tbuckley/cabot-search huggingface dataset:
Abstract 1032: High Clopidogrel Maintenance Dosing in Patients with Inadequate Platelet Inhibition: Functional Insights on Thienopyridine Usage According to Updated ACC/AHA/SCAI 2005 Guidelines for Percutaneous Coronary Interventions
Authors: Dominick J Angiolillo, Marco A Costa, Steven B Shoemaker, Bhaloo Desai, Yuan Hang, Ronald Charlton, Yoshie Suzuki, Esther Bernardo, Martin Z Zenni, Luis A Guzman, Theodore A Bass
Journal: Circulation (2007)

Background: Clopidogrel under-dosing is a cause of inadequate platelet inhibition. Inadequate clopidogrel-induced antiplatelet effects have been associated with an increased risk of stent thrombosis. Updated guidelines for percutaneous coronary interventions (PCI) recommend to increase the dose of clopidogrel to 150mg in high risk patients if &lt;50% platelet inhibition is demonstrated. However, to date there are no studies which have evaluated the functional impact of this recommendation. The aim of this study was determine the functional impact of a 150mg maintenance dose of clopidogrel in patients with 50% platelet inhibition while in their steady state phase of dual antiplatelet therapy. Methods: Platelet inhibition was screened by means of the VerifyNow P2Y 12 assay in patients in a steady state phase of dual antiplatelet therapy. Patients with &lt;50% platelet inhibition were treated with 150mg of clopidogrel for one-month. Adenosine diphosphate-induced aggregation using light transmittance aggregometry and P2Y 12 reactivity ratio determined by vasodilator-stimulated phosphoprotein-phosphorylation analysis were also performed. Results: A total of 32 patients were screened to identify 20 with &lt;50% platelet inhibition. Platelet inhibition increased from 28.3±12% to 43.2±18% in patients treated with 150mg of clopidogrel (p=0.004; primary endpoint). All other functional measures also showed that a high maintenance dose of clopidogrel reduces platelet function (Table ) . The degree of platelet inhibition achieved following one-month treatment with high dose clopidogrel broadly varied and only eight (40%) patients yielded a degree of platelet inhibition ≥50%. Conclusions: The use of a 150mg maintenance dose of clopidogrel in high risk patients with &lt;50% platelet inhibition increases platelet inhibition. However, the antiplatelet effects achieved are non-uniform and a considerable number of patients persist with elevated platelet function. Platelet function analysis pre and post high clopidogrel maintenance dose therapy
Abstract 18102: Safety and Efficacy of Triple versus Dual Anti-Platelet Therapy after Stent Implantation in Patients Requiring Chronic Anticoagulation: a Meta-analysis of Observational Studies
Authors: Chirag Bavishi, Ashwin Sawant, Sameer Ather, Jacqueline E Tamis-Holland
Journal: Circulation (2014)

Introduction: The optimal anti-thrombotic strategy for patients requiring chronic anticoagulation and undergoing PCI remains unclear. Dual anti-platelet therapy (DAPT) alone is less effective for stroke prevention, yet triple therapy (TT) (dual anti-platelet plus warfarin) carries increased bleeding risk. We performed a meta-analysis to evaluate the benefits and risks of DAPT versus TT.

Methods: A systematic search of PubMed, EMBASE and Scopus was performed. Studies comparing all-cause mortality between patients using DAPT and TT were selected. Secondary end-points of MI, stent thrombosis, stroke and major bleeding were also evaluated. Pooled effect estimates were calculated using random effects model.

Results: We identified 13 studies (n=14,994) that compared outcomes between TT and DAPT. The mean duration of follow-up ranged from 0.5 to 1.6 years. Indications for anticoagulation included atrial fibrillation (75.6%), prosthetic valve (1.2%), DVT/PE (0.9%), LV clot/prophylaxis (0.6%) and other (21.7%). There were no significant differences in all-cause mortality [pooled RR: 0.90 (0.59-1.35), p=0.60], MI [RR: 1.08 (0.63 - 1.87), p=0.77] or stent thrombosis [RR: 0.80 (0.34 - 1.93), p=0.63] among patients treated with TT, as compared to DAPT. However patients treated with TT had significantly lower risk of stroke [RR: 0.51 (0.28 - 0.91), p=0.02] and a significantly increased risk of major bleeding [RR: 1.55 (1.03 - 2.35), p=0.04]. Furthermore, there was no significant difference in Net adverse cardiovascular events (death, MI, stroke or major bleeding) between TT and DAPT [RR: 1.24 (0.85 - 1.81, p =0.26].

