tbuckley/cabot-search huggingface dataset:
Abstract 18864: A Genetic Variant of Human Aldosterone Synthase Causes Salt-Dependent High Blood Pressure in Transgenic Mice
Authors: Brahmaraju Mopidevi, Nitin Puri, Meenakshi Kaw, Sudhir Jain, Narsimha Keetha, Steven Fiering, Ashok Kumar
Journal: Circulation (2014)

Aldosterone, synthesized by the enzyme CYP11B2, induces positive sodium-balance and predisposes to hypertension. Various investigators, using genomic DNA analyses, have linked -344T polymorphism in...
Platelet-derived TLT-1 is a prognostic indicator in ALI/ARDS and prevents tissue damage in the lungs in a mouse model
Authors: Jessica Morales-Ortíz, Victoria Deal, Fiorella Reyes, Gerónimo Maldonado-Martínez, Nahomy Ledesma, Franklin Staback, Cheyanne Croft, Amanda Pacheco, Humberto Ortiz-Zuazaga, C. Christian Yost, Jesse W. Rowley, Bismark Madera, Alex St. John, Junmei Chen, Jose Lopez, Matthew T. Rondina, Robert Hunter, Angelia Gibson, A. Valance Washington
Journal: Blood (2018)
Vitamin D supplements do not protect bone health, analysis finds
Authors: Ingrid Torjesen
Journal: BMJ (2018)

Vitamin D supplementation does not prevent fractures or falls, or have any clinically meaningful effects on bone mineral density, a large meta-analysis has found.1 The authors concluded there “is little justification to use vitamin D supplements to maintain or improve musculoskeletal health,” as is currently recommended by Public Health England (PHE).

In July 2016, PHE issued guidance that the general population should consider taking a daily supplement containing 10 μg of vitamin D during the autumn and winter as people may not get enough of the vitamin through sunlight on the skin and diet.2

This recommendation coincided with the publication of a report by the Scientific Advisory Committee on Nutrition that concluded that everyone over the age of one year should consume 10 μg of vitamin D daily.3 …
OP0185 Emergency department visits for gout: a dramatic increase in the past decade
Authors: A. Mithal, G. Singh
Journal: Annals of the Rheumatic Diseases (2018)

