tbuckley/cabot-search huggingface dataset:
Fostamatinib for the treatment of diffuse large B-cell lymphoma.
Authors: Hendrik-Tobias Arkenau, Anna Patrikidou, Ian Flinn, Jonas C. Hylton, Sandra Tong, Kirit Ardeshna
Journal: Journal of Clinical Oncology (2020)

e20067 Background: Diffuse large B-cell lymphoma (DLBCL) is an aggressive and common form of non-Hodgkin’s lymphoma, characterized by marked genetic heterogeneity. The disease is difficult to treat, and patients with relapsed/refractory DLBCL often have poor outcomes. Some subsets of DLBCL have an increased reliance on B-cell receptor (BCR) activity. Spleen tyrosine kinase (SYK) is a signaling molecule essential for BCR activation. Fostamatinib, an oral SYK inhibitor, was evaluated for treatment of relapsed/refractory DLBCL in a phase 2 randomized, placebo-controlled trial 1 (NCT01499303), and 9 patients had clinical benefit (1 complete response, 1 partial response, and 7 stable disease). The patients with clinical benefit from fostamatinib treatment had DLBCL of germinal center B-cell (GCB) or intermediate cell of origin. We present the clinical outcomes of 2 patients from this trial who continued to benefit from fostamatinib treatment for over 6 years. Methods: Medical records for the 2 patients were retrospectively reviewed for dose regimen, clinical response, and safety data. Results: Patient A, a 63-year-old male patient with DLBCL of GCB origin, had been diagnosed with follicular lymphoma in 1996, transformation in 2002. He had undergone 1 line of treatment for follicular lymphoma and 5 treatments for DLBCL prior to fostamatinib treatment. He started fostamatinib at 100mg BID in Dec 2012, which was reduced to 100mg daily in Apr 2013, and patient continues at 100 mg QD. Patient A has maintained a complete response (CR) for &gt; 5 years. An isolated infra-centimetric suspicious lesion was noted in Patient A in May 2019, which is stable as of January 2020 with a progressive decrease of metabolic activity. Patient B, a male with DLBCL of an intermediate cell of origin, was 69 years old at baseline with 2 DLBCL treatments prior to fostamatinib treatment since his diagnosis in Aug 2012. He started fostamatinib in May 2013 at 200 mg BID with no dose changes over the last 7 years. Patient B had a partial response (PR) per Chesson criteria since December 2014, with a sustained improved metabolic response continuing since ( &gt; 6 years), with all but a single metastatic site no longer visible. The only serious adverse event in these 2 patients was a ventricular fibrillation and grade 4 cardiac arrest at Day 90 in Patient B, necessitating defibrillation insertion. This was deemed unrelated to treatment and resolved. Conclusions: Fostamatinib may provide durable benefit to a small subset of patients with relapsed/refractory DLBCL. 1. Flinn, I.W., et al., Eur J. Cancer 2016; 54:11-17
Knowledge and management capability on diabetic kidney disease among general practitioners in community health centers of Shanghai
Authors: Hua Yang, Huiling Xia, Limin Ren, Wei Qiu, Xiaoyun Cao, Shuyu Li, Zhangyan Chen
Journal: BMJ (2017)

Objective
To survey the status of knowledge and management capability on diabetic kidney disease (DKD) among general practitioners (GPs) in community health service centers (CHCs) of Shanghai.


Methods
A questionnaire survey was conducted among 152 GPs from 6 CHCs in 3 districts of Shanghai during May 2015 and March 2016.


