tbuckley/cabot-search huggingface dataset:
Abstract 21384: UNOS 1A Listing Trends in LVAD (Left Ventricular Assist Device) Recipients
Authors: Anthony Salimbangon, Darko Vucicevic, Amy Chang, Mario C Deng, Eugene DePasquale
Journal: Circulation (2017)

Introduction: LVAD utilization has increased in the face of continuing donor shortage. These patients may remain at the highest urgency status of UNOS 1A electively for 30 days. Upon completion of this time, LVAD patients may only regain this status with device complications. Trends in device complications of those undergoing HT have not been well-described. We sought to assess the trend of 1A exceptions in this population. Methods: 3551 HT recipients bridged with LVAD of 10,634 were identified from UNOS (2000-2015) were stratified by UNOS 1A listing exception: device infection, thromboembolism, device malfunction, life-threatening ventricular arrhythmia or other. Exclusions: age&lt;18, re-HT &amp; lost to follow up. Survival was censored at 12y. UNOS 1A listing exceptions over time were assessed via a nonparametric test for trend. Results: 3551 HT recipients bridged with LVAD with the following 1A exceptions: device infection (n=1516), thromboembolism (n=517), device malfunction (n=585), life-threatening ventricular arrhythmia (n=196) and other (n=737). During the study period, listing for each of these complications increased over time (Figure). Overall survival in patients listed with MCS exception was (1, 5 &amp; 10y): 87, 74 &amp; 56%. Survival by 1A exception is shown in Figure. Survival was significantly reduced in those with device infection (1, 5 &amp; 10y: 85, 70, 50%; log rank, p=0.007). Conclusions: UNOS 1A listing exceptions in LVAD patients have increased over time. Despite this increase, short and long-term survival does not appear to be impacted with the exception of device infection. Further study is warranted to explore this increase in exceptions and impaired outcomes in the device infection population.
Impella Support for Acute Myocardial Infarction Complicated by Cardiogenic Shock
Authors: Benedikt Schrage, Karim Ibrahim, Tobias Loehn, Nikos Werner, Jan-Malte Sinning, Federico Pappalardo, Marina Pieri, Carsten Skurk, Alexander Lauten, Ulf Landmesser, Ralf Westenfeld, Patrick Horn, Matthias Pauschinger, Dennis Eckner, Raphael Twerenbold, Peter Nordbeck, Tim Salinger, Peter Abel, Klaus Empen, Mathias C. Busch, Stephan B. Felix, Jan-Thorben Sieweke, Jacob Eifer Møller, Nilesh Pareek, Jonathan Hill, Philip MacCarthy, Martin W. Bergmann, José P.S. Henriques, Sven Möbius-Winkler, P. Christian Schulze, Taoufik Ouarrak, Uwe Zeymer, Steffen Schneider, Stefan Blankenberg, Holger Thiele, Andreas Schäfer, Dirk Westermann
Journal: Circulation (2019)

