tbuckley/cabot-search huggingface dataset:
Isoniazid (INH) mono-resistance and tuberculosis (TB) treatment success: analysis of European surveillance data, 2002 to 2014
Authors: Basel Karo, Anke Kohlenberg, Vahur Hollo, Raquel Duarte, Lena Fiebig, Sarah Jackson, Cathriona Kearns, Csaba Ködmön, Maria Korzeniewska-Kosela, Dimitrios Papaventsis, Ivan Solovic, Dick van Soolingen, Marieke J. van der Werf
Journal: Eurosurveillance (2019)

Introduction: Isoniazid (INH) is an essential drug for tuberculosis (TB) treatment. Resistance to INH may increase the likelihood of negative treatment outcome. Aim: We aimed to determine the impact of INH mono-resistance on TB treatment outcome in the European Union/European Economic Area and to identify risk factors for unsuccessful outcome in cases with INH mono-resistant TB. Methods: In this observational study, we retrospectively analysed TB cases that were diagnosed in 2002–14 and included in the European Surveillance System (TESSy). Multilevel logistic regression models were applied to identify risk factors and correct for clustering of cases within countries. Results: A total of 187,370 susceptible and 7,578 INH mono-resistant TB cases from 24 countries were included in the outcome analysis. Treatment was successful in 74.0% of INH mono-resistant and 77.4% of susceptible TB cases. In the final model, treatment success was lower among INH mono-resistant cases (Odds ratio (OR): 0.7; 95% confidence interval (CI): 0.6–0.9; adjusted absolute difference in treatment success: 5.3%). Among INH mono-resistant TB cases, unsuccessful treatment outcome was associated with age above median (OR: 1.3; 95% CI: 1.2–1.5), male sex (OR: 1.3; 95% CI: 1.1–1.4), positive smear microscopy (OR: 1.3; 95% CI: 1.1–1.4), positive HIV status (OR: 3.3; 95% CI: 1.6–6.5) and a prior TB history (OR: 1.8; 95% CI: 1.5–2.2). Conclusions: This study provides evidence for an association between INH mono-resistance and a lower likelihood of TB treatment success. Increased attention should be paid to timely detection and management of INH mono-resistant TB.
Prophylactic Irradiation of Tracts in Patients With Malignant Pleural Mesothelioma: An Open-Label, Multicenter, Phase III Randomized Trial
Authors: Neil Bayman, Wiebke Appel, Linda Ashcroft, David R. Baldwin, Andrew Bates, Liz Darlison, John G. Edwards, Veni Ezhil, David Gilligan, Matthew Hatton, Apurna Jegannathen, Talal Mansy, Michael D. Peake, Laura Pemberton, Robert C. Rintoul, Michael Snee, W. David Ryder, Paul Taylor, Corinne Faivre-Finn
Journal: Journal of Clinical Oncology (2019)

PURPOSE Prophylactic irradiation to the chest wall after diagnostic or therapeutic procedures in patients with malignant pleural mesothelioma (MPM) has been a widespread practice across Europe, although the efficacy of this treatment is uncertain. In this study, we aimed to determine the efficacy of prophylactic radiotherapy in reducing the incidence of chest wall metastases (CWM) after a procedure in MPM. METHODS After undergoing a chest wall procedure, patients with MPM were randomly assigned to receive prophylactic radiotherapy (within 42 days of the procedure) or no radiotherapy. Open thoracotomies, needle biopsies, and indwelling pleural catheters were excluded. Prophylactic radiotherapy was delivered at a dose of 21 Gy in three fractions over three consecutive working days, using a single electron field adapted to maximize coverage of the tract from skin surface to pleura. The primary outcome was the incidence of CWM within 6 months from random assignment, assessed in the intention-to-treat population. Stratification factors included epithelioid histology and intention to give chemotherapy. RESULTS Between July 30, 2012, and December 12, 2015, 375 patients were recruited from 54 centers and randomly assigned to receive prophylactic radiotherapy (n = 186) or no prophylactic radiotherapy (n = 189). Participants were well matched at baseline. No significant difference was seen in the incidence of CWM at 6 months between the prophylactic radiotherapy and no radiotherapy groups (no. [%]: 6 [3.2] v 10 [5.3], respectively; odds ratio, 0.60; 95% CI, 0.17 to 1.86; P = .44). Skin toxicity was the most common radiotherapy-related adverse event in the prophylactic radiotherapy group, with 96 patients (51.6%) receiving grade 1; 19 (10.2%), grade 2; and 1 (0.5%) grade 3 radiation dermatitis (Common Terminology Criteria for Adverse Events, version 4.0). CONCLUSION There is no role for the routine use of prophylactic irradiation to chest wall procedure sites in patients with MPM.
Abstract 17155: Complications with Cardiac Perforation and Lead Dislodgement of the 5086 MRI Pacing Lead
Authors: Jin Hee Choi, Jun Kim, Uk Jo, Chang Hee Kwon, Woo Seok Lee, Yoo Ri Kim, Gi-Byoung Nam, Kee-Joon Choi, You-Ho Kim
Journal: Circulation (2014)

