tbuckley/cabot-search huggingface dataset:
Effects of a new laparoscopic surgery for patients with hydrosalpinges on in vitro fertilization embryo transfer
Authors: Hong-chu Bag, Cui-fang Hao, Mei-mei Wang, Ning Zhang, Li-li Zhuang, Xin rong Wang
Journal: BMJ (2010)

A total of 199 patients of infertility caused by occlusion of fallopian tubes who visited Yantai Yuhuangding Hospital, Shandong province, from July 2006 to December 2007 were recruited and divided into three groups, 16 in Group A undergone with a new laparoscopic surgery for hydrosalpinx before in vitro fertilization embrgo transfer (IVF-ET) ,59 in Group B with traditional salpingectomy for hydrosalpinx or ectopic pregnancy prior to IVF-ET,and 124 in Group C without hydrosalpinx and with no interventions for their occluded fallopian tubes, but undergone IVF-ET only as controls. There were no significant difference in number of the antral follicles counted and serum level of estradiol on the day of human chorionic gonadotrupin (HCG) injection between in Group A and C [(8. 6 ±2. 5 ) vs. ( 10. 0± 2. 4), and ( 12 167±2053) vs. (12 278 ±1366) pmol/L, P＞0.05] ,as well as number of mature oocytes retrieved [(13 ±6)vs. and ( 12 ±6), P ＞0. 05]. Higher dose of ovary stimulant agent was used in Groups B, higher than that in Group A and C, but there were no significant difference in Group A and C [( 2325 ± 450 ) vs. ( 2250 ±375) U, P ＞0. 05]. The pregnancy rate was 62.5% in Group A,44. 1% in Group B,39. 5% in Group C.Hydrosalpinx is associated with poor outcomes of IVF-ET. The new methods of laparoscopic fallopian tube resection for patients with hydrosalpinx prior to IVF-ET improves pregnancy rate, but do not impair ovarian reserve and reaction to stimulation, as compared to traditional salpingectomy.

Key words: 
Embryo transfer; Infertility,female
Spectrum of physical symptoms in panic disorder
Authors: 魏镜, 武力勇
Journal: BMJ (2005)

目的 了解惊恐障碍患者惊恐发作时躯体症状和发生频率.方法对北京协和医院2000年8月至2002年11月门诊诊断为惊恐障碍的48例患者进行临床症状分类.结果 惊恐障碍患者最常出现的症状依次为心慌(44/48,91.7%)、胸闷(36/48,75.0%)、出汗(34/48,70.8%)、憋气(33/48,68.8%)、全身发软(31/48,64.6%)、头晕(27/48,56.3%)、濒死感(27/48,56.3%).按系统来说,惊恐发作时躯体症状平均累及4.8个系统.最常表现为心血管、神经、呼吸和植物神经系统症状.结论 惊恐发作的躯体症状广泛,由于症状的广泛性和非特异性,易被误诊或漏诊。
Sarcoma Treatment Efficacy Portal (STEP): A novel informatics portal providing real-time, real-world outcomes to clinicians.
Authors: Nicholas Grosenbacher, Audra Phillips, David A. Liebner, Gabriel Tinoco, James Lin Chen
Journal: Journal of Clinical Oncology (2020)

e23538 Background: There are currently no informatics tools that are capable of providing complex clinical decision support using real-world outcomes (RWO) for patients with sarcoma. Although existing nomograms can provide prognostic scores based on clinical or genomics features, they typically are static and lack the ability to compare outcomes for patients managed with alternative treatment strategies. To address this need, we present STEP, a Sarcoma Treatment Efficacy Portal, a web-based tool designed for real-time exploration and visualization of patient data with the potential to be integrated into clinical decision workflows during outpatient visits. Methods: At The Ohio State University, clinical histories and omics data for sarcoma patients are captured in our prospective Sarcoma Registry (NCT0267796). STEP is an interactive web-based tool built in R/Shiny and supported by a pipeline written Python that processes, transforms, and caches clinical data extracted from the Sarcoma Registry in near real-time. Protected health information (PHI) is stored on a secure HIPAA compliant server behind the hospital firewall and migrated to a secure, deidentified staging database. Results: The STEP system is powered by detailed treatment specific data elements that are continuously abstracted for over 400 patients with bone and soft tissue sarcoma. This consists of manually annotated clinical histories in addition to nearly 10 million discrete data points are pulled from the EHR (labs, ICD-9/10 codes, medications, omics data). Importantly, STEP includes a cohort builder which allows users to define a treatment group of interest though any number of variables including tumor histology, chemotherapy, and omic features of interest. For any predefined cohort, STEP can provide information on overall survival and response to a variety of treatments. It also provides sorting mechanisms for identifying candidate treatments. A secure web interface allows a simple integration into a busy clinic flow. Conclusions: STEP provides a first in class, convenient, clinician friendly platform for delivering access to real-time, real-world treatment outcomes (RWO) in patients with a diagnosis of bone or soft tissue sarcoma. Additional usability testing is forthcoming.
Clinical value of 64-row CT angiography in detection of carotid atherosclerotic plaque
Authors: Xiao-yan Yu, Wei-jun Tang, Rui-jiang Zhu, Hao-xiong Li, Dao-ying Geng
Journal: BMJ (2009)

