tbuckley/cabot-search huggingface dataset:
Early Risks of Death, Stroke/Systemic Embolism, and Major Bleeding in Patients With Newly Diagnosed Atrial Fibrillation
Authors: Jean-Pierre Bassand, Saverio Virdone, Samuel Z. Goldhaber, A. John Camm, David A. Fitzmaurice, Keith A.A. Fox, Shinya Goto, Sylvia Haas, Werner Hacke, Gloria Kayani, Lorenzo G. Mantovani, Frank Misselwitz, Karen S. Pieper, Alexander G.G. Turpie, Martin van Eickels, Freek W.A. Verheugt, Ajay K. Kakkar
Journal: Circulation (2019)

Background: Atrial fibrillation is associated with increased risks of death, stroke/systemic embolism, and bleeding (incurred by antithrombotic therapy), which may occur early after diagnosis. Methods: We assessed the risk of early events (death, stroke/systemic embolism, and major bleeding) over 12 months and their relation to the time after diagnosis of atrial fibrillation in 52 014 patients prospectively enrolled in the GARFIELD-AF registry (Global Anticoagulant Registry in the FIELD–Atrial Fibrillation) between March 2010 and August 2016. Results: Over 12 months, 2140 patients died (mortality rate, 4.3; 95% CI, 4.2–4.5 per 100 person-years), of whom 288 (13.5%) died in the first month (6.8; 95% CI, 6.1–7.6). Over 12 months, 657 patients had a stroke/systemic embolism (1.3; 95% CI, 1.2–1.4) and 411 had a major bleeding (0.8; 95% CI, 0.8–0.9). During the first month, the rates (per 100 person-years) of stroke/systemic embolism and major bleed were 2.3 (95% CI, 1.9–2.8) and 1.5 (95% CI, 1.2–1.9), respectively. The elevated 1-month mortality rate was mostly attributable to cardiovascular mortality (3.5; 95% CI, 3.0–4.1), in particular, heart failure, sudden death, and acute coronary syndromes (1.0 [95% CI, 0.8–1.4], 0.6 [95% CI, 0.4–0.8], and 0.5 [95% CI, 0.3–0.8], respectively). Age, heart failure, prior stroke, history of cirrhosis, vascular disease, moderate-to-severe kidney disease, diabetes mellitus, and living in North or Latin America were independent predictors of a higher risk of early death, whereas anticoagulation and living in Europe or Asia were independent predictors of a lower risk of early death. A predictive model developed for the 1-month risk of death had a C-statistic of 0.81 (95% CI, 0.78–0.83). Conclusions: The increased hazard of early events, in particular, cardiovascular mortality, in newly diagnosed atrial fibrillation points to the importance of comprehensive care for such patients and should alert clinicians to detect warning signs of possible early mortality. Clinical Trial Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT01090362.
Portal pressure gradient and serum albumin: A simple combined parameter associated with the appearance of ascites in decompensated cirrhosis treated with transjugular intrahepatic portosystemic shunt
Authors: Dongmei Zhao, Guobing Zhang, Mingquan Wang, Chaoxue Zhang, Jiabin Li
Journal: Clinical and Molecular Hepatology (2019)

