tbuckley/cabot-search huggingface dataset:
AB0093 Calciphylaxis due to long-term steroid using in a patient with rheumatoid arthritis
Authors: C Korkmaz, E Kasapoglu
Journal: Annals of the Rheumatic Diseases (2001)

<h3>Background</h3> Calciphylaxis is a rare and life-threatening condition of progressive cutaneous necrosis secondary to small and medium-sized vessel calcification seen almost exclusively in patients with end-stage renal disease and hyperparathyroidism. <h3>Objectives</h3> We report a case with calciphylaxis due to long-term steroid using in a patient with rheumatoid arthritis (RA). <h3>Methods</h3> Case report. <h3>Results</h3> A 43-year-old man admitted with a history of progressive left leg pain and ulcerations. Several hemoragic bullae were present in these areas as well, and the patient offered that the ulcers began as blisters that then brokedown. His past medical history included RA and he had been using steroid in doses of 5–40 mg/day according to his complaints for 20 years when he was admitted to our hospital. His examination revealed destructive and erosive arthritis affecting his bilateral wrists, MCP, and PIF joints, and ischaemic necrosis in the distal parts of the 2nd. and 3th. digits of the left hand. Laboratory results were as follows: erythrocyte sedimentation rate 77 mm/h, urea 9 mg/dl, creatinine 0.8 mg/dl, calcium 7 mg/dl, phosphate 3.7 mg/dl, albumin 2 gr/dl, parathyroid hormone 43 pg/ml (n = 12–72), protein S 38% (n = 7–115%). Roentgenogram of the lower aspect of the leg showed calcified larger vessels and subcutaneous vessels. His lesions progressed and required above the left knee and left 2nd., 3th. digits amputations. Pathologic examination showed extensive arterial wall calcification. Now he has been under the treatment of sulfasalazine and he has remained asymptomatic. <h3>Conclusion</h3> Calciphylaxis may appear without renal failure and hyperparathyroidism. Long-term steroid using in RA patients may lead to calciphylaxis. Acquired protein S deficiency may contribute to this process.
TCT CONNECT-328 Transcatheter Mitral Valve Repair in Patients With Heart Failure in Young Versus Elderly Patients: Analysis From the COAPT Trial
Authors: Christopher Song, Mahesh Madhavan, JoAnn Lindenfeld, William Abraham, Saibal Kar, Scott Lim, Paul Grayburn, Samir Kapadia, Lak Kotinkaduwa, Michael Mack, Gregg Stone
Journal: Journal of the American College of Cardiology (2020)
SAT0721-HPR INVESTIGATION OF FUNCTIONAL OUTCOMES AND QUALITY OF LIFE IN YOUNG ADULTS WITH INTERNAL FIXATION SURGERY OF FEMORAL SHAFT FRACTURE
Authors: Taha Tufek, Gizem İrem Kinikli, Omur Caglar
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> Femoral Shaft Fracture (FSF) is a severe injury with incidance 10-21 per 100,000 persons/year<sup>1</sup>. The union rate is reported between 95–99 %<sup>2</sup>. Unfortunately, even after union a number of patients still report impairments and limitations in functional outcomes and quality of life (QoL)<sup>3</sup>. The literature lacks studies evaluating long-term functional outcome and performance and QoL. <h3>Objectives:</h3> The aim of this study was to compare the functional outcomes and quality of life of the young adults who underwent internal fixation (IF) surgery of femoral shaft fracture (FSF) to the healthy individuals. <h3>Methods:</h3> Twenty patients who underwent IF surgery of FSF by the same surgeon and 20 healthy individuals were included in this retrospective study. Individuals with secondary osteoporosis risk were not included. Function of both two groups was assessed using Harris Hip Score. To evaluate performance Stair Climb Test (SCT) is applied. Quality of life was assessed by the EQ-5D-3L HrQoL. The Mann Whitney U-Test was used to compare the results of the function, performance and quality of life of the two independent