tbuckley/cabot-search huggingface dataset:
Prevalence of cerebral palsy in Uganda: a population-based study
Authors: Angelina Kakooza-Mwesige, Carin Andrews, Stefan Peterson, Fred Wabwire Mangen, Ann Christin Eliasson, Hans Forssberg
Journal: The Lancet Global Health (2017)

BackgroundFew population-based studies of cerebral palsy have been done in low-income and middle-income countries. We aimed to examine cerebral palsy prevalence and subtypes, functional impairments, and presumed time of injury in children in Uganda.MethodsIn this population-based study, we used a nested, three-stage, cross-sectional method (Iganga-Mayuge Health and Demographic Surveillance System [HDSS]) to screen for cerebral palsy in children aged 2–17 years in a rural eastern Uganda district. A specialist team confirmed the diagnosis and determined the subtype, motor function (according to the Gross Motor Function Classification System [GMFCS]), and possible time of brain injury for each child. Triangulation and interviews with key village informants were used to identify additional cases of suspected cerebral palsy. We estimated crude and adjusted cerebral palsy prevalence. We did χ2 analyses to examine differences between the group screened at stage 1 and the entire population and regression analyses to investigate associations between the number of cases and age, GMFCS level, subtype, and time of injury.FindingsWe used data from the March 1, 2015, to June 30, 2015, surveillance round of the Iganga-Mayuge HDSS. 31 756 children were screened for cerebral palsy, which was confirmed in 86 (19%) of 442 children who screened positive in the first screening stage. The crude cerebral palsy prevalence was 2·7 (95% CI 2·2–3·3) per 1000 children, and prevalence increased to 2·9 (2·4–3·6) per 1000 children after adjustment for attrition. The prevalence was lower in older (8–17 years) than in younger (<8 years) children. Triangulation added 11 children to the cohort. Spastic unilateral cerebral palsy was the most common subtype (45 [46%] of 97 children) followed by bilateral cerebral palsy (39 [40%] of 97 children). 14 (27%) of 51 children aged 2–7 years had severe cerebral palsy (GMFCS levels 4–5) compared with only five (12%) of 42 children aged 8–17 years. Few children (two [2%] of 97) diagnosed with cerebral palsy were born preterm. Post-neonatal events were the probable cause of cerebral palsy in 24 (25%) of 97 children.InterpretationCerebral palsy prevalence was higher in rural Uganda than in high-income countries (HICs), where prevalence is about 1·8–2·3 cases per 1000 children. Children younger than 8 years were more likely to have severe cerebral palsy than older children. Fewer older children than younger children with cerebral palsy suggested a high mortality in severely affected children. The small number of preterm-born children probably resulted from low preterm survival. About five times more children with post-neonatal cerebral palsy in Uganda than in HICs suggested that cerebral malaria and seizures were prevalent risk factors in this population.FundingSwedish Research Council, Promobilia.
Idiopathic pulmonary fibrosis: lessons from clinical trials over the past 25 years
Authors: Ganesh Raghu
Journal: European Respiratory Journal (2017)

Idiopathic pulmonary fibrosis (IPF) is a progressive and ultimately fatal disease. A major breakthrough in treatment came when, after decades of clinical trials which failed to identify an efficacious treatment regimen, two therapies were successful in Phase-III trials. The advent of these therapies, nintedanib and pirfenidone, meant that for the first time IPF patients had two treatment options that could reduce disease progression. This review summarises the key lessons to be obtained from the clinical trials that led to the current international clinical practice guidelines for the treatment of IPF and provides insights for the design of future clinical trials that are needed if we are to improve outcomes that are clinically meaningful to IPF patients.
Characterization of disease burden, comorbidities, and treatment use in a large, US-based cohort: Results from the Corrona Psoriasis Registry
Authors: Bruce Strober, Chitra Karki, Marc Mason, Ning Guo, Stacey H. Holmgren, Jeffrey D. Greenberg, Mark Lebwohl
Journal: Journal of the American Academy of Dermatology (2017)

