tbuckley/cabot-search huggingface dataset:
Abstract P122: Intersectional Effects of Racial and Gender Discrimination on Cardiovascular Health Vary Among Black and White Women and Men in the Cardia Study
Authors: Ganga S Bey, Sharina D Person, Catarina Kiefe
Journal: Circulation (2019)

Background: Some evidence suggests an association of perceived racial but not gender discrimination with disparities in cardiovascular health (CVH) among U.S. black women and men. We assessed whether there are race-gender differences in the effects of reporting experiences of racial and gender discrimination simultaneously compared with racial or gender discrimination alone, or no discrimination, on future CVH. Methods: Data were from a sample of 3,758 black or white adults in CARDIA, a population-based cohort recruited in Birmingham, AL; Chicago, IL; Minneapolis, MN, and Oakland, CA in 1985-6 (year 0). Racial and gender discrimination were assessed using the Lifetime Discrimination Scale at year 7. CVH at year 30 was evaluated using a 12-point composite outcome modified from the AHA’s Simple 7, with higher scores indicating better health. Multivariable linear regressions evaluated the associations between level of perceived discrimination at year 7 and CVH scores at year 30 stratified by race-gender. Results: Reporting racial and gender discrimination in ≥2 settings were 48% (496/1039) of black women, 42% (311/743) of black men, 10% (109/1045) of white women, and 5% (45/931) of white men. Year 30 CVH scores (mean, SD) were 7.9 (1.4), 8.1 (1.6), 8.8 (1.6), and 8.7 (1.3), respectively. Table: Compared with those of their race-gender groups reporting no discrimination, white women reporting gender only saw an adjusted score difference of +0.3 ( p =0.04); white men reporting racial only, +0.4 ( p =0.02), and both racial and gender, -0.6 ( p =0.03). Conclusions: Racial and gender discrimination interact in their association with CVH differently for different race-gender groups. While modest, a 1-point decrease in CVH score among white men has been shown to correspond to an ~30% increase in the rate of CVD development. More research is needed to understand why perceived discrimination might better predict CVH for whites than blacks, and which other factors associated with race-gender contribute variability to CVH among these groups.
Severe mental illness and substance use disorders in prisoners in low-income and middle-income countries: a systematic review and meta-analysis of prevalence studies
Authors: Gergő Baranyi, Carolin Scholl, Seena Fazel, Vikram Patel, Stefan Priebe, Adrian P Mundt
Journal: The Lancet Global Health (2019)

BackgroundAlthough more than two thirds of the world's incarcerated individuals are based in low-income and middle-income countries (LMICs), the burden of psychiatric disorders in this population is not known. This review provides estimates for the prevalence of severe mental illness and substance use disorders in incarcerated individuals in LMICs.MethodsFor this systematic review and meta-analysis, we searched 17 electronic databases to identify prevalence studies of psychiatric disorders in prison populations in LMICs, published between January, 1987, and May, 2018. We included representative studies from general prison samples, providing information about four major psychiatric diagnoses: psychosis, major depression, alcohol use disorders, and drug use disorders. We pooled data from studies using random-effects meta-analyses and assessed the sources of heterogeneity by meta-regression. We extracted general population estimates from the Global Burden of Diseases 2016 database to calculate comparative prevalence ratios. This study is registered with PROSPERO, number CRD42015020905.FindingsWe identified 23 publications reporting prevalence estimates of severe mental illness and substance use disorders for 14 527 prisoners from 13 LMICs. In this population, the estimated pooled 1 year prevalence rates for psychosis were 6·2% (95% CI 4·0–8·6), 16·0% (11·7–20·8) for major depression, 3·8% (1·2–7·6) for alcohol use disorders, and 5·1% (2·9–7·8) for drug use disorders. We noted increased prevalence at prison intake and geographic variations for substance use disorders. For alcohol use disorders, prevalence was higher in the southeast Asian region than in the eastern Mediterranean region; and drug use disorders were more prevalent in the eastern Mediterranean region than in Europe. Prevalence ratios indicated substantially higher rates of severe mental illness and substance use disorders among prisoners than in the general population (the prevalence of non-affective psychosis was on average 16 times higher, major depression and illicit drug use disorder prevalence were both six times higher, and prevalence of alcohol use disorders was double that of the general population).InterpretationThe prevalence of major psychiatric disorders is high in prisoners in LMIC compared with general populations. As these findings are likely to reflect unmet needs, the development of scalable interventions should be a public health priority in resource-poor settings.FundingCONICYT of the Chilean government and the Wellcome Trust.
B.coagullans в лечении гастроэнтерологических заболеваний воспалительной и функциональной природы: эффективность с позиций доказательной медицины
Authors: I.L. Vysochina
Journal: GASTROENTEROLOGY (2019)

