tbuckley/cabot-search huggingface dataset:
Abstract 15338: Determinants of Significant Paravalvular Regurgitation After Transcatheter Aortic Valve Implantation: Impact of Different Iterations of Devices and Degree of Valve Calcification
Authors: William K Kong, Philippe van Rosendael, Frank van der Kley, Arend de Weger, Vasileois Kamperidis, Madelien Regeer, Nina Ajmone Marsan, Jeroen Bax, Victoria Delgado
Journal: Circulation (2015)

Objectives: The aim of this study is to assess the impact of iterations of balloon expandable valves (Sapien, Sapien XT and Sapien 3) and degree of aortic valve calcification (AVC) on the severity of paravalvular regurgitation (PVR) after transcatheter aortic valve implantation (TAVI). Hypothesis: The iterations of the Sapien prosthesis might impact the frequency and grade of PVR. Methods: Multidetector computed tomography (MDCT) and echocardiographic examinations were performed in 262 patients (127 men, 81±7 years old, logistic EuroScore of 21±13%) who underwent TAVI with 23- and 26-mm balloon expandable valves. Patients receiving a 29-mm valves or undergoing valve-in-valve procedure were excluded. The degree of AVC was calculated with MDCT. PVR grade was assessed with echocardiography. The cover index was calculated as (prosthesis area- MDCT annulus area)/prosthesis area. Results: Sapien, Sapien XT and Sapien 3 prostheses were implanted in respective 103 (39%), 105 (40%) and 54 (21%) patients. Significant PVR (≥moderate) occurred in 14% of patients receiving the Sapien prosthesis and 10% receiving a Sapien XT prosthesis but none in patients of the Sapien 3 group (p=0.019) (Figure 1). Across the groups (Sapien vs. Sapien XT vs. Sapien 3) the aortic annulus size (4.4±0.8 cm2 vs. 4.4±0.7cm2 vs. 4.3±0.7cm2, respectively; p=0.2), degree of calcification (7.7±0.6 Au vs. 7.8±0.7 Au vs. 8.0±0.6 Au, respectively; p=0.1) and cover index (88±16% vs. 90±11% vs. 90±10%, respectively; p=0.4) were comparable. Significant PVR was independently associated with higher degree of AVC (OR 2.89 p=0.02)and cover index (OR 1.08, p=0.03) after adjusting for age, body surface area, gender, aortic annulus area and prosthesis iteration. Conclusions: The incidence of ≥moderate PVR significantly decreased over time with improvement in valve design. Significant PVR after TAVI remains independently associated with degree of AVC and cover index independently of the prosthesis iteration.
Attitudes and beliefs of a mandatory palliative care rotation by hematology and medical oncology fellows at a major comprehensive cancer center.
Authors: Suresh Reddy, Kimberson Cochien Tanco, Diane D. Liu, Janet L. Williams, Sriram J. Yennu, Robert A. Wolff, Eduardo Bruera
Journal: Journal of Clinical Oncology (2018)

