midic, Jenny Rinke, Florian Perner, Violetta Müller, Anna Hinze, Frank Pester, Jürgen Landschulze, Jana Ernst, Bernd Gruhn, Georg Matziolis, Florian H. Heidel, Andreas Hochhaus, Thomas Ernst
Journal: Leukemia (2020)

Abstract Clonal hematopoiesis is frequently observed in elderly people. To investigate the prevalence and dynamics of genetic alterations among healthy elderly individuals, a cohort of 50 people &gt;80 years was genotyped for commonly mutated leukemia-associated genes by targeted deep next-generation sequencing. A total of 16 somatic mutations were identified in 13/50 (26%) individuals. Mutations occurred at low variant allele frequencies (median 11.7%) and remained virtually stable over 3 years without development of hematologic malignancies in affected individuals. With DNMT3A mutations most frequently detected, another cohort of 160 healthy people spanning all age groups was sequenced specifically for DNMT3A revealing an overall mutation rate of 6.2% (13/210) and an age-dependent increase of mutation prevalence. A significant difference ( p = 0.017) in the DNMT3A expression pattern was detected between younger and healthy elderly people as determined by qRT-PCR. To evaluate the selection of clonal hematopoietic stem cells (HSCs), bone marrow of two healthy individuals with mutant DNMT3A was transplanted in a humanized mouse model. Xenografts displayed stable kinetics of DNMT3A mutations over 8 months. These findings indicate that the appearance of low-level clones with leukemia-associated mutations is a common age-associated phenomenon, but insufficient to initiate clonal selection and expansion without the additional influence of other factors.
Clinical features of nummular headache: report of 9 cases
Authors: null Maimaitiyiming·Waisiding, Weiying Ma, Bo Chen, Maimaiti Rexidamu, Hongmei Li, Abudusaimaiti Ayinuer, Xiang Zhang
Journal: BMJ (2016)

Clinical data of 9 patients with nummular headache (NH) admitted in Huashan Hospital and Kashgar Prefecture Second People's Hospital were retrospectively analyzed. There were 6 females and 3 males with a median age of 45 years (20-68) and a disease duration of 3-40 months. The patients had sustained or periodical mild-to-moderate pain exclusively felt in a rounded or elliptical area typically 2.5-5.0 cm in diameter, sometimes with lancinating exacerbation, and occasionally presented with hypoethesia or paresthesia. None had the definitely precipitating factors and presented with significantly abnormal physical or laboratorial examinations. The options of treatment, including therapeutic counselling, non-steroid drugs, neuralgic pain depressants may alleviate the sufferings of patients. The diagnosis of NH is maily based on clinical manifestations and symptomatic treatment is the main approach.


Key words: 
Nummular headache; Clinical features
Awake prone positioning for non-intubated oxygen dependent COVID-19 pneumonia patients
Authors: Ziqin Ng, Woo Chiao Tay, Choon Heng Benjamin Ho
Journal: European Respiratory Journal (2020)

<b>Adopting awake prone positioning in non-intubated patients with COVID-19 pneumonia is a low-risk, low-cost manoeuvre that may potentially delay or reduce the need for intensive care</b>https://bit.ly/2LPUnTl
Hormonal Treatments for Major Depressive Disorder: State of the Art
Authors: Jennifer B. Dwyer, Awais Aftab, Rajiv Radhakrishnan, Alik Widge, Carolyn I. Rodriguez, Linda L. Carpenter, Charles B. Nemeroff, William M. McDonald, Ned H. Kalin
Journal: American Journal of Psychiatry (2020)

Major depressive disorder is a common psychiatric disorder associated with marked suffering, morbidity, mortality, and cost. The World Health Organization projects that by 2030, major depression will be the leading cause of disease burden worldwide. While numerous treatments for major depression exist, many patients do not respond adequately to traditional antidepressants. Thus, more effective treatments for major depression are needed, and targeting certain hormonal systems is a conceptually based approach that has shown promise in the treatment of this disorder. A number of hormones and hormone-manipulating compounds have been evaluated as monotherapies or adjunctive treatments for major depression, with therapeutic actions attributable not only to the modulation of endocrine systems in the periphery but also to the CNS effects of hormones on non-endocrine brain circuitry. The authors describe the physiology of the hypothalamic-pituitary-adrenal (HPA), hypothalamic-pituitary thyroid (HPT), and hypothalamic-pituitary-gonadal (HPG) axes and review the evidence for selected hormone-based interventions for the treatment of depression in order to provide an update on the state of this field for clinicians and researchers. The review focuses on the HPA axis–based interventions of corticotropin-releasing factor antagonists and the glucocorticoid receptor antagonist mifepristone, the HPT axis–based treatments of thyroid hormones (T3 and T4), and the HPG axis–based treatments of estrogen replacement therapy, the progesterone derivative allopregnanolone, and testosterone. While some treatments have largely failed to translate from preclinical studies, others have shown promising initial results and represent active fields of study in the search for novel effective treatments for major depression.
哺乳期避孕
Authors: 徐晋勋
Journal: BMJ (2010)

