tbuckley/cabot-search huggingface dataset:
Hospitalization and Mortality among Black Patients and White Patients with Covid-19
Authors: Eboni G Price-Haywood, Jeffrey Burton, Daniel Fort, Leonardo Seoane
Journal: New England Journal of Medicine (2020)

BackgroundMany reports on coronavirus disease 2019 (Covid-19) have highlighted age- and sex-related differences in health outcomes. More information is needed about racial and ethnic differences in outcomes from Covid-19.MethodsIn this retrospective cohort study, we analyzed data from patients seen within an integrated-delivery health system (Ochsner Health) in Louisiana between March 1 and April 11, 2020, who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, the virus that causes Covid-19) on qualitative polymerase-chain-reaction assay. The Ochsner Health population is 31% black non-Hispanic and 65% white non-Hispanic. The primary outcomes were hospitalization and in-hospital death.ResultsA total of 3626 patients tested positive, of whom 145 were excluded (84 had missing data on race or ethnic group, 9 were Hispanic, and 52 were Asian or of another race or ethnic group). Of the 3481 Covid-19–positive patients included in our analyses, 60.0% were female, 70.4% were black non-Hispanic, and 29.6% were white non-Hispanic. Black patients had higher prevalences of obesity, diabetes, hypertension, and chronic kidney disease than white patients. A total of 39.7% of Covid-19–positive patients (1382 patients) were hospitalized, 76.9% of whom were black. In multivariable analyses, black race, increasing age, a higher score on the Charlson Comorbidity Index (indicating a greater burden of illness), public insurance (Medicare or Medicaid), residence in a low-income area, and obesity were associated with increased odds of hospital admission. Among the 326 patients who died from Covid-19, 70.6% were black. In adjusted time-to-event analyses, variables that were associated with higher in-hospital mortality were increasing age and presentation with an elevated respiratory rate; elevated levels of venous lactate, creatinine, or procalcitonin; or low platelet or lymphocyte counts. However, black race was not independently associated with higher mortality (hazard ratio for death vs. white race, 0.89; 95% confidence interval, 0.68 to 1.17).ConclusionsIn a large cohort in Louisiana, 76.9% of the patients who were hospitalized with Covid-19 and 70.6% of those who died were black, whereas blacks comprise only 31% of the Ochsner Health population. Black race was not associated with higher in-hospital mortality than white race, after adjustment for differences in sociodemographic and clinical characteristics on admission.
Expression of estrogen receptor in entopic and ectopic endometrium of abdominal wall endometriosis
Authors: Yu-tun Hao, Xue-ling Liu, Li-hua Pei
Journal: BMJ (2009)

Fifty-six patients with abdominal wall endometriosis(AWE)were assigned into the proliferous group or the secretory group and the expression of estrogen receptor(ER)in the entopie,ectopic and normal endometrium was investigated.In the proliferous group,the positive ER expression rate on the entopie endometrium(85%)was significantly higher than that on the normal(60%)or ectopie endometrium (58%)(P<0.05).In the secretory group,the positive ER expression rate on the eetopie endometrium (57%)was significantly higher than that on the entopic (26%) or normal endometrium(25%)(P< 0.05).There was significant difference in the entopie and normal endometriilm between the two groups (P<0.01):however,there was no significant diffeFence in the ectopic endometrium.Abnormal ER expression on the entopic or ectopic endometrium may play a role in the pathogenesis of AWE.

Key words: 
Receptors,estrogen;  Endometriosis
Effects of blood-lipid report's reformat on outpatients' behavior and knowledge of dyslipidemia therapy
Authors: Hong Jiang, Jia-hui Li, Yuan-nan Ke
Journal: BMJ (2012)

