tbuckley/cabot-search huggingface dataset:
The 2017 Clinical Practice Guideline for High Blood Pressure
Authors: Paul K. Whelton, Robert M. Carey
Journal: JAMA (2017)

This Viewpoint reviews key recommendations in the 2017 Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure authored by the AHA, ACC, and 9 other specialty organizations, and highlights differences from the 2003 JNC 7 guideline.
Socioeconomic status, unpredictability, and different perceptions of the same risk
Authors: Chiraag Mittal, Vladas Griskevicius
Journal: Behavioral and Brain Sciences (2017)

Abstract In this commentary, we address three questions: (1) How might outcomes be affected by the variation in the level of deprivation, rather than the average level of deprivation? (2) Could there be differences in the subjective perception of the same risk as either intrinsic or extrinsic, depending on people's socioeconomic status (SES)? (3) What other psychological mechanisms might play a role in influencing the psychology and behavior of people from deprived backgrounds?
Cetuximab plus carboplatin and paclitaxel with or without bevacizumab versus carboplatin and paclitaxel with or without bevacizumab in advanced NSCLC (SWOG S0819): a randomised, phase 3 study
Authors: Roy S Herbst, Mary W Redman, Edward S Kim, Thomas J Semrad, Lyudmila Bazhenova, Gregory Masters, Kurt Oettel, Perry Guaglianone, Christopher Reynolds, Anand Karnad, Susanne M Arnold, Marileila Varella-Garcia, James Moon, Philip C Mack, Charles D Blanke, Fred R Hirsch, Karen Kelly, David R Gandara
Journal: The Lancet Oncology (2017)
Retrospective review of safety and efficacy of programmed cell death-1 inhibitors in refractory high grade gliomas
Authors: Samantha N. Reiss, Prakirthi Yerram, Lisa Modelevsky, Christian Grommes
Journal: Journal for ImmunoTherapy of Cancer (2017)

Programmed cell death ligand-1 (PD-L1) expression has been reported in up to 61% of high grade gliomas (HGG). The purpose of this study was to describe safety and efficacy of PD-1 inhibition in patients with refractory HGGs.This Institutional Review Board approved single center retrospective study included adult patients with pathologically confirmed HGG who received a PD-1 inhibitor from 9/2014-10/2016 outside of a clinical trial at Memorial Sloan Kettering Cancer Center.Twenty five HGG patients received pembrolizumab as part of a compassionate use program. Median age was 50 years (range 30-72); 44% were men; 13 had glioblastoma (52%), 7 anaplastic astrocytoma (28%), 2 anaplastic oligodendroglioma (8%), 2 unspecified HGG (8%), and 1 gliosarcoma (4%). Median prior lines of treatments were 4 (range 1-9). Nineteen (76%) previously failed bevacizumab. Median KPS was 80 (range 50-100). Concurrent treatment included bevacizumab in 17 (68%) or bevacizumab and temozolomide in 2 (8%) patients. Median number of doses administered was 3 (range 1-14). Outcomes were assessed in 24 patients. PD-1 inhibitor related adverse events included LFT elevations, hypothyroidism, diarrhea, myalgias/arthralgias, and rash. Best radiographic response was partial response (n = 2), stable disease (n = 5), and progressive disease (n = 17). Median progression free survival (PFS) was 1.4 months (range 0.2-9.4) and median overall survival (OS) was 4 months (range 0.5-13.8). Three-month PFS was 12% and 6-month OS was 28%.While response rates are low, a few patients had a prolonged PFS. Pembrolizumab was tolerated with few serious toxicities, even in patients receiving concomitant therapy.
Acute Graft-versus-Host Disease — Biologic Process, Prevention, and Therapy
Authors: Robert Zeiser, Bruce R Blazar
Journal: New England Journal of Medicine (2017)

When T cells from a bone marrow donor begin to attack the host within 3 months after hematopoietic-cell transplantation, acute graft-versus-host disease results. The disease mainly affects the skin, liver, and gastrointestinal tract and is treated with immunosuppressive drugs.
A Review of Automated Pain Assessment in Infants: Features, Classification Tasks, and Databases
Authors: Ghada Zamzmi, Rangachar Kasturi, Dmitry Goldgof, Ruicong Zhi, Terri Ashmeade, Yu Sun
Journal: IEEE Reviews in Biomedical Engineering (2017)

