tbuckley/cabot-search huggingface dataset:
Abstract 025: Association of Dietary Patterns and Lifetime Risk of Heart Failure: The Cardiovascular Disease Lifetime Risk Pooling Project
Authors: Sadiya S Khan, Wenze Zhong, Hongyan Ning, Amanda Paluch, Norrina B Allen, Clyde W Yancy, John T Wilkins, Donald M Lloyd-Jones
Journal: Circulation (2019)

Introduction: Modifiable healthy lifestyle factors have been associated with lower risk of developing heart failure (HF). However, the role of dietary patterns in relation to lifetime risk (LR) of HF and years lived free of HF is not established. We hypothesized that better diet quality scores would be associated with lower risk of HF and more years lived free of HF. Methods: We included individual-level pooled data from 7 US population-based cohorts stratified by index age groups (middle-aged [40-59 years] and older [60-79 years]), sex, and race. We calculated the alternate Healthy Eating Index-2010 (AHEI) score for all participants and performed (1) modified Kaplan-Meier analysis to estimate LR of HF, (2) competing Cox models (adjusted for age, smoking, education, body mass index, physical activity, hypertension, and diabetes) to estimate joint cumulative risks for HF or death, and (3) Irwin restricted mean to estimates years lived free of and with HF. Results: Of the 39,082 middle-aged participants free of HF at baseline, 15% of participants were black and 84% were women. Over 125,214 person-years of follow-up, LR for HF was highest in those with the lowest quality diet (quintile 1) compared with those in higher aHEI quintiles ( FIGURE ). Competing hazard ratios for HF among middle-aged black men and women in the lowest quintile were 2.56 (95% confidence interval [CI] 1.38, 4.76) and 2.33 (95% CI 1.34, 4.04) compared with individuals in the highest quintile, with similar findings in white adults. Participants in the lowest aHEI quintile lived significantly fewer healthy years free of HF compared with those in the highest aHEI quintile (p&lt;0.05 for all sex-race groups). Similar patterns were observed in black and white older adults (index age 60-79 years). Discussion: A higher (better) diet quality score is independently associated with lower risk of HF and greater proportion of life lived without HF. Public health policies supporting adherence to the AHEI dietary recommendations may decrease the growing burden of HF.
Abstract P140: Sexual Orientation Disparities in Cardiovascular Risk Factors Differ by Sex and Race/Ethnicity Among High School Aged Youth
Authors: Lauren B Beach, Blair C Turner, Ying Han, Dylan Felt, Rachel Marro, Brian A Feinstein, Gregory L Phillips
Journal: Circulation (2019)

Compared to their sex-matched heterosexual counterparts, sexual minority high school aged youth have been found to be more likely to be overweight or obese and less likely to meet physical activity guidelines. Racial/ethnic minority (REM) youth have been shown to face similar disparities. These disparities mirror the cardiovascular (CVD) health disparities that have also been detected among sexual minority and REM adults later in life. To date, no national studies have investigated how health disparities associated with poor future CVD outcomes differ at the intersections of sex and race/ethnicity among diverse sexual minority high school aged youth. To compare weight and physical activity outcomes using an intersectional approach, we performed sex-stratified logistic regressions using a pooled national Youth Risk Behavior Surveillance (YRBS) dataset from 2009-2015; White heterosexual students as the dual reference group for all analyses. From these regressions, adjusted Prevalence risk ratios (PRR) were calculated. A total of 409,843 high school aged youth who completed the YRBS surveys across 45 jurisdictions across the United States were included in analyses. Overall, by race/ethnicity, 47.7% of respondents were White, 16.6% were Black, 25.5% were Hispanic/Latino, and 10.2% were “Other” race youth. Among male youth, 92.6% identified as heterosexual, 2.2% as gay, 2.4% as bisexual, and 2.7% as not sure, while among female students, 85.9% identified as heterosexual, 1.86% as lesbian, 8.25% as bisexual, and 4.0% as not sure. With the exception of heterosexual and not sure Other race students, all sexual minority/REM female students had 1.51 to 2.23 times higher risk of being overweight or obese compared to White heterosexual students. All non-White and non-heterosexual male youth were at greater risk of not meeting physical activity guidelines compared to their White heterosexual male student counterparts. Significant interactions between race/ethnicity and sexual identity were detected for both overweight/obesity and physical activity outcomes among female but not male high school aged youth. Future work should continue to characterize CVD risk factors among sexual minority and REM youth and explore how the intersections of these identities may predict risk factors for CVD related outcomes across the life course.
Prospective evaluation of a new patient decision aid to enhance prostate cancer screening decision-making.
Authors: Michael Austin Brooks, Anita Misra-Hebert, Alexander Zajichek, Sigrid V. Carlsson, Jonas Hugosson, Michael W. Kattan, Andrew J. Stephenson
Journal: Journal of Clinical Oncology (2019)