98 Background: The ACGME requires incorporating palliative care (PC) competencies into Hematology and Medical Oncology (HMO) fellowship curriculum. The primary aim of this study was to determine the attitudes and beliefs regarding PC of HMO fellows who completed a 4 week mandatory PC rotation. Methods: The rotation included a 4 week standardized curriculum covering all PC domains and all HMO fellows rotated in acute palliative care unit (APCU), consult service and outpatient clinic. HMO fellows were provided educational materials and attended all didactic sessions. All HMO fellows from 2004 to 2017 were sent a 39 item survey adapted from published studies on oncology trainee perception of PC. Results: 77/105 (73%) HMO fellows completed the survey (median age of 40 years, 57% males and 82% practicing in an academic setting). The following were reported to improve after the PC rotation: (a) assessment and management of symptoms (98%); (b) opioid prescription (89%), opioid rotation (78%) and identification of opioid side effects (87%); (c) communication with patients and families (91%), advance care planning discussion (88%), DNR discussion (88%); (d) comfort discussing ethical issues (74%); (e) ability to cope with stress of terminal illness (58%). Strongly agree to agree was expressed by 76 (98%) for improved knowledge of symptom assessment &amp; management vs 57 (74%) for ethics (p = 0.0001) and 45 (58%) for coping with stress of terminal illness (p = 0.0001). HMO fellows were more likely to refer patients to PC (83%) for uncontrolled symptoms (97%), psychological distress (88%) or with advanced disease regardless of symptoms (56%) after the rotation. The APCU rotation was felt to be most beneficial (93%). The PC rotation educational experience was felt to be either far better or better (53%) or same (45%) as other oncology rotations. 98% would recommend PC rotations to other HMO fellows and 95% felt rotation should be mandatory. Conclusions: HMO fellows reported PC rotation improved their knowledge in all PC domains, felt PC rotation was far better to better than other oncology rotations, and were more likely to refer patients to PC.
AB1025 Monosodium urate crystal formations from tophi in synovial fluid
Authors: E. Pascual, M. Andrés, F. Sivera
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> At the joints MSU crystals form primarily at the cartilage surface; on occasions also tophi form at joint margins. Most often monosodium urate (MSU) crystals at the synovial fluid (SF) are found isolated. In tophi MSU crystals often show as spherulitic formations, fanning away from a central point<sup>1</sup> (Figure 1, 200x, polarised light). We have detected in synovial fluid formations of MSU crystals with an organisation indicative that they formed in tophi, draining later to the fluid. The formations also help to understand how crystals formed in tophi. <h3>Methods</h3> Our photographic archive of SF have been reviewed. <h3>Results</h3> Two types of formations are found. A) A spherulitic formation where the crystals fan radially as in the segment of a sphere (Figure, middle, 600x, polarised light). B) Paired crystals bound longitudinally to each other (Figure, right, 600x, phase contrast). <h3>Conclusions</h3> At tophi spherulitic crystal formations are usual (figure 1) in which MSU crystals radiate as in a fan. <b>A)</b> Pieces of these same formations, seen as the segment of a sphere, are occasionally seen in SF (Figure 2), usually containing a large number of crystals and suggesting that they have drained from a tophus. Likely to build these formations, the initial crystals served as a template on which successive crystals formed by epitaxia, – the crystal formation method of least energy requirement -, explaining the rapid growth that tophi can present. Their unimpeded migration to the joint cavity suggest that they formed freely and unconnected to any organic structure within the tophus. <b>B)</b> In SF containing large numbers of crystals, paired crystals – two crystals lying side by side and usually of similar length and width – are also found. Their paired position likely indicates that one served as template to the other, or that they grew together sharing a crystal net – twin crystals. In all, these MSU crystal formations appear to indicate that besides the crystals formed in the surface of joint cartilages, the content of tophi can drain into the joint fluid, also contributing to the presence of crystals in it; the periarticular tophi frequently seen in ultrasound appear as the likely source for these formations. <h3>Reference</h3> [1] Nat Rev Rheumatol. 2015;11:725. <h3>Disclosure of Interest</h3> None declared
Three-Year Follow-up of Keynote-087: Pembrolizumab Monotherapy in Relapsed/Refractory Classic Hodgkin Lymphoma
Authors: Pier Luigi Zinzani, Hun Ju Lee, Philippe Armand, Nathalie Johnson, Pauline Brice, John Radford, Vincent Ribrag, Daniel Molin, Theodoros P. Vassilakopoulos, Akihiro Tomita, Bastian Von Tresckow, Margaret A. Shipp, Alex F. Herrera, Jianxin Lin, Eunhee Kim, Mohammed Farooqui, Patricia Marinello, Craig H. Moskowitz
Journal: Blood (2019)
Patch Testing and Allergen-Specific Inhibition in a Patient Taking Dupilumab
Authors: Jodie Raffi, Nina Botto
Journal: JAMA Dermatology (2018)

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 Dermatology 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 Dermatology journal
Association of Opioid Prescriptions From Dental Clinicians for US Adolescents and Young Adults With Subsequent Opioid Use and Abuse
Authors: Alan R. Schroeder, Melody Dehghan, Thomas B. Newman, Jason P. Bentley, K. T. Park
Journal: JAMA Internal Medicine (2018)

