tbuckley/cabot-search huggingface dataset:
Abstract 21126: Association Between Household Income and Intake of Aspirin for Prevention of Coronary Artery Disease: Insights From the BRFSS 2015 Database
Authors: Abhishek Maan, Brian Baturin, Karuppiah Arunachalam, Annie Gjelsvik, Nishant Shah
Journal: Circulation (2017)

Introduction: The current USPSTF guidelines recommend use of aspirin for primary prevention of CAD in adults aged between 50-69 years. In our study, we sought to determine the association of household income and socioeconomic factors and the use of aspirin for the primary prevention of CAD in the eligible population. Methods: After excluding the participants with prior diagnosis of CAD, those who had a condition which would make the use of aspirin unsafe and missing data on household income, we analyzed a total of 3,913 participants from the Behavioral Risk Factor Surveillance System 2015 database for our study. We performed univariate comparison of various covariates in two categories of participants based on an income threshold of 50,000$. Subsequently, we performed logistic regression and stepwise modeling approach for multivariable analyses to assess the association between the use of aspirin (outcome) and various covariates. Results: In an unadjusted logistic regression model, the participants with household income &lt; $15,000 were 67% less likely to use aspirin (OR: 0.33, 95% CI: 0.23-0.47, p&lt; 0.0001) in comparison with the reference group of &gt; $50,000 household income. After adjusting for race, education, insurance, gender, household size and cholesterol awareness in our fully adjusted model, we observed that the participants with household income of $35,000 to $50,000 were 53% less likely to take aspirin for prevention of CAD as compared to referent group of income &gt; 50,000$ (adjusted OR: 0.47, 95% CI: 0.28-0.76, p = 0.003). The participants of Hispanic race were also about 43% less likely to take aspirin as compared to Caucasians (adjusted OR: 0.57, 95% CI: 0.40-0.80, p = 0.002). Conclusions: Our findings highlight significant disparities in the use of aspirin for primary prevention of CAD potentially reflecting the role of income and racial factors. A targeted approach to address the use of aspirin in these subgroups might be beneficial.
Poor handovers and rota gaps are a sign of problems with training, says GMC
Authors: Abi Rimmer
Journal: BMJ (2018)

Junior doctors who experience problems with handovers and rotas may not be getting the quality of training and support that they should be, the General Medical Council has said.

The two aspects of work were highlighted in the GMC’s 2018 national training survey as pressure points which were signs of heavy workloads and could affect patient care.1

The survey was sent to all doctors in foundation, core, and higher specialty training programmes and 51 956 trainees responded (a 96% response rate).

