tbuckley/cabot-search huggingface dataset:
Abstract 16680: Lipoprotein(a) and Progression Rate of Aortic Valve Stenosis - A Pooled-Analysis of Two Prospective Studies
Authors: Romain Capoulade, Lionel Tastet, Ablajan Mahmut, Kwan L Chan, Sandra Guauque-Olarte, Marie Arsenault, Elisabeth Bedard, Benoit J Arsenault, Nathalie Gaudreault, Jean G Dumesnil, Koon K Teo, James W Tam, Jean-Pierre Després, Patrick Mathieu, Yohan Bossé, Philippe Pibarot
Journal: Circulation (2014)

BACKGROUND: Recent studies have reported a single nucleotide polymorphism (i.e. rs10455872) at the LPA gene locus, encoding the lipoprotein(a) [Lp(a)], is associated with the presence of aortic valve calcification and clinical aortic stenosis (AS). The objectives of this study were to examine the association of Lp(a) plasma levels and rs 10455872 with the progression rate of AS. METHODS: Lp(a) plasma levels were measured in 203 patients with AS included in the ASTRONOMER (NCT00800800) trial and 246 patients in the PROGRESSA study (NCT01679431). The polymorphism rs10455872 was genotyped in the PROGRESSA cohort. Hemodynamic progression rate of AS severity was assessed by measuring the annualized increase in peak aortic jet velocity (Vpeak) by Doppler-echocardiography. RESULTS: Twenty-seven (13%) patients of the ASTRONOMER trial and 47 (19%) of the PROGRESSA study had high Lp(a) plasma levels (i.e. &gt;50mg/dL). Baseline AS severity was similar in patients with high vs. low Lp(a) levels (p&gt;0.10). In the pooled-analysis of both cohorts (a total of 449 patients with mean follow-up: 3.0 ±1.4 yrs), AS progression rate was similar in patients with Lp(a)&gt;50 mg/dL compared to those with Lp(a)≤50 mg/dL (annualized change in Vpeak: +0.17±0.21 vs. +0.17±0.21 m/s/yr; p=0.97). Stratified analyses by cohort provided consistent results (ASTRONOMER: +0.20±0.21 vs. +0.25±0.19 m/s/yr; p=0.20; and PROGRESSA: +0.12±0.21 vs. +0.14±0.20 m/s/yr; p=0.46). In the PROGRESSA study, 38 (16%) patients carried at least one rs10455872 risk allele. Carriers of the risk allele had higher Lp(a) levels (58±24 vs. 20±38 mg/dL; p&lt;0.0001). Baseline AS severity was similar in carriers and non-carriers whereas there was a borderline significant association for lower AS progression rate in carriers compared to non-carriers (+0.07±0.17 vs. +0.15±0.21 m/s/yr; p=0.05). Similar results were obtained for baseline and annualized progression rate assessed by aortic valve area. CONCLUSION: This prospective study shows that neither LPA gene variant nor Lp(a) plasma levels are associated with faster AS progression rate. Our findings do not support the notion that Lp(a) levels are related to AS progression rate in patients with AS.
Abstract 15141: Influence of Diabetes on Trends in Perioperative Cardiovascular Events
Authors: Jonathan D Newman, Tanya Wilcox, Nathaniel R Smilowitz, Jeffrey S Berger
Journal: Circulation (2017)

Introduction: Patients undergoing non-cardiac surgery frequently have diabetes mellitus (DM) and an elevated risk of CVD. It is unknown whether declines in the frequency of perioperative major adve...
To what extent do disease severity and illness perceptions explain depression, anxiety and quality of life in hidradenitis suppurativa?
Authors: A. Pavon Blanco, M.A. Turner, G. Petrof, J. Weinman
Journal: British Journal of Dermatology (2018)

