tbuckley/cabot-search huggingface dataset:
Is it safe and worthwhile? A multi-site randomized clinical trial of FAmily CEntered (FACE) pediatric advance care planning for adolescents with cancer and their families.
Authors: Justin N. Baker, Jessica Thompkins, Jennifer Needle, Yao Cheng, Sarah Friebert, Maureen E Lyon
Journal: Journal of Clinical Oncology (2020)

10557 Background: Many clinicians express concern that pediatric ACP (pACP) is too distressful for families. We describe the effect of FAmily CEntered pACP for Teens with Cancer (FACE-TC) on families’ self-reported experience. Methods: A 4-site, intent-to-treat, longitudinal, randomized clinical trial recruited adolescent/family dyads from hospital-based cancer-specialty clinics from 2016-2019. Adolescent/family dyads were screened/assented/consented/enrolled and randomized at a 2:1 ratio to either FACE-TC or Treatment as Usual control. FACE-TC is three weekly, 60-minute sessions with a certified facilitator (ACP survey; Next Steps: Respecting Choices Interview; Five Wishes advance directive). Satisfaction Questionnaire measured 7 positive (useful, helpful, load off my mind, satisfied, something I needed to do, courageous, worthwhile) and 6 emotional reactions (scared, hurtful, harmful, too much to handle, angry, sad). It was administered by a trained/blinded research assistant immediately following the Respecting Choices interview or 3 weeks post-baseline for controls. Results: Family participants were: primarily mothers (75%); mean age 46 years; 83% female; 82% white. Household income was ≤100% Federal poverty level for 26%; 58% had less than a Bachelor’s degree. Attendance was 92% for three FACE sessions. FACE families (N = 116) compared to controls were more likely to report the study was “worthwhile” (97% vs. 86%, 0 = 0.0245); “useful” (97% vs. 83%, p = 0.0102); “helpful” (96% vs. 79%, p = 0.0079); and “something I needed to do” (84% vs. 55%, p = 0.0006). FACE families (Mean 28.1, SD 3.3) reported higher positive subscale scores than control families (Mean 24.9, SD 4.4) (β = 2.98, p = 0.0001). No significant differences were found for age, gender, race, household income, or adolescent on active treatment. There were no differences between FACE or control dyads on the 6 emotional reactions subscale score. Conclusions: Among a geographically, economically diverse families, FACE pACP was safe and worthwhile. Clinicians can be assured that a structured facilitated pACP intervention, although emotionally intense, did not unduly distress families who found the experience overwhelmingly worthwhile. Results fill the gap about how to successfully engage families in pACP with their adolescent child. Clinical trial information: NCT02693665.
Incidence of subclinical thyroid dysfunction in Beijing population by physical check-ups
Authors: Qiu-ming Jiang, Yan-ming Gao, Gui-zhi Lu, Jun Zhou, Ling-ding Xie, Hui-min Zhang, Song Dong, Chun-xia Peng, Xiao-hui Guo, Yan Gao
Journal: BMJ (2008)

Objective To understand the incidence of subclinical thyroid dysfunction in adult population of Beijing.Methods Serum levels of thyroid-stimulating hormone(TSH),T3,T4 and thyroid peroxidase antibody(TPOAb)were measured for 1966 persons living in Beijing by physical examinations in 2002,and 1646 of them(83.72%)were followed-up in 2004.Results Overall incidence of subclinical hypothyroidism and subclinical hyperthyroidism were 1.72 percent and 0.25 percent,respectively.Incidence of subclinical hypothyroidism in females aged ＞40 years was significantly higher than that in those ≤40 years(χ2=10.869,P＜0.01),but no significant difference between those ＞40 and ≤40 years in males was found.Incidence of subclinical hypothyroidism in females was significantly higher than that in males ＞40 years of age(χ2=24.122,P＜0.01),but no significant difference between females and males ≤40 years was found.No significant difference in incidence of subclinical hypothyroidism was noticed between varied age groups and between males and females.Incidence of subclinical hypothyroidism was significantly higher in those with history of subclinical hypothyroidism than that in those without it(χ2= 6.898,P＜0.01).No significant difference in incidence of subclinical hypothyroidism between those with family history of thyroid disease and those without it was found.Incidence of subclinical hypothyroidism was significantly higher in those with positive TPOAb than that in those with negative one(χ2=14.084,P＜0.01),but no significant difference in incidence of subclinical hyperthyroidism between those with positive and negative TPOAb was found.Conclusion Incidence of subclinical hypothyroidism was a little bit higher in population of Beijing area by physical examinations,particularly in females,elder age and positive TPOAb.

