tbuckley/cabot-search huggingface dataset:
Effect of Omega-3 Acid Ethyl Esters on Left Ventricular Remodeling After Acute Myocardial Infarction
Authors: Bobak Heydari, Shuaib Abdullah, James V. Pottala, Ravi Shah, Siddique Abbasi, Damien Mandry, Sanjeev A. Francis, Heidi Lumish, Brian B. Ghoshhajra, Udo Hoffmann, Evan Appelbaum, Jiazhuo H. Feng, Ron Blankstein, Michael Steigner, Joseph P. McConnell, William Harris, Elliott M. Antman, Michael Jerosch-Herold, Raymond Y. Kwong
Journal: Circulation (2016)

Background: Omega-3 fatty acids from fish oil have been associated with beneficial cardiovascular effects, but their role in modifying cardiac structures and tissue characteristics in patients who have had an acute myocardial infarction while receiving current guideline-based therapy remains unknown. Methods: In a multicenter, double-blind, placebo-controlled trial, participants presenting with an acute myocardial infarction were randomly assigned 1:1 to 6 months of high-dose omega-3 fatty acids (n=180) or placebo (n=178). Cardiac magnetic resonance imaging was used to assess cardiac structure and tissue characteristics at baseline and after study therapy. The primary study endpoint was change in left ventricular systolic volume index. Secondary endpoints included change in noninfarct myocardial fibrosis, left ventricular ejection fraction, and infarct size. Results: By intention-to-treat analysis, patients randomly assigned to omega-3 fatty acids experienced a significant reduction of left ventricular systolic volume index (–5.8%, P =0.017), and noninfarct myocardial fibrosis (–5.6%, P =0.026) in comparison with placebo. Per-protocol analysis revealed that those patients who achieved the highest quartile increase in red blood cell omega-3 index experienced a 13% reduction in left ventricular systolic volume index in comparison with the lowest quartile. In addition, patients in the omega-3 fatty acid arm underwent significant reductions in serum biomarkers of systemic and vascular inflammation and myocardial fibrosis. There were no adverse events associated with high-dose omega-3 fatty acid therapy. Conclusions: Treatment of patients with acute myocardial infarction with high-dose omega-3 fatty acids was associated with reduction of adverse left ventricular remodeling, noninfarct myocardial fibrosis, and serum biomarkers of systemic inflammation beyond current guideline-based standard of care. Clinical Trial Registration: URL: http://www.clinicaltrials.gov . Unique identifier: NCT00729430.
The genetics of inflammatory bowel disease.
Authors: J Satsangi, D P Jewell, J I Bell
Journal: Gut (1997)

<b>Background:</b> There is limited insight into the attributable effect of anemia and comorbidity on functional status and mortality in old age. <b>Methods:</b> The Leiden 85-plus Study is a population-based prospective follow-up study of 562 people aged 85 years. Anemia was defined according to World Health Organization criteria. We measured 3 parameters of functional status at baseline and annually thereafter for 5 years: disability in basic and instrumental activities of daily living, cognitive function and the presence of depressive symptoms. We obtained mortality data from the municipal registry. <b>Results:</b> The prevalence of anemia at baseline was 26.7% (150/562). Participants who had anemia at baseline had more disability in activities of daily living, worse cognitive function and more depressive symptoms than participants without anemia at baseline (<i>p</i> ≤ 0.01). These differences disappeared after adjustment for comorbidity. After adjustment for comorbidity in the prospective analyses, anemia at baseline was associated with an additional increase in disability in instrumental activities of daily living during follow-up; incident anemia during follow-up (<i>n</i> = 99) was associated with an additional increase in disability in basic activities of daily living. Prevalent and incident anemia were both associated with an increased risk of death, even after we adjusted for sex, education level, income, residence in a long-term care facility, C-reactive protein level, creatinine clearance and the presence of disease (hazard ratio for prevalent anemia 1.41, 95% confidence interval [CI] 1.13 to 1.76; hazard ratio for incident anemia 2.08, 95% CI 1.60 to 2.70). <b>Interpretation:</b> Anemia in very elderly people appears to be associated with an increased risk of death, independent of comorbidity. However, the associated functional decline appears to be attributed mainly to comorbidity.
Hyperspectral imaging: A noninvasive in vivo method of imaging melanoma lesions in a patient being treated with a novel B-RAF inhibitor.
Authors: N. Khan, D. Dicker, K. T. Flaherty, J. Lerner, W. El-Deiry
Journal: Journal of Clinical Oncology (2010)

