tbuckley/cabot-search huggingface dataset:
SAT0475 Anti-mda5 (+) clinically amyopathic dermatomyositis-associated rapidly progressive interstitial lung disease: role of hemoperfusion with polymyxin
Authors: A. Selva-O’callaghan, C. Vizcaino, J.C. Ruiz-Rodriguez, E. Trallero-Araguás, N. Ramos, C. Berastegui, A. Gil Vila, M.A. Martinez, X. Solanich, R. Ferrer
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Patients with clinically amyopathyc dermatomyositis (CADM) with MDA5 positive autoantibodies may develop a severe pulmonary syndrome with rapidly progressive interstitial lung disease (RP-ILD) with a bad prognosis and high mortality. <h3>Objectives</h3> To analyse the efficacy of a therapeutic protocol that includes hemoperfusion with polymyxin B (PMX-HP) in addition to immunosuppressive treatment with tacrolimus and glucocorticoids, plasmapheresis and intravenous immunoglobulin (IVIG). <h3>Methods</h3> We retrospectively analysed 12 (10 male) patients diagnosed with anti-MDA5 (+) CADM associated RP-ILD between 1983 and 2018. Anti-MDA5 antibodies were determined by ELISA and confirmed by blot. RP-ILD was defined as a worsening of radiologic interstitial changes with progressive dyspnoea and hypoxemia within 1 month after the onset of respiratory symptoms. From 2014 to 2018, patients (Group 1) were treated with the following protocol: pulses of methylprednisolone (500 mg/day for 3 consecutive days), tacrolimus 2 mg/12 hour, PMX-HP (Toraymyxin 20R, Toray Medical Co., Tokyo, Japan) at a flow of 100 ml/h for 3 hour once daily on two successive days, and a plasmapheresis scheme with replacement of 3.5 l of seroalbumin 5% followed by IVIG infusion (0.4 mg/kg) during 3 consecutive days and then in alternate days for 7 days more. A comparison was performed with anti-MDA5 (+) CADM associated RP-ILD patients from a historical group (Group 2). PaO<sub>2</sub>/FiO<sub>2</sub> (P/F) ratio was measured before and after PMX therapy. A composite endpoint that included mortality due to respiratory failure or lung transplantation was defined. Differences between pre- and post-PMX P/F values were evaluated using paired sample <i>t</i>-test. <h3>Results</h3> Mean (SD) age at diagnosis was 49 (3.5) yrs, with a mean (SD) follow-up of 13 (3.9) months. Comparison between both Groups showed that 3 out of 6 (50%) patients from the Group 1 in comparison with 5 out of 6 (83.3%) from the historical group (Group 2) reached the composite end point. Mean (CI 95%) values of P/F after PMX treatment showed a significantly improvement when compared with the pre-PMX values (240 [85–396] vs. 125,<sup>60–189</sup> p=0.038) <h3>Conclusions</h3> Our protocol seems to be useful at some extent in anti-MDA5 (+) CADM associated RP-ILD patients. A transient but significant improvement can be attributed to PMX-HP. Adsorption and elimination of inflammatory cytokines, mediators and activated leukocytes, as well as anti-MDA5 antibodies could be the rationale of its efficacy. <h3>Disclosure of Interest</h3> None declared
A Dedicated Prostate MRI Teaching Course Improves the Ability of the Urologist to Interpret Clinically Significant Prostate Cancer on Multiparametric MRI
Authors: Veeru Kasivisvanathan, Alessandro Ambrosi, Francesco Giganti, Edwin Chau, Alex Kirkham, Shonit Punwani, Clare Allen, Mark Emberton, Caroline M. Moore
Journal: European Urology (2018)
Abstract 15689: Anxiety and Depression Predict 1-year Mortality in Cardiac Patients: Results From the National Denheart Survey
Authors: Selina K Berg, Charlotte B Thorup, Britt Borregaard, Anne V Christensen, Lars Thrysøe, Trine B Rasmussen, Ola Ekholm, Knud Juel, Marianne Vamosi
Journal: Circulation (2016)

