tbuckley/cabot-search huggingface dataset:
Abstract 19387: Extracellular Matrix Remodelling in Porcine Coronary Arteries Upon Stent Implantation
Authors: Gonca Suna, Wojtek Wojakowski, Javier Barallobre-Barreiro, Xiaoke Yin, Steve J White, Krzysztof P Milewski, P Gasior, Piotr P Buszman, Pawel E Buszman, Jonathan M Hill, Manuel Mayr
Journal: Circulation (2015)

Introduction: Extracellular matrix (ECM) remodeling upon vascular stent injury contributes to both neointimal hyperplasia (restenosis) as well as endothelialization (propensity for thrombosis). Despite its important clinical implications little is known about ECM changes post stent implantation. Hypothesis: ECM remodelling, a determinant of stent healing, differs between drug-eluting (DES) and bare-metal stents (BMS). Methods: Using proteomics, we profile changes of vascular ECM proteins over time following implantation of DES and BMS in porcine coronary arteries in an overstretch model. Results: DES (n=14) or BMS (n=14) were implanted in coronary arteries of pigs. Quantitative coronary angiography and optical coherence tomography were performed at 1, 3, 7, 14 and 28 days after stent deployment. Animals were sacrificed at each of these time-points and their coronary arteries were retrieved for subsequent analysis by proteomics. A total of 126 ECM and ECM-associated proteins were identified by mass spectrometry. Within the first week after stent injury, proteins involved in inflammation and thrombosis were elevated in DES and BMS stented arteries. After one week, significant changes in regulatory ECM proteins such as small leucine rich proteins or matricellular proteins were observed. By day 28, differences between BMS and DES became apparent: basement membrane proteins as markers of cellularity were reduced in DES compared with BMS. In contrast, large aggregating proteoglycans such as aggrecan and versican were increased. Both belong to the lectican protein family that act as linkers of ECM molecules with their highly charged glycan side chains. The proteomics findings were validated by immunoblot analysis and real-time polymerase chain reaction. We were also able to detect aggrecan by immunohistochemistry in clinical specimen confirming differential expression patterns of aggrecan and versican in stented human coronary arteries. Conclusions: In the early course after BMS and DES implantation the ECM changes were similar. Significant differences were identified in the regulation of ECM proteins in long-term follow-up consisting of suppression of basement membrane proteins and up-regulation of large aggregating proteoglycans in DES.
Let’s chat: Piloting an approach to patient-caregiver goal discussions in a neuro-oncology clinic.
Authors: Maija Reblin, Dana Ketcher, Jennifer M. Taber, Kristin G Cloyes, Brian R Baucom, Margaret F. Clayton, Lee Ellington
Journal: Journal of Clinical Oncology (2018)

28 Background: Communication is important to fostering joint coping in patients with advanced cancer and their family caregivers. Joint goal setting has been shown to enhance relationship quality for dyads and increase interpersonal ease and connection. Often patients and caregivers indicate they wish to discuss issues together but have difficulty doing so, which can inhibit dyadic coping and achievement of treatment goals and interpersonal plans. The aim of this study was to determine the feasibility and describe the methods of a short, one-time goal communication intervention for neuro-oncology patients and their primary family caregivers. Methods: Participants were recruited from a neuro-oncology clinic at an NCI-Designated Comprehensive Cancer Center. After informed consent from both patient and caregiver, the dyad was taken to a private room to complete a demographic questionnaire, eight-minute self-directed dyadic discussion of goals, and post-discussion questionnaire. For the discussion, dyads were asked to create and discuss three goals they had for themselves, and three goals they thought their partner would list, with at least one non-cancer related goal. Results: 10 dyads (n=20) were recruited for this study. Participants were mostly white, non-Hispanic, and married spouses. Only one patient participant was unable to list three goals. Dyads reported that the discussion was not stressful and they found high levels of benefit. Analysis of questionnaire and open-ended feedback overwhelmingly indicated the discussion task was useful to participants and that the study environment encouraged open, non-confrontational communication. Conclusions: Our brief prompted dyadic discussion intervention was feasible to implement and participants reported it was useful. Communication between advanced cancer patients and caregivers is vitally important to facilitate dyadic coping and ensure dyads are better able to achieve their goals. This pilot could be easily adapted to facilitate dyadic communication longitudinally to help facilitate communication between patients and caregivers along the cancer care continuum.
How lobbying blocked European safety checks for dangerous medical implants
Authors: Simon Bowers, Deborah Cohen
Journal: BMJ (2018)