It found that of the 4712 (9.1%) trainees who said that their daytime workload was very heavy, 13% felt that handover arrangements did not always ensure continuity of care for patients …
AB0797 A randomised double blind placebo controlled trial to compare the efficacy of initial combination therapy vs monotherapy for pulmonary arterial hypertension in systemic sclerosis
Authors: P. Dwivedi, S.K. Sharma, V. Dhir, M.K. Rohit, D. Behera, S. Jain
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Pulmonary Arterial Hypertension(PAH) is one of the leading cause of death in Systemic Sclerosis(SSc) population. Trials that have studied the efficacy of initial oral combination therapy versus monotherapy for the treatment of PAH in SSc are limited. <h3>Objectives</h3> To study the efficacy and safety of monotherapy (sildenafil) versus initial combination therapy (sildenafil and bosentan) for treatment of SSc related PAH. <h3>Methods</h3> In a single centre, double blind, prospective, randomised, placebo controlled trial, 34 patients of SSc related PAH defined as Pulmonary Artery Systolic Pressures{PASP}&gt;35 mmHg as measured by echocardiography, New York heart Association(NYHA) functional class II and III with forced vital capacity &gt;60% were randomised in 1:1 ratio to sildenafil (20 mg thrice a day) and matched placebo of bosentan to one study arm or to the combination of sildenafil(20 mg thrice a day) and bosentan (62.5 mg twice daily for 4 weeks maximum up to 125 mg twice daily) to the other arm for 24 weeks. The primary end point of the study was to assess the change in pulmonary artery pressures measured by echocardiography at 24 weeks from baseline. The secondary efficacy end points was to compare the change in 6 min Walk Distance (6MWD), Time To Clinical Worsening(TTCW) and adverse events at 24 weeks. Intention to treat analysis was carried for the primary and secondary outcomes. p&lt;0.05 was considered significant. Kaplan Meier survival analysis was done to estimate the time to PAH worsening and hazard ratio was calculated. <h3>Results</h3> The mean change in Pulmonary Artery Systolic Pressures in the monotherapy arm was −1.0 mmHg versus +2.1 mmHg in the combination arm (p=0.56). TTCW is prolonged in the combination arm. The mean survival time in the initial combination arm was 23.76±0.59 weeks and 23.28±0.23 weeks in the monotherapy arm. The hazard ratio was 0.73{95% C.I 0.04–11.7} (p=0.87). The mean change in the 6 min walk distance in the monotherapy arm was 15.88±31.83 m and 25.88±38.25 m in the combination arm (p=0.38). The satisfactory clinical response in the combination arm was 82.3% versus 70% in the monotherapy arm (O.R=1.9{C.I 0.38–9.88} p=0.44). The upfront combination of sildenafil and bosentan was well tolerated with similar rates of adverse events in both group. <h3>Conclusions</h3> In this study we could not demonstrate any significant difference in the efficacy of initial combination therapy of sildenafil and bosentan over sildenafil monotherapy. The patients of systemic sclerosis tolerated the initial combination of sildenafil and bosentan well and the treatment prevented further deterioration. Larger studies with more number of subjects may be required to confirm the results. Trial Registration- Clinical Trials.gov:NCT03053739 <h3>Disclosure of Interest</h3> None declared
Neuropathology of Circadian Alterations in Parkinson Disease
Authors: Karim Fifel
Journal: JAMA Neurology (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 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
Whole-Fat or Nonfat Dairy? The Debate Continues
Authors: Rita Rubin
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
California wildfires: I am simultaneously worried about my own health, the health of my patients, and the safety of my children
Authors: Lily Morrison, Chen (Amy) Chen, Natalia Linou, Eleni Linos
Journal: BMJ (2018)

I am convinced clinic room three is smokier than clinic room two. Although I have a respirator mask in my bag, I don’t wear it because it feels hypocritical to try to protect myself if I can’t give a mask to the patient sitting in front of me. So I just hold my breath when I go into clinic room three. This is the first time I have ever felt simultaneously worried about my own health, the health of my patients, and the safety of my children—whose school has just closed because the air outside is too dangerous to breathe.

This was the experience of one of the authors (EL), but illustrates what many healthcare professionals across California have been dealing with for the past few weeks.

Wildfires continue to devastate California, leaving over 80 people dead, 1000 missing, and thousands displaced. Millions more are affected by the smoke blowing south east from the worst fire in California’s history, as northern California becomes the most polluted region in the world.

Air pollution …
Estrogen mediates protection against bacterial invasion on Huh-7 cells via both estrogen receptor and mitogen-activated protein kinase dependent pathway
Authors: Rashmi Kaul, Senait Assefa, Mamta Kalra, Anil Kaul
Journal: Cancer Research (2007)