BackgroundPsoriasis is an immunodysregulatory inflammatory disease associated with comorbidities affecting quality of life. With the advent of new treatments, there is growing need to assess the long-term safety and efficacy of treatments in a real-world setting.ObjectiveThe objective of the Corrona Psoriasis Registry is to study the comparative safety and efficacy of Food and Drug Administration–approved biologic treatments.MethodsA cross-sectional study of patients enrolled in the registry, who initiated or switched to a systemic therapy at enrollment or previous 12 months. Descriptive characteristics (demographics, clinical and patient-reported outcomes, comorbidities, and treatment history) were examined at registry enrollment.ResultsAs of October 1, 2016, there were 1942 patients enrolled in the registry: 23% on apremilast, 4% on other nonbiologic systemic medications, 25% on interleukin (IL) 17A inhibitors, 22% on an IL-12/23 inhibitor, and 26% on tumor necrosis factor inhibitors. Overall, mean disease duration was 15.6 years, and 40% had a concurrent psoriatic arthritis diagnosis. About 66% had >3% body surface area involvement and 49% had a moderate or severe Investigator Global Assessment.LimitationsSelection and channeling bias can result in potential confounding that needs to be addressed in modeled analyses.ConclusionThis disease-based registry cohort represents a population exposed to multiple therapies, long disease duration, and multiple comorbidities and can be used to examine comparative safety and efficacy of various therapies.
Hepatic neuregulin 4 signaling defines an endocrine checkpoint for steatosis-to-NASH progression
Authors: Liang Guo, Peng Zhang, Zhimin Chen, Houjun Xia, Siming Li, Yanqiao Zhang, Sune Kobberup, Weiping Zou, Jiandie D. Lin
Journal: Journal of Clinical Investigation (2017)

Nonalcoholic steatohepatitis (NASH) is characterized by progressive liver injury, inflammation, and fibrosis; however, the mechanisms that govern the transition from hepatic steatosis, which is relatively benign, to NASH remain poorly defined. Neuregulin 4 (Nrg4) is an adipose tissue–enriched endocrine factor that elicits beneficial metabolic effects in obesity. Here, we show that Nrg4 is a key component of an endocrine checkpoint that preserves hepatocyte health and counters diet-induced NASH in mice. Nrg4 deficiency accelerated liver injury, fibrosis, inflammation, and cell death in a mouse model of NASH. In contrast, transgenic expression of Nrg4 in adipose tissue alleviated diet-induced NASH. Nrg4 attenuated hepatocyte death in a cell-autonomous manner by blocking ubiquitination and proteasomal degradation of c-FLIPL, a negative regulator of cell death. Adeno-associated virus–mediated (AAV-mediated) rescue of hepatic c-FLIPL expression in Nrg4-deficent mice functionally restored the brake for steatosis to NASH transition. Thus, hepatic Nrg4 signaling serves as an endocrine checkpoint for steatosis-to-NASH progression by activating a cytoprotective pathway to counter stress-induced liver injury.
An Assessment in SpondyloArthritis International Society (ASAS)-endorsed definition of clinically important worsening in axial spondyloarthritis based on ASDAS
Authors: Anna Molto, Laure Gossec, Bhowmik Meghnathi, Robert B M Landewé, Désirée van der Heijde, Pamir Atagunduz, Bassel Kamal Elzorkany, Nurullah Akkoc, Uta Kiltz, Jieruo Gu, James Cheng Chung Wei, Maxime Dougados
Journal: Annals of the Rheumatic Diseases (2017)