Results
In the current survey, 138 (90.8%) valid questionnaires of DKD knowledge and 152 (100.0%) valid questionnaires of DKD management capability were retrieved.The overall accuracy rate of DKD knowledge was 60.2%(1 246/2 070); the accurate rates of epidemiology, diagnosis, treatment, and community management knowledge were 62.7%(173/276), 62.8%(520/828), 60.6%(502/828)and 35.5%(49/138), respectively.There were significant differences in accuracy rates of treatment related questions among GPs with different years of working (P=0.032 2); but no significant differences were observed in accuracy rates of 4 aspects related questions among GPs with different education and professional title (P>0.05). Among 152 participants, 113 (74.3%) responded to conduct DKD screening in clinic work; 97(63.8%) chose renal function, 86 (56.6%) chose urine routine and 86 (56.6%) chose urinary microalbumin for screening, respectively. The top three answers tohow to intervene patients with DKDwere blood glucose control(107, 70.4%), medication of ACEI or ARB(77, 50.7%), and high-quality low protein diet(68, 44.7%).


Conclusion
The knowledge and management capability on DKD among GPs in CHCs are insufficient. The capability of diagnosis and treatment of DKD should be improved by joint efforts of GPs, trainers, and community health administrators.


Key words: 
Diabetic kidney disease; Questionnaires; General practitioners
Clinical analysis for 66 cases of brucellosis in a general hospital
Authors: Ying Ge, Xiao-qing Liu, Guo-hua Deng
Journal: BMJ (2011)

Epidemiological, clinical, laboratory and treatment data, as well as outcomes of 66patients diagnosed as brucellosis during 1984 to 2010 in Peking Union Medical College Hospital were retrospectively analyzed. Thirty-four (51.5%) patients had a history of close contact with sheep or cows infected with brucellosis, eight (12. 1% ) had eaten not-fully-boiled or roasted mutton, three (4. 5% ) had drunk or contacted with contaminated milk, and transmission route was unknown in 21 (31.8%). The most common manifestations were fever ( 97.0%, 64/66 ), loss of appetite and fatigue ( 93. 9%, 62/66 ),sweating (47.0%, 31/66), myalgia and arthralgia (54. 5%, 34/66 ), hepatomegaly (27.3%, 18/66),splenomegaly (37.9%, 25/66), increased erythrocyte sedimentation rate (ESR) (62. 1%, 41/66), and elevated C-reactive protein (65.4%, 34/52). Average interval from onset to diagnosis was 19. 2 weeks. All 66 patients were positive in serum agglutination test for BruceUa, and 28 (42. 4% ) positive in blood or bone marrow culture for Brucella. Sixty-five of 66 patients were treated by standard combined treatment with rifampicin, quinolone, minocycline and streptomycin, with all effective, and only four with mild liver damage in treatment who got better after discontinuing medicines and changing treatment regimen.

Key words: 
Brucellosis;  Retrospective studies
不同起搏模式心电图的识别
Authors: 张海澄, 昃峰
Journal: BMJ (2009)

植入心脏起搏器的患者,心电图上可见到起搏刺激脉冲钉样标记、以及由其引起的心房和(或)心室激动波,称为起搏心电图.认识和了解起搏心电图对于分析起搏器是否正常工作,辨别所出现的问题及判断起搏心律与患者主诉之间的关系等十分重要。
Abstract 15305: Feasibility and Performance of a Diagnosis-only Cardiac Implantable Electronic Device Interrogation System and Process for Use in a Hospital Environment
Authors: Suneet Mittal, Kelly King-Ellison, Kevin Younge, Kenneth Stein
Journal: Circulation (2015)

