tbuckley/cabot-search huggingface dataset:
PWE-081 Body mass index is superior to symptom characteristics or oesophageal pH-metry in predicting response to proton pump inhibitors therapy in patients with normal endoscopy
Authors: G R Jones, J Fletcher, L S Murray, K E L McColl
Journal: Gut (2010)

<h3>Introduction</h3> Most patients with upper gastrointestinal symptoms are now <i>H pylori</i> negative and no abnormalities are seen at endoscopy. Proton pump inhibitors (PPIs) are usually prescribed to these patients, though only a proportion benefit. <h3>Aim</h3> To identify factors predicting response to PPI therapy in patients with upper GI symptoms and normal endoscopy. <h3>Methods</h3> 105 patients with upper gastrointestinal symptoms of &gt;3 months, normal endoscopy and HP-ve tests were prospectively recruited. Patients with hiatus hernia or taking NSAIDs were excluded. Character of symptoms and lifestyle factors were assessed by validated questionnaires and baseline severity over 7 days. The predominant symptom was retrosternal discomfort in 43, epigastric discomfort in 42, nausea/vomiting in 10, fullness/satiety in 1 and other symptoms in 6. Their median BMI was 26 (range 17.6–40.4) with 39% overweight and 20% obese. 24 h oesophageal pH monitoring and manometry of the lower oesophageal sphincter (LOS) by perfusion pull through technique (1 cm every minute) was performed. Patients were then randomised in double-blind fashion to 2 weeks daily treatment with 2/3 receiving lansoprazole 30 mg/day and 1/3 placebo. Symptoms were re-assessed throughout the second week of treatment, with the primary outcome being absolute change in symptom severity score (Glasgow Dyspepsia Score). <h3>Results</h3> 102 individuals were treated (69 randomised to Lansoprazole, 33 to placebo). The mean pre-treatment symptom score in the active treatment group was 10.4 (SD 2.2) and in placebo 10.9 (SD2.7). The mean reduction in score following active treatment was 3.8 (SD 3.8) vs 0.6 (SD 2.1) following placebo (p&lt;0.001). Within the PPI treated group, univariate analysis showed that BMI, LOS pressure, LOS abdominal length and per cent time oesophageal pH&lt;4 were statistically significant predictors of response. Multivariate regression modelling revealed that in the best model only BMI (p=0.003) and LOS abdominal length (p=0.013) were independent predictors of response (R<sup>2</sup>=19.4%). Neither predominant symptom nor any other symptom characteristic predicted response. <h3>Conclusion</h3> This study indicates the lack of value of detailed symptom assessment in predicting response to PPI therapy. The strong predictive value of BMI is likely to be due to its association with gastro-oesophageal reflux which will respond to PPI therapy and highlights the important role of BMI in reflux disease.
TCT-299 Percutaneous Coronary Intervention Versus Medical Therapy for Chronic Total Occlusions: Meta-Analysis
Authors: Arun Kanmanthareddy, Hemantha Koduri, Abilash Balmuri, Dixitha Anugula, Nagarjuna Gujjula, Scott Lilly, Michael White
Journal: Journal of the American College of Cardiology (2016)
TCT-45 Five Year Mortality Predictors After provisional T-stenting in Coronary Bifurcation Lesions, with Intracoronary Electrocardiogram Change Defined Strategy. From Intracoronary Electrocardiogram (ECG) and Myonecrosis After Bifurcation Stenting (COSIBRIA&amp;CO) (ClinicalTrials.gov Identifier:NCT01268228)
Authors: Dobrin Vassilev, Kiril Karamfiloff, Liubomir Dosev, Jivka Stoykova, Ralitsa Pancheva, Galina Zlatancheva, Monika Shumkova, Dobrin Svinarov, Adelina Cakova, Gianluca Rigatelli, Robert Gil
Journal: Journal of the American College of Cardiology (2016)
TCT-826 Prospective single center First In Human (FIH) clinical trial to evaluate the safety and effectiveness of a septal occluder with bioresorbable framework in patients with clinically significant atrial septum defect (ASD) or patent foramen ovale (PFO)
Authors: Björn Söderberg, Laura Vaskelyte, Kolja Sievert, Sameer Gafoor, Ilona Hofmann, Andreas Mellmann, Jerome Bernhard, Horst Sievert
Journal: Journal of the American College of Cardiology (2016)
TCT-627 Cardiovascular Outcomes Assessment of MitraClip Therapy in Heart Failure Patients with Functional Mitral Regurgitation (The COAPT Trial): Baseline Characteristics and Preliminary 30-Day and 1-Year Outcomes of the Roll-In Cohort
Authors: Gregg Stone, William Abraham, JoAnn Lindenfeld, Neil Weissman, Steven Marx, Jeff Ellis, Lori Anne Crosson, Michael Mack
Journal: Journal of the American College of Cardiology (2016)
Graft-Versus-Host Disease (GVHD) in Cord Blood Transplantation (CBT): Risk Factors, Clinical Manifestations and Outcomes.
Authors: Daniel Couriel, Poliana Patah, Rima Saliba, Lawrence Cooper, Laura Worth, Dimitrios Petropoulos, Leandro Depadua, Weiqing Zhang, Sergio Giralt, Richard Champlin, Elizabeth J. Shpall, Marcos de Lima
Journal: Blood (2007)
An incidental finding
Authors: H L Adams, David C Howlett
Journal: BMJ (2016)