Industry lobbyists have wrecked plans to overhaul safety regulations for medical devices in Europe, report <b>Simon Bowers, Deborah Cohen, and colleagues from the International Consortium of Investigative Journalists</b>. Meanwhile, confidential injury and malfunction reports have tripled in less than 10 years in many European countries
Abstract 10980: Myositis, Myocarditis, and Mitochondria: A Thread Connecting the Myofilaments
Authors: Brian A Houston, Steve Hsu, Marc Halushka, Allan Gelber, Daniel Judge
Journal: Circulation (2015)

A 67 year old man presented in 2013 with new heart failure symptoms. A curious past medical history prompted pursuit of an etiologic diagnosis. In 2006, he developed weakness and elevated creatine kinase (CK). Muscle biopsy was consistent with a necrotizing myopathy, and a serologic panel of auto-antibodies was unrevealing. He was started on prednisone. In 2011, he presented with atypical chest pain, and ECG demonstrated frequent atrial and ventricular ectopy. Both troponin-I and CK were elevated. Cardiac CT angiography ruled out obstructive coronary disease, and he remained stable until the onset of heart failure symptoms prompted his current admission. On examination, the patient had evidence of proximal muscle weakness and atrophy. His jugular venous pulse was elevated, and auscultation revealed an S3 gallop. Troponin (0.35 ng/mL) and CK (776 U/L) were both elevated and remained consistently so. Echocardiography revealed severely reduced left ventricular function. Search for a unifying diagnosis prompted review of his myositis panel whereupon immunoprecipitation bands characteristic for anti-mitochondrial antibodies were discovered. Serologies for anti-mitochondrial antibodies returned positive. His plasma lactate was elevated with a normal pyruvate level, mimicking the changes seen in inborn errors of mitochondrial function. Cardiac magnetic resonance imaging showed patchy gadolinium enhancement in the mid-myocardium of the septum and lateral wall in a non-coronary distribution and no perfusion abnormalities. Endomyocardial biopsy established the presence of myocarditis, confirming the diagnosis of anti-mitochondrial antibody-associated myocarditis and myositis. Along with a beta-blocker and diuretic (he experienced worsening renal insufficiency on low-dose ACE inhibitor), we initiated azathioprine at 50 mg up-titrating to a dose of 150 mg daily over several weeks. The patient reported no recrudescence of heart failure symptoms. Echocardiogram three months later revealed improved left ventricular function, and his CK and troponin-I levels normalized. In cases of idiopathic myositis and myocarditis, anti-mitochondrial antibodies may provide a unifying diagnosis and significantly alter management and prognosis.
Abstract 13392: Real World Evidence Showed Similar Efficacy and Safety for Ticagrelor Compared With Prasugrel in a Secondary Prevention Population Following Acute Coronary Syndrome
Authors: Zhong Yuan, Alexei N Plotnikov, James Weaver, Ajit Londhe, John Strony, Elliot Barnathan
Journal: Circulation (2018)

Real World Evidence Showed Similar Efficacy and Safety for Ticagrelor Compared with Prasugrel in a Secondary Prevention Population Following Acute Coronary Syndrome Introduction: Direct comparative...
Pretreatment Tumor 18F-FDG Uptake Improves Risk Stratification Beyond RECIST 1.1 in Patients With Advanced Nonsquamous Non–Small-Cell Lung Cancer
Authors: Seung Hwan Moon, Jong-Mu Sun, Jin Seok Ahn, Keunchil Park, Myung-Ju Ahn, Joon Young Choi
Journal: Clinical Nuclear Medicine (2018)