e19019 Background: Imaging techniques at the molecular level are increasingly being used in cancer diagnosis, staging, and evaluation of treatment responsiveness. This study sought to evaluate whether a prototype hyperspectral imaging (HSI) modality, could generate clinically relevant spectral signatures when imaging cutaneous melanomas in a patient undergoing systemic therapy with a BRAF- inhibitor. Methods: Utilizing a macroscopic Prism and Reflectance Imaging Spectroscopy System (MACRO-PARISS), spectral data were taken from human skin using a fiber optic probe. The subject was a patient at the University of Pennsylvania, with biopsy-proven stage IV melanoma, who underwent systemic therapy with a novel small molecule, selective B-RAF inhibitor as part of a phase I clinical trial. Cutaneous lesions were identified by an oncologist, and imaging was performed at 1, 7, 14, and 28 days after drug administration. The V600E B-RAF mutation was previously identified in this patient. Six lesions identified as malignant were imaged, and 2 control regions, including a solar lentigo and a relatively pigment-free region. Spectra were classified using a linearity-independent algorithm over wavelengths of 450-920 nm (cc. 0.97). Results: Lesions demonstrated observable changes over time, including changes in size and pigment, corresponding to disease responsiveness. Using PARISS, differences were shown between spectral signatures of treated lesions over a treatment course, indicating correlation of spectral data with changes in disease. A prominent spectral feature, present in pigmented lesions, decreased by 33% predominance (from 71% to 24% ) over time in the imaging of a solar lentigo, corresponding to decrement in pigment observed over time, whereas this feature nearly doubled (from 13% to 28%) in a malignant lymph node that revealed observable pigment only as it decreased in size and became more macular. Conclusions: The novel B-RAF inhibitor administered visibly affected pigment characteristics of both malignant and non-malignant lesions, which were reflected in quantifiable differences in spectral characteristics over time. MACRO-PARISS demonstrates promise as an imaging modality in melanoma, and may play an important role for determining response to novel treatment strategies in vivo, in the future. No significant financial relationships to disclose.
Prospective analysis of clinical outcomes and prognostic factors in patients with neuroendocrine tumors (NETs).
Authors: M. Ter-Minassian, C. S. Frauenhoffer, S. M. Hooshmand, K. Asomaning, X. Lin, J. A. Chan, D. C. Christiani, M. Kulke
Journal: Journal of Clinical Oncology (2010)

4044 Background: The clinical course of NET patients (pts) remains poorly defined. We evaluated clinical outcomes and prognostic factors in 853 NET pts enrolled in a large, prospective outcomes study. Methods: NET pts presenting to our institution were enrolled in the study beginning in 2003. Demographics and clinical information were recorded from time of initial diagnosis since 1958 and updated at 6-month intervals following study enrollment. Prognostic factors were evaluated with multivariate Cox regression analysis including age, gender, presence (M1) or absence (M0) of distant metastasis at initial diagnoses, tumor subtype (pancreatic NET, small bowel carcinoid or other carcinoid), histologic grade (well, moderate, or poorly differentiated) and octreotide administration (yes/no). Results: 853 pts enrolled with a > 98% consent rate. Median follow-up (initial diagnosis to death or last known follow-up) was 4.45 years; 210 (24.6%) deaths occurred in this interval. Patients included 190 pancreatic NET, 321 small bowel carcinoid, and 342 other carcinoid; male: female = 46%: 54%; M0: M1 = 44%: 55.9%. Median OS for the entire cohort was 12.8 yrs. For M0 pts, median OS was not reached, 5-yr OS was 94%, and 5-yr DFS was 65%. Median time to recurrence for resected (M0) pts was 7.9 yrs (9 yrs for small bowel carcinoid, 4.6 yrs for pancreatic NET, and 10 yrs for other carcinoid). Older age, male gender, pancreatic primary site, and higher histologic grade were associated with higher risk of recurrence. For M1 patients, median OS was 7.6 yrs (12.5 yrs for small bowel carcinoid, 4.7 yrs for pancreatic NET, and 4.6 yrs for other carcinoid). Older age, male gender, pancreatic primary site, and higher histologic grade were associated with shorter survival in pts with metastatic disease. A possible association between octreotide treatment and improved survival in metastatic pts was observed, but did not reach statistical significance (HR for death = 0.87, p = 0.37). Conclusions: Pts with NETS experience prolonged survival, even in the setting of metastatic disease. Tumor recurrences, when they occur, may develop more than 5 years after initial diagnosis. No significant financial relationships to disclose.
Mechanical strength vs. degradation of a biologically-derived surgical mesh over time in a rodent full thickness abdominal wall defect
Authors: A. Costa, J.D. Naranjo, N.J. Turner, I.T. Swinehart, B.D. Kolich, S.A. Shaffiey, R. Londono, T.J. Keane, J.E. Reing, S.A. Johnson, S.F. Badylak
Journal: Biomaterials (2016)
P204 Risk Factors for Requiring Intravenous Antibiotic Therapy Delivered in Hospital for Exacerbations of Bronchiectasis: Abstract P204 Table 1
Authors: P Palani Velu, P Bedi, K Turnbull, AT Hill
Journal: Thorax (2015)

