tbuckley/cabot-search huggingface dataset:
An Unusual Fundus Finding in a Teenage Girl
Authors: Flávio Moura Rezende Filho, José Luiz Pedroso, Orlando G. Póvoas Barsottini
Journal: JAMA Neurology (2018)

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P3.13-28 Heterogeneity, Prevalence and Prognostic Significance of PDL1 Expression in Early Resected NSCLC
Authors: M. Dean, A. Chan, E. Enwere, H. Li, A. Gibson, A. D'Silva, A. Elegbede, R. Tudor, S. Otsuka, D. Morris, G. Bebb
Journal: Journal of Thoracic Oncology (2018)
GW29-e1784 Cardiac Fibroblast Specific Deletion of Thioredoxin Interacting Protein (TXNIP) Exacerbates Ventricular Remodeling and Dysfunction After Myocardial Infarction.
Authors: Fuyang Zhang, Xiyao Chen, Yueyang Li, Zhenyu Xiong, Ling Tao
Journal: Journal of the American College of Cardiology (2018)
Abstract 14687: Mortality Among Patients Hospitalized With Congestive Heart Failure and Diabetes Mellitus: Results From the National Inpatient Sample, 2000 - 2010
Authors: Theingi T Win, Herbert T Davis, Warren K Laskey
Journal: Circulation (2015)

Background: Case-fatality and hospitalization rates for heart failure (HF) patients have been steadily decreasing. However, the prevalence of diabetes mellitus (DM), a risk factor and frequent co-existing condition of HF, continues to increase in the general population. Our aims were to assess the prevalence and impact of DM among adult patients hospitalized with HF with particular emphasis on age-, sex- and race/ethnicity-specific in-hospital mortality rate. Methods: We used the National Inpatient Sample to estimate trends in DM prevalence and in-hospital mortality among hospital discharge records with HF as the primary discharge diagnosis from 2000-2010 using survey data-analysis methods. Multivariable logistic regression was used to assess the impact of the above demographic characteristics on in-hospital mortality while adjusting for time (year). Results: Overall mortality among 749,910 patients with HF declined from 4.0% in 2000 to 2.3% in 2010 (p&lt;0.0001). Over this interval the prevalence of DM in HF patients increased from 35.9% to 37.5% (p &lt; 0.0001). Age standardized mortality in this group (n=261,620) deceased from 3.2% in 2000 to 1.6% in 2010 (Figure). However, not all demographic sub-groups shared equally in this decrease. Males remained at increased risk compared to females (OR=1.069, 95% CI=0.96, 1.20), non-white minority patients remained at decreased risk compared to non-Hispanic whites (OR=0.612, 95% CI=0.54, 0.69) and older patients (≥ 60 years) remained at increased risk compared to their younger counterparts (&lt; 60years) (OR=3.30, 95% CI=2.78, 3.92). Conclusions: In-hospital mortality among patients with HF and DM has significantly decreased over the past decade although important differences among demographic sub-groups remain and represent potential opportunities for further reduction in in-hospital mortality.
The Use of “Trend” Statements to Describe Statistically Nonsignificant Results in the Oncology Literature
Authors: Kevin T. Nead, Mackenzie R. Wehner, Nandita Mitra
Journal: JAMA Oncology (2018)

This study examines recent original research articles in leading oncology journals to evaluate the use of statements about the trend of a P value toward significance to describe statistically nonsignificant results.
Cost-effectiveness of a Brief Structured Intervention Program Aimed at Preventing Repeat Suicide Attempts Among Those Who Previously Attempted Suicide
Authors: A-La Park, Anja Gysin-Maillart, Thomas J. Müller, Aristomenis Exadaktylos, Konrad Michel
Journal: JAMA Network Open (2018)

