tbuckley/cabot-search huggingface dataset:
Cost-effectiveness analysis of neoadjuvant chemotherapy with intensive dose of epirubicin and different cycles in patients with locally advanced breast cancer: 4 FE<sub>100</sub>C versus 6 FE<sub>100</sub>C.
Authors: Nicolas Ramirez, Jorge Eduardo Herrera, Jose Fortino Chavez, Horacio Astudillo
Journal: Journal of Clinical Oncology (2012)

e11565 Background: There are different combinations of neoadjuvant chemotherapy (NCT) to treat locally advanced breast cancer (LABC); treatment with cytostatics drugs make it a costly concern, by establishing economic differences in the consumption of healthcare resources. To compare the cost-effectiveness of two NCT strategies (4FE 100 C vs. 6FE 100 C). Methods: It was made a cost-effectiveness analysis (CEA) of two treatment schemes (4FE 100 C vs. 6FE 100 C) in patients with clinical stage III breast cancer, each cohort included 48 patients. Effectiveness parameter: pathologic complete response (pCR). Differential cost: incremental cost-effectiveness ratio (ICER) using a Markov’s model. Results are expressed in terms of incremental cost per extra unit of effectiveness. Costs were expressed in Mexican (MXN) pesos ($) as of 2005; these were calculated under the perspective of public healthcare system (SSP, for its acronym in Spanish) denominated IMSS, with a 3 to 4 years analytical horizon. In order to determine the robustness of the results, a sensitivity analysis was carried out by modifying only the medical direct costs with a 3% discount rate. Results: The use of 6FE 100 C offered greater effectiveness compared against 4FE 100 C; the medical direct cost of only the cytostatic drugs for NCT with 6 FE 100 C and 4 E 100 C generated a cost per case of $30,467.00 MXN (€ 2,343.61) and $18,004.00 MXN (€ 1,384.92), respectively. The greatest unit price was given by epirubicin. The CEA demonstrated that the cost-effectiveness (C/E) was greater with 6 FE 100 C and the incremental cost-effectiveness ratio (ICER) showed that it was necessary to pay $11,765,925.42 MXN (€ 905,071.20) because it tells us how much it is paid additionally for every extra unit of effectiveness (pCR) which assumes 6 FE 100 C in front of 4 FE 100 C. The sensitivity analysis performed shows the robustness of the results. Conclusions: The6 FE 100 C scheme is the chemotherapeutic strategy with better cost-effectiveness ratio and is the most efficient in the short run for treating LABC.
Abstract 15302: NOAC or VKA With Antiplatelets Following Myocardial Infarction or PCI in Atrial Fibrillation
Authors: Caroline Sindet-Pedersen, Morten Lamberts, Laila Staerk, Anders Nissen Bonde, Jeffrey S Berger, Jannik Langtved Pallisgaard, Morten L Hansen, Christian Torp-Pedersen, Gunnar G Gislason, Jonas Bjerring Olesen
Journal: Circulation (2017)

Background: The optimal treatment strategy when combining antiplatelets with oral anticoagulants (OAC) in atrial fibrillation (AF) patients suffering myocardial infarction (MI) or undergoing percut...
Typhoid conjugate vaccines: a new tool in the fight against antimicrobial resistance
Authors: Jason R Andrews, Stephen Baker, Florian Marks, Marcella Alsan, Denise Garrett, Bruce G Gellin, Samir K Saha, Farah Naz Qamar, Mohammad Tahir Yousafzai, Isaac I Bogoch, Marina Antillon, Virginia E Pitzer, Jong-Hoon Kim, Jacob John, Jillian Gauld, Vittal Mogasale, Edward T Ryan, Stephen P Luby, Nathan C Lo
Journal: The Lancet Infectious Diseases (2018)
Abstract 18394: Heat Shock Protein Inducer Geranylgeranylacetone (gga) Protects Against Atrial Fibrillation via the PI3K Pathway
Authors: Tae-joon Cha, Eun Kyoung Choi, Ga-In Yu, Bong Joon Kim, Dong Hyeon Park
Journal: Circulation (2016)