leucocytes in synovial fluid plus presence of X-ray chondrocalcinosis in at least one joint) and controls (patients with synovial effusion shown to have no CPP crystals and no chondrocalcinosis in hands and knee X-rays), paired by age and gender.Patients with hemochromatosis or primary hyperparathyroidsm were not included.General variables were included along with plausible metabolic variables (Ca, P, Mg, iPth, iron saturation [satFe%], ferritin, diuretics and type of diuretic, and HFE genotype), and distributon of joint involvement (mono-oligopolyarticular) and clinical manifestations (acute [A-CPPCA] and chronic inflammatory [CI-CPPCA]), as in EULAR recommendations.Results: 340 patients and 316 controls were recruited, 53% were men, age at inclusion was 67±10 year (IC range 62-75), time from onset of symptoms 5.2 ±5.3 year (IC range 1-8).Regarding cases, A-CPPCA was present in 147 (43.2%),CI-CPPCA in 193 (56.8%), with monoarticular involvement in 102 (30.0%), oligoarticular in 176 (51.8%), and polyarticular in 62 (18.2%).Patients showed higher serum ferritine levels and lower Mg levels than controls (253 and 2.00 vs 204 and 2.08, respectively), along with higher rate of HFE gene mutations (Odds ratio 2.30, 95% CI: 1.66 to 3.20).Genotypes including homozygotic mutations of H63D allele, heterozygotic mutations for C282Y allele, and double heterozygotic mutations for C282Y and H63D were statistically associated with higher frequency of polyarticular involvement and with CI-PPA (figure 1).Clinical variables were also associated with higher SatFe% levels, but not Mg or ferritin levels.S65C gene mutations were not increased in patients compared to controls and did not show any association with clinical phenotype.Abstract OP0183 -Table 1 Rate (%) of polyarticular and chronic inflammatory clinical pattern impact of presence of any mutation and genotypes of FHE genes Conclusions: Patients with definite CPPCA show differences in serum Mg and Ferritin levels compared to that of controls, and may contribute, along with other factors, to development of CPPCA.Nevertheless, only presence of some HFE genotypes involving C282Y and H63D genes were associated with more severe phenotype of clinical involvement.
Impact of Gastric Banding Versus Metformin on β-Cell Function in Adults With Impaired Glucose Tolerance or Mild Type 2 Diabetes
Authors: Anny H. Xiang, Enrique Trigo, Mayra Martinez, Namir Katkhouda, Elizabeth Beale, Xinhui Wang, Jun Wu, Ting Chow, Cortney Montgomery, Krishna S. Nayak, Fadi Hendee, Thomas A. Buchanan, Steven E. Kahn, Silva A. Arslanian, Sharon L. Edelstein, David A. Ehrmann, Kristen J. Nadeau, Jerry P. Palmer, Kristina M. Utzschneider, Karla A. Temple, Abby Rue, Elena Barengolts, Babak Mokhlesi, Eve Van Cauter, Susan Sam, M. Annette Miller, Karen M. Atkinson, Tsige Gebremedhin, Abigail Kernan-Schloss, Alexandra Kozedub, Emily J. Morse, Kieren J. Mather, Tammy Garrett, Tamara S. Hannon, Amale Lteif, Aniket Patel, Robin Chisholm, Karen Moore, Vivian Pirics, Linda Pratt, Susan Gross, Philip S. Zeitler, Jayne Williams, Melanie-Cree Green, Yesenia Garcia, Krista Reyes, Kathleen Vissat, Nancy Brown, Kristin Guerra, Sonia Porter, Mary Caprio, Bridget Savoye, John M. Pierpont, Ashley N. Lachin, Santica Hogan, Jessica Marcovina, John Harting, Dave Albers, Peter J. Hill, None Savage, Ellen W. Leschek
Journal: Diabetes Care (2018)

OBJECTIVE Type 2 diabetes (T2D) results from progressive loss of β-cell function. The BetaFat study compared gastric banding and metformin for their impact on β-cell function in adults with moderate obesity and impaired glucose tolerance (IGT) or recently diagnosed, mild T2D. RESEARCH DESIGN AND METHODS Eighty-eight people aged 21–65 years, BMI 30–40 kg/m2, with IGT or diabetes known for &amp;lt;1 year, were randomized to gastric banding or metformin for 2 years. Hyperglycemic clamps (11.1 mmol/L) followed by arginine injection at maximally potentiating glycemia (&amp;gt;25 mmol/L) were performed at baseline, 12 months, and 24 months to measure steady-state C-peptide (SSCP) and acute C-peptide response to arginine at maximum glycemic potentiation (ACPRmax) and insulin sensitivity (M/I). RESULTS At 24 months, the band group lost 10.7 kg; the metformin group lost 1.7 kg (P &amp;lt; 0.01). Insulin sensitivity increased 45% in the band group and 25% in the metformin group (P = 0.30 between groups). SSCP adjusted for insulin sensitivity fell slightly but not significantly in each group (P = 0.34 between groups). ACPRmax adjusted for insulin sensitivity fell significantly in the metformin group (P = 0.002) but not in the band group (P = 0.25 between groups). HbA1c fell at 12 and 24 months in the band group (P &amp;lt; 0.004) but only at 12 months (P &amp;lt; 0.01) in the metformin group (P &amp;gt; 0.14 between groups). Normoglycemia was present in 22% and 15% of band and metformin groups, respectively, at 24 months (P = 0.66 between groups). CONCLUSIONS Gastric banding and metformin had similar effects to preserve β-cell function and stabilize or improve glycemia over a 2-year period in moderately obese adults with IGT or recently diagnosed, mild T2D.
Analysis of cranial adult pilocytic astrocytomas over a 10 year period
Authors: Ms Eva Bourama, Mr Erjon Agushi, Mr Alex Leggate, Dr Federico Roncaroli, Mr Pietro D’urso, Mr David Coope, Ms Konstantina Karabatsou
Journal: Neuro-Oncology (2018)