<h3>Importance</h3> Through prescription writing, dental clinicians are a potential source of initial opioid exposure and subsequent abuse for adolescents and young adults. <h3>Objective</h3> To examine the association between index dental opioid prescriptions from dental clinicians for opioid-naive adolescents and young adults in 2015 and new persistent use and subsequent diagnoses of abuse in this population. <h3>Design, Setting, and Participants</h3> This retrospective cohort study examined outpatient opioid prescriptions for patients aged 16 to 25 years in the Optum Research Database in 2015. Prescriptions were linked by National Provider Identifier number to a clinician category. <h3>Exposures</h3> Individuals were included in the index dental opioid (opioid-exposed) cohort if they filled an opioid prescription from a dental clinician in 2015, had continuous health plan coverage and no record of opioid prescriptions for 12 months before receiving the prescription, and had 12 months of health plan coverage after receiving the prescription. Two age- and sex-matched opioid-nonexposed control individuals were selected for each opioid-exposed individual and were assigned a corresponding phantom prescription date. <h3>Main Outcomes and Measures</h3> Receipt of an opioid prescription within 90 to 365 days, a health care encounter diagnosis associated with opioid abuse within 365 days, and all-cause mortality within 365 days of the index opioid or phantom prescription date. <h3>Results</h3> Among 754 002 individuals with continuous enrollment in 2015, 97 462 patients (12.9%) received 1 or more opioid prescriptions, of whom 29 791 (30.6%) received prescriptions supplied by a dental clinician. The opioid-exposed cohort included 14 888 participants (7882 women [52.9%], 11 273 white [75.7%], with mean [SD] age, 21.8 [2.4] years), and the randomly selected opioid-nonexposed cohort included 29 776 participants (15 764 women [52.9%], 20 078 [67.4%] white, with mean [SD] age, 21.8 [2.4] years). Among the 14 888 individuals in the index dental opioid cohort, 1021 (6.9%) received another opioid prescription 90 to 365 days later compared with 30 of 29 776 (0.1%) opioid-nonexposed controls (adjusted absolute risk difference, 6.8%; 95% CI, 6.3%-7.2%), and 866 opioid-exposed individuals (5.8%) experienced 1 or more subsequent health care encounters with an opioid abuse–related diagnosis compared with 115 opioid-nonexposed controls (0.4%) (adjusted absolute risk difference, 5.3%; 95% CI, 5.0%-5.7%). There was only 1 death in each cohort. <h3>Conclusions and Relevance</h3> The findings suggest that a substantial proportion of adolescents and young adults are exposed to opioids through dental clinicians. Use of these prescriptions may be associated with an increased risk of subsequent opioid use and abuse.
Annals Story Slam - Who Are You?
Authors: Vladimir Sluzar
Journal: Annals of Internal Medicine (2018)

Web Exclusives4 December 2018Annals Story Slam - Who Are You?FREEVladimir Sluzar, MDVladimir Sluzar, MDUniversity of Toronto and Trillium Health Partners, Toronto, Ontario, Canada (V.S.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/W18-0038 SectionsAboutVisual Abstract ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Video. Annals Story Slam - Who Are You? "Who Are You?," by Vladimir Sluzar, MD (Duration 5:05)Building on the popular Annals feature “On Being a Doctor,” storytellers share stories about the experience of doctoring on video.For more videos from and information on Annals Story Slam, visit go.annals.org/StorySlam. Comments0 CommentsSign In to Submit A Comment Author, Article, and Disclosure InformationAffiliations: University of Toronto and Trillium Health Partners, Toronto, Ontario, Canada (V.S.)Current Author Address: Vladimir Sluzar, MD; e-mail, Vladimir.[email protected]ca. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 4 December 2018Volume 169, Issue 11Page: SS1 ePublished: 4 December 2018 Issue Published: 4 December 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.Loading ...
A systematic review and meta- analysis of randomized controlled trials to evaluate the risk of hematological toxicities in patients with cancer treated with poly adenosine diphosphate ribose polymerase (PARP) inhibitors.
Authors: Anita Sultan, Sriman Swarup, Myo Zaw, Myat M. Han, Yin Mon Myat, Htay Htay Aung, Myet Mon Mon Zin, Kalpana Panigrahi, Kyaw Zin Thein
Journal: Journal of Clinical Oncology (2018)

