tbuckley/cabot-search huggingface dataset:
Response to: ‘Finding the right one’ by Zanwar
Authors: Thomas Renson, Filip E Van den Bosch, Dirk Elewaut
Journal: Annals of the Rheumatic Diseases (2020)

Response to: 'Finding the right one' by ZanwarWe thank Dr Zanwar for his interest in our study.We appreciate that he took the time to write down his remarks 1 regarding our work. 24][5] By including asymptomatic subjects with an uncomplicated pregnancy and childbirth, we demonstrated that pregnancy and giving birth are associated with the occurrence of spondyloarthritis (SpA)-like sacroiliac joint lesions.By using this strategy, we limited the possibility of erroneously including patients with SpA, whereas if all study subjects would have had postpartum chronic back pain, the distinction with patients with SpA would have been difficult to make.The present study design limited the possibility that the detected sacroiliac joint lesions can be attributed to a back pain-related pathology.By demonstrating important sacroiliitislike images even in healthy, asymptomatic postpartum subjects, we showed that caution is truly warranted in interpreting MRI images of the sacroiliac joints in the postpartum period.Consequently, performing an MRI in the postpartum period should be a well-considered decision.Therefore, we want to underscore that if an MRI of the sacroiliac joints is performed during the first 6 months postpartum, the possibility of pregnancy/ childbirth-associated sacroiliac joint lesions should be seriously considered, as these are difficult to distinguish from sacroiliitis in the context of SpA.When in doubt, a treatment with nonsteroidal anti-inflammatory drugs can be attempted to evaluate the treatment response and to buy some time before performing an additional MRI scan.The link of the imaging findings with the presence or absence of back pain was another point touched on.For clarity, Assessment of Spondyloarthritis International Society classification criteria for axSpA do not mandate presence of inflammatory back pain (IBP) for more than 3 months before proceeding to MRI of the sacroiliac joints. 6 7Furthermore, IBP has been shown to have high sensitivity but low specificity. 8As in our study only four subjects had IBP, it was not possible to make hard statements regarding this matter.Three out of four subjects with IBP had sacroiliitis at baseline, persisting in two out of four at month 6.The residual sacroiliitis at month 12 was limited in both subjects.The decline in Spondyloarthritis Research Consortium of Canada (SPARCC) scores over time in these subjects suggests that these lesions are pregnancy/childbirth-related and are not attributed to SpA.Inflammatory serum markers were not regarded in this study since they were not available for all subjects and they are heavily influenced by the process of childbirth itself and are therefore presumably not directly linked to the presence of sacroiliac joint MRI lesions.
咳嗽变异型哮喘患者脱敏治疗前后γ干扰素和IL-4的水平
Authors: 那美玲, 柯正华, 郭丽华, 刘丽群, 饶锦绣
Journal: BMJ (2007)

对30例咳嗽变异型哮喘患者脱敏治疗前和治疗1年后检测血清中γ干扰素(IFN-γ)、白细胞介素4(IL-4)以及总IgE的水平,并与30例对照者进行比较.结果显示脱敏治疗1年后,血清IFN-γ水平明显增高,IL-4和总IgE水平明显降低,治疗前后差异有统计学意义.提示脱敏治疗可调节咳嗽变异型哮喘患者血清IFN-γ和IL-4水平,降低总IgE,有效控制临床症状。
International consensus on the diagnosis and management of dumping syndrome
Authors: Emidio Scarpellini, Joris Arts, George Karamanolis, Anna Laurenius, Walter Siquini, Hidekazu Suzuki, Andrew Ukleja, Andre Van Beek, Tim Vanuytsel, Serhat Bor, Eugene Ceppa, Carlo Di Lorenzo, Marloes Emous, Heinz Hammer, Per Hellström, Martine Laville, Lars Lundell, Ad Masclee, Patrick Ritz, Jan Tack
Journal: Nature Reviews Endocrinology (2020)