Hidradenitis suppurativa (HS) can have significant psychological consequences and affect quality of life (QoL). This has been associated with disease severity. However, it has not been established whether these effects are more strongly related to the severity of the disease, as rated by the clinician, or to the patient's perception of their condition.To examine the relationships between disease severity and illness perceptions, and depression, anxiety and QoL in HS.This study was cross-sectional in design. In total, 211 patients with HS completed the Brief Illness Perception Questionnaire (BIPQ), the Patient's Health Questionnaire-2 (PHQ-2), the Generalized Anxiety Disorder-2 (GAD-2) and the Dermatology Life Quality Index (DLQI). HS severity was assessed by the clinician, using the Hurley staging system.Patients with HS perceived their condition as chronic - having many symptoms, severe consequences and a negative emotional influence - and felt low personal control over their illness. Self-reports showed significant levels of depression, anxiety and impaired QoL, which were strongly associated with illness perceptions. Hierarchical regression analyses revealed that illness perceptions explained a much greater proportion of variance in depression, anxiety and QoL than the traditional explanatory variable, disease severity.HS can severely impair psychological well-being and QoL, which are more strongly associated with the person's beliefs about their illness than clinicians' severity assessments. Therefore, illness perceptions may be useful in the routine assessment of patients with HS and may provide a strong basis for interventions aimed at improving their psychological well-being and QoL.
Effect of raw material variability of glipizide on the in vitro dissolution rate and in vivo bioavailability performance: The importance of particle size
Authors: Chenyao Zhao, Chan Jin, Hailing Gao, Liyuan Wang, Hongzhuo Liu, Zhonggui He
Journal: Asian Journal of Pharmaceutical Sciences (2018)

The objective of this study was to understand the impact of active pharmaceutical ingredients (API) particle size on a re-developed generic product of glipizide and to improve its formulation so that it exhibits bioequivalent to that of the reference listed drug (RLD). Two commercial batches of APIs (API-1 and API-2) with the same polymorphism and one batch of home-made APIs (API-3) with super-small particle size were used in the present study. The in vitro dissolution profiles of the tested formulations were compared with the RLD in a series of dissolution media. Then, the impact of particle size on in vivo absorption was evaluated in Beagle dogs. Compared with the RLD, formulation A with larger API size showed slower dissolution in pH 6.0 and 7.4 medium, resulting bioinequivalent with the RLD. Conversely, formulation B with smaller API size demonstrated similar in vitro dissolution profiles with the RLD and thus exhibited bioequivalent in the present study. Furthermore, formulation C with super small particle size still exhibited identical oral absorption although rapid dissolution was observed in the tested condition. Herein, it indicated that 2-5 µm might be defined as the "inert size range" of glipizide for ensuring the bioequivalence with the RLD. The results in the present study might help to obtain a better understanding of the variability in raw materials for oral absorption, develop a bioequivalent product and thus post-market quality control.
Abstract 188: Pediatric Medical Emergency Team Response and Outcomes: A Report of 4,181 Events From the AHA Get With the Guidelines®-Resuscitation Registry
Authors: Tia T Raymond, Christopher P Bonafide, Amy Praestgaard, Vinay M Nadkarni, Robert A Berg, Chris S Parshuram, Elizabeth Hunt
Journal: Circulation (2013)