groups. Statistically, p&lt;0.05 was accepted as a significant difference. <h3>Results:</h3> The mean time after surgery was 2.2±0.8 years. Comparing to the healthy group, the EQ-5D-3L VAS and TTO scores of the patient group were significantly lower (p&lt;0.001). When the function results were compared between the groups, the mean total HHS of the patient group were found significantly lower (p&lt;0.001). The results of mean stair climbing time in healthy group were significantly lower (p&lt;0.001). Descriptive outcomes and results' details is shown in Table 1. <h3>Conclusion:</h3> The results of the study showed that there were deficiencies in long-term function, performance and quality of life in young adults after IF surgery compared to healthy individuals. Therefore, we suggest that the assessment of the in long-term functional outcomes and quality of life of the patients with FSF after IF surgery is necessary to plan appropriate rehabilitation programs by determining the patient's needs. <h3>References</h3> [1] Enninghorst N, McDougall D, Evans JA. Population-based epidemiology of femur shaft fractures. J Trauma Acute Care Surg. 2013;74:1516–20. [2] Deepak MK, Jain K, Rajamanya KA, et al. Functional outcome of diaphyseal fractures of femur managed by closed intramedul- lary interlocking nailing in adults. Ann Afr Med. 2012;11:52–7. [3] El Moumni M, Voogd EH, ten Duis HJ, Wendt KW. Long-term functional outcome following intramedullary nailing of femoral shaft fractures. Injury. 2012;43:1154–8. <h3>Disclosure of Interests:</h3> None declared
Supramolecularly enabled pH- triggered drug action at tumor microenvironment potentiates nanomedicine efficacy against glioblastoma
Authors: Sabina Quader, Xueying Liu, Kazuko Toh, Yu-Lin Su, Amit Ranjan Maity, Anqi Tao, West Kristian D. Paraiso, Yuki Mochida, Hiroaki Kinoh, Horacio Cabral, Kazunori Kataoka
Journal: Biomaterials (2020)
Binding and Activity of Tetrabromobisphenol A Mono-Ether Structural Analogs to Thyroid Hormone Transport Proteins and Receptors
Authors: Xiao-Min Ren, Linlin Yao, Qiao Xue, Jianbo Shi, Qinghua Zhang, Pu Wang, Jianjie Fu, Aiqian Zhang, Guangbo Qu, Guibin Jiang
Journal: Environmental Health Perspectives (2020)

Background: Tetrabromobisphenol A (TBBPA) mono-ether structural analogs, identified as the by-products or transformation products of commercial TBBPA bis-ether derivatives, have been identified as emerging widespread pollutants. However, there is very little information regarding their toxicological effects. Objective: We aimed to explore the potential thyroid hormone (TH) system–disrupting effect of TBBPA mono-ether structural analogs. Methods: The binding potencies of chemicals toward human TH transport proteins [transthyretin (TTR) and thyroxine-binding globulin (TBG)] and receptors [TRα ligand-binding domain (LBD) and TRβ-LBD] were determined by fluorescence competitive binding assays. Molecular docking was used to simulate the binding modes of the chemicals with the proteins. The cellular TR-disrupting potencies of chemicals were assessed by a GH3 cell proliferation assay. The intracellular concentrations of the chemicals were measured by high-performance liquid chromatography and mass spectrometry. Results: TBBPA mono-ether structural analogs bound to TTR with half maximal inhibitory concentrations ranging from 0.1μM to 1.0μM but did not bind to TBG. They also bound to both subtypes of TR-LBDs with 20% maximal inhibitory concentrations ranging from 4.0μM to 50.0μM. The docking results showed that the analogs fit into the ligand-binding pockets of TTR and TR-LBDs with binding modes similar to that of TBBPA. These compounds likely induced GH3 cell proliferation via TR [with the lowest effective concentrations (LOECs) ranging from 0.3μM to 2.5μM] and further enhanced TH-induced GH3 cell proliferation (with LOECs ranging from 0.3μM to 1.2μM). Compared with TBBPA, TBBPA-mono(2,3-dibromopropyl ether) showed a 4.18-fold higher GH3 cell proliferation effect and 105-fold higher cell membrane transportation ability. Conclusion: This study provided a possible mechanism underlying the difference in TTR or TR binding by novel TBBPA structural analogs. These compounds might exert TH system–disrupting effects by disrupting TH transport in circulation and TR activity in TH-responsive cells. https://doi.org/10.1289/EHP6498