3459  Virulent bacterial pathogens use differential mechanisms to enter the cells to establish chronic infections and inflammation associated with epithelial cell damage that may lead to development of cancer in susceptible individuals. Dr adhesins of Escherichia coli (E.coli) are associated with recurrent urinary tract infections as well as with diarrheal disease. Dr adhesins bind to decay accelerating factor (DAF), a complement regulatory and signaling molecule on host cells and their binding is under the control of hormones. Previously, we reported that pretreatment with physiological concentration of 17-β estradiol protects Huh-7 hepatoma cells and primary human hepatocytes against Dr E.coli invasion (about 60% reduced invasion). This protection was abrogated by blocking with estrogen receptor (ER) antagonist ICI182, 780 (1uM) suggesting involvement of ERs. Evidence suggests that estrogen may also cause rapid activation of signal transduction pathways like mitogen-activated protein kinase (MAPK) pathways involving ERs. Therefore in the present study, we investigated the role of MAPK dependent pathway in estrogen mediated protection in Huh-7cells against Dr E.coli invasion. Blocking studies were performed by pretreating cells with MEK1 inhibitor (PD98059) or p38 MAPK inhibitor (SB 202190) prior to bacterial invasion assay using gentamicin to kill extracellular bacteria. Percent bacterial colony forming units (CFU) internalized after treatment with three different doses of inhibitors was analyzed. A combined effect of PD98059 or SB 202190 with ER antagonist ICI 182,780 was also investigated. Pretreatment with PD98059 or SB 202190 showed partial reversal of estrogen mediated protection by increasing internalized mean percent bacterial CFU than in cells treated with estrogen alone (54 to 59.66 ±4 (mean±SEM) vs control 33 to 40±4). Values are expressed as mean percent bacterial CFU of untreated control considered as hundred percent. With PD98059, the results were significant at 0.01uM (p=0.0009) and at 0.1uM (p
Chimeric antigen receptor (CAR) T therapies for the treatment of hematologic malignancies: clinical perspective and significance
Authors: Michael M. Boyiadzis, Madhav V. Dhodapkar, Renier J. Brentjens, James N. Kochenderfer, Sattva S. Neelapu, Marcela V. Maus, David L. Porter, David G. Maloney, Stephan A. Grupp, Crystal L. Mackall, Carl H. June, Michael R. Bishop
Journal: Journal for ImmunoTherapy of Cancer (2018)

Chimeric Antigen Receptor (CAR) T cell therapies – adoptive T cell therapies that have been genetically engineered for a new antigen-specificity - have displayed significant success in treating patients with hematologic malignancies, leading to three recent US Food and Drug Administration approvals. Based on the promise generated from these successes, the field is rapidly evolving to include new disease indications and CAR designs, while simultaneously reviewing and optimizing toxicity and management protocols. As such, this review provides expert perspective on the significance and clinical considerations of CAR T cell therapies in order to provide timely information to clinicians about this revolutionary new therapeutic class.
Breast cancer cell lines resistant to either tamoxifen or Herceptin exhibit sensitivity to the anti-IGF receptor antibody A12 in vitro
Authors: Carolyn J M Best, Dale L. Ludwig, Patricia S. Steeg
Journal: Cancer Research (2006)

1228  The insulin-like growth factor (IGF) system has long been recognized for its potential importance in cancer, but has only recently become the focus of therapeutic intervention. Cross-talk between the IGF-1 receptor (IGF-1R) pathway and those mediating resistance to molecular therapeutics has been investigated but is incompletely understood. There is potential utility in combinatorial therapy targeting these pathways. We have performed single agent studies with a monoclonal antibody against IGF-1R (A12, ImClone) in models of resistant breast cancer, and have combined this agent with the breast cancer antibody therapeutic trastuzumab (Herceptin). Inhibition of proliferation was performed in growth media supplemented with 10% fetal bovine serum and assessed by MTT assay. In single agent studies, the MCF7 cell line, a model that is relatively sensitive to traditional therapies, showed significant growth inhibition in response to A12, with an IC50 of 10nM. A12-dependent growth inhibition was also studied in two models of tamoxifen-resistance: MCF-7/LCC2, which is the MCF7 model selected in tamoxifen, and the BT474 cell line, which exhibits tamoxifen resistance due to cross-talk with the over-expressed Her-2 receptor. Both cell lines showed significant growth inhibition in response to A12, with 5nM inducing 20% inhibition, although IC50 concentrations were higher than with MCF7. BT474 cells were growth inhibited by Herceptin with an IC50 of 50 nM, so combinatorial studies were performed. Treatment of BT474 cells with A12 and Herceptin resulted in additive growth inhibition, where A12 at 5 nM increased Herceptin-dependent growth inhibition by 10%. To model Herceptin resistance, Her-2 overexpressing SKBR3 cells were cultured in the presence of 10 μg/ml Herceptin for 15 weeks. The resulting cell line, SKBR3-Her10, showed an increased response to A12, with up to 20% growth inhibition, in comparison to the parent cell line, which was unresponsive. This may indicate that a decreased reliance on Her-2 for growth stimulation is compensated with an increased reliance on IGF-1R. Collectively, inhibition of the IGF-1R pathway may hold promise for the treatment of resistant breast cancer. In vivo studies and Western analyses of differential signal transduction are ongoing.
Radiomic signature of<sup> 18</sup>F fluorodeoxyglucose PET/CT for prediction of gastric cancer survival and chemotherapeutic benefits
Authors: Yuming Jiang, Qingyu Yuan, Wenbing Lv, Sujuan Xi, Weicai Huang, Zepang Sun, Hao Chen, Liying Zhao, Wei Liu, Yanfeng Hu, Lijun Lu, Jianhua Ma, Tuanjie Li, Jiang Yu, Quanshi Wang, Guoxin Li
Journal: Theranostics (2018)