217 Background: Poly adenosine diphosphate ribose polymerase (PARP) inhibitors have shown to benefit in DNA repair-deficient tumors by enhancing synthetic lethality in cancer cells and are currently employed in many solid tumors. Nevertheless, the risk of hematological toxicities remains significant. We performed a systematic review and meta-analysis of randomized controlled trials (RCT) to determine the risk of hematological toxicities. Methods: We conducted a comprehensive literature search using MEDLINE, EMBASE databases and meeting abstracts from inception through June 2018. Phase III RCTs that mention hematological toxicities as adverse effects were incorporated in the analysis. Mantel-Haenszel (MH) method was used to calculate the estimated pooled risk ratio (RR) with 95% confidence interval (CI). Random effects model was applied. Results: Seven phase III RCTs with a total of 3,188 patients with breast, ovarian and gastric cancer were eligible. Studies compared olaparib or niraparib or rucaparib versus placebo, olaparib vs single agent chemotherapy, iniparib + gemcitabine / carboplatin (GC) versus GC, veliparib + C versus C and olaparib + paclitaxel vs paclitaxel. The RR of all-grade side effects were as follows: anemia, 2.38 (95% CI: 1.42 – 4.00, p = 0.001); thrombocytopenia, 2.96 (95% CI: 1.37 – 6.40, p = 0.006); neutropenia, 1.47 (95% CI: 1.06 – 2.05, p = 0.02); and leukopenia, 1.08 (95% CI: 0.77 – 1.50, p = 0.63). The RR of high-grade adverse effects were as follows: anemia, 3.63 (95% CI: 1.53 – 8.57, p = 0.003); thrombocytopenia, 2.65 (95% CI: 0.89 – 7.85, p = 0.07); neutropenia, 1.27 (95% CI: 0.87 – 1.86, p = 0.21); and leukopenia, 1.20 (95% CI: 0.90 – 1.58, p = 0.19). Conclusions: Our meta-analysis demonstrated that patients on PARP inhibitors experienced a significant increase in the risk of all grades of anemia with a relative risk of 3.63 for grade 3 and 4 anemia, along with any-grade thrombocytopenia and neutropenia. Proper supportive care is essential, and it will ultimately reduce drug dosing inconsistencies and financial burden among patients undergoing treatment.
An enzyme-free biosensor for sensitive detection of <i>Salmonella</i> using curcumin as signal reporter and click chemistry for signal amplification
Authors: Fengchun Huang, Li Xue, Huilin Zhang, Ruya Guo, Yanbin Li, Ming Liao, Maohua Wang, Jianhan Lin
Journal: Theranostics (2018)

In this study, an enzyme-free biosensor was developed for sensitive and specific detection of Salmonella typhimurium (S. typhimurium) using curcumin (CUR) as signal reporter and 1,2,4,5-tetrazine (Tz)-trans-cyclooctene (TCO) click chemistry for signal amplification.Methods: Nanoparticles composed of CUR and bovine serum albumin (BSA) were formulated and reacted with Tz and TCO to form Tz-TCO-CUR conjugates through Tz-TCO click chemistry.Then, the Tz-TCO-CUR conjugates were functionalized with polyclonal antibodies (pAbs) against S. typhimurium to form CUR-TCO-Tz-pAb conjugates.Magnetic nanoparticles (MNPs) conjugated with monoclonal antibodies (mAbs) against S. typhimurium through streptavidin-biotin binding were used to specifically and efficiently separate S. typhimurium from the background by magnetic separation.CUR-TCO-Tz-pAb conjugates were reacted with the magnetic bacteria to form CUR-Tz-TCO bacteria.Finally, CUR was released quickly from the CUR-Tz-TCO bacteria in the presence of NaOH, and the color change was measured at the characteristic wavelength of 468 nm for bacteria quantification.Results: A linear relationship between absorbance at 468 nm and concentration of S. typhimurium from 102 to 106 CFU/mL was found.The lower detection limit was calculated to be as low as 50 CFU/mL and the mean recovery was 107.47% for S. typhimurium in spiked chicken samples.Conclusion: This biosensor has the potential for practical applications in the detection of foodborne pathogens.
Evaluation of the absolute lymphocyte count as a biomarker for melanoma patients treated with the commercially available dose of ipilimumab (3mg/kg).
Authors: Michael Andrew Postow, Jianda Yuan, Katherine Panageas, Kita Bogatch, Margaret Callahan, Michael Cheng, Sebastian Edoardo Artur Schroeder, Ryan F. Kendle, James J. Harding, Mark Andrew Dickson, Sandra P. D'Angelo, Richard D. Carvajal, Gary K. Schwartz, Jedd D. Wolchok
Journal: Journal of Clinical Oncology (2012)