Проведен анализ баз данных PubMed, Scopus, Web of Science, MedLine, The Cochrane Library, CyberLeninka, РИНЦ в контексте поиска информации по эффективности B.coagullans в лечении гастроэнтерологических заболеваний воспалительной и функциональной природы. Системный анализ информации, представленный в данной статье, полностью соответствует международным рекомендациям по систематическим методам поиска литературы и содержит информацию о роли, значении, преимуществах, безопасности и эффективности данного штамма (GRAS Notice No. GRN 000660) и возможностях применения пробиотиков и препаратов B.сoagulans у человека с доказательной базой возможности расширения показаний для применения споросодержащих пробиотиков B.coagullans (в том числе и для препарата Лактовит Форте), в частности при синдроме раздраженного кишечника.
<i>ATM</i> mutation is associated with shorter overall survival in relapsed/advanced urothelial cancer.
Authors: Ming Yin, Petros Grivas, Amir Mortazavi, Paul Monk, Hamid Emamekhoo, Sheldon L. Holder, Joseph J. Drabick, Sumanta K. Pal, Michele Sue-Ann Woo, Jin Dexter, Monali K. Vasekar, Monika Joshi
Journal: Journal of Clinical Oncology (2019)

370 Background: Somatic mutations of ATM are frequently found in UC and have been associated with a better response to cisplatin-based neoadjuvant chemotherapy. However, we previously showed ATM mutations were associated with a short survival in UC (PMID: 29682192 ). In this study, we focused on prognostic values of mutations in ATM in tumors of patients with relapsed or advanced (TxN 2-3 M 0-1 ) UC through three independent datasets. Methods: 81 UC pts who underwent FoundationOne genomic sequencing (315 cancer-related genes) were used as a discovery dataset. Results were then validated in additional 91 pts with UC who received FoundationOne test (collected separately) and 129 relapsed/advanced UC patients selected from 412 TCGA bladder cohort. Fisher Exact test was used to determine difference of ATM mutation rates. Logistic regression analysis was performed to calculate odds ratio (OR) and 95% confidence interval (CI). Overall survival (OS) was measured from time of initial diagnosis and Cox proportional hazard regression analysis was performed to calculate the hazard ratio (HR) and 95% CI. Results: The median ages of the 3 cohorts were 65 (44–84), 65 (21–91) and 67 (45–-90). The majority of pts were Caucasians (86.4%, 75.8% and 81.4%) and ever smokers (77.8%, 67% and 76.7%). ATM mutations were present in 14.8% (12/81), 11% (10/91) and 6.2% (8/129) of the three cohorts (Fisher Exact, p = 0.118). In all three groups of pts, ATM mutations consistently correlated with a significantly shorter OS (Discovery: HR = 2.25, 95% CI, 1.03–4.89, p = 0.041; Validation 1: HR = 3.15, 95% CI, 1.17–8.44, p = 0.023; and Validation 2: HR = 2.17, 95% CI, 0.99–4.75, p = 0.051). In 144 pts treated with cisplatin or carboplatin pooled from the three cohorts, ATM mutations correlated with a non-significantly higher objective response rate (OR = 1.54, 95% CI 0.44–5.35, p = 0.5), but were still associated with a poorer survival (HR = 1.95, 95% CI 1.00–3.83, p = 0.05). Conclusions: These results suggest that ATM mutations may be considered as a negative prognostic biomarker in relapsed/advanced UC pts. Further studies are required to determine the underlying mechanisms.
How does 6 months of active bike commuting or leisure-time exercise affect insulin sensitivity, cardiorespiratory fitness and intra-abdominal fat? A randomised controlled trial in individuals with overweight and obesity
Authors: Martin Bæk Blond, Mads Rosenkilde, Anne Sofie Gram, Marie Tindborg, Anders Nymark Christensen, Jonas Salling Quist, Bente Merete Stallknecht
Journal: British Journal of Sports Medicine (2019)