Objective To evaluate the effects of blood-lipid report's reformat on outpatients' behavior and knowledge of dyslipidemia therapy.Methods The blood-lipid report was reformatted by adding three tables from the Chinese Guideline on the Prevention and Treatment of Adult Dyslipidemia on its back.The same questionnaire was used twice to evaluate the patients' behavior and knowledge of dyslipidemia therapy before and after reformat.Results Before and after reformat,the rates of correct deterination of their own risk stratification were 26.0％ ( 112/430 ) and 26.3％ ( 115/438 ) respectively.The awareness rates of Different LDL-C goals among different persons wcre 37.0％ (159/430) and 35.8％ (157/438).Only 0.7％ (2/306) and 1.0％ (3/299) of patients knew their blood lipid goals (P =0.557).When the report showed normal blood lipid levels,the percentages of taking lipid-lowering drug were 47.6％ ( 230/483 ) and 46.6％ ( 216/464 ),20.5％ ( 99/483 ) and 19.0％ ( 88/464 ) of patients questioned the prescription.Non-medication rates were 31.9％ ( 154/483 ) and 34.5％ ( 160/464 ) respectively before and after reformat ( P ＞ 0.05 ).For patients requiting lipid-lowering drug therapy by the guideline,treatment rate improved significantly in the low-risk group (13.3％ vs.75.0％,P =0.002).Treatment rate slightly increased in the high-risk and very high-risk groups after reformat (54.0％ vs.56.8％,62.4％ vs.69.0％,P ＞ 0.05 ).Rates of achieving lipid goal showed no change [ 41.5％ ( 102/ 245 ) vs.44.5％ ( 114/256 ),P ＞ 0.05 ] after reformat,especially among the very high-risk patients [17.9％(12/68) vs.21.6％(11/52),P＞0.05].Conclusions The blood-lipid report reformat did not improve the patient behaviors and knowledge of the prevention and treatment of dyslipidemia because of poor treatment rate and medication compliance.The combination of patient education and thorough blood-lipid report reformat may help to increase the attainment rate of dyslipidemia therapy.

Key words: 
Dyslipidemias; Health knowledge,attitudes, practice; Questionnaires
Emerging oncology drug targets in the 21st century: An FDA analysis.
Authors: Emma C. Scott, Yutao Gong, Ashim Subedee, Dickran Kazandjian, Richard Pazdur, V. Ashutosh Rao, Julia A. Beaver, Julie A. Schneider
Journal: Journal of Clinical Oncology (2020)

e14067 Background: Traditional chemotherapy agents are cytotoxic and typically act on all rapidly dividing cells. In contrast, targeted cancer therapies take advantage of unique genetic or proteomic susceptibility in cancer cells, their microenvironment, or the immune system to selectively target tumor tissue or stimulate immune activity. We catalogued oncology drug approvals in the U.S. in the 21 st century to study the evolution of molecular targets over the last twenty years. Methods: We used internal FDA databases and data repositories to generate a dataset of all oncology approvals granted 1/1/2000-12/31/2019. This dataset was curated through a comprehensive survey of drug labels, drug reviews, and published literature to include target gene(s), mechanism of action, drug class, and approved indications for each drug. Approvals were grouped into five-year periods for trend analyses. Results: There has been an increase in the number of oncology approvals over the last twenty years, the vast majority of which are targeted therapies. There have been considerable recent advances in some disease sites. Three disease sites (ovary, bladder, and liver) had many approvals in the last five years after few to none 2000-2014; lung cancer and melanoma have seen substantial advances in the last ten years. Additionally, the first site-agnostic approvals occurred in the last five years. Kinase inhibitors are the most common drug class by both number of drugs and indications. Immune checkpoint inhibitors (ICI) are the second most common class by number of indications, despite having only entered the market in 2011 and being the sixth most common class by number of drugs. The target gene PD-1 has the highest number of approved indications, followed by EGFR and the BCR-ABL fusion gene. The number of novel genes targeted by drugs approved in 2010-2019 is nearly double that of 2000-2009, with the most novel gene targets in 2019 (n = 7). Conclusions: This analysis captures the landscape of targeted drug approvals in the 21 st century, including the continued dominance of kinase inhibitors despite the dramatic impact of ICIs on cancer care since their introduction in 2011. The promise of targeted therapy in oncology is especially evident from the introduction of site-agnostic indications, new approvals in cancer types with limited therapy options, and ICIs with many indications due to targeting tumors indirectly via the immune system. The continual introduction of novel gene targets provides a snapshot of ongoing novel drug development, and it will be interesting to see whether this trend continues over the next twenty years.
Periodontal diseases in patients with diabetes
Authors: Ying Xie, Fei Li
Journal: BMJ (2018)