There is evidence suggesting that heat shock proteins protect against clinical atrial fibrillation (AF) by mediating cellular stress. Recently, investigators reported that the HSP-inducing compound...
Ultrasound Techniques for the Assessment of Liver Stiffness: A Correct Terminology
Authors: Giovanna Ferraioli
Journal: Hepatology (2018)

Potential conflict of interest: Dr. Ferraioli is on the speakers' bureau for Canon Medical Systems, Hitachi, Mindray Medical Systems, and Philips Ultrasound. To the Editor: I have read with great interest the article by Younossi et al.(1) and would like to express my gratitude for giving a thorough insight on the diagnostic modalities for assessing nonalcoholic fatty liver disease (NAFLD), nonalcoholic steatohepatitis, and associated fibrosis. As underlined by the authors, a subgroup of NAFLD patients will develop liver fibrosis, which predicts mortality. Due to the high prevalence of NAFLD in the general population worldwide, the noninvasive methods for staging liver fibrosis are highly attractive and cost‐effective. On the paragraph about the role of the radiologic modalities, incorrect information about the available ultrasound (US) elastography techniques for the assessment of liver stiffness is given. This mistake is reiterated several times in the literature, despite the clarification made by guidelines that have detailed the technical principles of all US elastography techniques available as of today.(2) Indeed, the use of correct terminology is an essential prerequisite to allow effective and appropriate comparison among the different available technologies. The widely used US‐based elastography techniques for the assessment of liver elasticity are based on the generation of shear wave by an external or internal mechanical push and are termed "shear wave elastography" (SWE).(2) Transient elastography is a SWE technique that makes use of an external mechanical push to generate shear waves that propagate into the liver and is performed with a dedicated device, the FibroScan (Echosens, Paris, France). With the SWE techniques incorporated in the US systems, the shear waves are generated by an internal acoustical push pulse made by the acoustic radiation force impulse (ARFI) (i.e., the force of the ultrasound beam) directly into the liver. The assessment of shear wave speed/stiffness is made either at one point as in point SWE or, using several ARFI lines, it is possible to obtain quantitative images of the elasticity, as in 2D SWE. The term "acoustic radial force imaging" identifies a completely different elastography technique that is not based on the generation of the shear waves and is not used for the assessment of diffuse liver disease.(4)
Serendipitous Ureteral Stone Revealed on 99mTc-MDP Bone Scintigraphy
Authors: Feng Yuan, Haili Wang, Chunyu Lei, Yishu Hu, Fuqiang Shao
Journal: Clinical Nuclear Medicine (2018)

Abstract A 62-year-old man with esophageal cancer was referred for a 99m Tc-MDP bone scintigraphy for staging. No metastatic lesion in the bone was identified. However, the images showed focally increased activity in the left pelvis, which were confirmed as ureteral stone on the SPECT/CT images.
Neurologic immune-related adverse events associated with adjuvant ipilimumab: report of two cases
Authors: Christine A. Garcia, Alex El-Ali, Tanya J. Rath, Lydia C. Contis, Vikram Gorantla, Jan Drappatz, Diwakar Davar
Journal: Journal for ImmunoTherapy of Cancer (2018)

