tbuckley/cabot-search huggingface dataset:
Community burden of undiagnosed HIV infection among adolescents in Zimbabwe following primary healthcare-based provider-initiated HIV testing and counselling: A cross-sectional survey
Authors: Victoria Simms, Ethel Dauya, Subathira Dakshina, Tsitsi Bandason, Grace McHugh, Shungu Munyati, Prosper Chonzi, Katharina Kranzer, Getrude Ncube, Collen Masimirembwa, Roslyn Thelingwani, Tsitsi Apollo, Richard Hayes, Helen A. Weiss, Rashida A. Ferrand
Journal: PLoS Medicine (2017)

Children living with HIV who are not diagnosed in infancy often remain undiagnosed until they present with advanced disease. Provider-initiated testing and counselling (PITC) in health facilities is recommended for high-HIV-prevalence settings, but it is unclear whether this approach is sufficient to achieve universal coverage of HIV testing. We aimed to investigate the change in community burden of undiagnosed HIV infection among older children and adolescents following implementation of PITC in Harare, Zimbabwe.Over the course of 2 years (January 2013-January 2015), 7 primary health clinics (PHCs) in southwestern Harare implemented optimised, opt-out PITC for all attendees aged 6-15 years. In February 2015-December 2015, we conducted a representative cross-sectional survey of 8-17-year-olds living in the 7 communities served by the study PHCs, who would have had 2 years of exposure to PITC. Knowledge of HIV status was ascertained through a caregiver questionnaire, and anonymised HIV testing was carried out using oral mucosal transudate (OMT) tests. After 1 participant taking antiretroviral therapy was observed to have a false negative OMT result, from July 2015 urine samples were obtained from all participants providing OMTs and tested for antiretroviral drugs to confirm HIV status. Children who tested positive through PITC were identified from among survey participants using gender, birthdate, and location. Of 7,146 children in 4,251 eligible households, 5,486 (76.8%) children in 3,397 households agreed to participate in the survey, and 141 were HIV positive. HIV prevalence was 2.6% (95% CI 2.2%-3.1%), and over a third of participants with HIV were undiagnosed (37.7%; 95% CI 29.8%-46.2%). Similarly, among the subsample of 2,643 (48.2%) participants with a urine test result, 34.7% of those living with HIV were undiagnosed (95% CI 23.5%-47.9%). Based on extrapolation from the survey sample to the community, we estimated that PITC over 2 years identified between 18% and 42% of previously undiagnosed children in the community. The main limitation is that prevalence of undiagnosed HIV was defined using a combination of 3 measures (OMT, self-report, and urine test), none of which were perfect.Facility-based approaches are inadequate in achieving universal coverage of HIV testing among older children and adolescents. Alternative, community-based approaches are required to meet the Joint United Nations Programme on HIV/AIDS (UNAIDS) target of diagnosing 90% of those living with HIV by 2020 in this age group.
Abstract 1141: Adaptation of Coronary Arteriolar Dilations to The Simultaneous Presence of Obesity and Hypertension: Role of Increased Nitric Oxide Sensitivity
Authors: Zsolt Bagi, Tibor Fulop, Eva Jebelovszki, Nora Erdei, Tamas Szerafin, Tamas Forster, Akos Koller, Istvan Edes
Journal: Circulation (2007)

