tbuckley/cabot-search huggingface dataset:
Multicenter prospective observational study of QoL after palliative surgery for patients with bowel obstruction caused by peritoneal dissemination of gastric cancer.
Authors: Yuichi Ito, Kazumasa Fujitani, Kentaro Sakamaki, Masahiko Ando, Ryohei Kawabata, Yutaka Tanizawa, Takaki Yoshikawa, Takanobu Yamada, Motohiro Hirao, Makoto Yamada, Jun Hihara, Ryoji Fukushima, Yasuhiro Choda, Yasuhiro Kodera, Shin Teshima, Hisashi Shinohara, Masato Kondo
Journal: Journal of Clinical Oncology (2019)

90 Background: Patients with peritoneal dissemination of gastric cancer have poor oral intake caused by bowel obstruction. Palliative surgery has often been undertaken to improve quality of life (QoL), but there is no prospective study on palliative surgery. Methods: We prospectively examined the significance of palliative surgery for patients with poor oral intake caused by peritoneal dissemination of gastric cancer using a patient-reported QoL measures. Eligibility criteria included histologically proven primary gastric adenocarcinoma presenting with bowel obstruction caused by peritoneal dissemination; presence of non-curable factors; extremely poor or no oral intake requiring parenteral nutrition. Patients underwent palliative surgery by small intestine/colon resection, small intestine/colon bypass or ileostomy/colostomy for bowel obstruction. The primary endpoint was change in QoL assessed at baseline, 14 days, 1 month and 3 months following surgical palliation by means of the Euro QoL Five Dimensions (EQ-5D) questionnaire and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire gastric cancer module (QLQ-STO22). Secondary endpoints were postoperative improvement in oral intake and surgical complications. Results: Between May 2013 and March 2018, 63 patients (33 bypass and 28 stoma, 3 exploratory laparotomy) were enrolled from 14 institutions. The mean EQ-5D utility index baseline score of 0.6 remained consistent. Gastric-specific symptoms mostly showed statistically significant improvement from baseline. 42 patients (67%) were able to eat solid food 2 weeks after palliative surgery and 36 patients (57%) tolerated it for 3 months. The rate of overall morbidity of grade III or more according to the Clavien–Dindo classification was 15.8 per cent (10 patients) and the 30-day postoperative mortality rate was 3.2 per cent (2 patients). Conclusions: In patients with bowel obstruction caused by peritoneal dissemination of gastric cancer, palliative surgery maintained QoL while improving solid food intake, with acceptable operative morbidity and mortality rate. Clinical trial information: 000023495.
Infliximab and risk of serious infection in patients with psoriasis
Authors: Z.Z.N. Yiu, D.M. Ashcroft, I. Evans, K. McElhone, M. Lunt, C.H. Smith, S. Walton, R. Murphy, N.J. Reynolds, A.D. Ormerod, C.E.M. Griffiths, R.B. Warren
Journal: British Journal of Dermatology (2019)

This study from the UK used information from a data source known as the British Association of Dermatologists Biologic Interventions Register, or BADBIR, which was established to collect information on the use and outcomes of new biologic treatments, versus nonbiologic systemic treatments, for skin disease. In this study, information on the use of the biologic treatment, Infliximab, used in a number of skin diseases including psoriasis was compared with other systemic therapies (systemic means treatments that work on the whole body, as opposed to something applied just to the skin). The focus of this work was on the occurrence of serious infections in patients under different treatments. These serious infections were those where patients had prolonged admissions to hospital, were treated with intravenous antibiotics or where they died. The investigation also considered the possible effects of other conditions which might also have led to the development of serious infections in both groups. The main conclusion of this work was that the likelihood (risk) of serious infection in patients receiving Infliximab compared with those receiving other systemic therapies was doubled. The main infections were either those affecting the lungs or skin and soft tissue infections. These infections were mainly seen in the first six months after patients started on Infliximab. This is an important finding as counselling patients on this risk will form a key part of preparatory assessment prior to use of this medicine. The authors point out that similar information is not yet available for other biologics used for the treatment of skin disease and these may also be associated with an increased risk of infection, although screening for existing chronic infections, such as tuberculosis, forms an important part of the pre‐treatment investigation of potential candidates for these biologic medications.
Abstract 19328: Years of Potential Life Lost Due to Sudden Death
Authors: Golsa Joodi, Mojtaba Mirzaei, Brittany M Bogle, Sarah Chen, Ross J Simpson
Journal: Circulation (2017)

