tbuckley/cabot-search huggingface dataset:
Efficacy and Harms of Direct Oral Anticoagulants in the Elderly for Stroke Prevention in Atrial Fibrillation and Secondary Prevention of Venous Thromboembolism
Authors: Manuj Sharma, Victoria R. Cornelius, Jignesh P. Patel, J. Graham Davies, Mariam Molokhia
Journal: Circulation (2015)

Background— Evidence regarding the use of direct oral anticoagulants (DOACs) in the elderly, particularly bleeding risks, is unclear despite the presence of greater comorbidities, polypharmacy, and altered pharmacokinetics in this age group. Methods and Results— We performed a systematic review and meta-analysis of randomized trials of DOACs (dabigatran, apixaban, rivaroxaban, and edoxaban) for efficacy and bleeding outcomes in comparison with vitamin K antagonists (VKA) in elderly participants (aged ≥75 years) treated for acute venous thromboembolism or stroke prevention in atrial fibrillation. Nineteen studies were eligible for inclusion, but only 11 reported data specifically for elderly participants. The efficacy in managing thrombotic risks for each DOAC was similar or superior to VKA in elderly patients. A nonsignificantly higher risk of major bleeding than with VKA was observed with dabigatran 150 mg (odds ratio, 1.18; 95% confidence interval, 0.97–1.44) but not with the 110-mg dose. Significantly higher gastrointestinal bleeding risks with dabigatran 150 mg (1.78, 1.35–2.35) and dabigatran 110 mg (1.40, 1.04–1.90) and lower intracranial bleeding risks than VKA for dabigatran 150 mg (0.43, 0.26–0.72) and dabigatran 110 mg (0.36, 0.22–0.61) were also observed. A significantly lower major bleeding risk in comparison with VKA was observed for apixaban (0.63, 0.51–0.77), edoxaban 60 mg (0.81, 0.67–0.98), and 30 mg (0.46, 0.38–0.57), whereas rivaroxaban showed similar risks. Conclusions— DOACs demonstrated at least equal efficacy to VKA in managing thrombotic risks in the elderly, but bleeding patterns were distinct. In particular, dabigatran was associated with a higher risk of gastrointestinal bleeding than VKA. Insufficient published data for apixaban, edoxaban, and rivaroxaban indicate that further work is needed to clarify the bleeding risks of these DOACs in the elderly. Systematic Review Registration— http://www.crd.york.ac.uk/PROSPERO . Unique identifier: PROSPERO CRD42014007171/
Is there a strong relationship between COPD and cardiovascular diseases
Authors: Laura Ciobanu, Vasile Maciuc, Gabriela Tofan, Livia Popa
Journal: European Respiratory Journal (2013)

Introduction: Cardiovascular diseases are the major comorbidities encountered in COPD. Hypertension (HT) and ischemic heart disease (IHD) may appear subsequently or independently to COPD, due to numerous common risk factors.  Aims and objectives: To investigate the correlations between HT, IHD and COPD in a lot of 709 patients (pts) and to estimate if COPD is a risk factor for hypertension and IHD.  Methods: 2 groups of pts were assessed for age, gender, body mass index (BMI), diabetes, dyslipidemia, HT, IHD and COPD. First group was composed of COPD pts (N 223, 138 M/61.9%, 85 F/38.1%, mean age 65.67, SD 10.84) and the second of non-COPD pts (N 486, 138 M/28.4%, 348 F/71.6%, mean age 60.68, SD 13.80). COPD pts were staged according to GOLD criteria in stage I 130/58.3%, stage II 43/19.3%, stage III 39/17.5% and stage IV 11/4.9%.  Results: HT intermediary and significantly (p  Conclusions: HT and COPD have significant correlations with some risk factors which are common, but insignificant direct relationship. IHD is insignificantly related to COPD, but significantly correlates to HT. COPD is a weak risk factor for HT and IHD.
Effects of prophylactic clarithromycin administration on quality of life in non-CF bronchiectasis patients
Authors: Evangelia Fouka, Stavros Anevlavis, Konstantinos Kaltsas, Antonios Antoniadis, Demosthenes Bouros
Journal: European Respiratory Journal (2014)