Introduction: Results from national DenHeart survey shows, that anxiety is present among 32% and depression among 19% of cardiac patients. Previous studies indicate that these symptoms are associated with an increased risk of mortality in patients with HF and ICD. Crucial knowledge about the danger of anxiety and depression across cardiac diagnoses is lacking. Hypothesis: The hypothesis was that patients with anxiety or depression have a higher mortality risk. The objective was to explore if anxiety and depression is a predictor of 1-year mortality across cardiac diagnoses. Methods: During one year all patients discharged from a national heart center were invited to participate in a health survey. The Hospital Anxiety and Depression Scale (HADS) were included and data was combined with national registers to obtain information about diagnosis at baseline and 1-year mortality. Cox regression was used to analyze anxiety and depression as predictors of mortality. Results: In total 14,239 patients across all c...
Assessment of quality of primary care with facility surveys: a descriptive analysis in ten low-income and middle-income countries
Authors: Erlyn K Macarayan, Anna D Gage, Svetlana V Doubova, Frederico Guanais, Ephrem T Lemango, Youssoupha Ndiaye, Peter Waiswa, Margaret E Kruk
Journal: The Lancet Global Health (2018)

BackgroundPrimary care has the potential to address a large proportion of people's health needs, promote equity, and contain costs, but only if it provides high-quality health services that people want to use. 40 years after the Declaration of Alma-Ata, little is known about the quality of primary care in low-income and middle-income countries. We assessed whether existing facility surveys capture relevant aspects of primary care performance and summarised the quality of primary care in ten low-income and middle-income countries.MethodsWe used Service Provision Assessment surveys, the most comprehensive nationally representative surveys of health systems, to select indicators corresponding to three of the process quality domains (competent systems, evidence-based care, and user experience) identified by the Lancet Global Health Commission on High Quality Health Systems in the Sustainable Development Goals Era. We calculated composite and domain quality scores for first-level primary care facilities across and within ten countries with available facility assessment data (Ethiopia, Haiti, Kenya, Malawi, Namibia, Nepal, Rwanda, Senegal, Tanzania, and Uganda).FindingsData were available for 7049 facilities and 63 869 care visits. There were gaps in measurement of important outcomes such as user experience, health outcomes, and confidence, and processes such as timely action, choice of provider, affordability, ease of use, dignity, privacy, non-discrimination, autonomy, and confidentiality. No information about care competence was available outside maternal and child health. Overall, scores for primary care quality were low (mean 0·41 on a scale of 0 to 1). At a domain level, scores were lowest for user experience, followed by evidence-based care, and then competent systems. At the subdomain level, scores for patient focus, prevention and detection, technical quality of sick-child care, and population-health management were lower than those for other subdomains.InterpretationFacility surveys do not capture key elements of primary care quality. The available measures suggest major gaps in primary care quality. If not addressed, these gaps will limit the contribution of primary care to reaching the ambitious Sustainable Development Goals.FundingBill & Melinda Gates Foundation.
GW29-e0862 NEW DISCOVERY: Gas Bubbles Rupture in the Coronary Arteries is Most Likely the Mechanism Breaking the Thin Cap of Plaques Causing Acute Coronary Syndrome
Authors: Thach Nguyen, Thao Dang, Tu NT. Nguyen, Cat Hoang Anh, Pham Le Huy Hoang, Tarneem Darwish, Gianluca Rigatelli, Ernest Talarico
Journal: Journal of the American College of Cardiology (2018)
Abstract 16964: The Functional Remodeling of Left Atrium After Ablation in Paroxysmal Atrial Fibrillation
Authors: Mi Na Kim, Su-A Kim, Jong-il Choi, Seong-Mi Park, Sang-Won Park, Young-Hoon Kim, Wan-Joo Shim
Journal: Circulation (2013)

Background: Reverse structural remodeling of left atrium (LA) ensues after successful radiofrequency catheter ablation (RFCA). But the functional reverse remodeling after RFCA has not been well stu...
Child mental health: government has “long way to go” to improve access, NAO finds
Authors: Gareth Iacobucci
Journal: BMJ (2018)

Mental health services for young people in England may struggle to meet demand despite ministerial pledges to boost funding, the government’s spending watchdog has warned.1

The National Audit Office (NAO) noted the government’s “laudable ambitions” to improve access by investing an additional £1.4bn (€1.6bn; $1.84bn) from 2015-16 to 2020-21. But it said that this was starting from “a very low base” and warned of “significant unmet need.”

