tbuckley/cabot-search huggingface dataset:
Development and validation of a new clinical prediction model of catheter-related thrombosis in cancer patients.
Authors: Binliang Liu, Junying Xie, Xiaoying Sun, Yanfeng Wang, Zhong Yuan, Xiyu Liu, Zhou Huang, Jiani Wang, Hongnan Mo, Zongbi Yi, Xiuwen Guan, Lixi Li, Wenna Wang, Hong Li, Fei Ma, Yi-Xin Zeng
Journal: Journal of Clinical Oncology (2020)

e14031 Background: The central venous catheter brings convenience for drug delivery and improves comfort for cancer patients, it also causes serious complications. The most common one is catheter-related thrombosis (CRT). This study aimed to evaluate the incidence and risk factors of CRT in cancer patients, and to develop an effective prediction model for CRT in cancer patients. Methods: The development of our prediction model was based on the data of a retrospective cohort (n = 3131) from National Cancer Center. The validation of our prediction model was done in a prospective cohort from National Cancer Center (n = 685) and a retrospective cohort from Hunan Cancer Hospital (n = 61). The predictive accuracy and the discriminative ability were determined by the receiver operating characteristic curves and calibration plots. Results: Multivariate analysis demonstrated that sex, cancer type, catheter type, position of the catheter tip, chemotherapy status, and antiplatelet/anticoagulation status at baseline were independent risk factors for CRT. The area under receiver operating characteristic (ROC) curve of our prediction model was 0.741 (CI: 0.715-0.766) in the primary cohort; 0.754 (CI: 0.704-0.803) and 0.658 (CI: 0.470-0.845) in validation cohorts respectively. Good calibration and clinical impact were also shown in primary and validation cohorts. The high-risk group had a higher incidence of CRTs than the low-risk group in the primary cohort and two validation cohort (p &lt; 0.001). Conclusions: Our model is a novel prediction tool for CRT risk which helps to assigning cancer patients into high-risk or low-risk group accurately. Our model will be valuable for clinicians in decision making of thromboprophylaxis.
Circulating and tumor-associated neutrophil subtypes discriminate hyperprogressive disease (HPD) from conventional progression (PD) upon immune checkpoint inhibitors (ICI) in advanced non-small cell lung cancer (NSCLC) patients (pts) and in vivo models.
Authors: Roberto Ferrara, Giuseppe Lo Russo, Diego Signorelli, Claudia Proto, Arsela Prelaj, Giulia Galli, Alessandro De Toma, Giuseppe Viscardi, Riccardo Lobefaro, Marta Brambilla, Giovanna Talarico, Barbara Bassani, Sestina Maria Spanò, Giuliano Molino, Nicoletta Zilembo, Monica Ganzinelli, Stefania Vitale, Mario Paolo Colombo, Marina Chiara Garassino, Sabina Sangaletti
Journal: Journal of Clinical Oncology (2020)

9547 Background: HPD occurs in ≃10-25% of NSCLC pts upon single-agent ICI and correlates with poor prognosis. High circulating neutrophil count and neutrophils/lymphocytes ratio have been associated with shorter survival and HPD in NSCLC pts. In mouse lung cancer models, interleukin-17 (IL-17) promoted tumour growth upon ICI increasing intratumoral neutrophils. The role of specific circulating and/or tumour-associated neutrophils in driving HPD is currently unknown. Methods: NSCLC pts treated with single agent ICI were assessed for HPD and circulating neutrophils’ phenotype. Conventional PD was defined by RECIST 1.1. HPD required 3 tumour assessments (2 before ICI, 1 upon ICI) and was defined as delta tumour growth rate (TGR) (TGR upon ICI – TGR before ICI) &gt; 50% and/or TGR ratio (TGR upon ICI/ TGR before ICI) ≥2. Correlations with continuous variables were performed by Mann-Whitney test. Circulating low density neutrophils (LDNs) subtypes were assessed by flow cytometry (FC) on peripheral blood mononuclear cells (PBMCs) from fresh blood samples. LDNs were defined as CD66b + CD15 + cells among CD11b + PBMCs. Immature subtypes were defined as CD10 − and CD10 − CD16 − LDNs. The occurrence of HPD upon anti-PD-1 treatment was tested in C57BL/6 immune competent mice bearing Lewis Lung Carcinoma and treated with anti-murine PD-1. Tumour associated neutrophils’ phenotype was assessed by FC. Results: Of 52 NSCLC, 65% were &gt; 65 years, 83% had stage IV, 25% PD-L1 on tumour cells ≥50%, 67% received 1 st line ICI. PD and HPD occurred in 21 (40%) and 5 (10%) pts, respectively. Before ICI start, HPD pts had higher circulating immature neutrophils measured as median percentage of CD10 − LDNs [41.9 (min 26.7; max 83.5) vs 10.1 (min 0.69; max 79.3), p = 0.01] and of CD16 − cells among CD10 − LDNs [93 (min 89.5; max 98.4) vs 86.3 (min 24.2; max 99), p = 0.03] compared to conventional PD pts. PD and HPD occurred in 17 (71%) and 3 (12.5%) of 24 immune competent mice treated with anti-murine PD-1. The median percentage of IL-17 + tumour associated neutrophils (Gr1 high Ly6C low ) was significantly higher in HPD compared to PD mice [0.25 (min 0.14; max 0.63) vs 0.06 (min 0.02; max 0.32), p = 0.02]. Conclusions: Circulating immature (CD10 − and CD10 − CD16 − ) LDNs and IL-17 + tumour associated neutrophils discriminate HPD from conventional PD upon ICI in NSCLC pts and in vivo models, respectively. Functional characterization of specific neutrophil subsets is ongoing.
The impact of <scp>COVID</scp> ‐19 on heart failure hospitalization and management: report from a Heart Failure Unit in London during the peak of the pandemic
Authors: Daniel I. Bromage, Antonio Cannatà, Irfan A. Rind, Caterina Gregorio, Susan Piper, Ajay M. Shah, Theresa A. McDonagh
Journal: European Journal of Heart Failure (2020)