In recent years, greater assessment accuracy after transjugular intrahepatic portosystemic shunt (TIPS) to ascertain prognosis has become important in decompensated cirrhosis due to portal hypertension. The aim of this study was to assess the ratio of the portal pressure gradient (PPG) pre-TIPS (pre-PPG) to albumin (PPA), which influence ascites formation in cirrhotic patients in the 6-months after TIPS placement, and is a metric introduced in our study.This was a retrospective cohort study of 58 patients with decompensated cirrhosis admitted to an academic hospital for the purpose of TIPS placement. We collected the following data: demographics, laboratory measures, and PPG during the TIPS procedure. Then we analyzed the association between the above data and ascites formation postTIPS in cirrhosis patients.Twenty-two patients with ascites and 28 without ascites were evaluated. Univariate and binary logistic regression analysis were adjusted for the following variables: to determine prognosis; Child-Pugh scores, lymphocyte count, platelet count, hemoglobin level, albumin level and pre-PPG or PPA. The outcome showed that PPA was better than pre-PPG and albumin for predicting ascites according to area under receiver operating characteristic curves and a statistical model that also showed PPA's influence 6-months post-TIPS.The combined measurement of pre-PPG and albumin, defined as PPA, may provide a better way to predict post-TIPS ascites in decompensated cirrhosis, which underlines the need for a large clinical trial in the future.
Evaluation of Low-Dose, Low-Frequency Oral Psoralen–UV-A Treatment With or Without Maintenance on Early-Stage Mycosis Fungoides
Authors: Pablo Vieyra-Garcia, Regina Fink-Puches, Stefanie Porkert, Roland Lang, Sophie Pöchlauer, Gudrun Ratzinger, Adrian Tanew, Sylvia Selhofer, Sator Paul-Gunther, Angelika Hofer, Alexandra Gruber-Wackernagel, Franz Legat, Vijaykumar Patra, Franz Quehenberger, Lorenzo Cerroni, Rachael Clark, Peter Wolf
Journal: JAMA Dermatology (2019)

Psoralen-UV-A (PUVA) photochemotherapy is standard first-line treatment for skin-limited, early-stage mycosis fungoides capable of producing high initial complete response (CR) rates. However, much remains unknown about PUVA's therapeutic mechanisms, optimal duration and frequency of treatment, dose escalation, or use as maintenance therapy.To evaluate low-dose, low-frequency PUVA, and whether maintenance treatment extends disease-free remission in patients with mycosis fungoides.This prospective randomized clinical trial with defined PUVA dosing regimen was carried out in 5 centers (Graz, Vienna, Hietzing, Innsbruck, and Salzburg) across Austria. Patients with stage IA to IIA mycosis fungoides (n = 27) were enrolled in the study beginning March 13, 2013, with the last patient enrolled March 21, 2016. These patients were treated with oral 8-methoxypsoralen followed by UV-A exposure 2 times per week for 12 to 24 weeks until CR. Patients with CR were randomized to PUVA maintenance for 9 months (14 total exposures) or no maintenance. The study was conducted from April 27, 2012, to July 27, 2018. Data analysis of the primary end point was of the intention-to-treat population, and the secondary end point analysis was of the evaluable population.Efficacy of the PUVA regimen was determined by the rate of CR as defined by a modified severity-weighted assessment tool (mSWAT) score reduction to 0. Levels of proinflammatory molecules in serum and histologic features and percentage of clonal T cells in skin were assessed to search for biomarkers of clinical response.In 27 patients with mycosis fungoides, 19 (70%) were male with mean (range) age 61 (30-80) years. At baseline, patients with CR had a mean (range) mSWAT score of 18.6 (1-66) compared with 16.8 (3-46) in patients with partial response. The 12- to 24-week PUVA induction regimen reduced the mSWAT score in all patients and led to CR in 19 (70%) of 27 patients and a low mean cumulative UV-A dose of 78.5 J/cm2. The subsequent standardized 9-month PUVA maintenance phase prolonged median (range) disease-free remission from 4 (1-20) months to 15 (1-54) months (P = .02). High density of histologic infiltrate and high percentage of clonal TCR sequences in skin biopsy specimens at baseline were inversely associated with therapeutic response. No severe adverse effects were seen during the PUVA induction or maintenance phase.This proof-of-concept study identifies potential biomarkers for therapeutic response to PUVA in mycosis fungoides; it also demonstrates that low-dose, low-frequency PUVA appears to be highly effective, and maintenance treatment may extend disease-free remission.ClinicalTrials.gov identifier: NCT01686594.
A randomized, double-blind, placebo-controlled phase 1 study of multiple ascending doses of subcutaneous M1095, an anti–interleukin 17A/F nanobody, in moderate-to-severe psoriasis
Authors: Danka Svecova, Martin W. Lubell, Florence Casset-Semanaz, Harald Mackenzie, Roland Grenningloh, James G. Krueger
Journal: Journal of the American Academy of Dermatology (2019)