Conclusions: The beneficial effect of TT for stroke reduction is compromised by a relative increased risk of major bleeding. It is important to individualize care when choosing antiplatelet and anticoagulant therapy for patients following stent implantation, with careful consideration of each patient’s individual risk for stroke and major bleeding.

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Impractical and unjust
Authors: Duncan A H Edwards
Journal: BMJ (2008)

No matter where you stand on immigration, I find it hard to see how denying primary care to a person can be compatible with being a doctor.1 Credit to Iona Heath, and also Frank Arnold, for highlighting this looming injustice. Fairly recently, a politician also highlighted that a policy of excluding “illegals” is as impractical as it is unjust:

“One of …
Screening for HIV: Recommendation Statement
Journal: Annals of Internal Medicine (2005)

This statement summarizes the U.S. Preventive Services Task Force (USPSTF) recommendations on screening for HIV infection and the supporting scientific evidence, and updates the 1996 recommendations on this topic. The complete information on which this statement is based, including evidence tables and references, is included in the summaries of the evidence and evidence syntheses on this topic, available through the USPSTF Web site (www.preventiveservices.ahrq.gov). The recommendation is also posted on the Web site of the National Guideline Clearinghouse (www.guideline.gov). *For a list of the members of the U.S. Preventive Services Task Force, see the Appendix.
Trends in Prevalence of the Metabolic Syndrome
Authors: Dragana Lovre, Franck Mauvais-Jarvis
Journal: JAMA (2015)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Study misses internet’s greater collection of support websites
Authors: John M Grohol
Journal: BMJ (2008)

I’m unsure why Biddle et al’s study of suicide and the internet focused on methods of suicide rather than on support, treatment, interventions, crisis hotlines, or information on how to stop or prevent suicide.1 Suicidal behaviour encompasses all of this and much more.

By stacking the deck with the keywords and search phrases chosen, the researchers found a plethora …
Intensity-modulated radiation therapy (IMRT) with concurrent chemotherapy for anal cancers: Acute toxicity profile and avoidance of a treatment break
Authors: R. A. Nordal, T. E. Wood, J. A. Posey
Journal: Journal of Clinical Oncology (2008)

15593 Background: IMRT allows delivery of a radiation (RT) dose distribution that conforms to the shape of complex or multiple targets and avoidance structures as in anal cancer. The improvement in dose distribution may reduce the acute toxicity of this treatment program, but data demonstrating this are lacking. We studied our initial experience with IMRT with concurrent chemotherapy for tumors of the anal canal or anorectum to determine the severity and frequency of toxicities and whether completion of therapy was compromised or enabled by use of complex RT planning. Methods: 15 patients (pts) with ≥ T3 or LN+ tumors of the anorectum received IMRT with concurrent chemotherapy (CT). Tumor and elective volume doses were 5400–5940 cGy (216–212.1 per fraction) and 4500–4760 cGy (180- 170 per fraction). 11 pts had squamous histology. 4 pts with adenocarcinoma who refused surgery were treated definitively. CT consisted of 5FU and either Cisplatinum (7), Mitomycin C (4), or 5FU or Capecitabine alone (4) at standard doses. Local and systemic toxicities were scored weekly during treatment, and at 3 month intervals in the 1st year therafter using the NCI CTCAE v.3.0 scoring system. Results: The % of pts with ≥ G2 skin, hematologic (heme.), and GI toxicity was 47, 67, and 87%, 1st occurring on average at 5.3, 4.3, and 3.4 weeks respectively. There were no G3 skin toxicities, and 1 G3 GI toxicity. 6 pts (40%) had ≥ G3 non-anemia heme. toxicity; 4 of 6 received Mitomcycin C. Notably, only 1 pt required a treatment break (3d) due to acute toxicity. No pts had CT reduced or delayed because of RT toxicity. Mean wt. loss was 5.0%, and no pts lost more than 10 %. 47% reported G1 fatigue. 1 pt developed G1 leg lymphedema after treatment, and 1 had persistent G2 diarrhea. Conclusion: IMRT for anorectal tumors had a favorable toxicity profile, despite delivery of higher than standard daily RT tumor doses. This is distinct from the expectation that 40–70 % of pts will require a treatment break due to acute toxicities with standard RT. The results are favorable compared with toxicities in completed phase III studies with conventional RT. These results are encouraging, as treatment breaks may compromise efficacy and negate potential benefits of efforts to augment standard therapy. No significant financial relationships to disclose.
Abstract B122: Hypoxia-inducible factor (HIF)-1α directly activates the leptin receptor (Ob-R) in pancreatic cancer cells
Authors: He Ren, Lingling Jia, Jihui Hao
Journal: Cancer Research (2015)

