tbuckley/cabot-search huggingface dataset:
Risk factors of atherogenic index of plasma in elderly male hypertensive patients
Authors: Keming Yang, Jingyu Gu, Xiaoping Tao, Jian Jia, Lina Mao, Chen Men, Chong Shen
Journal: BMJ (2015)

To investigate the risk factors of atherogenic index of plasma (AIP) in elderly male hypertensive patients. According to the cutoff point of AIP at 0.06, 384 elderly male hypertensive patients with AIP≥0.06 were enrolled as atherogenic phenotype group(A group) while 352 age and blood pressure matched male hypertensive patients with AIP<0.06 were enrolled as non-atherogenic phenotype group (NA group). Clinical biochemistry data and physical examination indexes were compared between the two groups. Parametric test showed that uric acid (UA), fasting blood-glucose (FBG), body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR) in group A were higher than those in group NA (all P<0.01). Binary logistic regression analysis revealed that WC, UA, FBG were independent risk factors of AIP (all P<0.01). These results indicate that elderly male hypertensive patients should regularly monitor and control their waist circumference, uric acid and fasting blood glucose levels to better control AIP and the risk of developing atherosclerosis. Before conducting relevant blood and imaging examinations, waist circumference can serve as a preliminary screening index for atherosclerosis in this population, evaluating their AIP level and atherosclerosis risk.


Key words: 
Hypertension; Atherosclerosis; Risk factors
The impact of primary pancreatic tumor location on clinical outcomes in advanced disease: Results from the chord consortium.
Authors: Abdulaziz AlJassim AlShareef, Mehrnoosh Pauls, Michael M. Vickers, Winson Y. Cheung, Brandon M. Meyers, Christina Kim, Rachel Anne Goodwin
Journal: Journal of Clinical Oncology (2020)

e19267 Background: Pancreatic cancer is the fourth leading cause of cancer-related death with an average life expectancy of approximately six months following diagnosis. It is essential to understand the behavior of cancer cells to predict pattern of progression. Previous studies have shown that location of pancreatic adenocarcinoma has an influence on overall survival (OS) with worse OS among patient whom developed pancreatic cancer in the tail of pancreas. The objective of this study was to determine if location of the primary pancreatic adenocarcinoma (head/neck vs. body vs. tail) has an influence on overall survival and study pattern of metastasis to lung, liver and peritoneum base on primary tumor site. Methods: A retrospective cohort design was used to identify cases of advanced adenocarcinoma pancreas and to assess disease and treatment-related characteristics. Medical records from all adult patients diagnosed with metastatic pancreatic cancer across five Canadian academic cancer centers in Canada from 2014 to 2019 were reviewed using a national Research Electronic Data Capture (REDCap) database. Prognostic variables including age, Charlson comorbidity index, ECOG, cigarette smoking, nodal status, sites of metastases, and type of first line chemotherapy were collected. Cox proportional hazards model was used to examine the association between anatomical location of pancreatic cancer and survival, adjusted for measured confounders. Analyses were completed using SAS, where alpha of 0.05 was defined as the level of significance. Results: A total of 1161 participants were included in the study. The primary origin of pancreatic cancer included head/neck (51.8%), tail (20%) and body (16%). Metastatic sites included peritoneum (n = 170), lung (n = 145), and liver (n = 563). Peritoneal metastasis originated from tail (21.3%) and body (16.8%) and less from head /neck (9.1%) (P &lt; 0.001). Liver metastasis originated from body (52.7%) and tail (66%) and less from head/neck (37%) (P &lt; 0.001). Lung metastasis originated from body (13.6%) and tail (19.6%) and less from head/neck (7.8%) (p &lt; 0.001). Multivariate analyses (MVA) showed that primary tumour location was not associated with overall survival (p &gt; 0.05). Conclusions: Pancreatic lesions that originate in the body and tail were more likely to metastasize to lung, liver and peritoneum. Anatomical location of the primary pancreatic cancer was not associated with overall survival.
Predictive survival ability of patient-reported in comparison to physician-reported performance status in solid malignancies.
Authors: Abdulla Al-Rashdan, Rinku Sutradhar, Narges Nezari-Rad, Cindy Yao, Lisa Catherine Barbera
Journal: Journal of Clinical Oncology (2020)