A 68 year old man presented with abdominal pain and underwent abdominal radiography. What finding is present on the radiograph (fig 1⇓)?



Fig 1  Anteroposterior abdominal radiograph



Calcification of the adrenal glands bilaterally (fig 2⇓ arrows).



Fig 2  Anteroposterior abdominal radiograph showing calcifications in paravertebral region at level of T12/L1 (black arrows), within adrenal glands



### Discussion

The patient underwent computed tomography, which confirmed bilateral adrenal calcification …
Resistance to anti-CD19/CD3 BiTE in acute lymphoblastic leukemia may be mediated by disrupted CD19 membrane trafficking
Authors: Friederike Braig, Anna Brandt, Mariele Goebeler, Hans-Peter Tony, Anna-Katharina Kurze, Peter Nollau, Thomas Bumm, Sebastian Böttcher, Ralf C. Bargou, Mascha Binder
Journal: Blood (2016)
Improvement in the awareness of palliative care nursing using STAS-J in an acute care hospital
Authors: Tsuyoshi Shirakawa, Keiko Hikage, Terumi Akino, Tomoko Hirata, HIroko Shigematsu, Tomoko Nagaie, Hiroshi Ariyama, Hitoshi Kusaba, Koichi Akashi, Eishi Baba
Journal: Annals of Oncology (2015)
Everolimus-Eluting Stents or Bypass Surgery for Left Main Coronary Artery Disease
Authors: Gregg W. Stone, Joseph F. Sabik, Patrick W. Serruys, Charles A. Simonton, Philippe Généreux, John Puskas, David E. Kandzari, Marie-Claude Morice, Nicholas Lembo, W. Morris Brown, David P. Taggart, Adrian Banning, Béla Merkely, Ferenc Horkay, Piet W. Boonstra, Ad J. van Boven, Imre Ungi, Gabor Bogáts, Samer Mansour, Nicolas Noiseux, Manel Sabaté, José Pomar, Mark Hickey, Anthony Gershlick, Pawel Buszman, Andrzej Bochenek, Erick Schampaert, Pierre Pagé, Ovidiu Dressler, Ioanna Kosmidou, Roxana Mehran, Stuart J. Pocock, A. Pieter Kappetein
Journal: New England Journal of Medicine (2016)

Patients with obstructive left main coronary artery disease are usually treated with coronary-artery bypass grafting (CABG). Randomized trials have suggested that drug-eluting stents may be an acceptable alternative to CABG in selected patients with left main coronary disease.
Sphingosine Kinase 2 Deficiency Attenuates Kidney Fibrosis via IFN-γ
Authors: Amandeep Bajwa, Liping Huang, Elvira Kurmaeva, Hong Ye, Krishna R. Dondeti, Piotr Chroscicki, Leah S. Foley, Z. Ayoade Balogun, Kyle J. Alexander, Hojung Park, Kevin R. Lynch, Diane L. Rosin, Mark D. Okusa
Journal: Journal of the American Society of Nephrology (2016)