Introduction: Interrogation of cardiac implantable electronic devices (CIEDs) typically requires in-person evaluation. When needed urgently in a hospital environment, the need for a company representative and/or specially trained physician/nurse delays diagnosis and increases resource utilization. A diagnosis-only remote interrogation device and process for Boston Scientific (BSC) CIEDs was developed to address this situation. Methods: LATITUDE Consult is a read-only interrogator that provides 24/7 access to expert technical review of data retrieved from a BSC CIED without requiring on-site access to a full-function programmer or specially trained personnel. Usage metrics, reason and results for each interrogation were recorded during the initial launch of the system. Results: 53 communicators were used in hospitals and clinics across 15 states. There were 509 discrete transmissions (ICD in 39%; PPM 35%; CRT-D 26%), most commonly from the ER (n=294, 58%) or PACU (n=145, 28%). A third of transmissions occurred outside of “working hours”. Results were communicated within 15 minutes in 89% of cases. The most common reasons for device check were evaluation of symptoms, post-procedure check, and shock evaluation. Transmissions were categorized as: no episodes in past 72 hours and no out of range measurements (n=174, 34%); episodes in past 72 hours but no out of range measurements (n=170, 33%); further review recommended (n=130, 26%). Overall, only 53 (10%) transmissions were classified as urgent and required immediate attention (Table). Conclusions: We demonstrate the feasibility of a stand-alone system that can rapidly interrogate a BSC CIED in a variety of hospital settings, even outside of traditional business hours. For 90% of all device interrogations, immediate attention was not required; this allows resources to be efficiently focused on the small minority of patients with an urgent device related issue.
Extramedullary relapse in lumbar spine of a patient with acute promyelocytic leukemia after remission for 16 years: case report and literature review
Authors: Zhengmei He, Yuan Deng, Shandong Tao, Xin Zhang, Yijia Fang, Yue Chen, Kankan Chen
Journal: BMJ (2016)

A 46-years female patients with extramedullary relapse of lumbar spine after 16-year remission of acute promyelocytic leukemia (APL) was reported. After surgical treatment, local radiotherapy combined with all-trans retinoic acid (ATRA) and arsenic trioxide (ATO), the patient achieved and maintained a second complete remission (CR). The literature showed that extramedullary relapse was a relatively rare complication of APL. The recurrence time of APL after remission varied from 6 months to 12 years, and the central nervous system was the most frequent site of relapse. The causes and treatment for extramedullary relapse of APL are various. The successful diagnosis and treatment of this case may provide experience for management of extramedullary relapse in APL patients.


Key words: 
Leukemia, myelocgtic, acute; Recurrence
Novel design fine-needle biopsy needles are ready to take over the supremacy of fine-needle aspiration needles for sampling of solid pancreatic masses
Authors: Angels Ginès
Journal: Endoscopy (2020)

Endoscopic ultrasound (EUS)-guided tissue acquisition is a well-established method for pathological diagnosis of solid tumors wherever the needle can reach. However, there is currently conflicting evidence on whether any specific needle or technique is superior to others.
Clinical characteristics and outcomes of patients with coronavirus disease 2019 (COVID-19) and rheumatic disease: a comparative cohort study from a US ‘hot spot’
Authors: Kristin M D’Silva, Naomi Serling-Boyd, Rachel Wallwork, Tiffany Hsu, Xiaoqing Fu, Ellen M Gravallese, Hyon K Choi, Jeffrey A Sparks, Zachary S Wallace
Journal: Annals of the Rheumatic Diseases (2020)

To investigate differences in manifestations and outcomes of coronavirus disease 2019 (COVID-19) infection between those with and without rheumatic disease.
Survival Outcomes Associated With 3 Years vs 1 Year of Adjuvant Imatinib for Patients With High-Risk Gastrointestinal Stromal Tumors
Authors: Heikki Joensuu, Mikael Eriksson, Kirsten Sundby Hall, Annette Reichardt, Barbara Hermes, Jochen Schütte, Silke Cameron, Peter Hohenberger, Philipp J. Jost, Salah-Eddin Al-Batran, Lars H. Lindner, Sebastian Bauer, Eva Wardelmann, Bengt Nilsson, Raija Kallio, Panu Jaakkola, Jouni Junnila, Thor Alvegård, Peter Reichardt
Journal: JAMA Oncology (2020)