Abstract The aim of this study is to investigate the regulatory mechanism of Ob-R in pancreatic cancer cells. we found that HIF-1α expression was correlated with Ob-R in both pancreatic cancer cell lines and tissues. Overexpression of HIF-1α and hypoxia upregulated the expression of Ob-R in pancreatic cancer cells. When hypoxia-inducible factor (HIF)-1α gene was silenced in vitro, the expression of Ob-R was significantly decreased. Furthermore, HIF-1α directly bound to the hypoxia-responsive element (HRE) located in Ob-R gene promoter (-828/-832) and activated the transcription. Finally, we demonstrated that silence of HIF-1α gene reversed the inhibitory effect of leptin/ObR in pancreatic cancer cells. Taken together, our results indicated that HIF-1α directly regulated Ob-R expression in pancreatic cancer, which might be a valuable therapeutic target to pancreatic cancer. Note: This abstract was not presented at the conference. Citation Format: He Ren, Lingling Jia, Jihui Hao. Hypoxia-inducible factor (HIF)-1α directly activates the leptin receptor (Ob-R) in pancreatic cancer cells. [abstract]. In: Proceedings of the AACR Special Conference on Pancreatic Cancer: Innovations in Research and Treatment; May 18-21, 2014; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2015;75(13 Suppl):Abstract nr B122.
P0453 : HSF1 regulates inflammasome NLRP3-mediated innate immunity via activating beta-catenin signaling in liver ischemia and reperfusion injury
Authors: J. Zhu, M. Zhang, S. Yue, M. Zhou, M. Ke, R.W. Busuttil, J.W. Kupiec-Weglinski, Q. Xia, B. Ke
Journal: Journal of Hepatology (2015)
Assessment of Culprit Lesion Morphology in Acute Myocardial Infarction
Authors: Takashi Kubo, Toshio Imanishi, Shigeho Takarada, Akio Kuroi, Satoshi Ueno, Takashi Yamano, Takashi Tanimoto, Yoshiki Matsuo, Takashi Masho, Hironori Kitabata, Kazushi Tsuda, Yoshiaki Tomobuchi, Takashi Akasaka
Journal: Journal of the American College of Cardiology (2007)
Abstract 1294: Identification of tumor-specific antigens associated with RET/PTC3 expression
Authors: Laura Sponton, Gabriela Cosma, Mark Mendonca, Mirella Giovarelli, Laurence Crane Eisenlohr
Journal: Cancer Research (2015)

Abstract Relocated in transformation/papillary thyroid carcinoma, RET/PTC3 (RP3) is a fusion oncogene that causes a form of papillary thyroid cancer (PTC). In addition to driving transformation, the constitutively active kinase precociously phosphorylates itself as well as other intracellular proteins, thereby providing tumor-specific targets for the adaptive immune system. PTCs are known to have the ability to escape the immune system driving a dysregulation of the activity of several cell populations involved in the immune response. Indeed we found that mice immunized with RP3+/MHC class II+ cells produce dramatically fewer IFNg-secreting CD4+ T cells compared to mice immunized with RP3-/MHC class II+ counterparts as measured in the spleens. We demonstrated the immunogenicity of RP3 with reactivity in both BALB/c and C57BL/6 mice to RP3/IEd- and RP3/CIITA-expressing cells. Also, we observed immunogenicity of RP3-derived phosphopeptides in ELISpot assays, supporting the hypothesis that the aberrant autophosphorylation of RP3 is a source of tumor-specific immunogenicity. Finally, utilizing a RP3-expressing vaccinia vector for immunization of C57BL/6 mice, we identified peptide sequences that appear to be immunogenic on the basis of unique conformation of the fusion protein that impacts antigen processing. Taken together these results could pave the way for better vaccine approaches without accompanying autoimmunity. Citation Format: Laura Sponton, Gabriela Cosma, Mark Mendonca, Mirella Giovarelli, Laurence Crane Eisenlohr. Identification of tumor-specific antigens associated with RET/PTC3 expression. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 1294. doi:10.1158/1538-7445.AM2015-1294
Thrombopoietin expression and effects of eltrombopag in prostate, breast, lung, and ovarian solid tumors.
Authors: C. L. Erickson-Miller, K. Pillarisetti, J. Kirchner, L. H. Ottesen, Y. M. Mostafa Kamel, Y. Liu, A. Martin, C. Messam
Journal: Journal of Clinical Oncology (2010)