7019 Background: Performance status (PS) is an important prognostic tool in cancer management that is mainly generated by physicians. In oncology, the Eastern Cooperative Oncology Group (ECOG) measure is commonly used. Patient-reported functional status (PRFS) is an emerging method that allows patients to provide an estimate of their function; however, there is limited information about its prognostic significance in solid tumors. We explored the prognostic value of PRFS in comparison to ECOG on survival. Methods: 13,045 newly diagnosed cancer patients in Ontario, Canada, who had information from both PRFS and ECOG on the same day of an outpatient visit between March 2013 and March 2018 were included. The dataset were randomly divided into 60% training (n = 7,827) and 40% validation (n = 5,218) cohorts. Covariates were similar at baseline for both training and validation datasets. Survival was estimated by modeling clinical characteristics with PRFS, with ECOG, and alone. Results: PRFS and ECOG scores were statistically significant predictors of overall survival. Both higher PRFS and ECOG scores tended to be associated with inferior survival, hazard ratio (HR) = 1.71 (P &lt; .0001), and HR = 1.90 (P &lt; .0001) respectively. Models that included either PRFS or ECOG scores outperformed the model with baseline clinical characteristics only. C statistics were 0.836, 0.839, and 0.811 respectively. Conclusions: Patient-reported functional status adds to survival modeling and is equally predictive as the ECOG scale at various stages of solid malignancies. PRFS may be used instead of ECOG in clinical or research setting for survival estimation.
National Comprehensive Cancer Network (NCCN) category I/FDA-approved metastatic pancreatic adenocarcinoma (mPDAC) treatments in commercially insured patients: An analysis of inpatient (IP) and emergency room (ER) admissions.
Authors: Paul Cockrum, Andy Surinach, Stella Arndorfer, Jim M. Koeller, George P. Kim
Journal: Journal of Clinical Oncology (2020)

e16739 Background: There are currently four NCCN category 1 systemic regimens approved in the United States for the treatment of mPDAC: FOLFIRINOX (FFX), gemcitabine+nab-paclitaxel (gem+nab-P), gemcitabine monotherapy (gem), and liposomal irinotecan + 5-fluorouracil/leucovorin (5-FU/LV) following progression with gem-based therapy. There is limited real-world research on the IP admissions and ER visit healthcare resource utilization (HRU) of patients receiving these treatments. Methods: Using the IQVIA PharMetrics Plus administrative claims database, data were analyzed for adult patients with mPDAC treated with NCCN category 1 regimens in first through fourth line of therapy between January 1, 2014 and May 31, 2019. For each line of therapy, continuous treatment was defined as the time from first administration of a therapy until the last administration. Mean all-cause and mPDAC-related IP admissions, ER visits, inpatient length of stay (LOS) during treatment were assessed. Results: Of the 2,731 patients with mPDAC included in the study, 101 (3.7%) were treated with a liposomal irinotecan based regimen, 1,316 (48.2%) were treated with gem+nab-P, 612 (22.4%) with FFX, and 624 (22.8%) with gem in any treatment line. The mean number of IP admissions was 1.2 for liposomal irinotecan treated patients, 1.5 for gem+nab-P, 1.5 for FFX, and 1.2 for gem. Among patients with at least one IP admission the mean LOS was 4.5 days for liposomal irinotecan, 5.4 days for gem+nab-P, 3.8 for FFX, and 5.1 for gem treated patients. Patients treated with liposomal irinotecan had a mean of 1.3 ER visits during treatment. Gem+nab-P, FFX, and gem-treated patients experienced 1.7, 1.4, and 1.8 mean ER visits, respectively. Mean mPDAC-related IP admissions ranged from 1.1 – 1.5, ER visits ranged from 1.1 – 1.7, and mean LOS ranged from 3.8 – 5.5 days. Conclusions: In this descriptive retrospective study patients receiving liposomal irinotecan, across all treatment episodes, generally experienced numerically lower mean IP admissions and ER visits. LOS was similar across all regimens. Further studies are necessary to characterize the IP and ER HRU burden among mPDAC patients treated with approved regimens.
U.S. trends and racial/ethnic disparities in opioid access among patients with poor prognosis cancer at the end of life (EOL).
Authors: Andrea Catherine Enzinger, Kaushik Ghosh, Nancy Lynn Keating, David M Cutler, Mary Beth Landrum, Alexi A. Wright
Journal: Journal of Clinical Oncology (2020)