BackgroundInterleukin 17 is involved in the pathogenesis of psoriasis, a chronic debilitating disease.ObjectivesTo evaluate the safety/tolerability, immunogenicity, pharmacokinetics/pharmacodynamics, and efficacy of M1095, an anti–interleukin 17A/F nanobody, in moderate-to-severe plaque psoriasis.MethodsThis multicenter, double-blind, placebo-controlled dose escalation phase 1 study randomized 44 patients 4:1 to treatment with subcutaneous M1095 (30, 60, 120, or 240 mg) or placebo biweekly for 6 weeks, in 4 ascending dose cohorts.ResultsThe most frequent treatment-emergent adverse events with M1095 were pruritus (n = 4) and headache (n = 3); 2 patients withdrew owing to adverse events (injection site reaction and elevated liver enzyme levels). The terminal half-life of M1095 was 11 to 12 days. The area under the curve/maximum concentration was dose proportional. Of 10 M1095-treated patients positive for antidrug antibodies, 5 showed treatment-emergent antidrug antibody responses. There was no effect on M1095 exposure. Marked decreases in psoriasis inflammatory markers were observed with M1095. By day 85, 100% and 56% of patients receiving M1095, 240 mg, achieved psoriasis area and severity index 90 and 100, respectively. Improvements in static Physician's Global Assessment and affected body surface area were also seen.LimitationsInterpretation of efficacy data is limited by the small sample size.ConclusionMultiple subcutaneous doses of M1095 showed a favorable safety profile with dose-dependent improvements in psoriasis.
Whole Exome Analysis Reveals Key Genomic Differences between Sporadic and Endemic Pediatric Burkitt Lymphoma
Authors: Denice Mae Palmos, Rikhia Chakraborty, Harshal Abhyankar, Joy C. Jayaseelan, Maria F. Cardenas, Joyce Kambugu, Jeff Otiti, Fadhil Geriga, Pietro Pala, John Sekabira, Peter Wasswa, Joseph Ssenyondwa, Jackson Orem, David A. Wheeler, Joseph Lubega, Carl E. Allen, Donald Williams Parsons
Journal: Blood (2018)
Identifying Modifiable Risk Factors of Mental Health Disorders—The Importance of Urban Environmental Exposures
Authors: Marianthi-Anna Kioumourtzoglou
Journal: JAMA Psychiatry (2019)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Psychiatry HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Psychiatry journal
Abstract 16699: Histopathological Characterization of Phospholamban p.Arg14del Mutation-Related Cardiomyopathy in Relation to Clinical Presentation
Authors: Wouter P te Rijdt, Johannes M Gho, Paul A van der Zwaag, Rudolf A de Boer, Maarten A van den Berg, J P van Tintelen, Allard C van der Wal, Aryan Vink, Albert J Suurmeijer
Journal: Circulation (2013)
Abstract 15711: Sleep Quality and Major Cardiovascular Events in Patients With Stable Coronary Heart Disease
Authors: Emil Hagstrom, Ralph A Stewart, Nermin Hadziosmanovic, Stefan Denchev, Athanasios J Manolis, Lars Wallentin, Harvey D White, Claes Held
Journal: Circulation (2017)

Introduction: Simple questions are commonly asked to identify patients who may have sleep-disordered breathing (SDB) such as obstructive sleep apnea (OSA). However, while SDB diagnosed by a sleep s...
Coronary Artery Occlusion in the Conscious Dog
Authors: DAVID R. REDWOOD, ELDON R. SMITH, STEPHEN E. EPSTEIN
Journal: Circulation (1972)