<h3>Background</h3> PD-1 and CTLA-4 inhibitors are associated with several adverse events including a spectrum of immune-related adverse effects (irAEs). Neurologic irAEs are uncommon occurrences with varied presentations. We describe two separate cases of ipilimumab associated meningoencephalomyelitis and demyelinating polyneuropathy with unusual presentations. <h3>Case presentation</h3> Two melanoma patients were treated with ipilimumab in the adjuvant setting. The first patient developed a meningoencephalitis following 3 doses of ipilimumab. MRI imaging of the brain confirmed leptomeningeal enhancement although cerebrospinal fluid (CSF) analyses were negative for malignant cells consistent with meningoencephalomyelitis. Although she initially improved following treatment with steroids and intravenous immunoglobulin, she subsequently relapsed. She was successfully treated with infliximab and made a complete neurological recovery. A second patient developed progressive lower extremity weakness following two doses of ipilimumab. MRI imaging of the spine confirmed diffuse nerve root enhancement consistent with acute inflammatory demyelinating polyneuropathy (AIDP). He was treated with high dose steroids with resolution of neurological symptoms. Both patients remain disease free. <h3>Conclusions</h3> Neurological irAEs are uncommon adverse events in the context of CTLA-4 and/or PD-1 inhibitor therapy. Care must be taken to distinguish these from leptomeningeal disease. Early recognition of neurological irAEs is critical for the initiation of specific anti-inflammatory agents to prevent and potentially reverse neurological sequelae.
Human antimicrobial cytotoxic T lymphocytes, defined by NK receptors and antimicrobial proteins, kill intracellular bacteria
Authors: Samuel J. Balin, Matteo Pellegrini, Eynav Klechevsky, Sohui T. Won, David I. Weiss, Aaron W. Choi, Joshua Hakimian, Jing Lu, Maria Teresa Ochoa, Barry R. Bloom, Lewis L. Lanier, Steffen Stenger, Robert L. Modlin
Journal: Science Immunology (2018)

Human CD8+ cytotoxic T lymphocytes (CTLs) contribute to antimicrobial defense against intracellular pathogens through secretion of cytotoxic granule proteins granzyme B, perforin, and granulysin. However, CTLs are heterogeneous in the expression of these proteins, and the subset(s) responsible for antimicrobial activity is unclear. Studying human leprosy, we found that the subset of CTLs coexpressing all three cytotoxic molecules is increased in the resistant form of the disease, can be expanded by interleukin-15 (IL-15), and is differentiated from naïve CD8+ T cells by Langerhans cells. RNA sequencing analysis identified that these CTLs express a gene signature that includes an array of surface receptors typically expressed by natural killer (NK) cells. We determined that CD8+ CTLs expressing granzyme B, perforin, and granulysin, as well as the activating NK receptor NKG2C, represent a population of "antimicrobial CTLs" (amCTLs) capable of T cell receptor (TCR)-dependent and TCR-independent release of cytotoxic granule proteins that mediate antimicrobial activity.
Gemcitabine Synergizes with Immune Checkpoint Inhibitors and Overcomes Resistance in a Preclinical Model and Mesothelioma Patients
Authors: Paulino Tallón de Lara, Virginia Cecconi, Stefanie Hiltbrunner, Hideo Yagita, Martina Friess, Beata Bode, Isabelle Opitz, Bart Vrugt, Walter Weder, Paul Stolzmann, Emanuela Felley-Bosco, Rolf A. Stahel, Verena Tischler, Christian Britschgi, Davide Soldini, Maries van den Broek, Alessandra Curioni-Fontecedro
Journal: Clinical Cancer Research (2018)

Combination of immune checkpoint inhibitors with chemotherapy is under investigation for cancer treatment.We studied the rationale of such a combination for treating mesothelioma, a disease with limited treatment options.The combination of gemcitabine and immune checkpoint inhibitors outperformed immunotherapy alone with regard to tumor control and survival in a preclinical mesothelioma model; however, the addition of dexamethasone to gemcitabine and immune checkpoint inhibitors nullified the synergistic clinical response. Furthermore, treatment with gemcitabine plus anti-PD-1 resulted in an objective clinical response in two patients with mesothelioma, who were resistant to gemcitabine or anti-PD-1 as monotherapy.Thus, treatment of mesothelioma with a combination of gemcitabine with immune checkpoint inhibitors is feasible and results in synergistic clinical response compared with single treatment in the absence of steroids.
Abstract 20115: Cross-Class Serine Protease Inhibitor Serp-2 Blocks Liver Ischemia Reperfusion Injury in Mice After Inflammasome Blockade
Authors: Sriram Ambadapadi, Dara Wakefield, Hao Chen, Jorge Fuentes, Jenni Davids, Bruno Marques, Lisa Dixon, William Clapp
Journal: Circulation (2016)

