tbuckley/cabot-search huggingface dataset:
Abstract 19828: Real-world Assessment of Patients Switching From Warfarin to Non-vitamin K Oral Anticoagulants Using MarketScan EarlyView Data
Authors: Cristina Masseria, Jack Mardekian, Hemant Phatak, Shital Kamble, Yaniv Ravee, Younous Abdulsattar, William Petkun
Journal: Circulation (2015)

Background: Non-valvular atrial fibrillation (NVAF) was commonly treated with warfarin. With the introduction of Non-Vitamin K Oral Anticoagulants (NOACs) in the United States, some patients are switching from standard of care to NOACs Purpose: To investigate demographic and clinical characteristics associated with switching among NVAF patients treated with warfarin to a NOAC (apixaban, dabigatran and rivaroxaban). Methods: A retrospective cohort study was conducted using Truven MarketScan EarlyView data. The patient recruitment period was from 01/12/2012 to 01/31/2015. Study enrolled adult NVAF patients ≥18 years with 2 or more warfarin prescriptions at least 90 days apart, with 6 months continuous enrollment prior to their last warfarin prescription. Warfarin switch to NOAC will be defined for patients who had a pharmacy claim of NOACs within 60 days from the last day of supply of the last filled prescription of warfarin. Stepwise logistic regression was used to identify patient characteristics associated with switching status (yes or no). Results: A total of 141,198 eligible patients were identified, apixaban n=2177, dabigatran n=771, rivaroxaban n=4317 and non-switchers n=133,933.Cardioversion was identified as the variable most significantly associated with switching followed in order by health plan type, hypertension, age, Charlson Comorbidity Index (CCI), stroke, days on warfarin, and bleeding history. On average people who undergo cardioversion, with hypertension at baseline, with prior stroke, with a history of bleeding, and with a longer exposure to warfarin treatment were more likely to switch to a NOAC than to continue warfarin treatment. NVAF elderly patients and those with multiple comorbidities were more likely to continue warfarin treatment. Conclusion: In the real world setting, by using a stepwise logistic regression, cardioversion, health plan type, hypertension, age, CCI, stroke, days on warfarin and bleeding history were the main demographic and clinical characteristics associated with switching from warfarin to a NOAC.
Abstract 15383: Clinical Features and Prognosis of Patients Who Survived Ventricular Fibrillation Due to Coronary Artery Spasm
Authors: Naoki Nakayama, Eiichi Akiyama, Noriaki Iwahashi, Nobuhiko Maejima, Kengo Tsukahara, Kiyoshi Hibi, Toshiaki Ebina, Shinichi Sumita, Kazuo Kimura, Satoshi Umemura
Journal: Circulation (2015)

Introduction: Coronary artery spasm can lead to lethal arrhythmia and sudden cardiac death. The aim of this study was to elucidate the clinical features and prognosis of patients who survived cardiac arrest due to coronary artery spasm. Methods: We retrospectively studied consecutive patients who survived ventricular fibrillation out of hospital cardiac arrest due to coronary artery spasm, and discharged neurologically intact. Results: Nineteen patients (18 men and 1 woman, mean age 55 ± 10 years) were enrolled. In all patients, ventricular fibrillation (VF) was documented as the initial rhythm at cardiac arrest. Transient ST-segment elevation during spontaneous attack was observed in 9 patients. Acetylcholine provocation tests were performed and resulted in positive in 15 patients. In 11 patients, cardiac arrest was the first episode of vasospastic attack. All patients were treated with vasodilators including calcium channel blockers. An implantable defibrillator (ICD) was implanted in 12 patients according to the discretion of the attending physician. During a mean follow-up interval of 42 months, 4 episodes of VF were observed in 3 patients and ST-segment elevation myocardial infarction (STEMI) was observed in 1 patient. Two episodes of VF were occurred before the diagnosis of coronary artery spasm was confirmed during the index hospitalization, and the other 2 VF were occurred after ICD implantation. All VF were treated by manual defibrillation or ICD shocks. None of patients developed cardiovascular death. There are no differences in the characteristics of the patients between those with and without recurrence of VF and STEMI. However, medications against coronary artery spasm were discontinued before the cardiac events in all episodes of VF and STEMI. The intervals between cessation of medications and cardiac events were less than 2 days in all cardiac events. Conclusions: The patients who survived cardiac arrest due to coronary artery spasm were at high risk for recurrence of severe ischemia and lethal arrhythmia. Cessation of medication, even within a few days, was closely associated with cardiac events. ICD therapy may be beneficial in patients who survived cardiac arrest due to coronary artery spasm.
Chemotherapy-induced peripheral neuropathy: A prospective study using methods of small fibre function and structure.
Authors: Ramachandran Venkitaraman, Sanjeev Sharma, Rubin Soomal, Christopher D Scrase, Gerry Rayman
Journal: Journal of Clinical Oncology (2015)

