tbuckley/cabot-search huggingface dataset:
Abstract P425: Central Aortic Stiffening in Late-life and Odds of Dementia: The Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS)
Authors: Priya Palta, Jingkai Wei, Aozhou Wu, Michelle Meyer, A Richey Sharrett, Hirofumi Tanaka, David Knopman, Anna Kucharska-newton, Timothy Hughes, Kunihiro Matsushita, Thomas Mosley, Gerardo M HEISS
Journal: Circulation (2020)

Introduction: Stiffening of the aorta is associated with greater pulse pressure and transmission of pulsatile energy into the cerebral circulation, which can increase susceptibility to microvascular damage in the brain. We tested the hypothesis that higher aortic stiffness measured in late-life is associated with a greater prevalence odds of dementia measured ~5 years later. Methods: Dementia-free ARIC-NCS participants (n=4753; mean age: 75 years; 42% male; 21% black) with measures of aortic stiffness at the visit 5 (2011-2013) examination were included. Aortic stiffness was measured by carotid-femoral pulse wave velocity (cfPWV) using the VP-1000 Plus device (Omron Co., Japan) and modeled as continuous (per standard deviation (SD)), categorical into distribution-based quartiles, and as elevated vs. non-elevated cfPWV according to the upper 25 th percentile (13.34 m/s). Cognitive status (normal/mild cognitive impairment (MCI)/dementia) was ascertained at the visit 5 and 6 (2016-2017) examinations with expert review by an adjudication committee of in-person cognitive testing. A multivariable logistic regression model estimated the adjusted association of cfPWV with 5-year odds of dementia. Results: Among dementia-free participants, a 1 SD higher cfPWV was associated with a greater odds of dementia (Odds Ratio (OR): 1.19 (95% Confidence Interval (CI): 1.03, 1.39). Elevated cfPWV (upper 25 th percentile) was also associated with a greater odds of dementia (OR: 1.54, 95% CI: 1.08, 2.19) in this sample. This association was stronger among participants who were cognitively normal at visit 5 (n=3758, Table): the multivariable-adjusted OR of dementia = 2.16 (95% CI: 1.35, 3.47) for elevated vs. non-elevated cfPWV. The risk of dementia among those with baseline MCI (n=955) was not associated with cfPWV levels. Results were robust to adjustment for vascular risk factors. Conclusions: Among older adults, especially when MCI is not present, greater central aortic stiffness is associated with dementia risk.
Trends in malignant melanoma mortality in 31 countries from 1985 to 2015*
Authors: D.D. Yang, J.D. Salciccioli, D.C. Marshall, A. Sheri, J. Shalhoub
Journal: British Journal of Dermatology (2020)

Background Malignant melanoma (MM) causes the highest absolute number of deaths among skin cancers. An up-to-date analysis of international MM mortality trends is required for assessing the burden of disease, and may support the assessment of the effectiveness of new diagnostic, therapeutic and preventative strategies. Objectives To report MM mortality trends between 1985 and 2015 using the World Health Organization (WHO) Mortality Database. Materials and methods We used country-level MM mortality data from the WHO Mortality Database for all countries with high usability death registration data. Mortality trends were described using Joinpoint regression modelling. Results Thirty-one countries met the inclusion criteria. All countries, except the Czech Republic, demonstrated increased age-standardized death rates (ASDRs) in males over the observation period. More countries exhibited decreased or stable MM mortality in females. The median mortality rate for 2013–2015 was 2·57 deaths per 100 000 for males and 1·55 per 100 000 for females. Australia and Norway had the highest ASDRs for males (5·72 per 100 000 and 4·55 per 100 000, respectively). Norway and Slovenia had the highest ASDRs for females (3·02 per 100 000 and 2·58 per 100 000, respectively). MM mortality was greater for males than females in all countries, with sex disparity increasing across the period. Disparity in mortality between older and younger cohorts in several countries was also found. Conclusions An overall increase in MM mortality over the past 30 years was observed. However, there was notable variation in mortality trends between countries, as well as between males and females, and between different age groups.
Abstract 15284: A New Method for Instantaneous and Noninvasive Evaluation of Left Ventricular-Arterial Performance Following Transcatheter Aortic Valve Replacement
Authors: Emad Mogadam, Gregory Giesler, Ray Matthews, Niema Pahlevn
Journal: Circulation (2019)