Percutaneous mechanical circulatory support devices are increasingly used in acute myocardial infarction complicated by cardiogenic shock (AMI-CS), despite limited evidence for their effectiveness. The aim of this study was to evaluate outcomes associated with use of the Impella device compared with intra-aortic balloon pump (IABP) and medical treatment in patients with AMI-CS. Data of patients with AMI-CS treated with the Impella device at European tertiary care hospitals were collected retrospectively. All patients underwent early revascularization and received optimal medical treatment. Using IABP-SHOCK II (Intraaortic Balloon Pump in Cardiogenic Shock II) trial inclusion and exclusion criteria, 372 patients were identified and included in this analysis. These patients were matched to 600 patients from the IABP-SHOCK II trial. The following baseline criteria were used as matching parameters: age, sex, mechanical ventilation, ejection fraction, prior cardiopulmonary resuscitation, and lactate. Primary end point was 30-day all-cause mortality. In total, 237 patients treated with an Impella could be matched to 237 patients from the IABP-SHOCK II trial. Baseline parameters were similarly distributed after matching. There was no significant difference in 30-day all-cause mortality (48.5% versus 46.4%, P=0.64). Severe or life-threatening bleeding (8.5% versus 3.0%, P<0.01) and peripheral vascular complications (9.8% versus 3.8%, P=0.01) occurred significantly more often in the Impella group. Limiting the analysis to IABP-treated patients as a control group did not change the results. In this retrospective analysis of patients with AMI-CS, the use of an Impella device was not associated with lower 30-day mortality compared with matched patients from the IABP-SHOCK II trial treated with an IABP or medical therapy. To further evaluate this, a large randomized trial is warranted to determine the effect of the Impella device on outcome in patients with AMI-CS. URL: https://www.clinicaltrials.gov . Unique identifier: NCT03313687.
AB1021 Aneurysmal bone cysts of the spine: 4 case reports and review of literature
Authors: A. Romdhane, N. Karmani, J. Kallel, I. Ben Said
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Aneurysmal bone cysts (ABC) are rare, benign, highly vascular pseudotumors of unknown cause. It most often affects individuals during their second decade of life. <h3>Objectives</h3> Our goal was to document the clinical characteristics, diagnostic modalities and treatment results of ABCs. <h3>Methods</h3> We reviewed our institution's database over a period of 15 years to identify patients diagnosed with aneurysmal bone cysts of the spine. Four patients underwent surgery in our department (2 men and 2 women). For those four patients, we tabulated the clinical characteristics, location, diagnostic modalities and treatment. <h3>Results</h3> The clinical manifestations were gait disturbance in 2 patients and legpain in the other two. The tumour occurred in the dorsal spine in 2 cases and in the lumbar spine in the other two. All patients underwent surgical resection with total removal in only 2 patients. Postoperatively, clinical signs improved in all patients. Only one case presented tumour recurrence requiring second intervention and instrumentation. ABCs constitute approximately 1.5% of spinal bone tumours. They usually affect the posterior elements of the spine. MRI is the most useful modality for preoperative planning. It also helps to evaluate the fluidfluid level, which is characteristic for ABC on MRI. The differential diagnosis is mainly with giant cell tumours and osteoblastomas. The primary option for treatment is surgery. Instrumentation is sometimes necessary because of the increased risk of postoperative instability, especially in cervical spine surgery. The recurrence rate is 20% to 30% in case of incomplete resection. <h3>Conclusions</h3> ABCs are benign lesions. Surgical resection en bloc has the lowest recurrence rate. Instrumentation is sometimes necessary because of the increased risk of postoperative instability. <h3>References</h3> [1] Boriani S, De Iure F, Campanacci L, et al. (2001) Aneurysmal bone cyst of the mobile spine: report on 41 cases. Spine. 26:27–35 [2] Pennekamp W, Peters S, Schinkel C, Kuhnen C, Nicolas V, Muhr G, Frangen TM (2008) Aneurysmal bone cyst of the cervical spine. Eur Radiol18:2356–2360 [3] Sundaram M, McDonald DJ, Steigman CK, Bocchini T (1997) Metachronous multiple aneurysmal bone cysts. Skeletal Radiol26(9):564–567 [4] Keenan S, Bui-Mansfield LT (2006) Musculoskeletal lesions with fluid–fluid level: a pictorial essay. J Comput Assist Tomogr30:517–524 [5] Saccomanni R (2008) Aneurysmal bone cyst of spine: a review of literature. Arch Orthop Trauma Surg128:1145– 1147 <h3>Disclosure of Interest</h3> None declared
Long-term Physician-Patient Relationships—Persevering in a Practice
Authors: Adam S. Cifu
Journal: JAMA Internal Medicine (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 Internal Medicine 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 Internal Medicine journal
Just Policy? An Ethical Analysis of Early Intervention Policy Guidance
Authors: Rose Mortimer, Alex McKeown, Ilina Singh
Journal: The American Journal of Bioethics (2018)