Background: In-hospital cardiac arrest (CA) is often preceded by signs and symptoms that predict subsequent deterioration. In response, hospitals created Medical Emergency Teams (METs) to bring skilled resources to the bedside with the aim of improving outcomes. Objective: Describe a cohort of pediatric MET events from the AHA Get With the Guidelines-Resuscitation (GWTG-R) registry. Methods: We analyzed consecutive pediatric (&lt; 18 yrs) MET events submitted to the AHA GWTG-R from Jan 2006 - Feb 2012. We excluded MET events in outpatient, critical care, newborn nurseries, delivery rooms, emergency departments (ED) and interventional/diagnostic areas. Results: We identified 4,181 MET events from 170 U.S. hospitals: median age 3.0 yrs (IQR = 0.0-13.0) with 52% male. Majority of MET events were in general inpatient wards (N = 3136, 75%) and telemetry/step-down units (N = 580, 13%). Medical (71%) and surgical (15%) non-cardiac patients were most frequent. Median length of MET event was 29.0 mins (IQR = 17.0-47.0). Most frequent triggers included: decreased oxygen saturation (30%), difficulty breathing (24%), staff concern (23%), tachypnea (21%), mental status changes (16%), and respiratory depression (12%). Within 24 hrs prior to MET call, 15% were transferred from an ICU, and 22% were admitted from the ED. Frequent non-drug interventions included: oxygen (58%), peripheral IV placement (30%), CXR (16%), suctioning (15%), and ICU consult (12%). Frequent drug interventions included: fluid bolus (21%), inhaled bronchodilators (16%), and anti-epileptics (7%). Almost half were transferred to the ICU (n = 2022, 48%), 236 (6%) progressed to require emergency assisted ventilation, and 18 patients (0.43%) progressed to CA. Survival to discharge was 92% (N = 3789). Conclusions: MET events occurred in general inpatient wards for objective indications, included assisted ventilation or CPR in 6.4%, and were associated with 8% hospital mortality. After treatment in 87% of events, 39% remained on inpatient wards, suggesting MET associated treatments may have stabilized or improved the condition of children judged to be clinically deteriorating by ward staff. Frequent events after ED admission or ICU transfer may represent an opportunity to improve the system of care.
Abstract 18242: High Dose Statin Results in a Further Reduction in Atherosclerotic Inflammation Compared with Low Dose Statin: Results of a Multi-Center PET-CT Study
Authors: Ahmed Tawakol, Zahi A Fayad, Robin Mogg, Achilles Alon, Sharath Subramanian, Amr Abdelbaky, Irene Nunes, Gary Herman, Chan Beals, Sudha S Shankar
Journal: Circulation (2011)

Background: Statin treatment results in a reduction in cardiovascular mortality. Here we test the hypothesis in a double-blinded multi-center randomized trial using fluorodeoxyglucose positron emission tomography imaging (FDG-PET), that high dose statins results in further reduction in plaque inflammation compared to low dose statins. Methods: Adults with risk factors for or established atherosclerosis, who were not already on high-dose statin (n= 83, median age 59 yrs, range 37-78 yrs, 78% men), were randomized (1:1) to 10 vs. 80mg of atorvastatin. FDG-PET imaging was performed before and 12 wks after randomization to measure atherosclerotic inflammation in the aorta and carotids. Arterial wall FDG uptake (target) was normalized to blood pool (background), yielding a target to background ratio (TBR). The most diseased segment (MDS) was defined as the 1.5 cm segment that included the highest TBR at baseline. All analyses were performed while blinded to time points and treatment. Results: Sixty-seven individuals completed the protocol and provided data for analysis. At 12 wks, inflammation (TBR) in the MDS was significantly reduced in atorva 10mg (% reduction from baseline [90% CI], 6.3 [1.2,11.2], 2-sided p&lt; 0.05, fig A), as well as atorva 80mg groups (14.6 [9.7, 19.2], p&lt;0.001). Moreover, atorva 80 resulted in a significant additional reduction in TBR relative to atorva 10 (%relative additional reduction= 8.8 [1.6, 15.6], p&lt;0.05). Further, a reduction in TBR was seen in patients randomized to atorva 80 who were already on a low-dose statin at baseline, (13.5 [6.9, 19.6], p=0.002, fig B). Changes in TBR did not correlate with changes in lipids. Conclusions: We observe a dose-related reduction in atherosclerotic inflammation in this first multi-center double-blinded trial evaluating effect of statins on FDG-PET measures of atherosclerotic inflammation. FDG-PET imaging may provide a useful assessment of treatment effect in patients already taking statins.
Childhood Lensectomy Is Associated with Static and Dynamic Reduction in Schlemm Canal Size
Authors: Moritz C. Daniel, Adam M. Dubis, Maria Theodorou, Ana Quartilho, Gillian Adams, John Brookes, Maria Papadopoulos, Peng T. Khaw, Annegret H. Dahlmann-Noor
Journal: Ophthalmology (2018)