<h3>Importance</h3> Adjuvant imatinib is associated with improved recurrence-free survival (RFS) when administered after surgery to patients with operable gastrointestinal stromal tumor (GIST), but its influence on overall survival (OS) has remained uncertain. <h3>Objective</h3> To evaluate the effect of adjuvant imatinib on OS of patients who have a high estimated risk for GIST recurrence after macroscopically complete surgery. <h3>Design, Setting, and Participants</h3> In this open-label, randomized (1:1), multicenter phase 3 clinical trial conducted in Finland, Germany, Norway, and Sweden, 400 patients who had undergone macroscopically complete surgery for GIST with a high estimated risk for recurrence according to the modified National Institutes of Health Consensus Criteria were enrolled between February 2004 and September 2008. Data for this follow-up analysis were analyzed from September to November, 2019. <h3>Interventions</h3> Imatinib 400 mg/d administered orally for either 12 months or 36 months after surgery. <h3>Main Outcomes And Measures</h3> The primary end point was RFS; the secondary objectives included OS and treatment safety. <h3>Results</h3> The intention-to-treat cohort consisted of 397 patients (12-month group, 199; 36-month group, 198; 201 men and 196 women; median [IQR] age, 62 (51-69) years and 60 (51-67) years, during a median follow-up time of 119 months after the date of randomization, 194 RFS events and 96 OS events were recorded in the intention-to-treat population. Five-year and 10-year RFS was 71.4% and 52.5%, respectively, in the 36-month group and 53.0% and 41.8% in the 12-month group (hazard ratio [HR], 0.66; 95% CI, 0.49-0.87;<i>P</i> = .003). In the 36-month group, 5-year OS and 10-year OS rates were 92.0% and 79.0%, respectively, and in the 12-month group 85.5% and 65.3% (HR, 0.55; 95% CI, 0.37-0.83;<i>P</i> = .004). The results were similar in the efficacy population, from which 15 patients who did not have GIST in central pathology review and 24 patients who had intra-abdominal metastases removed at surgery were excluded (36-month group, 10-year OS 81.6%; 12-month group, 66.8%; HR, 0.50; 95% CI, 0.32-0.80;<i>P</i> = .003). No new safety signals were detected. <h3>Conclusions and Relevance</h3> Three years of adjuvant imatinib is superior in efficacy compared with 1 year of imatinib. Approximately 50% of deaths may be avoided during the first 10 years of follow-up after surgery with longer adjuvant imatinib treatment. <h3>Trial Registration</h3> ClinicalTrials.gov Identifier:NCT00116935
The carotid plaque as paradigmatic case of site-specific acceleration of aging process: The microRNAs and the inflammaging contribution
Authors: Salvatore Collura, Cristina Morsiani, Andrea Vacirca, Sara Fronterrè, Carmen Ciavarella, Francesco Vasuri, Antonia D’Errico, Claudio Franceschi, Gianandrea Pasquinelli, Mauro Gargiulo, Miriam Capri
Journal: Ageing Research Reviews (2020)

Atherosclerosis is considered a chronic inflammatory disease of arteries associated with the aging process. Many risk factors have been identified and they are mainly related to life-styles, gene-environment interactions and socioeconomic status. Carotid and coronary artery diseases are the two major atherosclerotic conditions, being the primary cause of stroke and heart attack, respectively. Nevertheless, carotid plaque assumes particular aspects not only for the specific molecular mechanisms, but also for the types of atheroma which may be associated with a better or a worst prognosis. The identification of circulating blood biomarkers able to distinguish carotid plaque types (stable or vulnerable) is a crucial step for the improvement of adequate therapeutic approaches avoiding or delaying endarterectomy in the oldest old individuals (> 80 years), a population predicted to growth in the next years. The review highlights the most recent knowledge on carotid plaque molecular mechanisms, focusing on microRNAs (miRs), as a site-specific accelerated aging within the conceptual framework of Geroscience for new affordable therapies.
Assessment of mutation burden after clinical intervention in pancreatic ductal adenocarcinomas (PDAC), and biliary tract cancers (BTC) via profiling circulating tumor DNA (ctDNA).
Authors: Fabio Pittella-Silva, Masayo Motoya, Yasutoshi Kimura, Toru Nakamura, Siew-Kee Kee Low, Yusuke Nakamura
Journal: Journal of Clinical Oncology (2020)