Bedside caregivers assess infants' pain at constant intervals by observing specific behavioral and physiological signs of pain. This standard has two main limitations. The first limitation is the intermittent assessment of pain, which might lead to missing pain when the infants are left unattended. Second, it is inconsistent since it depends on the observer's subjective judgment and differs between observers. Intermittent and inconsistent assessment can induce poor treatment and, therefore, cause serious long-term consequences. To mitigate these limitations, the current standard can be augmented by an automated system that monitors infants continuously and provides quantitative and consistent assessment of pain. Several automated methods have been introduced to assess infants' pain automatically based on analysis of behavioral or physiological pain indicators. This paper comprehensively reviews the automated approaches (i.e., approaches to feature extraction) for analyzing infants' pain and the current efforts in automatic pain recognition. In addition, it reviews the databases available to the research community and discusses the current limitations of the automated pain assessment.
Doctors in India still carry out “two finger test” on rape victims
Authors: Sanjeet Bagcchi
Journal: BMJ (2017)

Doctors in India are still carrying out the “two finger” test on rape victims despite the government calling for a ban on the practice.

A report by Human Rights Watch1 found that hospitals in Rajasthan still require doctors to carry out the “degrading practice,” where a doctor inserts their fingers into the vagina to assess a woman’s sexual activity.

The report, based on research and interviews in the states of Haryana, Madhya Pradesh, Rajasthan, and Uttar Pradesh, and the cities of New Delhi and Mumbai, found that some doctors were unaware that the government had called for a ban on the test and introduced …
Case 37-2017
Authors: Ali S. Raja, Emily S. Miller, Efrén J. Flores, Sarah E. Wakeman, George Eng
Journal: New England Journal of Medicine (2017)

of the Massachusetts General Hospital as a teaching exercise or reference material is now eligible to receive a complete set of PowerPoint slides, including digital images, with identifying legends, shown at the live Clinicopathological Conference (CPC) that is the basis of the Case Record.This slide set contains all of the images from the CPC, not only those published in the Journal.Radiographic, neurologic, and cardiac studies, gross specimens, and photomicrographs, as well as unpublished text slides, tables, and diagrams, are included.Every year 40 sets are produced, averaging 50-60 slides per set.Each set is supplied on a compact disc and is mailed to coincide with the publication of the Case Record.
Using the Icelandic genealogical database to define the familial risk of primary biliary cholangitis
Authors: Kristjan T. Örnolfsson, Sigurdur Olafsson, Ottar M. Bergmann, M. Eric Gershwin, Einar S. Björnsson
Journal: Hepatology (2017)

Hereditary factors in primary biliary cholangitis (PBC) have been well defined in genome‐wide association studies, but there are few direct data available that define the relative risk (RR) for family members with an affected proband. An increased risk in first‐degree relatives has been demonstrated in a variety of studies, but data have been lacking on further detailed associations for subsequent generations. The objective of this study was to use the unique Icelandic genealogical database to study the familiality of PBC. All patients with positive antimitochondrial antibody measurements in Iceland during the period 1991‐2015 who fulfilled diagnostic criteria for PBC were included. The Icelandic genealogical database was used to assess familial relations. For each case of PBC, 10,000 control subjects matched for age, sex, and number of known relatives were randomly chosen from this database to calculate the familial RR of PBC. The average kinship coefficient (KC) of the patients was calculated and compared with the average KC of controls. Overall, 222 PBC patients were identified (182 females, 40 males; median age, 62 years). First‐, second‐ and third‐degree relatives of the PBC patients had a high RR of the disease: 9.13 (P < 0.0001), 3.61 (P = 0.014) and 2.59 (P = 0.008), respectively. In fourth‐ and fifth‐degree relatives, the RR was also increased to 1.66 (P = 0.08) and 1.42 (P = 0.08), respectively. The average KC of the patients was also higher than that of the control subjects, with 21.34 × 10−5 versus 9.56 × 10−5 (P < 0.0001). Conclusion: Relatives of PBC patients had markedly higher risk for development of the disease compared with controls and importantly our data demonstrate that the risk was significantly increased even in second‐ and third‐degree relatives. (Hepatology 2018;68:166‐171).
Effect of Several Negative Rounds of Human Papillomavirus and Cytology Co-testing on Safety Against Cervical Cancer
Authors: Philip E. Castle, Walter K. Kinney, Xiaonan Xue, Li C. Cheung, Julia C. Gage, Fang-Hui Zhao, Barbara Fetterman, Nancy E. Poitras, Thomas S. Lorey, Nicolas Wentzensen, Hormuzd A. Katki, Mark Schiffman
Journal: Annals of Internal Medicine (2017)