e21084 Background: Eltrombopag is a novel, oral thrombopoietin receptor (TPO-R; MPL) agonist that interacts with the TPO-R on bone marrow progenitors to stimulate megakaryocyte production, thus increasing platelet counts. TPO-R is expressed on lymphoma and leukemia cell lines, but little data are available on TPO-R expression on solid tumors including prostate cancer. The objective of the present study was to assess the effects of eltrombopag and expression of MPL mRNA on a variety of tumor types. Methods: Proliferation was measured by Cell Titer Glo assay on 3 breast, 4 lung, 3 ovarian, and 2 prostate cancer cell lines from the ATCC treated with 0.1–100 μg/mL eltrombopag for up to 72 hours. MPL mRNA expression was determined by microarray analysis and qRT-PCR on patient tumors and normal tissue. Results: Eltrombopag, at clinically achievable concentrations (≥ 4 μg/mL), decreased proliferation of all cancer cell lines (IC50 range of 3.7–49.7 μg/mL). Eltrombopag did not increase proliferation at any eltrombopag concentration tested, consistent with very low or undetectable levels of MPL expression observed in normal tissue and 40 samples each of breast, lung, ovarian or prostate tumors. In comparison, erythropoietin receptor (EPOR) mRNA was expressed at low-to-moderate levels in lung and prostate tumors and at higher levels in ovarian and breast tumors. HER2neu/ErbB2 receptor (ERBB2) mRNA was also expressed at low-to-moderate levels in all tumor types. Insulin-like growth factor-1 receptor mRNA (IGF1R) was expressed at low to undetectable levels in all tumor types. Microarray data on an additional set of breast tumor (n = 118) and lung cancer (n = 48) samples showed similarly low levels of MPL. These breast cancer samples also had low levels of EPOR and IGF1R and higher levels of ERBB2, while the lung cancer samples had moderate to high levels of EPOR, ERBB2, and IGF1R. Conclusions: Eltrombopag causes a dose-dependent decrease in proliferation at concentrations ≥ 4 μg/mL. The undetectable or very low levels of MPL expression in patient tumors supports the proliferation results. Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration GlaxoSmithKline GlaxoSmithKline GlaxoSmithKline
Abstract 8489: Study Modifications & Primary Endpoint Reinterpretations Prior to Food & Drug Administration Approval of High-Risk Cardiovascular Devices
Authors: Sanket S Dhruva, Lucy H Liu, Lisa A Bero, Rita F Redberg
Journal: Circulation (2011)

Introduction: It is known that post-hoc analysis is less reliable and reduces the certainty of research findings. The most rigorous Food & Drug Administration (FDA) review process, for novel and hi...
Abstract 2280: Urine Albumin/creatinine Ratio, Cardiac Structure And Diastolic Function In Patients With Hypertension And Diastolic Dysfunction: The Validd Study
Authors: Anil Verma, Rajesh Janardhanan, William L Daley, Susan Ritter, William A Kaye, Tasneem Naqvi, Yves Lacourcier, Gerard Aurigemma, James D Thomas, Michael Zile, Scott D Solomon
Journal: Circulation (2007)

Background: Increasing urine albumin/creatinine ratio (ACR) is associated with systemic microvascular damage and increased cardiovascular morbidity and mortality. However, the relationship between albuminuria and left ventricular (LV) diastolic function, an early measure of myocardial end-organ damage in hypertension, has not been well defined. Methods: Urine ACR and echocardiographic measures of LV structure and function were assessed in 384 patients enrolled in the VALsartan In Diastolic Dysfunction (VALIDD) trial with mild hypertension and no heart failure and evidence of diastolic dysfunction based on Doppler assessment of myocardial relaxation velocities. Results: Urine ACR was undetected in 151 (39.3%) subjects, between 1 to 30 mg/g in 194 (50.5%), and &gt; 30mg/g in 39 (10.2%). The mean blood pressure in the cohort was 143.8 ± 16.1/86.2 ± 10.3 mmHg and LV hypertrophy was present in &lt; 4% of enrolled patients. Higher urine ACR was associated with lower annular relaxation velocity (E′), higher E/E′ (Figure ), higher prevalence of concentric LV remodeling and higher NT-ProBNP even after adjusting for age, diabetes, systolic BP, eGFR and LV mass index (LVMi) (p &lt; 0.02 for all associations). Conclusion: Albuminuria is associated with worsening diastolic function in patients with hypertension, and both measures may represent important and modifiable markers of early end-organ damage even in patients with mild blood pressure elevation. E′ stratified by urine albumin creatinine ratio E/E′ stratified by urine albumin creatinine ratio
425. Systemic Antisense-Mediated Exon Skipping in Mouse Models for Duchenne Muscular Dystrophy
Authors: A Aartsma-Rus, H Heemskerk, C De Winter, M Van Putten, A Janson, J Verschuuren, J Den Dunnen, J Van Deutekom, GJ Van Ommen
Journal: Molecular Therapy (2009)
Abstract 9360: Dual-Energy X-ray Absorptiometry for Quantification of Visceral Adipose Tissue
Authors: Sanjiv Kaul, Megan R Rothney, Dawn Peters, Wynn Wacker, Michael Shapiro, David Ergun
Journal: Circulation (2011)

