tbuckley/cabot-search huggingface dataset:
Abstract 14688: Paradox of Right Ventricular Function: Lower the Better? -- Right Ventricular Dysfunction May Predict the Diagnosis of Tachycardia Induced Cardiomyopathy
Authors: Atsushi Okada, Ikutaro Nakajima, Yoshiaki Morita, Tsukasa Kamakura, Mitsuru Wada, Kohei Ishibashi, Koji Miyamoto, Satoshi Nagase, Takashi Noda, Takeshi Aiba, Shiro Kamakura, Toshihisa Anzai, Teruo Noguchi, Satoshi Yasuda, Hisao Ogawa, Kengo F Kusano
Journal: Circulation (2015)

Background: Differentiating tachycardia induced cardiomyopathy (TIC) from other dilated cardiomyopathies (DCM) remains challenging in patients presenting with LV dysfunction and AF tachycardia. While sustained rapid pacing in animals produces biventricular dysfunction, left-sided heart failure patients develop right ventricular (RV) dysfunction in advanced stages following increase in pulmonary vascular resistance. We hypothesized that RV dysfunction at presentation may predict the diagnosis of TIC. Methods: We studied the RV function using CMR in 102 consecutive patients with LVEF&lt;45% and uncontrolled AF tachycardia (defined as heart rate over 100 at rest or over 160 on exercise). Patients with coronary, valvular, congenital, or other secondary cardiomyopathies were not included. CMR was performed after heart rate stabilization, and ventricular functions assessed by Argus (Siemens, Germany), endomyocardial biopsies and hemodynamic data from Swan-Ganz catheter were analyzed. Patients who had normal EF after 1 year treatment were classified as TIC group (n=45), and patients who did not as DCM group (n=57). Results: LVEF at presentation by echocardiogram were similar between the 2 groups (29.2±9.7 vs.28.1±8.0%, p=0.79). At CMR, TIC group had higher LVEF (33.5±9.8 vs. 24.8±7.6%, p&lt;0.001) but tended to have lower RVEF (33.0±7.4 vs. 35.0±6.7%, p=0.11). No significant differences were observed between TIC and DCM in myocardial fibrosis, hypertrophy or hemodynamic parameters including pulmonary vascular resistance. RVEF/LVEF ratio was significantly lower in TIC (1.03±0.25 vs. 1.51±0.45, p&lt;0.001), and by ROC analysis, RVEF/LVEF ratio&lt;1.1 predicted TIC with a sensitivity of 76% and specificity of 87% (AUC=0.85). Logistic regression analysis showed RVEF/LVEF ratio is a strong independent predictor of TIC (OR=0.62 per 0.1, p&lt;0.001). Conclusions: RV dysfunction assessed by RVEF/LVEF ratio was highly predictive of TIC. Ventricular impairment in TIC occurs equally in both ventricles, and RV dysfunction in TIC develops without elevation of pulmonary vascular resistance. While RV dysfunction generally indicates advanced heart failure with worse prognosis, it may also indicate TIC, which is generally considered to have good prognosis.
Kawasaki disease in infants 3 months of age and younger: a multicentre Spanish study
Authors: Carlos Daniel Grasa, Elisa Fernandez-Cooke, Judith Sánchez-Manubens, Jordi Antón, David Crespo, Moneyba García, Agustín López, María José Lirola Cruz, Rafael Díaz-Delgado de la Peña, Cristina Calvo
Journal: Annals of the Rheumatic Diseases (2018)

Kawasaki disease (KD) is a multisystem vasculitis of small and medium vessels typical of childhood. Timely treatment with intravenous immunoglobulin (IVIG) has reduced the incidence of coronary artery abnormalities (CAAs) from 25% to approximately 4%.1 Asian studies have focused on infants under 3 months of age, but there are no published data about these patients from Western countries.2 3 

We reviewed 621 patients under 16 years old with a diagnosis of KD between 2011 and 2016 from a multicentre study in Spain (KAWA-RACE study); 84 hospitals participated throughout the country.

We found seven children under 90 days (1.13%), with a male predominance (6 of 7). Five presented irritability, but only two fulfilled the criteria for complete KD (table 1).1 The following were the main laboratory findings (median, IQR): highest C reactive protein (CRP) 24 mg/L (8.48–31.4), highest erythrocyte sedimentation rate 79 mm (70–105.5), maximum and minimum platelet count 900 ×10^9/L (682–1 117) and 506 ×10^9/L (449–612), minimum haemoglobin 10 g/dL (9–10.8), maximum leucocytes 21 ×10^9/L (16.45–23.37), minimum sodium 135.5 mEq/L (133–137.5), and minimum albumin 2.9 mg/dL (2.6–3.4).