Introduction: Transcatheter aortic valve replacement (TAVR) is an established alternative to prosthetic surgical valve replacement. Intrinsic Frequency (IF) method has recently been utilized as a s...
Phase 2 study of suberoylanilide hydroxamic acid (SAHA) in relapsed or refractory indolent non-Hodgkin lymphoma: A California Cancer Consortium study
Authors: M. Kirschbaum, J. Zain, L. Popplewell, V. Pullarkat, N. Obadike, P. Frankel, J. Zwiebel, S. Forman, E. Newman, D. Gandara
Journal: Journal of Clinical Oncology (2007)

18515 Background: The indolent (follicular, marginal zone and mantle cell) lymphomas tend to recur with decreasing intervals of remission post standard chemotherapy. Vorinostat (SAHA, Zolinza), an orally administered hydroxamic acid histone deacetylase inhibitor with activity against class I and II deactylases, with preclinical and clinical activity against various forms of lymphoma, is being studied in patients with relapsed or refractory indolent lymphoma. Methods: Patients with relapsed or refractory follicular, marginal zone, or mantle cell lymphoma are eligible. Vorinostat is dosed at 200 mg po twice daily for 14 consecutive days on a 21 day cycle. CT scanning and marrow biopsy is performed after every three cycles. Patients may have received up to four prior chemotherapy regimens including Zevalin or Bexxar; previous transplant is allowed. Results: 15 patients (9 female, 6 male) have been enrolled thus far. Median age is 64 (40- 78) years One patient was found to have coexisting DLBCL and was removed from study. Four patients were taken off study due to progression, three stopped due to toxicity (fatigue in a 73 yo woman who had stable to improved marginal zone lymphoma after 10 cycles, fatigue and atrial fibrillation in a 65 yo man after 7 cycles, diarrhea in a 78 year old woman after 2 cycles). Complete Response (CR) in a patient with follicular lymphoma was attained after 9 cycles, this CR persists now for eight months at the time of abstract submission off therapy. A partial response (PR) was seen in a 40 yo man with lymphoma progression despite multiple rounds of therapy, with rapidly expanding masses just prior to starting vorinostat, the largest of which was 16x12.3 cm. This lesion currently measures 7.2x4.6 cm, with disappearance of many other sites; patient continues on vorinostat. Three of the patients with continued stable disease beyond 9 cycles have marginal zone lymphoma, while the two responders (CR or PR) have follicular lymphoma. A patient with PET resolution and decreases in two of the involved sites stopping after 10 cycles due to fatigue, developed rapid progression three months after stopping vorinostat. Conclusions: Vorinostat demonstrates preliminary activity against follicular and marginal zone lymphoma. No significant financial relationships to disclose.
Sunitinib malate (SU) plus interferon (IFN) in first line metastatic renal cell cancer (mRCC): Results of a dose-finding study
Authors: G. V. Kondagunta, G. R. Hudes, R. Figlin, G. Wilding, S. Hariharan, S. N. Kempin, R. Fayyad, S. Hoosen, R. J. Motzer
Journal: Journal of Clinical Oncology (2007)