Current U.S. cervical cancer screening and management guidelines do not consider previous screening history, because data on multiple-round human papillomavirus (HPV) and cytology "co-testing" have been unavailable.To measure cervical cancer risk in routine practice after successive negative screening co-tests at 3-year intervals.Observational cohort study.Integrated health care system (Kaiser Permanente Northern California, Oakland, California).990 013 women who had 1 or more co-tests from 2003 to 2014.3- and 5-year cumulative detection of (risk for) cervical intraepithelial neoplasia grade 3, adenocarcinoma in situ, and cervical cancer (≥CIN3) in women with different numbers of negative co-tests, overall and within subgroups defined by previous co-test results or baseline age.Five-year ≥CIN3 risks decreased after each successive negative co-test screening round (0.098%, 0.052%, and 0.035%). Five-year ≥CIN3 risks for an HPV-negative co-test, regardless of the cytology result, nearly matched the performance (reassurance) of a negative co-test for each successive round of screening (0.114%, 0.061%, and 0.041%). By comparison, ≥CIN3 risks for the cytology-negative co-test, regardless of the HPV result, also decreased with each successive round, but 3-year risks were as high as 5-year risks after an HPV-negative co-test (0.199%, 0.065%, and 0.043%). No interval cervical cancer cases were diagnosed after the second negative co-test. Independently, ≥CIN3 risks decreased with age. Length of previous screening interval did not influence future ≥CIN3 risks.Interval-censored observational data.After 1 or more negative cervical co-tests (or HPV tests), longer screening intervals (every 5 years or more) might be feasible and safe.National Cancer Institute Intramural Research Program.
Bendamustine plus rituximab for indolent B‐cell lymphoma of renal significance
Authors: David Ribes, Hélène E. L. Hachem, Lucie Oberic, François Vergez, Audrey Delas, Julie Belliere, Caroline Protin, Nassim Kamar, Inès Ferrandiz, Suzanne Tavitian, Camille Laurent, Antoine Huart, Dominique Chauveau, Loïc Ysebaert, Stanislas Faguer
Journal: American Journal of Hematology (2017)

Treatment of indolent B-cell non-Hodgkin lymphomas (iNHL) of renal significance is challenging given the need for deep and prolonged hematological response to restore and control renal function overtime, yet to be balanced with the risk of adverse drug-related events. This prospective single-center study included 20 patients with iNHL of renal significance (tubulointerstitial presentation [n = 8], glomerulopathy with or without monoclonal Ig deposits [n = 12]) who received a steroid-sparing regimen of rituximab plus bendamustine (BR), with either no or <1 month of steroid intake (as a first line therapy in 80%). Seventeen patients (85%) achieved a complete (CHR, n = 12) or a partial (PHR, n = 5) hematological response. Nine out of the 12 patients (75%) with iNHL-related glomerulopathy had a complete (CRR) or a partial (PRR) renal response. Among the six patients with glomerulopathy and CHR, five had a CRR (83%) compared to 1/6 (17%) that did not reach CHR. eGFR increased from 38 to 58 mL/min/1.73 m2 , and returned to baseline in five patients. Among the eight patients with a tubulointerstitial presentation, six (75%) had a renal response (5 CRR), and eGFR increased from 29 to 48 mL/min/1.73 m2 . One patient with a PHR had a renal relapse. Mortality rate was 10% at 12 months. The BR regimen was well tolerated overall. Thus, despite severe renal disease at presentation, a relapsing iNHL in 20% of patients and several comorbidities, the BR regimen was efficient and safe in our series. It should be further assessed as a first line therapy for patients with iNHL of renal significance.
Prospects for using risk scores in polygenic medicine
Authors: Cathryn M. Lewis, Evangelos Vassos
Journal: Genome Medicine (2017)

Genome-wide association studies have made strides in identifying common variation associated with disease. The modest effect sizes preclude risk prediction based on single genetic variants, but polygenic risk scores that combine thousands of variants show some predictive ability across a range of complex traits and diseases, including neuropsychiatric disorders. Here, we consider the potential for translation to clinical use.
Abstract 21060: The Association Between Post-Resusciation Cerebral Oxygenation and Survival With Favorable Neurological Outcomes: A Multicenter Study
Authors: Linh N Tran, Jie Yang, Caitlin M O'Neill, Donglei Yin, Niraj Sinha, Robert T Nguyen, Vikram Chabra, Sam Parnia
Journal: Circulation (2017)