Review of clinical features and outcomes in patients with adult pilocytic astrocytoma (PA). Retrospective study of all adult PAs treated in our centre using clinical & pathological data. 55 cases of pilocytic astrocytomas (>16 y old). All adult patients with histologically proved cranial PA operated between 2007 and 2017. Analysis was performed using STATA 11.0 (Stata Corp LP). 55 patients with PA were reviewed: 26 M/29 F. 9 had NF 1. PA was first diagnosed in childhood in 12 patients. Patients diagnosed before 18 years experienced a greater number of recurrences (p=0.023). Mean follow up was 8.4 years. The most frequent tumour locations were the cerebral lobes (41.8%) and cerebellum (32.7%). PA WHO grade I was confirmed histologically in 89.9% of cases. 22 patients underwent radiotherapy, of which 8 (36, 6%) had also chemotherapy. Tumour recurrence occurred in 19 patients (34.5%). WHO grade was an independent predictor of tumour recurrence (p=0.02). Of the 19 recurrences, 5 (26.4%) had a total/near total resection (p=0.014). Patients with incomplete resections had higher rates of post-surgical radiotherapy (p=0.018). Progression-free survival was longer in patients with WHO grade I tumours that had total resection. Radiotherapy did not improve progression-free survival rates (p=0.54). Recurrence in PAs seems to depend on the age of first diagnosis. WHO grade and extension of resection were independent predictors of progression-free survival, although resection was largely dependent on tumour location. Adjuvant radiotherapy in incomplete resections did not impede disease progression although mean times to recurrence were longer in the radiotherapy group.
Abstract 11531: The Three-Legged Stool, Balancing Diuretics, Sodium and Fluid Intake in Heart Failure
Authors: Barbara Riegel, Julia Hill, Joyce Wald, George Knafl, Marguerite Daus, Isabella Ciuffetelli, Lisa Basel-Brown
Journal: Circulation (2016)

Stable sodium and fluid intake balanced with consistent oral diuretic use is thought to minimize fluid retention and avoid heart failure (HF) hospitalization. However, these 3 factors are rarely examined together so we know little about how patients manage this self-care. Purpose: To describe patterns of diuretic use with sodium and fluid intake in relation to readmission. Methods: We enrolled 24 hospitalized HF patients in a longitudinal, observational pilot study. All (16 men, 11 Blacks, mean age 60, mean HF duration 4.8 years) were discharged on a loop diuretic after hospitalization for a HF exacerbation. Over 3-months, diuretic use was measured daily using the medication event monitoring system (MEMS®). Percentage of prescribed doses taken (% PDT) was calculated and standardized (0 no adherence to 1.0 perfect adherence, &gt;1.0 extra doses) for each 2-week period. Every 2 weeks patients were called to assess diet and fluid intake. Dietary sodium was measured using a list of 24 high sodium foods (e.g., pizza, hot dogs). Validity of the measure was confirmed with formal 3-day dietary recall assessments (randomly chosen days, 2 weekdays and 1 weekend day, each month) performed on 5 participants by a registered dietitian. After in-person training on cup size, fluid intake was estimated in cups for each 2-week period. Clinical events (ED visits, hospital readmissions, death) were obtained from the electronic medical record and confirmed by self-report. Results: Six (25%) were readmitted within 3 months; 2 of the 6 died before any diuretic data could be obtained. The remaining 4 readmissions were explainable with poor diuretic use usually coupled with high sodium and/or fluid intake. In the 18 patients not readmitted, few (n=4) managed all 3 factors simultaneously, but 14 were savvy in adjusting one or two factors, showing insight that was not evident in those readmitted. Some increased their diuretic use only when sodium and fluid intake were high and decreased diuretics again later. Conclusion: Rigid guidelines regarding diuretic use, sodium and fluid intake fail to acknowledge patients’ abilities to balance these 3 factors. Promoting skill in balancing diuretic use, sodium and fluid intake may encourage expertise in self-care.
Abstract 17782: In the Prehospital Setting the Glasgow Algorithm for Electrocardiogram Analysis is not Specific in Patients With Suspected ST Elevation Myocardial Infarction
Authors: Amir Faour, Oliver GIbbs, Callum Cherrett, Karen Lintern, Rohan Rajaratnam, Craig Juergens, John French
Journal: Circulation (2016)