Maladaptive repair after AKI may lead to progressive fibrosis and decline in kidney function. Sphingosine 1-phosphate has an important role in kidney injury and pleiotropic effects in fibrosis. We investigated the involvement of sphingosine kinase 1 and 2 (SphK1 and SphK2), which phosphorylate sphingosine to produce sphingosine 1-phosphate, in kidney fibrosis induced by folic acid (FA) or unilateral ischemia-reperfusion injury. Analysis of Masson trichrome staining and fibrotic marker protein and mRNA expression 14 days after AKI revealed that wild-type (WT) and Sphk1-/- mice exhibited more kidney fibrosis than Sphk2-/- mice. Furthermore, kidneys of FA-treated WT and Sphk1-/- mice had greater immune cell infiltration and expression of fibrotic and inflammatory markers than kidneys of FA-treated Sphk2-/- mice. In contrast, kidneys of Sphk2-/- mice exhibited greater expression of Ifng and IFN-γ-responsive genes (Cxcl9 and Cxcl10) than kidneys of WT or Sphk1-/- mice did at this time point. Splenic T cells from untreated Sphk2-/- mice were hyperproliferative and produced more IFN-γ than did those of WT or Sphk1-/- mice. IFN-γ blocking antibody administered to Sphk2-/- mice or deletion of Ifng (Sphk2-/-Ifng-/- mice) blocked the protective effect of SphK2 deficiency in fibrosis. Moreover, adoptive transfer of Sphk2-/- (but not Sphk2-/-Ifng-/- ) CD4 T cells into WT mice blocked FA-induced fibrosis. Finally, a selective SphK2 inhibitor blocked FA-induced kidney fibrosis in WT mice. These studies demonstrate that SphK2 inhibition may serve as a novel therapeutic approach for attenuating kidney fibrosis.
TCT-256 Comparing the Rate of Side Branch Occlusion between Coronary Bifurcation Lesions with Low and High Carina Angle: Validating the Hypothesis of Carina Shift by Using a Consecutive Cohort of 1200 Coronary Bifurcation Lesions
Authors: Changzhe Chen, Yiping Li, Dong Zhang, Bo Xu, Kefei Dou
Journal: Journal of the American College of Cardiology (2016)
Trastuzumab-mediated cardiac dysfunction (CDx) outside of clinical trials: Single Asian center experience
Authors: J. Park, S. Han, D. Oh, J. Kim, H. Lee, Y. Kim, S. Im, T. Kim, Y. Bang
Journal: Journal of Clinical Oncology (2009)

e20732 Background: Trastuzumab is an effective drug for the treatment of HER2 positive breast cancer (BC) and CDx has been reported as a major toxicity. The purpose of our study was to investigate the trastuzumab mediated CDx in practice setting and the treatment outcome at single Asian center. Methods: We retrospectively analyzed 181 HER2-overexpressing BC patients (pts) who were treated with trastuzumab containing regimen between January 2005 and December 2007 at Seoul National University Hospital. We investigated the incidence of CDx and the degree of reversibility using echocardiography (EchoCG) and identify the risk factors to predict CDx. Results: Among 181 patients (pts), 112 were treated for palliative purpose and 139 had previously received anthracycline-based chemotherapy. Baseline EchoCG results were available in 129 pts (median age 47; range 25–79) and median left ventricular ejection fraction (LVEF) was 59% (range 45–70). Median follow-up duration was 21 months. LVEF decreased more than 5% points in 37 out of 129 (28.6%). According to the national cancer institute common terminology criteria for adverse events, grade (G) 2 and G 3/4 CDx developed in 4 (3.1%) and 8 (6.2%) pts respectively. Seven pts experienced symptomatic heart failure (HF). 3 among 5 pts who experienced discontinuation of trastuzumab could resume trastuzumab after median 146 (range 94–163) days of discontinuation. Median LVEF was 54% (range 45–63) at baseline in pts who experienced G2–4 CDx and deceased to 45% (range 30–49) after median 175 (range 65–415) days of trastuzumab treatment. HF treatment was initiated in 9 pts. 4 pts received angiotensin converting enzyme inhibitors (ACEI), 3 pts angiotensin receptor blockers (ARB) and 2 pts ACEI or ARB with diuretics. Occurrence of CDx (G2–4) was associated with higher anthracycline cumulative doses (p=0.039) and lower baseline LVEF (p=0.003). The incidence of symptomatic HF was related with past medical history such as hypertension (p=0.019) and lower baseline LVEF (p=0.005). Among the pts who had G2–4 CDx, LVEF was restored to 54% (range 40–59) which was similar to baseline at median 187 (range 56–477) days after the diagnosis of CDx. Conclusions: The majority pts with trastuzumab-mediated CDx were asymptomatic and LVEF could be reversible. No significant financial relationships to disclose.
Defibrillators
Authors: Sana M. Al-Khatib, Paul Friedman, Kenneth A. Ellenbogen
Journal: Circulation (2016)