7005 Background: Heightened US opioid regulations may limit advanced cancer patients’ access to effective pain management, particularly for racial/ethnic minority and other vulnerable populations. We examined trends in opioid access, disparities in access, and pain-related emergency department (ED) visits among cancer patients near end of life (EOL). Methods: Using a 20% random sample of Medicare FFS beneficiaries, we identified 243,124 patients with poor prognosis cancers who died between 2007-2016. We examined trends in outpatient opioid prescription fills and pain-related ED visits near EOL (30 days prior to death or hospice enrollment), for the overall cohort and by race (white, black, other). Per-capita opioid supply by state was obtained from the federal Drug Enforcement Agency ARCOS database. Geographic fixed-effects models examined predictors of opioid use near EOL, opioid dose in morphine milligram equivalents (MMEs), and pain-related ED visits, adjusted for patient demographic and clinical characteristics, state, opioid supply, and year. Results: From 2007-2016 the proportion of patients with poor prognosis cancers filling an opioid prescription near EOL fell from 41.7% to 35.7%, with greater decrements among blacks (39.3% to 29.8%) than whites (42.2% to 36.5%) and other races (38.2% to 32.4%). The proportion of patients receiving long-acting opioids near EOL fell from 17% to 12% overall (15% to 9% among blacks). Among patients receiving EOL opioids, the median daily dose fell from 40MMEs (IQR 16.5-98.0) to 30MMEs (IQR 15.0–78.8). In adjusted analyses, blacks were less likely than whites to receive EOL opioids (AOR 0.85; 95% CI, 0.80 to 0.91) and on average received 10MMEs less per day (b -9.9; 95% CI -15.7 to -4.2). Patients of other race were also less likely to receive EOL opioids (AOR 0.92; 95% CI, 0.85-0.95), although their dose did not differ significantly from whites. Rates of pain-related ED visits near EOL increased from 13.2% to 18.8% over the study period. In adjusted analyses, blacks were more likely than whites to have pain-related ED visits (AOR 1.29, 95% CI, 1.16-1.37) near death, as were those of other races (AOR 1.30; 95% CI, 1.17-1.37). Conclusions: While lawmakers have sought to mitigate the impact of opioid regulations upon cancer patients, access to EOL opioids have decreased substantially over time with concomitant increases in pain-related ED visits. There are significant racial/ethnic disparities in opioid access, with blacks receiving fewer opioids at lower doses and having more ED-based care for pain near EOL.
Next generation proteomics in precision oncology: 1000s of proteome and phosphoproteome profiles of tumors and matching healthy tissues as meaningful layer in multi-omics database.
Authors: Claudia Escher, Jakob Vowinckel, Karel Novy, Thomas Corwin, Tobias Treiber, Roland Bruderer, Lukas Reiter, Eike-Christin von Leitner, Oliver Rinner
Journal: Journal of Clinical Oncology (2020)

e15672 Background: The rise of precision oncology therapeutics requires deep understanding of all molecular mechanisms involved in cancer biology. IndivuType offers the world’s first multi-omics database for individualized cancer therapy, analyzing the highest quality cancer biospecimens to generate the most comprehensive dataset, including genomics (WGS), transcriptomics, proteomics, and clinical outcome information. Indivumed is committed to the quality of the IndivuType ecosystem starting with stringent SOP-driven sample collection combined with thorough validation of clinical information and data integrity. The availability of multi-omics data from the same tumor can provide a comprehensive molecular picture of cancer for a given patient. Protein expression and activation are directly related to cellular function and hence provide actionable information about druggable targets. Until recently, the proteomics technology could not match the scale of next-gen sequencing and consequently precision medicine has almost exclusively been based on gene level data. Here we present the first large-scale data set for protein expression and phosphorylation. Enabled by the data independent acquisition (DIA) workflow, a mass spectrometric method provided by Biognosys that obtains peptide fragmentation data in a highly parallelized way with high sensitivity, more than 7,000 proteins in the whole proteome (WP) and 20,000 phospho-peptides in the phospho-proteome (PP) workflow were profiled. Methods: Sample processing from 5 mg of tissue per sample was performed using liquid handling robot. Phospho-peptide enrichment was carried out with a Kingfisher Flex device and MagReSyn Ti-IMAC magnetic beads. DIA LC-MS/MS was performed on multiple platforms consisting of a Thermo Scientific Q Exactive HF-X mass spectrometer coupled to a Waters M-Class LC. Chromatography was operating at 5 µL/min, and separation was achieved using 45 min (WP) and 60 min (PP) gradients. Results: Several thousands of high-quality patient samples of various cancer types have been analyzed to date. The resulting proteome and phospho-proteome data has been integrated into the IndivuType database, thereby providing a solid foundation to advance our understanding of cancer. Conclusions: With the ongoing addition of more samples and associated deep and rich data, the platform could unravel key molecular events and is expected to transform knowledge into actionable treatments and personalized therapies.
Correlation between obstructive sleep apnea-hypopnea syndrome and type 2 diabetes mellitus of Han nationality and Uygur nationality
Authors: Zhong-ming He, Shan-jiang Rouzi Ai, Cui-ying Wei, Xiao-song Dong, Hong-xia Li, Min Li
Journal: BMJ (2013)