Key words: 
Thyroid diseases;  Incidence;  Cross-sectional studies;  Questionnaire
Early pulmonary function changes associated with brigatinib initiation.
Authors: Terry L. Ng, Amber Johnson, Andrea Abeyta Osypuk, Derek Smith, Kimberly R. Jordan, Anna Tram Anh Nguyen, Nicole Conti, Adrie van Bokhoven, Elena Hsieh, D. Ross Camidge, Erin Lynn Schenk
Journal: Journal of Clinical Oncology (2020)

9538 Background: Phase I-III studies reported symptomatic pulmonary toxicity within the first week of initiating brigatinib in 6% patients post-crizotinib and 3% in TKI naive patients with standard dosing (90mg QD for 7 days then 180mg QD as tolerated). A prospective observational study of pulmonary function testing (PFT) on initiating brigatinib was conducted. Methods: Patients PS≤2, with resting O2 sats on RA ≥90% and Hg ≥10 g/dL, without significant heart/lung disease or steroid use initiating brigatinib 90 mg QD were eligible. PFT with DLCO, Borg dyspnea and 6-minute walk tests were performed at baseline (prior to brigatinib), and on day 2 (D2), 8 (D8), and 15 (D15) of brigatinib. D15 analyses were initially as clinically indicated but became mandatory if DLCO had not returned to baseline by D8. Peripheral blood was collected at baseline, D2 and D8 for CyTOF analysis. The primary endpoint was the incidence of Early Onset Pulmonary Events (EOPEs), defined as a DLCO reduction of ≥ 20% from baseline. An interim analysis was performed on the first 10 patients due to a higher than expected incidence of DLCO reduction. Results: D2 and D8 measurements were captured in all 10 patients, D15 in 7 patients. Ninety percent (9/10) of patients experienced DLCO reduction with nadir occurring on D2 in 4/9 and on D8 in 5/9 patients. Median DLCO nadir was −13.33% from baseline (range: −34.44 to −5.00). Three patients (30%) met EOPE criteria, all on D8, all without symptoms. Brigatinib was not held and all 10 patients escalated to 180mg on D8. Despite continued dosing, 4/9 patients recovered DLCO to baseline or above by D15 (2/3 EOPEs cases), 2/9 recovered above nadir but below baseline by D15 (1/3 EOPE case), and 3/9 did not have improvement from nadir values but no D15 assessment was performed. Dyspnea and 6-minute walk test did not correlate with DLCO changes. Patients who experienced an EOPE had significantly higher levels of activated neutrophils (pERKhi) at baseline. On the day of the EOPE event, patients who met EOPE criteria had significantly higher levels of activated neutrophils and fewer activated CD4+ effector memory T cells. Conclusions: Modest DLCO reduction occurred in 90% (9/10) patients during the first 8 days of brigatinib-dosing without associated symptoms. When rechecked on D15, DLCO improved in 100% patients (6/6) despite continued dosing and standard dose escalation at D8. Patients unlikely to tolerate even this modest, short-lived change should consider shallower step-up dosing or alternative drugs. CyTOF analysis suggests levels of pretreatment neutrophils may be a biomarker for developing EOPEs. Clinical trial information: NCT03389399 .
Dynamic changes in full blood count (FBC) occurring in patients treated with immune checkpoint inhibitors (ICIs) to predict responses in patients with metastatic renal cell carcinoma (mRCC).
Authors: Yasmin Abu Ghanem, Julia Choy, Francesca Jackson-Spence, Agne Jovaisaite, Michael Grant, Axel Bex, Thomas Powles, Bernadett Szabados
Journal: Journal of Clinical Oncology (2020)