To examine the impact of COVID-19 on acute heart failure (AHF) hospitalization rates, clinical characteristics and management of patients admitted to a tertiary Heart Failure Unit in London during the peak of the pandemic.Data from King's College Hospital, London, reported to the National Heart Failure Audit for England and Wales, between 2 March-19 April 2020 were compared both to a pre-COVID cohort and the corresponding time periods in 2017 to 2019 with respect to absolute hospitalization rates. Furthermore, we performed detailed comparison of patients hospitalized during the COVID-19 pandemic and patients presenting in the same period in 2019 with respect to clinical characteristics and management during the index admission. A significantly lower admission rate for AHF was observed during the study period compared to all other included time periods. Patients admitted during the COVID-19 pandemic had higher rates of New York Heart Association III or IV symptoms (96% vs. 77%, P = 0.03) and severe peripheral oedema (39% vs. 14%, P = 0.01). We did not observe any differences in inpatient management, including place of care and pharmacological management of heart failure with reduced ejection fraction.Incident AHF hospitalization significantly declined in our centre during the COVID-19 pandemic, but hospitalized patients had more severe symptoms at admission. Further studies are needed to investigate whether the incidence of AHF declined or patients did not present to hospital while the national lockdown and social distancing restrictions were in place. From a public health perspective, it is imperative to ascertain whether this will be associated with worse long-term outcomes.
Efficiency of one-stage posterior median incision via costotransverse joint in treating thoracic spinal tuberculosis
Authors: Deming Bao, Junwei Li, Lei Xia, Peng Li, Xin Li
Journal: BMJ (2015)

Objective
To assess the efficacy of one-stage posterior median incision via costotransverse joint in treating thoracic spinal tuberculosis.


Methods
Thirty three patients with tuberculosis of thoracic spine undergoing one-stage posterior thoracic spine debridement, bone grafting fusion and posterior instrumentation from July 2011 to October 2013 were included in the study.There were 18 males and 15 females. The age was from 17 to 39 years old with an average of 29.5. The course was from 5 to 11 months with an average of 7.3. The Cobb angle was from 19° to 42° with an average of 29.8°. There were 5 in upper thoracic spine, 17 in middle thoracic spine and 11 in lower thoracic spine. 6 were in Frankel scale grade C, 11 were in grade D and 16 were in grade E before surgery. Postoperative kyphosis correction, recovery of neurological function and bone fusion were observed.


Results
All the surgeries were completed successfully. The operation time was from 120 to 230 min with an average of 183. The blood loss during operation was from 480 to 700 ml with an average of 530. All 33 patients were followed-up for 12-36 months with an average of 22.7 months. The Cobb angle was from 8° to 15° with an average of 10.2°, the correction rate was 77%. The Frankel scale of 11 patients recovered from D to E, 2 recovered from C to D and 4 recovered from C to E. The postoperative kyphosis correction and Frankel scale were significantly improved, all patients had a 100% bone fusion rate and there were no internal fixation loosened or shift of graft bone at the last follow-up. ESR and CRP were returned to the normal range and the tuberculosis symptoms disappeared.