This is the first cost-effectiveness analysis of a brief therapy, the Attempted Suicide Short Intervention Program (ASSIP), for individuals who attempt suicide.To explore the cost-effectiveness of the ASSIP intervention in the context of the Swiss health care system.In this economic evaluation, the cost-effectiveness analysis was performed from a health care perspective between January 2017 and April 2018 using data from a randomized clinical trial conducted between June 2009 and December 2014. Participants were individuals who had attempted suicide and were receiving treatment at a psychiatric university hospital in Switzerland that provides inpatient and outpatient services for suicide attempters referred from an emergency department of a general hospital.The intervention group received 3 manual-based therapy sessions followed by regular personalized letters over 24 months. The control group was offered a single suicide risk assessment.The main economic analysis explored cost per suicide attempt avoided expressed in 2015 Swiss francs (CHF). Cost-effectiveness planes were plotted and cost-effectiveness acceptability curves calculated.One hundred twenty participants (mean [SD] age, 37.8 [14.4] years; 66 [55%] women and 54 [45%] men) were assigned to an intervention group or a control group, each with 60 participants. At 24 months of follow-up, 5 suicide attempts were reported in the ASSIP group among 59 participants with follow-up data available, and 41 were reported in the control group among 53 participants with follow-up data available. The ASSIP group had higher intervention costs, with CHF 1323 vs CHF 441 for the control group. At 24 months of follow-up, psychiatric hospital costs were lower in the ASSIP group than in the control group, although this difference was not significant (mean [SD], CHF 20 559 [38 676] vs CHF 45 488 [73 306]; mean difference, CHF -16 081; 95% CI, CHF -34 717 to 1536; P = .11). General hospital costs were significantly lower for the ASSIP group. Total health care costs were also lower, but the difference was not significant (mean [SD], CHF 21 302 [38 819] vs 41 287 [74 310]; difference, CHF -12 604; 95% CI, CHF -29 837 to 625; P = .14). In a base-case analysis, ASSIP was dominant, with significantly fewer reattempts at lower overall cost. The intervention had a 96% chance of being less costly and more effective. A sensitivity analysis showed a 96% and 95% chance of ASSIP being more effective and less costly at willingness-to-pay levels of CHF 0 and CHF 30 000, respectively.The ASSIP intervention is a cost-saving treatment for individuals who attempt suicide. The findings support the use of ASSIP as a treatment for suicide attempters. Further studies are needed to determine cost-effectiveness in other contexts.ClinicalTrials.gov Identifier: NCT02505373.
Abstract 19121: PCSK9 Inhibitors: Patient-Reported Barriers to Medication Initiation and Persistence
Authors: Ann Marie Navar, Robert J Sanchez, Eric D Peterson
Journal: Circulation (2017)

Background: Since the FDA approval of proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i), alirocumab and evolocumab, in 2015, initial and ongoing use has been low. The reasons for th...
Abstract 19633: A Novel Stent Based Gene Delivery System for the Prevention of Restenosis
Authors: Ilia Fishbein, Ivan S Alferiev, Jonathan B Foster, David T Guerrero, Alejandro Mas Monteys, Michael Chorny, Robert J Levy
Journal: Circulation (2016)

Introduction: In-stent restenosis (ISR) remains an important clinical problem in the era of drug-eluting stents. Gene therapy of ISR has not come into clinical translation, mostly due to the immunogenicity of applied vectors and inadequate gene delivery systems. Herein we describe a new versatile stent-based gene delivery platform adaptable to provide local arterial gene transfer with a range of viral and non-viral vectors. This system exploits a natural affinity of protein G (PrG) to Fc region of mammalian IgG, making PrG a universal adaptor for surface immobilization of vector-capturing antibodies (Ab). Hypotheses: Our studies tested 1) whether reversible surface immobilization of AAV gene vectors is feasible using vector tethering by AAV-specific Ab appended to the stent surface through covalently attached PrG; and 2) whether a PrG/Ab-tethered AAV2, engineered to overexpress inducible nitric oxide synthase (AAV2-iNOS), attenuates restenosis in the rat model of stent angioplasty. Methods: The surface of...
Effect of Targeted Polymyxin B Hemoperfusion on 28-Day Mortality in Patients With Septic Shock and Elevated Endotoxin Level
Authors: R. Phillip Dellinger, Sean M. Bagshaw, Massimo Antonelli, Debra M. Foster, David J. Klein, John C. Marshall, Paul M. Palevsky, Lawrence S. Weisberg, Christa A. Schorr, Stephen Trzeciak, Paul M. Walker
Journal: JAMA (2018)