e20723 Background: Chemotherapy induced peripheral neuropathy (CIPN) is the commonest neurological complication of cancer treatment. Its accurate diagnosis remains a clinical challenge. Conventional methods like nerve conduction studies and quantitative sensory testing are limited in their ability to detect subclinical changes and have not been shown to correlate with severity of patients’ symptoms. In this prospective study, two new methods—LDI (laser doppler imager) FLARE technique and Corneal confocal microscopy (CCM)—are used to study small fibre function and structure respectively. Methods: 40 patients (20 each on Taxane and Platinum chemotherapy) were assessed at baseline and 3 months after successful completion, with detailed neurological examination, the LDIFLARE technique and corneal nerve fibre density (CNFD) using CCM for small fibre neuropathy. Large fibre assessments included vibration perception threshold and sural nerve conduction velocity and amplitude. The QLQ-CIPN20 questionnaire was used to assess symptom severity. 20 age-matched healthy controls were also used as comparators and assessed at baseline and after 1 year. Results: No significant change was seen in any of the large fibre methods (p ≥ 0.05) and similarly, no correlation was observed with large fibre methods and the QLQ-CIPN20 scores (p ≥ 0.05). Conclusions: Our prospective study shows that both LDIFLARE and CCM methods are sensitive indicators of progressive small fibre dysfunction in CIPN, and they strongly correlate with symptom scores and functional impairment due to CIPN. We propose that these methods should be considered for the diagnosis and for prospective assessment of CIPN. Group Method Baseline 3 months after completion of chemotherapy Significance of change compared to baseline Mean (± SD) Mean (± SD) Correlation with QLQ-CIPN20 Taxane (n = 20) LDIFLARE (cm2) 7.84 ± 2.39 5.01 ± 2.78 p ≤ 0.001 p ≤ 0.001 CNFD using CCM 54.02 ± 11.56 38.90 ± 12.56 p = 0.01 p ≤ 0.001 Platinum (n = 20) LDIFLARE (cm2) 7.11 ± 1.58 3.89 ± 1.78 p ≤ 0.001 p ≤ 0.001 CNFD using CCM 40.88 ± 10.29 34.67 ± 8.87 p = 0.002 p = 0.01 Healthy controls (n=20) LDIFLARE (cm2) 8.25 ± 1.54 8.01 ± 2.40 - p = 0.58 CNFD using CCM 61.13 ± 8.98 58.78 ± 5.59 - p = 0.83
Prognostic impact of the use of antibiotics in patients with advanced non-small cell lung cancer (NSCLC) receiving PD-(L)1 targeting monoclonal antibodies
Authors: A. Schett, S.I. Rothschild, L.A. Mauti, S. Schmid, C. Appenzeller, A. Curioni-Fontecedro, M. Frueh, M. Joerger
Journal: Annals of Oncology (2019)