Objective To explore clinical significance of muhidetector(64-row)computed tomography carotid atherosclerosis angiography(MDCTA)in detecting carotid atherosclerotic plaque.Methods Data of 116 patients with carotid atherosclerosis undergone with MDCTA stayed at Huashan Hospital,Shanghai from January to August,2008 were analyzed retrospectively.Results Three hundred and seventy-seven plaques were identified among all the 116 patients in the study,with an incidence of calcified plaque of 63.40 percent,and more detected at the common carotid artery(27.85%).the carotid bifurcation(39.78%)and the internal carotid artery (21.48%).There was significantly statistical difference in plaque types between those with mild,moderate and severe carotid stenosis(P=0.000)and between those aged equal to or lower than 50 years and equal to or greater than 70 years(P=0.005).Plaque types at the common carotid artery were significantly difierent from those at the carotid bifurcation(P=0.000)and at the internal carotid artery(P=0.000).Results of regression analysis showed a positive and significant association between carotid occlusion and clinical symptomatology(with a coefficient of correlation of 1.080.P=0.023)and inverse association between calcified plaque and clinical symptomatology(with a coefficient of correlation of 0.688,P=0.006).Conclusions Not only imaging characteristics of carotid atherosclerotic plaque can be accurately assessed by MDCTA,but also measurement of its stenosis degree.Assessment of plaque type,degree of stenosis and distribution of plaque in different Vascular segments with MDCTA can be used to predict clinical occurrence of cerebevaseular events in patients with carotid atherosclerosis.

Key words: 
Angiography; Carotid stenosis; Tomography scanners.X-ray,computed,mulidetector
A phase I study of TGF-β inhibitor, vactosertib in combination with imatinib in patients with advanced desmoid tumor (aggressive fibromatosis).
Authors: Hyo Song Kim, Jin-Hee Ahn, Jeong Eun Kim, Jung Yong Hong, Jeeyun Lee, Sung Hyun Kim, Jin Lee, Sunjin Hwang, Min Kyung Jeon, Seong-Jin Kim
Journal: Journal of Clinical Oncology (2020)

11557 Background: Desmoid tumor (aggressive fibromatosis) is fibroproliferative neoplasm arising from deep connective tissues. TCGA pan-cancer analysis revealed high expression TGF-β responsive signature in desmoid tumor. This phase I study assessed the safety, tolerability, and pharmacokinetics of the TGF-β inhibitor, vactosertib in combination with imatinib for desmoid tumor. Methods: Patients with advanced desmoid tumors not treatable by surgery or radiotherapy were eligible. The primary objective is to assess the safety and recommended phase 2 dose (RP2D) of vactosertib given 5 days on and 2 days off in combination with imatinib (400 mg QD). Two dose levels of vactosertib were tested; cohort -1 (100 mg BID) and cohort 1(200 mg BID). Secondary objectives include pharmacokinetics, anti-tumor activity by response rate (RECIST v1.1), and biomarker analysis. Results: Seven patients (cohort -1, n = 4; cohort 1, n = 3) were enrolled and finished the safety evaluation. The most frequently reported treatment related adverse events were myalgia (57.1%), fatigue (42.8%), diarrhea (42.8%), anemia (28.5%) and stomatitis (28.5%) with mostly grade 1. No dose limiting toxicity was observed. Tumor response included 2 (28.5%) partial response (PR) and 2 stable disease (SD) in the cohort -1, and 3 SD in the cohort 1. The time to response were 5.5 and 8.2 months and all 7 cases are ongoing. Updated safety, pharmacokinetics, efficacy and biomarker data will be presented at the meeting. Conclusions: The combination of vactosertib plus imatinib was well tolerated and showed promising activity in desmoid tumor. RP2D of vactosertib was defined as 200 mg BID. Further efficacy will be explored in the phase 2 part of the study. Clinical trial information: NCT03802084 .
Germline ATM mutations on survival in metastatic pancreatic cancer patients.
Authors: Arjan Gower, Gillian Gresham, Nanor Haladjian, John Lee, Camille Ng, Sejal Mehta, Andrew Eugene Hendifar
Journal: Journal of Clinical Oncology (2020)