Introduction: Ischemia reperfusion injury (IRI) causes approximately 10% of transplant failure, contributing to a higher incidence of acute and chronic rejection and to a shortage of donor organs. ...
Prevention of malaria transmission around reservoirs: an observational and modelling study on the effect of wind direction and village location
Authors: Noriko Endo, Elfatih A B Eltahir
Journal: The Lancet Planetary Health (2018)

BackgroundMany large dams are constructed annually in Africa, with associated reservoirs that might exacerbate the risk of malaria in new villages built nearby. We aimed to investigate the heterogeneous risk of malaria around reservoirs related to the impact of wind direction on malaria transmission.MethodsBetween June 15, 2012, and April 22, 2015, we obtained field data on climate and hydrological conditions, and monitored Anopheles mosquito populations around the Koka reservoir in Ethiopia using in-situ weather stations, mosquito light traps, and larval dipping. The field data were used to calibrate a field-tested, spatially explicit mechanistic malaria transmission model, the Hydrology, Entomology, and Malaria Transmission Simulator (HYDREMATS), to investigate the effect of relative wind direction on malaria transmission and associated mechanisms. We combined our simulation results and observational data to assess the association between village location around a reservoir and risk of malaria.FindingsHYDREMATS simulations showed that wind blowing from a village towards a reservoir increases the size of malaria vector populations, whereas wind blowing from a reservoir towards a village decreases the size of malaria vector populations, which was consistent with our field data. Larval mortality is low in locations with village-to-reservoir wind due to weak surface waves, and this wind direction creates conditions that enable mosquitoes to identify village locations more easily than in conditions caused by reservoir-to-village wind, which increases the size of malaria vector populations, and thus malaria transmission. Among the wind conditions investigated (0·5–5 m/s), the effect of CO2 attraction on the size of the Anopheles population was largest at wind speeds of 0·5 m/s and 1 m/s, decreasing with higher wind speed. At a wind speed of 5 m/s, the effect of CO2 attraction was negligible, whereas the effect of waves was strongest. The effect of advection on Anopheles population size was negligible at all wind speeds and wind directions.InterpretationThe effect of wind on malaria transmission around reservoirs can be substantial. The transmission of malaria can be minimised if the location of villages situated near a reservoir is carefully considered. For areas in which the environmental conditions surrounding a resevoir are equal, villages should be located downwind of reservoirs to reduce the incidence of malaria, although further research will be required in locations where wind direction changes in different seasons.FundingUS National Science Foundation, and Cooperative Agreement between the Masdar Institute of Science and Technology, Abu Dhabi, UAE, and the Massachusetts Institute of Technology, Cambridge, MA, USA.
Abstract 13555: Acute Efficacy of Sodium Zirconium Cyclosilicate (ZS-9) in Patients on Mineralocorticoid-Receptor Antagonists: Analysis From Two Phase 3 Studies
Authors: Mikhail Kosiborod, Peter A McCullough, Henrik Rasmussen, Bhupinder Singh, Philip T Lavin, Prakash Deedwania
Journal: Circulation (2015)