Early intervention (EI) aims to identify children or families at risk of poor health, and take preventative measures at an early stage, when intervention is more likely to succeed. EI is concerned with the just distribution of "life chances," so that all children are given fair opportunity to realize their potential and lead a good life; EI policy design, therefore, invokes ethical questions about the balance of responsibilities between the state, society, and individuals in addressing inequalities. We analyze a corpus of EI policy guidance to investigate explicit and implicit ethical arguments about who should be held morally responsible for safeguarding child health and well-being. We examine the implications of these claims and explore what it would mean to put the proposed policies into practice. We conclude with some remarks about the useful role that philosophical analysis can play in EI policy development.
Fractional CO2 laser therapy for genitourinary syndrome of menopause (GSM) in survivors of breast cancer (BC).
Authors: Allison M Quick, Filadelfiya Zvinovski, Catherine Hudson, Andrew Hundley, Cynthia Evans, Anupama Suresh, Julie Stephens, Kristen Carpenter, Bhuvaneswari Ramaswamy, Raquel E. Reinbolt, Anne M. Noonan, Jeffrey Bryan VanDeusen, Robert Wesolowski, Daniel G. Stover, Nicole Olivia Williams, Sagar D. Sardesai, Karen L. Smith, Stephanie S. Faubion, Charles L. Loprinzi, Maryam B. Lustberg
Journal: Journal of Clinical Oncology (2018)

202 Background: Fractional CO2 laser therapy is an emerging treatment for GSM. The objective of this study was to determine the feasibility, tolerability and preliminary efficacy of fractional CO2 laser therapy in BC survivors. Methods: This was a single arm feasibility study of BC survivors with dyspareunia and/or vaginal dryness. Participants received three treatments with office-based fractional CO2 laser on at least 30 day intervals and returned for a one-month follow-up. Feasibility was defined as treatment completion without serious adverse events (SAE) in a minimum of 80% of patients. Primary efficacy was evaluated using the mean change (∆) in the score on the Vaginal Assessment Scale (VAS). Secondary efficacy endpoints included mean ∆ in scores on the Female Sexual Function Index (FSFI) and Urogenital Distress Inventory (UDI). Descriptive statistics (means and 95% confidence intervals (CI) for continuous variables and proportions for categorical variables) were used. Results: The study is ongoing with 65 patients enrolled. To date, 37 patients have completed all study treatments and follow-up. Median age for those who have completed treatment was 57 years (range 34-72). Most were ER/PR positive (78%) and Her 2 negative (81%) with stage I (43%) or II (41%) BC. Ninety-five percent were receiving endocrine therapy, most commonly aromatase inhibitors (73%). No SAEs were reported in the 37 patients who have completed study treatments and their outcomes are as follows. Based on the VAS, 78% reported moderate-severe dyspareunia and 89% reported moderate-severe vaginal dryness at baseline. At follow up, 28% reported moderate-severe dyspareunia and 28% reported moderate-severe vaginal dryness. The VAS score improved from baseline to follow up (mean ∆ 4.1; 95% CI [3.1, 5.1]). Similarly, the FSFI score improved (mean ∆ -10.0; 95% CI [-13.2, -6.9]) and the UDI score improved (mean ∆ -5.7; 95% CI [-10.1, -1.3]). Final efficacy analysis will be reported once all patients have completed all time points. Conclusions: Fractional CO2 laser treatment is feasible and tolerable in BC survivors and may reduce symptom burden from GSM. A randomized controlled trial with sham laser is currently in development. Clinical trial information: NCT03307044.
Public Health Response to an Avian Influenza A(H7N8) Virus Outbreak in Commercial Turkey Flocks — Indiana, 2016
Authors: Jennifer A. Brown, Reema Patel, Lynn Maitlen, Donna Oeding, Karen Gordon, Joshua L. Clayton, Shawn Richards, Pam Pontones, James Brewer, Sara Blosser, Joan Duwve
Journal: MMWR Morbidity and Mortality Weekly Report (2018)

In January 2016, highly pathogenic avian influenza (HPAI) A(H7N8) virus and low pathogenicity avian influenza (LPAI) A(H7N8) virus were detected in commercial turkey flocks in Dubois County, Indiana. The Indiana State Department of Health (ISDH) and the Dubois County Health Department (DCHD) coordinated the public health response to this outbreak, which was the first detection of HPAI A(H7N8) in any species (1). This response was the first to fully implement unpublished public health monitoring procedures for HPAI responders that were developed by the U.S. Department of Agriculture (USDA) and CDC in 2015 (Sonja Olsen, CDC, personal communication, October 2017). No cases of zoonotic avian influenza infection in humans were detected during the outbreak.
Hypertension Drug Fails to Slow Cognitive Decline
Authors: Anita Slomski
Journal: JAMA (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 HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal
Quantitative versus standard pupillary light reflex for early prognostication in comatose cardiac arrest patients: an international prospective multicenter double-blinded study
Authors: Mauro Oddo, Claudio Sandroni, Giuseppe Citerio, John-Paul Miroz, Janneke Horn, Malin Rundgren, Alain Cariou, Jean-François Payen, Christian Storm, Pascal Stammet, Fabio Silvio Taccone
Journal: Intensive Care Medicine (2018)