Polymyxin B hemoperfusion reduces blood endotoxin levels in sepsis. Endotoxin activity can be measured in blood with a rapid assay. Treating patients with septic shock and elevated endotoxin activity using polymyxin B hemoperfusion may improve clinical outcomes.To test whether adding polymyxin B hemoperfusion to conventional medical therapy improves survival compared with conventional therapy alone among patients with septic shock and high endotoxin activity.Multicenter, randomized clinical trial involving 450 adult critically ill patients with septic shock and an endotoxin activity assay level of 0.60 or higher enrolled between September 2010 and June 2016 at 55 tertiary hospitals in North America. Last follow-up was June 2017.Two polymyxin B hemoperfusion treatments (90-120 minutes) plus standard therapy completed within 24 hours of enrollment (n = 224 patients) or sham hemoperfusion plus standard therapy (n = 226 patients).The primary outcome was mortality at 28 days among all patients randomized (all participants) and among patients randomized with a multiple organ dysfunction score (MODS) of more than 9.Among 450 eligible enrolled patients (mean age, 59.8 years; 177 [39.3%] women; mean APACHE II score 29.4 [range, 0-71 with higher scores indicating greater severity), 449 (99.8%) completed the study. Polymyxin B hemoperfusion was not associated with a significant difference in mortality at 28 days among all participants (treatment group, 84 of 223 [37.7%] vs sham group 78 of 226 [34.5%]; risk difference [RD], 3.2%; 95% CI, -5.7% to 12.0%; relative risk [RR], 1.09; 95% CI, 0.85-1.39; P = .49) or in the population with a MODS of more than 9 (treatment group, 65 of 146 [44.5%] vs sham, 65 of 148 [43.9%]; RD, 0.6%; 95% CI, -10.8% to 11.9%; RR, 1.01; 95% CI, 0.78-1.31; P = .92). Overall, 264 serious adverse events were reported (65.1% treatment group vs 57.3% sham group). The most frequent serious adverse events were worsening of sepsis (10.8% treatment group vs 9.1% sham group) and worsening of septic shock (6.6% treatment group vs 7.7% sham group).Among patients with septic shock and high endotoxin activity, polymyxin B hemoperfusion treatment plus conventional medical therapy compared with sham treatment plus conventional medical therapy did not reduce mortality at 28 days.ClinicalTrials.gov Identifier: NCT01046669.
A Randomized Trial Comparing Extended-Release Injectable Suspension and Oral Naltrexone, Both Combined With Behavioral Therapy, for the Treatment of Opioid Use Disorder
Authors: Maria A. Sullivan, Adam Bisaga, Martina Pavlicova, Kenneth M. Carpenter, C. Jean Choi, Kaitlyn Mishlen, Frances R. Levin, John J. Mariani, Edward V. Nunes
Journal: American Journal of Psychiatry (2018)

The oral formulation of the opioid antagonist naltrexone has shown limited effectiveness for treatment of opioid use disorder due to poor adherence. Long-acting injection naltrexone (XR-naltrexone), administered monthly, circumvents the need for daily pill taking, potentially improving adherence, and has been shown to be superior to placebo in reducing opioid use over 6 months of treatment. This open-label trial compared the outcomes of patients with opioid use disorder treated with XR-naltrexone or oral naltrexone in combination with behavioral therapy.Sixty opioid-dependent adults completed inpatient opioid withdrawal and were transitioned to oral naltrexone. They were stratified by severity of opioid use (six or fewer bags versus more than six bags of heroin per day) and randomly assigned (1:1) to continue treatment with oral naltrexone (N=32) or XR-naltrexone (N=28) for 24 weeks. The first dose of XR-naltrexone (380 mg) was administered prior to discharge, with monthly doses thereafter, and oral naltrexone was given in a 50-mg daily dose. All participants received weekly behavioral therapy to support treatment and adherence to naltrexone.A Cox proportional hazards model adjusting for race, gender, route of use, and baseline opioid use severity indicated that significantly more patients were retained in treatment for 6 months in the XR-naltrexone group (16 of 28 patients, 57.1%) than in the oral naltrexone group (nine of 32 patients, 28.1%) (hazard ratio=2.18, 95% CI=1.07, 4.43).Patients receiving XR-naltrexone had twice the rate of treatment retention at 6 months compared with those taking oral naltrexone. These results support the use of XR-naltrexone combined with behavioral therapy as an effective treatment for patients seeking opioid withdrawal and nonagonist treatment for preventing relapse to opioid use disorder.
Brain metastasis in ovarian cancer patients
Authors: A.A.B.A. da Costa, E.S. Dos Santos, L. de Brot, A.R.G. Ribeiro, D.P. Cotrim, N. Carvalho Pandolfi, M.G. Cesca, M.J. Chen, G. Baiocchi
Journal: Annals of Oncology (2018)
SP0160 2018 eular recommendations for the use of glucocorticoid therapy
Authors: F. Buttgereit
Journal: Annals of the Rheumatic Diseases (2018)