e16746 Background: Ataxia telangiectasia mutated (ATM) protein is a DNA damage repair enzyme and regulates normal cell-cycle mechanisms. Germline ATM mutations are associated with increased risk for developing pancreatic cancer (PC), occurring in approximately 2% of PC patients (pts). The role of germline ATM mutations in PC is not well defined. The objective of this study was to compare survival outcomes in patients with germline ATM mutations compared to somatic ATM mutations in PC. Methods: Tumor genomic profiling was completed in 144 PC patients at a single institution in the US, where pts were included in the analysis if they had either germline ATM mutations or somatic ATM mutations. Clinical outcomes were compared between pts with germline ATM mutations and pts with somatic ATM mutations only. Adjusted Cox regression models were fit to evaluate the impact of ATM mutation on overall survival (OS), calculated from treatment (tx) initiation to death, and progression free survival (PFS) calculated from tx initiation to first progression. Results: From 144 PC pts evaluated, 7 pts (4.9%) had germline ATM mutations, all of whom presented with metastatic disease, and 14 pts (9.7%) with somatic ATM mutations only, of whom 10 presented with metastatic disease and 4 who initially presented with locally advanced PC. The majority of pts (15/21), including all 7 pts with germline ATM mutations and 8 with somatic ATM mutations, were treated with first line gemcitabine and abraxane. Median OS was not reached in patients with germline mutations, and 11 months for patients with somatic mutations. Pts with germline ATM mutations had significantly higher OS (HR: 0.12, 95% CI 0.03-0.62, p = 0.01) and PFS (HR:0.26, 95%CI 0.07-0.91, p = 0.04) compared to patients with somatic ATM mutations only after adjusting for age, sex, and first-line tx. Conclusions: Pts with germline ATM mutations may experience greater survival benefit from tx compared to those with only somatic ATM mutations. Further research into the underlying mechanism is warranted.
Real-world evidence: Adjuvant chemotherapy in colorectal cancer with liver metastases.
Authors: Feng-Che Kuan, Gengping Lin, Chih-Chien Chin, Wen Shih Huang, Chung-Wei Fan, Jy Ming Chiang, Hong-Hwa Chen, Jinn-Shiun Chen
Journal: Journal of Clinical Oncology (2020)

e16008 Background: Systematic chemotherapy with biologics improves survival in metastatic colorectal cancer (mCRC). Oxaliplatin-based adjuvant chemotherapy is suggested in stage III and high-risk stage II CRC. However, whether adjuvant oxaliplatin-based chemotherapy remains standard treatment in CRC with liver metastases after hepatectomy is not elucidated. Methods: Medical records were searched in Chang-Gung Research Database from 2004 to 2017. Patients with CRC and liver metastases who received systematic therapies and salvage hepatectomy were included. The Kaplan-Meier method was used to estimate survival, and multivariate Cox proportional hazard models were used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). Results: Total 454 patients received upfront hepatectomy (cohort 1) and 232 patients received neoadjuvant chemotherapy +/- biologics and salvage hepatectomy (cohort 2) were included in this study. In cohort 1 or cohort 2, the baseline characteristics of those received either postoperative oxaliplatin-containing regimen or other systematic regimens were not statistically different in gender, age, primary site, and biologic drugs. In cohort 1, overall survival (OS) in those received postoperative oxaliplatin-containing chemotherapy was significantly better than that of those received non-oxaliplatin-containing chemotherapy (median OS: 6.6 vs. 4.5 years, Log-rank p = 0.032; 5-year survival rate: 57.5 vs. 47.0%). In cohort 2, OS in those received postoperative oxaliplatin-containing chemotherapy was similar with that of those received irinotecan or biologics-containing chemotherapy (median OS: 3.1 vs. 3.5 vs. 3.8 years, Log-rank p = 0.472; 5-year survival rate: 30.9 vs. 33.3 vs. 37.0%). Conclusions: Oxaliplatin-containing chemotherapy provides better OS and remains standard adjuvant treatment in CRC with liver metastases after upfront hepatectomy. However, adjuvant chemotherapy in those received neoadjuvant chemotherapy +/- biologics and salvage hepatectomy should be individualized. Further prospective studies are warranted to validate these findings.
单纯疱疹病毒脑炎的早期诊断与治疗
Authors: 周宝桐, 邓国华
Journal: BMJ (2008)