Objectives To evaluate effects of active bike commuting or leisure-time exercise of two intensities on peripheral insulin sensitivity (primary outcome), cardiorespiratory fitness and intra-abdominal adipose tissue mass (secondary outcomes). Methods 188 physically inactive, healthy women and men (20-45 years) with overweight or class 1 obesity were recruited. In the 6-month trial, 130 participants were randomised to either: no intervention (CON), active commuting (BIKE) or leisure-time exercise of moderate (MOD, 50% VO 2 peak) or vigorous (VIG, 70% VO 2 peak) intensity. 100 completed follow-up testing. Exercise prescription was 5 days/week with a weekly exercise energy expenditure of 1600 kcal for women and 2100 kcal for men. Testing was performed at baseline, 3 months and 6 months. Results Peripheral insulin sensitivity (ml/min/pmol insulin/L) increased (improved) by 24% (95% CI 6% to 46%, p=0.01) in VIG compared with CON at 3 months. Peripheral insulin sensitivity increased (improved) by 20% in BIKE (95% CI 1% to 43%, p=0.04) and 26% in VIG (95% CI 7% to 47%, p&lt;0.01) compared with CON at 6 months. Cardiorespiratory fitness increased in all exercise groups compared with CON at 6 months; but the increase was higher in those that undertook vigorous exercise than those who did moderate exercise. Intra-abdominal adipose tissue mass diminished across all exercise groups in comparison to CON at 6 months. Conclusions Active bike commuting improved cardiometabolic health; as did leisure-time exercise. Leisure-time exercise of vigorous intensity conferred more rapid effects on peripheral insulin sensitivity as well as additional effects on cardiorespiratory fitness than did moderate intensity exercise. Trial registration NCT01962259
Association of <i>MAPT</i> Subhaplotypes With Risk of Progressive Supranuclear Palsy and Severity of Tau Pathology
Authors: Michael G. Heckman, Rebecca R. Brennan, Catherine Labbé, Alexandra I. Soto, Shunsuke Koga, Michael A. DeTure, Melissa E. Murray, Ronald C. Petersen, Bradley F. Boeve, Jay A. van Gerpen, Ryan J. Uitti, Zbigniew K. Wszolek, Rosa Rademakers, Dennis W. Dickson, Owen A. Ross
Journal: JAMA Neurology (2019)

The association between the microtubule-associated protein tau (MAPT) H1 haplotype and the risk of progressive supranuclear palsy (PSP) has been well documented. However, the specific H1 subhaplotypes that drive the association have not been evaluated in large studies, nor have they been studied in relation to neuropathologic severity of disease.To comprehensively evaluate the associations of MAPT haplotypes with the risk of PSP and the severity of tau pathology using a large series of neuropathologically confirmed PSP cases.A case-control study was used to investigate the associations between MAPT haplotypes and the risk of PSP, and a case series was conducted for examination of associations of MAPT haplotypes with the severity of tau pathology. All 802 neuropathologically confirmed PSP cases were obtained from a neurodegenerative disorders brain bank between January 1, 1998, and December 31, 2013, and 1312 clinical controls were obtained from the neurology department of the Mayo Clinic. Statistical analysis was performed from February 17 to December 12, 2018.Presence of PSP in case-control analysis and semiquantitative tau pathology scores for neurofibrillary tangles, neuropil threads, tufted astrocytes, and oligodendroglial coiled bodies in PSP cases.For 802 patients with PSP (376 women and 426 men), the median age at death was 75 years (range, 52-98 years). For 1312 controls (701 women and 611 men), the median age at blood collection was 69 years (range, 45-92 years). After adjustment for multiple testing, known associations with risk of PSP were observed for the H2 and H1c haplotypes. Novel associations with PSP were observed for 3 H1 subhaplotypes, including H1d (odds ratio, 1.86; 95% CI, 1.43-2.42; P = 2 × 10-6), H1g (odds ratio, 3.64; 95% CI, 2.04-6.50; P = 2 × 10-6), and H1o (odds ratio, 2.60; 95% CI, 1.63-4.16; P = 2 × 10-5). Although not significant after multiple testing adjustment, 3 of these PSP risk haplotypes (H2, H1c, and H1d) were also nominally associated with measures of severity of tau pathology in PSP cases. Nominally significant associations with severity of tau pathology were also noted for the H1e and H1q haplotypes.This study has identified novel associations with risk of PSP for 3 MAPT H1 subhaplotypes. In addition, potential weaker associations between several haplotypes (including several PSP risk haplotypes) and severity of tau pathology were observed. These findings expand the current understanding of the role of MAPT haplotypic variation in susceptibility to and neuropathologic severity of PSP.
Avoiding an opioid crisis in the UK
Authors: Nicholas Levy, Patricia Mills, William J Fawcett
Journal: BMJ (2019)

