tbuckley/cabot-search huggingface dataset:
Factors related to neonatal skin infection in community
Authors: Yanping Li, Fengli Song, We Shi, Jingzhi Chen, Lin Ma, Xiuhua Ma
Journal: BMJ (2018)

Total 1 452 newborns were home visited within 28 d after birth during January 2016 to December 2016, and 27 cases of skin infections were found. Umbilical inflammation was more common (11 cases), followed by folliculitis (9 cases) and impetigo (7 cases). Samples were collected for bacterial culture and identification from the skin of infected newborns, the hands and nasal cavity of family baby caretakers, and household articles, including faucets, mobile phones, toilet buttons and so on. The pathogens identified were Staphylococcus aureus in 20 cases (including 2 methicillin-resistant strains) and Escherichia coli in 7 cases. The isolation of Staphylococcus aureus in household articles was significantly correlated with newborns infected with Staphylococcus aureus (χ2=678.808, P<0.01); and the isolation of Staphylococcus aureus from family baby caretakers was also significantly associated with neonatal Staphylococcus aureus infection (χ2=820.396, P<0.01). In 7 cases of Escherichia coli infection, the Escherichia coli were detected from samples of baby caretakers or household articles. The study suggests that the awareness of baby caretakers and home hygiene are important to reduce neonatal skin infections.


Key words: 
Newborn; Skin infection; Family environment; Home care workers
Neoadjuvant chemotherapy plus surgery for high-risk advanced gastric cancer: Long-term results of KDOG1001 trial.
Authors: Kei Hosoda, Mizutomo Azuma, Chikatoshi Katada, Kenji Ishido, Masahiro Niihara, Hideki Ushiku, Mikiko Sakuraya, Marie Washio, Takuya Wada, Akinori Watanabe, Wasaburo Koizumi, Satoshi Tanabe, Keishi Yamashita, Naoki Hiki
Journal: Journal of Clinical Oncology (2020)

4521 Background: In the phase 2, open-label, KDOG1001 (UMIN000003642) study, neoadjuvant chemotherapy (NAC) with docetaxel, cisplatin, and S-1 (DCS), followed by gastrectomy with D2 lymph node dissection for high-risk advanced gastric cancer showed feasibility of DCS therapy with an enough R0 resection rate of 90%. Here we present long-term results after a minimum follow-up of 3 years. Methods: Patients with bulky node metastasis (bulky N), linitis plastica (type 4), or large ulcero-invasive-type tumors (type 3) received up to four 28-day cycles of DCS neoadjuvant chemotherapy (docetaxel at 40 mg/m 2 , cisplatin at 60 mg/m 2 on day 1, and S-1 at 40 mg/m 2 twice daily for 2 weeks) followed by gastrectomy with D2 lymphadenectomy. This analysis presents the final preplanned assessment of outcomes after 3 years. Primary endpoint was R0 resection rate. Secondary endpoints included overall survival (OS), progression free survival (PFS), completion rate of the protocol treatment, and pathological response rate (pRR) of DCS NAC. Results: Of 40 patients enrolled from May 2010 through January 2017, 7 (17.5%) had bulky N, 18 (45.0%) had type 4, and 16 (40%) had large type 3 with 1 (2.5%) having both large type 3 and bulky N2. All included patients underwent preoperative DCS chemotherapy followed by surgery with D2 lymphadenectomy with 32 (80%) completed postoperative S-1 therapy for 1 year. After a median follow-up for surviving patients of 67 mo (range, 36 mo to 110 mo) at the last follow-up in January 2020, 3-year OS was 78% [95% confidence interval (CI) 62–88%], while 3-year PFS was 63% (95% CI 47–76%). Completion rate of the protocol treatment was 62.5% (25/40) with pRR of 57.5% (23/40). In bulky N2, 3-y OS was 86% and 3-y PFS was 71% with pRR of 100%. In type 4, 3-y OS was 67% and 3-y PFS was 50% with pRR of 44%. In large type 3, 3-y OS was 88% and 3-y PFS was 75% with pRR of 56%. Patients with type 4 had significantly worse OS and PFS than those with the other types [HR 7.20 (95% CI 2.23–32.21) and HR 3.00 (95% CI 1.21–8.19)]. Conclusions: Preoperative chemotherapy with up to four cycles of DCS followed by gastrectomy plus adjuvant S-1 therapy is a promising treatment strategy for patients with bulky node metastasis, type 4 and large type 3 gastric cancers. For type 4 cancer, further improvement of treatment strategy is needed. Clinical trial information: 000003642 .
Phase I clinical trials as a therapeutic option for patients with metastatic renal cell carcinoma (mRCC).
Authors: Andrew W Hahn, Omar Alhalabi, Funda Meric-Bernstam, Aung Naing, Eric Jonasch, Pavlos Msaouel, Sarina Anne Piha-Paul, David S. Hong, Shubham Pant, Timothy A Yap, Erick Campbell, Hung Le, Nizar M. Tannir, Jason Roszik, Vivek Subbiah
Journal: Journal of Clinical Oncology (2020)