TCT CONNECT-113 Impact of Implantation Depth on Outcomes After Transcatheter Aortic Valve Replacement With SAPIEN-3 Valve
Authors: Yasser Sammour, Kinjal Banerjee, Arnav Kumar, Hassan Lak, Sanchit Chawla, Lars Svensson, Daniel Burns, James Yun, Rishi Puri, Grant Reed, Amar Krishnaswamy, Samir Kapadia
Journal: Journal of the American College of Cardiology (2020)
TCT CONNECT-105 The Safety of Early Discharge Following Transcatheter Aortic Valve Replacement Among Patients in Northern Ontario and Rural Areas Utilizing the Vancouver 3M TAVR Study Clinical Pathway
Authors: Sami Alnasser, Derek Macdonald, Rony Atoui, Abdulrahman Alqahtani, Hooman Hennessey, Carly Pulkkinen, Bhanu Nalla, John Fenton, Melissa Stringer, Joanne Collin, Raed Abu Shama, Suzanne Leblanc, Mohammed Shurrab, Bindu Bittira
Journal: Journal of the American College of Cardiology (2020)
Evaluating the psychometric properties of the Immunotherapy module of the MD Anderson Symptom Inventory
Authors: Tito Mendoza, Ajay Sheshadri, Mehmet Altan, Kenneth Hess, Goldy George, Bettzy Stephen, Lilibeth Castillo, Enedelia Rodriguez, Jing Gong, Christine Peterson, Jordi Rodon Ahnert, Siqing Fu, Sarina A Piha-Paul, Shubham Pant, Ecaterina Dumbrava, Timonthy A Yap, Filip Janku, Apostolia M Tsimberidou, Vivek Subbiah, Daniel D Karp, Abdulrazzak Zarifa, Lacey M McQuinn, Charles Cleeland, David S Hong, Aung Naing
Journal: Journal for ImmunoTherapy of Cancer (2020)

Introduction Immunotherapies have revolutionized the treatment of various cancers, but little is known about their symptomatic toxicity. Assessing these symptoms is best accomplished by asking the patients themselves. However, such reports are subjective and may face challenges as bonafide scientific data. Demonstrating the validity of symptom assessment tools, mainly through the reduction of measurement errors, has the potential to improve patient care if these tools are widely adopted. To that end, we present herein the psychometric properties of the Immunotherapy for Early-Phase Trials module of the MD Anderson Symptom Inventory (MDASI-Immunotherapy EPT) in patients receiving various immunotherapies in early phase trials at a major cancer center. Methods One hundred forty-five patients completed the inventory at baseline, with 85 of them also doing so after 9 weeks of treatment. The mean (±SD) age of the patients was 57.0±12.9 years. Also, 56% of the patients were women, 79% identified as white, and 49% had at least some college education. Results The internal consistency reliability of the MDASI-Immunotherapy EPT was excellent, as the Cronbach’s alphas for all of its subscales were at least 0.88 (range 0.88–0.95). Known-group validity based on Eastern Cooperative Oncology Group performance status groupings was excellent at 9 weeks after the start of an immunotherapy trial for the MDASI-Immunotherapy EPT severity (effect size, 0.96) and interference (effect size, 0.82) subscales. We found substantial changes in the symptom items difficulty remembering (effect size, −0.85), fever and/or chills (effect size, −0.63), disturbed sleep (effect size, −0.52), diarrhea (effect size, −0.42), and swelling of hands, legs, or feet (effect size, −0.39). Conclusions In conclusion, the MDASI-Immunotherapy EPT is a valid, reliable, and sensitive tool for measuring symptomatic toxicity.