<h3></h3> Glucocorticoids (GC) are potent anti-inflammatory and immunosuppressive drugs which are used successfully to treat many disorders, including rheumatoid arthritis, polymyalgia rheumatica, giant cell arteritis, myositis, systemic lupus erythematodes and other rheumatic diseases. However, these drugs also have the potential to cause severe adverse effects, particularly if high doses are used for prolonged periods. Therefore, the benefits of GC therapy must be balanced against the potential risks. Key strategies to achieve this goal include (i) following guideline recommendations regarding GC therapy dosing, monitoring for potential adverse events, and adverse event prevention and management, (ii) using or developing new therapeutic advances to improve the therapeutic balance. The EULAR Glucocorticoid Task Force has already published several recommendations over the last years such as those on the standardised nomenclature for GC dosages and treatment regimens, on the management of systemic GC therapy in rheumatic diseases, and on monitoring adverse events of low-dose GC therapy. Recent work of this group dealt with the question under which conditions long-term treatment with GC has an acceptably low level of harm. As a result, the task force members agreed that the risk of harm is low for the majority of patients at long-term dosages of ≤5 mg prednisone equivalent per day, whereas at dosages of &gt;10 mg/day the risk of harm is elevated. At dosages between &gt;5 and ≤10 mg/day, patient-specific characteristics determine the risk of harm. This means general and glucocorticoid-associated risk factors and protective factors such as a healthy lifestyle should be taken into account when evaluating the actual and future risk. Another new information on the use of GCs has been recently provided by EULAR 2016 update of RA recommendations: "Short-term GCs should be considered when initiating or changing csDMARDs, in different dose regimens and routes of administration, but should be tapered as rapidly as clinically feasible." This wording does acknowledge that there are several different regimens for oral use, intramuscular injection, and intravenous pulse therapy. It is now also being stated more clearly that GCs should be given as bridging therapy together with csDMARDs, either as part of the initial strategy or subsequently if this has failed. In contrast, GCs are usually not needed as a bridging therapy when bDMARDs or tsDMARDs are used. This recommendations reconfirms that GCs should be gradually reduced and ultimately stopped, ideally within 3 to 6 months. Finally, the role of GCs in the management of polymyalgia rheumatica as has been described and discussed by the recent EULAR/ACR recommendations will be briefly discussed. <h3>Disclosure of Interest</h3> F. Buttgereit Grant/research support from: Mundipharma, Horizon, Pfizer, Consultant for: Horizon, Pfizer, Speakers bureau: Horizon, Pfizer,
Development and validation of prediction models to estimate risk of primary total hip and knee replacements using data from the UK: two prospective open cohorts using the UK Clinical Practice Research Datalink
Authors: Dahai Yu, Kelvin P Jordan, Kym I E Snell, Richard D Riley, John Bedson, John James Edwards, Christian D Mallen, Valerie Tan, Vincent Ukachukwu, Daniel Prieto-Alhambra, Christine Walker, George Peat
Journal: Annals of the Rheumatic Diseases (2018)

Objectives The ability to efficiently and accurately predict future risk of primary total hip and knee replacement (THR/TKR) in earlier stages of osteoarthritis (OA) has potentially important applications. We aimed to develop and validate two models to estimate an individual’s risk of primary THR and TKR in patients newly presenting to primary care. Methods We identified two cohorts of patients aged ≥40 years newly consulting hip pain/OA and knee pain/OA in the Clinical Practice Research Datalink. Candidate predictors were identified by systematic review, novel hypothesis-free ‘Record-Wide Association Study’ with replication, and panel consensus. Cox proportional hazards models accounting for competing risk of death were applied to derive risk algorithms for THR and TKR. Internal–external cross-validation (IECV) was then applied over geographical regions to validate two models. Results 45 predictors for THR and 53 for TKR were identified, reviewed and selected by the panel. 301 052 and 416 030 patients newly consulting between 1992 and 2015 were identified in the hip and knee cohorts, respectively (median follow-up 6 years). The resultant model C-statistics is 0.73 (0.72, 0.73) and 0.79 (0.78, 0.79) for THR (with 20 predictors) and TKR model (with 24 predictors), respectively. The IECV C-statistics ranged between 0.70–0.74 (THR model) and 0.76–0.82 (TKR model); the IECV calibration slope ranged between 0.93–1.07 (THR model) and 0.92–1.12 (TKR model). Conclusions Two prediction models with good discrimination and calibration that estimate individuals’ risk of THR and TKR have been developed and validated in large-scale, nationally representative data, and are readily automated in electronic patient records.
GW29-e0867 Demonstration of Cavitation in the Coronary Arteries by Computational Fluid Dynamic
Authors: Thach Nguyen, Marco Zuni, Nguyen Thanh Luan, Nguyen Ngoc Huyen Vy, Kim Truong, Thao Dang, Tu NT. Nguyen, Tarneem Darwish, Gianluca Rigatelli, Ernest Talarico
Journal: Journal of the American College of Cardiology (2018)
Identification of a distinct imaging phenotype may improve the management of palindromic rheumatism
Authors: Kulveer Mankia, Maria-Antonietta D’Agostino, Richard J Wakefield, Jackie L Nam, Waqar Mahmood, Andrew J Grainger, Paul Emery
Journal: Annals of the Rheumatic Diseases (2018)