INTRODUCTION: Quality of life (QOL) is impaired in non-CF bronchiectasis. St George Respiratory Questionnaire (SGRQ) can be used as a measure of QOL.  AIM: To estimate the efficacy of Clarithromycin prophylaxis on QOL in patients with non-CF bronchiectasis and to evaluate potential associations with sputum bacteriology.  SUBJECTS-METHODS: Prospective observational study of 22 adult non-CF bronchiectasis patients suffering from more than 3 infective exacerbations during the previous 12 months. QOL assessments with the SGRQ were performed at baseline and after 24 weeks of daily Clarithromycin administration, 500 mg p.o. Data regarding sputum cultures were also recorded.  RESULTS: No sputum bacterial growth was noticed in 9 patients, while  P.aeruginosa  was isolated in 7 and other bacteria in 6 patients. Post-treatment SGRQ scores decreased significantly, both totally (mean±SEM 29.93±4.32 vs 40.14±4.44,p=0.002) as well as in specific domains (symptoms, activity, impacts: 27.91±5.61 vs 38.79±4.61,p=0.04, 38.36±5.08 vs 51.34±4.88,p P.aeruginosa  group (mean±SEM 31.85±9.90 vs 47.07±9.47,p=0.015 and 43.51±5.02 vs 46.41±5.08,p=0.368 respectively).  DISCUSSION: Our results indicate a favorable effect of Clarithromycin prophylactic administration in QOL in non-CF bronchiectasis, regardless the status of sputum colonization. Patients with  P.aeruginosa  probably benefit more from the intervention.
Abstract 16788: Platelet Distribution Width is an Independent Predictor of All-Cause and Cardiovascular Mortality Among Healthy US Adults
Authors: Rehan Qayyum, Dhananjay Vaidya
Journal: Circulation (2011)

Background: Platelets play an important role in pathogenesis of acute coronary syndromes and platelet parameters (platelet count[PC], mean platelet volume[MPV], and platelet distribution width[PDW]) have been proposed as risk factors for cardiovascular disease. Our aim was to examine the association of platelet parameters with all-cause and cardiovascular (CV) mortality in a large US cohort. Methods: We used the Third National Health and Nutrition Examination Survey and the data linked to mortality files to examine association between platelet parameters and all-cause and CV mortality. We used Cox proportional hazards model to calculate hazards ratio (HR) and 95% confidence interval (CI) using age as time-scale in 13,701 participants who were &gt; 20 and &lt;85 years and were free of clinical CV disease at baseline. Results: There were 2741 all-cause deaths and 1084 CV deaths during the follow-up (median follow-up 14.3 years, range 0 to 18). The mean (SD) age of the participants was 45 (18) years, 54% were females, 40% were Caucasians, 26% were current smokers and 24% had history of hypertension. Mean (SD) PC was 276(71) 10 9 /L, MPV 8.5(1.0) fL, and PDW 16.4% (0.56). Univariate analyses found no association of PC or MPV with all-cause or CV mortality but a significant association with PDW (all-cause mortality HR: 1.12 per unit increase in PDW, 95%CI: 1.03 to 1.21; CV mortality HR: 1.15, 95%CI: 1.01 to 1.31). Similarly, in multivariable analyses after adjusting for sex, race, CRP, diabetes, hypertension, smoking status, glomerular filtration rate, total cholesterol, WBC count, liver function tests, and ferritin, there was no association between PC or MPV and all-cause or CV mortality but the association with PDW remained significant (all-cause mortality HR: 1.16, 95%CI: 1.07 to 1.26 and HR for CV mortality: 1.17, 95%CI: 1.02 to 1.33. Conclusions: Among the platelet parameters, we found PDW, and not PC or MPV, as an independent predictor of all-cause and CV mortality. We propose that this test should be routinely reported with other hematological parameters in complete blood count reports.
Abstract 8428: Percutaneous Intrapericardial Echocardiographic Imaging with CMUT Based Imaging Catheters: First In Vivo Results
Authors: Douglas N Stephens, Uyen T Truong, Chi H Seo, Amin Nikoozadeh, Omer Oralkan, Butrus (Pierre) T Khuri-Yakub, Alan de la Rama, Aaron Dentinger, Feng Lin, Kai Thomenius, Kalyanam Shivkumar, Aman Mahajan, Matthew O'Donnell, David J Sahn
Journal: Circulation (2011)

