tbuckley/cabot-search huggingface dataset:
Abstract P173: The Impact of Asleep Blood Pressure on the Prevalence of Masked Hypertension by Race/ethnicity: Analysis of Pooled Population- and Community-based Studies
Authors: Yuichiro Yano, Bharat Poudel, Ligong Chen, Swati Sakhuja, Byron Jaeger, Anthony Viera, Daichi Shimbo, Donald Clark, D. Edmund Anstey, Lewis Cora, James M Shikany, Jamal S Rana, Adolfo Correa, Joseph E Schwartz, Donald M Lloyd-jones, Paul Muntner
Journal: Circulation (2020)

Introduction: Masked hypertension is defined as having hypertensive blood pressure (BP) outside of the office setting among adults with non-hypertensive BP when measured in the office. Some guidelines recommend defining out-of-office BP using awake measurements while other guidelines recommend using awake and asleep measurements. Hypothesis: We hypothesized that defining masked hypertension using the awake and asleep BP measurements would increase the prevalence of masked hypertension compared to using the awake period alone, and the magnitude of this difference would be greater among non-Hispanic blacks compared with non-Hispanic whites and Hispanics. Methods: We pooled previously collected data from 5 NHLBI-funded population- and community-based studies including the Jackson Heart Study, the Coronary Artery Risk Development in Young Adults Study (total participants: 2,866). All participants had office systolic BP (SBP)&lt;140mmHg and diastolic BP (DBP)&lt;90mmHg and underwent ambulatory BP monitoring (ABPM) for 24 hours. Hypertensive awake BP was defined as SBP ≥135mmHg or DBP ≥85mmHg while awake, hypertensive asleep BP as SBP ≥120mmHg or DBP ≥70mmHg while asleep and hypertensive 24-hour BP as SBP ≥130mmHg or DBP ≥80mmHg over the entire ABPM period. Results: The prevalence of masked hypertension increased from 29% to 43% when defined using awake, asleep, or 24-hour BP versus using awake BP alone (Table). This increase was larger in non-Hispanic blacks (31-54%) compared with non-Hispanic whites (28-37%) and Hispanics (17-26%). The adjusted prevalence ratio (95% confidence interval) for having masked hypertension for non-Hispanic blacks compared with Non-Hispanic whites was higher from 1.20(1.05,1.37) to 1.33(1.20,1.47) when defined using awake, asleep and 24-hour BP versus awake BP only. Conclusions: Including asleep BP to define masked hypertension increased the prevalence of masked hypertension to a larger extent among non-Hispanic blacks compared to non-Hispanic whites and Hispanics.
Abstract P161: A Learning Healthcare System Improves Cardiovascular Risk Management: Results From the Utrecht Cardiovascular Cohort Initiative
Authors: Michael Bots, Katrien Groenhof, Saskia Haitjema, Titia Lely, Folkert Asselbergs
Journal: Circulation (2020)