View this table:

Table 1 
Diagnosis, symptoms, cardiological and microbiological findings



In three cases, a viral infection was diagnosed and four patients presented with CAA, but no other echocardiographic findings were detected (table 1).

The median time interval since fever onset to IVIG administration was 8 days. All patients responded well to the first dose of IVIG, and only one received concomitant intravenous steroids because he was considered to be at high risk for IVIG resistance. All CAAs were transient and resolved during follow-up (table 1).

Epidemiology is different in Western countries when compared with Asian …
Targeting Resistance against the MDM2 Inhibitor RG7388 in Glioblastoma Cells by the MEK Inhibitor Trametinib
Authors: Anne Berberich, Tobias Kessler, Carina M. Thomé, Stefan Pusch, Thomas Hielscher, Felix Sahm, Iris Oezen, Lara-Marie Schmitt, Sara Ciprut, Nanina Hucke, Petra Ruebmann, Manuel Fischer, Dieter Lemke, Michael O. Breckwoldt, Andreas von Deimling, Martin Bendszus, Michael Platten, Wolfgang Wick
Journal: Clinical Cancer Research (2018)

Abstract Purpose: Resistance is an obstacle of glioma therapy. Despite targeted interventions, tumors harbor primary resistance or become resistant over short course of treatment. This study examined the mouse double minute 2 (MDM2) inhibitor RG7388 together with radiotherapy and analyzed strategies to overcome acquired MDM2 inhibitor resistance in glioblastoma. Experimental Design: Effects of RG7388 and radiotherapy were analyzed in p53 wild-type glioblastoma cell lines and glioma-initiating cells. RG7388 resistant cells were generated by increasing RG7388 doses over 3 months. Regulated pathways were investigated by microarray, qRT-PCR, and immunoblot analysis and specifically inhibited to evaluate rational salvage therapies at RG7388 resistance. Effects of RG7388 and trametinib treatment were challenged in an orthotopical mouse model with RG7388 resistant U87MG glioblastoma cells. Results: MDM2 inhibition required functional p53 and showed synergistic activity with radiotherapy in first-line treatment. Long-term exposure to RG7388 induced resistance by activation of the extracellular signal-regulated kinases 1/2 (ERK1/2)–insulin growth factor binding protein 1 (IGFBP1) signaling cascade, which was specifically overcome by ERK1/2 pathway inhibition with trametinib and knockdown of IGFBP1. Combining trametinib with continued RG7388 treatment enhanced antitumor effects at RG7388 resistance in vitro and in vivo. Conclusions: These data provide a rationale for combining RG7388 and radiotherapy as first-line therapy with a specific relevance for tumors insensitive to alkylating standard chemotherapy and for the addition of trametinib to continued RG7388 treatment as salvage therapy after acquired resistance against RG7388 for clinical practice.
Abstract 16666: Hydrogen Sulfide Attenuates Ischemic Heart Failure by Suppressing Pro-Apoptotic Cofilin-2
Authors: Khoa Nguyen, David Durrant, Anindita Das, Jun He, Stefano Toldo, Antonio Abbate, Fadi N Salloum
Journal: Circulation (2014)

Background: Hydrogen sulfide (H2S) has been shown to protect against ischemic and inflammatory injury following myocardial ischemia/reperfusion via induction of microRNA (miR)-21. We sought to dete...
Reducing Nicotine in Cigarettes to Minimally Addictive Levels
Authors: Dorothy K. Hatsukami
Journal: JAMA Psychiatry (2018)

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 Psychiatry HomeNew OnlineCurrent IssueFor Authors Podcast 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 Psychiatry journal
Reply to Francesco Montorsi and Giorgio Gandaglia's Letter to the Editor re: Georg Jancke, Firas Aljabery, Sigurdur Gudjonsson, et al. Port-site Metastases After Robot-assisted Radical Cystectomy: Is There a Publication Bias? Eur Urol 2018;73:641–2
Authors: Georg Jancke, Firas Aljabery, Sigurdur Gudjonsson, Anne Sörenby, Fredrik Liedberg
Journal: European Urology (2018)
IS DYNAMIC SUSCEPTIBILITY CONTRAST PERFUSION- WEIGHTED MRI RELIABLE IN THE ESTIMATION OF IDH MUTATION IN GLIOMAS?
Authors: S Eser Sanverdi, Sotirios Bisdas, Carole Sudre, Diana Roettger, Sebastian Brandner, Vasileios Katsaros
Journal: Neuro-Oncology (2018)