整个育龄阶段,夫妇的避孕需求和所采用的措施可能会有变化.妊娠与分娩这一生理过程,常常迫使夫妇面临这样的问题.产后避孕,尤其是哺乳期,对医生和妇幼、计划生育工作者也同样是难题.本文就哺乳期妇女如何避孕作一讨论。
Gelsolin level for evaluating severity and prognosis in patients at critically ill
Authors: Xu-tao Wang, Xin-chao Zhang
Journal: BMJ (2011)

Objective To investigate clinical value of gelsoin level for evaluating severity and prognosis in patients with critical illness. Methods Forty-eight patients with critical illness admitted to the Emergency Intensive Care Unit of Beijing Hospital during February to December 2008 were enrolled in this study, with 23 survivors and 25 deaths. Serum level of gelsolin was measured for 31 of them at least twice during their hospital stay, and for other 17 only once at their admission. They all were evaluated with acute physiology and chronic health evaluation Ⅱ ( APACHE Ⅱ ) scores within 24 hours after admission. In addition, serum level of gelsolin was measured for another 307 healthy adults as controls. Results Initial level of gelsolin was significantly lower in 48 patients at critically ill than that in controls [(24 ± 11) mg/L vs. (192 ±39) mg/L, P < 0. 01]. There was significant difference in initial level of gelsolin between surviving group (23 cases) and death group (25 cases) [(28 ± 10) mg/L vs. (21 ±12) mg/L, P = 0. 033]. Fatality of patients at critically ill increased as their level of gelsolin at 22 mg/L or less, with a predicting accuracy of 74. 19% , as well as decreasing trend of their gelsolin levels in continuously minitoring, with a predicting accuracy of 70. 97%. Predicting accuracy of APACHE Ⅱ scores of 30 or more was 67.74%. However, predicting accuracy would reach 93.55% as final level of gelsolin and its decreasing trend combined with APACHE Ⅱ scores in prognostic assessment for critically ill patients. Conclusions Severity of patients at critically ill can be predicted by their gelsolin level, especially in continuously monitoring, which is an indicator better than APACHE Ⅱ scores. Combination of gelsolin level with APACHE Ⅱ scores shows a more accurate prognostic assessment for critically ill patients.

Key words: 
Critical care;  Evaluation studies;  Gelsolin
吲哒帕胺治疗老年单纯收缩期高血压的效果观察
Authors: 高红, 孙涛, 郝学军
Journal: BMJ (2005)

36例老年单纯收缩期高血压患者,停用降压药2周后开始服用吲哒帕胺2.5 mg/d ,于服药前和服药8周后分别对其进行血压和血生化测定.结果示治疗8周后降压总有效率为72.2%.治疗前后血糖、血脂、肝功能等无明显变化,但尿酸、肌酐、血钾有不同程度的变化(P＜0.05).提示老年单纯收缩期高血压患者应用吲哒帕胺治疗后降压效果良好,其对糖脂代谢无不良影响,但长期应用需注意监测血钾、尿酸及肌酐。
Association of geriatric conditions with survival and health care use in older adults with colon cancer living in long-term care facilities.
Authors: Daniel E Lage, Ryan David Nipp, Areej El-Jawahri, Jennifer S. Temel, Grant Richard Williams, Kelly Kenzik
Journal: Journal of Clinical Oncology (2020)

12045 Background: Older adults with colon cancer residing in nursing homes are at risk for experiencing geriatric conditions such as cognitive decline, limitations in activities of daily living (ADLs), needing pain medications, and incontinence, due to cancer and its treatment. We sought to investigate these factors pre- and post-diagnosis and explored their relationship with health care use and survival. Methods: We identified 483 patients age 65+ with colon cancer from 2011-2015 in SEER-Medicare with linked quarterly nursing home assessments from the Minimum Data Set both pre- and post-cancer diagnosis. We determined the number of geriatric conditions (cognitive functioning, limitation in any ADL, pain medication use, bowel/urinary incontinence) at the pre- and post-cancer diagnosis assessment. We created four groups based on changes in these factors from pre- to post- assessment: improved (n = 105), worsened (n = 25), remained limited (n = 240), never limited (n = 113). Regression models estimated how changes from pre- to post-cancer diagnosis were associated with number of emergency department (ED) visits, hospitalizations, and survival, adjusted for age, sex, race/ethnicity, insurance status, cancer stage, number of pre-cancer comorbidities, urban/rural status, and time from diagnosis. Results: Overall, 55.3% of patients were age &gt; 80 at diagnosis, with 64.8% female; 73.3% non-Hispanic white; and 9.9% Stage IV. Pre- versus post-diagnosis, 20.7% vs. 34.8% of patients were limited in cognitive functioning, and 75.4% vs. 77.8% were limited in ADLs. About a third of patients required pain medication, and about half of patients had urinary incontinence, which did not change pre- and post-diagnosis. Patients who remained limited had higher rates of ED visits (Risk ratio [RR] 1.05, p &lt; .01) compared to those never limited. Those who worsened had higher rate of hospitalization (RR 1.44, p &lt; .01) and ED visits (RR 1.63, p &lt; .01). 12-month and 5-year survival was 46.7% and 6.1%, respectively. Factors associated with worse survival in a multivariable model included: remaining limited at both assessments (OR 1.52, p &lt; .01), worsening from prior (OR 2.00, p = .01), as well as older age and higher cancer stage. Conclusions: Older adults with colon cancer residing in nursing homes have high prevalence of geriatric conditions and differential health care use and survival based on the presence of geriatric conditions, highlighting the need to consider geriatric conditions when providing cancer care to this population.
Establishment of evaluation index system for urban general practice service team in Shanghai
Authors: Hua Yang, Shan-zhu Zhu, Sun-fang Jiang, Jian Wang
Journal: BMJ (2009)