Bradycardia, with or without hypotension, frequently occurs in the early phases of acute myocardial infarction. To determine the relative effects of alterations in heart rate and blood pressure on the degree of ischemic injury, the left anterior descending coronary artery was occluded for 15-min periods in closed-chest conscious dogs by inflating a balloon cuff previously implanted around the artery. The degree of myocardial ischemia was estimated by summating the S-T elevation recorded from 12 myocardial electrodes. Heart rate was increased by atropine or pacing and decreased by electrical stimulation of the vagus nerve. Hypotension was produced by venesection (average decrease in mean BP, 56 mm Hg). At normal arterial pressures there was a positive correlation between percent change in heart rate (range 30-215 beats/min) and percent change in S-T elevation (y = 0.75 X + 30.2, r = 0.93, P &lt; 0.01). When myocardial ischemia was induced during hypotension and bradycardia, S-T elevation totaled 68 mv at 15 min of ischemia. When heart rate was increased to control levels in the presence of hypotension S-T elevation during myocardial ischemia was greater (mean difference 29 mv, P &lt; 0.05). In contrast, when blood pressure was increased to control in the presence of bradycardia, S-T elevation in seven of 10 dogs was less than during hypotension and bradycardia. Thus, during experimental acute myocardial ischemia, hypotension induced by hemorrhage increases ischemic injury, and bradycardia reduces it. It is concluded that in acute myocardial ischemia increases in heart rate, even from slow baseline rates; may be deleterious to the myocardium. It remains to be determined whether alterations in the degree of myocardial ischemia induced by hemorrhagic-hypotension are analogous to those caused by the type of hypotension that often accompanies bradycardia occurring during acute myocardial infarction in man.
Lifetime Risks for Hypertension by Contemporary Guidelines in African American and White Men and Women
Authors: Vincent Chen, Hongyan Ning, Norrina Allen, Kiarri Kershaw, Sadiya Khan, Donald M. Lloyd-Jones, John T. Wilkins
Journal: JAMA Cardiology (2019)

Patterns of hypertension risk development over the adult lifespan and lifetime risks for hypertension under the American Heart Association and American College of Cardiology (AHA/ACC) 2017 thresholds for hypertension (≥130/80 mm Hg) are unknown.To quantify and compare lifetime risks for hypertension in white and African American men and women under the AHA/ACC 2017 and the Seventh Joint National Commission (JNC7) hypertension thresholds.We used individual-level pooled data from 3 contemporary cohorts in the Cardiovascular Lifetime Risk Pooling Project: the Framingham Offspring Study, the Coronary Artery Risk Development in Young Adults study, and Atherosclerosis Risk in Communities study. These community-based cohorts included white and African American men and women with blood pressure assessment at multiple cohort examinations.Cumulative lifetime risk for hypertension from ages 20 through 85 years, adjusted for competing risk of death and baseline hypertension prevalence. Incident hypertension under the AHA/ACC threshold was defined by a single-occasion blood pressure measurement of 130/80 mm Hg or more or self-reported use of antihypertensive medications. Incident hypertension under the JNC7 threshold was defined by a single-occasion blood pressure measurement of 140/90 mm Hg or more or the use of antihypertensive medications.A total of 13 160 participants contributed 227 600 person-years of follow-up; the data set included individual-level data on 6313 participants at baseline (median age, 25 years), plus person-year data from participants in the Atherosclerosis Risk in Communities and Framingham Offspring studies who enrolled at older ages. Baseline prevalence of hypertension under the AHA/ACC 2017 threshold in participants entering the data set between 20 and 30 years of age was 30.7% in white men (n = 549 of 1790), 23.1% in African American men (n = 245 of 1063), 10.2% in white women (n = 210 of 2070), and 12.3% in African American women (n = 171 of 1390). White men had lifetime risk of hypertension of 83.8% (95% CI, 82.5%-85.0%); African American men, 86.1% (95% CI, 84.1%-88.1%); white women, 69.3% (95% CI, 67.8%-70.7%); and African American women, 85.7% (95% CI, 84.0%-87.5%). These were greater than corresponding lifetime risks under the JNC7 threshold for hypertension (white men, 60.5% [95% CI, 58.9%-62.1%]; African American men, 74.7% [95% CI, 71.9%-77.5%]; white women, 53.9% [95% CI, 52.5%-55.4%]; and African American women, 77.3% [95% CI, 75.0%-79.5%]).Under the AHA/ACC 2017 blood pressure threshold for hypertension, lifetime risks for hypertension exceeded 75% for African American men and women and white men. Furthermore, prevalence of blood pressure of 130/80 mm Hg or more is very high in young adulthood, suggesting that efforts to prevent development of hypertension should be focused early in the life course.
HSR19-083: Treatment Heterogeneity and Overall Survival (OS) in Patients With Advanced/Metastatic Gastric/Gastroesophageal Junction Cancer (aGC/GEJ) in the United States
Authors: Jessica A. Davis, Zhanglin Lin Cui, Madiha Ghias, Xiaohong Li, Robert Goodloe, Astra M. Liepa, Kenyon Ogburn, Lisa M. Hess
Journal: Journal of the National Comprehensive Cancer Network (2019)