牙周病被认为是糖尿病的一个重要并发症，是牙齿支持组织的慢性感染性破坏性疾病，反过来也会加重糖尿病。因此，应该重视糖尿病患者牙周病的诊治，清除牙周感染因素，控制牙周疾病，促进患者糖尿病的控制。
Loading of metal isotope-containing intercalators for mass cytometry-based high-throughput quantitation of exosome uptake at the single-cell level
Authors: Jinheng Wang, Chenggong Tu, Hui Zhang, Jian Zhang, Yueyuan Feng, Yangyang Deng, Yongliang Huo, Maobin Xie, Bin Yang, Miao Zhou, Jinbao Liu
Journal: Biomaterials (2020)
急性肺血栓栓塞症一例
Authors: 李光
Journal: BMJ (2007)

患者男,42岁,以突发胸痛,伴呼吸困难、气急1 d为主诉于2006年8月17日入院.患者1 d前夜间睡眠时突发胸痛,以左侧为重,伴呼吸困难、气急,咳痰带血丝.既往20 d前因车祸脾破裂行脾切除术,5 d前出现左小腿痛.查体:心率105次/min,呼吸20次/min,血压60/40 mm Hg(1 mm Hg=0.133 kPa),口唇略发绀,左下肺呼吸音略弱,双肺未闻及干湿啰音,心音有力,律齐,未闻及病理性杂音。
Hypothyroidism and its impact on outcomes in head and neck cancer.
Authors: Sujay Srinivas, Vanita Noronha, Vijay Maruti Patil, Amit Joshi, Nandini Sharrel Menon, Kumar Prabhash
Journal: Journal of Clinical Oncology (2020)

e24066 Background: Hypothyroidism is a known late side effect of chemo-radiation in head and neck cancer. Hypothyroidism has been known to be associated with improved outcomes in renal cell carcinoma. Whether such a phenomenon exists in head and neck cancer is unknown. Methods: We performed a phase 3 study evaluating the role of Nimotuzumab in head and neck squamous cell cancers (HNSCC). In this study adult HNSCC patients treated with Cisplatin and radiation were randomly assigned to receive Nimotuzumab or not. The data of this study has been utilized for this analysis. Hypothyroidism was defined as TSH level more than 4.95 U/L. The cumulative incidence of hypothyroidism and its impact on PFS (progression free survival), OS (overall survival) and loco-regional control (LRC) was evaluated using binary regression analysis. To study the impact of hypothyroidism in outcomes a landmark analysis was performed. Results: 176/536 patients analyzed developed hypothyroidism with a cumulative incidence of 33%. Hypothyroidism showed a favorable impact on PFS, OS and LRC. Median PFS was 19.5 months while median OS was 22.2 months in the euthyroid subgroup vs not reached (NR) for both in the hypothyroid subgroup. The respective hazard rates (HR) for PFS and OS was 0.37 (95% CI: 0.27 - 0.52) and 0.15 (95% CI: 0.11 - 0.23). The LRC was also better with its median duration being 39.2 months vs NR in the euthyroid and hypothyroid subgroups respectively; HR for LRC being 0.40 (95% CI: 0.28 - 0.58). Conclusions: Thus development of hypothyroidism is associated with improved outcomes in HNSCC in terms of LRC and survival.
Risk of cardiovascular disease in women with and without a history of breast cancer: The Pathways Heart Study.
Authors: Heather Greenlee, Carlos Iribarren, Romain Neugebauer, Jamal S Rana, Mai Nguyen-Huynh, Richard Cheng, Zaixing Shi, Monika Izano, Cecile Laurent, Valerie S. Lee, Janise M. Roh, Hanjie Shen, Margarita Santiago-Torres, Dawn L. Hershman, Lawrence H. Kushi, Marilyn L. Kwan
Journal: Journal of Clinical Oncology (2020)