Objective
To explore the prevalence of diabetes in obstructive sleep apnea-hypopnea syndrome (OSAHS) adults over 35 years old of Han and Uygur nationalities and elucidate the relationship between sleep apnea and type 2 diabetes mellitus.


Methods
From 2010 to 2012, A total of 755 subjects aged ≥35 years (Han, n=398; Uygur, n=357) were selected from a natural population in Tianshan District of Kelamayi, Xinjiang Autonomous Region. Height, weight, neck circumference, abdominal circumference and blood sugar were measured. And all subjects of snoring underwent respiration and pulse oximeter tests. Apnea-hypopnea index (AHI), mean SaO2 (MSaO2%), lowest SaO2 (LSaO2%) and the number of desaturations ≥4% per hour (ODI4) were calculated. They were divided into OSAHS and non OSAHS groups. Both Han nationality and Uygur nationality groups were matched for age and gender.


Results
The parameters of body mass [(24.9±3.2)vs. (28.2±4.4) kg/m2], neck circumference [(35.2±3.2) vs. (37.4±3.4) cm], abdominal circumference [(87.1±9.5)vs. (98.0±11.6) cm], oxygen desaturation index [(9.9±0.5) vs. (8.2±0.4)/h], nadir arterial oxygen saturation [(83.3±6.9)% vs. (82.7±7.4)%], apnea-hypopnea index [(15.0±14.3) vs. (11.9±11.4)/h] and blood sugar [(6.3±1.4) vs.(7.1±2.8) mmol/L] were significantly different between Han and Uygur nationality snoring groups (P<0.05). Significant difference existed in the prevalence of diabetes in OSAHS groups between Han and Uygur nationalities [16.8%(47/279)vs. 30.5% (69/226)] (P<0.05). Logistic regression analysis revealed that age (OR=1.667), apnea-hypopnea index (AHI) (OR=2.074) and nationality (OR=1.922) were major risk factors for diabetes. The prevalence of diabetes for OSAHS was 19.3%(69/357) in Uygur nationality versus 11.8%(47/398) in Han nationality.


Conclusion
The prevalence of diabetes for OSAHS in Uygur nationality is higher than that in Han nationality. The high-risk diabetic factors are age, nationality and AHI. And a close relationship exists between type 2 diabetes mellitus and sleep apnea.


Key words: 
Sleep apnea syndromes; Diabetes mellitus，type 2; Correlation
Evaluation of general practice mentors training in Zhejiang province
Authors: Ruian Chen, Yaping Du
Journal: BMJ (2015)

By questionnaire we conducted a cluster sampling survey on 150 general practice mentors in Zhejiang province who completed training program during November 2011 to May 2013. By using Kirkpatrick's four level evaluation methods, we evaluated the training program based on the response level, learning level and behavior level. A total of 141 valid questionnaires were collected. The results showed that 92.2% of participants (130/141) were satisfied with the training contents, 94.3% (133/141) were satisfied with the teachers, 87.9% (124/141) were satisfied with the training environment, 83.7% (118/141) thought the training contents useful, and 89.4% (126/141) were satisfied with the training organization. Only 31.2% (44/141) of participants mastered the knowledge and skills of general practice before training, and the figure increased to 87.2% (123/141) after training. The results also showed that 67.3% (95/141) of participants were able to use the knowledge acquired in the training, and 81.6% (115/141) of them were able to apply the concept of general practice in their teaching practice. These results indicate that general practice mentors are satisfied with the training in the aspects of response, learning and behavior, and the training program would play a positive role in promoting their performance in teaching practice.