Background: Cerebral ischemia/reperfusion injury in the post-resuscitation period contributes to morbidity and mortality following cardiac arrest (CA). Cerebral oximetry is a non-invasive system that uses near infrared spectroscopy to measure regional cerebral oxygenation level (rSO2) in the frontal lobe of the brain. Studies have shown that post-resuscitation rSO2 may be associated with survival and neurological outcomes in out-of-hospital cardiac arrest patients, however no studies have examined this in in-hospital cardiac arrest (IHCA) patients. Hypothesis: rSO2 changes following return of spontaneous circulation (ROSC) after IHCA are associated with survival with favorable neurological outcomes. Methods: A multi-site prospective study of consecutive day-time IHCA patients admitted to the ICU after ROSC at 7 sites. Continuous rSO2 monitoring (Equanox 7600, Nonin Medical, MN, USA) was applied for 48 hours after ROSC using a forehead sensor. Mean rSO2 was calculated hourly between 1-6 hrs. and at 6, 12, 18, 24, 48 hr. intervals. Demographic and data pertaining to possible confounding variables for rSO2 and survival with favorable neurological outcomes (cerebral performance scale [CPC] 1-2) vs death or severe neurological injury (CPC 3-5) at hospital discharge were collected. Results: Among 87 studied patients, 26 (29.9%) achieved CPC1-2. There were no differences in age, Charlson comorbidity index, APACHE II scores, and resuscitation duration, however, CPC 1-2 was higher in men vs. women (36.5% vs. 12.5%, p = 0.036). A significant difference in mean rSO2 was observed during hours 1-2 after ROSC in CPC 1-2 vs CPC3-5 (73.08 vs. 66.59, p = 0.031) but not at other time points. There were no differences in mean arterial pressure, PaO2, PaCO2, and hemoglobin levels, however subjects with CPC 1-2 had lower glucose (154.4mg/dL vs. 202.8mg/dL, p = 0.0054), lactate level (4.11 mmol/dL vs. 6.39 mmol/dL, p = 0.030), and higher Glasgow coma scale (9.42 vs. 5.96, p = 0.0026) within the first 24 hours. Conclusions: Changes in rSO2 as measured by cerebral oximetry in the first two hours after ROSC may predict survival with neurological outcomes after resuscitation following IHCA.
Chemotherapy-induced (febrile) neutropenia prophylaxis with biosimilar filgrastim in solid tumours versus haematological malignancies: Patterns, outcomes and determinants (MONITOR-GCSF study)
Authors: M. Aapro, C. Bokemeyer, M. Boccadoro, P. Gascón, K. Denhaerynck, A. Krendyukov, I. Abraham, K. Macdonald, H. Ludwig
Journal: Annals of Oncology (2017)
Diagnostic Accuracy of Screening Tests and Treatment for Post–Acute Coronary Syndrome Depression
Authors: Jason A. Nieuwsma, John W. Williams Jr., Natasha Namdari, Jeffrey B. Washam, Giselle Raitz, James A. Blumenthal, Wei Jiang, Roshini Yapa, Amanda J. McBroom, Kathryn Lallinger, Robyn Schmidt, Andrzej S. Kosinski, Gillian D. Sanders
Journal: Annals of Internal Medicine (2017)