5073 Background: Immune checkpoint inhibitors, multi-kinase VEGF agents, and mTOR inhibitors are approved for mRCC. Due to the overlapping mechanisms of action of the twelve approved therapies for mRCC, select patients are referred for phase I clinical trials after progression on multiple lines of treatment. We sought to evaluate the efficacy of phase I trials in patients with mRCC. Methods: Patients with all histologies of mRCC were included if they received treatment on a phase I clinical trial at MD Anderson Cancer Center. Baseline clinical characteristics and outcomes data were retrospectively collected. The historical control was a study of 1112 patients with mRCC who received third-line treatment in the IMDC database (PMID: 27318422). Time to event endpoints were calculated using Kaplan-Meier methods. Hazard ratios (HR) were calculated using the Cox proportional hazard model. Results: Between 2014 and 2019, there were 106 cases where 82 patients with mRCC were enrolled in a phase I clinical trials (40 unique trials). 30% (32/108) of the cases were in patients with non-clear cell RCC (nccRCC), and the most prevalent nccRCC histologies were papillary (n = 7) and renal medullary carcinoma (n = 7). The median number of prior systemic therapies was 2 (range 0-9). Across the entire cohort, median PFS was 5.9 months (m), median OS was 31.2 m, and the ORR was 23% (Table). In patients who received at least two prior lines of therapy (n = 70), the median PFS was 4.8 m and median OS was 24.9 m. In patients with metastatic nccRCC, median OS, PFS, and ORR were numerically lower, but statistically did not contradict the supposition that these outcomes did not differ from ccRCC (Table). Conclusions: In the largest pooled phase I clinical trial experience for patients with mRCC, phase I trials may have therapeutic value when compared to historical controls, where median PFS was 3.9 m, median OS was 12.4 m, and ORR was 10.5%. Patients with all histologies of mRCC may derive clinical benefit from phase I clinical trials, yet patients with ccRCC had numerically better outcomes. Patients with mRCC should be considered for phase I clinical trials. [Table: see text]
一名外国糖尿病患者在社区卫生服务中心咨询引发的思考
Authors: 吕玉洁
Journal: BMJ (2009)

一天,门诊来了一位外国糖尿病患者,不懂也不会说中文,用英语寻求帮助.经过我中国式的英语交流,了解了他的就诊目的:他来自德国,在中国短期停留,患有糖尿病,担心在外发生低血糖,所以专门在住所附近寻找到社区卫生服务机构,请求帮助把英文的糖尿病患者信息急救卡翻译成中文的,以便在外出现低血糖时能够得到他人的帮助,他随身携带了片剂的葡萄糖。
Analysis of prescriptions for eradication of Helicobacter pylori in community health service centers of Shanghai Jing′an district
Authors: Xiaojian Zhu, Pei Zhang, Chunrong Tian
Journal: BMJ (2017)

A total of 8 099 outpatient prescriptions for treatment of Helicobacter pylori (Hp) infection in 9 community health service centers of Shanghai Jing′an district were collected from the regional health information platform. The prescriptions were reviewed and analyzed according to the criteria of the Forth National Consensus Report on the Treatment of Helicobacter pylori Infection. The results showed that only 195 prescriptions met the criteria (2.4%). For those not meeting the criteria, 611 prescriptions (7.5%) gave the right therapeutic protocol but incorrect treatment course; 6 893 prescriptions (85.1%) gave the incorrect protocol. It is suggested that incorrect treatment for Hp eradication is common in community health service centers consist in the Helicobacter pylori therapy prescriptions in the community health service cente in Shanghai, Jing′an District, which should be paid more attention to.