Conclusions
One-stage posterior median incision via costotransverse joint can complete surgery by the same position and the same incision in treating thoracic spinal tuberculosis with safety and good clinical efficacy.


Key words: 
Tuberculosis, osteoarticular; Thoracic vertebrae; Curettage; Treatment outcome; Posterior median incision
淤胆型戊型肝炎一例
Authors: 何叶林, 高连祥, 王莹
Journal: BMJ (2010)

患者男性,58岁,农民.因腹胀、纳差、肝区胀痛伴皮肤黄染约一周,大便呈陶土色5 d,以黄疸待查,可疑胆管肿瘤、胆管结石于2008年5月4日入院.患病以来无发热、寒战.体格检查:体温37.5℃,神志清楚,营养一般,皮肤、黏膜、巩膜重度黄染。
Updated results of the ASPEN trial from a cohort of patients with <i>MYD88</i> wild-type (<i>MYD88</i><sup>WT</sup>) Waldenström macroglobulinemia (WM).
Authors: Ramón Garcia-Sanz, Meletios A. Dimopoulos, Hui-Peng Lee, Marek Trneny, Marzia Varettoni, Roger G. Owen, Jorge J. Castillo, Tanya Siddiqi, Alessandra Tedeschi, Christian Buske, Veronique Leblond, Wai Y. Chan, Jingjing Schneider, Sunhee K. Ro, Aileen Cohen, Jane Huang, Constantine Si Lun Tam
Journal: Journal of Clinical Oncology (2020)

e20056 Background: Inhibitors of Bruton tyrosine kinase (BTK) have shown significant activity in patients with WM harboring a mutation in the MYD88 gene. However, lower response rates and shorter progression-free survival have been reported in patients with WM who lack such mutations ( N Engl J Med. 2015;372:1430). The ASPEN trial evaluated zanubrutinib (ZANU), a potent and selective BTK inhibitor, in WM patients. Methods: In the ASPEN trial, bone marrow MYD88 mutations were assessed at study entry by a central laboratory (NeoGenomics). Based on the results of the MYD88 mutation assay, patients were assigned to cohort 1 ( MYD88 mutation) or cohort 2 ( MYD88 WT or mutation unknown). All cohort 2 patients received ZANU 160 mg twice daily until disease progression. The objective was to assess the safety and efficacy of ZANU in patients with MYD88 WT WM. Results: In total, 28 patients with 26 MYD88 WT WM were enrolled into cohort 2. The median age was 72 years; 5 patients were treatment-naïve (TN) and 23 patients were relapsed/refractory (R/R; ≥1 prior therapy). Most patients had intermediate- (39.3%) or high-risk (42.9%) disease by International Prognostic Scoring System for WM. With the median follow-up of 17.9 months, 2 patients discontinued ZANU due to adverse events, and 6 patients experienced disease progression; there were no cases of disease transformation. The overall response rate was 80.8%, with a major response rate of 50.0%, including a very good partial response (VGPR) rate of 26.9% (Table). Progression-free survival event-free rate at 12 months was 72.4%. The most frequently reported adverse events (AEs) were diarrhea, anemia, contusion, pyrexia, and upper respiratory tract infection. Major hemorrhage was reported in 2 patients, and atrial fibrillation was reported in 1 patient. There were no fatal AEs. Conclusions: ZANU showed clinically meaningful antitumor activity, including achieving major responses and durability of responses, and was considered well-tolerated with a low discontinuation rate due to AEs, in patients with MYD88 WT WM. ZANU demonstrated efficacy regardless of MYD88 mutational status in WM. Clinical trial information: NCT03053440 . [Table: see text]
Therapeutic effectiveness at community and designated hospitals for extensive influenza A H1N1 outbreaks
Authors: Cun-zhi Lin, Jun Wang, Yan Qi
Journal: BMJ (2010)

It is purposed to analyze therapeutic effectiveness at community and designated hospitals for extensive influenza A H1N1 outbreaks at five universities in Qingdao,Shandong,east China during September 1 to 30,2009,including 28 confirmed cases,182 suspected cases and 136 close contacts treated at community health-care facilities,and 56 confirmed cases treated at designated hospitals.There was no significant difference in therapeutic effectiveness between community health-care facilities and designated hospitals (P ＞ 0.05).No new cases occurred seven days after their isolation was lifted for suspected cases and close contacts at community,indicating influenza A H1N1 could be prevented,controlled and cured and its mild cases could be treated at community health-care facilities.