e17110 Background: ICI transformed the treatment of 1L mRCC, yet early clinical predictors of response are still unknown. Methods: Retrospective database analysis from Barts Cancer Institute, London was carried out. Patients with treatment naïve mRCC were identified and grouped according to their 1L treatment: 1: VEGF inhibitor 2: IO/IO 3: IO/VEGF Data on hemoglobin, neutrophil-to-lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR) at baseline, 6weeks and 12weeks after treatment initiation was correlated with outcome. Results: Between Jan 2014 - Dec 2019; 28, 29 and 21 patients received 1L VEGF, IO/IO or IO/VEGF respectively. Patient receiving 1L VEGF inhibitors showed a decrease in Hb levels both in responding and non-responding groups (significant group effect: F(1,6) = 6.6, p = 0.04); significant time effect:F(2,12) = 12.4, p = 0.001). Group x time interaction was not significant. NLR levels decreased both in responding and non-responding groups over time (significant time effect: F(2,12) = 16.7, p = 0.001. PLR levels in non-responders increased over time, whereas in responding group, PLR levels steadily decreased over 6 and 12 weeks (significant time effect: F(2,12) = 0.3, 0.044). Patients receiving IO/IO combination therapy; within the non-responder group, Hb levels didn’t change significantly whereas in the responding group Hb levels increased significantly and overtook Hb levels of non-responding group (P = 0.001). NLR levels significantly decreased in the responding group (0.041) and a similar trend was observed at 12 weeks with a decrease in PLR among non-responders, with a significant group affect (F(1,5) = 0.18, 0.035). In patient treated with 1L IO/VEGF, among non-responders Hb levels increased slightly, only to return to baseline levels again at 12 weeks after treatment initiation. Whereas, Hb levels in the responding group increased significantly in both 6weeks and 12weeks after starting therapy. Significant time effect:F(2,20) = 3.65, p = 0.044. NLR levels in the responding group presented a steady decrease over time with a significant group and time effect. Both responders and non-responders experienced an increase in PLR over time. However, while PLR decreased at 12 weeks among responders, it continued to increase among non responders (significant time effect: F(2,20) = 0.3, 0.03), (significant group effect: F(1,10) = 0.05, 0.005) and significant interaction: F(2,20) = 0.1, 0.01) Conclusions: Close monitoring of FBC changes may predict response to ICI.
Concordance of next-generation sequencing between tissue and liquid biopsies in non-small cell lung cancer.
Authors: Fahmin Basher, Diana Saravia, Dino Fanfan, Jared Addison Cotta, Gilberto Lopes
Journal: Journal of Clinical Oncology (2020)

e21547 Background: While genetic profiling has become standard of care for patients diagnosed with non-small cell lung cancer (NSCLC), next-generation sequencing (NGS) provides a wealth of information about targetable mutations. Advances in genetic testing have led to sequencing platforms that utilize tissue itself or extracellular circulating tumor DNA in the blood, known as a “liquid biopsy.” Methods: We identified 55 patients with NSCLC who had undergone both tissue and liquid biopsy, using Foundation One and Guardant 360 at the University of Miami / Sylvester Comprehensive Cancer Center between January 2016 and December 2018, and performed retrospective analysis to determine patient characteristics as well concordance between different NGS platforms. Results: In our patient population, 34% of patients had never smoked prior to diagnosis, while 22% had more than a 30 pack-year smoking history. 64% of patients had no treatment prior to initial NGS. 40% of patients had both testing done essentially simultaneously, while 60% of patients had one test done after disease progression. Of these patients, therapy was changed as a result in 73%. Median number of days between tests was 21 days, with 56% of testing done within 90 days of the previous testing. Nine patients had an additional Foundation One tissue NGS performed. Concordance across all genes tested in both platforms was 98 ± 0.2%. Concordance with consideration of genetic alterations detected in both assays was 24.5 ± 3.0%. The median number of gene alterations determined by Foundation One testing was 4 (range 1-9), while the median for gene alterations detected by Guardant 360 was 3 (range 1-13). The median number of variants of unknown significance (VUS) was 10 (range 5-25). Conclusions: Our analysis indicates a role for both tissue-based and circulating tumor DNA-based NGS for determination of targetable mutations and thus appropriate treatment regimens. Low levels of concordance are potentially related to post-treatment changes in the tumor genetic profile as well as evolution in the testing itself.
Characteristics and intentions of ceasing smoking among patients at a smoking cessation clinic of a Shanghai hospital
Authors: Lin-yi Rong, Wen-ting Jin, Xiao-dan Wang, Jing Zhang
Journal: BMJ (2013)