This study investigated the prognostic role of tumor F-FDG uptake on pretreatment scans as an independent indicator and whether its addition improves risk prediction from Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1).We measured the SUVmax of the most F-FDG-avid tumor lesions on pretreatment scans from 222 patients (age, 60.5 ± 9.5 years; males, 55.2%) with advanced nonsquamous non-small-cell lung cancer who were enrolled in a prospective phase II clinical trial. We then examined the prognostic value of SUVmax compared with other clinical factors, including chemotherapy response according to RECIST 1.1 criteria.A multivariable Cox proportional hazards model revealed that an SUVmax greater than 16.3 was an independent predictor of poor progression-free survival (hazards ratio, 3.50; 95% confidence interval, 1.89-6.51; P < 0.000) and overall survival (hazards ratio, 6.87; 95% confidence interval, 2.51-18.76; P < 0.000), whereas RECIST 1.1 did not show a significant association with any survival outcome. Furthermore, improvement was achieved by adding SUVmax to RECIST 1.1, which increased the net reclassification index (27.4%; P = 0.046) and integrated discrimination improvement (integrated discrimination improvement, 10.6%; P = 0.026). Similarly, adding RECIST 1.1 to SUVmax also improved net reclassification index (68.9%, P = 0.006) and integrated discrimination improvement (25.4%, P = 0.006) for prognosis prediction.High tumor F-FDG uptake on a pretreatment scan is an independent prognostic indicator that can significantly improve risk stratification when added to RECIST 1.1 for patients with advanced nonsquamous non-small-cell lung cancer.
Richter Syndrome Presenting With Colon Localization
Authors: Mariadea Lavalle, Laura Maria Minordi, Stefan Hohaus, Riccardo Manfredi, Vittoria Rufini
Journal: Clinical Nuclear Medicine (2018)

A 75-year-old man, who had been diagnosed with small lymphocytic lymphoma with cervical localization, underwent F-FDG PET/CT with iodinated contrast medium due to the appearance of cervical swelling suspected of illness relapse. PET/CT revealed intense F-FDG uptake in multiple cervical and subdiaphragmatic lymph nodes and in the left parotid. Moreover, diffuse uptake and wall thickening of the colon were evident; endoscopy with biopsy revealed a diffuse large B-cell lymphoma. Transformation into a more aggressive lymphoma occurs in 2% to 8% of small lymphocytic lymphoma, the so-called Richter syndrome. Extranodal localization in the sigmoid colon is an extremely rare site for transformed lymphoma.
Small Primary Cutaneous γδT-Cell Lymphoma Lesions Successfully Treated With Pralatrexate
Authors: Osamu Imataki, Shumpei Uchida, Shigeyuki Yokokura, Makiko Uemura, Norimitsu Kadowaki
Journal: Clinical Nuclear Medicine (2018)

Here we report on the treatment of a 38-year-old woman with primary cutaneous γδT-cell lymphoma, which is a rare subset of cutaneous T-cell lymphoma. She presented with multiple subtle subcutaneous nodules, which were not clearly observed on computed tomography scans or after biopsy. However, F-fluorodeoxyglucose positron emission tomography (F-FDG-PET) accurately detected small cutaneous lesions. She achieved a second complete remission, as demonstrated by F-FDG-PET performed after pralatrexate infusion.
Shared decision-making preferences and pain characterization in patients with cancer.
Authors: Jeannine M. Brant, Carrie Tompkins Stricker, Alison Petok, Regina Sih-Meynier, Debra Wujcik
Journal: Journal of Clinical Oncology (2018)