Abstract Dumping syndrome is a common but underdiagnosed complication of gastric and oesophageal surgery. We initiated a Delphi consensus process with international multidisciplinary experts. We defined the scope, proposed statements and searched electronic databases to survey the literature. Eighteen experts participated in the literature summary and voting process evaluating 62 statements. We evaluated the quality of evidence using grading of recommendations assessment, development and evaluation (GRADE) criteria. Consensus (defined as &gt;80% agreement) was reached for 33 of 62 statements, including the definition and symptom profile of dumping syndrome and its effect on quality of life. The panel agreed on the pathophysiological relevance of rapid passage of nutrients to the small bowel, on the role of decreased gastric volume capacity and release of glucagon-like peptide 1. Symptom recognition is crucial, and the modified oral glucose tolerance test, but not gastric emptying testing, is useful for diagnosis. An increase in haematocrit &gt;3% or in pulse rate &gt;10 bpm 30 min after the start of the glucose intake are diagnostic of early dumping syndrome, and a nadir hypoglycaemia level &lt;50 mg/dl is diagnostic of late dumping syndrome. Dietary adjustment is the agreed first treatment step; acarbose is effective for late dumping syndrome symptoms and somatostatin analogues are preferred for patients who do not respond to diet adjustments and acarbose.
Institutional-based rehabilitation training improves rehabilitation and quality of life for patients with schizophrenia in community
Authors: Weibo Zhang, Jiani Ma, Hao Gu, Ghuofang Zhang, Yi Zhu
Journal: BMJ (2015)

Objective
To evaluate the effects of institutional-based rehabilitation training on the rehabilitation and quality of life for patients with schizophrenia in community.


Methods
An institutional-based rehabilitation program for schizophrenia patients Sunny Garden was implemented by Shanghai Mental Health Center. One hundred and sixty eight patients with schizophrenia were enrolled and randomly assigned into training group (n=83) and control group (n=85); 8 patients dropped off, there were 80 cases in each group by the end of the study. Patients in training group received institutional-based training for 6 months, including rehabilitation training courses and family education; while patients in control group received conventional management in community. Insight and Treatment Attitude Questionnaire (ITAQ), Positive and negative symptom scale (PANSS), Personal and Social Performance scale (PSP) and Chinese Version of the Schizophrenia Quality of Life Scale (SQLS) were applied for assessment before and after study in both groups.


Results
There were no significant differences in ITAQ, PANSS, PSP and SQLS between two groups before intervention(t=0.59, P=0.56; t=1.21, P=0.23; t=1.08, P=0.28; t=-1.41, P=0.16, respectively). After intervention, these indicators in the training group were significantly superior to those in control group(t=3.07, P=0.03; t=-2.25, P=0.03; t=2.60, P=0.01; t=-3.24, P<0.01, respectively).


Conclusion
The institutional-based rehabilitation training program can effectively promote the rehabilitation of patients with schizophrenia in community and improve their quality of life.


Key words: 
Rehabilitation; Schizophrenia; Quality of life
Engineered biomaterials for cancer immunotherapy
Authors: Lulu Cai, Jialu Xu, Zhenglin Yang, Rongsheng Tong, Ziliang Dong, Chao Wang, Kam W. Leong
Journal: MedComm (2020)

Abstract Although cancer immunotherapy is showing tremendous promise and has progressed to the clinic, it has only achieved sporadic efficacy, with only a fraction of patients benefitting from the therapy and with undesirable side effects due to poor selectivity and high doses. Localized delivery of immunomodulators to activate anticancer immunity in situ avoids overactivation of the systemic immune system and reduces side effects. Engineered biomaterials—implantable, injectable, or transdermal—fabricated into drug delivery devices are critical components for the development of localized cancer immunotherapies. In this review, we briefly summarize progress in the application of engineered biomaterials to the localized delivery of cancer immunotherapy.
Prevalence of pathogens in the hospitalized patients with community-acquired pneumonia in HebeiProvince
Authors: Xi-xin Yan, Hai-bo Xu
Journal: BMJ (2012)