Background: Obesity is the major risk factor for metabolic syndrome and through it diabetes as well as cardiovascular disease. Visceral fat (VF) rather than subcutaneous fat (SF) is the major predictor of adverse events. Currently the gold standard for measuring VF is abdominal x-ray computed tomography (CT), which exposes patients to significant amounts of radiation and is relatively time-consuming. Dual-energy x-ray absorptio-metry (DXA) can accurately measure body composition with high precision, low x-ray exposure and short scanning time. The purpose of this study was to validate a new method whereby VF can be measured by DXA. Methods: We studied124 adult men and women volunteers, aged 18 to 90 years, representing a wide range of BMI values (18.5 to 40 kg/m 2 ) who underwent DXA and CT in a fasting state within one hour of each other. The DXA VF algorithm uses measurements of the total abdominal thickness, based on x-ray attenuation, and the width of the SF layer along the lateral extent of the abdomen along with geometric constants to estimate SF in the android region. VF is computed by subtracting SF from the total fat in the android region. Results: Our results are depicted in the Figure. The coefficient of determination (r²) for regression of CT on iDXA values was 0.959 for females, 0.949 for males and 0.957 combined. The 95% confidence interval for r was 0.968 to 0.985 for the combined data. The 95% confidence interval for the mean of the differences between CT and iDXA VF volume was -96.0 to - 16.3 cm³. Bland-Altman bias was +67 cm³ for females and +43 cm³ for males. The 95% limits of agreement were -339 to +472 cm³ for females and -379 to +465 cm³ for males. Combined, the bias was +56 cm³ with 95% limits of agreement of -355 to +468 cm³. Conclusion: We conclude that DXA can measure VF precisely in both men and women. This simple non-invasive method can therefore be used to measure VF in individual patients and help define cardiovascular risk.
Abstract 2248: Prevalence and Long-term Clinical Significance of Aortic Root Dilatation in Competitive Athletes
Authors: Fernando M Di Paolo, Elvira De Blasiis, Emanuele Guerra, Cataldo Pisicchio, Filippo M Quattrini, Barbara Di Giacinto, Roberto Ciardo, Stefano Caselli, Franco Culasso, Antonio Pelliccia
Journal: Circulation (2008)

OBJECTIVES: Prevalence, clinical significance, and long-term consequences of aortic root (AoR) dilatation in competitive athletes are not yet investigated. Our aim was to assess the distribution and determinants of AoR size in a large population of competitive athletes. METHODS: AoR dimension were assessed by echocardiography in 2,361 athletes participating in 48 different sports. Of them, 43 were excluded because aortic structural abnormalities, such as bicuspid aortic valve, Marfan’s Syndrome, aortic prosthesis. The remaining 2,318, including 1,301 (56%) males and 1,017 (44%) females were the study population. Arbitrary cut-off of ≥ 40 mm, according to #36 th Bethesda Conference, was used as upper normal limits for AoR. RESULTS: AoR dimension was 32.2 ± 2.7 mm (23 to 44) in males, and 27.5 ± 2.6 mm (20 to 36) in females. AoR dimension exceeded accepted upper limits in only 18 male athletes (0.8%). Figure . Multivariate regression analysis showed left ventricular (LV) mass and body size explaining majority of AoR variability (R 2 = 0,59). Surprisingly, type of sport was not a determinant for AoR dimension. The 18 athletes with enlarged AoR were periodically followed for 7.0 ± 4.2 years. None developed cardiovascular events or symptoms. Two showed progression of AoR dilatation (from 40 to 48, and 43 to 46 mm, respectively), one had incident myocarditis and one developed moderate aortic regurgitation with enlarged LV cavity. CONCLUSIONS: Dilated aortic root is an uncommon finding in competitive athletes and do not represent expression of physiologic cardiac remodelling of the athlete’s heart. Therefore, athletes with dilated AoR deserves continued clinical surveillance.