The report identified slow progress on tackling staff shortages and “significant data …
Evaluation of the diet wide contribution to serum urate levels: meta-analysis of population based cohorts
Authors: Tanya J Major, Ruth K Topless, Nicola Dalbeth, Tony R Merriman
Journal: BMJ (2018)

Abstract Objective To systematically test dietary components for association with serum urate levels and to evaluate the relative contributions of estimates of diet pattern and inherited genetic variants to population variance in serum urate levels. Design Meta-analysis of cross sectional data from the United States. Data sources Five cohort studies. Review methods 16 760 individuals of European ancestry (8414 men and 8346 women) from the US were included in analyses. Eligible individuals were aged over 18, without kidney disease or gout, and not taking urate lowering or diuretic drugs. All participants had serum urate measurements, dietary survey data, information on potential confounders (sex, age, body mass index, average daily calorie intake, years of education, exercise levels, smoking status, and menopausal status), and genome wide genotypes. The main outcome measures were average serum urate levels and variance in serum urate levels. β values (95% confidence intervals) and Bonferroni corrected P values from multivariable linear regression analyses, along with regression partial R 2 values, were used to quantitate associations. Results Seven foods were associated with raised serum urate levels (beer, liquor, wine, potato, poultry, soft drinks, and meat (beef, pork, or lamb)) and eight foods were associated with reduced serum urate levels (eggs, peanuts, cold cereal, skim milk, cheese, brown bread, margarine, and non-citrus fruits) in the male, female, or full cohorts. Three diet scores, constructed on the basis of healthy diet guidelines, were inversely associated with serum urate levels and a fourth, data driven diet pattern positively associated with raised serum urate levels, but each explained ≤0.3% of variance in serum urate. In comparison, 23.9% of variance in serum urate levels was explained by common, genome wide single nucleotide variation. Conclusion In contrast with genetic contributions, diet explains very little variation in serum urate levels in the general population.
Abstract 16744: Identification of Atherosclerotic Plaque Evolution by Imaging Cell Death
Authors: Christy Barber, Brandon T Larson, Brian D Gray, Koon Y Pak, Zhonglin Liu
Journal: Circulation (2016)

Introduction: As a consequence of inflammatory cellular infiltrates in atherosclerotic plaques, chemokines and cytokines promote a cell death cascade that contributes to plaques destabilization and rupture. This study was designed to exploit the evolution of cell death, including apoptosis and early necrosis, in atherosclerosis using 99mTc-duramycin (99mTc-DUR) targeting externalized phosphatidylethanolamine of the cell membrane. Methods: Atherosclerosis was induced in Apolipoprotein E-Deficient (ApoE-/-) mice by feeding an atherogenic diet. Using a small-animal SPECT imager, three groups of ApoE-/- mice (n=6 each) were imaged at 2 h after 37-48 MBq 99mTc-DUR injection and euthanized at 15, 20, and 40 weeks of age (G-15, G-20, and G-40). The mice in G-40 were repeatedly imaged at three time-points before sacrifice. Age-matched wild-type mice (Apo-E+/+) were studied as controls. The aortas and other large arteries of all mice were harvested for postmortem analyses. Results: SPECT and autoradiograph images ...
LAG-3 inhibits the activation of CD4+ T cells that recognize stable pMHCII through its conformation-dependent recognition of pMHCII
Authors: Takumi Maruhashi, Il-mi Okazaki, Daisuke Sugiura, Suzuka Takahashi, Takeo K. Maeda, Kenji Shimizu, Taku Okazaki
Journal: Nature Immunology (2018)
Screening, diagnosis and treatment of iron deficiency in chronic heart failure: putting the 2016 European Society of Cardiology heart failure guidelines into clinical practice
Authors: Theresa McDonagh, Thibaud Damy, Wolfram Doehner, Carolyn S.P. Lam, Andrew Sindone, Peter van der Meer, Alain Cohen‐Solal, Ingrid Kindermann, Nicolas Manito, Otmar Pfister, Hanna Pohjantähti‐Maaroos, Jackie Taylor, Josep Comin‐Colet
Journal: European Journal of Heart Failure (2018)

Iron deficiency is common in patients with chronic heart failure (CHF) and is associated with reduced exercise performance, impaired health-related quality of life and an increased risk of mortality, irrespective of whether or not anaemia is present. Iron deficiency is a serious but treatable condition. Several randomized controlled clinical trials have demonstrated the ability of intravenous (IV) iron, primarily IV ferric carboxymaltose (FCM), to correct iron deficiency in patients with heart failure with reduced ejection fraction (HFrEF), resulting in improvements in exercise performance, CHF symptoms and health-related quality of life. The importance of addressing the issue of iron deficiency in patients with CHF is reflected in the 2016 European Society of Cardiology (ESC) heart failure guidelines, which recognize iron deficiency as an important co-morbidity, independent of anaemia. These guidelines recommend that all newly diagnosed heart failure patients are routinely tested for iron deficiency and that IV FCM should be considered as a treatment option in symptomatic patients with HFrEF and iron deficiency (serum ferritin < 100 µg/L, or ferritin 100-299 µg/L and transferrin saturation < 20%). Despite these specific recommendations, there is still a lack of practical, easy-to-follow advice on how to diagnose and treat iron deficiency in clinical practice. This article is intended to complement the current 2016 ESC heart failure guidelines by providing practical guidance to all health care professionals relating to the procedures for screening, diagnosis and treatment of iron deficiency in patients with CHF.
Abstract 19199: A Novel Mobile Phone Delivered Diabetes Prevention Program in Overweight Adults at Risk for Type 2 Diabetes - A Randomized Controlled Trial
Authors: Yoshimi Fukuoka, Kevin Joiner, Eric Vittinghoff
Journal: Circulation (2014)