Background: Anti-PD-(L)1 monoclonal antibodies (mAb) have changed the therapeutic landscape in patients with advanced NSCLC, still 35-40% of these patients derive no benefit from anti-PD-(L)1 mAb. Antibiotics alter gut microbiota diversity and composition, and may affects antitumor immune responses following immune checkpoint inhibitors (ICI) in NSCLC. Methods: We retrospectively included 218 patients with advanced NSCLC receiving anti-PD-(L)1 mAb. Overall survival (OS) (primary endpoint), progression free survival (PFS) and radiological response was compared between patients who received antibiotics within 2 months prior to the start of immunotherapy (ATB+) and patients who did not (ATB-). Assuming a rate of antibiotic comedication of 20% of all patients included, the study had a power of 70% to detect a 35% OS improvement in ATB- patients. Results: Patients are well balanced with the exception of PD-L1 immunohistochemical expression that was more frequent in ATB+ compared to ATB- (30% vs. 19%, p = 0.05). ATB+ compared to ATB- was associated with a significantly shorter OS (median OS, 10.6 vs 29.9 months, HR 2.7, 95% CI 1.7-4.1, P < 0.001) and shorter PFS (median PFS 1.4 vs 5.8 months, HR 2.2, 95% CI 1.5-3.4, P < 0.001). In the adjusted model for OS, the following 4 parameters retained a statistically significant prognostic value : ATB+ vs. ATB- (HR 2.8, 95% CI 1.7-4.5, P < 0.001), ECOG performance score >1 vs. 0-1 (HR 2.3, 95% CI 1.4-3.7, p = 0.001), squamous-cell vs. Non squamous-cell histology (HR 2.1, 95% CI 1.4-3.2, P < 0.001) and no prior radiotherapy vs. prior radiotherapy (HR 1.7, 95% CI 1.2-2.6, p = 0.006). ATB+ compared to ATB- was significantly associated with an increased risk of progressive disease as best radiological response (73% vs 41%, p = 0.002). Conclusions: Antibiotic treatment is associated with a reduced clinical benefit from therapy with anti-PD-(L)1 mAb. The negative prognostic value of antibiotics was independent from known prognostic factors. However, further investigation is required on the mechanism behind this observation, with emphasis on the role of the gut microbiota composition in the context of anticancer immune response. Legal entity responsible for the study: M. Joerger. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
Coping strategies of Dutch servicemembers after deployment
Authors: Loes G. M. de Kruijff, Olivia R. M. Moussault, Marie-Christine J. Plat, Rigo Hoencamp, Peter van der Wurff
Journal: Military Medical Research (2019)

This study examines the relationship between coping strategies and symptoms of anxiety or depression among Dutch servicemembers deployed to Afghanistan.Coping strategies were assessed in 33 battlefield casualties (BCs) and the control group (CTRLs) of 33 uninjured servicemembers from the same combat units using the Cognitive Emotion Regulation Questionnaire. A factor analysis was performed, and two clusters of coping strategies were derived, namely, adaptive and maladaptive coping. Symptoms of anxiety and depression were evaluated using the depression and anxiety subscales of the Symptom Checklist-90-Revised. Correlations between coping and symptoms of anxiety and between coping and symptoms of depression were calculated, and a logistic regression was performed.A moderate correlation was observed between maladaptive coping and symptoms of anxiety in the BC group (r = 0.42) and among the CTRLs (r = 0.56). A moderate correlation was observed between maladaptive coping and symptoms of depression in both groups (r = 0.55). The statistical analysis for the total sample (BCs and CTRLs) demonstrated no association between coping and symptoms of anxiety or depression.A correlation but no association was observed between maladaptive coping and mental health disorders in deployed Dutch servicemembers. Further research should focus on constructing cluster profiles of coping strategies and associating them with mental health outcomes and reintegration into society.
Percutaneous Edge-to-Edge Repair for Atrial Functional Mitral Regurgitation
Authors: Takafumi Nagaura, Atsushi Hayashi, Jun Yoshida, Hiroki Ikenaga, Satoshi Yamaguchi, Hiroto Utsunomiya, Florian Rader, Robert J. Siegel, Saibal Kar, Takahiro Shiota
Journal: JACC. Cardiovascular imaging (2019)
Delayed Puberty—Phenotypic Diversity, Molecular Genetic Mechanisms, and Recent Discoveries
Authors: Sasha R Howard, Leo Dunkel
Journal: Endocrine Reviews (2019)