An investigation on pathogens was performed on 219 consecutive adult inpatients with community-acquired pneumonia (CAP) from November 2008 to August 2009 in Hebei Province.Sputum samples from all patients in acute phase were collected for multiplex polymerase chain reaction (PCR) detection. Pathogens were identified in 125 patients. Streptococcus pneumoniae was the most common pathogen isolated in 75 cases (60％) ; influenza A virus was the most common virus isolated in 32 cases (26％) ; and mixed infection were found in 31 patients (25％). Streptococcus pneumoniae species were more frequent among patients aged ≤30 and 51 -70; Haemophilus influenzae species were more frequent among patients with coexisting disease; the percent of Mycoplasma pneumoniae species infections in the lowrisk groups( Ⅰ - Ⅱ ) was higher than patients in the high-risk groups ( Ⅲ - V ).The percent of virus pneumoniae species infections in patients with coexisting disease trended to higher than patients without coexisting disease,but the difference was not statistically significant ( P ＞ 0.05 ).The results indicate that Streptococcus pneumoniae remains the major bacteria,Viruses are frequently detected in CAP with influenza A virus being the most common one; and mixed infection should not be ignored.The age and underlying diseases are important factors influencing the distribution of pathogens.

Key words: 
Community-acquired infection; Pathogens
A phase I/II clinical trial of the reversible LSD1 inhibitor, seclidemstat, in patients with relapsed/refractory Ewing sarcoma.
Authors: Damon R. Reed, Leo Mascarenhas, Paul A. Meyers, Sant P. Chawla, Douglas James Harrison, Bhuvana Setty, Jonathan Metts, David S. Wages, David D. Stenehjem, Daniela Y. Santiesteban, Steven G. DuBois
Journal: Journal of Clinical Oncology (2020)

TPS11567 Background: Ewing sarcoma (ES) is a rare, aggressive bone and soft tissue cancer that predominantly afflicts adolescents and young adults. Novel therapeutic agents are needed as there are no approved targeted treatments for this disease. ES is characterized by a chromosomal translocation resulting in an EWS/ETS fusion oncoprotein, a transcription factor that results in aberrant gene expression leading to ES progression. Lysine specific demethylase 1 (LSD1) associates with EWS/ETS oncoproteins to alter gene expression and contribute to disease progression. Directly inhibiting EWS/ETS is challenging and little progress has been made, though targeting LSD1 presents a viable therapeutic strategy for ES. Seclidemstat (SP-2577, Salarius Pharmaceuticals) is a first-in-class, orally bioavailable, small molecule with reversible and noncompetitive selective inhibition of LSD1 at low nanomolar concentrations (IC 50 : 25-50 nM). Seclidemstat inhibits LSD1’s scaffolding functions and enzymatic activity to help reverse aberrant gene expression. In vitro data show that treatment with seclidemstat, or seclidemstat analog, modulates EWS/ETS transcriptional activity, down-regulating oncogene expression and up-regulating tumor-suppressor gene expression. In in vivo xenograft studies (e.g., SK-N-MC, A673), mice treated with seclidemstat show significant tumor growth inhibition/regression vs the control vehicle group. Methods: This phase 1/2 clinical study of seclidemstat is being conducted in relapsed or refractory ES (NCT03600649). The trial is an open-label, non-randomized dose-escalation/dose-expansion study designed to determine the maximum tolerated dose through single-patient dose escalation followed by traditional 3+3 design. The primary objective is to assess seclidemstat’s safety and tolerability while secondary objectives include pharmacokinetics, efficacy and exploratory pharmacodynamic markers. Patients must be ≥12 years old, have received at least 1 prior line of therapy including a prior camptothecin-based regimen, with a life expectancy &gt; 4 months. All patients receive seclidemstat twice-daily (BID) as oral tablets until unacceptable toxicity or disease progression. Patients are followed for survival until the end of study. The trial is currently recruiting across 8 locations in the United States. Upon identification of the recommended phase 2 dose, that cohort will be expanded to enroll a total of 20 patients. Clinical trial information: NCT03600649 .
咳嗽变异型哮喘误诊为慢性支气管炎原因分析
Authors: 刘国华
Journal: BMJ (2007)