5101 Background: Sunitinib malate is an oral, multitargeted tyrosine kinase inhibitor of VEGFRs and PDGFRs with anti-tumor activity in mRCC patients previously treated with cytokines (JAMA, 2006;295:2516). A phase 3 randomized trial showed superiority for SU over IFN in first-line mRCC (PROC ASCO 24,18S, 2006). Dose and safety for SU combined with IFN was investigated in this phase I trial. Methods: Patients (pts) with previously untreated clear-cell mRCC received SU in repeated 6-week cycles of 50 or 37.5 mg/day orally for 4 weeks, followed by 2 weeks off treatment. IFN was given continuously, starting at 3 MU SC 3x/week with intrapatient dose escalation weekly as tolerated, to a maximum of 9 MU. Pts not tolerating a dose combination received lower doses of SU or IFN, or had dose interruptions. Doses of SU plus IFN were considered tolerable if = 4/6 pts completed 2 cycles without dose reduction or interruption. Results: 25 pts were enrolled; 19 are evaluable for safety/response. 6 pts who started treatment at 37.5 SU and 3 MU IFN are too early. The median age of the 19 pts (16 M: 3 F) was 63 years (range 45–77). MSKCC risk group (JCO 20:289–96, 2002) was 37% good and 63% intermediate. 12 pts started treatment with SU 50 mg and dose escalated IFN to 6 or 9 MU TIW. 13 pts started treatment with SU 37.5 mg and dose escalated IFN at 3 MU or to 6 MU TIW. 4 of 19 pts tolerated two cycles. 68% of pts had dose interruptions of SU; 90% of pts had dose interruptions of IFN. 15/19 pts had grade 3 toxicity, 1 pt had grade 4 hypertension and 1 pt grade 5 toxicity (myocardial infarction). Most common grade 3 toxicities were neutropenia (26%), fatigue (26%), and hand-foot syndrome (16%). Although response was not a primary endpoint, at a median of 3 cycles, there were 2 PR, 14 SD, 2 PD and 1 pt was not evaluable. Conclusions: The adverse events seen with combination SU and IFN in mRCC, neutropenia and fatigue, were similar to those seen with single agent SU and IFN, and resulted in frequent dose modifications and interruptions. The safety and efficacy of 37.5 mg sunitinib and 3 MU IFN is being evaluated. No significant financial relationships to disclose.
The evolving algorithm of biological selection in severe asthma
Authors: Nikolaos G. Papadopoulos, Peter Barnes, Giorgio Walter Canonica, Mina Gaga, Liam Heaney, Andrew Menzies‐Gow, Vicky Kritikos, Mark Fitzgerald
Journal: Allergy (2020)

New therapeutic options for severe asthma have recently emerged, mostly in the form of monoclonal antibodies ("biologicals") targeting relevant inflammatory pathways. Currently available agents target different aspects of "Type 2" immunity, and their indications often include overlapping patient groups. We present a round-table discussion that took place during the Annual Meeting of the Respiratory Effectiveness Group (REG), on the reasoning behind the use of different add-on medications for severe asthma, and crucially, on selection strategies. The proposed rational is based on current evidence, including real-life studies, as well as on the appreciation of the relevant complexities. Direct head-to-head comparisons of biologicals are lacking; therefore, algorithms for initial choice and potential switch between agents should be based on understanding the key characteristics of different options and the development of a clear plan with predefined targets and shared decision-making, in a structured way.
Outcome measures that matter: exploring the edges of sport and exercise medicine
Authors: Jane S Thornton, Preston Wiley, Andrew Pipe
Journal: British Journal of Sports Medicine (2020)

As sport and exercise medicine continues to establish itself as a fertile discipline for clinically relevant research, we are making discoveries across a broad spectrum of content—from the harmful effects of sitting to the best injury prevention protocols for elite athletes, and everything in between. There is one area that our community should pay more attention to: implementation.

As more laboratory data roll in and theoretical frameworks roll out, we should ask ourselves the fundamental question, ‘Yes, but does it matter?’ Are we moving the needle on physical inactivity? Are we pushing the edges of sport, including who can and should participate? This issue has been curated by the Canadian Academy of Sport and Exercise Medicine (CASEM) and we explore the answers to some of those questions.

Wearables are becoming increasingly common, mining ever more detailed data for the user… but does it matter? O’Driscoll et al ( See page 332 ) of Leeds University explore how activity monitors stack up on estimating energy expenditure; among other findings, without heart rate sensors, large …
Abstract P202: Prevalence, Factors, And Long-Term Outcomes Associated With Myocardial Infarction With Non-Obstructive Coronary Artery (MINOCA) Diagnosis In A Large Rural Health Care System Cohort
Authors: Katlin Schmitz, Catherine P Benziger
Journal: Circulation (2020)