To assess the ability of quantitative pupillometry [using the Neurological Pupil index (NPi)] to predict an unfavorable neurological outcome after cardiac arrest (CA).We performed a prospective international multicenter study (10 centers) in adult comatose CA patients. Quantitative NPi and standard manual pupillary light reflex (sPLR)-blinded to clinicians and outcome assessors-were recorded in parallel from day 1 to 3 after CA. Primary study endpoint was to compare the value of NPi versus sPLR to predict 3-month Cerebral Performance Category (CPC), dichotomized as favorable (CPC 1-2: full recovery or moderate disability) versus unfavorable outcome (CPC 3-5: severe disability, vegetative state, or death).At any time between day 1 and 3, an NPi ≤ 2 (n = 456 patients) had a 51% (95% CI 49-53) negative predictive value and a 100% positive predictive value [PPV; 0% (0-2) false-positive rate], with a 100% (98-100) specificity and 32% (27-38) sensitivity for the prediction of unfavorable outcome. Compared with NPi, sPLR had significantly lower PPV and significantly lower specificity (p < 0.001 at day 1 and 2; p = 0.06 at day 3). The combination of NPi ≤ 2 with bilaterally absent somatosensory evoked potentials (SSEP; n = 188 patients) provided higher sensitivity [58% (49-67) vs. 48% (39-57) for SSEP alone], with comparable specificity [100% (94-100)].Quantitative NPi had excellent ability to predict an unfavorable outcome from day 1 after CA, with no false positives, and significantly higher specificity than standard manual pupillary examination. The addition of NPi to SSEP increased sensitivity of outcome prediction, while maintaining 100% specificity.
The cost implications of palliative radiation therapy dose and fractionation for painful metastatic bone lesions.
Authors: Mark Raymond Waddle, Tasneem Kaleem, William C Stross, Timothy D Malouff, Mikayla Jenkins, Delaney Pacitti, Matthew DeVries, Aditya Patibandla, Jackson May, Launia White, Aaron Spaulding, James Naessens, Daniel Ma, Sameer R. Keole, Robert Clell Miller
Journal: Journal of Clinical Oncology (2018)

145 Background: Palliative radiation treatment (pRT) is used for symptomatic bone metastases (mets). Several fractionation schedules show equal efficacy for pain relief, and ASTRO’s Choosing Wisely recommends 8Gy x1, 4Gy x5, or 3Gy x10. This study aims to investigate the cost implications of pRT for bone mets. Methods: Patients (Pts) treated with pRT for bone mets at Mayo Clinic from 2007 - 2016 were included in this study. Costs for all services were subdivided into RT and total costs at 30 &amp; 90 days (30D &amp; 90D). Standardized costs were obtained from the Mayo Clinic Cost Data Warehouse and Medicare reimbursements were assigned to all services with cost to charge adjustments and 2017 GDP Implicit Price Deflator for inflation. Cost means were compared via the Kruskal-Wallis test. Results: 538 pts were treated with pRT, 124 receiving 8Gy x1, 204 receiving 4Gy x5, and 210 receiving 3Gy x10. Pts with breast and prostate cancer were most likely to be treated with 3Gy x10 and pts with GI and lung cancer were most likely to be treated with 8Gy x1. RT costs at 30D were $1,497, $1,891, and $1,982 (p=0.03) and RT costs at 90D were $2,602, $2,753, and $3,032 (p=0.08) for initial RT regimens of 8Gy x1, 4Gy x5, and 3Gy x10. Total costs of care at 30D were similar from $15,969 - 17,687 (p=0.6) and total costs at 90D were similar from $22,361 - 23,219 (p=0.7) between arms. A total of 23%, 28%, and 39% of pts were alive 2 years following pRT from each arm (p=0.07). Conclusions: This is the first study of its kind to analyze actual treatment costs for the three most common pRT regimens in bone mets. Single fraction RT was most used for pts with poor prognoses and was associated with lower RT costs at 30D, but similar RT costs at 90D, possibly due to retreatment. RT choice had no impact on overall costs of care at 30D or 90D. pRT remains of high value, representing only 11-13% of total costs.[Table: see text]
Development of a small molecule inhibitors of replication protein A and its role in nucleotide excision repair and DNA replication
Authors: Brooke J. Andrews, Arnold R. Coleman, John J. Turchi
Journal: Cancer Research (2005)