Key words: 
Helicobacter pylori; Prescriptions; Hospitals, community
Advance in first aid and treatment of drowning
Authors: Jiefeng Xu, Ya Fang, Mao Zhang
Journal: BMJ (2018)

Drowning is a major life-threatening public health problem, particularly for children and adolescents. The prevention, early rescue and intensive care of drowning patients are important aspects of drowning management. This article reviews the recent advances in the first aid and treatment of drowning patients.


Key words: 
Drowning; Resuscitation; Treatment
胸腔镜辅助小切口治疗自发性气胸42例临床分析
Authors: 卢勇, 郭喜平, 丁卫忠, 杨鹏, 张玉辉, 崔海哲, 冷维刚
Journal: BMJ (2007)

对42例自发性气胸患者行胸腔镜辅助小切口肺大疱切除术,其中左侧19例,右侧23例.42例手术顺利,手术时间30～85 min,平均42.5 min,术后48～72 h拔出胸腔引流管,住院时间5～8 d,平均5.8 d,平均住院费用8300元,无手术并发症发生.术后随访5～20个月,无复发.提示,胸腔镜辅助小切口治疗自发性气胸具有创伤小、恢复快、痛苦小、手术费用低等优点,易于在基层医院推广。
Associating liver partition and portal vein ligation for staged hepatectomy versus portal vein embolization in staged hepatectomy for hepatocellular carcinoma: A randomized comparative study.
Authors: Gang Huang
Journal: Journal of Clinical Oncology (2020)

4578 Background: Both Portal Vein Embolization (PVE) and Associating Liver Partition and Portal vein ligation for Staged hepatectomy (ALPPS) have been used in patients with unresectable hepatocellular carcinoma (HCC) due to insufficient volumes in future liver remnant (FLR). But it remains unclear for which thetapy has better long-term overall survival. Methods: This study was a single-center, prospective randomized comparative study. Patients were randomly assigned in a 1:1 ratio to the 2 groups. The primary endpoints was three-year overall survival rates. Results: Between November 2014 to June 2016, 76 patients with unresectable HCC due to inadequate volume of FLR were randomly assigned to ALPPS groups (n = 38) and PVE groups (n = 38). Thirty-seven patients (97.4%) in the ALPPS Group compared with 25 patients (65.8%) in the PVE Group were able to undergo staged hepatectomy (risk ratio 1.48, 95% CI 1.17-1.87, p &lt; 0.001). The three-year overall survival (OS) rate of the ALPPS group (65.8%) (95% CI 50.7-80.9) was significantly better than the PVE Group (42.1%) (95% CI 26.4-57.8), (HR 0.50, 95% CI 0.26-0.98, two-sided p = 0.036). Major postoperative complications rates after the stage-2 hepatectomy were 54.1% in the ALPPS group and 20.0% in the PVE group ((risk ratio 2.70, 95% CI 1.17-6.25, p = 0.007). Conclusions: ALPPS resulted in significantly better long-term overall survival outcomes, at the expenses of a significantly higher perioperative morbidity rate compared with PVE in patients who had initially unresectable HCC. Clinical trial information: ChiCTR-IOC-14005646 .
Identification of transgender people with cancer in electronic health records (EHR): Recommendations based on CancerLinQ observations.
Authors: Ash Alpert, Suanna S. Bruinooge, Don S. Dizon, Becky Koronkowski, Elizabeth Garrett-Mayer, Stephen C. Meersman, Robert S. Miller, Danielle Potter, George Anthony Komatsoulis
Journal: Journal of Clinical Oncology (2020)