单纯疱疹病毒脑炎(herpes simplex virus encephalitis,HSE)是一种散发性脑炎,发病无明显季节性,亦无性别差异,主要见于6个月以上儿童和成人.病原体为单纯疱疹病毒(herpes simplex virus,HSV),是疱疹病毒科中的一种嗜神经性的双链DNA包膜病毒,当累及中枢神经系统后常侵犯大脑颞叶、额叶及边缘系统,导致脑组织出血性坏死及(或)变态反应性脑损害。
Prevention and treatment of stroke in patients on dialysis
Authors: Wenjun Zhang, Zeping Huang, Jianqin Wang
Journal: BMJ (2018)

Stroke remains the major complication among patients on dialysis. In chronic hemodialysis patients, prevalence and incidence of stroke are higher than those in general population. This article provides an overview of stroke in patients on dialysis, including clinical features, early warning and recognition, prevention and treatment.


Key words: 
Dialysis; Stroke; Universal precautions
Recommendations for the Conduct and Reporting of Research Involving Flexible Electronic Health Record–Based Interventions
Authors: Adam Wright, Allison B. McCoy, Niteesh K. Choudhry
Journal: Annals of Internal Medicine (2020)

In the past 2 decades, the United States has seen widespread adoption of electronic health records (EHRs) and a transition from mostly locally developed EHRs to commercial systems. However, most research on quality improvement and safety interventions in EHRs is still conducted at a single site, in a single EHR. Although single-site studies are important early in the innovation lifecycle, multisite studies of EHR interventions are critical for generalizability. Because EHR software, configuration, and local context differ considerably across health care organizations, it can be difficult to implement a single, standardized intervention across multiple sites in a study. This article outlines key strengths, weaknesses, challenges, and opportunities for standardization of EHR interventions in multisite studies and describes flexible trial designs suitable for studying complex interventions, including EHR interventions. It also outlines key considerations for reporting on flexible trials of EHR interventions, including sharing details of the process for designing interventions and their content, details of outcomes being studied and approaches for pooling, and the importance of sharing code and configuration whenever possible.
Quantitative analysis and application value of CT spectral parameter in lung cancer
Authors: Yulin Jia, Xigang Xiao, Qiulian Sun, Guangsheng Jia, Huijie Jiang
Journal: BMJ (2018)

Objective
To analyze the characteristics and to evaluate the application of quantitative CT spectral parameters in patients with suspected lung cancer.


Methods
One hundred and thirty two patients with occupying lesions of the lung underwent chest plain and two-phase contrast enhanced CT scan with gemstone spectral imaging (GSI) mode. The CT images of patients with confirmed lung cancer by pathological evidence were analyzed with GSI viewer. Optimal energy value supplying optimal contrast-to-noise ratio (CNR) was recorded. The CT values of lesions at 40 keV, 70 keV and optimal energy level were measured. Spectral curve slope at different intervals of 40-70 keV, 40-100 keV and 40-140 keV was computed. Effective atomic number (Zeff), iodine concentration (IC) and water concentration (WC) were measured and analyzed by statistical methods.