<h3>Introduction</h3> Recurrent exacerbations requiring IV antibiotic therapy are a feature of advanced bronchiectasis. Our group has previously established the safety and efficacy of domiciliary antibiotic therapy compared to inpatient hospital treatment for exacerbations of bronchiectasis. In this study we aimed to identify factors at presentation that could predict the requirement for inpatient antibiotic therapy compared to domiciliary antibiotic therapy. <h3>Methods</h3> We assessed the management of bronchiectasis exacerbations referred to a specialist respiratory unit over a 1-year period (April 2013 to 2014). All patients received 10 to 14 days of IV antibiotic therapy and were assessed at the beginning and end of their treatment course. We assessed demographic data, treatment outcomes, morbidity, mortality and 30-day readmission rates. Logistic regression analysis was performed to identify factors predictive of the treatment modality used. <h3>Results</h3> A total of 72 patients were treated with 131 courses of IV antibiotic therapy. Thirty-six cases (27.5%) were managed as inpatients, 20 cases (15.2%) required initial admission and subsequently received early supported discharges (ESD) to complete IV antibiotic therapy at home and 75 cases (57.2%) received domiciliary IV antibiotics. Logistic regression showed that Charlson Co-morbidity Index was independently predictive of the requirement for inpatient antibiotic therapy (p = 0.03). White Cell Count at presentation was also positively associated with the requirement for inpatient antibiotic therapy approaching statistical significance (p = 0.05). There were no mortalities in the ESD or domiciliary antibiotic groups but 2 mortalities (5.6%) were noted in the inpatient group (Table 1). Morbidity in the inpatient, ESD and domiciliary antibiotic groups were 8.3%, 5.0% and 2.9% respectively (p = 0.40). The median length of stay before early supported discharge was 7 (interquartile range 7 – 9) days. Thirty-day readmission rates were 11.1%, 25.0% and 2.7% respectively (2 × 3 Chi-square; p &lt; 0.05). Total bed days saved from ESD and domiciliary antibiotic therapy was 1153 days (interquartile range 9–14). <h3>Conclusions</h3> Our study has demonstrated that the Charlson Co-morbidity Index is the independent risk factor that predicts the need for inpatient intravenous antibiotic therapy in exacerbations of bronchiectasis. Those patients that received domociliary treatment received it safely.
Renal dosing of allopurinol results in suboptimal gout care
Authors: Tuhina Neogi, Nicola Dalbeth, Lisa Stamp, Geraldo Castelar, John Fitzgerald, Angelo Gaffo, Ted R Mikuls, Jasvinder Singh, Janitzia Vázquez-Mellado, N Lawrence Edwards
Journal: Annals of the Rheumatic Diseases (2016)