Key words: 
Influenza A virus,H1N1 subtype;  Community health services
谷胱甘肽致过敏性休克一例
Authors: 张清格
Journal: BMJ (2006)

患者男,39岁,因反复纳差,乏力6个月,加重1周于2003年10月12日入院.查体:体温36.6℃,脉搏78 次/min,呼吸18次/min,血压120/78 mm Hg(1 mm Hg=0.133kPa),慢性肝病面容,皮肤、巩膜无黄染,肝掌阳性,心肺正常,腹软,肝脾肋下未及,肝区有叩击痛,腹水征阴性,双下肢无水肿.血清丙氨酸氨基转移酶(ALT)457 U/L,天冬氨酸氨基转移酶(AST)509U/L,总胆红素(TBIL)16.2 μmol/L,直接胆红素(DBIL)6 μmol/L,总蛋白(TP)74g/L,自蛋白(ALB)39g/L,HBsAg(+)、HBeAg(+)、抗-HBc(+);乙型肝炎病毒DNA 4.2×106拷贝/ml;抗甲型肝炎病毒IgM(-),抗丁型肝炎病毒IgM(-).腹部B超示肝内回声光点粗大。
Cutaneous pigmentary changes related to anticancer therapy in African Americans.
Authors: Dulce M. Barrios M.S, Sarah J. Noor, Mario E. Lacouture
Journal: Journal of Clinical Oncology (2020)

12074 Background: Pigmentary disorders are known to disproportionately affect individuals with darker skin, including African Americans (AAs)— a historically underrepresented population in oncology research. However, reports on the prevalence and characterization of anticancer-therapy related cutaneous pigmentary changes in this population are lacking. Methods: A retrospective analysis of AA cancer patients that ever received a hematopoietic stem cell transplantation (HSCT) and/or systemic oncologic therapy within six months prior to diagnosis of cutaneous hypo- or hyperpigmentation at our institution between 4/18/2012 and 8/26/2019 was conducted. Clinical and management characteristics were summarized; severity of pigmentary changes was assessed using the Common Terminology Criteria for Adverse Events version 5.0 (CTCAE v.5.0). Results: From a total of 1342 AA patients evaluated by oncodermatologists during the study period, 121 (9%) met inclusion criteria. Average age in this cohort was 52, and 102 (84%) were women. Breast (63, 52%), gastrointestinal (14, 12%), and hematologic malignancies (13, 11%) comprised the majority of cancer diagnoses. Most (93, 77%) patients had skin hyperpigmentation (84, 69%) or hypopigmentation (9, 7%) as a primary CTCAE diagnosis; the rest had secondary post-inflammatory hyperpigmentation (28, 23%). A higher proportion (105, 87%) of pigmentary alterations was attributed to single agents [i.e. chemo- (55, 46%), radiation (16, 13%), targeted (12, 10%), endocrine (9, 7%), and supportive oncologic (6, 5%) therapy] versus combination treatment (16, 13%). Five (4%) patients had graft versus host disease associated with allogeneic HSCT, four (80%) of which presented as cutaneous hypopigmentation. Hand foot syndrome (24, 20%), acneiform rash (24, 20%), and radiation dermatitis (16, 13%) were commonly diagnosed dermatologic adverse events (dAEs), generally classified as mild/grade 1 (67, 55%) in severity. For management, skin lightening agents +/- emollients (36, 30%) or emollients alone (25, 21%) were highly recommended. Topical corticosteroids +/- emollients were prescribed just as frequently as reassurance and/or avoidance of sun exposure (22, 18%). Conclusions: Cutaneous pigmentary changes related to cytotoxic chemotherapy, radiation and/or targeted oncologic therapy are common in AA cancer patients. Undertreatment of these dAEs, possibly due to under-recognition in darker skin, warrants further investigation to assess impact on quality of life and help improve management in this population.
Evidence for persistent radiation-related injury to the immune system in patients with local breast cancer.
Authors: Janhavi Athale, Kristen Broderick, Xiaojun Wu, Stuart A. Grossman
Journal: Journal of Clinical Oncology (2020)