Introduction In a previous phase, 12 draft definitions for clinically important worsening in axial spondyloarthritis (axSpA) were selected, of which 3 were based on absolute changes in Ankylosing Spondylitis Disease Activity Score (ASDAS)-CRP (ASDAS). The objective here was to select the best cut-off for ASDAS for clinically important worsening in axSpA for use in clinical trials and observational studies. Methods An international longitudinal prospective study evaluating stable patients with axSpA was conducted. Data necessary to calculate ASDAS were collected at two consecutive visits (spaced 7 days to 6 months). Sensitivity and specificity of the three cut-offs for change in ASDAS were tested against the patient’s subjective assessment of worsening as the external standard (ie, the patient reporting that he had worsened and felt a need for treatment intensification). Final selection was made by a consensus and voting procedure among Assessment of SpondyloArthritis International Society (ASAS) members. Results In total, 1169 patients with axSpA were analysed: 64.8% were male and had a mean age of 41.7 (SD 12.4) years. At the second visit, 127 (10.9%) patients judged their situation as worsened. Sensitivity and specificity for an increase of at least 0.6, 0.9 and 1.1 ASDAS points to detect patient-reported worsening were 0.55 (Se) and 0.91 (Sp), 0.38 (Se) and 0.96 (Sp), and 0.33 (Se) and 0.98 (Sp), respectively. The ASAS consensus was to define clinically important worsening as an increase in ASDAS of at least 0.9 points. Conclusion This data-driven ASAS consensus process resulted in an ASDAS-based cut-off value defining clinically important worsening in axSpA for use in trials.
Human Epidermal Growth Factor Receptor 2 as a Molecular Biomarker for Metastatic Colorectal Cancer
Authors: Andrea Sartore-Bianchi, Silvia Marsoni, Salvatore Siena
Journal: JAMA Oncology (2017)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Oncology HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Oncology journal
TCT-469 Revascularization strategies in STEMI patients with multivessel disease and high risk of stent restenosis: 2-year clinical outcomes
Authors: Mariusz Tomaniak, Dominika Klimczak, Maria Tovar, Joost Daemen, Jeroen Wilschut, Peter de Jaegere, Felix Zijlstra, Nicolas Van Mieghem, Roberto Diletti
Journal: Journal of the American College of Cardiology (2017)
65 Localised cavity formation in oesophageal carcinoma
Authors: DJ McKernan, Jbm Doyle, J McGoran, R Kennedy, I Mainie
Journal: Gut (2017)

Background  Oesophageal cavity formation secondary to oesophageal carcinoma is a rare complication, with significant morbidity and mortality.  We describe two cases treated with a partially covered Cook stent for symptom control and palliation.  Aim  To describe the management of oesophageal cavity formation secondary to oesophageal carcinoma.  Method  Retrospective case notes review.  Results  Case 1-A 67 year old gentleman presented with dysphagia. OGD showed a squamous cell carcinoma in the lower oesophagus with imaging showing no metastatic disease. Four weeks after diagnosis he deteriorated rapidly with pyrexia and malaise.  Repeat OGD showed a large cavity with mediastinal structures seen. A 12 cm partialy covered Cook stent was deployed. Subsequent CT Chest revealed no distal leak/fistula, and he was discharged after 5 days with nutritional optimisation. He was palliated in the community and died almost 4 months after his stent insertion.  Case 2-A 84 year old gentleman with known metastatic oesophageal adenocarcinoma who had undergone palliative chemo/radiotherapy presented with regurgitation of food.  OGD showed a cavity with mediastinal structures seen. A 12 cm partially covered Cook stent was deployed. Subsequent CT Chest revealed a small cavity with no distal leak/fistula, and was discharged after 4 days. He was palliated in the community, and died 13 months after his procedure.  Conclusions  Oesophageal cavity formation is a rare complication of oesophageal carcinoma. Management options include surgical and none surgical conservation options.  We describe successful none operative management via partially covered stent insertion, facilitating palliation and reducing morbidity with significant improvement in quality of life.
Landscape of Driver Mutations and Their Clinical Impacts in Pediatric Acute Lymphoblastic Leukemia
Authors: Hiroo Ueno, Kenichi Yoshida, Yuka Yamashita, Yusuke Shiozawa, Tomomi Ishida, Hiroyuki Tsukamoto, Yuichi Shiraishi, Hiroko Tanaka, Kenichi Chiba, Takao Deguchi, Atsushi Sato, Yoshiko Hashii, Sadao Tokimasa, Junichi Hara, Yoshiyuki Kosaka, Koji Kato, Toshihiko Imamura, Satoru Miyano, Seishi Ogawa, Keizo Horibe, Masashi Sanada
Journal: Blood (2016)
68Ga-DOTATATE Uptake in a Soft Tissue Metastasis From Clear Cell Renal Cell Cancer
Authors: S. Vamadevan, K. Le, L. Shen, A. Stevanovic, H. Loh, R. Mansberg
Journal: Clinical Nuclear Medicine (2017)