PurposeTo compare Schlemm canal (SC) and trabecular meshwork (TM) in children with healthy eyes and those with and without glaucoma after lensectomy.DesignCross-sectional observational study.ParticipantsFifty children 4 to 16 years of age with healthy eyes and 48 children who underwent lensectomy (124 healthy and 72 postlensectomy eyes).MethodsAnterior segment (AS) OCT (Tomey SS-1000 CASIA; Tomey, Nagoya, Japan) of the nasal iridocorneal angle at 2 levels of accommodative effort (2.5 diopters [D] and 15 D). For each parameter and state of accommodation, a random effects model was fitted to estimate differences between healthy eyes and eyes with history of lensectomy.Main Outcome MeasuresDimensions of SC and TM and conventional AS OCT iridocorneal angle measurements.ResultsThe horizontal diameter of SC and its cross-sectional area (CSA) are significantly smaller in eyes that have undergone lensectomy versus healthy eyes. Accommodative effort increases SC size in healthy eyes, but not in eyes that have undergone lensectomy.ConclusionsLensectomy is associated with a reduction in SC size and a loss of physiologic SC dilatation during accommodative effort, which may reflect a reduction in outflow facility and may contribute to the development of glaucoma after lensectomy.
Abstract 226: Neuromuscular Blockade in Post--Cardiac Arrest: Practice Patterns and Association with Outcome Measures
Authors: Justin D Salciccioli, Michael N Cocchi, Jon C Rittenberger, Mary Ann Peberdy, Benjamin S Abella, David F Gaieski, Joseph P Ornato, Clifton Callaway, John N Clore, Shiva Gautam, Michael W Donnino
Journal: Circulation (2012)

Introduction: Neuromuscular blockade (NMB) may improve outcomes in acute respiratory distress syndrome. In post-cardiac arrest (CA) patients receiving therapeutic hypothermia (TH) NMB is sometimes used to prevent shivering. Whether NMB improves outcomes from CA is unknown. Objective: To assess the association between NMB and outcomes from CA. Methods: A post-hoc analysis of a prospective multicenter observational study of adult CA from 6/2011 to 3/2012. Inclusion criteria were: adult (&gt; 18 years), out-of-hospital CA, return of spontaneous circulation (ROSC), comatose following ROSC. Traumatic CA were excluded. Patient characteristics, vital signs, laboratory data and discharge data were recorded. The exposure of interest was NMB within 24hrs of ROSC. The primary outcome was in-hospital survival. Secondary outcomes were neurological status (Modified Rankin [MR]), oxygenation (PaO 2 :FiO 2 ), and lactate clearance. We used simple descriptive statistics to describe the study population, Chi-square for unadjusted tests, and multivariable (age, downtime, rhythm, SOFA score) logistic regression or linear mixed-models for the relationship between NMB and outcomes. Results: 111 patients were analyzed. The median age was 63 years (IQR: 50 - 75) and 41% were female. TH was completed in 97% and overall survival was 47%. 60% received any NMB within 12hrs of ROSC and 69% received any NMB within 24hrs of ROSC. With 12hrs of sustained NMB, the crude survival rate was 15/21 (71%) compared to 37/90 (41%) without 12hrs of NMB (p = 0.01). With 24hrs of sustained NMB, the crude survival rate was 14/18 (78%) compared to 38/93 (41%) in patients without sustained NMB (p = 0.004). There was a trend toward improved neurologic outcome with NMB: MR 0 - 2: 44% vs. 23% (p = 0.05). After multivariable adjustment, NMB was not associated with survival (adjusted OR: 3.35, 95% CI: 0.83 - 13.57, p = 0.09; H-L goodness-of-fit: p = 0.95). Sustained NMB improved lactate clearance over 24hrs (adjusted p = 0.03). There was no effect of NMB on PaO 2 :FiO 2 (p = 0.5). Conclusion: In post-CA early NMB is common. Early, sustained NMB is associated with improved lactate clearance and a trend in improved survival, but no effect was observed on PaO 2 :FiO 2 ratio.
Abstract 14490: Outcome of Symptomatic Partial Atrioventricular Septal Defect Requiring Repair During Infancy. Multicentric Study.
Authors: Sylvia Krupickova, Gareth Morgan, Mun Hong Cheang, Olivier Ghez, Michael Rigby, Andrea Battista, Ariana Spanaki, Rodney Franklin, Jan Marek, Alain Fraisse
Journal: Circulation (2016)