Introduction: Few population-based studies quantify the societal burden of sudden death. Years of potential life lost (YPLL) is a measure of social and economic loss due to premature death. We aimed to compare YPLL from out-of-hospital sudden deaths (OHSD) to leading causes of death in the state of North Carolina (NC). Methods: From 2013-2015, all out-of-hospital deaths aged 18-64 reported by EMS in Wake County, NC were screened to adjudicate OHSD. Incidence rates for OHSD in Wake were calculated by age-sex group, and were used to estimate age-standardized OHSD incidence rates in NC. Leading causes of death were identified from the annual NC State Center for Health Statistics report, and total number of deaths for these causes were obtained from statewide death certificates, stratified by age-sex group. For OHSD and other causes, YPLL was calculated by multiplying the number of deaths in each age-sex group by the remaining life expectancy of NC residents in that group. Results: We identified 399 cases of ...
Benefits and Limitations of Long-Term Eculizumab Treatment for Paroxysmal Nocturnal Hemoglobinuria (PNH): Real-World Data from Large Cohort Study in Russia
Authors: Aleksandr Kulagin, Olesya Klimova, Tatiana Rudakova, Irina Golubovskaya, Maria Ivanova, Anna Smirnova, Alexandra Lapina, Tatiana Bykova, Elena Babenko, Marina Popova, Vladimir Dobronravov, Boris Afanasyev
Journal: Blood (2018)
Abstract 11698: Endothelial Function Measured by Enclosed Zone Flow-mediated Vasodilation Predicts Cardiovascular Events
Authors: Masato Kajikawa, Haruka Morimoto, Nozomu Oda, Naomi Idei, Harutoyo Hirano, Tatsuya Maruhashi, Shinji Kishimoto, Shogo Matsui, Takayuki Hidaka, Farina B Yusoff, Yasuki Kihara, Kensuke Noma, Ayumu Nakashima, Teiji Ukawa, Toshio Tsuji, Yukihito Higashi
Journal: Circulation (2017)

Introduction: We developed a new device for automatic measurement of flow-mediated vasodilation (FMD) using an oscillometric method to solve technical problems of conventional FMD measurement. The ...
Abstract 15099: The Economic Burden of Insulin Resistance, Obesity, and Cardiovascular Disease in Medicare Beneficiaries 65 Years of Age and Older
Authors: Naomi Sacks, Yanmei Liu, Arun Sanyal, Ralph DeFronzo, Deepak Bhatt, Jay Caplan, Harith Rajagopalan, Philip Cyr, Anupam Jena
Journal: Circulation (2017)

Introduction: Insulin resistance (IR) is thought to be a common pathogenic driver of cardiovascular disease (CVD) in patients with Type 2 Diabetes (T2DM), metabolic syndrome, and non-alcoholic fatt...
Partha Kar: Applying aviation safety to healthcare—are we missing the fundamental?
Authors: Partha Kar
Journal: BMJ (2019)

If we want to improve patient safety the healthcare sector should become more like the aviation industry. This, at least, is a common refrain we hear whenever the issue of patient safety comes up.

It’s certainly not fanciful to think that healthcare organisations should try to learn from a high risk industry with an enviable record in keeping people safe. With just 0.07 deaths per billion passenger miles, flying is currently the safest mode of transport, and trying to reach something equivalent to that level of safety in healthcare certainly isn’t a bad aspiration.

The comparison has even brought some useful insights, …
Micro-RNA Profiling Reveals the Key Role of miR-206 in the Hematopoietic Potential of Human Embryonic and Induced Pluripotent Stem Cells
Authors: Stephane Flamant, Jean-Claude Chomel, Christophe Desterke, Olivier Feraud, Emilie Gobbo, Maria Teresa Mitjavila-Garcia, Adlen Foudi, Frank Griscelli, Ali G Turhan, Annelise Bennaceur-Griscelli
Journal: Blood (2018)
PIONEERing the In-Hospital Initiation of Sacubitril–Valsartan
Authors: John Jarcho
Journal: New England Journal of Medicine (2019)