Hypothesis: Myocardial infarction (MI) with non-obstructive coronary arteries (MINOCA) is a common cause of false positive (FP) ST-segment elevation myocardial infarction (STEMI) with associated high morbidity and mortality. Background: MINOCA is an important clinical problem found in patients presenting with acute coronary syndrome. Various clinical disorders lead to a working MINOCA diagnosis and make treatment and diagnosis a challenge for clinicians. MINOCA was recently defined by the American Heart Association (AHA) as those presenting with myocardial infarction with nonobstructive coronary arteries on angiography and no alternative diagnoses for presentation. Methods: Between 5/01/2009 -6/24/2019, all consecutive STEMI patients were prospectively examined and categorized into true positive STEMI activations or false positive STEMI activations (FP-STEMI). FP- STEMI were further categorized into groups based on the presence or absence of obstructive coronary arteries by angiography. Results: We had 472 FP-STEMI patients (42.3% female, median age of 58.9±16.9 years, 53.4% lived rurally) with 152 (31.4%) having evidence of coronary artery stenosis &gt;50%. A secondary cause was identified for an additional 162 (34.3%) patients. Of the remaining FP-STEMI, 82 (2.9%) met criteria for MINOCA and 76 (2.6%) were borderline MINOCA due to not meeting the troponin criteria. Within the MINOCA group, the three most common presentations were: unknown etiology (42.7%), supply-demand mismatch (26.8%), and spontaneous coronary artery dissection (17.1%). The MINOCA group had a higher baseline incidence of dyslipidemia (p=0.037) compared to FP-STEMI and borderline MINOCA and lower smoking compared to borderline MINOCA (p=0.029). At discharge, referral to cardiac rehabilitation was lower (p=0.015) with only 69.7% of MINOCA patients having prescriptions for aspirin, 50% angiotensin converting enzyme inhibitors or angiotensin receptor blockers, 64.5% beta blockers, and 65.8% statins. MINOCA had the highest statin prescription rate compared to borderline MINOCA and secondary (65.8% vs 51% vs 42.1%; respectively p=0.012). There was no significant difference between the mortality of MINCOA patient compared to the FP-STEMI patients. Only 10 (3.5%) had cardiac magnetic imaging studies obtained within 6 months (MINOCA 3.9%, borderline MINCOA 3.9%, and FP-STEMI 2.7% respectively). MINOCA patients had similar 30-day and 1-year mortality to FP-STEMI patients (9.0% vs 12.4% and 12.5% vs 15.2 % 30-day and 1-year respectively; p=0.064 and p=0.107). Conclusion: MINOCA represents a challenging group of patients with high mortality and low rates of medication prescription and cardiac rehabilitation referral.
Abstract MP13: Prospective Associations of Prenatal Sedentary Behavior and Physical Activity Trajectories With Adverse Pregnancy Outcomes
Authors: Bethany Barone Gibbs, Melissa A Jones, John M Jakicic, Arundhathi Jeyebalan, Kara M Whitaker, Janet M Catov
Journal: Circulation (2020)

Background: Adverse pregnancy outcomes (APO) are risk factors for future cardiovascular disease. Though factors such as obesity increase the risk of APO, whether patterns of prenatal sedentary behavior (SED) or physical activity are associated with APO is unclear. Methods: This cohort study measured objective SED, steps, and moderate-vigorous intensity physical activity (MVPA) during each trimester of pregnancy. Women were instructed to wear two monitors for 7 d: a thigh-mounted activPAL3 micro to measure SED and steps, and an Actigraph GT3X on an elastic waist belt to measure MVPA. Women also completed a detailed wear log. Data were considered valid with ≥4 d of ≥10 hr of wear. Physician-diagnosed APO (gestational hypertension, preeclampsia, gestational diabetes, preterm birth, or intrauterine growth restriction) were abstracted from medical records by trained research personnel. Growth mixture modelling was used to construct separate SED, steps, and MVPA trajectories across pregnancy. Associations between trajectory groups and APO were evaluated using logistic regression with adjustment for prepregnancy BMI, race, education, and age. Results: Women (n=100) had mean (SD) age 31.2 (4.8) yr, pregnancy BMI 26.2 (6.8) kg/m 2 , and were 25% non-white. Trajectory analyses revealed three groups within each SED, steps, and MVPA (see Table). Nineteen women (19%) had at least one APO: gestational hypertension and/or preeclampsia (n=13), gestational diabetes (n=3), preterm birth (n=6), or intrauterine growth restriction (n=4). High vs. low SED trajectory was associated with more than 6-fold higher odds of APO. Medium and high vs. low steps trajectory was associated with lower odds of APO, but only medium vs. low trajectories were statistically different. MVPA trajectory was not associated with APO risk (see Table). Conclusion: Reducing SED and increasing daily steps, though not increasing MVPA, could be novel intervention targets for reducing APO and future cardiovascular risk in pregnant women.
Meaning at the Fingertips
Authors: Vincent Quagliarello
Journal: Annals of Internal Medicine (2020)