Introduction: Patients with symptomatic partial atrioventricular septal defect (pAVSD) requiring early surgical repair are thought to be at greater risk. However, the outcome and risk profile of this cohort of patients is currently poorly defined. Hypothesis: The aim of this study was to investigate the outcome of symptomatic pAVSD infants requiring early repair and to identify risk factors which may predict mortality and left atrioventricular valve (LAVV) reoperation. Methods: This multicenter study recruited 51 patients (24 female) in 3 tertiary centres. The inclusion criteria were: i) pAVSD (including cases with negligible ventricular component), ii) heart failure unresponsive to treatment, iii) biventricular repair during the first year of life. Medical notes and operative notes were retrospectively analysed for demographic, perioperative and echocardiographic data. Results: The median age at the corrective surgery was 179 (range 0-357) days. Sixteen patients (31%) had unfavorable anatomy of the LAVV:...
A Child With Multiple Hypopigmented Macules on the Abdomen
Authors: Min Wha Choi, June Hyunkyung Lee, Tae Young Han
Journal: JAMA Dermatology (2018)

A child presented with multiple, asymptomatic, scattered white macules on the lower abdomen and pubic area, which were present at birth and had gradually increased in size and number; there was no history of any systemic disorder and no family history of similar lesions. What is your diagnosis?
Population-level analysis of <i>Blastocystis</i> subtype prevalence and variation in the human gut microbiota
Authors: Raul Y Tito, Samuel Chaffron, Clara Caenepeel, Gipsi Lima-Mendez, Jun Wang, Sara Vieira-Silva, Gwen Falony, Falk Hildebrand, Youssef Darzi, Leen Rymenans, Chloë Verspecht, Peer Bork, Severine Vermeire, Marie Joossens, Jeroen Raes
Journal: Gut (2018)

Human gut microbiome studies are mainly bacteria- and archaea-oriented, overlooking the presence of single-cell eukaryotes such as
PD-L1 expression, tumor mutational burden, and response to immunotherapy in patients with MET exon 14 altered lung cancers
Authors: J.K. Sabari, G.C. Leonardi, C.A. Shu, R. Umeton, J. Montecalvo, A. Ni, R. Chen, J. Dienstag, C. Mrad, I. Bergagnini, W.V. Lai, M. Offin, K.C. Arbour, A.J. Plodkowski, D.F. Halpenny, P.K. Paik, B.T. Li, G.J. Riely, M.G. Kris, C.M. Rudin, L.M. Sholl, M. Nishino, M.D. Hellmann, N. Rekhtman, M.M. Awad, A. Drilon
Journal: Annals of Oncology (2018)