Recommendation #9: "In patients with renal impairment, the allopurinol maximum dosage should be adjusted to creatinine clearance.If the SUA target cannot be achieved at this dose, the patient should be switched to febuxostat or given benzbromarone with or without allopurinol, except in patients with estimated glomerular filtration rate <30 mL/min."
Comprehensive Analysis of Surface Antigens on Adult T-Cell Leukemia/Lymphoma (ATL) Cells and Search for ATL-Initiating Cell Markers
Authors: Tomohiro Ishigaki, Seiichiro Kobayashi, Nobuhiro Ohno, Nobuaki Nakano, Atae Utsunomiya, Satoshi Yamazaki, Nobukazu Watanabe, Kaoru Uchimaru, Arinobu Tojo, Hiromitsu Nakauchi
Journal: Blood (2014)
Chemotherapy-Induced IL34 Enhances Immunosuppression by Tumor-Associated Macrophages and Mediates Survival of Chemoresistant Lung Cancer Cells
Authors: Muhammad Baghdadi, Haruka Wada, Sayaka Nakanishi, Hirotake Abe, Nanumi Han, Wira Eka Putra, Daisuke Endo, Hidemichi Watari, Noriaki Sakuragi, Yasuhiro Hida, Kichizo Kaga, Yohei Miyagi, Tomoyuki Yokose, Atsushi Takano, Yataro Daigo, Ken-ichiro Seino
Journal: Cancer Research (2016)

The ability of tumor cells to escape immune destruction and their acquired resistance to chemotherapy are major obstacles to effective cancer therapy. Although immune checkpoint therapies such as anti-PD-1 address these issues in part, clinical responses remain limited to a subpopulation of patients. In this report, we identified IL34 produced by cancer cells as a driver of chemoresistance. In particular, we found that IL34 modulated the functions of tumor-associated macrophages to enhance local immunosuppression and to promote the survival of chemoresistant cancer cells by activating AKT signaling. Targeting IL34 in chemoresistant tumors resulted in a remarkable inhibition of tumor growth when accompanied with chemotherapy. Our results define a pathogenic role for IL34 in mediating immunosuppression and chemoresistance and identify it as a tractable target for anticancer therapy. Cancer Res; 76(20); 6030-42. ©2016 AACR.
Long-Term Immunological Profile and T Cell Dynamics In Patients Treated With Allogeneic Transplantation and TK-Cells For Hematological Malignancies
Authors: Giacomo Oliveira, Maria Teresa Lupo Stanghellini, Nicoletta Cieri, Raffaella Greco, Maddalena Noviello, Veronica Valtolina, Luca Vago, Catia Traversari, Eliana Ruggiero, Anna Paruzynski, Manfred Schmidt, Christof von Kalle, Fabio Ciceri, Claudio Bordignon, Chiara Bonini
Journal: Blood (2013)
Treatment, Outcomes, and Adherence to Medication Regimens Among Dual Medicare-Medicaid–Eligible Adults With Myocardial Infarction
Authors: Jacob A. Doll, Anne S. Hellkamp, Abhinav Goyal, Nadia R. Sutton, Eric D. Peterson, Tracy Y. Wang
Journal: JAMA Cardiology (2016)