30 Background: Cancer pain prevalence is high (52%-77%) with breakthrough pain flares and end-of-dose failure adding to patient suffering and increased health care utilization. Shared decision-making (SDM), incorporating patient-stated preferences, goals, and concerns, can foster comprehensive pain assessment (CPA) and improve pain outcomes. Methods: This study will evaluate SDM and CPA in patients with cancer to manage chronic and breakthrough pain. Eligible patients have pain or are taking opioids to manage chronic cancer pain. Patients complete a tablet-based survey at enrollment to record baseline pain and activity levels, pain flare severity and length, end-of-dose pain, and SDM preferences. Results are presented on an electronic dashboard and the provider and patient collaboratively establish a pain care plan. The effectiveness of SDM on pain outcomes will be measured with the Pain Care Quality Survey. Results: Pain characterization is described for the first 43 patients enrolled, of which 42% (n=18) desire to share decision-making with the provider, while 35% (n=15) prefer to make the final decision after considering provider input. Patients are 57% (n=26) female with a mean age of 56 (range 20-93); baseline mean pain scores were 5.4, and overall distress scores were 5.43, (scale 0-10); 91% had a pain flare in the last seven days with mean severity of 5.53; 72% of flares lasted longer than 30 minutes. All patients had end-of-dose pain. Less than half (42%) have restricted activity and 23% manage self-care but cannot work. Participants reported incident pain associated with certain activity (63%) as well as insidious pain not associated with activity (65%). Enrolled patients selected 143 pain descriptors: burning (16), achy (24), sharp and stabbing (21), pins and needles (15), cramping (14) radiating (14), intermittent (19), and continuous (20). Conclusions: The majority (77%) of patients desire SDM. Although most patients were already taking opioids at presentation, they had moderate pain and distress, frequent flares and end of dose pain, and limitations on activity level due to the pain. Baseline pain characterization with a drill down CPA offers opportunity to use SDM to develop effective pain care plans and measure outcomes. Clinical trial information: NCT03304145.
Adding shared laughter to optimise shared medicine.
Authors: Hilde M. Buiting, Remco de Bree, Linda Brom, Jennifer W. Mack, Michiel van den Brekel
Journal: Journal of Clinical Oncology (2018)

43 Background: Most people are familiar with the expression "laughter is the best medicine". By triggering endorphin release and strengthening relationships, it can be considered a perfect holistic care-approach. We explored the occurrence, acceptability, and functions of humor and laughter in patients with incurable cancer. Methods: We performed 16 in-depth interviews with patients with incurable cancer at the day-care unit of a Dutch comprehensive cancer hospital. We further performed and online questionnaire-study among 33 oncologists (41% of 81 approached) about experiences with humour and laughter in breast, lung, head and neck, or urological cancer. Results: Nearly all oncologists reported using humour (97%), and all reported to sometimes laugh during consultations; 83% reported experiencing a positive effect of laughter. These results were in line with patients’ experiences: Patients noted that humor always stayed alive, despite having incurable cancer. Apart from this human aspect, patients also used humor to broach difficult topics and to downplay challenges. Some patients explicated that the appreciation of humor was dependent on the type of humor, since humor is rather personal. Patients and oncologists acknowledged that using humor is delicate, and sometimes inappropriate, partly because they did not always share the same type of humor. Laughter, in contrast, was regarded as ‘lighter’ than humor, and could, accordingly, more easily be implemented. However, both patients and specialists cautioned against patients using laughter to avoid uncertainty or broach difficult topics. Conclusions: Our results suggest that patients and healthcare professionals can benefit from humour or laughter. Many conversations were joyful, even in the midst of medical challenges. Although humor is personal, laughter can be applied more easily. Healthcare professionals therefore need to have a basic comprehension of the impact of laughter to facilitate discussions, improve the doctor-patient relationship, and identify underlying wishes. If applied appropriately, shared laughter will possibly add to optimise shared medicine.
The FDA Sentinel Initiative — An Evolving National Resource
Authors: Richard Platt, Jeffrey S. Brown, Melissa Robb, Mark McClellan, Robert Ball, Michael D. Nguyen, Rachel E. Sherman
Journal: New England Journal of Medicine (2018)

A decade after the launch of the FDA Sentinel Initiative, it has matured from a pilot program designed to assess potential drug-safety signals in insurance claims into a core component of the agency's evolving safety surveillance system.
Cancer Immunity and Gene Expression Data: A Quick Tool for Immunophenotype Evaluation
Authors: Masayuki Hirano
Journal: Cancer Research (2018)