e15529 Background: PDAC and BTC have very poor prognosis with limited treatment options. Blood-based monitoring of ctDNA may have great potential to improve early detection of relapse or failure to chemotherapy and to possibly identify actionable genetic alterations. Methods: We performed targeted sequencing using NGS with Ion S5 Oncomine PanCancer gene panel to investigate mutations in 52 genes in 42 PDAC and 24 BTC patients. Blood samples were obtained from PDAC and BTC cases before the first intervention (baseline) as well as 2-4 weeks later to evaluate cfDNA mutations after surgery or chemotherapy. Actionable alterations with potential therapeutic relevance was defined as those with possible treatments within OncoKB system. We also compared the amount of cfDNA and mutant allele detection rates in pre-, intra- and post-operative samples. Results: Overall detection of ctDNA alterations in baseline samples was 74% (31/42) in PDAC cases. Alterations including SNVs and CNVs were detected among 15 genes; mutations in TP53 (53%), KRAS (41%) and SMAD4 (10%) were most commonly identified. Overall detection rate in BTC patients was 83% (20/24) comprising 9 genes; frequent mutations were observed in TP53 (58%) and KRAS (33%). Decrease in MAF (mutant allele frequency) was observed in 64% (18/28) of PDAC cases after the treatment and that of CA19-9 was observed in 50% (14/28) of the cases. In BTC pts, reduction of MAF was observed in 60% of the cases after surgery. Potentially actionable mutations were observed in 38% of PDAC samples and in 25% of BTC samples. Interestingly, the amounts of cfDNA were 4-fold higher in intraoperative samples compared to pre- and post-operative samples indicating release of cfDNA during surgery, possibly by tissue damage. Conclusions: We have shown the feasibility to assess minimum residual tumor cells or drug response by liquid biopsy in both PDAC and BTC which may improve the clinical management.
Correlations of neurophysiological features with clinical manifestation in patients with diabetic peripheral neuropathy
Authors: Che Chunhui, Wei Xiaofan, Huang Huapin, Jiang Fang
Journal: BMJ (2016)

Objective
To explore the correlation of electrophysiological features with clinical manifestation in patients with diabetic peripheral neuropathy(DPN).


Methods
The clinical data of 306 patients with DPN undergoing nerve conduction study (NCS) during May 2013 to June 2015 were retrospectively analyzed. Among 306 patients, 304 were type 2, and 2 were type 1 diabetes with a mean age of 64.1 years and disease duration of 1 week-31 years. The relationship between the electrophysiological features and clinical manifestations was evaluated. Nerve conduction studies and F-wave and in sympathetic skin response were analyzed.


Results
① NCS in lower limbs presented more abnormalities than that in upper limbs. There was the highest prevalence of not elicited sensory potential in Tibial nerve [56.9%(174/306), χ2=175.9] and the highest prevalence of not elicited motor potential in peroneal nerve [7.8%(24/306), χ2=1 103.1]. Amplitude abnormality was more severe in sensory nerve than that in motor nerve [41.4%(507/1 224) vs. 10.8%(132/1 224), χ2=559.2]. The ratio of abnormal motor conduction velocity or distal latency was higher than that of amplitude decreased [22.9%(280/1 224) vs. 10.8%(132/1 224), χ2=1 077.4]. ② The abnormal ratios of the shortest F-wave latency was lower than that of the prolonged distal latency in median and tibial nerve [5.4%(33/612) vs. 20.6%(126/612), χ2=607.6]. ③ The abnormal ratio of sympathetic skin response (SSR) in lower limbs were higher than that of upper limbs [40.2%(246/612)vs. 27.3%(167/612), χ2=129.4, P<0.001], abnormal ratio of amplitude was higher than that of the prolonged latency [30.1%(368/1 224) vs. 4.7%(58/1224), χ2=1 040.5, P<0.001]. Among the 99 cases presenting abnormal SSR in upper limbs, 32 cases were normal in conventional NCS. Among the 127 cases presenting abnormal SSR in lower limbs, 7 cases were normal in conventional NCS. ④Disease course and glycosylated hemoglobin values were positively correlated with the distal motor latency, and negatively correlated with the nerve conduction velocity and amplitude.