喘息通常被认为是支气管哮喘的主要症状,而咳嗽是急性或慢性支气管炎的特征.因此,临床上很易将以咳嗽为主要或惟一症状的咳嗽变异型哮喘误诊为慢性支气管炎.现将我院2年来遇到的15例报告如下。
Relationship between oxidative stress and endothelial cell apoptosis in patients with obstructive sleep apnea-hypoventilation syndrome
Authors: Zhi-hong Feng, Xiu-hong Nie, Lian-guo Zhang, Xiao-jun Fan
Journal: BMJ (2009)

Objective To study the relationship between oxidative stress and endothelial cell apoptosis in patients with obstructive sleep apnea-hypoventilation syndrome (OSAHS). Methods Sixth-seven patients definitely diagnosed by potysomnography (PSG) as OSAHS were divided into three groups according to their apnea-hypoventilation index (AHI), 14 in mild group (5 < AHI≤20), 21 in moderate group (20 < AHI≤40) and 32 in severe group (AHI 40). And, 18 healthy persons (AHI <5) were recruited as controls. Blood samples were obtained form all of them after PSG performance for measuring apoptotic endothelial cells (CD146AnnV+) and serum levels of superoxide dismutase (SOD) and malondialdehyde (MDA). Results Serum level of MDA and CD146AnnV+ in moderate and severe OSAHS group were significantly higher than those in control group (all P < 0.05). Serum level of SOD in moderate and severe OSAHS group was significantly lower than that in control group (P < 0.05). CD146AnnV+ correlated positively with AHI, the longest apnea time (LAT) and oxygen desaturation index (ODI) (r = 0.778, 0.609 and 0.689, respectively, all P < 0.05) and correlated reversely with saturation of arterial blood oxygen at night (SaO2min) (r =-0.635, P < 0.01). CD146AAnnV+ correlated positively with serum level of MDA (r = 0. 698, P < 0.01), and correlated reversely with serum level of SOD (r =-0.705, P < 0.01). Results of linear multivariate regression analysis showed that AHI, serum levels of SOD and MDA were independent risk factors for endothelial cells apoptosis in patients with OSAHS. Conclusions There existed oxidative stress due to intermittent hypoxia in patients with OSAHS, which could be one of the major causes in exacerbating endothelial damage. 

Key words: 
Sleep apnea-hypopnea, obstructive;  Vascular endothelial cell;  Apoptosis; Oxidative stress
胆道感染合并肝脓肿一例
Authors: 宋晓华
Journal: BMJ (2009)

患者男,57岁.主因腹痛3周伴发热2周于2008年5月16日人院.患者入院前3周进食油腻食物后突发中上腹疼痛,以右上腹阵发性绞痛为主,当时无发热、寒战及黄疸等,在地段医院予抗炎解痉等治疗,1周后患者腹痛稍有缓解,但出现高热,最高达39.9℃,伴寒战,并出现皮肤、巩膜黄染,继续予头孢他啶及奥硝唑抗炎治疗,体温无明显下降,黄疸进行性加重,为进一步诊治收入我院.2型糖尿病病史5年余,血糖控制欠佳,随机血糖最高20 mmol/L。
Analysis of community health service team in service mode
Authors: Yan-min Dong, De-lu Yi, Yuan-yuan Li, Jie Luo
Journal: BMJ (2013)

A total of 526 team members from 28 community health service (CHS) centers in 5 pilot cities were surveyed by a questionnaire. All CHS centers developed team service. And 275 service teams were established and the coverage rate of area resident committee was 100%. The teaming modes were mainly divided into four kinds: medical-nursing-prevention classic combination, big team professional expansion, small team medical combination and non-health technology extensive participation. The team services showed multiple advantages of professionism, energy and time complementing. We should strengthen team construction, improve perfect team service mode and policy support and create a good environment for CHS development.