A 64-year-old man with a history of metastatic clear cell renal cell cancer was referred for progress Ga-DOTATATE PET/CT imaging. Ga-DOTATATE PET/CT imaging demonstrated increased DOTATATE uptake (SUVmax 13.8) in the left thigh localized to a soft tissue lesion. Cytopathology of the resected lesion was in keeping with a clear cell renal cell cancer metastasis. This case illustrates that Ga-DOTATATE accumulation in a soft tissue lesion can be due to a clear cell renal cell cancer metastasis.
Racial Differences in Prevalence and Risk for Intracranial Atherosclerosis in a US Community-Based Population
Authors: Ye Qiao, Fareed K. Suri, Yiyi Zhang, Li Liu, Rebecca Gottesman, Alvaro Alonso, Eliseo Guallar, Bruce A. Wasserman
Journal: JAMA Cardiology (2017)

Intracranial atherosclerotic disease (ICAD) is an important cause of stroke; however, little is known about racial differences in ICAD prevalence and its risk factors.To determine racial differences in ICAD prevalence and the risk factors (both midlife and concurrent) associated with its development in a large, US community-based cohort.Analysis of 1752 black and white participants recruited from the Atherosclerosis Risk in Communities (ARIC) cohort study who underwent 3-dimensional intracranial vessel wall magnetic resonance imaging from October 18, 2011 to December 30, 2013; data analysis was performed from October 18, 2011 to May 13, 2015.Midlife and concurrent cardiovascular risk factors.Intracranial plaque presence, size (maximum normalized wall index) and number were assessed by vessel wall magnetic resonance imaging. Midlife and concurrent vascular risk factor associations were determined by Poisson regression (plaque presence), negative binominal regression (plaque number), and linear regression (plaque size), and compared between races.Of the 1752 study participants (mean [SD] age, 77.6 [5.3] years; range, 67-90 years), 1023 (58.4%) were women and 518 (29.6%) were black. Black men had the highest prevalence (50.9% vs 35.9% for black women, 35.5% for white men, and 30.2% for white women; P < .001) and the highest frequency (22.4% vs 12.1% for black women, 10.7% for white men, and 8.7% for white women; P < .01) of multiple plaques. Prevalence increased with age, reaching 50% before ages 68, 84, and 88 years in black men, white men, and white women, respectively (ICAD prevalence remained <50% in black women). Midlife hypertension and hyperlipidemia were associated with 29% (prevalence ratio [PR], 1.29; 95% CI, 1.08-1.55) and 18% (PR, 1.18; 95% CI, 0.98-1.42), respectively, increased ICAD prevalence with no significant differences between races. Midlife hypertension was also associated with larger plaques (1.11 higher mean maximum normalized wall index; 95% CI, 0.21-2.01). Midlife smoking and diabetes were associated with increased risk of ICAD in black individuals (102% [PR, 2.02; 95% CI, 1.12-3.63] and 57% [PR, 1.57; 95% CI, 1.13- 2.19], respectively), but not in white participants (P < .05 interaction by race).The prevalence of ICAD was highest in black men. Midlife smoking and diabetes were strongly associated with late-life ICAD in blacks only, whereas midlife hypertension and hyperlipidemia were associated with late-life ICAD in both races. These associations may help to explain racial differences in US stroke rates and offer insight into preventive risk-factor management strategies.
TCT-645 N-terminal Pro-B-type Natriuretic Peptide complements the ACEF Score in Predicting 3-Year Mortality following Acute Myocardial Infarction
Authors: JaeHyuk Jang, Young Kyoung Sa, Kwan Yong Lee, Mineok Chang, Doo soo Jeon, Young Su Lee, ByungHo Kim
Journal: Journal of the American College of Cardiology (2017)
Hepatitis C virus-induced natural killer cell proliferation involves monocyte-derived cells and the OX40/OX40L axis
Authors: Julia Pollmann, Jana-Julia Götz, Daniel Rupp, Otto Strauss, Markus Granzin, Oliver Grünvogel, Pascal Mutz, Catharina Kramer, Felix Lasitschka, Volker Lohmann, Niklas K. Björkström, Robert Thimme, Ralf Bartenschlager, Adelheid Cerwenka
Journal: Journal of Hepatology (2017)
Abstract 12649: Long-Term Results of Early Surgery Versus Conventional Treatment for Infective Endocarditis Trial
Authors: Duk-Hyun Kang, Sahmin Lee, Yong-Jin Kim, Dae-Hee Kim, Jong-Min Song, Kee-Joon Choi, Jae-Kwan Song, Jae-Won Lee, Joo-Hee Zo
Journal: Circulation (2015)