In 2015, sacubitril–valsartan was approved in Europe and the United States as a new therapeutic agent for heart failure with reduced ejection fraction. Approval was based primarily on the results of the PARADIGM-HF trial.1 In that trial, sacubitril–valsartan was compared with enalapril in clinically stable patients with heart failure. At a median follow-up of 27 months, there was a significantly lower rate of the primary outcome of death from cardiovascular causes or hospitalization for heart failure with sacubitril–valsartan than with enalapril. Despite the robust evidence of benefit seen in the PARADIGM-HF trial, the adoption of sacubitril–valsartan in clinical practice has . . .
Analysis of US Claims Real World Data of Hemophilia a &amp; B Patients: Units Dispensed &amp; Expenditures Associated with Utilization of and Switching from Standard to Extended Half-Life Factor Products
Authors: Bartholomew J. Tortella, Amit Chhabra, José Alvir, Emily R. Rubinstein, Lisa J. Young, Patrick F. Fogarty
Journal: Blood (2018)
PBI-4050 reduces pulmonary hypertension, lung fibrosis, and right ventricular dysfunction in heart failure
Authors: Quang T Nguyen, Mohamed J Nsaibia, Martin G Sirois, Angelino Calderone, Jean-Claude Tardif, Yan Fen Shi, Matthieu Ruiz, Caroline Daneault, Lyne Gagnon, Brigitte Grouix, Pierre Laurin, Jocelyn Dupuis
Journal: Cardiovascular Research (2019)

Heart failure with reduced ejection fraction (HFrEF) causes lung remodelling with myofibroblasts proliferation and fibrosis leading to a restrictive lung syndrome with pulmonary hypertension (PH) and right ventricular (RV) dysfunction. PBI-4050 is a first-in-class anti-fibrotic, anti-inflammatory, and anti-proliferative compound. The present study evaluated the therapeutic impact of PBI-4050 on PH in an HFrEF model.HFrEF was induced after myocardial infarction (MI) in rats. Two weeks later, sham-operated and MI groups received PBI-4050 (200 mg/kg/day by gavage) or saline for 3 weeks. Animals were analysed according to infarct size as large (≥30% left ventricle) or medium MI (<30%). Large MI caused PH and RV hypertrophy (RVH) with a restrictive lung syndrome. PBI-4050 did not adversely affect left ventricular (LV) function but markedly reduced PH and RVH and improved RV dysfunction. PBI-4050 reduced lung remodelling and improved respiratory compliance with decreased lung fibrosis, alveolar wall cellular proliferation and α-smooth muscle actin expression. The increased expression of endothelin-1 (ET-1), transforming growth factor beta (TGF-β), interleukin-6 (IL-6) and of tissue inhibitor of metalloprotease-1 in the lungs from HFrEF were reduced with PBI-4050 therapy. Activation of isolated human lung fibroblasts (HLFs) to a myofibroblastic pro-fibrogenic phenotype was markedly reduced by PBI-4050. The fatty acid receptor GPR84 was increased in HFrEF lungs and in activated HLFs, and reduced by PBI-4050. GPR84 agonists activated fibrogenesis in HLFs and finally, PBI-4050 reduced ERK1/2 phosphorylation.PBI-4050 reduces PH and RVH in HFrEF by decreasing lung fibrosis and remodelling. This novel agent decreases the associated restrictive lung syndrome and recovers RV function. A contributing mechanism involves reducing the activation of lung fibroblasts by IL-6, TGF-β, and ET-1 by antagonism of GPR84 and reduced ERK1/2 phosphorylation. PBI-4050 is a novel promising therapy for targeting lung remodelling in group II PH.
A promising approach to targeting type 1 IFN in systemic lupus erythematosus
Authors: Yashaar Chaichian, Daniel J. Wallace, Michael H. Weisman
Journal: Journal of Clinical Investigation (2019)

Despite advances in understanding systemic lupus erythematosus (SLE) pathogenesis, most clinical trials of new targeted therapies have been met with disappointment. The type I IFN pathway is believed to play an important role in SLE, and the proposed involvement of this pathway helps explain the frustration behind the failure at targeting either IFN-α or the type 1 IFN receptor itself. In this issue of the JCI, Furie et al. report on an intriguing phase 1b study that demonstrates an approach for inhibiting this pathway in the skin using an mAB (BIIB059) that targets the blood DC antigen 2 (BDCA-2) receptor on plasmacytoid DCs (pDCs). BIIB059 decreased IFN expression and improved cutaneous lupus disease activity, with a favorable safety profile. Whether or not this strategy will be effective in managing SLE in other organs remains unanswered. However, these results suggest that closing the door on targeting the type 1 IFN pathway in SLE may be premature and highlight the emerging question of whether an organ-specific approach toward lupus trials and treatment should be the wave of the future.
Abstract 16573: Overcoming Underpowering: Simulation Study to Evaluate an STS Global Rank Endpoint for Trials in Congenital Heart Surgery
Authors: Kevin D Hill, Sean O'Brien, H. Scott Baldwin, David Bichel, Christoph Hornik, Jeffrey Jacobs, Marshall Jacobs, Robert Jaquiss, Prince Kannankeril, Rachel Torok, Jennifer S Li
Journal: Circulation (2017)