Advances in the field of defibrillation have brought to practice different types of devices that include the transvenous implantable cardioverter-defibrillator (ICD) with or without cardiac resynchronization therapy, the subcutaneous ICD (S-ICD), and the wearable cardioverter-defibrillator. To ensure optimal use of these devices and to achieve best patient outcomes, clinicians need to understand how these devices work, learn the characteristics of patients who qualify them for one type of device versus another, and recognize the remaining gaps in knowledge surrounding these devices. The transvenous ICD has been shown in several randomized clinical trials to improve the survival of patients resuscitated from near-fatal ventricular fibrillation and those with sustained ventricular tachycardia with syncope or systolic heart failure as a result of ischemic or nonischemic cardiomyopathy despite receiving guideline-directed medical therapy. Important gaps in knowledge regarding the transvenous ICD involve the role of the ICD in patient subgroups not included, or not well represented, in clinical trials and the need to refine the selection criteria for the ICD in patients who are indicated for it. S-ICDs were recently introduced into the clinical arena as another option for many patients who have an approved indication for a transvenous ICD. The main advantage of the S-ICD is a lower risk of infection and lead-related complications; however, the S-ICD does not offer bradycardia or antitachycardia pacing. The S-ICD may be ideal for patients with limited vascular access, high infection risk, or some congenital heart diseases. However, more data are needed regarding the efficacy and effectiveness of the S-ICD in comparison to transvenous ICDs, the extent of defibrillation testing required, and the use of the S-ICD with other novel technologies, including leadless pacemakers. Cardiac resynchronization therapy-defibrillators are indicated in patients with a left ventricular ejection fraction ≤35%, QRS width ≥130 ms, and New York Heart Association class II, III, or ambulatory IV symptoms despite treatment with guideline-directed medical therapy. Multiple randomized controlled trials have shown that the cardiac resynchronization therapy-defibrillator improves survival, quality of life, and several echocardiographic measures. One main challenge related to cardiac resynchronization therapy-defibrillators is the 30% nonresponse rate. Many initiatives are underway to address this challenge including improved cardiac resynchronization therapy and imaging technologies and enhanced selection of patients and device programming.
Gemcitabine (G) combined with gefitinib in patients with inoperable or metastatic pancreatic cancer. A phase II trial
Authors: G. Fountzilas, S. Murray, N. Xiros, G. Karayannopoulou, U. Dafni, H. Linardou, A. Kalogera-Fountzila, M. Bobos, A. Koumarianou, P. Kosmidis
Journal: Journal of Clinical Oncology (2007)