Abstract This review presents a comprehensive discussion of the clinical condition of delayed puberty, a common presentation to the pediatric endocrinologist, which may present both diagnostic and prognostic challenges. Our understanding of the genetic control of pubertal timing has advanced thanks to active investigation in this field over the last two decades, but it remains in large part a fascinating and mysterious conundrum. The phenotype of delayed puberty is associated with adult health risks and common etiologies, and there is evidence for polygenic control of pubertal timing in the general population, sex-specificity, and epigenetic modulation. Moreover, much has been learned from comprehension of monogenic and digenic etiologies of pubertal delay and associated disorders and, in recent years, knowledge of oligogenic inheritance in conditions of GnRH deficiency. Recently there have been several novel discoveries in the field of self-limited delayed puberty, encompassing exciting developments linking this condition to both GnRH neuronal biology and metabolism and body mass. These data together highlight the fascinating heterogeneity of disorders underlying this phenotype and point to areas of future research where impactful developments can be made.
SAT-423-Spleen extracellular volume fraction and platelet count/spleen volume ratio are accurate non-invasive markers of portal hypertension
Authors: Christina Levick, Michael Pavlides, DavidJ Breen, Kathryn Nash, Gideon Hirschfield, Dhiraj Tripathi, Matthew Robson, Stefan Neubauer, Eleanor Barnes
Journal: Journal of Hepatology (2019)
Abstract 17050: Aminolevulinic Acid Attenuates Atherosclerotic Plaque Progression of Ldl Receptor Deficient Mice by an Antioxidant Action. An Antioxidant Action
Authors: Kohsuke Hagisawa, Yuji Morimoto, Motowo Nakajima, Makoto Ayaori, Katsunori Ikewaki
Journal: Circulation (2017)

Introduction: Aminolevulinic acid (5-ALA) is known as a photosensitizer precursor that is metabolized in vivo by cells to protoporphyrin IX (PpIX) which in turn can be activated for photodynamic th...
Causes of hOCT1‐Dependent Cholangiocarcinoma Resistance to Sorafenib and Sensitization by Tumor‐Selective Gene Therapy
Authors: Elisa Lozano, Rocio I.R. Macias, Maria J. Monte, Maitane Asensio, Sofia del Carmen, Laura Sanchez‐Vicente, Marta Alonso‐Peña, Ruba Al‐Abdulla, Patricia Munoz‐Garrido, Letizia Satriano, Colm J. O'Rourke, Jesus M. Banales, Matias A. Avila, Maria L. Martinez‐Chantar, Jesper B. Andersen, Oscar Briz, Jose J.G. Marin
Journal: Hepatology (2019)