Introduction: The University of Glasgow 12-Lead ECG Analysis Algorithm (GA) has a reported sensitivity of 78% and specificity of 94% for the diagnosis of STEMI in the prehospital setting. Aim: To a...
Association of Risk for Venous Thromboembolism With Use of Low-Dose Extended- and Continuous-Cycle Combined Oral Contraceptives
Authors: Jie Li, Genna Panucci, David Moeny, Wei Liu, Judith C. Maro, Sengwee Toh, Ting-Ying Huang
Journal: JAMA Internal Medicine (2018)

<h3>Importance</h3> Continuous/extended cyclic estrogen use (84/7 or 365/0 days cycles) in combined oral contraceptives (COCs) could potentially expose women to an increased cumulative dose of estrogen, compared with traditional cyclic regimens (21/7 days cycle), and may increase the risk for venous thromboembolism (VTE). <h3>Objective</h3> To determine, while holding the progestogen type constant, whether the risk for VTE is higher with use of continuous/extended COCs than with cyclic COCs among women who initiated a COC containing ethinyl estradiol and levonorgestrel. <h3>Design, Setting, and Participants</h3> Incident user retrospective cohort study of primarily commercially insured US population identified from the Sentinel Distributed Database. Participants were women aged 18 to 50 years at the time of initiating a study COC between May 2007 and September 2015. Using a propensity score approach and Cox proportional hazards regression models, we estimated the hazard ratios of VTE overall and separately by ethinyl estradiol dose and age groups. <h3>Exposures</h3> Initiation of continuous/extended or traditional cyclic COCs containing ethinyl estradiol or levonorgestrel of any dose. <h3>Main Outcomes and Measures</h3> First VTE hospitalization that occurred during the study follow-up, identified by an inpatient<i>International Classification of Diseases, Ninth Revision, Clinical Modification </i>diagnosis code of 415.1, 415.1x, 453, 453.x, or 453.xx. <h3>Results</h3> We identified 210 691 initiators of continuous/extended COCs (mean [SD] age, 30.4 [8.6] years) and 522 316 initiators of cyclic COCs (mean [SD] age, 28.8 [8.3] years), with a mean of 0.7 person-years at risk among continuous/extended and cyclic users. Baseline cardiovascular and metabolic conditions (7.2% vs 4.7%), gynecological conditions (39.7% vs 32.3%), and health services utilization were slightly higher among continuous/extended cyclic than cyclic COC users. Propensity score matching decreased the hazard ratio estimates from 1.84 (95% CI, 1.53-2.21) to 1.32 (95% CI, 1.07-1.64) for continuous/extended use compared with cyclic COC use. The absolute risk difference (0.27 per 1000 persons) and the incidence rate difference (0.35 cases per 1000 person-years [1.44 vs 1.09 cases per 1000 person-years]) between the 2 propensity score–matched cohorts remained low, which may not translate into a clinically significant risk differences between cyclic and noncyclic estrogen use. <h3>Conclusions and Relevance</h3> Holding the progestogen type constant (levonorgestrel), we observed a slightly elevated VTE risk in association with continuous/extended COC use when compared with cyclic COC use. However, due to the small absolute risk difference and potential residual confounding, our findings did not show strong evidence supporting a VTE risk difference between continuous/extended and cyclic COC use.
Abstract 15447: Multicenter, Randomized, Double-Blind Trial of Etanercept in Acute Kawasaki Disease
Authors: Michael A Portman, Nagib Dahdah, Aaron K Olson, April Slee, Nadine Choueiter, Carolyn Altman
Journal: Circulation (2017)