Abstract The rapid advancement of next generation sequencing technology has resulted in accumulation of many datasets in cancer clinical and research laboratories, many of which do not have bioinformaticians. Xu and colleagues developed a user-friendly web-based tool to define the tumor immunophenotype among patients with cancer. By uploading user-defined datasets on the web, it can systematically track, analyze, and visualize the status of anticancer immune activity and the proportion of tumor-infiltrating immune cells. This tool can help immunologists and clinical researchers to perform quick, efficient, and comprehensive analysis of the tumor immunophenotype. See related article by Xu et al., p. 6575
Abstract P289: Cesarean Section is Associated with Increased Risk for Overweight and Obesity in Grade Six Children
Authors: Liang Wang, Arsham Alamian, Jodi Southerland, James Anderson, Kesheng Wang, Marc Stevens
Journal: Circulation (2013)

Introduction— Few studies have investigated the relationship between delivery mode in the U.S. and the risk of overweight and obesity in the offspring. The findings from these studies have not been consistent. Hypothesis— We assessed the hypothesis that children born by cesarean section (C-section) compared with those born vaginally were at an increased risk of overweight and obesity in grade six. Methods— Data were obtained from Phase I to Phase IV of the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development. Subjects with complete data through stage 3 (from year 1991 to 2005), when the children were in grade six, were included in this study (n=917). Multiple logistic regression was used to adjust for potential confounding by the maternal factors of age, education, poverty status, living status, depression, breastfeeding, and smoking status during pregnancy and the child factors of sex, race, birth weight, physical activity, total TV time, and video/computer game time. The association between C-section and childhood overweight and obesity was evaluated. Results— In grade six, 41.4% (77 of 186) of children delivered by C-section were overweight compared with 32.2% (235 of 731) of children born vaginally while 24.7% (46 of 186) of children delivered by C-section were obese compared with 17.0% (124 of 731) of children born vaginally (both p&lt;0.05). After adjustment for potential confounders, children delivered by C-section compared to vaginal delivery had about twice the risk of being overweight (OR=1.85, 95% CI=1.26-2.71) or obese ((OR=1.87, 95% CI=1.19-2.94). However, after examining the association separately by sex, males delivered by C-section had an increased risk only for being obese (OR=2.56, 95% CI=1.35-4.85) while females delivered by C-section had an increased risk only for being overweight (OR=1.99, 95% CI=1.16-3.40). It was also found that lower maternal education and higher child birth weight were both associated with increased risk of overweight and obesity in sixth grade children. Conclusions— In conclusion, C-section was associated with an increased risk of overweight and obesity in children in grade six, and the relationship varied by sex. Additional longitudinal studies are warranted to examine the long-term effects of delivery mode on the risk of childhood overweight and obesity.
Association of pyrin mutations and autoinflammation with complex phenotype hidradenitis suppurativa: a case–control study
Authors: S. Vural, M. Gündoğdu, E. Gökpınar İli, C.D. Durmaz, A. Vural, L. Steinmüller‐Magin, A. Kleinhempel, L.M. Holdt, T. Ruzicka, K.A. Giehl, H.I. Ruhi, A. Boyvat
Journal: British Journal of Dermatology (2018)

Hidradenitis suppurativa (HS) is a rare, debilitating neutrophilic dermatosis characterized by chronic inflammation of hair follicles. Many inflammatory conditions may accompany HS. To investigate the association of variants of the MEFV gene with a complex HS phenotype. Firstly, we identified the clinical characteristics of 119 patients with HS with a complex phenotype (Hurley stage III disease and/or additional inflammatory symptoms). Then, we searched for MEFV variants among these patients. The odds ratios (ORs) for pathogenic MEFV mutations were calculated using data from these patients with HS and 191 healthy controls. The male/female ratio was higher, and the mean age of onset was earlier, in our complex HS group compared with patients with HS in general. Five of the patients with HS (4·2%) had a diagnosis of familial Mediterranean fever (FMF) with a standardized morbidity ratio of 45 [95% confidence interval (CI) 16·50–99·84, P < 0·001] when compared with the frequency of FMF in the general Turkish population. Of the patients with complex HS, 38% were positive for pathogenic variants of MEFV. The OR for carrying a pathogenic MEFV allele was 2·80 (95% CI 1·31–5·97, P < 0·001). The frequency of MEFV mutations in the group of patients with complex HS was higher than that in healthy controls, suggesting that MEFV mutations may contribute to the pathogenesis of HS. Understanding the role of autoinflammation in HS is of fundamental importance for the development of novel therapies.