e19046 Background: Data regarding people who are gender minorities are not well-captured in oncology practices or large cohorts. Given this, collection of cancer prevalence and outcomes data, which are necessary to understand disparities in this population, are significantly hampered. Real-world data may be the most readily available source to explore outcomes in transgender populations. A database of EHR data on people with cancer, CancerLinQ is housed by the American Society of Clinical Oncology and collected from nation-wide practices and multiple EHRs. Methods: In order to identify people with cancer who may be transgender within CancerLinQ, we used three criteria: 1. ICD 9/10 diagnosis (Dx) code indicating likely transgender or non-binary gender conforming status 2. Male gender and Dx of cervical, endometrial, ovarian, or Fallopian tube cancers 3. Female gender and Dx of prostate, testicular, or penile cancers . We reviewed medical records for gender, cancer diagnosis, Dx indicating transgender identity and surgical history of transition-related surgeries, in other words surgeries that align bodies with identities and constructed a de-identified dataset of people who met one of the three criteria listed above. People without evidence of transgender identity were assigned as: (1) likely Dx error, because the person had either (a) no cancer, (b) an alternate cancer Dx consistent with sex assigned at birth, or (c) a cancer not listed in the above criteria (e.g. lung); or (2) likely error in gender data, if the cancer Dx was confirmed, but gender data was not; or (3) unknown. Results: Of ~1.3 million records in CancerLinQ at time of case selection, 557 matched inclusion criteria and 242 were abstracted. 76% of patients with ICD9/10 gender related Dx codes had evidence confirming transgender identity. By contrast, only 2% and 3% of the people identified by criteria 2 and 3 had evidence of transgender identity, respectively. Conclusions: Given the need for data regarding transgender people with cancer and the deficiencies of current data resources, a national concerted effort is needed to broaden terminology in EHRs to include whether people are transgender or not as routine and required data elements, provided by patients at their discretion. [Table: see text]
院前急救的四项基本原则
Authors: 冯庚
Journal: BMJ (2009)

对突发的危重症患者实施院前急救是急诊医学中一门较新的、正在发展和不断完善的分支,其重要性不言而喻,许多患者突发急症后在到达医院前已经死亡或濒临死亡,其中最重要的原因之一就是没有得到及时正确的院前急救。
Pembrolizumab and concurrent radiation is an effective regimen for muscle invasive bladder cancer.
Authors: Niraj K. Gupta, Chad A. Reichard, Michael Large, Christopher A. Leagre, Kenneth Ney, Robert H. Liebross, John Ramsey, Thomas Dugan, Vasu Tumati, Rina Yadav, Patrick Heckman, Rachelle Tutterrow, Kristen Schmidt
Journal: Journal of Clinical Oncology (2020)

e17020 Background: Neo-adjuvant chemotherapy with Gemcitabine and Cisplatin followed by radical cystectomy is the standard of care in muscle invasive bladder ca. Some patients, usually older patients or those with poor PS with bladder ca are either cisplatin in-eligble or medically unfit for radical cystectomy. We share our experience using a combination of Pembrozulimab and concurrent radiation in cisplatin in-eligible patients with muscle invasive bladder cancer. Methods: Patients with muscle invasive bladder ca underwent TURBT followed by treatment with Pembrolizumab 200 mg IV every three weeks for 4 cycles concurrent with radiation treatments. Radiation treatments were started 1 week after starting pembrolizumab. A total of 64-65 Gy was given to the bladder and pelvis. All patients underwent a cystoscopy to assess local response and imaging studies to rule out distant metastases. Results: Between June 2018 and October 2019, 9 patients with locally advanced, cT2-cT4 urothelial ca were treated. Male to female ratio 7 to 2. Median age was 76 years, range was 71-90. Reasons were not using cisplatin were, renal-insufficiency, 7 pts. and pt refusal in 2 pts. ECOG PS was 1 in 6 patients and 2 in 3 pts. All patients finished radiation treatments. All but one patient finished 4 cycles of pembrolizumab. One patient declined the last dose. Grade-3/4 I/O inhibitor AEs were seen in 2 patients, One had pneumonitis and other had elevation of LFTs. None of the patients was found to have distant mets on the scans done after 4 cycles of Pembrolizumab. A complete response, by cystoscopy (histology/cytology) was seen in 7/9 (77%) of the patients. The other 2 pts. with PR declined cystectomy and have continued on immunotherapy without any evidence of progression. Conclusions: A combination of Pembrolizumab concurrent with radiation treatments is an effective option and can be safely administered in cT2-T4 bladder cancer. It is an attractive option for cis-ineligible patients. The feasibility and efficacy of this combination needs to be further explored in larger studies
Clinical and imaging findings of staphylococcal pneumonia induced by intravenous injection of heroin
Authors: 陈忠, 练旭辉, 姚慧文, 陈键腾, 叶文钦, 王晓波
Journal: BMJ (2005)