Conclusion
Electrophysiological features of DPN is mainly shown in axon of the distal sensory nerve. Long duration and hyperglycemia may lead to more abnormalities in electrophysiological tests.


Key words: 
Diabetic neuropathies; Peripheral nerves; Neural conduction studies; Electrophysiology
家庭教育不当造成小儿语言发育落后一例
Authors: 毕桂英, 杜中颀
Journal: BMJ (2004)

患儿女,2岁6个月,曾于1岁6个月来我院保健门诊就诊时发现其语言发育落后,不会说简单的字词,很少有语言-动作的条件反射.查体格和智力发育正常,听力正常.追问生活史,患儿生后即哭,3个月时能发一些元音,6个月左右咿呀学语,说明发音器官正常.但患儿1岁半都对语言的反应不敏感。
An analysis of relevant factors for depressive symptoms in residents aged 60 and over in Shimen Erlu Community of Shanghai
Authors: Chun-hui Liu, Sheng Liu, Jian-lin Ji
Journal: BMJ (2008)

Objective It aims to investigate prevalence of depressive symptoms among the elderly in community and to understand their related social factors. Methods Four neighborhood committees were randomly selected with cluster sampling as survey sites. Enrolled residents at age of 60 to 89 years were evaluated with a general background inventory and a geriatric depression scale(GDS). All the data were input to a microcomputer and were analyzed for its relevant factors with SPSS13. 0 software by multivariate logistic regression model. Results Totally, 1731 elderly people in the community were interviewed and rated with the inventory and scale mentioned above, and depressive symptoms were found in 297 of them, with prevalence of 17. 2 percent. Multivariate logistic regression analysis showed that there were seven factors associated to their depressive symptoms in the elderly, including family expenditure, housing condition, medical condition, familial support, hobbies in spare-time, ability to take care of oneself and participation to social activities. Conclusions A few social factors, such as living alone, insufficient income for family expenditure, disability of self care-taking, lack of hobby in spare-time, less participation to social activities, lack of familial support and severe chronic diseases by serf-evaluation, are all associated with depressive symptoms in the elderly.

Key words: 
Community health services;  Aged; Depressive disorder
鼻内镜手术与手术适应证
Authors: 周兵
Journal: BMJ (2008)

20世纪70年代,奥地利学者:Messeklinger首创针对鼻腔外侧壁的系统内镜诊断方法.他的著作 (Endoscopy of Nose)成为鼻内镜解剖和病理生理研究方面的基础参考书.他发现慢性鼻窦炎、鼻息肉的发生与鼻腔、鼻窦,特别是鼻腔外侧壁的病理和解剖变异等密切相关。
输卵管妊娠误诊致死亡二例尸检
Authors: 董艳光, 李新功, 吴起嵩, 丁洪基
Journal: BMJ (2005)

例1 患者41岁,因头晕、呕吐3 d于2003年12月24日晚11时30分入院.患者3 d前无明显诱因头晕、心慌,血压70/50 mm Hg(1 mm Hg = 0.133 kPa),无呕血、黑便,在家输液(具体药物不详)过程中出现意识丧失,以重度贫血收入当地医院.体温:36℃,心率:84次/min,呼吸:21次/min,血压:84/60 mm Hg,神志清,精神差,贫血貌,全身皮肤、黏膜苍白.血红蛋白:45 g/L.入院后输液、去甲肾上腺素治疗无效,于次日3时40分死亡.尸检所见:腹腔内有 4 800 ml不凝血液,右侧附件区有大量凝血块包绕,输卵管壶腹部增粗呈紫红色,直径3 cm,并见一处2 cm×1.4 cm的破口,剖开输卵管,内见胚胎及胎囊.子宫体积增大,质软.镜检所见:输卵管壶腹部出血并见胚胎及胎盘组织;子宫内膜未见妊娠期变化。