As the MR-conditional Medtronic 5086 lead has been implanted, there were some reports that the 5086 lead demonstrated higher lead dislodgement and cardiac perforation compared with the 5076 lead. However, little is known regarding the rates of complications between the 5086 lead and the 5076 lead especially in asian populations. The purpose of this study was to describe the incidence of lead-related complications including cardiac perforation and lead dislodgement of the 5086 lead compared to the 5076 lead and to investigate the clinical factors associated with development of cardiac perforation or lead dislodgement. This study was a retrospective single center study. Consecutive 292 patients who underwent dual chamber pacemaker implantation using either 5076 (N=121) or 5086 lead (N=171) between January 2008 and March 2014 were enrolled in this study. Primary endpoint was incidence of cardiac perforation with pericardial effusion or cardiac tamponade within 30 days of implant. Secondary endpoint was combined incidence of cardiac perforation or lead dislodgement. Primary outcome occurred in 3 patients with the 5806 lead (1.8%) and no patient with the 5076 lead (0.0%) (p=0.269). Lead dislodgement occurred in 9 patients with the 5806 lead (5.3%) and 5 patient with the 5076 lead (4.1%) (p=0.784) (Table1). There was no difference in the incidence of secondary endpoint between groups (7.0 vs 4.1%, p=0.447). On logistic regression analysis after multivariate adjustment, factors associated with an increased risk for dislodgement and cardiac perforation included heart failure, taking a rivaroxaban, and location of atrial lead other than right atrial appendage (Table2). Compared with the 5076 lead, the rate of cardiac perforation and lead dislodgement was not significantly higher with the 5086 MRI lead in asian population. Cardiac perforation and lead dislodgements occured more often in patient with heart failure, taking a rivaroxaban, and unusual location of atrial lead.
QIM19-134: Improving Access to Bone Marrow Transplant in the Community: The Memorial Sloan Kettering Cancer Alliance Shared Care Program
Authors: Craig Sauter, W. Jeffrey Baker, Elizabeth Rodriguez, Silvia Willumsen, Barbara Morcerf, Kristi Gafford, Jessica Kennington, Richard Korman, Peter Yu, David Pfister, Sergio Giralt
Journal: Journal of the National Comprehensive Cancer Network (2019)

Background: Memorial Sloan Kettering Cancer Center (MSK) created the MSK Cancer Alliance in 2014, a dynamic and bidirectional collaboration with high-quality community providers to enhance access to state-of-the-art cancer care close to home. Hartford HealthCare Cancer Institute (HHC), joined the MSK Cancer Alliance as the first member in 2014. Research suggests that bone marrow transplant (BMT) is an underutilized definitive therapy (Yao et al, Biol Blood Bone Marrow Transplant 2013) for patients with hematologic malignancies and the timing of a referral for transplant has significant impact on patient outcomes (National Marrow Donor Program, available at: https://bethematchclinical.org/transplant-indications-and-outcomes/additional-outcomes/timing-impact-on-outcomes/ ). MSK and HHC developed the BMT Shared Care program to improve access to transplant, ensure BMT specialist consults for appropriate candidates occur during initial treatment planning, reduce burdensome travel for patients by facilitating care locally, and enhance seamless coordination between local oncologists and BMT providers from initial consult through post-transplant care. Methods: To achieve these goals, MSK and HHC physicians, nurses, and staff created a program that includes: HHC hiring a BMT nurse, who trained for 4 weeks at MSK, and works with MSK counterparts to create a streamlined referral process, pretransplant care at HHC, and travel logistics to MSK; MSK and HHC physicians hold virtual tumor boards to jointly evaluate patients and provide BMT consults at the optimal time; onsite lectures and observer-ships focused on advances in BMT, supportive care, and management of complications like graft versus host disease, leading to the integration of additional clinical services like infectious disease and dermatology; and research, including an MSK clinical trial open at HHC to identify and understand barriers to transplant in the community for patients with newly diagnosed or relapsed acute leukemia. Results: Since November 2015, HHC has referred 86 patients for BMT consult through this Shared Care program, with 35 patients transplanted or receiving immune effector cells (IEC) to date. Conclusions: The BMT Shared Care program effectively facilitates the referral and transplant of appropriate patients while allowing them to receive much of their pre- and post-transplant care in their local communities. Collaboration between BMT nurse coordinators and robust physician engagement are essential to this program. Future opportunities include expanding the use of telemedicine, enhancing electronic data sharing, quantifying and analyzing patient satisfaction, and expanding BMT research at HHC.
Abstract 20773: Contribution of Ox-CaMKII and CaMKII-Phosphorylated Nav1.5 to Atrial Fibrillation Substrate Development in the Failing Heart
Authors: Georg Gussak, Shin Yoo, Suzanne Browne, Gary L. Aistrup, Jason Ng, J. Andrew Wasserstrom, David Gordon, Bradley Knight, Rod Passman, Jeffrey Goldberger, Rishi Arora
Journal: Circulation (2016)