Assessment and Comparison of Performance of ABCD-10 and SCORTEN in Prognostication of Epidermal Necrolysis
Authors: Hui Kai Koh, Stephanie Fook-Chong, Haur Yueh Lee
Journal: JAMA Dermatology (2020)

Epidermal necrolysis is a rare severe cutaneous drug reaction associated with high mortality. The ABCD-10 score (age, bicarbonate, cancer, dialysis, 10% body surface area), a new prognostic score for mortality in epidermal necrolysis, was recently developed and validated in the US. However, to our knowledge, it remains to be externally validated in other cohorts.To assess ABCD-10 among patients in a contemporary Asian cohort and compare its performance with the Score of Toxic Epidermal Necrosis (SCORTEN) and study the associations of time and immunomodulatory therapy with the performance of ABCD-10 and SCORTEN.This retrospective cohort study was conducted over a 17-year period from January 2003 to March 2019 and included 196 patients with epidermal necrolysis who were recruited from Singapore General Hospital, the national referral center for epidermal necrolysis.In-hospital mortality. Discrimination and calibration of each risk score were assessed and compared using the area under the receiver operating characteristic curve and calibration plot, respectively.Among 196 patients (median [interquartile range] age, 56 [42-70] years; 116 women [59.2%]), 45 (23.0%) did not survive to discharge. All risk factors in ABCD-10 were significantly associated with in-hospital mortality. However, dialysis before admission, the most heavily weighted factor in ABCD-10, performed weaker in this cohort (odds ratio, 3.7; 95% CI, 1.0-13.2, P = .04). Although the discrimination of ABCD-10 and SCORTEN did not differ (area under the curve: ABCD-10, 0.78; 95% CI, 0.72-0.85; vs SCORTEN, 0.77; 95% CI, 0.69-0.84; P = .53), the calibration of ABCD-10 was poorer compared with SCORTEN. From graphical analysis of the calibration plots, ABCD-10 showed mortality underestimation at lower score ranges and overestimation at higher score ranges. By contrast, SCORTEN was generally well calibrated, although at higher score ranges mortality may be overestimated. Assessment of calibration plots showed that there was increasing overestimation of mortality by SCORTEN during the later period or when immunomodulatory therapy was used compared with patients treated with supportive care alone. Calibration of ABCD-10 remained poor even during the later period or among patients treated with immunomodulatory therapy.In this cohort of patients, the performance of SCORTEN was superior to ABCD-10 in mortality prognostication in epidermal necrolysis. However, it did display time-associated deterioration in calibration leading to overestimation of mortality risk. Future studies may consider revising the existing SCORTEN given its current good discrimination.
Case 33-2020: A 55-Year-Old Man with Abdominal Pain, Joint Swelling, and Skin Lesions
Authors: Mariko R. Yasuda, Lauren A. Roller, Peter J. Fagenholz, Mai P. Hoang
Journal: New England Journal of Medicine (2020)

A 55-year-old-man with a history of neurofibromatosis and chronic necrotizing pancreatitis presented with abdominal pain and recurrent painful skin lesions. Three months before presentation, polyarticular joint swelling had developed and a central fluctuant nodule on an erythematous base had been noted on the left lower leg. A diagnostic test was performed.