To analyze the data of 284 smoking patients visiting the clinic during January 2009 to December 2011. There were 273 males and 11 females with a mean age of 49 years and an average length of 26 years of smoking 24 cigarettes per day. The average volume fraction of exhaled carbon monoxide was 16×10-6. The average score of Fagerstrom test of nicotine dependence (FTND) was 5. The importance, confidence and preparation of quitting smoking were graded at an average of 8.5, 6.7 and 7.6 respectively. Abstinence rate was 66.1% at 1 month and 50.9% at 3 months. A particular focus was placed upon those smokers with more serious nicotine dependence and longer smoking years. They knew much about the importance of smoking cessation, but there was a lack of confidence. Smoking cessation improves abstinence rate via behavioral counseling, psychotherapy and medication. We should strengthen publicity of smoking cessation and smoking cessation clinic to attract more patients with heightened confidence through treatment.


Key words: 
Smoking cessation; Dependency(psychology)
Analysis of Gastrointestinal and Hepatic Manifestations of SARS-CoV-2 Infection in 892 Patients in Queens, NY
Authors: Samson Ferm, Constantine Fisher, Tina Pakala, Michelle Tong, Disha Shah, David Schwarzbaum, Victoria Cooley, Syed Hussain, Sang Hoon Kim
Journal: Clinical Gastroenterology and Hepatology (2020)
A phase Ib/II study of the CD123-targeting antibody-drug conjugate IMGN632 as monotherapy or in combination with venetoclax and/or azacitidine for patients with CD123-positive acute myeloid leukemia.
Authors: Naval Guastad Daver, Eunice S. Wang, Kendra L Sweet, Pau Montesinos, Harry Paul Erba, Daniel J. DeAngelo, Callum Mortimer Sloss, Jiuzhou Wang, Kara E Malcolm, Patrick A Zweidler-McKay
Journal: Journal of Clinical Oncology (2020)

TPS7564 Background: Overexpression of CD123 is characteristic of a number of hematological malignancies, including acute myeloid leukemia (AML) and blastic plasmacytoid dendritic cell neoplasm (BPDCN). IMGN632 is a CD123-targeting antibody-drug conjugate (ADC) with a novel anti-CD123 antibody coupled to a unique DNA-alkylating payload of the recently developed IGN (indolinobenzodiazepine pseudodimer) class of payloads. In preclinical models of AML, IMGN632 exhibited potent anti-leukemia activity, with a wide therapeutic index. Confirming preclinical expectations, encouraging single-agent activity and favorable tolerability have emerged for IMGN632 in the ongoing Phase I trial in patients with CD123-positive AML (ASH 2019, NCT03386513). Preclinical data from AML xenograft models have demonstrated synergy in IMGN632 combinations with azacitidine and venetoclax (EHA 2019), supporting the exploration of these combinations in AML patients. Methods: This Phase Ib/II study is designed to determine the safety, tolerability, and preliminary anti-leukemia activity of IMGN632 when administered in combination with azacitidine and/or venetoclax to patients with relapsed and frontline CD123-positive AML, and the single-agent activity of IMGN632 in patients with minimal residual disease (MRD)-positive AML after frontline treatment. Study Design: Adult patients with CD123-positive relapsed or refractory AML, who are deemed appropriate for experimental therapy, are eligible to enroll as part of the dose escalation phase. Key exclusion criteria for all regimens include active central nervous system disease, and history of sinusoidal obstruction syndrome/venous occlusive disease of the liver. Three combination regimens are being evaluated: Regimen A, IMGN632 plus azacitidine (632+AZA); Regimen B, IMGN632 plus venetoclax (632+VEN); and Regimen C, IMGN632 plus azacitidine and venetoclax (632+AZA+VEN). For each regimen, a Phase Ib dose escalation cohort will determine the recommended Phase II dose (RP2D) of IMGN632 for the specific combination. This will be followed by a Phase II dose expansion stage to further characterize the safety profile and assess antileukemia activity in frontline or relapsed AML patients, depending on combination regimen. In addition, IMGN632 monotherapy is being explored in expansion cohorts of MRD-positive patients to assess conversion rate from MRD+ to MRD-, in fit and unfit AML subpopulations. Clinical trial information: NCT04086264 .
Association between serum RANKL/OPG ratio and osteoporotic fracture in patients with rheumatoid arthritis
Authors: Wen Liu, Tong Liu, Shengqian Xu, Xixi Ma, Linwei Hu, Liping Peng
Journal: BMJ (2015)

Objective
To investigate the value of serum receptor activator of nuclear factor kappa B ligand (RANKL)/osteoprotegrin (OPG) ratio in osteoporotic fracture (OPF) of patients with rheumatoid arthritis (RA).