Introduction: Although event-free survival in patients with infective endocarditis (IE) and large vegetations has been shown to be significantly higher at 6 months in those receiving early surgery vs. conventional treatment, long-term data are lacking. Hypothesis: We tried to compare the long-term outcomes of early surgery with those of a conventional treatment strategy. Methods: The Early Surgery versus Conventional Treatment in Infective Endocarditis (EASE) trial randomly enrolled 76 patients (51 men, 47±16 years) from 2006 through 2011 with left-sided native valve IE accompanied by severe valve disease and a diameter of vegetation &gt; 10 mm. The end points were all-cause death and the composite of death, embolic events and recurrence of IE that occurred within 4 years after enrollment. Results: All patients in the early surgery group (n=37) underwent valve surgery within 48 hours, and 30 (77%) patients in the conventional treatment group (n=39) underwent surgery during the initial hospitalization. During median follow-up of 5.8 years (IQR, 4.8 to 7.1), 4 deaths occurred in the early surgery group and 5 deaths, 10 embolic events and 1 recurrence of IE in the conventional treatment group. There were no significant differences between the early surgery and the conventional treatment group in all-cause mortality (8.1% and 7.7% at 4 years, respectively; HR 1.04; 95% CI, 0.21 to 5.15; P=0.96). At 4 years, the rate of the composite of death from any cause, embolic events or recurrence of IE was 3.7% in the early surgery group as compared with 30.8% in the conventional treatment group (HR, 0.22; 95% CI, 0.06-0.79; P=0.02). The estimated actuarial rate of end points was significantly lower in the early surgery group than in the conventional treatment group (Figure). Conclusions: In the EASE trial, the beneficial effect of early surgery in IE patients with large vegetations persisted during long-term follow-up, and late clinical outcome after surgery was excellent in survivors of IE.
The pathogenesis of cutaneous squamous cell carcinoma in organ transplant recipients
Authors: C.A. Harwood, A.E. Toland, C.M. Proby, S. Euvrard, G.F.L. Hofbauer, M. Tommasino, J.N. Bouwes Bavinck
Journal: British Journal of Dermatology (2017)

The pathogenesis of keratinocyte carcinoma following organ transplantation is multifactorial, and recent evidence suggests a complex and often synergistic interplay between the carcinogenic effects of ultraviolet radiation, compromised immune surveillance, direct pro‐ and anticarcinogenic effects of drugs, oncogenic viruses (in particular, beta‐genus human papillomaviruses) and host genetic susceptibility factors. We present an overview of those factors for which there is currently the most convincing evidence and highlight important gaps in our knowledge. In particular, a clear understanding of the interdependence and relative contributions of these co‐factors is currently lacking, yet has important implications for rational development of clinically relevant biomarkers and targeted strategies for treatment and prevention of post‐transplant keratinocyte cancers.
Surveillance colonoscopy in Austria: Are we following the guidelines?
Authors: Irina Gessl, Elisabeth Waldmann, Martha Britto-Arias, Daniela Penz, Eleonore Pablik, Michael Trauner, Monika Ferlitsch
Journal: Endoscopy (2017)

Abstract Background and study aim The European guidelines for quality assurance in colorectal cancer screening and diagnosis contain postpolypectomy surveillance recommendations. They recommend follow-up intervals depending on the findings at index colonoscopy, and divide patients into a low-, intermediate- or high-risk group. The aim of this study was to assess the adherence of Austrian endoscopists to the European guidelines and to determine whether sending a reminder letter resulted in better adherence. Methods A single reminder letter containing the guidelines was sent to all endoscopists who participated in the Certificate of Quality for Screening Colonoscopy program in Austria. Adherence was assessed before and after the letter had been sent. Factors associated with adherence were investigated. Results We found poor baseline adherence to the guidelines. After the reminder letter, the adherence slightly improved in the low-risk group, but did not change in the intermediate-risk or high-risk groups. An adenoma detection rate of at least 20 % was associated with higher adherence rates. Generally, internists and hospitals showed better adherence compared with surgeons and private practices, respectively, both before and after the reminder letter. Conclusion A single reminder letter was not enough to improve the poor adherence to the European postpolypectomy surveillance guidelines. Thus, future studies are required to identify and eliminate all factors responsible for nonadherence to postpolypectomy guidelines in order to reach the goal of a safe, effective, and cost-effective colorectal cancer prevention tool in the near future.