Introduction: A moderate amount of weight loss through intensive lifestyle interventions can prevent or delay the onset of type 2 diabetes, but these labor-intensive lifestyle programs are expensiv...
Immunomodulatory germline variation impacts the development of multiple primary melanoma (MPM)
Authors: R. Ferguson, A. Archambault, D. Simpson, E. Kazlow, R. Lax, U. Moran, M.A. Wilson, R. Shapiro, A. Pavlick, I. Osman, D. Polsky, T. Kirchhoff
Journal: Annals of Oncology (2018)
Predictive factor of hyperprogressive disease during nivolumab in patients with advanced gastric cancer
Authors: Akinori Sasaki, Yoshiaki Nakamura, Saori Mishima, Akihito Kawazoe, Yasutoshi Kuboki, Hideaki Bando, Takashi Kojima, Toshihiko Doi, Takayuki Yoshino, Kohei Shitara
Journal: Annals of Oncology (2018)
Equity in antenatal care quality: an analysis of 91 national household surveys
Authors: Catherine Arsenault, Keely Jordan, Dennis Lee, Girmaye Dinsa, Fatuma Manzi, Tanya Marchant, Margaret E Kruk
Journal: The Lancet Global Health (2018)

Emerging data show that many low-income and middle-income country (LMIC) health systems struggle to consistently provide good-quality care. Although monitoring of inequalities in access to health services has been the focus of major international efforts, inequalities in health-care quality have not been systematically examined.Using the most recent (2007-16) Demographic and Health Surveys and Multiple Indicator Cluster Surveys in 91 LMICs, we described antenatal care quality based on receipt of three essential services (blood pressure monitoring and urine and blood testing) among women who had at least one visit with a skilled antenatal-care provider. We compared quality across country income groups and quantified within-country wealth-related inequalities using the slope and relative indices of inequality. We summarised inequalities using random-effects meta-analyses and assessed the extent to which other geographical and sociodemographic factors could explain these inequalities.Globally, 72·9% (95% CI 69·1-76·8) of women who used antenatal care reported blood pressure monitoring and urine and blood testing; this number ranged from 6·3% in Burundi to 100·0% in Belarus. Antenatal care quality lagged behind antenatal care coverage the most in low-income countries, where 86·6% (83·4-89·7) of women accessed care but only 53·8% (44·3-63·3) reported receiving the three services. Receipt of the three services was correlated with gross domestic product per capita and was 40 percentage points higher in upper-middle-income countries compared with low-income countries. Within countries, the wealthiest women were on average four times more likely to report good quality care than the poorest (relative index of inequality 4·01, 95% CI 3·90-4·13). Substantial inequality remained after adjustment for subnational region, urban residence, maternal age, education, and number of antenatal care visits (3·20, 3·11-3·30).Many LMICs that have reached high levels of antenatal care coverage had much lower and inequitable levels of quality. Achieving ambitious maternal, newborn, and child health goals will require greater focus on the quality of health services and their equitable distribution. Equity in effective coverage should be used as the new metric to monitor progress towards universal health coverage.Bill & Melinda Gates Foundation.
Treatment-free interval (TFI) following discontinuation of first-line nivolumab plus ipilimumab (N+I) or sunitinib (S) in patients (Pts) with advanced renal cell carcinoma (aRCC): CheckMate 214 analysis
Authors: D.F. McDermott, B.I. Rini, R.J. Motzer, N.M. Tannir, B. Escudier, C.K. Kollmannsberger, H.J. Hammers, C. Porta, S. George, F. Donskov, H.P. Gurney, M.-O. Grimm, M. Harrison, T.E. Hutson, J. Doan, S. Yang, S. Rao, S. Mekan, A. Ambavane, T. Powles
Journal: Annals of Oncology (2018)
Abstract P011: Cardiovascular Risk Factors and Longevity
Authors: Michelle C Odden, Andreea Rawlings, Alice Arnold, Mary Cushman, Mary Lou Biggs, Bruce Psaty, Anne Newman
Journal: Circulation (2018)