12016 Background: Breast cancer (BC) survivors are at increased risk of cardiovascular disease (CVD) following diagnosis, as compared to women without BC. To provide a population-based estimate of CVD risk in BC survivors, we compared risk of CVD events in women with and without BC history enrolled in the Kaiser Permanente Northern California (KPNC) integrated health system. Methods: Data were extracted from KPNC electronic health records. All invasive BC cases diagnosed between 2005-2013 were identified and matched 1:5 with non-BC controls on birth year, race/ethnicity and KPNC membership at date of BC diagnosis. Cox regression models were used to assess differences in the hazard of four major CVD events (ischemic heart disease (IHD), heart failure (HF), cardiomyopathy, and stroke). Models were adjusted for factors known to influence risk of breast cancer or CVD.Other CVD events included arrhythmia, cardiac arrest, carotid disease, myocarditis/pericarditis, transient ischemic attack, valvular disease, and venous thromboembolism (VTE). We additionally examined subgroups of cases who received chemotherapy, radiation, and endocrine therapy, and their controls. Results: A total of 14,942 women with a new diagnosis of invasive BC were identified and matched to 74,702 women without BC history. On average, women were 62.0 years, 28.3 kg/m 2 BMI, 64.9% non-Hispanic white. Among all cases and controls, there were no significant differences in hazard of developing IHD, cardiomyopathy, and stroke; there was a borderline difference in HF (HR: 1.08, 95% CI: 0.99, 1.19). Cases were more likely to have a cardiac arrest (HR: 1.39, 95% CI: 1.09, 1.78) and develop VTE (HR: 1.97, 95% CI: 1.74, 2.23). Women treated with chemotherapy were more likely than controls to develop HF (HR: 1.44, 95% CI: 1.21, 1.72), cardiomyopathy (HR: 2.01, 95% CI: 1.02, 3.98), and VTE (HR: 3.15, 95% CI: 2.62, 3.79). Women who received radiation therapy were more likely to develop carotid disease (HR: 5.49, 95% CI: 1.22, 24.66) and VTE (HR: 1.65, 95% CI: 1.35, 2.03) than controls. Women who received endocrine therapy were more likely to experience a cardiac arrest (HR: 1.49, 95% CI: 1.07, 2.09) and develop VTE (HR: 1.70, 95% CI: 1.42, 2.03) than controls. Conclusions: Women with BC were at increased risk of heart failure, cardiomyopathy, cardiac arrest, VTE and carotid disease. These risks varied by cancer treatment, with higher risk in those who received chemotherapy. Future studies should explore the effects of chemotherapy class and radiation dose exposure on diverse CVD endpoints in BC survivors.
Effects of removing heat and phlegm prescription on the proliferation and autoantigens expression of esophageal carcinoma cell.
Authors: Fuchun Si
Journal: Journal of Clinical Oncology (2020)