Increased body weight and elevated blood pressure could lead to the development of hyperdynamic circulation requiring increased coronary blood flow. Thus, we aimed to characterize the effects of simultaneous presence of obesity and hypertension on the dilator function of human coronary arterioles. Agonist-induced dilations were assessed in pressurized coronary arterioles isolated from the right atrial appendages of patients (N=38), that underwent cardiac surgery. There were no significant differences in bradykinin (BK)-induced and the nitric oxide (NO)-donor, sodium-nitroprusside (SNP)-evoked dilations of coronary arterioles between normotensive and hypertensive lean patients. In contrast, in the obese, normotensive patients BK- and SNP-induced dilations were reduced (BK, 10 −7 M, lean:90±4%, obese:64±7%; SNP, 10 −6 M, lean:89±7%, obese:76±5%), whereas in the obese, hypertensive patients BK- and SNP-induced dilations were significantly enhanced, when compared to lean subjects (BK, 10 −7 M, lean:71±7%, obese:85±3%; SNP, 10 −6 M, lean:60±6%, obese:83±2%). Correspondingly, in hypertensive individuals, but not in those of normotensives, a positive correlation was found between body mass index (BMI) and bradykinin-induced ( P =0.03, r=0.46), and also SNP-evoked ( P&lt; 0.03, r=0.44) coronary dilations. To correlate coronary responses to those of peripheral vessels, in an additional 55 hypertensive patients flow-mediated (FMD) and nitroglycerin (NTG)-induced dilations were assessed by high-resolution ultrasound. In obese, hypertensive individuals both FMD and NTG-induced dilations were significantly greater (FMD:6.2±0.7%, NTG:17.2±0.9%), than in lean hypertensive patients (FMD:3.7±0.6%, NTG:13.6±1.1%). Correspondingly, both FMD and NTG-induced dilations were positively correlated with BMI, ( P =0.02, r=0.31, P =0.03, r=0.29, respectively). These findings are the first to show that in humans obesity may lead to activation of an adaptive vascular mechanisms in hypertension, such as an increased sensitivity to NO, enhancing the dilator function of coronary and peripheral arterial vessels.
Ibrutinib-Lenalidomide-Rituximab in Patients with Relapsed/Refractory Mantle Cell Lymphoma: First Results from the Nordic Lymphoma Group MCL6 (PHILEMON) Phase II Trial
Authors: Mats Jerkeman, Martin Hutchings, Riikka Räty, Karin Fahl Wader, Anna Laurell, Hanne Kuitunen, Helle Toldbod, Lone Bredo Pedersen, Christian Winther Eskelund, Kirsten Grønbæk, Carsten Utoft Niemann, Christian H Geisler, Arne Kolstad
Journal: Blood (2016)
Sports medicine highlights from other journals #13
Authors: Ronan Kearney, Brady Desmond Green, Josh Heerey, Aoife Carolan
Journal: British Journal of Sports Medicine (2019)

### Circulatio n 2017; 136(2):138–48

It is well recognised that physical activity is associated with a lower risk of cardiovascular events but what actually happens within the coronary arteries of those who regularly exercise?

This study used CT to assess coronary artery calcification (CAC) and plaque characteristics in 284 middle-aged asymptomatic men engaging in sport. The participants had no history of cardiovascular disease and gave lifelong exercise history grouped as  2000 MET-min/week.

Surprisingly, the most active group had approximately 50% higher prevalence of CAC and burden of atherosclerotic plaques. Reassuringly, these plaques were 3.5 times more likely to be stable and less likely to rupture compared with unstable non-calcified plaques with fibrous caps and necrotic cores that are most vulnerable to rupture and cause an ischaemic event. Those engaging <2000 MET-min/week had no statistically significant increase in CAC.

The clinical relevance of CAC in the most active athletes remains unclear. We need to investigate coronary physiology in sport further. So while we harden up in more ways than one while …
THE PREVENTION OF SUDDEN CARDIAC DEATH IN ATHLETES: CARDIOVASCULAR SCREENING PRACTICES IN UNITED STATES NATIONAL GOVERNING BODIES AND PARALYMPIC COMMITTEES
Authors: Brett Toresdahl, Cindy Chang, Jamie Confino, Irfan Asif
Journal: British Journal of Sports Medicine (2017)

Background Cardiac screening in athletes has recently been a focus of investigation and debate among the sports medicine community. Athletic associations and organizations, including the International Olympic Committee, have issued recommendations regarding screening practices in an effort to prevent sudden cardiac death in sport. Objective To examine cardiovascular screening strategies among Olympic-level athletic teams. Design Cross-sectional survey. Setting United States National Governing Bodies (NGBs) and National Paralympic Committees (NPCs). Participants Medical team members for US NGBs and NPCs. Interventions Medical team members were surveyed regarding the cardiovascular screening practices of their respective teams. Main Outcome Measurements The screening components and screening frequency performed by US NGBs and NPCs. Results Medical team members for 49/72 (68%) of the US NGBs and NPCs were identified and contact information was obtained through various sources. 42/49 teams (86%) completed the assessment (34 from NGBs and 8 from NPCs). Twenty-one of 42 teams (50%) reported that there was a periodic health evaluation requirement that directed the cardiovascular screening components, frequency, and/or provider. The following screening components were reported as being performed at least once in all or most athletes: personal history (91% of teams), family history (86%), physical exam (81%), electrocardiogram (33%), echocardiogram (5%), and stress test (2%). For teams who did not screen athletes with ECG, the most frequently cited reasons were lack of ECG equipment (40%), lack of evidence (33%), and lack of consensus regarding follow-up testing (20%). Conclusion The US NGBs and NPCs are a heterogeneous collection of athletic teams that have varying approaches to cardiovascular screening. Lack of infrastructure appears to be the biggest barrier to implementing advanced screening protocols. Results from this investigation can be used to support efforts to provide consistent cardiovascular screening practices to NGB and NPC athletes with the goal of preventing tragedy from sudden cardiac death.
Using NOTES to salvage a misdeployed lumen-apposing metal stent during an endoscopic ultrasound-guided gastroenterostomy
Authors: Amy Tyberg, Monica Saumoy, Michel Kahaleh
Journal: Endoscopy (2017)