Introduction: Substrate for atrial fibrillation (AF) in heart failure (HF) is thought to be mediated by slow conduction and conduction inhomogeneity (CI). Among various contributors, oxidative stre...
Abstract P061: Blood Pressure Control in the Outpatient Setting Among Patients with Diabetes: The Guideline Advantage
Authors: Julie K Bower, Sejal Patel, Yosef Khan, James R Langabeer, Randi E Foraker
Journal: Circulation (2017)

Introduction: Blood pressure (BP) screening and control is often suboptimal in patients with diabetes, a population in whom cardiovascular disease (CVD) is the leading cause of morbidity and mortality. Hypertension in the context of diabetes uniquely increases risk for CVD incidence and mortality. The aim of this study was to describe the burden of uncontrolled BP among patients with diabetes seen in the outpatient setting and factors associated with BP control using data from a large, electronic health record (EHR) data registry. Methods: Outpatient EHR data were analyzed from The Guideline Advantage™ (TGA), a joint quality improvement initiative of the American Heart Association, American Diabetes Association, and American Cancer Society. Data were compiled from patients aged ≥18 years seen at &gt;70 individual clinics across the U.S. “Uncontrolled BP” was defined as measured BP ≥140/90mmHg at the most recent outpatient visit with or without a clinical diagnosis of hypertension. Logistic regression was used to examine factors associated BP control status. Results: We observed 1,710,702 BP measurements among 216,947 unique patients. The population was 42% male (n= 91,062) with a mean age of 49 years; 19% (n=41,714) of patients had BP ≥140/90 mmHg at their most recent outpatient visit and 8% of the population had a history of diabetes (n= 18,242). Patients with diabetes had 1.15 times the odds of BP ≥140/90 mmHg at their most recent outpatient visit [aOR(95% CI): 1.15 (1.11-1.20)]. Among patients with a diabetes history, the following factors were associated with uncontrolled BP: race/ethnicity [(aOR: 2.81 (2.48-3.19) for non-Hispanic blacks compared to non-Hispanic whites, 1.44 (1.31-1.57) for multiracial patients versus non-Hispanic whites] , sex [aOR: 1.28 (1.25-1.31)] for males compared to females], age [aOR per 10-year increase in age: 1.22 (1.21-1.23)], and time since diabetes diagnosis [aOR per 1-year increase in time since diagnosis: 0.99(0.98-1.00)]. Conclusions: Uncontrolled BP disproportionately impacts diabetes patients in the outpatient setting. Among these patients, BP control status differed by race/ethnicity, sex, and age. Additionally, patients were more likely to have uncontrolled BP ≥140/90 mmHg closer to the time of their diabetes diagnoses (i.e. time since diagnosis was inversely associated with BP control status). Additional investigation to identify underlying patient- and provider-level factors contributing to these observed differences will be particularly important moving forward for accountable care organizations to meet metrics for equitable quality care delivery across patient subgroups.
Experimental and clinical studies on plastic periodontal procedures
Authors: Arthur Belém Novaes, Daniela Bazan Palioto
Journal: Periodontology 2000 (2019)