Background: The standard approach for the catheter ablation of arrhythmias and the accompanying guidance of intracardiac echocardiography (ICE) is performed from the endocardial aspect of the heart. This approach may now also include percutaneous epicardial mapping which has been developed and utilized in several electrophysiology (EP) laboratories. Previous research using percutaneous pericardial procedures has been safely and effectively applied to a range of supraventricular arrhythmia substrates. Methods: Our family of ICE devices now includes a new 9F forward-looking catheter which is constructed with a silicon based capacitive micromachined ultrasonic transducer (CMUT) technology. Several CMUT ML catheters have been tested in 3 porcine experiments. The percutaneous epicardial approach was tested with successful imaging of heart chambers from the oblique sinus of the pericardial space. Results: This micro-linear (ML) catheter provides high-resolution, real-time, 2D ultrasound images at 14 MHz, and is capable of both electrical mapping and electroanatomical guidance. Although the 24 element array aperture is small (1.6 mm), the imaging depth of penetration is considerable (&gt; 3 cm). A thin metalized cap can be placed over the array for performing radiofrequency ablation without distorting imaging. Conclusions: This silicon based technology has the unique prospect of enhancing both miniaturization and multiple modalities of operation.
Abstract 175: Genetic Ablation Of S-nitrosoglutathione Reductase In Mice Enhances Proliferative Expansion Of Adult Heart Progenitors And Myocytes Post Myocardial Infarction
Authors: Konstantinos E Hatzistergos, Ellena C Paulino, Raul A Dulce, Lauro M Takeuchi, Shathiyah Kulandavelu, Wayne Balkan, Rosemeire M Kanashiro-Takeuchi, Joshua M Hare
Journal: Circulation Research (2014)

Objectives: The molecular pathways underlying the proliferative activity of adult cardiac myocytes and stem/progenitors in response to heart damage remain elusive. Since perturbing nitroso-redox balance in mice by genetic deletion of GSNOR (GSNOR -/- ) confers resilience to experimental myocardial infarction (MI), we investigated whether GSNOR knockout influences the proliferative activity of the post-MI heart. Hypothesis: Knockout of GSNOR in mice enhances the proliferative expansion of CMs and cKit + cardiac stem cells (CSCs) in response to MI. Methods: Wild-type (WT) and GSNOR -/- mice (n=5/ group) underwent experimental MI. To assess proliferative activity, animals received intraperitoneal injections of 5-bromodeoxyuridine (BrdU) at selected time-points during the first 2 weeks post-MI. Immunnohistochemical evaluation was performed 1 month post-MI. Results: Confocal immunofluorescence revealed that GSNOR -/- hearts exhibited higher rates of BrdU incorporation in CSCs after MI (10.9%±4.99% of WT CSCs compared to 15.9%±3% of GSNOR -/- CSCs, p =0.02). Similarly, there were ~3-fold more BrdU + /Tropomyosin + cardiomyocytes in the infarct zone of GSNOR -/- mice compared to WT ( p &lt;0.05). Immunohistochemical evaluation of cardiac troponin-T + cardiomyocytes co-expressing the mitotic marker ser-10 phosphorylated histone H3 (H3P) showed further that cardiomyocyte mitosis was 2.4-fold greater in GSNOR -/- compared to WT mice ( p &lt;0.05), whereas the presence of aurora-b kinase in the cleavage furrow of GSNOR -/- cardiomyocytes substantiated their competence for mitosis after MI. The rate of cardiomyocyte apoptosis after MI, was not different between GSNOR -/- and WT mice, as shown by activated cleaved caspase-3 immunofluorescence. Conclusions: Collectively, our findings suggest that protein S-nitrosothiol turnover by GSNOR regulates proliferation of cardiomyocytes and CSCs in the adult heart in response to damage. These findings have therapeutic implications for the treatment of heart disease since they reveal novel pathways by which nitroso-redox balance influences cardiac repair.
Late-breaking abstract: Increased IL-33 expression is related to high levels of TLR-2 and -4 in steroid-free subjects with asthma
Authors: Asger Sverrild, Katherine Baines, Vibeke Backer, Peter Gibson, Celeste Porsbjerg
Journal: European Respiratory Journal (2014)

Background: IL-33 is released as a consequence of infection or trauma to airway epithelium, and promotes Th2 type immunity, eosinophilic inflammation and mast cell activation. Toll like receptors (TLR) can be triggered by both pathogens and inhaled allergens, and TLR-4 signaling results in generation of IL-33 in mice. However, only little in vivo evidence is available in humans.

Aim: We hypothesized increased expression of IL-33 to be associated with TLR expression in subjects with asthma.

Methods: 19 steroid-free asthma patients with at least one objective marker of asthma (AHR to mannitol or methacholine, or reversibility to beta-2-agonist) and 9 healthy controls had airway mucosa biopsies taken. IL-33, TLR-2 and TLR-4 mRNA expression using real-time PCR was measured in the airway biopsies. Results were calculated as relative expression levels as compared to the housekeeping gene β-actin and the healthy control group.