The presence of mutation in the encoding gene of isocitrate-dehydrogenase (IDH) enzyme has been defined as a molecular biomarker by World Health Organisation (WHO) in 2016 in the diagnosis and differentiation of gliomas. MRI techniques have been widely used in the radiological evaluation of gliomas. Among advanced MRI techniques, Dynamic Susceptibility Contrast Perfusion- Weighted Imaging (DSC - PWI) appears as a recently established technique for histopathological WHO grading of gliomas. In this study, we aimed to investigate whether DSC - PWI, enhanced by texture analysis and machine learning, can stratify gliomas according to their IDH mutation status. MATERIAL & 208 patients (F/ 84 /119, median age: 47 [range: 21–81 year]) from a multicenter setting, who have been immunohistopathologically diagnosed with gliomas (IDH positive / negative: 98 /105) were prospectively included in our study. The raw data from DSC - PWI was processed on a dedicated workstation to create leakage-corrected relative cerebral blood volume (rCBV) maps. Tumours were manually segmented and registered to rCBV maps. rCBV maps were used to generate distribution and rotational invariant Haralick texture features over the tumour mask. The predictive power of the extracted features in differentiating between IDH status was assessed in a 2-fold cross-validation setting of 1000 iterations using support vector machine and multinomial ordinal regression, respectively. In the differentiation of IDH-mutant tumours from wild-type ones, overall sensitivity and specificity rates for the rCBV values were 68% and 81%, respectively. Nine of the ten classical histogram statistics and twelve texture features appeared significantly different across mutation status (p< 0.05) when using a non parametric Wilcoxon test. Preliminary results are promising in the differentiation of gliomas with DSC- PWI on the basis of IDH mutation status, especially regarding the high specificity rates obtained using features from rCBV data.
Ross Procedure vs Mechanical Aortic Valve Replacement in Adults
Authors: Amine Mazine, Rodolfo V. Rocha, Ismail El-Hamamsy, Maral Ouzounian, Bobby Yanagawa, Deepak L. Bhatt, Subodh Verma, Jan O. Friedrich
Journal: JAMA Cardiology (2018)

<h3>Importance</h3> The ideal aortic valve substitute in young and middle-aged adults remains unknown. <h3>Objective</h3> To compare long-term outcomes between the Ross procedure and mechanical aortic valve replacement in adults. <h3>Data Sources</h3> The Ovid versions of MEDLINE and EMBASE classic (January 1, 1967, to April 26, 2018; search performed on April 27, 2018) were screened for relevant studies using the following text word search in the title or abstract: ("Ross" OR "autograft") AND ("aortic" OR "mechanical"). <h3>Study Selection</h3> All randomized clinical trials and observational studies comparing the Ross procedure to the use of mechanical prostheses in adults undergoing aortic valve replacement were included. Studies were included if they reported any of the prespecified primary or secondary outcomes. Studies were excluded if no clinical outcomes were reported or if data were published only as an abstract. Citations were screened in duplicate by 2 of the authors, and disagreements regarding inclusion were reconciled via consensus. <h3>Data Extraction and Synthesis</h3> This meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Meta-analysis of Observational Studies in Epidemiology guidelines. Data were independently abstracted by 3 reviewers and pooled using a random-effects model. <h3>Main Outcomes and Measures</h3> The prespecified primary outcome was all-cause mortality. <h3>Results</h3> The search identified 2919 reports, of which 18 studies (3516 patients) met inclusion criteria, including 1 randomized clinical trial and 17 observational studies, with a median average follow-up of 5.8 (interquartile range, 3.4-9.2) years. Analysis of the primary outcome showed a 46% lower all-cause mortality in patients undergoing the Ross procedure compared with mechanical aortic valve replacement (incidence rate ratio [IRR], 0.54; 95% CI, 0.35-0.82;<i>P</i> = .004;<i>I</i><sup>2</sup> = 28%). The Ross procedure was also associated with lower rates of stroke (IRR, 0.26; 95% CI, 0.09-0.80;<i>P</i> = .02;<i>I</i><sup>2</sup> = 8%) and major bleeding (IRR, 0.17; 95% CI, 0.07-0.40;<i>P</i> &lt; .001;<i>I</i><sup>2</sup> = 0%) but higher rates of reintervention (IRR, 1.76; 95% CI, 1.16-2.65;<i>P</i> = .007;<i>I</i><sup>2</sup> = 0%). <h3>Conclusions and Relevance</h3> Data from primarily observational studies suggest that the Ross procedure is associated with lower all-cause mortality compared with mechanical aortic valve replacement. These findings highlight the need for a large, prospective randomized clinical trial comparing long-term outcomes between these 2 interventions.
Intellectual Disability and Psychotic Disorders in Children: Association With Maternal Severe Mental Illness and Exposure to Obstetric Complications in a Whole-Population Cohort
Authors: Patsy Di Prinzio, Vera A. Morgan, Jonas Björk, Maxine Croft, Ashleigh Lin, Assen Jablensky, Thomas F. McNeil
Journal: American Journal of Psychiatry (2018)