We have compiled, in this Periodontology 2000 review, all Latin American literature on experimental and clinical studies of periodontal plastic procedures. The body of literature on this subject has led to a discussion of the features and treatment outcomes of root-coverage procedures. Over time, knowledge on periodontal plastic procedures has become less empirical and more supportive of the clinical management of recession-type defects. Gingival recession etiology, animal studies, free gingival grafts, pedicle flaps (semilunar, laterally positioned, and coronally positioned), and subepithelial connective tissue grafts are extensively reviewed. The use of allografts as an alternative to subepithelial connective tissue grafts, the treatment of multiple gingival recessions, and the rationale for use of guided tissue regeneration and enamel matrix derivative in plastic periodontal procedure is discussed. We also assess how smoking can affect the treatment outcomes in plastic surgery procedures. Minimally invasive procedures are of great value in improving the features of the final tissues. The following aspects identified in this compilation were of great interest: (a) some factors, anatomical in nature, favor the formation of root recessions, but it is the inflammatory process (caused by the presence of biofilm and/or by traumatic toothbrushing) that is responsible for the development of root recessions; and (b) pedicle flap procedures (especially the coronally positioned flap) are extremely versatile and have the most predictable outcome of all root-coverage procedures, especially when combined with subepithelial connective tissue grafting and/or allogeneic grafts. In summary: subepithelial connective tissue grafting is considered as the first option to augment gingival width and thickness, and it may provide better long-term results; the same principles of root-coverage procedures in individual sites appear be used in clinical practice also for multiple-recession type defects; an allograft is an efficient alternative to a subepithelial connective tissue graft and, when it is the treatment option of choice, the use of wide, extended flaps should be considered; because of the superiority of plastic periodontal procedures over guided tissue regeneration and the technical difficulty of the latter, guided tissue regeneration has become obsolete for root-coverage procedures; there is rather a large body of evidence attesting that smoking negatively influences root-coverage procedures, especially subepithelial connective tissue grafts; and minimally invasive techniques may be of great value for improving the results obtained with plastic periodontal procedures, but these techniques need to be better addressed in clinical trials, both in terms of the quality and quantity of the new tissue generated.
Commercial health apps: in the user’s interest?
Authors: Claudia Pagliari
Journal: BMJ (2019)

Excitement about digital health is at an all time high, with innovations in mobile personal computing, robotics, genomics, artificial intelligence, cloud based infrastructure, and more, promising to revolutionise the organisation, quality, cost effectiveness, inclusivity, and personalisation of patient care. 1 2 Amid this celebration, the shadow of privacy risks continues to lurk, like an unwelcome guest at a party.
Assessment of health-related quality of life among patients with hypertension: a cross-sectional study from Palestine
Authors: Samah W Al-Jabi, Sa'ed H Zyoud, Waleed M Sweileh, Aysha H Wildali, Hanan M Saleem, Hayat A Aysa, Mohammad A Badwan, Rahmat Awang
Journal: The Lancet (2019)
HSR19-094: A Comparison of Cancer Burden and Funding From the National Cancer Institute and Nonprofit Organizations Reveals Disparities in the Distribution of Funding Across Cancer Types
Authors: Suneel D. Kamath, Sheetal M. Kircher, Al B. Benson
Journal: Journal of the National Comprehensive Cancer Network (2019)

Background: National Cancer Institute (NCI) and nonprofit organization (NPO) funding have driven recent advancements in oncology through research and advocacy. However, some cancers may be underfunded relative to their burden. This study examined the alignment of cancer burden by histology with NCI and NPO funding for each histology. Methods: The GuideStar database was used to find all cancer NPOs with &gt;$5 million (M) in annual revenue (AR) using NTEE codes and 165 cancer-related search terms. Care delivery NPOs were excluded. NPOs were classified by the histology they support. AR was obtained from IRS Form 990s for each NPO. NCI funding allocation across histologies was obtained from the NCI Funded Research Portfolio data. Total funding for each histology was calculated by adding the NCI funding and the ARs for all NPOs in that histology. Cancer burden based on annual incidence, deaths, and person-years of life lost (PYLL) was obtained from SEER data. Comparison of total NCI and NPO funding with incidence, deaths, and PYLL of each histology was done using descriptive statistics and Pearson correlation coefficients. Results: 119 NPOs with total AR of $6 billion were included. 59 (50%) were histology agnostic and accounted for $4.6 billion (76.8%) of total AR. Cancers with the most NPOs were breast (13, 11%), pediatric (13, 11%), leukemia (4, 3.4%) and lung (4, 3.4%). There were no NPOs with AR &gt;$5 M for esophageal, gastric, kidney, or bladder cancers. Cancers with the most combined NCI and NPO funding were breast ($1 billion), leukemia ($448 M), lung ($348 M), and prostate ($303 M). The ratios of combined NCI and NPO funding vs incidence, mortality, and PYLL are shown in Table 1. Cancers with the best funding vs incidence were leukemia, ovarian, and breast. Cancers with the best funding vs deaths were breast, leukemia, and melanoma. Cancers with the best funding vs PYLL were breast, leukemia, and prostate. Colon, liver, lung, and bladder cancers were poorly funded in all 3 metrics. The correlation coefficients between funding and incidence, deaths, and PYLL were 0.74, 0.34, and 0.36, respectively. Conclusions: There is substantial support for cancer research and advocacy in both the government and nonprofit sectors. While funding by cancer type was moderately proportional to incidence, it was poorly correlated with deaths and PYLL. There is significant need to increase awareness and support for many under-supported, but common and highly lethal cancers.
Antibody Stabilization of Neutrophil Extracellular Trap-Platelet Factor 4 Complexes Is Therapeutic in a Murine Model of Endotoxemia
Authors: Amrita Sarkar, Gowthami Arepally, M. Anna Kowalska, Douglas B. Cines, Lubica Rauova, Mortimer Poncz, Kandace Gollomp
Journal: Blood (2018)
Hyaluronic Acid Oligosaccharides Improve Myocardial Function Reconstruction and Angiogenesis against Myocardial Infarction by Regulation of Macrophages
Authors: Ning Wang, Chao Liu, Xinxin Wang, Tao He, Lu Li, Xiuqi Liang, Li Wang, Linjiang Song, Yuquan Wei, Qinjie Wu, Changyang Gong
Journal: Theranostics (2019)