Endoscopic ultrasound (EUS)-guided gastroenterostomy with placement of a lumen-apposing metal stent (LAMS) is a minimally invasive endoscopic option for patients with gastric outlet obstruction (GOO) [1] [2] [3]. The procedure involves accessing the small bowel and deploying a LAMS to connect the stomach to the small bowel. In rare cases, stent misdeployment results in one end of the stent being deployed outside the targeted lumen. When wire access is preserved, the misdeployed stent can be successfully salvaged by placing a fully covered self-expanding metal stent (FCSEMS) through the misdeployed LAMS using fluoroscopy guidance [4]. In this report, we present a case of a misdeployed LAMS without preserved wire access that was salvaged using the natural orifice transluminal endoscopic surgery (NOTES) technique.
I-SPY 2 Breast Cancer Trial as a Model for Innovation in Alzheimer Disease Therapies
Authors: Mindi F. Messmer, Erin E. Wilhelm, Ira Shoulson
Journal: JAMA Neurology (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 Neurology 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 Neurology journal
Icotinib versus whole-brain irradiation in patients with EGFR -mutant non-small-cell lung cancer and multiple brain metastases (BRAIN): a multicentre, phase 3, open-label, parallel, randomised controlled trial
Authors: Jin-Ji Yang, Caicun Zhou, Yisheng Huang, Jifeng Feng, Sun Lu, Yong Song, Cheng Huang, Gang Wu, Li Zhang, Ying Cheng, Chengping Hu, Gongyan Chen, Li Zhang, Xiaoqing Liu, Hong Hong Yan, Fen Lai Tan, Wenzhao Zhong, Yi-Long Wu
Journal: The Lancet Respiratory Medicine (2017)
Brain metastasis (BM) prediction by transcriptomic profiling in triple-negative breast cancer (TNBC).
Authors: Renata Duchnowska, Michal Jarzab, Jadwiga Zebracka, Rafal Matkowski, Anna Kowalczyk, Barbara Radecka, Malgorzata Foszczynska-Kloda, Antonino Musolino, Bogumila Czartoryska-Arlukowicz, Maria Malgorzata Litwiniuk, Sylwia Szablowska-Siwik, Bozenna Karczmarek-Borowska, Katarzyna Sosinska-Mielcarek, Ewa Chmielowska, Wojciech P Olszewski, Janusz Patera, Anton Zawrocki, Dagmara Rusinek, Jacek Jassem, Wojciech Biernat
Journal: Journal of Clinical Oncology (2016)

1076 Background: TNBC lacks expression of steroid hormone receptors and HER2. This phenotype shows high metastatic potential, with particular predilection to lungs and brain. Determination of genetic profiles specific for BM-prone TNBC might identify high-risk patients requiring the use of alternative, more aggressive or specific preventive and therapeutic approaches. Methods: Using cDNA-mediated Annealing, Selection, Extension and Ligation (DASL) assay, we investigated expression of 29,369 gene transcripts in primary TNBC samples from discovery Cohort A (71 patients) and independent Cohort B (48 patients), derived from a consecutive series of 324 advanced TNBC treated in 17 oncology centers in Poland and Italy between 1997 and 2013. Expression of mRNA was correlated with the occurrence of symptomatic BM. Results: The patient median age at primary tumor diagnosis and at BM was 58 years (range 28-82) and 56 years (range 38-79), respectively, 74% of patients were postmenopausal, and the majority of tumors were of no special type and grade 3. The median follow-up from breast cancer diagnosis in Cohort A and B was 32 months (range 1 to 234) and 28 months (range 0 to 129), respectively. Within these periods, 32% of patients in Cohort A and 46% in Cohort B developed BM. The difference in expression profile between patients who did and did not develop BM at the non-corrected p < 0.005 was found for 64 transcripts, but none showed significant difference at a preset level of p < 0.001 (p = 0.51 for global test). The false discovery rate (FDR) was 44%, and no gene showed FDR < 10%. There were also no differences in gene expression profile in patients with early vs. late BM. Of the 30 transcripts with optimal different expression in patients with and without BM in Cohort A, none was significantly associated with BM in Cohort B. In Cohort B, the three genes presumably mediating BM (NEUROD1, FGF8 and MAPT) from Cohort A were additionally assessed using the real-time quantitative reverse transcription PCR. None of these genes showed a significantly different expression between patients with and without BM. Conclusions: The analysis based on the primary tumor gene transcripts alone is unlikely to predict development of symptomatic BM in advanced TNBC.
PREVENTION OF TIME-LOSS INJURIES IN THE A-LEAGUE PROFESSIONAL FOOTBALL: A 5-YEAR PROSPECTIVE STUDY
Authors: Vincent Gouttebarge, Gino Kerkhoffs
Journal: British Journal of Sports Medicine (2017)