Objective To establish an evaluation index system for Shanghai urban general practice service team to improve standardized and scientific management. Methods The evaluation index system for Shanghai urban general practice service team was established using two rounds of Delphi consultation. Results The established system consisted of 5 fast-grade indicators and 56 second-grade indicators. The 5 first-grade indicators were staffing, infrastructure, quality and quantity of service, continuing education and satisfaction degree of suppliers and demanders, with weight of 0.2153, 0.1978, 0.2087, 0.1869 and 0.1923 respectively. The active coefficient for two rounds of Delphi consultation was both 100%. The authoritative coefficient of the two rounds was 0.852 and 0.883 respectively. The harmonious coefficient of importance of the evaluation index was 0.251 and 0.411 respectively. Conclusion Through using Delphi method scientifically and reasonably, we set up the evaluation index system for Shanghai urban general practice service team, with integral contents, strong operability and easy application. 

Key words: 
Community health service;  Evaluation studies;  Quality indicators,health care; Delphi technique
Survey on general background and professional competency of general practitioners with standardization training in Beijing
Authors: Lili Bian, Kai Huang, Xiaoxiao Li
Journal: BMJ (2014)

One hundred and thirty general practitioners (GP) who received standard training (training group) and 189 GPs who did not receive standard training (non-training group) were selected with cluster random sampling method from five districts in Beijing.A questionnaire survey was conducted from April to May 2013, including basic information, working condition, professional competency and continuing education of the interviewees.The survey showed that 72.3%(94/130)in training group had physician titles; 89.3%(116/130 )had work experience <10 y; 97.0%(126/130)of them had bachelor degree or above; 82.3%(107/130)expressed their interest in scientific research, but the 95.4% of them had no research projects; and 96% had no teaching appointment.GPs in non-training group were in a favorite position of education level and professional competency over those in training groups; however, the latter were highly enthusiastic in further training and scientific research, and had strong potential for career development.


Key words: 
General practitioners; Inservice training; Questionnaires
Cause of mortality in patients with lung cancer and brain metastasis.
Authors: Rajat Thawani, Kareem Fakhoury, Kevin Douglas Becker
Journal: Journal of Clinical Oncology (2020)

e21743 Background: Lung cancer is the most common cause of cancer-related mortality and most deaths are associated with metastatic disease, with brain being a common site. Historically, whole brain radiation therapy was the treatment of choice and resulted in median survivals in the range of 6 months. There is no consensus in management of patients who have brain metastasis with systemic disease.We aim to evaluate patients with brain metastasis from lung cancer for cause of death, to investigate whether patients died from central nervous system (CNS) progression or systemic disease or other/undetermined causes. Our hypothesis is that most deaths in contemporary patients with brain metastasis in lung cancer are due to systemic disease, and less commonly due to CNS progression. Methods: In this retrospective observational study, we did a chart review of all adult patients with non-small cell lung cancer and brain metastasis or leptomeningeal disease, who received treatment at Maimonides Cancer Center between 2010 and 2017. Patients with unavailable or incomplete medical records were excluded. Baseline characteristics, pathological factors of the tumor and cause of death was collected from the chart. The cause of death was categorized into systemic and brain causes, and difference in characteristics of patients and tumor were studied. Results: A total of 132 patients were included and their charts were reviewed. Out of 132, 96 could have a clear cause of death categorized into systemic or brain causes, the rest were either mixed or uncategorized. We found that 33% patients died of brain metastasis, and related causes, whereas 67% died of systemic disease progression. There were no different in the two groups in terms of gender, smoking status, histology, size of lung lesion, or number and size of brain lesion. The patients who died of brain metastasis had a significantly higher age, and worse Eastern Cooperative Oncology Group status. Interestingly, the patients who died of systemic causes more commonly had adrenal metastasis (12 vs 0) which was statistically significant, and liver (14 vs 3) metastasis which was not statistically significant. Conclusions: Two-thirds of patients with brain metastases died of systemic disease rather than CNS progression. This may reflect improvements in systemic and local therapies to forestall cancer progression in the CNS. This finding suggests that delaying systemic therapy for CNS treatment may negatively impact overall cancer control. More research needs to be done to answer this question with certainty, including prospective clinical trials.