Although the multi‐tyrosine kinase inhibitor sorafenib is useful in the treatment of several cancers, cholangiocarcinoma (CCA) is refractory to this drug. Among other mechanisms of chemoresistance, impaired uptake through human organic cation transporter type 1 (hOCT1) (gene SLC22A1 ) has been suggested. Here we have investigated the events accounting for this phenotypic characteristic and have evaluated the interest of selective gene therapy strategies to overcome this limitation. Gene expression and DNA methylation of SLC22A1 were analyzed using intrahepatic (iCCA) and extrahepatic (eCCA) biopsies (Copenhagen and Salamanca cohorts; n = 132) and The Cancer Genome Atlas (TCGA)‐CHOL (n = 36). Decreased hOCT1 mRNA correlated with hypermethylation status of the SLC22A1 promoter. Treatment of CCA cells with decitabine (demethylating agent) or butyrate (histone deacetylase inhibitor) restored hOCT1 expression and increased sorafenib uptake. MicroRNAs able to induce hOCT1 mRNA decay were analyzed in paired samples of TCGA‐CHOL (n = 9) and Copenhagen (n = 57) cohorts. Consistent up‐regulation in tumor tissue was found for miR‐141 and miR‐330. High proportion of aberrant hOCT1 mRNA splicing in CCA was also seen. Lentiviral‐mediated transduction of eCCA (EGI‐1 and TFK‐1) and iCCA (HuCCT1) cells with hOCT1 enhanced sorafenib uptake and cytotoxic effects. In chemically induced CCA in rats, reduced rOct1 expression was accompanied by impaired sorafenib uptake. In xenograft models of eCCA cells implanted in mouse liver, poor response to sorafenib was observed. However, tumor growth was markedly reduced by cotreatment with sorafenib and adenoviral vectors encoding hOCT1 under the control of the BIRC5 promoter, a gene highly up‐regulated in CCA. Conclusion : The reason for impaired hOCT1‐mediated sorafenib uptake by CCA is multifactorial. Gene therapy capable of selectively inducing hOCT1 in tumor cells can be considered a potentially useful chemosensitization strategy to improve the response of CCA to sorafenib.
Complete Regression of Advanced Pancreatic Ductal Adenocarcinomas upon Combined Inhibition of EGFR and C-RAF
Authors: María Teresa Blasco, Carolina Navas, Guillermo Martín-Serrano, Osvaldo Graña-Castro, Carmen G. Lechuga, Laura Martín-Díaz, Magdolna Djurec, Jing Li, Lucia Morales-Cacho, Laura Esteban-Burgos, Javier Perales-Patón, Emilie Bousquet-Mur, Eva Castellano, Harrys K.C. Jacob, Lavinia Cabras, Monica Musteanu, Matthias Drosten, Sagrario Ortega, Francisca Mulero, Bruno Sainz, Nelson Dusetti, Juan Iovanna, Francisco Sánchez-Bueno, Manuel Hidalgo, Hossein Khiabanian, Raul Rabadán, Fátima Al-Shahrour, Carmen Guerra, Mariano Barbacid
Journal: Cancer Cell (2019)
Narative Based Medicine
Authors: Debashis Singh
Journal: BMJ (1999)

While walking back from the supermarket, Marcia and I became embroiled in a rather abstract conversation. I am not quite sure how it began, but we wondered what it would be like to have the ability to dive into people's heads and live their lives, feel their feelings, and read the archive of their memories, secrets, and lies for a fleeting moment. We would then return to our bodies and quietly chuckle or reel in absolute horror on what we had discovered. Fortunately, this gripping book is a much simpler …
PS-029-Eradication of HCV by DAAs provides patients with immunological benefits by the restoration of antigen-presenting dendritic cells
Authors: Sachio Yoshio, Yuzuru Sakamoto, Hironari kawai, Michitaka Matsuda, Taizo Mori, Yoshihiko Aoki, Yosuke Osawa, Tatsuya Kanto
Journal: Journal of Hepatology (2019)
Retinal oximetry: Metabolic imaging for diseases of the retina and brain
Authors: Einar Stefánsson, Olof Birna Olafsdottir, Thorunn S. Eliasdottir, Wouter Vehmeijer, Anna Bryndis Einarsdottir, Toke Bek, Thomas Lee Torp, Jakob Grauslund, Thor Eysteinsson, Robert Arnar Karlsson, Karel Van Keer, Ingeborg Stalmans, Evelien Vandewalle, Margarita G. Todorova, Martin Hammer, Gerhard Garhöfer, Leopold Schmetterer, Martin Šín, Sveinn Hakon Hardarson
Journal: Progress in Retinal and Eye Research (2019)
PS-088-Impaired cardiac contractile reserve on dobutamine stress echocardiography predicts development of hepatorenal syndrome
Authors: Anoop Koshy, Benjamin Cailes, Omar Farouque, Adam Testro, Jithin Sajeev, Jay Ramchand, Paul Calafiore, Hamid Salehi, Piyush Srivastava, Matthew Peverelle, Han Lim, Hui-Chen Han, Andrew Teh, Paul Gow
Journal: Journal of Hepatology (2019)
TCTAP C-137 The Fly Away
Authors: Yoke Loong Foo, Chin Keong Gary Lee, Abd Kahar Bin Abd Ghapar, Kamaraj Selvaraj, Abdul Muizz Bin Abd Malek, Norzian Ismail, Ahmad Fazli Abdul Aziz, Asri Ranga Abdullah Ramaiah
Journal: Journal of the American College of Cardiology (2019)
Abstract 062: Aortic Stiffness, Blood Pressure Progression and Incident Hypertension: The Framingham Heart Study
Authors: Bernhard M Kaess, Jian Rong, Martin G Larson, Naomi M Hamburg, Joseph A Vita, Daniel Levy, Emelia J Benjamin, Ramachandran R Vasan, Gary F Mitchell
Journal: Circulation (2012)