MET exon 14 alterations are actionable oncogenic drivers. Durable responses to MET inhibitors are observed in patients with advanced MET exon 14-altered lung cancers in prospective trials. In contrast, the activity of immunotherapy, PD-L1 expression and tumor mutational burden (TMB) of these tumors and are not well characterized.Patients with MET exon 14-altered lung cancers of any stage treated at two academic institutions were identified. A review of clinicopathologic and molecular features, and an analysis of response to single-agent or combination immune checkpoint inhibition were conducted. PD-L1 immunohistochemistry was carried out and TMB was calculated by estimation from targeted next-generation sequencing panels.We identified 147 patients with MET exon 14-altered lung cancers. PD-L1 expression of 0%, 1%-49%, and ≥50% were 37%, 22%, and 41%, respectively, in 111 evaluable tumor samples. The median TMB of MET exon 14-altered lung cancers was lower than that of unselected non-small-cell lung cancers (NSCLCs) in both independently evaluated cohorts: 3.8 versus 5.7 mutations/megabase (P < 0.001, n = 78 versus 1769, cohort A), and 7.3 versus 11.8 mutations/megabase (P < 0.001, n = 62 versus 1100, cohort B). There was no association between PD-L1 expression and TMB (Spearman's rho=0.18, P = 0.069). In response-evaluable patients (n = 24), the objective response rate was 17% (95% CI 6% to 36%) and the median progression-free survival was 1.9 months (95% CI 1.7-2.7). Responses were not enriched in tumors with PD-L1 expression ≥50% nor high TMB.A substantial proportion of MET exon 14-altered lung cancers express PD-L1, but the median TMB is lower compared with unselected NSCLCs. Occasional responses to PD-1 blockade can be achieved, but overall clinical efficacy is modest.
Uncommon Imaging Findings of Inflammatory Myofibroblastic Tumor
Authors: Hao Fu, Xiuyu Guo, Zijun Chen, Hua Wu, Haojun Chen
Journal: Clinical Nuclear Medicine (2018)

The inflammatory myofibroblastic tumor (IMT) is a rare stromal tumor with diverse imaging findings. The present study describes a case of contrast-enhanced CT and F-FDG PET/CT manifestations of an IMT with diffuse omental and mesenteric thickening and swelling in the entire abdominal cavity. It is extremely rare to observe such imaging features in the extrapulmonary IMT. Furthermore, this case emphasizes that F-FDG PET/CT holds the potential for demonstrating IMT lesion extent and correctly identifying appropriate sites for biopsy.
Abstract 12769: Amplitude-Spectral Area of the Ventricular Fibrillation Waveform and Chest Compression Quality in Witnessed and Unwitnessed Out-Of-Hospital Cardiac Arrest: Can We Predict Who is Unlikely to Survive?
Authors: Julia Indik, Zacherie Conover, Meghan McGovern, Annemarie Silver, Daniel Spaite, Bentley Bobrow, Karl Kern
Journal: Circulation (2014)

Background: Previous investigations in human out of hospital cardiac arrest (OHCA) due to ventricular fibrillation (VF) have shown that the frequency-based waveform characteristic, amplitude spectral area (AMSA) predicts defibrillation success and is associated with survival to hospital discharge. We evaluated the relative strength of factors associated with hospital discharge including witnessed/unwitnessed status, chest compression (CC) quality and AMSA. We then investigated if there is a threshold value for AMSA that can identify patients who are unlikely to survive. Methods: Adult OHCA patients (age ≥18), with initial rhythm of VF from an Utstein-Style database (collected from 2 EMS systems) were analyzed. AMSA was measured from the waveform immediately prior to each shock, and averaged for each individual subject (AMSA-ave). Univariate and stepwise multivariable logistic regression, and receiver-operator-characteristic (ROC) analyses were performed. Factors analyzed: age, sex, witnessed status, time from dispatch to monitor/defibrillator application, number of shocks, mean CC rate, depth, and release velocity (RV). Results: 140 subjects were analyzed, [104 M (74%), age 62 ± 14 yrs, witnessed 65%]. Survival was 38% in witnessed and 16% in unwitnessed arrest. In univariate analyses, age (P=0.001), witnessed status (P=0.009), AMSA-ave (P&lt;0.001), mean CC depth (P=0.025), and RV (P&lt; 0.001) were associated with survival. Stepwise logistic regression identified AMSA-ave (P&lt;0.001), RV (P=0.001) and age (P=0.018) as independently associated with survival. The area under the curve (ROC analysis) was 0.849. The probability of survival was &lt; 5% in witnessed arrest for AMSA-ave &lt; 5 mV-Hz, and in unwitnessed arrest for AMSA-ave &lt; 15 mV-Hz. Conclusion: In OHCA with an initial rhythm of VF, AMSA-ave and CC RV are highly associated with survival. Further study is needed to evaluate whether AMSA-ave may be useful to identify patients highly unlikely to survive.