Effect of Catheter Ablation With Vein of Marshall Ethanol Infusion vs Catheter Ablation Alone on Persistent Atrial Fibrillation
Authors: Miguel Valderrábano, Leif E. Peterson, Vijay Swarup, Paul A. Schurmann, Akash Makkar, Rahul N. Doshi, David DeLurgio, Charles A. Athill, Kenneth A. Ellenbogen, Andrea Natale, Jayanthi Koneru, Amish S. Dave, Irakli Giorgberidze, Hamid Afshar, Michelle L. Guthrie, Raquel Bunge, Carlos A. Morillo, Neal S. Kleiman
Journal: JAMA (2020)

Catheter ablation of persistent atrial fibrillation (AF) has limited success. Procedural strategies beyond pulmonary vein isolation have failed to consistently improve results. The vein of Marshall contains innervation and AF triggers that can be ablated by retrograde ethanol infusion.To determine whether vein of Marshall ethanol infusion could improve ablation results in persistent AF when added to catheter ablation.The Vein of Marshall Ethanol for Untreated Persistent AF (VENUS) trial was an investigator-initiated, National Institutes of Health-funded, randomized, single-blinded trial conducted in 12 centers in the United States. Patients (N = 350) with persistent AF referred for first ablation were enrolled from October 2013 through June 2018. Follow-up concluded in June 2019.Patients were randomly assigned to catheter ablation alone (n = 158) or catheter ablation combined with vein of Marshall ethanol infusion (n = 185) in a 1:1.15 ratio to accommodate for 15% technical vein of Marshall ethanol infusion failures.The primary outcome was freedom from AF or atrial tachycardia for longer than 30 seconds after a single procedure, without antiarrhythmic drugs, at both 6 and 12 months. Outcome assessment was blinded to randomization treatment. There were 12 secondary outcomes, including AF burden, freedom from AF after multiple procedures, perimitral block, and others.Of the 343 randomized patients (mean [SD] age, 66.5 [9.7] years; 261 men), 316 (92.1%) completed the trial. Vein of Marshall ethanol was successfully delivered in 155 of 185 patients. At 6 and 12 months, the proportion of patients with freedom from AF/atrial tachycardia after a single procedure was 49.2% (91/185) in the catheter ablation combined with vein of Marshall ethanol infusion group compared with 38% (60/158) in the catheter ablation alone group (difference, 11.2% [95% CI, 0.8%-21.7%]; P = .04). Of the 12 secondary outcomes, 9 were not significantly different, but AF burden (zero burden in 78.3% vs 67.9%; difference, 10.4% [95% CI, 2.9%-17.9%]; P = .01), freedom from AF after multiple procedures (65.2% vs 53.8%; difference, 11.4% [95% CI, 0.6%-22.2%]; P = .04), and success achieving perimitral block (80.6% vs 51.3%; difference, 29.3% [95% CI, 19.3%-39.3%]; P < .001) were significantly improved in vein of Marshall-treated patients. Adverse events were similar between groups.Among patients with persistent AF, addition of vein of Marshall ethanol infusion to catheter ablation, compared with catheter ablation alone, increased the likelihood of remaining free of AF or atrial tachycardia at 6 and 12 months. Further research is needed to assess longer-term efficacy.ClinicalTrials.gov Identifier: NCT01898221.
FRI0029 Treatment of therapy-resistant rheumatoid arthritis (ra) with immunoadsorption
Authors: H Haschkovitz, O Warchol, A Dunky, G Leitner, N Worel, P Höcker
Journal: Annals of the Rheumatic Diseases (2001)

<h3>Background</h3> Refractory RA – periods of untreatable progression. <h3>Objectives</h3> Failure to conventional therapy with DMARD`s including immunosuppressive drugs can be a major problem in patients with refractory RA. We studied especially the clinical efficacy of an additional treatment with immunoadsorption using a protein A column. Totally six patients with rheumatoid factor positive RA according to the criteria of ARA (female, mean age: 45 years (20–65), duration of disease: 4–12 years) were observed in a follow-up of 6 months. <h3>Methods</h3> Plasma was separated by a continuous flow cell separator (A S 104, Fresenius) with venous access. Separated plasma passed down columns containing protein A sepharose (Excorim, Lund, Sweden). The application was performed every second day (number of treatments = 65). Two times of patient`s total plasma volume was treated. Beside clinical parameters like morning stiffness, number of swolen and painful joints and pain scale, values of IgG, IgM and IgA, peripheral blood counts, total protein and coagulation parameters were evaluated before and after each procedure. <h3>Results</h3> Four patients showed a significant, sustaining improvement in clinical syndroms over five months. In two cases there was only minimal and transient success. All six patients tolerated the treatment very well. In three patients transfusion of packed red cells, in two patients also substitution of 20% human albumin was necessary in addition to IgG support. <h3>Conclusion</h3> Protein A Immunoadsorption can be considered as a method, which sometimes improves the course of refractory RA and overcomes periods of untreatable progression.