15016 Introduction: Pancreatic cancer is one of the most lethal cancers, with a high incidence of overexpression of EGFR and its ligands. Gemcitabine (G) is the treatment of choice in this tumor. Patients and Methods: From June 2004 to May 2006, 54 patients were registered in the study. Median age was 65 years (range 44–80) and median Karnofsky performance status was 80%. G (1000 mg/m 2 ) was administered weekly for 7 cycles. Gefitinib (250 mg) was given orally. EGFR, HER-2 and PTEN were assessed by IHC and FISH. Biopsies containing =70% tumor were evaluated for the presence of somatic mutations in exons 18–21 of EGFR and exon 2 of RAS by bi-directional sequencing. Results: Ten patients (19%) completed treatment, while 36 patients (67%) progressed before the completion of the treatment. Three patients (6%) had a partial response and 11 patients (20%) had stable disease. After a median follow-up of 9 months, median survival time was 7.4 months, while median time to disease progression (TTP) was 3.9 months. The one-year survival rate was 23%. Rash of any grade was reported in 28 patients (52%). Most common severe toxicities were neutropenia (13%) and leucopenia (6%). RAS mutations were identified in 18/34 patients (53%). Two additional patients had an EGFR point mutation in exon 20. EGFR expression was found in 23/30 patients (77%), while EGFR amplification was not observed. HER-2 gain was detected in 4/20 patients and PTEN deletion in 14/20 patients. PTEN expression was noticed in 7/30 patients and was the only marker associated with significantly increased TTP (p=0.008). Conclusions: The results from this small single arm study were similar to those seen with G plus erlotinib with respect to median and one-year survival. These findings, and the selection of patients with better prognosis based on molecular markers, need to be confirmed in a larger study. No significant financial relationships to disclose.
TCT-705 Gender Impact on the Outcome after Transcatheter Aortic Valve Replacement
Authors: Felix Woitek, Stephan Haussig, Norman Mangner, David Michael Holzhey, Georg Stachel, Florian Schlotter, Robert Höllriegel, Sergey Leontyev, Friedrich Mohr, Gerhard Schuler, Axel Linke
Journal: Journal of the American College of Cardiology (2016)
A phase II trial of thalidomide, bevacizumab, and docetaxel in patients (pts) with metastatic androgen-independent prostate cancer (AIPC)
Authors: Y. M. Ning, P. Arlen, J. Gulley, L. Latham, E. Jones, C. Chen, H. Parnes, J. Wright, W. D. Figg, W. L. Dahut
Journal: Journal of Clinical Oncology (2007)

5114 Background: Angiogenesis plays a vital role in the progression of prostate cancer. Antiangiogenic agents thalidomide (T) and bevacizumab (Bv) may enhance docetaxel (Doc) activity in metastatic AIPC. However, T and Bv have different antiangiogenic mechanisms. Since tumor angiogenesis is a complex interplay of multiple angiogenic factors, we reasoned that combination of mechanistically different antiangiogenic agents T and Bv with Doc might be associated with an adequately high and durable PSA response to merit further study. Methods: Pts are required to have progressive metastatic AIPC and no prior chemotherapy for AIPC. Treatment consists of Doc 75 mg/m 2 plus Bv 15 mg/kg day 1, q 21 days as a cycle (C), plus T 200 mg qhs and prednisone 10 mg qd. Enoxaparin is used for thrombosis prevention and pegfilgrastim initiated after detection of grade ≥3 neutropenia. PSA is assayed q C and staging studies are done at C 0, C 2, &amp; then q 3 Cs. Results: 39 pts were enrolled, median age 66 [54–79], Gleason score 8 [74% Gs 10∼8, 26% Gs 7∼6], on-study PSA 92 ng/ml [5.9–4399] and pre-study PSA doubling time 1.6 months [0.3–18.2, 87 % &lt;3 months]. Median treatment Cs is 14 [1- 28]. 34 pts (87%) had PSA declines of ≥50%, with median ≥50% PSA-duration 12 Cs [0∼28]. 3 pts have PSA declines around 40% and 2 stable. 26 pts (67%) had &gt;80% PSA declines. 17 pts with measurable disease were evaluable: 1 CR, 9 PR, &amp; 7 SD, with 59% ORR. Significant toxicities: febrile neutropenia (5/39), syncope (4/39), colon perforation or fistula (2/39), grade 3 bleeding (2/39), thrombosis (2/39). Conclusions: This trial is the first study to combine antiangiogenic agents of different mechanisms with Doc in metastatic AIPC. Most of the accrued patients have unfavorable characteristics as evidenced by a high Gleason score and a short PSA doubling time. However, the combination of T and Bv with Doc appears to result in both a high durable PSA decline rate (87%) and a high response in measurable disease (59%) with acceptable toxicities. No significant financial relationships to disclose.
The Development of Psoriatic Arthritis in Patients With Psoriasis Is Preceded by a Period of Nonspecific Musculoskeletal Symptoms: A Prospective Cohort Study
Authors: Lihi Eder, Ari Polachek, Cheryl F. Rosen, Vinod Chandran, Richard Cook, Dafna D. Gladman
Journal: Arthritis & Rheumatology (2016)