Background: Previous work has demonstrated treatment (tx) heterogeneity in the care of patients with aGC/GEJ. This study was designed to examine heterogeneity temporal trends and OS in patients with aGC/aGEJ in the United States from 2011 to 2018. Methods: The Flatiron Advanced/metastatic gastric/esophageal cohort electronic medical records (EMR) data were used for this study. Eligible patients were adults receiving anticancer therapy for aGC/GEJ during the study period. Tx patterns were summarized by line of therapy. Drugs were grouped by class. Heterogeneity was measured using the Herfindahl-Hirschman index (HHI); HHI scores range from 0.0000 (complete heterogeneity) to 1.0000 (complete homogeneity). A difference of 0.1000 in HHI scores is considered to be practically meaningful. HHI scores were calculated for each clinic with ≥10 patients. OS was estimated using Kaplan-Meier method. Trend analyses were conducted for HHI scores over time using a linear regression model. Results: There were 2,912 patients who met eligibility criteria. The median age of the study cohort was 67 years; majority were male (70.9%) and white (61.1%). aGC patients comprised the majority (n=1,630, 55.9%). Median OS from the start of first-line (1L) therapy was 12.7 months (95% CI: 12.07, 13.6). The most common 1L regimens were fluoropyrimidine + oxaliplatin (n=651, 22.4%), platinum (ie, cisplatin or carboplatin) + taxane (n=511, 17.5%), and single-agent fluoropyrimidine (n=280, 9.6%). 1,230 patients received second line (2L) and the most common regimens were ramucirumab + taxane (n=203, 16.5%), fluoropyrimidine + oxaliplatin (n=155, 12.6%), and platinum + taxane (n=101, 8.2%). Overall median HHI for 1L was 0.1728 (min/max: 0.0926–0.4380). Median 1L HHI for 2011–2012 was 0.21665 (min/max: 0.1626–0.3156) and was 0.2419 (min/max 0.1716–0.4583) for 2017–2018. There were no significant differences in HHI score over time ( P =.078). Overall median HHI for 2L was 0.1309 (min/max: 0.0694–0.2400). Due to small number of sites with ≥10 patients, data in 2L were too limited to conduct time trend analyses. Conclusions: Heterogeneity in 1L treatment of gastric/GEJ cancer persists, despite the continued refinement of guidelines and approval of new drugs in subsequent lines of therapy. Further analyses are needed to examine the relationship between heterogeneity, guideline adherence, and patient outcomes. These future data will shed light on the persistence of heterogeneous treatment patterns observed in the United States.
Outdoor Activity Protects Against Childhood Myopia—Let the Sun Shine In
Authors: Karla Zadnik, Donald O. Mutti
Journal: JAMA Pediatrics (2019)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Pediatrics HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Pediatrics journal
Innate immunity in allergy
Authors: Kazuhiko Maeda, Matias J. Caldez, Shizuo Akira
Journal: Allergy (2019)

Abstract Innate immune system quickly responds to invasion of microbes and foreign substances through the extracellular and intracellular sensing receptors, which recognize distinctive molecular and structural patterns. The recognition of innate immune receptors leads to the induction of inflammatory and adaptive immune responses by activating downstream signaling pathways. Allergy is an immune‐related disease and results from a hypersensitive immune response to harmless substances in the environment. However, less is known about the activation of innate immunity during exposure to allergens. New insights into the innate immune system by sensors and their signaling cascades provide us with more important clues and a framework for understanding allergy disorders. In this review, we will focus on recent advances in the innate immune sensing system.