Objectives To use high-resolution imaging to characterise palindromic rheumatism (PR) and to compare the imaging pattern observed to that seen in new-onset rheumatoid arthritis (NORA). Methods Ultrasound (US) assessment of synovitis, tenosynovitis and non-synovial extracapsular inflammation (ECI) was performed during and between flares in a prospective treatment-naive PR cohort. MRI of the flaring region was performed where possible. For comparison, the same US assessment was also performed in anticyclic citrullinated peptide (CCP) positive individuals with musculoskeletal symptoms (CCP+ at risk) and patients with NORA. Results Thirty-one of 79 patients with PR recruited were assessed during a flare. A high frequency of ECI was identified on US; 19/31 (61%) of patients had ECI including 12/19 (63%) in whom ECI was identified in the absence of synovitis. Only 7/31 (23%) patients with PR had synovitis (greyscale ≥1 and power Doppler ≥1) during flare. In the hands/wrists, ECI was more prevalent in PR compared with NORA and CCP+ at risk (65% vs 29 % vs 6%, p&lt;0.05). Furthermore, ECI without synovitis was specific for PR (42% PR vs 4% NORA (p=0.003) and 6% CCP+ at risk (p=0.0012)). Eleven PR flares were captured by MRI, which was more sensitive than US for synovitis and ECI. 8/31 (26%) patients with PR developed RA and had a similar US phenotype to NORA at progression. Conclusion PR has a distinct US pattern characterised by reversible ECI, often without synovitis. In patients presenting with new joint swelling, US may refine management by distinguishing relapsing from persistent arthritis.
The efficacy of eribulin for patients with taxane-resistant cutaneous angiosarcoma: Interim result of multi-center, prospective observational study
Authors: Y. Fujisawa, K. Yoshino, T. Fujimura, S. Matsushita, H. Uchi, Y. Yamamoto, H. Hata, A. Otsuka, T. Miyagi, M. Ishii, T. Funakoshi
Journal: Annals of Oncology (2018)
Epidemiology of nickel sensitivity: Retrospective cross-sectional analysis of North American Contact Dermatitis Group data 1994-2014
Authors: Erin M. Warshaw, Amy J. Zhang, Joel G. DeKoven, Howard I. Maibach, Donald V. Belsito, Denis Sasseville, Joseph F. Fowler, Anthony F. Fransway, Toby Mathias, Melanie D. Pratt, James G. Marks, Kathryn A. Zug, Matthew J. Zirwas, James S. Taylor, Vincent A. DeLeo
Journal: Journal of the American Academy of Dermatology (2018)
Activation of NF-κB driven inflammatory programs in mesenchymal elements attenuates hematopoiesis in low-risk myelodysplastic syndromes
Authors: Zhen Ping, Si Chen, Sjoerd J. F. Hermans, Keane J. G. Kenswil, Jacqueline Feyen, Claire van Dijk, Eric M. J. Bindels, Athina M. Mylona, Niken M. Adisty, Remco M. Hoogenboezem, Mathijs A. Sanders, Eline M. P. Cremers, Dicky J. Lindenbergh-Kortleve, Janneke N. Samsom, Arjan A. van de Loosdrecht, Marc H. G. P. Raaijmakers
Journal: Leukemia (2018)

Hairy cell leukemia (HCL) is a chronic, incurable B cell malignancy that presents with splenomegaly, bone marrow infiltration, and cytopenias [1].Long remissions are typically achieved with purine analogs such as cladribine, but most cases will relapse and require further therapy.The discovery of the
En bloc resection of carcinoid tumor by a hybrid endoscopic submucosal dissection technique
Authors: Sergio Rubel Cohen, Fernando Fluxa, Pablo Fabre, Fernando Uribe Reyes, Mara Ferraris
Journal: Endoscopy (2018)

Rectal carcinoids are rare tumors, most of which are diagnosed incidentally during routine colonoscopy. Unfortunately, endoscopists tend to attempt resection using traditional resection methods, such as snare, which often results in incomplete resection [1] [2]. The endoscopic submucosal dissection (ESD) method has recently been proposed as a valuable endoscopic treatment for rectal carcinoids, because it provides a higher en bloc resection rate than conventional endoscopic mucosal resection (EMR), enabling accurate pathologic diagnosis and potentially curative treatment [3] [4] [5].