87 Background: We previously developed screening nomograms to predict 15-year risk of all-cause mortality, prostate cancer diagnosis, and prostate cancer mortality, and incorporated them into a graphical patient decision aid (PtDA). Our objective was to prospectively recruit primary care patients interested in shared-decision making regarding prostate specific antigen (PSA) screening and assess the impact of individualized counseling using our new PtDA. Methods: 50 patients from one internal medicine practice were enrolled in a single-arm sequential trial design, with face-to-face clinician counseling and questionnaires. Eligibility criteria included men age 50-69 years old and life expectancy &gt; 10 years. Patients were excluded for a personal history of prostate cancer or PSA screening within the prior year. Participants completed baseline questionnaires regarding prior PSA testing, demographic information, health literacy, and the Control Preferences Scale (CPS). They then received standardized counseling (based on large trial and epidemiologic data) regarding PSA screening, followed by individualized counseling using our new PtDA. Participants then made a screening decision, and completed a post decision questionnaire including a Decisional Conflict Scale. Results: The median age was 60 (IQR 54; 65). 41 (82%) had a prior PSA test, while 9 (18%) had not. 42 (84%) of participants received some education beyond high school, 41 (82%) demonstrated high health literacy, and 45 (90%) desired to have an active role in decision-making based on the CPS. After undergoing counseling, 34 (68%) participants chose to undergo initial or repeat PSA screening, 8 (16%) chose against future screening, and 8 (16%) remained uncertain. 45 (90%) participants found individualized counseling using the PtDA more useful than standardized counseling. Finally, patients reported reduced decisional conflict compared to historical controls (P &lt; 0.001). Conclusions: Our process of standardized counseling followed by individualized counseling using our new PtDA was effective in reducing decisional conflict. The majority of participants found the PtDA more useful for decision making than standardized counseling. Clinical trial information: NCT03387527.
The clinical impact of bone scan (BS) flare with enzalutamide (ENZA) in men with metastatic castration-resistant prostate cancer (mCRPC).
Authors: Andrew J. Armstrong, Mohammed Al-Adhami, Ping Lin, Teresa Parli, Jennifer Sugg, Joyce Leta Steinberg, Bertrand F. TOMBAL, Cora N. Sternberg, Johann S. De Bono, Howard I. Scher, Tomasz M. Beer
Journal: Journal of Clinical Oncology (2019)

183 Background: Current PCWG3 guidelines for men with mCRPC define BS progression during therapy as requiring confirmation of new bone lesions that develop over time with additional new lesions. New unconfirmed BS lesions may reflect slow progression or a favorable osteoblastic reaction called a “BS flare” that can be misinterpreted as radiographic progression and lead to premature therapy discontinuation. The prevalence and clinical impact of BS flare is unknown for ENZA. Methods: We analyzed the association of BS flare with clinical outcomes and quality of life (QoL) in a retrospective analysis of two phase 3 trials of men with mCRPC treated with ENZA after (AFFIRM n = 1199) and before (PREVAIL n = 1717) docetaxel. Early and late BS flare was defined as new lesions on the first posttreatment BS (weeks 9-13) or subsequent BS, respectively, that were not confirmed to meet progression criteria on the next BS, while also requiring responding/stable PSA and soft-tissue disease. Results: Unconfirmed BS lesions were observed in 22% and 25% of stable/responding men receiving ENZA in AFFIRM and PREVAIL, respectively. Most BS flares were early, but late flares (week 17 or later) were seen in 2% and 13% of men, respectively. Unconfirmed BS lesions (early or late) had no impact on OS (HR 0.87; 95% CI 0.62-1.21) or rPFS (HR 0.91; 95% CI 0.58-1.44) in PREVAIL, but were associated with worse OS (HR 2.26; 95% CI 1.55-3.30) and rPFS (HR 1.73; 95% CI 1.33-2.26) in AFFIRM. Soft-tissue responses and PSA declines were more prominent in chemo-naïve men with unconfirmed BS lesions, which also had no impact on QoL or pain deterioration in either setting. Conclusions: BS flare occurred in ≈25% of responding men with mCRPC receiving ENZA and was not associated with adverse outcomes in chemo-naïve men. Our findings support the importance of avoiding premature treatment discontinuation in the presence of unconfirmed new BS lesions in the first 4 months of therapy. Worse outcomes associated with unconfirmed lesions in men post docetaxel illustrate the need for improved functional bone imaging in mCRPC and broader patient assessment to decide on treatment continuation. Clinical trial information: NCT00974311; NCT01212991.
Prevalence and prognostic impact of prior cancer in locally advanced lung cancer.
Authors: David E. Gerber, Andrew L. Laccetti, Lei Xuan, Ethan Halm, Sandi Pruitt
Journal: Journal of Clinical Oncology (2015)