Introduction: Global rank scores are increasingly used in clinical trials. The approach permits combinations of binary, surrogate or continuous outcomes in a composite endpoint with components rank...
Breakthrough cancer pain
Authors: A. N Davies, A. Dickman, C. Reid, A.-M. Stevens, G. Zeppetella
Journal: BMJ (2008)

The SIGN guidelines say that both morphine sulphate immediate release and oral transmucosal fentanyl citrate are effective in reducing breakthrough cancer pain.1 But little evidence (and certainly not grade B evidence) supports the unlicensed use of oral morphine. Its pharmacodynamic profile also does not mirror the temporal characteristics of most episodes of breakthrough cancer pain. These are acute in onset, short in duration, and …
Abstract 20878: Increasing Bystander AED Use at ROC Sites in Out-of-Hospital Cardiac Arrest From 2005-2015
Authors: Ross A Pollack, Siobhan Brown, Susanne May, Rebecca Piasecki, Tom Aufderheide, Clifton Callaway, Jim Christenson, Mohamud Daya, Ahamed Idris, Peter Kudenchuk, Laurie Morrison, Christian Vaillancourt, Henry Wang, Graham Nichol, George Sopko, Joseph P Ornato, Thomas Rea, Myron Weisfeldt
Journal: Circulation (2017)

Background: Over 60% of out-of-hospital cardiac arrests (OHCA) that occur in public locations have an initial shockable rhythm, making these patients optimal for rapid defibrillation by a bystander...
Prognostic Role of Ammonia in Patients With Cirrhosis
Authors: None Shalimar, Mohammed Faisal Sheikh, Rajeshwar P. Mookerjee, Banwari Agarwal, Subrat Kumar Acharya, Rajiv Jalan
Journal: Hepatology (2019)

Ammonia is thought to be central to the pathogenesis of hepatic encephalopathy (HE), but its prognostic role in patients with cirrhosis and acute decompensation is unknown. The aims of this study were to determine the relationship between ammonia levels and severity of HE and its association with organ dysfunction and short-term mortality. We identified 498 patients from two institutions as part of prospective observational studies in patients with cirrhosis. Plasma ammonia levels were measured on admission and Chronic Liver Failure-Sequential Organ Failure Assessment criteria were used to determine the presence of organ failures. The 28-day patient survival was determined. Receiver operating characteristic analysis was used to identify the cutoff points for ammonia values, and multivariable analysis was performed using the Cox proportional hazard regression model. The 28-day mortality was 43.4%. Plasma ammonia correlated with severity of HE (P < 0.001), was significantly higher in nonsurvivors (93 [73-121] versus 67 [55-89] µmol/L, P < 0.001), and was an independent predictor of 28-day mortality (hazard ratio, 1.009, P < 0.001). An ammonia level of 79.5 µmol/L had sensitivity of 68.1% and specificity of 67.4% for predicting 28-day mortality. An ammonia level of ≥79.5 µmol/L was associated with a higher frequency of organ failures (liver [P = 0.004], coagulation [P < 0.001], kidney [P = 0.004], and respiratory [P < 0.001]). Lack of improvement in baseline ammonia at day 5 was associated with high mortality (70.6%). Conclusion: Ammonia level correlates with not only the severity of HE but also the failure of other organs and is an independent risk factor for mortality; lack of improvement in ammonia level is associated with high risk of death, making it an important biomarker and a therapeutic target.
Injury epidemiology and risk factors in competitive artistic gymnasts: a systematic review
Authors: Rhiannon A Campbell, Elizabeth J Bradshaw, Nick B Ball, David L Pease, Wayne Spratford
Journal: British Journal of Sports Medicine (2019)