Patients with dual Medicare-Medicaid eligibility have a higher burden of chronic disease conditions and increased health care utilization compared with patients with Medicare coverage alone, but the treatment patterns and outcomes of dual-eligible patients with myocardial infarction (MI) are unknown.To examine the association of dual-eligible status with clinical outcomes and adherence to medication regimens (hereinafter "medication adherence") among older adults after MI.In this retrospective study conducted from February 2015 to April 2016, we linked patients 65 years or older enrolled in a national myocardial infarction registry (the Acute Coronary Treatment Intervention Outcomes Network Registry-Get With the Guidelines [ACTION Registry-GWTG]) from July 1, 2007, to December 31, 2009, to Medicare claims data to obtain 1-year follow-up and medication adherence data. The ACTION Registry-GWTG is the largest quality-improvement registry of patients with MI in the United States. Included patients were all 65 years or older; had Medicare Parts A, B, and D; presented with MI; and survived to hospital discharge.Dual Medicare and Medicaid eligibility.Death, readmission, major adverse cardiovascular events (death, recurrent MI, stroke), and medication adherence at 1 year.Of 17 419 Medicare patients discharged alive after MI, 4674 (27%) were dual eligible. Dual-eligible patients were more likely to be female (64% vs 49%) and nonwhite (29% vs 6%), with a higher prevalence of comorbid conditions and more frequent presentation with non-ST elevation MI (non-STEMI) (75% vs 69%). Dual-eligible patients were less likely to receive primary percutaneous coronary intervention for STEMI (77% vs 81%), revascularization for non-STEMI (58% vs 65%), and prescription of secondary prevention medications at discharge. After multivariable adjustment, dual eligibility status was associated with a higher risk of readmission at 30 days (hazard ratio [HR], 1.16; 95% CI, 1.06-1.26), death at 1 year (HR, 1.24; 95% CI, 1.14-1.36), and major adverse cardiac events at 1 year (HR, 1.21; 95% CI, 1.12-1.31). Dual-eligible patients had higher 1-year adherence to medications prescribed at discharge (HR, 1.55; 95% CI, 1.39-1.74) than Medicare-only patients.Compared with Medicare-only patients, older adults with dual Medicare-Medicaid eligibility presenting with MI have superior rates of medication adherence but higher rates of postdischarge readmission and adverse cardiovascular outcomes.
Ultrasound vs Angiography for Drug-Eluting Stent Implantation
Authors: Arie Steinvil, Ron Waksman, Hector M. Garcia-Garcia
Journal: JAMA (2016)

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Long-Term Follow-Up Of Reduced-Intensity Allogeneic Hematopoietic Stem Cell Transplantation For High Risk Follicular Lymphoma
Authors: Silvana Novelli, Albert Esquirol, Javier Briones, Pilar Leoz, Rodrigo Martino, Garrido Ana, Irene Garcia, Saavedra Silvana, Miquel Granell, Carol Moreno, Salut Brunet, Jorge Sierra
Journal: Blood (2013)
Safety and Outcome of Intra-Arterial Treatment for Basilar Artery Occlusion
Authors: Reinier C. van Houwelingen, Gert-Jan Luijckx, Aryan Mazuri, Reinoud P. H. Bokkers, Omid S. Eshghi, Maarten Uyttenboogaart
Journal: JAMA Neurology (2016)

After the many positive results in thrombectomy trials in ischemic stroke of the anterior circulation, the question arises whether these positive results also apply to the patient with basilar artery occlusion (BAO).To report up-to-date outcome data of intra-arterial (IA) treatment in patients with BAO and to evaluate the influence of collateral circulation on outcome.Single-center retrospective case series of 38 consecutive patients with BAO who underwent IA treatment between 2006 and 2015 at a comprehensive stroke center.Intra-arterial treatment by mechanical thrombectomy and/or IA thrombolysis.Adequate recanalization was defined as a score of 2b or 3 on the Thrombolysis in Cerebral Infarction score. Favorable outcome was defined as a modified Rankin Scale of 0 to 3 at first follow-up. Imaging data on the patency of the vertebral arteries and posterior communicating arteries, as well as the presence of cerebellar arterial anastomosis, were recorded and posttreatment imaging results were reviewed.Of the 38 patients with BAO, mean (SD) age was 58 (16) years, and 21 (55%) were male. Twenty-seven patients (71%) were treated with intravenous thrombolysis before IA therapy. Mechanical thrombectomy was applied to 30 patients, and 7 patients received local urokinase without thrombectomy. The median National Institutes of Health Stroke Scale score was 21 (interquartile range [IQR], 15-32) points, and median time to IA treatment was 288 (IQR, 216-380) minutes. Adequate recanalization was achieved in 34 of 38 cases (89%). Functional outcome was favorable in 19 (50%) patients. No association between patent collateral circulation and favorable outcome was found. Symptomatic intracranial hemorrhage occurred in 2 patients (5%).The proportion of patients reaching a favorable outcome in our study is comparable to the IA-treated group of the MR CLEAN trial and better than the results reported in the BASICS registry, suggesting that IA intervention in patients with BAO is an effective and safe treatment modality in daily clinical practice.