Deprescribing should be integral to every clinician’s practice1; the General Medical Council emphasised the importance of regular review of a patient’s medication in 2013.2 Deprescribing should be undertaken by anaesthetists and intensivists,3 as we are in a position to advise …
Long-term consequences of intermittent and continuous androgen deprivation in older patients with metastatic prostate cancer.
Authors: Dawn L. Hershman, Joseph M. Unger, Jason Dennis Wright, Scott David Ramsey, Cathee Till, Catherine M. Tangen, William E. Barlow, Charles David Blanke, Ian Murchie Thompson, Maha Hussain
Journal: Journal of Clinical Oncology (2015)

5008 Background: Although intermittent androgen deprivation therapy (ADT) has not been associated with better overall survival in prostate cancer (PC), it has the potential for lower side effects and potential for better quality of life (QOL). The incidence of long-term side effects has not been reported. Methods: We analyzed a subset of patients from S9346, a randomized SWOG trial of intermittent vs. continuous ADT in patients with metastatic PC. To identify late-effects by treatment arm , we established an innovative linkage between patient trial data and corresponding Medicare claims. To incorporate time from beginning of observation through evidence of a late effect, and to account for potential competing risks of death, we analyzed claims to determine the cumulative incidence of late effects. Cox regression was used to examine time-to-late effects, adjusting for covariates. Results: In total, n = 1134 eligible U.S.-based patients with metastatic prostate cancer were randomized to continuous vs. intermittent ADT on S9346. A total of 636 (56%) of trial participants had ≥ 1 year of continuous Medicare parts A & B coverage and no HMO participation. The mean age was 71.5 years. The most common late effects recorded in claims in the cohort were hypercholesterolemia (31%) and osteoporosis (21%). the 10-year cumulative incidence of ischemic and thrombotic events were differed by arm; 23% for continuous therapy and 32% for intermittent therapy patients (Hazard Ratio = 0.68, p = .02). On the IAD arm, there was no difference in the mean percentage of time receiving therapy between those with and without ischemic or thrombotic events (47% vs 47%, p = 0.86). There were no statistically significant differences by arm in any other late effects. Conclusions: Despite beliefs that intermittent ADT could reduce long-term health-related effects compared to continuous ADT, we found that older men assigned to intermittent therapy had a slightly increased incidence of ischemic and thrombotic events and no apparent reduction in bone related, endocrine, or cognitive events
Concomitant chemoradiotherapy using docetaxel, cisplatin and 5-FU for the patients with advanced hypopharyngeal cancer: Second report.
Authors: Kiyoto Shiga, Katsunori Katagiri, Daisuke Saitoh, Takenori Ogawa
Journal: Journal of Clinical Oncology (2015)

e17074 Background: Chemotherapy using TPF protocol has been showed efficacy in the neo-adjuvant setting for head and neck squamous cell carcinoma (SCC) so far. However, effectiveness of concomitant chemoradiotherapy (CCRT) using TPF protocol has not yet been clearly distinguished. On the other hand, prognoses of the patients with SCC of the hypopharynx, especially those of advanced stage patients, were poor. The aim of this study was to determine the safety and efficacy of newly developed CCRT using TPF protocol in patients with SCC of the hypopharynx. Methods: Patients with previously untreated, histologically proven stage IVA disease were eligible for the study. Sixteen patients were enrolled between January 2002 and September 2008. Treatment consisted of radiotherapy administered once daily to a total dose of 70 Gy, concomitant with 120 hour infusions of 5-FU (600 mg/m2/day), Docetaxel (50 mg/m2, day 2) and Cisplatin (60 mg/m2, day 2) given during first and fifth weeks of radiotherapy. These drug doses were determined from the results of our former phase I study to assess the dose limiting toxicity of this protocol. Median follow-up period was 72 months. Results: Fifteen patients completed this protocol. Bone marrow suppression was the most common adverse event observed through this study. Grade 4 leukopenia, neutropenia and hemoglobin were observed in 4 (25%), 8 (50%) and 2 (12.5%) of the patients and also those grade 3 events were observed in 5 (31.3%), 4 (25%) and 2 (12.5%) of the patients. Grade 3 lymphopenia were observed in all patients. As all patients showed mucositis at any grade, feeding tube dependence and dietary limitation were observed in two patients at the time of discharge. Complete remission of primary tumor was obtained in all patients. However, salvage neck dissection was performed in 3 patients. The disease-specific survival rates at 60 months of the patients were 88.0%. On the other hand, those of the patients with stage IVA disease who underwent surgery during the same period were 70.0%. Conclusions: Our data suggested that CCRT using TPF protocol was feasible and very effective in patients with advanced stage SCC of the hypopharynx.
Transmission Trees on a Known Pathogen Phylogeny: Enumeration and Sampling
Authors: Matthew D Hall, Caroline Colijn
Journal: Molecular Biology and Evolution (2019)