Introduction: The Etanercept as Adjunctive Treatment for Acute Kawasaki Disease (KD) study is the largest North American KD clinical trial to date. We performed this multicenter double blind, place...
Notch signaling suppresses glucose metabolism in mesenchymal progenitors to restrict osteoblast differentiation
Authors: Seung-Yon Lee, Fanxin Long
Journal: Journal of Clinical Investigation (2018)

Notch signaling critically controls cell fate decisions in mammals, both during embryogenesis and in adults. In the skeleton, Notch suppresses osteoblast differentiation and sustains bone marrow mesenchymal progenitors during postnatal life. Stabilizing mutations of Notch2 cause Hajdu-Cheney syndrome, which is characterized by early-onset osteoporosis in humans, but the mechanism whereby Notch inhibits bone accretion is not fully understood. Here, we report that activation of Notch signaling by either Jagged1 or the Notch2 intracellular domain suppresses glucose metabolism and osteoblast differentiation in primary cultures of bone marrow mesenchymal progenitors. Importantly, deletion of Notch2 in the limb mesenchyme increases both glycolysis and bone formation in the long bones of postnatal mice, whereas pharmacological reduction of glycolysis abrogates excessive bone formation. Mechanistically, Notch reduces the expression of glycolytic and mitochondrial complex I genes, resulting in a decrease in mitochondrial respiration, superoxide production, and AMPK activity. Forced activation of AMPK restores glycolysis in the face of Notch signaling. Thus, suppression of glucose metabolism contributes to the mechanism, whereby Notch restricts osteoblastogenesis from bone marrow mesenchymal progenitors.
Comparing Adjuvant vs Early-Salvage Radiotherapy After Radical Prostatectomy
Authors: Sebastian Berg, Junaid Nabi, Quoc-Dien Trinh
Journal: JAMA Oncology (2018)

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Abstract 3104: Heart Rate Recovery Predicts Major Cardiac Events in Patients with Heart Failure Receiving a Beta-Blocking Agent
Authors: Ross Arena, Jonathan Myers, Mary Ann Peberdy, Daniel Bensimhon, Joshua Abella, Paul Chase, Marco Guazzi
Journal: Circulation (2007)