Key words: 
Community health services; Team work; Model
急性心肌梗死合并左眼视网膜分支动脉栓塞一例
Authors: 林兆恒, 金靖
Journal: BMJ (2004)

患者男,40 岁,因左胸部持续压榨性疼痛4 h 于2002年1月12日入院. 既往有高脂血症史2年.体格检查:体温36.5℃,脉搏83次/min,呼吸22次/min,血压100/60 mm Hg(13/8 kPa).肥胖体型,急性痛苦貌;双肺呼吸音粗糙,左下肺闻及湿啰音;心界无扩大,心率83次/min,律齐,心音低弱,各瓣膜区未闻及杂音;双下肢无浮肿.心电图:胸导联V2～4呈QS波群,ST段弓背样抬高0.2～0.4 mV, T波倒置.心肌酶谱:天冬氨酸转氨酶287 U/L,肌酸激酶468 U/L,心型肌酸激酶90 U/L.入院诊断:急性前壁心肌梗死.给予扩张冠状动脉、心肌营养治疗,准备静脉溶栓。
酚磺乙胺致阴茎异常勃起一例
Authors: 郭建峰, 肖永芳
Journal: BMJ (2005)

患者男,58岁,因阴茎异常勃起3 d入院.患者3 d前因鼻出血在村卫生室静脉滴注酚磺乙胺(酚磺乙胺1.5 g加入5% 葡萄糖液 500 ml)1次,约2 h后阴茎异常持续勃起、疼痛,一直未治疗.今日来我院就诊,在门诊行冷敷、镇静、硬膜外麻醉、穿刺冲洗治疗,无效后收入院.既往无其他病史.专科检查见:阴茎高度勃起,坚硬,包皮轻度水肿,龟头呈紫红色,尿道海绵体及阴茎头触痛,较松软.治疗方法:局麻下行阴茎头阴茎海绵体分流术.术后按摩阴茎,常规换药,10 d后拆线痊愈。
Elevating the standard of care: Impact of a regimen-level prior authorization tool on provider adherence to clinical guidelines.
Authors: Rogelio Alberto Brito, Geri Kuklinski, Patricia Angelica, Anne Claussen, Diana Fischer, Heeseon Yeon, Chiara Leprai, Rebecca Karos
Journal: Journal of Clinical Oncology (2020)

e19235 Background: New developments in oncology therapy continue to grow in complexity, fueling a dramatically rising cost of care. Traditional care models present opportunities to streamline plan sponsor management efforts, expedite therapy, and improve health outcomes. Studies suggest adherence to evidence-based standards results in higher quality care. Current plan sponsor management platforms match medical policy to individual drugs, not to combination therapy regimens and lack real-time access to standard treatment guidelines. 70% of precertification requests are submitted via antiquated, cumbersome methods such as paper and fax. Methods: CVS Health/Aetna developed a comprehensive oncology solution featuring an enterprise web-based clinical decision support prior authorization tool (Novologix) at the regimen level to reduce administrative burden and support quality care. Novologix regimens were updated via collaboration with the National Comprehensive Cancer Network (NCCN) evidence-based guidelines. Groups also entered a value-based payment (VBP) model to help support quality of care by promoting adherence to NCCN guidelines when clinically appropriate and tool utilization. Eligible members were Commercial, fully-insured members newly diagnosed with breast, colorectal, or lung cancer. Providers were offered dedicated, individual training sessions to provide education on the Novologix tool. NCCN-aligned regimens requested through the platform were automatically certified. Any non-NCCN aligned regimens received accelerated medical review by a board-certified medical oncologist with the option for an external peer-to-peer review upon denial. Providers received ongoing quality and cost of care reporting. Results: Primary in progress. N of precertification requests submitted via Novologix ( 28 requests as of 1/23/2020) - (will include graph displaying N of requests by month). N of regimens submitted via Novologix that were automatically certified (46% as of 1/23). Avg turnaround times for modified regimen requests requiring clinical review (TBD). Avg % adherence to NCCN guidelines (100% as of 1/23/20) Secondary: Total cost of care (preliminary/other leading indicator). Conclusions: By engaging oncology practices through an enhanced payer-provider collaboration and implementing an automated regimen-level precertification process we can facilitate higher-quality oncology care. Future studies will be needed to measure the impact of this program on total cost of care.
Final analysis of a phase II, open label, randomized study of osimertinib versus osimertinib plus carboplatin/pemetrexed for patients with locally advanced or metastatic non-small cell lung cancer whose disease has progressed with previous EGFR-TKI and whose tumours harbour a T790M mutation (LOGIK1604/NEJ032A).
Authors: Kentaro Tanaka, Hajime Asahina, Morihito Okada, Takahiro Uchida, Kana Watanabe, Kosuke Hamai, Taishi Harada, Yukari Tsubata, Shunichi Sugawara, Kunihiko Kobayashi, Kenji Sugio, Satoshi Oizumi, Isamu Okamoto
Journal: Journal of Clinical Oncology (2020)