Introduction: Although mineralocorticoid-receptor antagonists (MRAs) are strongly recommended by guidelines for chronic management of patients with heart failure (HF), less than 1/3 of eligible patients receive these cardio-protective medications due to the risk of hyperkalemia (hyperK; potassium [K+] ≥5.1 mEq/L). Sodium zirconium cyclosilicate (ZS-9) is a highly selective K+ ion trap that binds K+ throughout the GI tract. We examined the effectiveness of ZS-9 in treating hyperK in patients receiving MRAs using pooled data from 2 recently completed Phase 3 clinical trials. Methods: Data were pooled from 2 Phase 3 trials of patients with hyperK: ZS003 (N=753) and HARMONIZE (N=258). In both trials, patients receiving MRAs at baseline, and treated with 10 g, three times daily (TID), ZS-9 for 48 hrs were selected. Per protocol, MRA doses remained stable for the duration of the study. We examined absolute change in K+ from baseline, proportion of patients who achieved normokalemia by 24 and 48 hrs, and time to K+ normalization. Results: Across studies, 19 patients were on MRAs (age 73y; 74% HF; 90% eGFR &lt;60; 74% diabetes mellitus). Mean baseline K+ was 5.7 mEq/L. ZS-9 significantly reduced K+ during 48 hrs after treatment initiation (Figure): by 0.3, 0.5, 0.5, 0.7 and 1.1 mEq/L at 1, 2, 4, 24 and 48 hrs, respectively (P&lt;0.005 for each time point vs. baseline). Normokalemia was achieved in 84% and 95% of patients by 24 and 48 hours, respectively. Median time to K+ normalization was 3.8 hrs. During the initial 48 hrs of treatment of the overall population treated with 10 g ZS-9, the adverse event rate was 9% compared to 11% among patients who received placebo. Conclusions: In patients with hyperK while on MRA therapy, ZS-9 rapidly lowered K+ to normal range, with 95% of patients achieving normokalemia by 48 hrs. If confirmed in future studies, these results suggest that ZS-9 may enable optimization of cardio-protective MRA therapy in HF patients with or at high risk for hyperK.
Abstract 14872: Sensitivity of Cinefluoroscopy Compared With Visual Inspection of the Extracted Lead for Detection of Conductor Externalization of Riata/Riata St ICD Leads
Authors: Ali A Azeem, Nauman Khalid, D Guertin, Jeffrey Kluger, Steven Zweibel, Edmond Cronin
Journal: Circulation (2015)

Background: The Riata/Riata ST implantable cardioverter defibrillator (ICD) lead series (St Jude Medical, Sylmar, CA) is vulnerable to a characteristic insulation failure mechanism which results in conductor externalization (CE). This may be visible on cinefluoroscopy, however the sensitivity of this test is unknown when compared with direct visible inspection of extracted leads. Methods: We retrospectively reviewed the records of patients with Riata leads extracted at our center since 01/01/2011, and compared CE on fluoroscopic imaging before extraction with the visual appearance of the extracted lead ex vivo. Cinefluoroscopy of the Riata lead was performed in three planes: posteroanterior, left and right anterior oblique. CE was defined as a conductor that had breached the outer insulation material and was clearly visible outside the lead body on fluoroscopy. Ex vivo, CE was defined as externalization of the conductor cable(s) visible on inspection of the extracted lead with a corresponding linear insulation defect. Results: Of 424 patients with Riata leads 37(8.7%) patients underwent extraction with a mean implant duration of 6.24 years ±1.9 years. The indication for extraction was infection in 12 (32.4%); 7 (18.9%) for electrical or structural lead failure and other indications in 18 (48.6%). CE was evident on cinefluoroscopy in 8 (21.6%) patients before extraction including 2 (25%) leads extracted for electrical failure. Post extraction, CE was visible in an additional 3 (8.1%) leads including 1 (33%) extracted for electrical failure. Overall sensitivity was 72.7%. Conclusions: Cinefluoroscopy has suboptimal sensitivity for detection of CE in Riata ICD leads. The absence of CE on cinefluoroscopy does not imply that the outer insulation is structurally intact. Our results suggest that routine cinefluoroscopy of Riata/Riata ST leads is of limited utility.
Abstract 14498: Variability in Practice Patterns and Consistency With Published Guidelines for Aortic and Pulmonary Balloon Valvuloplasty: An Analysis of Data From the IMPACT Registry
Authors: Andrew C Glatz, Michael L O’Byrne, Kevin F Kennedy, Jonathan J Rome
Journal: Circulation (2016)