Background Epidemiological data on the occurrence of time-loss injuries over several A-League seasons remains lacking, while the effect of the implementation of ‘Minimum Medical Standards’ as preventive measure needs evaluation. Objective To explore the preventive effect of the mandatory implementation of ‘Minimum Medical Standards’ in the A-League professional football on the occurrence of total time-loss injuries (and total matches missed). Design An observational prospective study was conducted over five A-League seasons (2008 to 2013). Setting A-League professional football. Patients (or Participants) All professional players from all clubs from the A-League were monitored over five consecutive seasons. Interventions (or Assessment of Risk Factors) “Minimum Medical Standards” were made mandatory in 2011 in the A-League professional football, relying on appropriate medical testing and employment of medical physicians and physiotherapists. Main Outcome Measurements Data were collected weekly based on official match previews, official match reviews, official media releases, official websites, and self-report by the players. Results The number of total time-loss injuries rose from 129 in 2008–2009 to 202 in 2010–2011, decreasing to 162 in 2012–2013 (repeated measures ANOVA not statistically significant). The number of total matches missed rose from 506 in 2008–2009 to 1110 in 2010–2011, decreasing to 542 in 2012–2013. This difference in matches missed over five seasons was found to be statistically significant (P&lt;0.01). Conclusions The introduction of "Minimum Medical Standards" in the A-League had a favourable effect on the number of total, hamstring, knee and ankle injuries and on the number of matches missed due to these injuries, but not on the number of groin injuries.
A phase I dose-escalation study of BGB-290, a novel PARP1/2 selective inhibitor in patients with advanced solid tumors.
Authors: Jason D. Lickliter, Hui Kong Gan, Tarek Meniawy, Jason Yang, Lai Wang, Lusong Luo, Ni Lu, Michael Millward
Journal: Journal of Clinical Oncology (2016)

e17049 Background: BGB-290 is a novel highly-selective inhibitor of PARP1/2 with potent DNA-trapping activity. It had excellent oral bioavailability and DMPK properties in animal studies. In addition, BGB-290 displays good brain penetration in preclinical models. Methods: A phase I, multicenter study was conducted to evaluate the safety, tolerability, pharmacokinetics (PK) and antitumor activity of BGB-290 in patients (pts) with advanced solid tumors. A modified 3+3 dose escalation design was used. Intra-patient dose escalation was allowed. Pts received escalating dose of BGB-290 BID orally. Results: As of 7 Jan 2016, 40 pts had been enrolled in 8 escalating cohorts, receiving BGB-290 at 2.5 mg BID (n = 4), 5 mg BID (n = 3), 10 mg BID (n = 3), 20 mg BID (n = 3), 40 mg BID (n = 6), 60 mg BID (n = 6), 80 mg BID (n = 10) and 120 mg BID (n = 5). The maximum tolerated dose (MTD) was determined as 80 mg BID. The dose-limiting toxicity (DLT) included persistent Grade (G) 2 nausea (one at 40 mg BID and 80 mg BID, 2 at 120 mg BID) and G3 fatigue (1 at 120 mg BID in one of the pts with persistent G2 nausea). Common treatment-emergent adverse events (AEs) were nausea (50%), fatigue (33%), anemia (20%), vomiting (15%) and neutropenia (13%). Common drug-related G3/4 AEs were anemia (13%), neutropenia (8%) and fatigue (5%). Linear dose-dependent PK was observed with ~ 2-fold accumulation at steady state. BGB-290 induced significant PAR inhibition in PBMCs from the starting dose level and achieved robust ( > 80%) and sustained PAR inhibition at steady state at doses ≥ 10 mg BID. Of the 20 evaluable pts with ovarian cancer, 9 pts demonstrated objective responses, including 2 complete and 7 partial responses. These objective responses were observed in 7 of the 8 dose levels tested, including a partial response in the first cohort (2.5 mg BID). Objective responses were seen in 6 of 11 pts with germ-line BRCA mutations and in 3 of 9 pts with wild-type or unknown germ-line BRCA status. Eight of nine responding pts remained on BGB-290 treatment as of 7 Jan 2016, ranging from 5+ to 18+ months. Conclusions: BGB-290 demonstrated a favorable safety profile, promising anti-tumor activity in ovarian cancer. Further studies of BGB-290 in ovarian and other cancers are planned. Clinical trial information: NCT02361723.
The prognostic role of KRAS and BRAF in patients undergoing surgical resection of colorectal cancer liver metastasis: a systematic review and meta-analysis
Authors: F. Passiglia, A. Galvano, S. Rizzo, A. Listì, N. Barraco, R. Maragliano, L. Insalaco, E. Bronte, I. Alessi, A. Guarini, L. Terruso, L. Castellana, A. Perez, D. Massihnia, F. Di Piazza, V. Calò, M. Castiglia, V. Bazan, A. Russo
Journal: Annals of Oncology (2016)
Abstract 149: How Effective Is Steroid Combination Therapy For High-risk Cases Of Kawasaki Disease?
Authors: Yukako Yoshikane, Junichi Hashimoto, Shinichi Hirose
Journal: Circulation (2015)