6578 Background: Locally advanced lung cancer patients with prior cancer diagnoses are generally excluded from clinical trials. Although the impact of prior cancer on outcomes has been described for early-stage and metastatic disease, it remains largely unknown for locally advanced lung cancer. To inform future decisions about this widespread clinical trial exclusion policy, we determined the characteristics and prognostic impact of prior cancer diagnoses among patients with locally advanced lung cancer. Methods: We identified patients > 65 years of age with locally advanced lung cancer in the Surveillance, Epidemiology, and End Results-Medicare linked registry. Prior cancer was characterized by prevalence, type, stage, and timing. All-cause and lung cancer-specific mortality were compared between patients with and without prior cancer using propensity score-adjusted Cox regression. Results: Of 50,715 locally advanced lung cancer patients, 16.4% had a history of prior cancer. Prostate (24%), gastrointestinal (17%), breast (16%), and other genitourinary cancers (15%) were the most common cancer types; 69% of prior cancers were localized or in situ. The majority (57%) of prior cancers were diagnosed within 5 years of the index lung cancer diagnosis. Prior cancer did not adversely impact all-cause (HR 0.97; 95% CI, 0.95-1.00; P= 0.03) or lung cancer-specific (HR 0.84; 95% CI, 0.82-0.87; P< 0.001) mortality compared to patients with no prior cancer. Similar outcomes were seen in a simulated clinical trial eligible population (age < 75 years, no recorded co-morbidities, and received surgery and/or radiation for the locally advanced lung cancer diagnosis; N = 3,601): overall survival HR 1.07; 95% CI, 0.97-1.19; P= 0.19; lung cancer-specific survival HR 0.85; 95% CI, 0.75-0.97; P= 0.02). Conclusions: For locally advanced lung cancer, prior cancer does not negatively impact outcomes. Given the ongoing need for new and better treatments for this disease, locally advanced lung cancer patients with history of prior cancer should not be excluded from clinical trials. Modifying this longstanding and widespread eligibility criterion will increase trial accrual rates and improve generalizability of study results.
Veverimer versus placebo in patients with metabolic acidosis associated with chronic kidney disease: a multicentre, randomised, double-blind, controlled, phase 3 trial
Authors: Donald E Wesson, Vandana Mathur, Navdeep Tangri, Yuri Stasiv, Dawn Parsell, Elizabeth Li, Gerrit Klaerner, David A Bushinsky
Journal: The Lancet (2019)
Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease: the GOLD science committee report 2019
Authors: Dave Singh, Alvar Agusti, Antonio Anzueto, Peter J. Barnes, Jean Bourbeau, Bartolome R. Celli, Gerard J. Criner, Peter Frith, David M.G. Halpin, Meilan Han, M. Victorina López Varela, Fernando Martinez, Maria Montes de Oca, Alberto Papi, Ian D. Pavord, Nicolas Roche, Donald D. Sin, Robert Stockley, Jørgen Vestbo, Jadwiga A. Wedzicha, Claus Vogelmeier
Journal: European Respiratory Journal (2019)