Results
Sixty six patients with confirmed lung cancer were included in the analysis. The optimal energy values for optimal CNR on plain scan, arterial phase and venous phase were (63.09±5.33) keV, (52.65±6.44) keV and (54.06±5.53) keV, respectively. The difference of CT values at different energy levels on each scan phase was statistically significant (F=4.561, P=0.025). The spectral curve slope values among three different energy intervals were significantly different (F=2.137, P<0.001). The differences of the slope between arterial phase and venous phase at same energy interval were not significant (40-70 keV: t=1.165, P=0.248; 40-100 keV: t=1.102, P=0.274; 40-140 keV: t=1.118, P=0.268). Zeff on plain scan, arterial phase and venous phase was 7.73±0.14, 8.35±0.37 and 8.39±0.30, respectively. There was positive correlation between IC and Zeff on enhanced phase (arterial phase: r=0.998, P<0.001; venous phase: r=0.998, P<0.001).


Conclusion
CT spectral imaging can supply the optimal energy value for optimal CNR. CT value at optimal energy level and spectral curve slope at 40-140 keV are suitable for analysis. IC and Zeff can be used jointly in evaluation of patients with suspected lung cancer.


Key words: 
Lung neoplasms; Tomography, X-ray; Dual-energy scanned projection
A survey of cancer pain management among hospitalized elderly patients
Authors: Yuejuan Shao, Jianlei Hao, Xianjiang Cheng, Kai Ji, Bingqing Guan
Journal: BMJ (2015)

To explore the status of cancer pain management among hospitalized elderly patients. Pain intensity, use of analgesic drugs and incidence of adverse reactions were surveyed for 620 cancer pain patients. And 218 of them were aged over 65 years. The proportions of mild, moderate and severe pain were 29.8%, 36.2% and 34.0% respectively. And the corresponding rates in young and middle-aged patients were 28.4%, 34.8% and 36.8% respectively (P>0.05). In elders with cancer pain, 28% used no analgesic. For severe pain patients, only 71.6% received potent opioids and 5.4% nonsteroidal anti-inflammatory drugs. And the corresponding rates in young and middle-aged patients were 26.1%, 73.0% and 4.7% respectively (P>0.05). The rates of constipation, dysuria and delirium in elderly patient group were higher than young and middle-aged patient group (P<0.05). Pain management is unsatisfactory and rational uses of analgesic drugs should be strengthened for preventing the relevant adverse reactions.


Key words: 
Carcinoma; Analgesics, opioids; Cross-sectional studies
霉菌性副鼻窦炎致视力丧失一例
Authors: 姜鹏飞, 高磊, 孙英
Journal: BMJ (2010)

患者女,70岁.因左侧头面部疼痛1个月,左眼视力丧失20 d于2008年8月29日由当地医院转入本院.曾以视神经炎给予全身抗生素及球周注射地塞米松治疗,颅脑CT未见异常.入院时患者一般情况可,空腹血糖12 mmol/L(有10年糖尿病史),视力右眼0.6(国际标准视力表),左眼无光感,双眼前节检查除左眼瞳孔直接对光反应消失,间接对光反应存在以及双眼底散在少许微动脉瘤外,未见其他异常。
卡维地洛治疗慢性充血性心力衰竭的临床研究
Authors: 侍作胜, 林荣
Journal: BMJ (2004)

对66例慢性充血性心力衰竭患者使用卡维地洛治疗并随访24个月,观察其疗效及治疗前后的心功能变化,显示治疗组的显效率明显高于对照组,而总死亡率明显低于对照组,心功能明显改善,且左室舒张末径及收缩末径明显缩小,而6 min行走试验无明显改变。
Anti-PD-1 for patients with leptomeningeal metastasis from advanced solid tumors: Efficacy, safety, and biomarkers of response.
Authors: Jarushka Naidoo, Karisa C. Schreck, Chen Hu, Christopher Blair Douville, Cesar Augusto Santa-Maria, Roisin M Connolly, Matthias Holdhoff, Evan J. Lipson, Rose Parkinson, Joanne Riemer, Amanda Barnes, Arun Venkatesan, Chetan Bettegowda, Stuart A. Grossman, Julie R. Brahmer
Journal: Journal of Clinical Oncology (2020)