We aimed to evaluate whether radiomic feature-based fluorine 18 ( 18 F) fluorodeoxyglucose (FDG) positron emission tomography (PET) imaging signatures allow prediction of gastric cancer (GC) survival and chemotherapy benefits.Methods: A total of 214 GC patients (training (n = 132) or validation (n = 82) cohort) were subjected to radiomic feature extraction (80 features).Radiomic features of patients in the training cohort were subjected to a LASSO cox analysis to predict disease-free survival (DFS) and overall survival (OS) and were validated in the validation cohort.A radiomics nomogram with the radiomic signature incorporated was constructed to demonstrate the incremental value of the radiomic signature to the TNM staging system for individualized survival estimation, which was then assessed with respect to calibration, discrimination, and clinical usefulness.The performance was assessed with concordance index (C-index) and integrated Brier scores.Results: Significant differences were found between the high-and low-radiomic score (Rad-score) patients in 5-year DFS and OS in training and validation cohorts.Multivariate analysis revealed that the Rad-score was an independent prognostic factor.Incorporating the Rad-score into the radiomics-based nomogram resulted in better performance (C-index: DFS, 0.800; OS, 0.786; in the training cohort) than TNM staging system and clinicopathologic nomogram.Further analysis revealed that patients with higher Rad-scores were prone to benefit from chemotherapy. Conclusion:The newly developed radiomic signature was a powerful predictor of OS and DFS.Moreover, the radiomic signature could predict which patients could benefit from chemotherapy.
Comparative microbiome analysis of Dermatophagoides farinae, Dermatophagoides pteronyssinus, and Tyrophagus putrescentiae
Authors: Jinyoung Lee, Ju Yeong Kim, Myung-hee Yi, Younjee Hwang, In-Yong Lee, Sung-Hyun Nam, Dongeun Yong, Tai-Soon Yong
Journal: Journal of Allergy and Clinical Immunology (2018)
Abstract P216: Elevated Blood Glutathione Does Not Reduce Arterial Stiffness or Central Blood Pressure in Healthy Males and Females
Authors: Brianna K Bruggeman, Katharine E Storo, Haley M Fair, Andrew J Wommack, James M Smoliga, Colin R Carriker
Journal: Circulation (2018)