Artistic gymnastics is reported to have some of the highest injury rates in sports, which limits participation and often involves considerable medical expenses.To critically appraise the epidemiological literature on injury patterns and risk factors in competitive artistic gymnastics.Systematic review.Six databases were searched for articles that investigated injuries in competitive artistic gymnasts. Injury incidence, prevalence and risk factor data were extracted, alongside information on injury location, type, severity, nature and mechanism of injury. Quality and level of evidence were assessed using a modified Downs and Black quality index checklist and the Oxford Centre for Evidence-based Medicine guidelines.The search identified 894 articles, with 22 eligible for inclusion. Descriptive analysis showed that injury incidence and prevalence varied from 0.3 to 3.6 injuries per gymnast (female=0.3-3.6, male=0.7) and 2.0-2.3 (female=2.0-2.3, male=2.0), respectively. Male gymnasts sustained mostly upper limb injuries, while female gymnast reported lower limb injuries. Floor was associated with the greatest number of injuries for both male and female gymnasts. Higher competitive level and exposure to competition were risk factors for gymnastics injury: age, body mass, body size, training duration and life stress were significant associated factors.Injury incidence and prevalence results are substantial among artistic gymnasts of all competitive levels. Gymnasts who train at highly competitive levels and are exposed to competition environments are a greater risk of injury. Future researchers should implement consistent reporting methods.
Abstract P125: Aerobic Exercise Training Reduces Postprandial Thermogenesis in Older Women
Authors: Xuewen Wang, Kimberly Bowyer, Ryan Porter, Charity Breneman, Sabra Custer
Journal: Circulation (2016)

Introduction: Thermic effect of food is a component of total daily energy expenditure (TDEE). Some literature suggests lower postprandial rise in energy expenditure predicts future weight gain. It is also known that other components of TDEE, resting metabolic rate (RMR) and free-living physical activity energy expenditure, are prone to change in response to exercise training. However, most studies estimate thermic effect of food as a proportion of TDEE and thus have not evaluated whether changes in postprandial thermogenesis occur in response to exercise training. The objective of this study was to determine whether postprandial thermogenesis changed after completing aerobic exercise training in older women. Hypothesis: We hypothesize that the postprandial thermogenesis decreases in sedentary older women who complete 16-week aerobic exercise training. Methods: Sedentary older women (n = 47; age = 65.1 ± 4.3 years) completed 16-week moderate-intensity aerobic exercise training. RMR and 5-hour postprandial thermogenesis following ingesting the same meal, before and at the end of training, was measured via indirect calorimetry. The meal consisted of approximately 40% of each woman’s RMR at baseline. Postprandial thermogenesis was calculated as area under the curve. TDEE was also measured using doubly labelled water before and at the end of training. Results: After exercise training, RMR and TDEE did not change (p &gt; 0.05 for both). Total postprandial thermogenesis (from 287 ±36 to 276 ± 40 kcal for 5 hours, p = 0.008) and postprandial thermogenesis in the first hour (from 69.9±8.7 to 66.3±8.1 kcal, p = 0.05) decreased significantly. The ratios of total and first-hour postprandial thermogenesis to TDEE also decreased (p = 0.026 and 0.013, respectively). Conclusion: Postprandial thermogenesis following the same meal reduced after aerobic training in older women. This adaptive change may contribute to an individual’s ability to defend the body’s energy store.
Abstract 14550: LQT5-Lite: Defining the Clinical Phenotype Associated With the Potentially Pro-Arrhythmic KCNE1-D85N Common Variant
Authors: David J Tester, John R Giudicessi, Ram K Rohatgi, Martijn J Bos, Michael J Ackerman
Journal: Circulation (2017)

Introduction: The common p.Asp85Asn-KCNE1 (D85N) variant modestly reduces IKs and IKr current in vitro and is associated with QT prolongation and risk of drug-induced torsades de pointes. However, ...
A Case of Mediastinal Leiomyosarcoma Demonstrated on FDG PET/CT Imaging
Authors: Xiaodong Wu, Yan Huang, Yi Li, Huoqiang Wang, Lei Jiang
Journal: Clinical Nuclear Medicine (2019)

A 56-year-old man presented with persisting chest tightness over 1 month. A mediastinal mass was found by chest radiography. To further evaluate the mass, chest CT was performed and the malignancy was suspected. Staging FDG PET/CT demonstrated a hypermetabolic lesion located in the left middle mediastinum without extra-lesion involvement. The lesion pathologically confirmed mediastinal leiomyosarcoma after surgical resection.