Results: Subjects with asthma had significantly higher gene expression of IL-33 compared to healthy controls (median [IQR]: 1.12 [0.82-1.59] vs. 0.86 [0.59-0.99], p=0.02). The expression of IL-33 was significantly increased in asthmatics with high TLR-2 and TLR-4 expression compared to low expression (median [IQR]: 1.06 [0.62-1.15] vs. 1.59 [1.07-1.95], p=0.02 and 0.82 [0.62-1.15] vs. 1.59 [1.11-1.95], p=0.003). Gene expression of IL-33, and TLR-2 and TLR-4 were highly correlated (rho(s)=0.61, p=0.005 and rho(s)=0.72, p=0.001).

Conclusion: IL-33 is up-regulated in asthmatics with a high TLR-2 and -4 airway gene expression. This potentially links recognition of epithelial damage through TLR's and a Th2-skewed inflammatory response mediated by IL-33.
Gender difference in the association of melanoma etiology to solar UV exposure.
Authors: Feng Liu-Smith, Ahmed Farhat, Anthony Arce, Thomas H. Taylor, Argyrios Ziogas, Zi Wang, Vandy Yourk, JIng Liu, Archana McEligot, Hoda Anton-Culver, Frank L. Meyskens
Journal: Journal of Clinical Oncology (2015)

e20012 Background: UV radiation has been considered the major environmental causative factor for melanoma. Our previous limited epidemiologic study suggested additional causative factors for early age onset melanoma in females. Methods: Melanoma and non-melanoma skin cancer case and population information were retrieved from various cancer registries and public domains. Age-specific and age-standardized incidence rates were calculated and compared between genders and age groups; and correlated with average daily UV index. Results: The current study further compared the age and gender-specific incidence rates for melanoma and non-melanoma skin cancer (NMSC) from the Netherlands (N), UK and Nordic (NOR) countries, and confirmed a peak gender difference at age 20-24 (the peak age for pregnancy) for melanoma in all countries examined( N, RR = 2.40, 95% CI 2.12, 2.72; UK, RR = 2.10, 95% CI: 1.84, 2.38; NOR, RR = 2.14, 95% CI: 2.16, 2.68) which was not observed (N, RR = 0.98, 95% CI: 0.65-1.49; NOR, RR = 1.01, 9%% CI: 0.74, 1.37) or less obvious (UK, RR = 1.36, 95% CI: 1.15, 1.61) in NMSC. We further analyzed the relationship between UV index (UVI) and gender-specific and age-standardized melanoma incidence rates from 14 selected countries and regions, where most populations are Caucasians and have light hair color, and discovered that there was a significant correlation between the male incidence rates and UVI (Pearson’s coefficient r = 0.67, p = 0.009), but only modest and non-significant correlation (r = 0.45, p = 0.109) between the female incidence rates and UVI. Conclusions: These results suggest that UV radiation exhibits a limited effect on development of melanoma in females compared to males. To our knowledge, this study is the first to describe a non-significant association of UV radiation with female melanoma development. This extensive study suggests that melanoma is a gender-enhanced cancer whose development is heavily impacted by gender-specific factors including the immune changes and hormones
Levels of Serum Cholesterol Among Offspring of Parents Who Died of Cancer: A Comparison With Coronary Heart Disease<xref ref-type="fn" rid="FN2">2</xref>
Authors: Sigismond Deutscher
Journal: JNCI Journal of the National Cancer Institute (1971)

During an epidemiological study of an entire community (Tecumseh, Mich.), mortality rates among parents of persons with varying concentrations of serum cholesterol were compared. The study was conducted to understand better some of the familial factors that may influence the role of serum cholesterol in disease. Cancer among mothers tended to be associated with low levels of serum cholesterol among the sons and daughters of these mothers—a pattern which was the reverse of the one observed for offspring whose parents died of coronary heart disease. This association was more likely to be present when death from cancer occurred relatively early in life than later in life. The results relating to early paternal death from cancer were in marked contrast to the above findings; the pattern observed, instead of being the reverse of the one seen for coronary heart disease, tended to be similar. The limited nature of the data allows no speculations regarding mechanisms which might account for these findings. Possibly, persons whose levels of serum cholesterol are well below average may have characteristics transmissible to their offspring, which are related to forms of malignancy commonly affecting younger women, whereas the reverse is true for some forms of malignancy more commonly observed among males.
Abstract 16195: A Novel Differential Role of Apolipoprotein C-I on the Expression of Large HDL and Triglycerides in Infants at Birth and Follow-Up Compared With Their Parents
Authors: Peter O Kwiterovich, Donna G Virgil, Audrey Chu, Victor A Khouzami, Petar Alaupovic, James Otvos
Journal: Circulation (2011)