On Being a Doctor3 March 2020Meaning at the FingertipsVincent Quagliarello, MDVincent Quagliarello, MDYale School of Medicine, New Haven, Connecticut (V.Q.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M19-2093 Audio Reading - “Meaning at the Fingertips” Audio. Michael A. Lacombe, MD, Annals Associate Editor, reads “Meaning at the Fingertips” by Vincent Quagliarello, MD Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail A colleague recently recounted a story about his 4-year-old grandson. The grandson asked whether he could play doctor while grandpa played patient. So, they approached a table next to each other, and the boy did his imitation of a doctor: He positioned himself, asked grandpa how he was feeling, and pretended to type at a computer on the tabletop. The 4-year-old's perception of the doctor's job wasn't to examine the throat with a tongue depressor, use a stethoscope to examine the heart and lungs, or touch the abdomen with his hands; it was to peck at a keyboard. I wonder ... Author, Article, and Disclosure InformationAffiliations: Yale School of Medicine, New Haven, Connecticut (V.Q.)Corresponding Author: Vincent Quagliarello, MD, Department of Internal Medicine, PO Box 208056, Yale School of Medicine, New Haven, CT 06520-8056; e-mail, vincent.[email protected]edu. PreviousarticleNextarticle Advertisement Audio Reading - “Meaning at the Fingertips” Audio. Michael A. Lacombe, MD, Annals Associate Editor, reads “Meaning at the Fingertips” by Vincent Quagliarello, MD Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics 3 March 2020Volume 172, Issue 5Page: 360-361KeywordsEmotionsNerve endingsPerceptionPharynxPrevention, policy, and public healthQuality of lifeResidencyTongueTouchUlcers ePublished: 3 March 2020 Issue Published: 3 March 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
ASSOCIATION OF ETHNICITY, AGE AND BODY SIZE WITH ELECTROCARDIOGRAPHIC VALUES IN THE COMMUNITY
Authors: Eugene Tan, Chang Feng Xu, Feng Liang, Rajalakshmi Santhanakrishnan, Michelle MY Chan, Swee-Chong Seow, Chi Keong Ching, Mark Richards, Tze Pin Ng, Toon Wei Lim, Carolyn Lam
Journal: Journal of the American College of Cardiology (2014)
Management of hyperleukocytosis and impact of leukapheresis among patients with acute myeloid leukemia (AML) on short- and long-term clinical outcomes: a large, retrospective, multicenter, international study
Authors: Maximilian Stahl, Rory M. Shallis, Wei Wei, Pau Montesinos, Etienne Lengline, Judith Neukirchen, Vijaya R. Bhatt, Mikkael A. Sekeres, Amir T. Fathi, Heiko Konig, Selina Luger, Irum Khan, Gail J. Roboz, Thomas Cluzeau, David Martínez-Cuadron, Emmanuel Raffoux, Ulrich Germing, Jayadev Manikkam Umakanthan, Sudipto Mukherjee, Andrew M. Brunner, Adam Miller, Christine M. McMahon, Ellen K. Ritchie, Rebeca Rodríguez-Veiga, Raphaël Itzykson, Blanca Boluda, Florence Rabian, Mar Tormo, Evelyn Acuña-Cruz, Emma Rabinovich, Brendan Yoo, Isabel Cano, Nikolai A. Podoltsev, Jan Philipp Bewersdorf, Steven Gore, Amer M. Zeidan
Journal: Leukemia (2020)
What Are Two Days Worth? Facing Dilemmas Together at the End of Life
Authors: Leah B. Rosenberg
Journal: New England Journal of Medicine (2020)

At 35, Mr. J. was dying of an invasive pelvic sarcoma and had a tolerance to opioids. Despite his pain, he wanted to be present with his family and friends. When his physician broached the possibility of palliative sedation, he said, "We aren't there yet."