Objective To assess whether the presence of nonspecific musculoskeletal symptoms, their degree, and change over time predict the development of psoriatic arthritis (PsA) in a prospective cohort of psoriasis patients without arthritis at baseline. Methods This prospective cohort study involved patients with psoriasis who were assessed at baseline to exclude the presence of clinical PsA. The study participants were reassessed annually to determine if they had developed PsA. The presence of musculoskeletal symptoms and the patients’ assessments of pain, fatigue, stiffness, physical function, and psychological distress were recorded at each visit. Cox proportional hazards models were used to assess what symptoms predicted the development of PsA. Results A total of 57 of 410 psoriasis patients developed PsA. At baseline, the presence of arthralgia in women (hazard ratio [HR] 2.59, P = 0.02), heel pain (HR 4.18, P = 0.02), high fatigue score (HR 2.36, P = 0.007), and high stiffness score (HR 2.03, P = 0.045) predicted subsequent development of PsA. In addition, an increase from baseline in fatigue score (HR 1.27, P = 0.001), pain score (HR 1.34, P &lt; 0.001), and stiffness score (HR 1.21, P = 0.03), and a worsening in physical function score (HR 0.96, P = 0.04) predicted the development of PsA. Conclusion A preclinical phase exists in patients with PsA prior to the diagnosis of the disease. This phase is characterized by nonspecific musculoskeletal symptoms, including joint pain, fatigue, and stiffness.
ORAL02.01: Safety and Efficacy of Single-Agent Rovalpituzumab Tesirine, a DLL3-Targeted ADC, in Recurrent or Refractory SCLC
Authors: Todd M. Bauer, David Spigel, Neal Ready, Daniel Morgensztern, Bonnie S. Glisson, Lauren A. Byers, Howard Burris, Francisco Robert, Donald K. Strickland, Maria C. Pietanza, Ramaswamy Govindan, Scott J. Dylla, Stanford Peng, Charles Rudin
Journal: Journal of Thoracic Oncology (2016)
IFN-γ orchestrates mesenchymal stem cell plasticity through the signal transducer and activator of transcription 1 and 3 and mammalian target of rapamycin pathways
Authors: Tiziana Vigo, Claudio Procaccini, Giovanni Ferrara, Sergio Baranzini, Jorge R. Oksenberg, Giuseppe Matarese, Alberto Diaspro, Nicole Kerlero de Rosbo, Antonio Uccelli
Journal: Journal of Allergy and Clinical Immunology (2016)
Association Between Treatment Facility Volume and Mortality of Patients With Multiple Myeloma
Authors: Ronald S. Go, Adam C. Bartley, Cynthia S. Crowson, Nilay D. Shah, Elizabeth B. Habermann, Sara J. Holton, David R. Holmes
Journal: Journal of Clinical Oncology (2017)

Purpose To determine the association between the number of patients with multiple myeloma (MM) treated annually at a treatment facility (volume) and all-cause mortality (outcome). Methods Using the National Cancer Database, we identified patients diagnosed with MM between 2003 and 2011. We classified the facilities by quartiles (Q; mean patients with MM treated per year): Q1: &lt; 3.6; Q2: 3.6 to 6.1, Q3: 6.1 to 10.3, and Q4: &gt; 10.3. We used random intercepts to account for clustering of patients within facilities and Cox regression to determine the volume-outcome relationship, adjusting for demographic (sex, age, race, ethnicity), socioeconomic (income, education, insurance type), geographic (area of residence, treatment facility location, travel distance), and comorbid (Charlson-Deyo score) factors and year of diagnosis. Results There were 94,722 patients with MM treated at 1,333 facilities. The median age at diagnosis was 67 years, and 54.7% were men. The median annual facility volume was 6.1 patients per year (range, 0.2 to 109.9). The distribution of patients according to facility volume was: Q1: 5.2%, Q2: 12.6%, Q3: 21.9%, and Q4: 60.3%. The unadjusted median overall survival by facility volume was: Q1: 26.9 months, Q2: 29.1 months, Q3: 31.9 months, and Q4: 49.1 months ( P &lt; .001). Multivariable analysis showed that facility volume was independently associated with all-cause mortality. Compared with patients treated at Q4 facilities, patients treated at lower-quartile facilities had a higher risk of death (Q3 hazard ratio [HR], 1.12 [95% CI, 1.08 to 1.16]; Q2 HR, 1.17 [95% CI, 1.12 to 1.21]; Q1 HR, 1.22 [95% CI, 1.17 to 1.28]). Conclusion Patients who were treated for MM at higher-volume facilities had a lower risk of mortality compared with those who were treated at lower-volume facilities.