Introduction: Heart rate recovery (HRR) following a maximal exercise test has demonstrated prognostic value in several investigations. The analysis of HRR in the heart failure (HF) population is, however, limited, particularly in a cohort receiving a beta-blocking (BB) agent. Hypothesis: We assessed the hypothesis that HRR would maintain prognostic value in HF patients prescribed a BB agent. Methods: One hundred and fifty-one subjects with HF (79% male/21% female, 54% ischemic/ 46% non-ischemic, age: 54.3 ± 12.6 years, ejection fraction: 31.2 ± 15.3%), on a stable dose of a BB agent, underwent cardiopulmonary exercise testing to determine peak oxygen consumption (VO 2 ), the minute ventilation/carbon dioxide production (VE/VCO 2 ) slope, peak respiratory exchange ratio (RER), percent-predicted maximal heart rate achieved (PPMHR) and HRR at one minute. Subjects were tracked for major cardiac events following testing. Results: Mean values for peak VO 2 , the VE/VCO 2 slope, peak RER, PPMHR and HRR were 17.9 ± 6.8 mlO 2 ·kg −1 ·min −1 , 33.0 ± 8.7, 1.07 ± 0.14, 75.1 ± 14.9% and 16.4 ± 13.6 beats per minute, respectively. There were 25 major cardiac events (20 deaths, 2 transplants, 3 left ventricular assist device implantations; mean tracking period: 26.7 ± 23.2 months, annual event rate: 6.8%) during the tracking period. A HRR threshold of ≤/&gt; 11 beats per minute was prognostically optimal (hazard ratio: 4.4, 95% confidence interval: 1.8 –10.6, 91.1% vs. 72.1% event free survival, p&lt;0.001). Multivariate Cox regression analysis revealed the VE/VCO 2 slope was the strongest predictor of cardiac events (Chi-square: 13.7, p&lt;0.001) while HRR added significant value and was retained (residual chi-square: 4.6, p = 0.03). Peak VO 2 did not add prognostic value and was removed from the regression (residual chi-square: 0.97, p = 0.33). Conclusions: In conclusion, these results indicate HRR maintains prognostic value in HF patients prescribed a BB agent. Furthermore, HRR added predictive value to the VE/VCO 2 slope, perhaps one of the strongest prognostic markers obtained from cardiopulmonary exercise testing. The clinical assessment of HRR may therefore be warranted in HF patients who are prescribed a BB agent.
Abstract 15495: Elevated Left Ventricular End Diastolic Pressure Reduces Intra Left Ventricular Pressure Gradient During Atrial Contraction
Authors: Kazuaki Wakami, Marina Ishida, Tomoyuki Banno, Keisuke Muto, Junki Yamamoto, Shohei Kikuchi, Koji Yamamoto, Toshihiko Goto, Hidekatsu Fukuta, Nobuyuki Ohte
Journal: Circulation (2016)

Background: Vector Flow Mapping (VFM, Hitachi-Aloka) was recently developed to obtain intra-left ventricular pressure gradient (IVPG) from the data set of blood flow velocity vectors obtained in th...
MANAGEMENT AND OUTCOMES OF INCIDENTAL MENINGIOMAS: IS ROUTINE FOLLOW-UP REQUIRED?
Authors: Abdurrahman Islim, Nitika Rathi, Samantha Mills, Andrew R Brodbelt, Michael Jenkinson
Journal: Neuro-Oncology (2018)

30% of newly-diagnosed meningiomas are incidental findings. There is no consensus on the optimal management of these patients. To determine the clinical outcomes of patients diagnosed with incidental meningioma. Single centre retrospective cohort study of patients diagnosed with an incidental meningioma between 2007 and 2015. 441 patients were included (459 meningiomas). Mean age at diagnosis was 63.3 years (range: 19–97); 348 female and 93 male. The main indication for MRI/CT was headache (25.9%). Median meningioma volume at diagnosis was 1.58 cm3 range: 0.06–51.8). Commonest location was convexity (39.9%). At initial presentation, 6 patients underwent surgical resection, 50 were discharged and the remaining 385 entered surveillance imaging (1303 scans in total, 3.4 on average over a median of 36 months [range: 3–120]). Overall outcomes by the end of the study period were: 219 discharged, 12 lost to follow-up, 4 deaths (unrelated to their meningiomas) and 206 under continued observation. Of those 206, 38 (18.4%) (mean age: 52.9 years) had intervention (34 surgery, 2 stereotactic radiosurgery, 2 fractionated radiotherapy) after a median follow-up period of 24 months (range: 3–78). Indications for treatment were radiological progression (n=26), development of symptoms (n=6), and patient preference (n=6). Pathology revealed WHO grade I (benign) in 36 patients and WHO grade II (atypical) in 4 patients, of which one had recurrence 5 months after surgery and required salvage radiotherapy. For 231 patients discharged/lost to follow-up (mean age: 68.1 years), median follow-up duration was 18 months (range: 0–120). Nine patients (3.9%) had further MRI/CT for unrelated symptoms after a median of 37 months. The majority of incidental meningiomas do not require long-term follow-up and our data suggests that a 5-year period is sufficient. Further analyses of clinical and radiological predictors of growth and subsequent intervention are planned.