Key words: 
Training; Evaluation; General practitioners
Multiple Classes of Antibiotic Use in Infancy and Allergic Disease in Childhood
Authors: Farzin Khosrow-Khavar, Saeed Ganjizadeh-Zavareh, Mahyar Etminan
Journal: JAMA Pediatrics (2020)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Pediatrics HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Pediatrics journal
Financial toxicity (FT) real-world data evidence (RWDE) in American patients (pts) receiving cancer immunotherapy drugs (IOT).
Authors: Daniel A. Vorobiof, Lior Hasid, Alon Litvin, Irad Deutsch, Eliran Malki
Journal: Journal of Clinical Oncology (2020)

e19331 Background: Real-word data obtained through cutting edge technology paired with consumer mobile devices on 310 worldwide pts, members of Belong.life, an international mobile application, who received immunotherapy for diverse solid tumors, was obtained following a short, targeted survey related to the potential development of FT as a result of the reported diagnosis and IOT. Methods: 310 worldwide pts anonymously and voluntarily replied to a 14 questions survey describing their demographics and FT related points including reported causes, health insurances coverages and personal financial coping strategies. In this abstract we present the data on 205 American pts. Results: All 205 pts were US based. 29 pts (14 %) were &lt;50 years of age (yoa), 68 pts (33%) were 51-60 yoa and 108 (53%) were &gt;61 yoa. Pts’s stages were 3 in 39(19%) and 4 in 141 (69%). There were 72 males and 133 females. The most common cancer diagnosis was lung in 96 pts (47%), malignant melanoma in 37(18%), kidney in 29(14%), colorectal in 14(7%) and bladder in 12(6%). The frequent administered immunotherapy drugs were pembrolizumab in 44%, nivolumab in 39%, ipilimumab in 18 % and durvalumab in 13%. Of the 172/205 pts that replied in full to the FT survey, 82/172 (48%) reported FT during their treatment journey. Of them 24/82 (29.3%) received pretreatment FT information from their medical team while 58/82 pts (70.7%) mentioned that they did not receive FT information. Common reported FTs were high medical copayments in 50 % of the repliers, loss of income in 47% and high drugs and treatment copayments in 38 %. 41 % of the pts were insured by Medicare and 23 % by Medicaid and other HMOs. When asked about coping strategies, 62 % used personal savings, 35% received financial support from family and friends and 32 % trimmed their household expenses. Conclusions: 205 American pts members of the Belong.life application reported on their FTs experiences while receiving cancer immunotherapy. 172/205 replied to the complete survey. FT was most prevalent in the older group (&gt;61 yoa) due to high medical and treatment copayments. Nearly half of the pts were not aware of the possible development of FT before treatment and only 29.3% received pre-treatment advisory information from their doctors. Reduced FT incidence (from 70.7% to 29.3%) was reported by those pts who received financial advice prior to initiation of treatment. Physicians should become aware of their pts’ possible risks for FTs and follow it up with relevant advice prior to immunotherapy initiation.
出血性疾病的诊断
Authors: 黄晓明, 陈嘉林
Journal: BMJ (2009)

黄晓明:关于出血性疾病的诊断可能很多全科医生不是很清楚,在讲出血性疾病之前,先复习一下人体的止血机制.我们知道一般正常人具有正常的止血机制,不会发生自发性出血.止血机制大致分为血管、血小板、凝血因子,还有抗凝系统等几大部分.发生损伤以后如何肩动止血机制呢?
针药结合治疗痤疮23例
Authors: 邵建明
Journal: BMJ (2006)

痤疮,又名青春痘、粉刺,是一种皮肤毛囊的慢性炎症性疾病,若不及时治疗或治疗方法不当,可发展成为慢性迁延性痤疮,有些患者可产生严重的心理压力,甚至不敢参与正常社交活动.我们采用针药结合治疗痤疮23例,取得较好效果。