Precision medicine is a patient-specific approach that integrates all relevant clinical, genetic and biological information in order to optimise the therapeutic benefit relative to the possibility of side-effects for each individual. Recent clinical trials have shown that higher blood eosinophil counts are associated with a greater efficacy of inhaled corticosteroids (ICSs) in chronic obstructive pulmonary disease (COPD) patients. Blood eosinophil counts are a biomarker with potential to be used in clinical practice, to help target ICS treatment with more precision in COPD patients with a history of exacerbations despite appropriate bronchodilator treatment.The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017 pharmacological treatment algorithms, based on the ABCD assessment, can be applied relatively easily to treatment-naive individuals at initial presentation. However, their use is more problematic during follow-up in patients who are already on maintenance treatment. There is a need for a different system to guide COPD pharmacological management during follow-up.Recent large randomised controlled trials have provided important new information concerning the therapeutic effects of ICSs and long-acting bronchodilators on exacerbations. The new evidence regarding blood eosinophils and inhaled treatments, and the need to distinguish between initial and follow-up pharmacological management, led to changes in the GOLD pharmacological treatment recommendations. This article explains the evidence and rationale for the GOLD 2019 pharmacological treatment recommendations.
Predictors of germline DNA damage repair gene mutations (gDDRm) in patients (pts) with metastatic castration-resistant prostate cancer (CRPC).
Authors: Steven Yip, Katherine Sunderland, Arshia Beigi, Arkhjamil Angeles, Daniel Khalaf, Evan W Warner, Gillian Vandekerkhove, Sophie Sun, Matti Annala, Alexander William Wyatt, Kim N. Chi
Journal: Journal of Clinical Oncology (2019)

159 Background: gDDRm are present in 6-12% of pts with CRPC and have implications for prognosis, treatment outcomes and familial screening. This study's aim was to identify clinical/pathologic characteristics associated with a higher risk of a pt harboring a gDDRm. Methods: 631 consecutive pts with metastatic prostate cancer were screened for germline mutations in 22 DNA repair genes (including ATM, BRCA1/2, MSH2/6, FANC/ERCC members). Clinical/pathologic characteristics (age at diagnosis, visceral metastases (mets) at time of CRPC, Gleason score, intraductal/cribriform histology (I/C) at diagnosis, family history (FHx) of prostate, breast, ovarian, or pancreatic cancer, time from androgen deprivation therapy initiation to CRPC) were compared between gDDRm+ and gDDRm- cases. A multivariate logistic model of gDDRm status was constructed using purposeful selection of covariates where clinical judgement was employed in addition to statistical significance. A weighted scoring system was created by multiplying each risk factor (RF) by its estimated β coefficient. A pt’s total score was calculated by the sum of each weighted RF. Results: gDDRm+ were identified in 38/631 pts (6.0%, BRCA2 = 28, ATM = 4, BRCA1 = 2, PALB2 = 2, MSH2 = 1, ERCC3 = 1). 29 gDDRm+ and 128 gDDRm- cases with complete clinical/pathologic information were included in the model. Multivariate modeling revealed that visceral mets, FHx and I/C were statistically significantly associated with gDDRm+; age ≤ 65 was included in the model because it was considered clinically relevant (Table). Based on the model results, the weights of each RF are: visceral mets (2), FHx (1), I/C (2), age ≤ 65 (1). Using a total score cut-off ≥ 1, the model achieves a sensitivity, specificity, positive predictive value, and negative predictive value of 97%, 31%, 24%, and 98%, respectively. Conclusions: In this cohort, visceral mets, FHx and I/C were independently associated with a higher risk of harboring a gDDRm. The predictive model may aid in selecting pts for gDDRm screening. Model validation is required. [Table: see text]
Predictive value of single-nucleotide polymorphism signature for recurrence in localised renal cell carcinoma: a retrospective analysis and multicentre validation study
Authors: Jin-Huan Wei, Zi-Hao Feng, Yun Cao, Hong-Wei Zhao, Zhen-Hua Chen, Bing Liao, Qing Wang, Hui Han, Jin Zhang, Yun-Ze Xu, Bo Li, Ji-Tao Wu, Gui-Mei Qu, Guo-Ping Wang, Cong Liu, Wei Xue, Qiang Liu, Jun Lu, Cai-Xia Li, Pei-Xing Li, Zhi-Ling Zhang, Hao-Hua Yao, Yi-Hui Pan, Wen-Fang Chen, Dan Xie, Lei Shi, Zhen-Li Gao, Yi-Ran Huang, Fang-Jian Zhou, Shao-Gang Wang, Zhi-Ping Liu, Wei Chen, Jun-Hang Luo
Journal: The Lancet Oncology (2019)
Abstract 18493: The Effect of Eating Frequency on Atherosclerotic Cardiovascular Disease and Carotid Intima Media Thickness: The Corinthia Study
Authors: Evangelos Oikonomou, Georgios Lazaros, Evangelia Christoforatou, Christos Chasikidis, George-Angelo Papamikroulis, Georgia Vogiatzi, Sotirios Tsalamandris, Margenti Papakonstantinou, Maria Tousouli, Konstantinos Mourouzis, Aimilios Kalampogias, Athina Goliopoulou, Evgenia Bourouki, Panayiota Anastasopoulou, Dimitrios Tousoulis
Journal: Circulation (2017)