Background: There are three scoring systems for the prediction of non-response to IVIG in Japan. Steroid combination therapy for initial treatment is recommended for high risk cases in the new guideline from the scientific committee the Japanese society of pediatric cardiology and cardiac surgery in 2012. Objective: to evaluate efficacy of steroid combination therapy for high risk cases which have high scores in more than two prediction scoring systems. Subjects and Methods: From January 2009 to 2014, a total of 54 hospitalized patients with high scores in more than two prediction scoring systems were enrolled. The patients were separated into two groups. Group S (n=21): who were administered steroid+IVIG, Group N (n=33): who were administered only IVIG. Clinical data, clinical course, and circumstances of additional therapies were compared. Results: In the patients who had high scores in two prediction scoring systems, there were fewer patients who received additional therapies in group S compared to that in group N (13% 1/8 vs. 38% 8/21). However, for patients who had high scores in all prediction scoring systems, those who received additional therapies had not decreased in group S compared to that in group N (50% 6/12 vs. 46% 6/13). Conclusions: Steroid combination therapy is beneficial for the patient who has high scores in two or less prediction scoring systems. On the other hand, in the most severe cases those who have high scores in all prediction scoring systems, Steroid combination therapy is less efficacious and other additional therapy should be considered in the early stage to improve prognosis.
Maternal pneumococcal nasopharyngeal carriage and risk factors for neonatal carriage after the introduction of pneumococcal conjugate vaccines in The Gambia
Authors: E. Usuf, A. Bojang, B. Camara, I. Jagne, C. Oluwalana, C. Bottomley, U. D'Alessandro, A. Roca
Journal: Clinical Microbiology and Infection (2017)

Pneumococcal nasopharyngeal carriage occurs early in life. However, the role of vertical transmission is not well understood. The aims of this study were to describe carriage among mothers and their newborns, and to assess for risk factors for neonatal carriage.In a nested retrospective cohort study, we analysed data from the control arm of a randomized controlled trial conducted in The Gambia 2 to 3 years after introduction of pneumococcal conjugate vaccine (PCV) 13. Nasopharyngeal swabs were collected from 374 women and their newborns on the day of delivery, then 3, 6, 14 and 28 days later. Pneumococci were isolated and serotyped using conventional microbiologic methods.Carriage increased from 0.3% (1/373) at birth to 37.2% (139/374) at day 28 (p <0.001) among neonates and from 17.1% (64/374) to 24.3% (91/374) (p 0.015) among women. In both groups, PCV13 vaccine-type (VT) serotypes accounted for approximately one-third of the pneumococcal isolates, with serotype 19A being the most common VT. Maternal carriage (adjusted odds ratio (OR) = 2.82; 95% confidence interval (CI), 1.77-4.80), living with other children in the household (adjusted OR = 4.06; 95% CI, 1.90-8.86) and dry season (OR = 1.98; 95% CI, 1.15-3.43) were risk factors for neonatal carriage. Over half (62.6%) of the neonatal carriage was attributable to living with other children in the same household.Three years after the introduction of PCV in The Gambia, newborns are still rapidly colonized with pneumococcus, including PCV13 VT. Current strategies for pneumococcal control in Africa do not protect this age group beyond the herd effect.