目的 探讨静脉注射海洛因致继发性金黄色葡萄球菌肺炎的临床和影像学表现特点.方法 16例25～45岁男性,均有不洁注射海洛因史,均具有急性肺部感染的症状和体征,身体其他部位均未查及感染灶,白细胞均高于正常,全部病例做X线胸片,5例加做螺旋CT.以回顾性分析方法分析资料.结果全部患者尿海洛因试验呈阳性,血培养均有金黄色葡萄球菌生长.影像学发现肺实变12例,肺气囊12例,空洞6例,胸膜病变6例,多有2种以上影像学表现同时存在.并发右心内膜炎4例,病毒性肝炎5例,贫血5例.结论本组病例临床和影像学表现与非吸毒性继发性金黄色葡萄球菌肺炎相似,但身体其他部位无感染灶,合并症较多,肺气囊较多见。
尿毒症并发带状疱疹16例临床分析
Authors: 张春英, 王晓丹
Journal: BMJ (2011)

带状疱疹是水痘-带状疱疹病毒引起的侵犯皮肤和神经的急性疱疹性皮肤病.尿毒症患者因其自身免疫力低下,容易并发带状疱疹,疼痛明显,病情复杂,治疗困难.本院门诊曾治疗16例尿毒症血液透析并发带状疱疹病例,报告如下。
A preclinical model for skin sensitization prediction of antineoplasic drugs.
Authors: Jose Alejandro Perez-Fidalgo, Paula Montero Magallo, Ines Roger Laparra, Pilar Ribera Alba, Jesus Poveda Ferriols, Javier Milara Paya, Andres Cervantes, Julio Cortijo Gimeno
Journal: Journal of Clinical Oncology (2020)

e15643 Background: Skin side effects are common manifestations of antineoplastic drugs that are frequently observed in early clinical trials. Therefore, there is a need to identify skin toxic agents before clinical development in order to predict severe skin manifestations. In many cases, skin toxicity is due to sensitization, a key immunologic process mediating redness, swelling and itching that can lead to more severe skin alterations. Methods: We adapted three skin cellular in vitro techniques for cutaneous drug sensitization assessment of the Organization for Economic Cooperation and Development (OECD, 2012) in order to predict antineoplastic drug skin sensitization: 1) Direct peptide reactivity assay (DPRA) was assessed by high performance liquid chromatography (HPLC) coupled to ultraviolet detector, to detect covalent binding of antineoplastic to skin proteins (haptenation). 2) KeratinoSense skin sensitization assay was evaluated in keratinocyte cell line (HaCaT) transfected with a selectable plasmid to quantify luciferase gene induction by chemiluminescence as a measure of activation of Keap1-Nrf2-antioxidant response element involved in the cellular processes in skin sensitization and 3) The human cell line activation test (h-CLAT) represents the activation of dendritic cells by the increase of CD86 and CD54 surface markers measured by flow cytometry. An antineoplastic was considered sensitizing when at least two of these three tests were positive. Antineoplastic tested were paclitaxel, erlotinib, imatinib, sunitinib, cetuximab, olaparib, palbociclib and everolimus. Results: Paclitaxel was positive for all the three tests; the DPRA formation, keratinoSense activation and h-CLAT expression showing the highest level of sensitization. Moreover sunitinib, and imatinib were positive for two of the three in vitro cellular tests, being considered sensitizing drugs. In contrast, erlotinib, cetuximab, olaparib, palbociclib and everolimus were considered non-sensitizing antineoplastic agents. In the case of erlotinib a high proportion of apoptosis of the keratinocytes during the keratinosense test was observed, suggesting that cutaneous toxicity could be due to cytolysis instead of sensitization. Conclusions: Results obtained in this work suggest that pre-clinical assays may predict skin sensitization and be of potential value to predict skin sensitization of antineoplastic drugs before clinical development. Further assessment with in vivo tests will help to identify the cutaneous toxic mechanisms of those non-sensitizing drugs as cetuximab
A case report of lung cancer presenting as interstitial pneumonia and a review of literatures
Authors: Youchao Yu
Journal: BMJ (2014)

A case of lung adenocarcinoma was reviewed. Its major symptoms were cough, sputum and progressive dyspnea. High resolution computed tomography presented ground-glass, bilateral fibrosis and some solid opacities. In conjunctions with the related literatures, its clinical manifestations and imaging features were analyzed for a better understanding of lung cancer.