Patients who have had an acute coronary syndrome (ACS) event have an increased risk for depression.To evaluate the diagnostic accuracy of depression screening instruments and to compare safety and effectiveness of depression treatments in adults within 3 months of an ACS event.MEDLINE, EMBASE, PsycINFO, CINAHL, and Cochrane Database of Systematic Reviews from January 2003 to August 2017, and a manual search of citations from key primary and review articles.English-language studies of post-ACS patients that evaluated the diagnostic accuracy of depression screening tools or compared the safety and effectiveness of a broad range of pharmacologic and nonpharmacologic depression treatments.2 investigators independently screened each article for inclusion; abstracted the data; and rated the quality, applicability, and strength of evidence.Evidence from 6 of the 10 included studies showed that a range of depression screening instruments produces acceptable levels of diagnostic sensitivity, specificity, and negative predictive values (70% to 100%) but low positive predictive values (below 50%). The Beck Depression Inventory-II was the most studied tool. A large study found that a combination of cognitive behavioral therapy (CBT) and antidepressant medication improved depression symptoms, mental health-related function, and overall life satisfaction more than usual care.Few studies, no evaluation of the influence of screening on clinical outcomes, and no studies addressing several clinical interventions of interest.Depression screening instruments produce diagnostic accuracy metrics that are similar in post-ACS patients and other clinical populations. Depression interventions have an uncertain effect on cardiovascular outcomes, but CBT combined with antidepressant medication produces modest improvement in psychosocial outcomes.Agency for Healthcare Research and Quality (PROSPERO: CRD42016047032).
Antitumoral effect of low molecular weight heparin in localized lung cancer. A randomized phase III controlled trial
Authors: B. Besse, P. Girard, H. Doubre, A. Charles-Nelson, S. Aquilanti, A. Izadifar, R. Azarian, I. Monnet, C. Lamour, R. Descourt, G. Oliviero, L. Taillade, C. Chouaid, F. Giraud, P -E Falcoz, M -P Revel, V. Westeel, M. Alifano, G. Chatellier, G. Meyer
Journal: Annals of Oncology (2017)
Heterogeneity of respiratory disease in children and young adults with sickle cell disease
Authors: Alan Lunt, Lucy Mortimer, David Rees, Sue Height, Swee Lay Thein, Anne Greenough
Journal: Thorax (2017)

To detect and characterise different phenotypes of respiratory disease in children and young adults with sickle cell disease (SCD), 11 lung function and haematological biomarkers were analysed using k-means cluster analysis in a cohort of 114 subjects with SCD aged between 5 and 27 years. Three clusters were detected: cluster 1 had elevated pulmonary capillary blood volume, mixed obstructive/restrictive lung disease, hypoxia and moderately severe anaemia; cluster 2 were older patients with restrictive lung disease; and cluster 3 were younger patients with obstructive lung disease, elevated serum lactate dehydrogenase and bronchodilator reversibility. These results may inform more personalised management strategies to improve outcomes.
A randomized, double-blind, placebo-controlled, dose-finding trial with <i>Lolium perenne</i> peptide immunotherapy
Authors: R. Mösges, E. M. Kasche, E. Raskopf, J. Singh, L. Sohlich, A. Astvatsatourov, K. Shah‐Hosseini, S. Pirotton, L. Haazen, S. R. Durham, T. Legon, G. Zadoyan, M. H. Shamji
Journal: Allergy (2017)

A novel subcutaneous allergen immunotherapy formulation (gpASIT+™) containing Lolium perenne peptides (LPP) and having a short up-dosing phase has been developed to treat grass pollen-induced seasonal allergic rhinoconjunctivitis. We investigated peptide immunotherapy containing the hydrolysate from perennial ryegrass allergens for the optimum dose in terms of clinical efficacy, immunogenicity and safety.This prospective, double-blind, placebo-controlled, phase IIb, parallel, four-arm, dose-finding study randomized 198 grass pollen-allergic adults to receive placebo or cumulative doses of 70, 170 or 370 μg LPP. All patients received weekly subcutaneous injections, with the active treatment groups reaching assigned doses within 2, 3 and 4 weeks, respectively. Efficacy was assessed by comparing conjunctival provocation test (CPT) reactions at baseline, after 4 weeks and after completion. Grass pollen-specific immunoglobulins were analysed before and after treatment.Conjunctival provocation test (CPT) response thresholds improved from baseline to V7 by at least one concentration step in 51.2% (170 μg; P = .023), 46.3% (370 μg), and 38.6% (70 μg) of patients receiving LPP vs 25.6% of patients receiving placebo (modified per-protocol set). Also, 39% of patients in the 170-μg group became nonreactive to CPT vs 18% in the placebo group. Facilitated allergen-binding assays revealed a highly significant (P < .001) dose-dependent reduction in IgE allergen binding across all treatment groups (70 μg: 17.1%; 170 μg: 18.8%; 370 μg: 26.4%). Specific IgG4 levels increased to 1.6-fold (70 μg), 3.1-fold (170 μg) and 3.9-fold (370 μg) (mPP).Three-week immunotherapy with 170 μg LPP reduced CPT reactivity significantly and increased protective specific antibodies.
Pazopanib toxicity in a metastatic sarcoma cohort: Are Indian patients different?
Authors: A. Sharma, A. Aggarwal, I. Vanidassane, V. Sharma, A. Sharma, A.R. Mridha, A. Barwad, S.V.S. Deo, S. Rastogi
Journal: Annals of Oncology (2017)