Objective: Children of mothers with severe mental illness are at significantly increased risk of developing intellectual disability. Obstetric complications are also implicated in the risk for intellectual disability. Moreover, children of mothers with severe mental illness are more likely to be exposed to obstetric complications. The purpose of this study was to examine the independent and joint contributions of familial severe mental illness and obstetric complications to the risk of intellectual disability. Method: Record linkage across Western Australian whole-population psychiatric, inpatient, birth, and midwives' registers identified 15,351 children born between 1980 and 2001 to mothers with severe mental illness and 449,229 children born to mothers with no mental illness. Multivariable models were adjusted for paternal psychiatric status, parental intellectual disability, and other family and sociodemographic covariates. Results: The risk of intellectual disability was increased among children of mothers with severe mental illness compared with children of unaffected mothers. The impact varied across maternal diagnostic groups. For children of mothers with schizophrenia, the unadjusted odds ratio was 3.8 (95% CI=3.0, 4.9) and remained significant after simultaneous adjustment for exposure to obstetric complications and other covariates (odds ratio=1.7, 95% CI=1.3, 2.3). The odds ratio for exposure to obstetric complications also remained significant after adjustment (odds ratio=1.7, 95% CI=1.6, 1.8). For intellectual disability of a genetic basis, the adjusted odds ratio for maternal schizophrenia was elevated but not statistically significant. Among children with intellectual disability, 4.2% later developed a psychotic disorder, compared with 1.1% of children without intellectual disability. Conclusions: Maternal severe mental illness and exposure to obstetric complications contribute separately to the risk of intellectual disability, suggesting potentially different causal pathways.
Association of Sustained Response Duration With Survival After Conventional Transarterial Chemoembolization in Patients With Hepatocellular Carcinoma
Authors: Yaojun Zhang, Mengping Zhang, Minshan Chen, Jie Mei, Li Xu, Rongping Guo, Xiaojun Lin, Jiaping Li, Zhenwei Peng
Journal: JAMA Network Open (2018)

<h3>Importance</h3> Defining early reliable surrogate end points for survival in patients with hepatocellular carcinoma (HCC) after conventional transarterial chemoembolization (cTACE) is of great value. <h3>Objective</h3> To evaluate the association between sustained response duration (SRD) and overall survival (OS) after cTACE for intermediate HCC. <h3>Design, Setting, and Participants</h3> This multicenter cohort study enrolled 2403 consecutive patients in China with naive intermediate HCC between June 1, 2000, and December 31, 2008, as the primary cohort, and 331 consecutive patients with intermediate naive HCC between January 1, 2011, to June 30, 2012, as the validation cohort. All patients received cTACE as an initial treatment. Initial response and best response were defined as the radiological response after first cTACE or best radiological response after 2 or more sessions of cTACE, respectively. Responders were those who experienced complete response or partial response. Sustained response duration was defined as the time between the date when complete response, partial response, or stable disease was achieved and the date progressive disease occurred after cTACE. Response was evaluated by modified Response Evaluation Criteria in Solid Tumors. Information about patients in the study was collected from January 1, 2018, to March 31, 2018, and analysis of these data was performed in April 2018. <h3>Main Outcomes and Measures</h3> Overall survival. <h3>Results</h3> A total of 2734 total patients (2499 of 2734 [91.4%] male; median [range] age, 56.5 [18-75] years) were included in the analysis. In the primary cohort, SRD of 6 months or more was found to have the strongest association with 5-year OS after cTACE among different durations of sustained response. Patients with SRD of 6 months or more (387 of 430 male; median [range] age, 57 [18-75] years) had the longest median (range) OS (67.7 [64.8-72.1] months), followed by initial responders (760 of 874 male; median [range] age, 56 [18-75] years; median [range] OS, 55.8 [55.0-57.7] months) and best responders (939 of 1032 male; median [range] age, 57 [18-75] years; median [range] OS, 53.2 [52.2-54.6] months). Response duration of 6 months or more was found to be an independent prognostic factor for OS (hazard ratio, 0.145; 95% CI, 0.124-0.170;<i>P</i> &lt; .001). The significance of SRD as a factor associated with OS was confirmed in the validation cohort. <h3>Conclusions and Relevance</h3> Sustained response duration of 6 months or more was associated with OS and may serve as an early surrogate end point after cTACE for intermediate HCC.
Evaluating the Potential Benefits of Using Sustained Response as a Prognostic Factor in Intermediate Hepatocellular Carcinoma Following Treatment With Conventional Chemoembolization
Authors: Jesse A. Berlin
Journal: JAMA Network Open (2018)