e16510 Background: o explore the effects of removing heat and phlegm prescription (RHPP) on the proliferation and autoantigens expression of esophageal carcinoma(EC) cell, so as to provide basis for the molecular pathogenesis and clinical medication of EC. Methods: RHPP was developed by us for treating EC, EC autoantigens CK13, CK16, CaD, ACTG2 were identified in our previous studies. The effects of RHPP and and its ethanol extraction on the proliferation, cell cycle and autoantigen protein expression of Eca109 cell, EC9706 cell and TE-1 cell were investigated by MTT assay, flow cytometry and western blot analysis. Results: RHPP and its removing heat (RH) and removing phlegm (RP) separated prescriptions all have inhibitory effects on the proliferation of EC9706, EC109 and TE-1 cells in dose-dependent and time-dependent manner, changed morphology of four esophageal carcinoma cells, which appeared as round with rough edges, karyopyknosis, and karyorrhexis. Ic50 values of RHPP for Ec9706, Eca109 and TE1 cell were 33.31 ug·ml −1 , 20.70 ug·ml −1 , 21.93 ug·ml −1 respectively, while Ic50 values of RHPP’s ethanol extraction for Ec9706, Eca109, TE1 were 0.653 ug·ml −1 , 0.082 ug·ml −1 , 0.172 ug·ml −1 respectively. RHPP and RP induced G2/M phase arrest in EC109 and TE-1 cells, while RH induced G0/G1 phase arrest in EC109 and TE-1 cells; RHPP and RP induced G0/G1 phase arrest in EC9706 cells, while RH induced S phase arrest in EC9706 cells. RHPP and its two separated prescription could downregulate CK16, CaD, ACTG2 expression and upregulate CK13 expression. Conclusions: Autoantigens CK13, CK16, CaD and ACTG2 were expressed in EC cell, RHPP could regulate these four autoantigens expression. This study provides new basis for the EC mlecular mechanism and development of anti-esophageal carcinoma drugs in traditional Chinese medicine.
系统性红斑狼疮合并弥漫性出血性肺泡炎及急性横贯性脊髓炎一例
Authors: 李忱, 马丽, 王丽英, 吴东海
Journal: BMJ (2006)

报告1例临床少见的系统性红斑狼疮合并弥漫性出血性肺泡炎及急性横贯性脊髓炎病例,提示早期诊断,联合应用激素、免疫抑制剂、免疫球蛋白及鞘内注射,能够有效的控制病情.并检索复习国内、外相关文献,讨论其并发症的临床表现、诊断、治疗与预后,以提高临床医生对其的认识。
围手术期静脉血栓栓塞症的防治
Authors: 王乐民
Journal: BMJ (2006)

肺栓塞(pulmonary embolism,PE)是指全身静脉系统内的栓子脱落后堵塞肺血管床,其中99%的栓子是血栓性质的,也称为肺动脉血栓栓塞症(pulmonary thromboembolism,PTE),简称为PE.围手术期发生的PE在外科已屡见不鲜,重者发生猝死,由此引发不少医疗纠纷.PE的发生与深静脉血栓形成(deep venous thrombosis,DVT)直接关联,后者发生隐匿,常常在毫无察觉中血栓已脱落并随血液回流堵塞肺动脉。
Climate shaped how Neolithic farmers and European hunter-gatherers interacted after a major slowdown from 6,100 bce to 4,500 bce
Authors: Lia Betti, Robert M. Beyer, Eppie R. Jones, Anders Eriksson, Francesca Tassi, Veronika Siska, Michela Leonardi, Pierpaolo Maisano Delser, Lily K. Bentley, Philip R. Nigst, Jay T. Stock, Ron Pinhasi, Andrea Manica
Journal: Nature Human Behaviour (2020)
Nationwide analysis of healthcare burden and risk of mortality in cancer patients with deep venous thrombosis.
Authors: Sheeba Habeeb Ba Aqeel, Prasanth Lingamaneni, Muhammad Zain Farooq, Binav Baral, Shristi Upadhyay Banskota, Shweta Gupta
Journal: Journal of Clinical Oncology (2020)