Introduction: Dietary patterns have been associated with cardiovascular disease. Accumulating evidence suggests the importance role of eating frequency (etFr) on cardiovascular risk factors and atherosclerosis progression. Hypothesis: Frequent meal consumption may affect cardiovascular risk factors and protect against atherosclerosis. Methods: The study was conducted on a subgroup population of Corinthia study consisted of 923 (aged 38-91, 435 males) subjects. IMT was measured in the left and right common carotid artery, carotid bulb and internal carotid artery. The average of the measurements (combinedIMT) was determined as representative value of carotid atherosclerosis burden. Standard questionnaires, medical history and physical examination were used to record several demographic and clinical characteristics as well as eating preferences. Results: Median number of meals per day was 2 (1-3) in our study. Subjects consuming > 3 meals/day were female (p<0.001) or younger (64±12y vs. 62±12y, p=0.05) compa...
Slow-release naltrexone implant versus oral naltrexone for improving treatment outcomes in people with HIV who are addicted to opioids: a double-blind, placebo-controlled, randomised trial
Authors: Evgeny Krupitsky, Elena Blokhina, Edwin Zvartau, Elena Verbitskaya, Dmitri Lioznov, Tatiana Yaroslavtseva, Vladimir Palatkin, Marina Vetrova, Natalia Bushara, Andrei Burakov, Dmitri Masalov, Olga Mamontova, Daniel Langleben, Sabrina Poole, Robert Gross, George Woody
Journal: The Lancet HIV (2019)
Abstract P415: Correlation of Screening Electrocardiogram, Transthoracic Echocardiogram, and ASCVD Risk Score to 10 Year ASCVD Outcomes Among Asymptomatic Community Dwelling Women
Authors: Arianne Clare Agdamag, Joanne Michelle Gomez, Nilam P Patel, Maria Isabel Camara, Simisola Alalade, Katherine Khazey, Meghna Patiath, Isabel Kats, Emma Fleisher, Estefania Oliveros Soles, Neelum Aggarwal, Kim Williams, Annabelle Volgman
Journal: Circulation (2019)

Background: The efficacy and value of non-traditional screening methods such as electrocardiogram (ECG) and transthoracic echocardiography(TTE) remain unknown. In this study, we examined the correlation between initial ECG and TTE findings, and atherosclerotic cardiovascular disease (ASCVD) 10 year risk score with actual 10-year ASCVD outcomes among asymptomatic women from a community-based screening program cohort at Rush University Medical Center. Methodology: A 10-year follow-up survey was conducted in March-September 2018 from the 355 participants from the initial 2BigHearts community screening program in 2007. Demographics, past medical history, ASCVD outcomes (stroke, non-fatal MI, PAD), and self-reported medication lists were obtained from the 107 participants who responded to the survey. Pearson Chi-square Test was used to determine the association of ECG, TTE, and calculated ASCVD risk score with ASCVD outcomes and heart failure(HF). Results: Amongst the 107 participants (mean age 63±10.6 years, 68.3% (71/104) Caucasian, 18.3% (19/104) African American, 8.6% (9/104) Hispanic, 4.8% (5/104) Asian), 15% (16/107) had baseline TTE abnormality with chamber enlargement as most common while 29.9% (32/107) had baseline ECG abnormality with conduction abnormalities as most common. The mean ASCVD 10 year risk score was 4.02%±4.5%. Of the 107, 11 had ASCVD score ≥ 7.5% of which 2 developed non-fatal MI and PAD. Other co-morbid conditions included 29% (31/107) hyperlipidemia, 22.4% (24/107) hypertension, 8.4% (9/107) diabetes, 6.5% (7/107) obstructive sleep apnea and 12.1% (13/107) any type of cancer. Chi-square testing showed no statistically significant correlation between ECG or TTE abnormality with ASCVD outcome (p=0.251 ECG, p=0.461 TTE). Baseline ASCVD risk score of ≥7.5% was associated with 10-year ASCVD outcome (p=0.003) and abnormal TTE at baseline was associated with heart failure in 10-year follow-up (p=0.017). Conclusion: This study found no association between abnormal screening ECG and TTE findings with 10-year ASCVD outcomes (stroke, non-fatal MI, PAD). However, abnormal TTE findings are associated with HF. ASCVD pooled cohort equation proved to be better than ECG and TTE in predicting ASCVD outcomes.