e21594 Background: Osimertinib is now available not only as a second line treatment for the patients with EGFR and T790M-mutation positive non-small cell lung cancer (NSCLC) after initial tyrosine kinase inhibitors (TKIs) but as a first line treantment for those who are TKI-naive. The efficacy and the safety of osimertinib plus palatinum-based chemotherapy has not yet been evaluated. Methods: This phase 2, open-label, randomized study enrolled adult patients (pts) with clinical stage IIIB or IV, or postoperative recurrent NSCLC harbouring susceptible EGFR and T790M mutations after preceded EGFR-TKI failure. Pts were randomly assigned to receive either an osimertinib [80 mg/day 1-21; q3w] or a combination of osimertinib [80 mg/day 1-21] with carboplatin/pemetrexed (hereafter combination) [area under the curve (AUC) = 5 and 500 mg/m 2 day 1; q3w]. The primary endpoint was progression-free survival (PFS). Secondary endpoints included incidence of adverse events, response rate and overall survival. As indiction of osimertinib was expanded to a first line, we amended the protocol to discontinue the enrollment and perform final analyses. Results: From October 2016 to January 2019, 62 pts were enrolled [31 pts osimertinib; 31 pts combination] (median age 68 (37-80); 53.2% male; 83.3% stage IV; 100% adenocarcinoma; 59.7% exon 19 deletion and 40.3% L858R; 45.2% never smoker). The rate of grade (G) ≥ 3 treatment-related adverse events was 32.2% in the osimertinib group and 83.9% in the combination group. Neutropenia, anemia and thrombocytopenia were more common in the combination group and the rates of G ≥ 3 were 0%, 0% and 6.4% in the osimertinib group and 38.7%, 25.8% and 29.1% in the combination group, respectively. Three episodes (9.7%) of G ≥ 3 infection and one episode (3.2%) of G ≥ 3 febrile neutropenia were uniquely observed in the combination group, however, these were well managed. Two episodes (6.5%) of G ≥ 3 pneumonitis was observed only in the osimertinib group. Exaggeration of adverse events specific for osimertinib or any unknown adverse event was not observed in the combination group. Final PFS analysis is to be demonstrated in the presentation. Conclusions: Combination of osimertinib with carboplatin and pemetrexed demonstrated safety in patients with EGFR and T790M mutation-positive NSCLC and the efficacy should be validated in the future phase 3 study. Clinical trial information: 000024438.
Influencing factors of self-efficacy among community-based patients with chronic obstructive pulmonary disease
Authors: Qi Xu, Zhi-zhen Yao, Jian-guo Mao
Journal: BMJ (2012)

Objective To investigate the self-efficacy levels and its influencing factors of community-based patients with chronic obstructive pulmonary diseases (COPD).Methods From October 2008 to March 2009,320 community COPD patients were recruited from a Shanghai community.They undertook questionnaires,scale survey and pulmonary function testing so as to investigate the influencing factors of self-efficacy.Results The total scale of self-efficacy was 74.24 ± 9.50 and the level of selfefficacy in 286 cases( 89.4％ )was intermediate.The knowledge of COPD,social supports,forced expiratory volume at 1 second (FEV1)/forced vital capacity (FVC) and self-management level were entered into regression equation and could explain 57.1％ of the total variance of independent variables.Conclusions The knowledge of COPD,social supports,FEV1/FVC and self-management level are the major influencing factors of self-efficacy in the COPD patients.We should improve the knowledge of disease and strengthen the psychological care and social supports so as to improve their quality of life.

Key words: 
Pulnonary disease,chronic obstructive; Factors analysis,statistical; Selt-eflicacy