Introduction: Potential measures of quality in practice are its variability and consistency with published guidelines. We sought to assess, for the first time, these measures in congenital cardiac ...
Availability and affordability of essential medicines for diabetes across high-income, middle-income, and low-income countries: a prospective epidemiological study
Authors: Clara K Chow, Chinthanie Ramasundarahettige, Weihong Hu, Khalid F AlHabib, Alvaro Avezum, Xiaoru Cheng, Jephat Chifamba, Gilles Dagenais, Antonio Dans, Bonaventure A Egbujie, Rajeev Gupta, Romaina Iqbal, Noorhassim Ismail, Mirac V Keskinler, Rasha Khatib, Lanthé Kruger, Rajesh Kumar, Fernando Lanas, Scott Lear, Patricio Lopez-Jaramillo, Martin McKee, Noushin Mohammadifard, Viswanathan Mohan, Prem Mony, Andres Orlandini, Annika Rosengren, Krishnapillai Vijayakumar, Li Wei, Karen Yeates, Khalid Yusoff, Rita Yusuf, Afzalhussein Yusufali, Katarzyna Zatonska, Yihong Zhou, Shariful Islam, Daniel Corsi, Sumathy Rangarajan, Koon Teo, Hertzel C Gerstein, Salim Yusuf
Journal: The Lancet Diabetes & Endocrinology (2018)
Abstract 13360: Impact of Aortic Valve Calcification on the Incidence of Periprocedual Myocardial Injury in Patients Undergoing Coronary Stent Implantation
Authors: Yohei Shibata, Susumu Suzuki, Hideki Ishii, Kazuhiro Harada, Kenshi Hirayama, Yousuke Tatami, Tomoyuki Ota, Toyoaki Murohara
Journal: Circulation (2015)

Object: Previous studies have shown an association between aortic valve calcification (AVC) and cardiovascular events and mortality. On the other hand, periprocedual myocardial injury (PMI) is known as a predictor of subsequent mortality and other poor clinical outcomes. Hypohtesis: We assessed the hypothesis that presence of AVC could predict PMI in elective percutaneous coronary intervention (PCI). Methods: This study included a total of 372 patients treated with PCI for stable angina pectoris. Aortic valve calcification was defined as bright echoes &gt;1mm on one or more cusps of aortic valve by ultrasound cardiography. PMI was defined as an increase in high-sensitivity troponin T &gt;5 times (0.070 ng/ml) the upper normal limit at 24hours after PCI. Results: AVC was detected in 46.0% (n = 171). The incidence of PMI was significantly higher in patients with AVC than in those without AVC (43.9% vs 10.9%, respectively, p &lt; 0.001). The presence of AVC independently predicted PMI after adjusting for other significant variables (OR 2.18, 95% CI 1.30 to 3.66, p = 0.003). Other predictors were estimated glomerular filtration rate (OR 0.975, 95% CI 0.962 to 0.989, p &lt; 0.001), left anterior descending artery lesion (OR 0.496, 95% CI 0.293 to 0.840, p = 0.01) and total stent length (odds ratio 1.02, 95% confidence interval 1.00 to 1.05, p = 0.03). Conclusion: In conclusion, presence of AVC could predict incidence of PMI. Because detection of AVC by ultrasound cardiography is very simple, it is useful for risk stratifications in elective PCI with stent implantation.
Abstract 17052: Wearable Vibroacoustic Transthoracic Stimulation Improves Left Ventricular Function, Remodeling and Regulates Syndecan-4 / VEGF Levels in Rats After Myocardial Infarction
Authors: Arkady Uryash, Jose A Adams
Journal: Circulation (2016)

Background: Heart Failure (HF) post MI remains an important cause of morbidity and mortality and leads to high healthcare expenditures. Wearable devices that address chronic medical conditions will...