Role of Positive End-Expiratory Pressure and Regional Transpulmonary Pressure in Asymmetrical Lung Injury
Authors: Luca Bastia, Doreen Engelberts, Kohei Osada, Bhushan H. Katira, L. Felipe Damiani, Takeshi Yoshida, Lu Chen, Niall D. Ferguson, Marcelo B. P. Amato, Martin Post, Brian P. Kavanagh, Laurent Brochard
Journal: American Journal of Respiratory and Critical Care Medicine (2020)

Rationale: Asymmetrical lung injury is a frequent clinical presentation. Regional distribution of Vt and positive end-expiratory pressure (PEEP) could result in hyperinflation of the less-injured lung. The validity of esophageal pressure (Pes) is unknown.Objectives: To compare, in asymmetrical lung injury, Pes with directly measured pleural pressures (Ppl) of both sides and investigate how PEEP impacts ventilation distribution and the regional driving transpulmonary pressure (inspiratory - expiratory).Methods: Fourteen mechanically ventilated pigs with lung injury were studied. One lung was blocked while the contralateral one underwent surfactant lavage and injurious ventilation. Airway pressure and Pes were measured, as was Ppl in the dorsal and ventral pleural space adjacent to each lung. Distribution of ventilation was assessed by electrical impedance tomography. PEEP was studied through decremental steps.Measurements and Results: Ventral and dorsal Ppl were similar between the injured and the noninjured lung across all PEEP levels. Dorsal Ppl and Pes were similar. The driving transpulmonary pressure was similar in the two lungs. Vt distribution between lungs was different at zero end-expiratory pressure (≈70% of Vt going in noninjured lung) owing to different respiratory system compliance (8.3 ml/cm H2O noninjured lung vs. 3.7 ml/cm H2O injured lung). PEEP at 10 cm H2O with transpulmonary pressure around zero homogenized Vt distribution opening the lungs. PEEP ≥16 cm H2O equalized distribution of Vt but with overdistension for both lungs.Conclusions: Despite asymmetrical lung injury, Ppl between injured and noninjured lungs is equalized and esophageal pressure is a reliable estimate of dorsal Ppl. Driving transpulmonary pressure is similar for both lungs. Vt distribution results from regional respiratory system compliance. Moderate PEEP homogenizes Vt distribution between lungs without generating hyperinflation.
TCT CONNECT-286 Long-Term Outcomes Following Drug-Eluting Balloon Versus Thin-Strut Drug-Eluting Stents for Treatment of In-Stent Restenosis: Multicenter Propensity Score-Matched Analysis (DEB-Dragon Registry)
Authors: Wojciech Wańha, Jacek Bil, Rafał Januszek, Natasza Gilis, Tomasz Figatowski, Marek Milewski, Maksymilian Mielczarek, Łukasz Dylewski, Artur Pawlik, Bartłomiej Staszczak, Maciej Wybraniec, Brunon Tomasiewicz, Piotr Kubler, Tomasz Walczak, Bruno Hrymniak, Marta Piekarska, Piotr Desperak, Piotr Niezgoda, Rafal Wolny, Magdalena Chudzik, Grzegorz Smolka, Dariusz Ciećwierz, Krzysztof Reczuch, Marcin Gruchała, Jacek Kubica, Robert Gil, Elvin Kedhi, Fabrizio D'Ascenzo, Damian Hudziak, Andrzej Ochala, Dariusz Dudek, Stanisław Bartuś, Mariusz Gasior, Adam Witkowski, Miłosz Jaguszewski, Wojciech Wojakowski
Journal: Journal of the American College of Cardiology (2020)
Purdue Pharma to plead guilty and pay $8.3bn over opioid marketing
Authors: Owen Dyer
Journal: BMJ (2020)

Purdue Pharma, the company that became the unacceptable corporate face of the US opioid epidemic, will plead guilty to criminal charges as part of a legal settlement that resolves the federal government’s allegations against it. But the partly UK based Sackler family that owned and directed the company will be spared prosecution in a deal that critics say allows family members to profit from the company’s crimes.

The $8.3bn (£6.3bn; €7bn) settlement includes a criminal fine on the company of $3.5bn, a civil settlement of $2.8bn,1 and criminal forfeiture of $2bn. But the sum is largely symbolic, as Purdue is a bankrupt company with thousands of other litigants likely to number among its creditors. Much of the profit from two decades of marketing OxyContin was transferred years ago to the …