Methods
Three hundred and eighty four RA patients with mean age of (49±14)y (16-82) admitted in the First Affiliated Hospital of Anhui Medical University from 2010 to 2013 and 158 sex- and age-matched healthy subjects were enrolled in the study. OPF was diagnosed by X-ray examination and BMDs of femur and lumbar spine 2-4 (L2-4) were measured by dual energy X-ray absorptiometry. Levels of RANKL and OPG in the peripheral blood of 220 RA patients and 100 normal subjects were detected by ELISA method.


Results
Eighty-two cases of OPF was diagnosed in 384 RA patients (21.35%), the rate was higher than that in controls (3.80%, 6/158, χ2=25.371, P<0.01). The peripheral blood levels of RANKL (0.150±0.143 vs. 0.101±0.066, t=4.178, P<0.01), OPG (0.457±0.293 vs. 0.359±0.216, t=3.347, P=0.001) and ratio of RANKL/OPG (0.41±0.35 vs. 0.34±0.20, t=2.111, P=0.036) in RA patients were significantly higher than those in control group. In comparison with normal controls, BMDs of all detected regions in RA were decreased significantly (P<0.01). The incidence of osteoporosis in RA (121/327, 37%) was higher than that in normal controls (22/158, 13.92%) (χ2=27.291, P<0.01). RA patients with OPF had higher age (t=4.377, P<0.01), longer duration of disease (t=2.612, P=0.009), higher RANKL level (t=3.554, P=0.001), higher RANKL/OPG ratio (t=2.651, P=0.010), higher health assessment questionnaires (HAQ) score (t=2.418, P=0.016), lower serum calcium level (t=2.183, P=0.030), lower hemoglobin level (t=2.125, P=0.036), higher Sharp score in hands X-ray examination (t=2.747, P=0.007), worse X-ray stage (χ2=7.856, P=0.049), higher glucocorticoid utilization rate (χ2=9.066, P=0.003) and higher incidence of osteoporosis (χ2=38.186, P<0.01), compared with patients without OPF. RA patients taking corticosteroids had higher incidence of osteoporosis (χ2=7.489, P=0.006) and higher incidence of OPF (χ2=9.066, P=0.003). Logistic regression analysis showed that age (OR=1.029, P=0.039, 95%CI: 1.001-1.057)and the occurrence of osteoporosis (OR=3.159, P=0.001, 95%CI: 1.562-6.385), RANKL/OPG ratio(OR=3.516, P=0.013, 95%CI: 1.305-9.647) were risk factors for RA patients with OPF.


Conclusion
A higher incidence of OPF is prevalent in RA patients, and age, osteoporosis, taking glucocorticoids and RANKL/OPG ratio are risk factors for OPF in RA patients.


Key words: 
Arthritis, rheumatoid; Fractures, bone; Osteoporosis; Receptor activator of nuclear factor kappa B
哮喘患者病情轻重的自我评估
Authors: 何权瀛
Journal: BMJ (2007)

支气管哮喘是一种慢性呼吸道疾患,由于各种原因,包括接触诱因、治疗,甚至情绪心理因素,其病情经常处于动态变化之中.正确评估病情轻重不仅是医生关心的事,同时更是广大哮喘患者关注的事,也是哮喘患者应当掌握的一项基本技能,因为正确地评估哮喘病情轻重不仅关系到预测疾病发展趋势、预后、指导治疗方案和用药的调整,同时也有助于患者决定何时就医等。
滕州市城区2～14岁儿童哮喘危险因素的病例对照研究
Authors: 马士学, 戴恩成, 蒋召伦
Journal: BMJ (2006)