Intro: Glutathione is endogenous within human plasma, erythrocyte lysate and is also bound to the protein within plasma. Glutathione mediates redox chemistry and prevents oxidative damage within and around cellular components via reduction of reactive species (e.g. reactive oxygen, nitrogen, or sulfur species). Polyphenols and antioxidants have been shown to improve NO bioavailability which may reduce long term incidence of endothelial dysfunction. Less is known about whether changes in antioxidant capacity augments the risk of developing hypertension. Hypothesis: We hypothesized that acute glutathione supplementation would decrease arterial stiffness and reduce both brachial (bBP) and central blood pressure (cBP) in healthy male and female volunteers. Methods: Six males and six females (25 ± 3 and 22 ± 1 years, respectively) participated in a randomized, double blind, placebo controlled, crossover protocol. On two visits separated by 1 week, following a 12-hour fast, participants consumed either a placebo or glutathione (negligible and 200 mg, respectively) supplement via 90 second sublingual absorption which was then swallowed. Concentrations of oxidized (GSSG) and reduced glutathione (GSH) were spectrophotometrically measured in plasma (protein-bound) and erythrocyte lysate using a kinetic, enzymatic assay. Arterial stiffness was measured via pulse wave velocity (PWV) using applanation tonometry, and cBP was determined non-invasively using pulse wave analysis. All data were recorded before supplementation (baseline) and at 10, 30, 60 and 120 minutes post-consumption. Results: Linear mixed effect models revealed a significant (p&lt;0.01) increase in total glutathione (GSH+GSSG) in the supplement group compared to placebo across all post-supplementation time points with the greatest increase occurring at 120 minutes (mean 99.0; 95%CI: 7.9,190.1). At 120 minutes post-consumption, no difference was present between glutathione and placebo groups for PWV (5.86 ± 1.19 and 6.08 ± 1.25 m/s, respectively; p=0.43), resting heart rate (52.95 ± 3.55 and 55.83 ± 6.36, respectively; p=0.16), systolic bBP (123.05 ± 12.75 and 123.13 ± 14.52 mmHg; p=0.22), diastolic bBP (71.81 ± 7.87 and 74.21 ± 6.53; p=0.48), systolic cBP (108.05 ± 10.45 and 108.68 ± 11.14 mmHg, respectively; p=0.11) and diastolic cBP (72.03 ± 7.82 and 74.94 ± 6.42 mmHg, respectively; p=0.46). Conclusion: Young healthy males and females experienced an increase in circulating humoral antioxidants in response to glutathione supplementation. However, supplementation had minimal effects on resting hemodynamics. Future research should examine glutathione supplementation’s effect in participants with decreased antioxidant capacity and increased oxidative stress including patients with known disease such as hypertension or peripheral artery disease.
Abstract 175: Dual source 128-slice computed tomography coronary angiography: A low radiation paradigm in evaluation of Kawasaki disease at Chandigarh, North India
Authors: Manphool Singhal, Pankaj Gupta, Surjit Singh, Anju Gupta, Manoj K Rohit, Suman Arora, Niranjan Khandelwal
Journal: Circulation (2015)

Objective: To evaluate the feasibility of low dose computed tomography coronary angiography (CTCA) on a dual source scanner in children on follow up for Kawasaki disease (KD). Methods: A prospective study comprising 20 consecutive children with KD was conducted from November 2013 to August 2014 on 128-dual source second generation Siemens Definition Flash with either prospective or retrospective electrocardiographic (ECG) gating. A radiologist blinded to the clinical profile and echocardiography (ECHO)/ stress thallium data evaluated each scan. Peak Kilovolts (KVp), milliampere (mA) and radiation dose (dose length product-mGycm and effective dose milliSieverts-mSv) were recorded. Another radiologist correlated CTCA data with clinical/ other imaging data. Results: Demographic/ clinical data and scan parameters are given in Table. Mean effective dose was 1.25 mSv (range 0.22 to 2.74), with prospective ECG gating in 8 patients, it was even lower (0.22 to 0.91 mSv). Six of the 20 patients showed abnormalities including ectasia (n=3), aneurysm (n=2) and stenosis (n=3). More than one abnormality was seen in 2 patients. Four children with normal ECHO had abnormalities detected on CTCA. Stress thallium scintiscan had been performed in 16 patients with mild/ moderate reversible perfusion defects detected in 14. Six of 14 patients with moderate perfusion abnormalities had an abnormal CTCA. Conclusion: In our experience, dual source CTCA is a feasible low radiation dose modality in evaluation in patients with KD. Future impact: Dual source CTCA has potential to be standard of care for evaluation of coronary artery abnormalities in KD.