At birth, HDL is the major lipoprotein class and the largest (> 10 nm) HDL subclass, H5C, is elevated in 20 % of infants, absent in another 20% with the rest intermediate. In utero, apolipoprotein ...
Characteristics of prosthetic joint infections due to Enterococcus sp. and predictors of failure: a multi-national study
Authors: E. Tornero, E. Senneville, G. Euba, S. Petersdorf, D. Rodriguez-Pardo, B. Lakatos, M.C. Ferrari, M. Pilares, A. Bahamonde, R. Trebse, N. Benito, L. Sorli, M.D. del Toro, J.M. Baraiaetxaburu, A. Ramos, M. Riera, A. Jover-Sáenz, J. Palomino, J. Ariza, A. Soriano
Journal: Clinical Microbiology and Infection (2014)
Prevention: Rhetoric and Reality
Authors: Leon Eisenberg
Journal: Journal of the Royal Society of Medicine (1984)

This article examines the value context in which health policy is decided and reviews the empirical evidence in support of present and future initiatives in preventie psychiatry. Health ministries today enthusiastically embrace the rhetoric of prevention because of the relentless growth of medical care costs. US health expenditures in 1981 for example accounted for 9.8% of the gross national product, up from 8.9% 2 years previously. A comparison of health gains from vaccination against poliomyelitus with health gains from vaccination against influenza virus illustrates that the dollar amount expended per year of life saved may vary greatly. Vaccination of persons against influenza and pneumonia would necessitate increasing the very health expenditures that governments are trying to reduce. Fundamental problems of social justice exist in the asymmetry between those who pay and those who benefit from preventive health measures, and in the scales on which costs and benefits are assessed. Moreover, prevention of premature death results in a larger population in the older age groups which consume proportionately more health resources. Such consideratons make obvious the danger of trying to justify prevention on purely economic grounds. Medical knowledge provides a technological base for the analysis of health policy options, but the political process, reflecting the power and the values of the various constituencies in society, is what determines which choices are made. Present knowledge of prevention of psychiatric disorders in children must be considered against the context in which policy decisions are made. Prenatal preventive measures migh address birth weight, maternal smoking and alcohol intake, and rubella, and the conditions diagnosed by amnioscentesis. Neonatal screening could be used to identify phenylketonuria and congenital hypothyroidism. Measures to prevent accidents and poisonings could minimize brain trauma. Vaccination has become the paradigm for prevention, an inexpensive measure applied once or a few times to yield permanent immunity, but the model does not apply to the prevention of psychosocial disorders: there is no shortterm psychiatric intervention that confers immunity to later challenge. Psychosocial measures proposed for the reduction of psychiatric morbidity and mortality in childhood and adolescence include family planning, preschool intervention programs, shortterm psychotherapy, and suicide prevention.
Lung cancer: the American view
Authors: DR Sanderson, None Jett
Journal: European Respiratory Journal (1989)

Bronchogenic carcinoma is a major public health problem in the United States, and the leading cancer killer in both men and women. In the early 1970s, the National Cancer Institute (NCI) sponsored multicentre clinical trials to assess the effects of screening by sputum cytology testing and serial chest X-ray examinations on lung cancer mortality in high-risk male smokers. Although more lung cancers were detected, more early stage 1 cancers were resected, and 5 year survival rates were improved in the screened populations than in unscreened controls, there were nearly equal numbers of advanced cancers, and mortality rates were not significantly different. Thus, mass screening to detect early lung cancer has not been pursued as public policy in the United States. In the 1980s, emphasis has shifted to efforts at lung cancer prevention through educational programs aimed at smoking prevention and cessation. In 1984, the NCI adopted a national goal of reducing lung cancer mortality by 50% by the year 2000. Strategy to achieve this is an intensive behaviour modification program to encourage a social climate for smoking abstinence, prevent initiation of smoking among children and adolescents and supply educational materials and encouragement through health care workers and community-based programs.
Insights and Perspectives in the Clinical and Operational Management of Cancer-Related Anemia
Authors: Jennifer M. Hinkel, Edward C. Li, Stephen L. Sherman
Journal: Journal of the National Comprehensive Cancer Network (2010)

Management of anemia in patients with cancer presents challenges from clinical, operational, and economic perspectives. Clinically, anemia in these patients may result from treatment (chemotherapy, radiation therapy, or surgical interventions) or from the malignancy itself. Anemia not only contributes to cancer-related fatigue and other quality of life issues, but also affects prognosis. From the operational perspective, a patient with cancer who is also anemic may consume more laboratory, pharmacy, and clinical resources than other patients with cancer.