5006  The human single-stranded DNA binding protein, replication protein A (RPA), is essential for DNA repair and DNA replication. RPA is a viable target in the treatment of cancer as many chemotherapeutic agents act by blocking DNA replication. Furthermore, inhibition of RPA and its role in DNA repair could prove useful in treating cancers that have acquired resistance to DNA damaging agents through enhanced DNA repair mechanisms, as has been observed with certain cisplatin resistant carcinomas. In an effort to identify inhibitors of RPA, we established a homogeneous high-throughput screening assay to measure RPA’s DNA binding activity. Using this assay, we initiated a large scale screening effort of the DTP library of pure and synthetic compounds. Following initial screening, secondary assays were performed using an electrophoretic mobility shift assay, fluorescence polarization analyses and in vitro NER catalyzed excision of a single cisplatin-lesion in a duplex DNA. The identification and development of potential lead compounds and structure/activity relationships will be presented. The identification and use of RPA inhibitors may aid in inhibiting NER activity, which could potentially circumvent resistance to certain chemotherapeutic agents, as well as be useful in the characterization of RPA and its interaction with DNA.
Mitochondrial Dynamics Is Critical for the Full Pluripotency and Embryonic Developmental Potential of Pluripotent Stem Cells
Authors: Xiuying Zhong, Peng Cui, Yongping Cai, Lihua Wang, Xiaoping He, Peipei Long, Kangyang Lu, Ronghui Yan, Ying Zhang, Xin Pan, Xiaoyang Zhao, Wei Li, Huafeng Zhang, Qi Zhou, Ping Gao
Journal: Cell Metabolism (2018)

While the pluripotency of stem cells is known to determine the fate of embryonic development, the mechanisms underlying the acquisition and maintenance of full pluripotency largely remain elusive. Here, we show that the balance between mitochondrial fission and fusion is critical for the full pluripotency of stem cells. By analyzing induced pluripotent stem cells with differential developmental potential, we found that excess mitochondrial fission is associated with an impaired embryonic developmental potential. We further uncover that the disruption of mitochondrial dynamics impairs the differentiation and embryonic development of pluripotent stem cells; most notably, pluripotent stem cells that display excess mitochondrial fission fail to produce live-born offspring by tetraploid complementation. Mechanistically, excess mitochondrial fission increases cytosolic Ca2+ entry and CaMKII activity, leading to ubiquitin-mediated proteasomal degradation of β-Catenin protein. Our results reveal a previously unappreciated fundamental role for mitochondrial dynamics in determining the full pluripotency and embryonic developmental potential of pluripotent stem cells.
The epithelial-to-mesenchymal transition activator ZEB1 initiates a prometastatic competing endogenous RNA network
Authors: Xiaochao Tan, Priyam Banerjee, Xin Liu, Jiang Yu, Don L. Gibbons, Ping Wu, Kenneth L. Scott, Lixia Diao, Xiaofeng Zheng, Jing Wang, Ali Jalali, Milind Suraokar, Junya Fujimoto, Carmen Behrens, Xiuping Liu, Chang-gong Liu, Chad J. Creighton, Ignacio I. Wistuba, Jonathan M. Kurie
Journal: Journal of Clinical Investigation (2018)
Air Pollution in the Asia-Pacific Region. A Joint Asian Pacific Society of Respirology/American Thoracic Society Perspective
Authors: Crystal M. North, Mary B. Rice, Thomas Ferkol, David Gozal, Christopher Hui, Soon-Hee Jung, Kozo Kuribayashi, Meredith C. McCormack, Michiaki Mishima, Yasuo Morimoto, Yuanlin Song, Kevin C. Wilson, Woo Jin Kim, Kwun M. Fong
Journal: American Journal of Respiratory and Critical Care Medicine (2018)