Background: Increased vascular stiffness and excessive blood pressure (BP) pulsatility are important risk factors for age-related morbidity. Vascular stiffness and BP pulsatility are related, with a prevailing view that hypertension antedates and contributes to premature vascular aging and a secondary increase in vascular stiffness. However, temporal relations between comprehensive vascular measures and BP elevation have not been fully delineated in a large community-based sample. Methods: We examined longitudinal relations of BP and 3 measures of vascular stiffness and pressure pulsatility derived from arterial tonometry (carotid-femoral pulse wave velocity [CFPWV], forward wave amplitude and augmentation index) over a 7-year period in 1,898 Framingham Offspring participants (mean age 60 yrs, 1,057 women). We also examined relations between measures of microvascular and endothelial function derived from brachial artery Doppler and future progression of BP or vascular stiffness. Results: In multivariable-adjusted regression models, baseline tonometry measures were separately and jointly associated with higher systolic and pulse pressure and incident hypertension ( Table ). Conversely, higher baseline BP was associated with higher forward wave amplitude and augmentation index (all p&lt;0.05) but not CFPWV at follow-up. Higher baseline resting brachial artery flow and lower flow-mediated dilation were associated with incident hypertension in models that included BP and tonometry measures ( Table ). Conclusion: Higher aortic stiffness (CFPWV), pressure pulsatility (forward wave amplitude), and wave reflection (augmentation index) and lower flow-mediated dilation are associated with blood pressure progression and incident hypertension. Our findings support the notion of aortic stiffness as a precursor of hypertension and further suggest a vicious cycle of increasing pressure pulsatility with advancing age. Table. Correlates of incident hypertension. Predictor Variables (baseline) OR 95% CI P Systolic BP 3.24 (2.17; 4.84) &lt;0.0001 Diastolic BP 1.47 (1.13; 1.92) 0.0042 CFPWV 1.30 (1.02; 1.67) 0.037 Forward wave amplitude 1.66 (1.32; 2.09) &lt;0.0001 Augmentation index 1.78 (1.45; 2.17) &lt;0.0001 Brachial artery baseline flow 1.23 (1.05; 1.45) 0.013 Flow-mediated dilation 0.83 (0.70; 0.98) 0.029 Results of a single multivariable model that further adjusted for age,sex, BMI, height and triglycerides in 1,019 participants free of hypertension at baseline who experienced 337 cases of incident hypertension during follow-up. OR expressed per 1 SD of the independent variable.
Can Academic Population Health Departments Improve Population Health?
Authors: David Kindig, Sanne Magnan
Journal: JAMA Network Open (2019)

Marc N. Gourevitch, MD, MPH; Lesley H. Curtis, PhD; Maureen S. Durkin, PhD, DrPH; Angela Fagerlin, PhD; Annetine C. Gelijns, PhD, JD; Richard Platt, MD, MSc; Belinda M. Reininger, DrPH; Judith Wylie-Rosett, EdD, RD; Katherine Jones, MA; William M. Tierney, MD