Introduction: Cardiovascular disease (CVD) is a good example of a high complex, multi-morbid, chronic condition. This asks for multidisciplinary and transmural collaboration and communication between caretakers, forming a care continuum. Research is often conducted outside routine practice, namely in randomized controlled trials and dedicated cohorts with strict in- and exclusion criteria. Since our real world patient does not fit these criteria, generated evidence does not always translate to practice. Yet, we can learn from each patient. Within a learning healthcare system (LHS), data collection in routine daily practice is used as input for analysis , interpretation and actionable feedback . CVD management (CVRM) guidelines provide various recommendations for diagnosis, modification and referral from primary to secondary or tertiary care for the evaluation of a CV condition. Starting with uniform structured collection of the CVD risk profile in the our hospital in all patients, we developed a learning health care system focused on CVD risk management. Hypothesis: We hypothesize that a learning health care system improves CVD risk management. Methods: Embedded in routine clinical practice, the Utrecht Cardiovascular Cohort (UCC) supports structured and uniform assessment and registration of guideline based CVD risk profile in the electronic health record across all departments. We studied, with data from 2800 participants, data collection (uniform and linkage); data extraction ((un)structured); data analysis (missings); and actionable feedback (computer decision support system). Results: Establishment of UCC resulted in more complete CVD risk profile: increase in risk factor completeness ranged from 8% (eGFR) to 50% (HbA1c). Linking UCC patient data to general practitioner records, showed considerable gaps in transmural CVD communication: from GP to specialist and from specialist to GP. To address missing information in electronic health records we developed a text mining algorithm to detect smoking status: algorithm showed a 99% yield, a positive and negative predictive value of 65% and 95%. We developed strategies to handle missing data for risk prediction on an individual level in a ‘live’ setting: joint conditional model led to a lower mean squared error (the lower, the more precise estimates). We developed a CVD risk management computerized decision support system embedded in our electronic health record, filled with extracted information and incorporating all lessons learned from reviews, clinician expert opinions, and patient expert opinions. This dashboard, favorably received by physicians, shows in the consulting room the CVD risk profile, potential treatment effects in one glance and helps with shared decision making. Conclusions: Our learning health care approach shows improvement in some areas and provides actionable leads for further improvement.
Erratum: Buruli ulcer (M. ulcerans infection): New insights, new hope for disease control (PLoS Medicine 2:4 DOI: 10.1371/journal.pmed.0020108)
Authors: Pdr Johnson, T Stinear, Plc Small, G Pluschke, RW Merritt, F Portaels, K Huygen, JA Hayman, K Asiedu
Journal: PLoS Medicine (2005)
Treatment of upper urinary tract urothelial carcinoma
Authors: Simon J Crabb
Journal: The Lancet (2020)

Upper tract urothelial (transitional cell) carcinoma (UTUC) is a rare malignant disease occurring in roughly two people per 100 000 population. UTUCs comprise 5–10% of urothelial carcinomas overall. 1 Roupret M Babjuk M Comperat E et al. European Association of Urology Guidelines on upper urinary tract urothelial carcinoma: 2017 update. Eur Urol. 2018; 73: 111-122 Summary Full Text Full Text PDF PubMed Scopus (448) Google Scholar A paucity of dedicated high-level evidence has led to extrapolation from studies of urothelial bladder cancer to establish treatment recommendations. Although UTUC biology and clinical features overlap with those of urothelial bladder cancer, differences exist in gene alteration patterns (eg, FGFR3 and HRAS are more frequently altered in UTUC whereas TP53, RB1, and ERBB2 are less frequently mutated), clinical stage at presentation (higher stage at presentation, on average, for patients with UTUC), gender differences (a higher percentage of women get UTUC, although in terms of total numbers they are still in a minority compared with men), and stage-for-stage outcomes (prognosis is poorer for patients with UTUC). 2 Audenet F Isharwal S Cha EK et al. Clonal relatedness and mutational differences between upper tract and bladder urothelial carcinoma. Clin Cancer Res. 2019; 25: 967-976 Crossref PubMed Scopus (67) Google Scholar , 3 Winters BR De Sarkar N Arora S et al. Genomic distinctions between metastatic lower and upper tract urothelial carcinoma revealed through rapid autopsy. JCI Insight. 2019; 4e128728 Crossref Scopus (12) Google Scholar As with many rare disease settings, patients with UTUC are disenfranchised because dedicated research is challenging. Adjuvant chemotherapy in upper tract urothelial carcinoma (the POUT trial): a phase 3, open-label, randomised controlled trialGemcitabine–platinum combination chemotherapy initiated within 90 days after nephroureterectomy significantly improved disease-free survival in patients with locally advanced UTUC. Adjuvant platinum-based chemotherapy should be considered a new standard of care after nephroureterectomy for this patient population. Full-Text PDF Open Access
Long-term Sequelae of Nonobstructive Chronic Bronchitis—Is Airflow Obstruction Important?
Authors: Prescott G. Woodruff, Stephen C. Lazarus
Journal: JAMA Internal Medicine (2020)

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 Internal Medicine 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 Internal Medicine journal
Abstract MP43: Urine And Plasma Metabolome of Healthy Adults Consuming the Dietary Approaches to Stop Hypertension Diet: A Pilot Study
Authors: Shirin Pourafshar, Mira Nicchitta, Crystal C Tyson, Laura P Svetkey, David Corcoran, James Bain, Michael Muehlbauer, Olga Ilkayeva, Thomas M O’Connell, Pao-Hwa Lin, Julia Scialla
Journal: Circulation (2020)