8575 Background: Ipilimumab (ipi) has demonstrated an overall survival (OS) benefit in 2 phase III trials. Only ~30% of patients (pts) achieve clinical benefit, and factors that determine which pts benefit are unclear. For pts treated with 10mg/kg of ipi, we previously reported that an absolute lymphocyte count (ALC) ≥1000/μL prior to dose 3 [week (wk) 7] was associated with improved OS. Since the mean increase in ALC during ipi treatment correlates with dose, we investigated if ALC is also associated with improved OS at 3mg/kg, the currently FDA approved, commercially available dose. Methods: In an IRB-approved analysis, we evaluated landmark survival data from 137 pts treated with 3mg/kg of ipi at Memorial Sloan-Kettering Cancer Center. 67 pts were treated on an expanded access protocol (CA 184-045). 70 pts were treated per FDA approval (commercial ipi) with 4 standard induction doses. These 2 groups were analyzed separately because some pts in CA 184-045 received re-induction ipi. ALC was determined at first ipi dose (baseline, wk 1) and at subsequent doses (wks 4, 7, and 10). Results: Pts treated with 3mg/kg on CA 184-045 with a wk 7 (prior to dose 3) ALC ≥1000/µL had significantly improved OS compared to pts with an ALC at wk 7 &lt;1000/μL (Median OS: not reached vs. 4.24 mos, p&lt;0.001). This OS difference was also seen for pts treated with commercial ipi (Median OS: not reached vs. 4.44 mos, p&lt;0.01). This difference remained significant in a multivariable model accounting for Karnofsky performance score, LDH, M-stage, and number of prior therapies for pts in the CA 184-045 group and commercial ipi group (p=0.01 and p=0.05, respectively). Baseline ALC ≥1000/µL was associated with improved OS (p=0.02) for pts in the commercial ipi group, though follow-up is limited. Conclusions: At the FDA approved dose of ipi, 3mg/kg, ALC at wk 7 remains significantly associated with improved OS. Our preliminary finding of improved OS for pts treated with commercial ipi whose pre-treatment baseline ALC ≥1000/µL deserves confirmation with longer follow-up and prospective validation. Baseline or on treatment ALC may be a marker of overall prognosis, regardless of therapy.
Evaluating patient and public involvement in research
Authors: Antoine Boivin, Tessa Richards, Laura Forsythe, Alexandre Grégoire, Audrey L’Espérance, Julia Abelson, Kristin L Carman
Journal: BMJ (2018)

2][3] In the literature and policy discourse, PPI is justified by two lines of argument: one on the basis of ethical principles, the other on the assumption that it
Evidence for Superior Efficacy and Disease Modification after Three Years of Prospective Randomized Controlled Treatment of Polycythemia Vera Patients with Ropeginterferon Alfa-2b Vs. HU/BAT
Authors: Heinz Gisslinger, Christoph Klade, Pencho Georgiev, Dorota Krochmalczyk, Liana Gercheva-Kyuchukova, Miklos Egyed, Viktor Rossiev, Petr Dulicek, Arpad Illes, Halyna Pylypenko, Lylia Sivcheva, Jiri Mayer, Vera Yablokova, Kurt Krejcy, Barbara Grohmann-Izay, Hans Carl Hasselbalch, Robert Kralovics, Jean-Jacques Kiladjian
Journal: Blood (2018)
Dose-adjusted EPOCH-R (etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab) in untreated aggressive diffuse large B-cell lymphoma with MYC rearrangement: a prospective, multicentre, single-arm phase 2 study
Authors: Kieron Dunleavy, Michelle A Fanale, Jeremy S Abramson, Ariela Noy, Paolo Fabrizio Caimi, Stefania Pittaluga, Samir Parekh, Ann Lacasce, John W Hayslip, Deepa Jagadeesh, Sunil Nagpal, Mary Jo Lechowicz, Rakesh Gaur, Andrea Lucas, Christopher Melani, Mark Roschewski, Seth M Steinberg, Elaine S Jaffe, Brad Kahl, Jonathan W Friedberg, Richard F Little, Nancy L Bartlett, Wyndham H Wilson
Journal: The Lancet Haematology (2018)
Health gains make actions to curb climate change cost neutral, says WHO
Authors: Matthew Limb
Journal: BMJ (2018)

Millions of lives could be saved if countries keep to global goals for mitigating the effects of climate change, but efforts must be radically stepped up, say experts.

A World Health Organization report said a million lives a year worldwide could be saved by 2050 just through reductions in air pollution linked to burning fossil fuels.

It said that the economic benefits of improving people’s health would be around “double the cost” of fulfilling commitments to curb carbon emissions made under the 2015 Paris Agreement.

WHO delivered a special report on climate change and health at the United Nations Climate Change Conference in Katowice, Poland, on 5 December.1

World leaders, scientists, and government officials have gathered there for discussions, three years after the Paris Agreement set clear …