2004年9月至10月,选择滕州市城区2～14岁哮喘患儿106例进行1:1配对病例对照研究.进入多因素条件logistic回归模型的有儿童呼吸道感染史、家族哮喘史、儿童过敏史、儿童特应性体质和家庭同居人口吸烟,5个变量的OR值分别为22.09、18.21、17.12、9.10和3.84。
发现血压升高20年,加重伴头晕半年
Authors: 刘丽琼, 许忠, 田蕾, 孙君雷, 祝墡珠
Journal: BMJ (2012)

病史摘要患者,男性,52岁,因发现血压升高20年,加重伴头晕半年.于2011年12月10日入院.患者20年前体检测血压140～ 150/90～95 mm Hg(1 mm Hg=0.133 kPa),无不适,未诊治.10年前起血压升高明显,最高180/110 mm Hg,始服用降压药物,先后服用复方降压片、非洛地平缓释片、倍他乐克、氯沙坦钾片、氯沙坦钾氢氯噻嗪片等,2联或3联用药,血压140 ～ 150/85 ～ 90 mm Hg,近半年血压控制不佳,3联用药血压波动在160～180/100 ～110 mm Hg,时感头晕,无视物旋转,无头痛,无肢体活动不利,1个月前降压药物调整为硝苯地平控释片30 mg/d+比索洛尔片5 mg/d+厄贝沙坦氢氯噻嗪片1粒/d,规律用药,血压仍在150/100 mm Hg左右,现为进一步明确诊治收入院。
Acquisition of parasternal short axis view and image interpretation on echocardiography
Authors: Wenying Jin, Zhilong Wang
Journal: BMJ (2019)

胸骨旁短轴切面包含多个重要切面，其获取图像的探头位置大致相近，即探头置于胸骨左缘第2、3肋间或3、4肋间，探头标记指向左肩锁关节；扫描平面与左心长轴相垂直，轻微调整探头位置和角度，从胸骨左缘第2、3肋间，沿肋间滑行探查至心尖部，可依次获得左侧胸骨旁的多个短轴切面。此组胸骨旁短轴切面包含内容众多，在各种先天性心脏病、肺动脉高压、右心室功能、左心室功能、二尖瓣及三尖瓣病变等多种疾病的诊断中，都是至关重要的切面。
青岛高校大学生缺铁性贫血知识知晓率的调查研究
Authors: 赵新东, 吴少玲, 赵金霞, 张静
Journal: BMJ (2007)

采用自行设计的调查问卷就青岛地区高校大学生对缺铁性贫血知识知晓率进行不记名调查.272份有效问卷分析结果显示,对缺铁性贫血的病因完全了解者占2.2%,部分了解者占95.6%,不了解者占2.2%;对缺铁性贫血的不同预防措施中,知道采用食品的多样性预防缺铁性贫血者占49.6%,但对其他预防措施知晓率较低;大学生对自身血红蛋白水平的知晓率仅为9.6%.提示青岛大学生缺铁性贫血的知识知晓率较低,这为在大学生中开展缺铁性贫血的相关知识的教育提供了理论依据。
Blood glucose control in a patient with diabetes mellitus after facial composite allotransplantation
Authors: Jing-bo Lai, Li Wang, Jian-fang Fu, Nan-yan Zhang, De-qiang Li, Hong-wei Cao, Xiang-yang Liu, Qiu-he Ji
Journal: BMJ (2011)

A facial allotransplanted patient presented hyperglycemia with blood glucose ranged 14. 3 -33. 3 mmol/L after receiving immunosuppressive drugs and glucocorticoids. To control the blood glucose level, the patient was treated with two subcutaneous doses of 10 U human neutral protamine hagedorn (NPH) insulin, and the fasting glucose level came down to 3. 6 - 9. 4 mmol/L. Then the continuous subcutaneous infusion of insulin aspart ( Novo Industri) was administrated (from 96 to 21 U/d) , and the fasting blood glucose levels were 3. 9 -4. 6 mmol/L. With oral administration of Metformin and Repaglinide, the fasting blood glucose was maintained to 4. 3 -5.9 mmol/L. With these medications, the blood glucose level of the patient was under good control and the acute and chronic complications of hyperglycemia were effectively prevented.

Key words: 
Diabetes mellitus; Therapy