e14506 Background: Leptomeningeal metastasis (LMM) from solid tumors are rare and often refractory to standard therapies. Pembrolizumab (anti-PD-1) has efficacy in patients (pts) with brain metastases from ICI-responsive tumors, however pts with LMM are often excluded from ICI trials. We hypothesized that: 1. Pembrolizumab will lead to CNS response in LMM, and 2. Genomic/immunologic analyses on CSF could identify CNS biomarkers of response. Methods: We conducted an investigator-initiated open-label phase 2 trial of Pembrolizumab in pts with LMM from any solid tumor (NCT03091478). Eligible pts had: LMM on MRI ( &gt; 3mm lesion) or CSF cytology, ECOG PS ≤1, and were PD-naïve. Prior RT to LMM was allowed &gt; 3 months before study start or to non-target areas. Pembrolizumab was administered IV 200mg q3W until disease progression/unacceptable toxicity. The primary endpoint was CNS response after 12 weeks, defined as radiologic (RECIST 1.1)/cytologic/clinical response to therapy. Serial CSF samples were assessed by chromosomal copy number changes using a PCR-based approach (RealSeqS) to detect tumor-derived DNA (CSF-tDNA), and 16-color flow cytometry. Results: Thirteen of a planned 18 pts were treated 04/2017-12/2019, the study was closed early for low accrual. Median age was 58 years (22-79), 53% were female. Pts had breast carcinoma (38%, n = 5), NSCLC (23%, n = 3), high-grade glioma (23%, n = 3), HNSCC (8%, n = 1) and cutaneous squamous cell carcinoma (8%, n = 1). Median no. of prior therapies was 4 (0-8), 76% of pts had prior RT to LMM. CNS response was seen in 38% of pts (5/13: 2 = complete response (NSCLC; Squamous skin); 3 = stable disease (NSCLC, Glioma, HER2+BC) by RECIST 1.1. Treatment-related adverse events were seen in 31% (4/13) of pts, 15% (2/13) G3+ (fatigue = 1, infection = 1). CSF cytology was negative at ICI start in 6 cases, but positive by CSF-tDNA in 5/6 cases. In addition, CSF-tDNA levels can correlate with disease status. CSF flow cytometry demonstrated increase in CD45R0+ activated memory T-cells, and a shift from immature to antibody-secreting B-cells in both pts with CRs in LMM. Conclusions: Pembrolizumab was well-tolerated and demonstrated anti-tumor activity in pts with LMM in ICI-responsive tumors. Correlative analyses identified CSF-tDNA can potentially be used from diagnosis to longitudinally monitor LMM; and that T and B cell populations may be enriched in the CSF of pts whose LMM regressed. These findings support inclusion of pts with LMM in ICI studies and interrogation of CSF biomarkers. Clinical trial information: NCT03091478.
Impact of celecoxib on prognosis of elderly patients with hip fracture
Authors: Yong Wang, Yejing Yang
Journal: BMJ (2016)

One hundred and six patients with hip fracture admitted in hospital from 2011 to 2014 were randomly divided into two groups: 52 patients received celecoxib and parecoxib (trial group) and 54 patients received oxycodone hydrochloride and bucinnazine (control group). On d1 and d7 after the surgery, serum levels of C-reactive protein[(26.2±5.4) and (10.4±2.8) mg/L], tumor necrosis factor-α [(40.6±6.1) and (31.8±5.3)ng/L], interleukin-6 [(22.3±5.7) and (18.3±5.2) ng/L]and prostaglandin E2 [(181.1±19.4) and (153.3±25.8) ng/L] in trial group were all significantly lower than those in control group [(46.1±14.0) and (22.1±5.2)mg/L, (53.2±5.3) and (44.6±7.4) ng/L, (43.3±11.0) and (29.1±8.6)ng/L, (354.3±105.9) and (251.0±37.3)ng/L, all P<005]. The length of hospital stay [(11.0±2.2) d], rate of lung infections (6/52) and neurological abnormality (3/52) in trial group were significantly lower than those in control group [(15.5±1.8) d, 15/54 and 11/54, all P<0.05]. The expression of CD4+ CD45+ T cells [(34.9±3.7)% vs. (42.5±4.3)%] was reduced and CD4+ Foxp3+ T cells [(19.7±3.8)% vs. (6.9±1.5)%] was increased at 24 h after surgery in trial group compared with control group( all P<0.05). The results indicates that calecoxib can reduce the inflammatory reaction by promoting CD4+ to Foxp3+ CD4+ T cell differentiation and may improve the prognosis of elderly patients with hip fracture.


Key words: 
Anti-inflammatory agents, non-steroidal; Aged; Hipfractures; Prognosis