e15189 Background: Clinical data in multiple tumors has demonstrated that the inadvertent radiation of circulating lymphocytes causes grade III-IV lymphopenia which is associated with worse outcomes in cancer patients and failure to respond to immunologic interventions. Murine data from our lab demonstrated that radiation to the brain results in striking changes in the anatomy and cellularity of distant unirradiated lymph nodes. This study was designed to understand the relationship between local radiation and the depletion of distant unirradiated lymph nodes in humans which has not been previously studied. Methods: Adult women with breast cancer who had undergone prior mastectomy with pathology, labs, and radiation data available at our institution were enrolled at the time of their deep inferior epigastric perforator artery (DIEP) flap reconstruction. During reconstruction, a single abdominal lymph node was extracted, and subsequently formalin fixed. The pre- and post-treatment lymph nodes of radiated and non-radiated patients were presented in a blinded manner to the hematopathologist. The pathologist described each lymph node and graded the lymph node density as (1) low, (2) low-normal, (3) normal, or (4) high. Results: Seven women have been enrolled (median age 50; range 31-55) with AJCC tumor stages from 1a – 3b (five are hormone positive, and two are triple negative). The reconstruction was completed on average 488.71 + 224.57 days after initial mastectomy. Three of the women received neoadjuvant chemotherapy, and five received adjuvant chemotherapy. Five of the seven women had received radiation (mean 50.9 + 5.6 Gy). The baseline median LN density score in all patients was 4 (range 1-4), with a post mean LN density of 1.2 + 0.4 in the radiation group compared to a mean score of 3 + 1.4 in the control group. Conclusions: Systemic lymphocyte counts remain relatively stable but lymph node density is markedly lower than baseline in 80% of patients who received chest wall irradiation consistent with data from animal model studies. It is important to note that this effect on the nodes is seen long after the radiation has been completed. [Table: see text]
Efficacy analysis of family-involved diabetic self-management
Authors: Chunyan Liu, Keming Wu, Jianbo Wang
Journal: BMJ (2015)

A total of 216 patients with type 2 diabetes mellitus and their family members were randomly divided into intervention and control groups. On the basis of conventional drug therapy, for intervention group, the patients and their family members were instructed to participate in health education activities and self-monitoring guidance. For control group, only patients were required to participate. The intervention continued for 12 months. Compared with control group, the intervention group significantly improved their living habits and the level of knowledge structure. The levels of low-density lipoprotein (LDL), 2 h postprandial blood glucose and glycated hemoglobin improved after intervening. And there were statistically significant differences (P<0.05). The family members of patients had more knowledge of identifying and dealing with low blood sugar while their knowledge of medication and regular monitoring was significantly better than that of control group. And there were statistically significant differences (P<0.05). Family-involved diabetic management is conducive for forming diabetic self-management behaviors.


Key words: 
Diabetes; Disease management, self care
Sex cord stromal and germ cell ovarian cancer: Is there a racial disparity?
Authors: Fatima Reyes, Rosa Guerra, Cheng-I Liao, Chris Argueta, Amandeep Kaur Mann, Mary Kathryn Abel, Daniel Stuart Kapp, John K. Chan
Journal: Journal of Clinical Oncology (2020)

e18056 Background: We proposed to determine the incidence and presentation of sex cord stromal and germ cell ovarian cancers in various racial groups. Methods: Data was obtained from the United States Cancer Statistics (USCS) and National Cancer Database (NCDB) databases between 2004 and 2016. Chi-squared tests were used for statistical analyses. Results: Of 8,917 women, 48.2% were diagnosed with sex cord stromal ovarian cancer, and 52.5% had germ cell ovarian cancer. White, Black, and Asian individuals comprised 72.5%, 19.8%, and 4.16% of the population, respectively. Of the sex cord stromal tumors, 84.1% were granulosa cell, 7.9% sertoli leydig, 1.8% steroid cell, and 6.2% "other" tumors. Of the germ cell tumors, 23.3% were immature teratoma, 19.6% dysgerminoma, 10.3% yolk sac, 8.3% mixed germ cell tumor, 0.1% embryonal carcinoma, and 38.3% "other" germ cell tumor histologies. Using the UCSC database, the age-adjusted incidence of sex cord stromal was 0.50 per 100,000 for Blacks compared to 0.23 for Whites and 0.14 for Asians. The incidence for germ cell tumors was 0.40 per 100,000 in Whites, 0.46 in Blacks, and 0.44 in Asians. Using NCDB data, the proportion of sex cord stromal tumor was 5.6% in Blacks compared to 1.5% in Whites and 1.55% in Asians, and the most common histology of sex cord stromal tumors was granulosa cell tumors in every racial group. The proportion of germ cell tumors was also higher in Blacks at 4.4% compared to 2.0% in Whites and 3.9% in Asians. Of germ cell tumors, the most common histology was dysgerminoma for Whites at 22.3% and immature teratoma in Blacks and Asians at 28.0% and 26.9%, respectively. Conclusions: Our data suggest that Black women are more likely to be diagnosed with sex cord stromal tumors compared to White and Asian women. Black and Asian women also had more germ cell cancer than White women.