Yaojun Zhang, MD; Mengping Zhang, PhD; Minshan Chen, MD; Jie Mei, MD; Li Xu, MD; Rongping Guo, MD; Xiaojun Lin, MD; Jiaping Li, PhD; Zhenwei Peng, MD, PhD
Create new posts to ease newly qualified GPs into partnerships, review says
Authors: Abi Rimmer
Journal: BMJ (2018)

Newly qualified GPs should get more support to become partners and be offered roles that encourage them to follow this career, a government commissioned review has said.

The review, led by Wessex Local Medical Committee chief executive Nigel Watson, was launched earlier this year to try to reinvigorate the GP partnership model in the face of workload, workforce, and resource pressures.1

An interim report published on 2 October,2 which was based on feedback from GPs across England, said that recruitment, especially of GP partners, was one of the major difficulties facing practices. Newly qualified GPs often preferred to work …
Abstract MP34: Tai Chi Exercise is More Effective Than Brisk Walking in Reducing Cardiovascular Disease Risk Factors
Authors: Aileen W Chan, Doris Y Leung, SY Chair, Janet W Sit, Ruth E Taylor-Piliae
Journal: Circulation (2018)

Background: Physical inactivity is one of the major modifiable lifestyle risk factors associated with cardiovascular disease (CVD). Tai Chi (TC) is safe and popular among older adults; yet direct comparisons between TC and brisk walking (BW) on reducing CVD risk factors are lacking. Methods: A total of 246 adults (mean age=64.4±9.8 years, 45.5% men) with hypertension and two other CVD risk factors (i.e., smoker, diabetic, dyslipidemia, or overweight) were randomly assigned to either TC (n=82), BW (n=82), or control (C, n=82) groups. The TC and BW groups had 150 minutes/week, moderate-intensity physical activity for three months; with home-based practice encouraged for another six months. The primary outcome was blood pressure (BP). Secondary outcomes were: fasting blood sugar (FBS), HbA1c, total cholesterol, triglycerides, high and low density lipoprotein, body mass index (BMI), waist circumference and perceived stress. Data were collected at baseline, post-intervention at 3-month, 6-month and 9-month follow-up assessments. Generalized estimating equations models compared changes in the outcomes over time between groups. Results: At baseline, average BP=141/81, smokers=11%, diabetics=58%, dyslipidemia=61%, average BMI=26; with no significant differences between groups. TC significantly lowered BP (systolic -13.33 mmHg; diastolic -6.45 mmHg), FBS (-0.72 mmol/L), HbA1c (-0.39%), and perceived stress (-3.22 score) at 9-months, compared to C group. Pairwise comparisons indicated significantly greater reductions in SBP (p&lt;0.001), DBP (p=0.049), FBS (p=0.001), HbA1c (p=0.002), and perceived stress (p=0.027) in TC group, compared to BW group. No significant changes in other CVD risk indicators over time between groups were observed. Conclusion: TC was better than BW in reducing several CVD risk factors, and can be recommended as a viable exercise to build a healthier life free of CVD.
Abstract 16367: Treatment With Insulin is Associated With Worse Outcome in Patients With Chronic Heart Failure and Diabetes
Authors: Franco Cosmi, Li Shen, Michela Magnoli, William T Abraham, Inder S Anand, John G Cleland, Jay N Cohn, Deborah Cosmi, Giorgia De Berardis, Kenneth Dickstein, Maria Grazia Franzosi, Lars Gullestad, Pardeep S Jhund, John Kjekshus, Lars Køber, Vito Lepore, Giuseppe Lucisano, Aldo P Maggioni, Serge Masson, John J McMurray, Antonio Nicolucci, Vito Petrarolo, Fabio Robusto, Lidia Staszewsky, Luigi Tavazzi, Roberto Teli, Gianni Tognoni, John Wikstrand, Roberto Latini
Journal: Circulation (2017)

Introduction: Up to a third of patients with type-2 diabetes mellitus (T2DM) and heart failure (HF) are treated with insulin. Hypothesis: As insulin causes sodium retention and hypoglycemia, its us...