e19093 Background: Occurrence of venous thromboembolism is well known to have increased mortality in cancer patients with pulmonary embolism known to be the leading contributor. However, risk of mortality and healthcare burden with deep venous thrombosis (DVT) alone is not well elucidated, and primary prophylaxis is still controversial. We sought to evaluate risk of hospitalization, mortality, as well as, differences in resource utilization in patients with and without cancer, who were diagnosed in the emergency department (ED) with acute DVT alone. Methods: Adult patients diagnosed with acute DVT from January 2016 to December 2017 were identified from the Nationwide Emergency Department Samples (NEDS) database. Univariate and Multivariate logistic regression analysis was used to compare the risk of admission from the ED and inpatient mortality in DVT patients with cancer and those without. Secondary outcomes assessed were length of hospital stay (LOS), inpatient hospital charges, risk of GI bleed, and rates of inferior vena cava (IVC) filter placement and thrombolysis. Results: A total of 404,121 patients were diagnosed with acute DVT only, of which 8% had an underlying malignancy. Most common primary cancers were GI tract (20.1%), hematologic (16.5%) and lung (13.5%). Patients with cancer were older (mean age 66.4 vs 59.8 years, p&lt;0.0001), with a slight male preponderance (51.8% vs 47.5%, p&lt;0.0001). They were also more likely to be admitted from the ED (70.5% vs 39.1%, p&lt;0.0001). Patients with malignancy had longer length of stay, higher hospital charges, higher mortality and rates of GI bleed (p&lt;0.001 for all outcomes). On multivariable analysis, after adjusting for age, sex and comorbidities, patients with cancer were more likely to be admitted than those without cancer (OR 3.71, CI 3.41-4.04, p&lt;0.001), had higher mortality (OR 3.09, CI 2.42-3.94, p&lt;0.001) and rates of GI bleed (1.75, CI 1.45-2.12, p&lt;0.001). Likely for this reason, patients with cancer were more likely to undergo IVC filter placement (15.2% vs 9.4%, p&lt;0.0001) and less likely to receive thrombolysis (4.5% vs 7.4%, p&lt;0.0001). Conclusions: Cancer patients with DVT presenting to ED had higher hospitalization rates with increased risk of mortality, GI bleed, IVC filter placement and decreased rates of thrombolysis than those without malignancy that was compounded by longer in-hospital LOS and healthcare costs. Further studies are needed to evaluate the need of prevention strategies for DVT that can help mitigate these factors in cancer patients.
Voruciclib plus venetoclax show high efficacy for CLL b cells on human stromal cells.
Authors: Connie Lesnick, Jamie Wood, Sameer Ashok Parikh, Neil E. Kay
Journal: Journal of Clinical Oncology (2020)

e20009 Background: Although treating B-Chronic Lymphocytic Leukemia (CLL) with small molecule inhibitors has shown promise, a lasting cure for this disease has yet to be found. Further treatments directed at key molecular targets in the CLL B cell need development for patients with adverse prognostic factors, and relapsed/refractory patients. We evaluated the impact of two novel drugs with non-overlapping mechanisms of action on CLL B cells: Voruciclib, a cyclin dependent kinase (CDK) inhibitor targeting CDKs 9, 6, 4, 1 and Venetoclax a BCL-2 inhibitor. To mimic the protective effect of the CLL micro-environment these experiments were done with CLL cells cocultured in the presence of bone marrow mesenchymal stromal cells (BMSC). Methods: Voruciclib, (MEI Pharma) and Venetoclax were tested for killing activity alone and in combination against CLL cells cocultured with healthy human bone marrow MSC. CLL B cells were from untreated patients stratified on risk of disease progression. Low risk had mutated and high risk patients had unmutated IVGH genetic status. CLL cells were cultured on BMSC’s with a series of escalating doses of individual drugs and drug combinations at fixed molar ratios then Annexin/PI stained for viability testing by flow cytometry. Killing curves generated for each drug/combination were analyzed by the combination index (C.I.) approach of Chou and Talalay with Calcusyn, characterizing interactions as synergistic, additive or inhibitory. C.I. value hierarchy classes synergy as moderate (0.7-0.9), synergistic (0.3-0.7), strong (0.1-0.3) and very strong (below 0.1). Results: CLL cells with unmutated IGVH status were more sensitive to Voruciclib than mutated IGVH both with and without BMSC’s. The combination Voruciclib +Venetoclax showed synergism for all patients regardless of risk; half strongly to very strongly (Table). Similar synergistic effects were seen with relapsed/refractory patients. Conclusions: Based on these preclinical data, Voruciclib + Venetoclax is a very promising combination to improve treatment of CLL patients. We speculate that CDK9 inhibition, which regulates transcription of Mcl-1, with Bcl-2 inhibition results in potent apoptosis induction in CLL B cells. [Table: see text]