Introduction: Cardiovascular disease is the leading cause of mortality in old age, yet there is limited research on the patterns of cardiovascular risk factors that predict survival to 90 years. Hypothesis: The patterns of cardiovascular risk factors that portend longevity will differ from those that confer low cardiovascular risk. Methods: We examined repeated measures of blood pressure, LDL-cholesterol, and BMI from age 67 and survival to 90 years in the Cardiovascular Health Study (CHS). CHS is a prospective study of 5,888 black and white adults in two waves (1989-90 and 1992-93) from Medicare eligibility lists in four counties in the U.S. We restricted to participants aged 67 to 75 years at baseline to control for birth cohort effects and examined repeated measures of cardiovascular risk factors throughout the late-life course. We fit logistic regression models to predict survival to age 90 using generalized estimating equations, and modeled the risk factors as linear, a linear spline, and clinically relevant categories. Models were adjusted for demographics and medication use, and we also examined whether the association of each risk factor with longevity varied by the age of risk factor measurement. Best fit models are presented. Results: Among 3,645 participants in the birth cohort, 1,160 (31.8%) survived to 90 by June 16 th , 2015. Higher systolic blood pressure in early old age was associated with reduced odds for longevity, but there was an interaction with age such that the association crossed the null at 80 years. (Table) Among those with LDL-cholesterol &lt;130 mg/dL, higher LDL-cholesterol was associated with greater longevity; at levels above 130 mg/dL there was no association between LDL-cholesterol and longevity. BMI had a u-shaped association with longevity. Conclusions: In summary, the patterns of risk factors that predict longevity differ from that considered to predict low cardiovascular risk. The risk of high systolic blood pressure appears to depend on the age of blood pressure measurement.
Diagnosis, Prognosis, and Treatment of Alveolar Soft-Part Sarcoma
Authors: Luca Paoluzzi, Robert G. Maki
Journal: JAMA Oncology (2018)

<h3>Importance</h3> Alveolar soft-part sarcoma (ASPS) is a rare, translocation-driven sarcoma of the soft tissues. Alveolar soft-part sarcoma often affects young adults and is characterized by indolent behavior but early evidence of metastatic spread. After recognition of ASPS as a specific entity in 1952, retrospective data indicated prolonged survival in patients with metastases, despite inherent resistance to conventional doxorubicin-based chemotherapy. Tyrosine kinase inhibitors and immune checkpoint inhibitors have provided unexpected new treatment strategies for ASPS. <h3>Observations</h3> This review includes articles published between 1952 and March 1, 2018. With the introduction of new molecular diagnostic tools and therapies, the distinctive features of ASPS have become more evident. The identification and better understanding of molecular pathways activated by the characteristic t(X;17)(p11;q25) translocation and its correspondent chimeric ASPSCR1-transcription factor E3 (TFE3) fusion protein open new paths to drug development. The associations of TFE3 and facilitation of an immunosuppressive microenvironment provide a rationale for exploring treatments that affect the balance between T-effector cells and T-regulatory cells. Tyrosine kinase inhibitors, such as sunitinib, cediranib, and pazopanib, show activity with either tumor responses or disease stabilization in more than 50% of the cases. Given the association of new agents with patient outcomes, it is too early to say whether metastatic ASPS should still be considered incurable in all patients. <h3>Conclusions and Relevance</h3> The biologic outcomes of the canonical genomic event in ASPS remain under investigation; a better understanding of the tumor microenvironment and the multiple pathways activated in this sarcoma, including unusual bioenergetics, MET signaling, and angiogenesis, should lead to more rational therapy. Basket trials and related prospective studies focusing on the intersection of specific signaling pathways and diseases with unique genomic features, such as ASPS, will provide an understanding of new options for care.
P3.16-26 Anatomic Segmentectomy in Stage I Non-Small-Cell Lung Cancer Reveals Equivalent Long-Term Outcomes Compared to Lobectomy
Authors: A. Hoda, K. Sinn, T. Stork, A. Steindl, G. Lang, S. Taghavi, T. Klikovits, W. Klepetko
Journal: Journal of Thoracic Oncology (2018)
Multicentric retrospective analysis of patients with KIT exon 9 mutated GIST
Authors: A. Callejo Goena, S. Faouzi, O. Bouche, T. Chevalier, N. Isambert, F. Duffaud, O. Collard, O. Mir, P. Terrier, J.-Y. Blay, A. Le Cesne
Journal: Annals of Oncology (2018)