Myocardial infarction (MI) is identified as one of the major causes of mortality and disability worldwide.For severe myocardial infarction, even advanced forms of clinical intervention often lead to unsatisfactory therapeutic results.Thus, alternative strategies for MI treatment are still desirable.Previously studies reported the capacity of degradative fragment of h-HA (high molecular weight hyaluronic acid), hyaluronan oligosaccharides (<10 disaccharides units, o-HA), for wound healing by influence on angiogenesis, inspiring us to study its potential for myocardial functional recovery against MI.However, there are few reports about o-HA in MI therapy.Methods: In our study, we synthesized o-HA with 6~10 disaccharides (4-5 kDa) by enzymatic degradation and investigated its therapeutic effects on MI.Results: We found that o-HA could reduce infarct size and apoptosis in MI region, also promote myocardial angiogenesis and myocardial function reconstruction in MI mouse model.Furthermore, our results also indicated that o-HA in cardiac improved polarization of M2 type macrophage, removed the inflammatory response caused by neutrophil for accelerating myocardial function reconstruction in vivo.The transcriptomic analyses revealed that o-HA could activate expression of chemokines Ccl2 and Cxcl5 for promoting macrophage polarization and stimulate MAPK and JAK/STAT signaling pathway for compensatory response of myocardial function.Conclusion: Collectively, our results suggested o-HA with 6~10 disaccharides might be a potential agent for reconstruction of cardiac function against MI.
HSR19-076: A Prospective Study of the Usage of Pain Medication, Cost, Alternative Medication Use, and Outcome by Cancer Patients in Real World
Authors: Praveen Adusumilli, Vidya Viswanath, Raghunadha Rao Digumarthi
Journal: Journal of the National Comprehensive Cancer Network (2019)

Introduction: Perception of pain and the need to treat it is highly variable, even amongst oncologists. Availability of pain specialists is an added advantage. This is an analysis of prescription patterns of pain medication and its outcome in cancer patients. Materials and Methods: The center has 8 oncologists and a pain and palliative care specialist. All the patients presenting to the outpatient department of our institute with a diagnosis of cancer were prospectively analyzed for usage of pain medication using a structured questionnaire. Data on diagnosis, stage, treatment given, and outcomes were analyzed. Pain intensity was recorded on visual analogue scale, types of pain medicines used, and their side effects were noted. The average cost of the pain medication purchased in our pharmacy was calculated. Use of alternative medicines was also noted. Results: A total of 1,098 cancer patients were evaluated. Pain was a prominent complaint in 64.6% of patients. Of these, only 89.5% received pain medication. Mild, moderate, and severe pain was seen in 52.1%, 26.7%, and 21.2% respectively. The 3 most common diagnoses were breast cancer in 19.7%, gastrointestinal cancer in 14%, and 12.1% with head and neck cancers. Weak opioids and NSAIDS were most commonly prescribed analgesics in 44.2% and 42.1%, respectively. Morphine was prescribed for 13.7% of patients. The average cost of pain medicines is Re 148 (US $2.25 a month). Side effects from medication were seen in 13.5% of patients, with constipation being the most common. Alternative forms of medicine were reportedly used by 148 patients: Ayurveda by 20.8%, and homeopathy by 12.9%, native medication by 6.1%, Unani by 1.8%. Good relief of pain was reported by 66%, fair relief by 27%, no relief by 6.1%, and worsening by &lt;1%. Conclusion: Pain management is near ideal with the availability of services of pain and palliative care specialist in a cancer center.