One approach to the reconstruction of infectious disease transmission trees from pathogen genomic data has been to use a phylogenetic tree, reconstructed from pathogen sequences, and annotate its internal nodes to provide a reconstruction of which host each lineage was in at each point in time. If only one pathogen lineage can be transmitted to a new host (i.e., the transmission bottleneck is complete), this corresponds to partitioning the nodes of the phylogeny into connected regions, each of which represents evolution in an individual host. These partitions define the possible transmission trees that are consistent with a given phylogenetic tree. However, the mathematical properties of the transmission trees given a phylogeny remain largely unexplored. Here, we describe a procedure to calculate the number of possible transmission trees for a given phylogeny, and we then show how to uniformly sample from these transmission trees. The procedure is outlined for situations where one sample is available from each host and trees do not have branch lengths, and we also provide extensions for incomplete sampling, multiple sampling, and the application to time trees in a situation where limits on the period during which each host could have been infected and infectious are known. The sampling algorithm is available as an R package (STraTUS).
Prognostic impact of neutrophil-to-lymphocyte ratio in renal cell carcinoma: A systematic review and meta-analysis.
Authors: Veronica Mollica, Vincenzo Di Nunno, Lidia Gatto, Matteo Santoni, Laura Cosmai, Camillo Porta, Francesco Massari
Journal: Journal of Clinical Oncology (2019)

572 Background: Several clinical scores have been adopted in clinical practice for the prognostic estimation in patients with Renal Cell Carcinoma (RCC). Neutrophil-lymphocytes ratio (NLR) has shown to be a reliable and economic parameter associated with prognosis however its role has not been fully understood. Methods: We performed a systematic review and meta-analysis according to PRISMA guidelines to evaluate the prognostic value of NLR in terms of overall and progression free survival (OS/PFS) in both metastatic and non metastatic patients with RCC. We applied the inverse variance technique for the meta-analysis of the HRs and due to the intrinsic heterogeneity of the data we adopted a Random Effects model. 24 studies were selected for the final analysis, 21 for the comparison of NLR and OS and 15 for the comparison of NLR and DFS/PFS. Results: In overall population higher NLR resulted in worst OS benefit with a pooled HR of 1.80 (95% confidence interval of 1.61 – 2.00, I 2 45%.) as well as in non metastatic (pooled HR of 1.57, 95% CI 1.27-1.94, I 2 39%) and metastatic patients (2.05, 95% CI 1.74-2.41, I 2 0%). Moreover, NLR resulted in worst PFS in overall population (pooled HR 1.69, 95% CI 1.42-2.01, I 2 81%), in non metastatic (HR 1.52, 95% CI 1.23-1.87, I 2 53%) and metastatic (HR 1.95, 95% CI 1.43-2.64 I 2 90%). Conclusions: According to our results NLR ratio is a variable correlated to prognosis in RCC patients. The low level of heterogeneity among studies included suggests that it has a strong association with patients’ survival. Thus it appears as an attractive, dynamic and economic biomarker which could be adopted to further subdivide prognostic classes into even more accurate groups of prognosis in order to choose the best treatment strategy possible. Further prospective studies are needed to confirm our findings.
Case 6-1994
Authors: Richard C. Cabot, Robert E. Scully, Eugene J. Mark, William F. McNeely, Betty U. McNeely, J. Thomas LaMont, Asif Rashid
Journal: New England Journal of Medicine (1994)

Presentation of CaseA 31-month-old girl was admitted to the hospital because of fever and diarrhea.Her early growth and development had been normal, except that her weight was consistently at or just below the 5th percentile. She had been well until two months before entry, when she was admitted to another hospital because of cough, wheezing, and a low-grade fever and was treated with antibiotics and a five-day course of prednisone. She was discharged taking amoxicillin and nebulized albuterol. Eighteen days before admission her symptoms recurred, and she returned to the same hospital, where she received antibiotics and prednisone . . .