Key words: 
Lung neoplasms; Diagnostic imaging
Plasma N-terminal probrain natriuretic peptides and serum cystatin C in patients with chronic heart failure and their significance
Authors: Zhong-bao Ruan, Li Zhu, Yi-gang Yin, Ru-zhu Wang, Yin Ren, Ge-cai Chen, Ming Chen
Journal: BMJ (2011)

Objective To evaluate and analyze relationship of plasma level of N-terminal probrain natriuretic peptides (NT-proBNP) and serum level of cystatin C (CysC) with cardiac and renal functions in patients with chronic heart failure (CHF) , and explore significance of CysC measurement in early diagnosis for renal damage in patients with CHF. Methods Totally, 162 patients with CHF and 150 normal healthy (controls) undergone routine physical check-up at, Taizhou People's Hospital, Jiangsu were enrolled in the study. Their plasma level of NT-proBNP and serum level of CysC, as well as serum levels of creatinine ( SCr) , urea nitrogen ( BUN) were measured and echocardiography was performed. Glomerular filtration rate (eGFR) was evaluated by modification of diet in renal disease (MDRD) study group formula. Results Compared with the control group, blood levels of NT-proBNP, CysC, SCr, BUN and left ventricular end diastolic diameter ( LVEDD) all elevated, both eGFR and left ventricular ejection fraction ( LVEF) decreased (P <0. 05 or P <0. 01 ) in CHF group, and CHF patients were prone to complicate with renal dysfunction (P<0. 01). Blood levels of NT-proBNP and CysC elevated significantly and LVEF lowered significantly in CHF patients with NYHA functional classes II , III and IV than those in control group. There was significant difference in blood levels of NT-proBNP and CysC between patients with varied NYHA functional classes (P<0. 05). Blood levels of NT-proBNP and CysC reversely correlated with LVEF (r = -0. 36, P < 0. 01 and r = - 0. 39, P < 0. 01) . Blood level of CysC correlated with that of NT-proBNP ( r = 0. 87 , P < 0. 01). Results of logistic regression analysis showed that elevated blood levels of NT-proBNP and CysC were risk factors for mortality during hospitalization in patients with CHF. Conclusions Patients with CHF were more likely to complicate with renal dysfunction than controls, with main manifestations of more severe damaged eGFR, more severe heart failure and more obviously renal damage. Blood levels of NT-proBNP and CysC can be used as indicators for evaluating exacerbation of chronic condition, and serumlevel of CysC can be used as marker for early diagnosing renal damage in patients with CHF.

Key words: 
Heart failure, congestive;  Natriuretic peptides, brain;  Cystatin C
β-cell function of subjects with 1-hour hyperglycemia in oral glucose tolerance test
Authors: Jing Guan, Ying Yang, Xian-cheng Liu
Journal: BMJ (2011)

Based on the results of oral glucose tolerance test( OGTT )and the levels of 1-h plasma glucose ( 1 hPG),793 subjects were classified into three groups:583 with NGTN ( normal 1 hPG in OGTT),127 with NGT1 H( higher 1 hPG in OGTT) and 83 with IGT( impaired glucose tolerance).NGT1H group had large waist circumference,higher body mass index,fasting plasma glucose( FPG),triglyceride,and lower high density lipoprotein-cholesterol than those of NGTN group.NGT1 H group had higher homeostasis model assessment insulin index ( 1.2 ± 0.6),lower homeostasis model assessment β3 ( HOMA-β ) (4.5 ± 0.7 ) and insulinogenic index (2.1 ±0.7) than those of NGTN group(0.5 ±0.6,4.8 ±0.7,2.7 ±0.9,respectively,all P ＜0.05 ).HOMA-β of NGT1 H group was higher than that of IGT group(4.5 ±0.7 vs.4.4 ±0.6,P ＜0.05 ).The results indicate that 1 hPG in OGTT may identify a condition of glucose metabolic abnormalities characterized by insulin resistance and reduced β-cell function.

Key words: 
Glucose metabolism disorders;  pancreatic β-cell function