The mechanisms of the Dietary Approaches to Stop Hypertension (DASH) diet on various health markers remain unclear. The objective of this study was to identify plasma and urine metabolites altered by DASH that may elucidate mechanisms of benefit and suggest biomarkers to facilitate research and monitoring. We tested metabolomics differences in a controlled feeding study of 20 people consuming a Control diet for one wk followed by 2 wks of random assignment to Control or DASH. Fasting plasma and 24-hour urine samples collected at the end of each wk were profiled for metabolites using non-targeted GC/MS and amino acids and acylcarnitines were measured in plasma using a targeted panel. Linear models compared metabolite levels between DASH and Control during the final two randomized feeding wks [nominal p&lt;0.05 and false discovery rate (FDR) adjusted p&lt;0.2]. Compared to Control, DASH is designed to be lower in total fat and saturated fat, but higher in protein, fiber, potassium, magnesium and calcium. Overall, we found 161 identifiable urine metabolites. In FDR adjusted tests, urine excretion of a variety of polyphenolic acids were higher on DASH. In plasma, gamma tocopherol, acylcarnitine C5 from branched chain amino acid (BCAAs) metabolism, and amino acids including BCAAs leucine/isoleucine and valine were lower on DASH (Table 1). Several small and medium chain dicarboxylic acylcarnitines were higher on DASH. Consumption of DASH increases urine levels of a set of polyphenolic compounds many of which have been linked to lower blood pressure in animal and small human studies. In plasma, BCAAs are lower on DASH despite higher protein intake. Further research is needed to investigate these metabolites as a panel for dietary monitoring in hypertension. Table 1. Nontargeted and targeted metabolites (Selected metabolites are shown here) in DASH and Control.
Abstract P2-05-06: Nuclear STING localization induces chemoresistance in breast cancer
Authors: Laura Cheradame, Chiara Guerrera, Jean-Gabriel Judde, Vincent Goffin, Stefano Cairo
Journal: Cancer Research (2020)

Abstract Efficient DNA damage repair (DDR) is crucial for a cell as aberrant repair can create deleterious mutations and genomic instability while unrepaired damage leads to cell apoptosis. Cells with altered DDR are more inclined to develop a variety of diseases, including cancers Cancer therapies including radiotherapy and chemotherapy rely on double strand break (DBS) formation to drive the killing of rapidly cycling tumor cells. As efficient DNA repair pathways can enable tumor cells to survive treatment-induced DNA damage, the identification of new actors participating in efficient DDR will help design alternative therapeutic approaches. Here we report that the well-known DNA sensor of innate immunity Stimulator of Interferon Genes (STING) is directly involved in the modulation of DSB repair efficiency in breast cancer cells. STING partly resides at the inner membrane of the nucleus where it interacts with core proteins of DNA-damage complexes and promotes its assembly with chromatin. STING silencing decreases DNA repair and cell viability, while STING overexpression protects cancer cells from genotoxic treatment. STING involvement in DNA repair is independent of the canonical STING-triggered pro-inflammatory response. In line with this observation, while overall STING expression level is positively correlated with favorable outcome in breast cancer patients, high STING expression in breast and ovarian cancer patients treated with adjuvant chemotherapy is associated with poor prognosis. This newly-identified function of STING elucidates a cell autonomous tumor-promoting mechanism complementary and independent from its well-documented role in tumor immunosurveillance. Citation Format: Laura Cheradame, Chiara Guerrera, Jean-Gabriel Judde, Vincent Goffin, Stefano Cairo. Nuclear STING localization induces chemoresistance in breast cancer [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P2-05-06.
Intra vesical gemcitabine (G) single agent as adjuvant chemotherapy in superficial transitional cell carcinoma (TCC) of the bladder: Final results
Authors: A. Bounedjar, R. Ferhat, F. Smaili, K. Bouzid
Journal: Journal of Clinical Oncology (2007)

5078 Background: Systemic intravenous G is usually used in advanced bladder carcinoma. A phase I study of intravesical G has shown safety profile in pts refractory to BCG therapy (Dalbani G et al JCO 2002; 20:3193–98). In this study we evaluate the toxicity and the efficacy of intravesical G in patients (pts) with superficial bladder carcinoma. Methods: The study population criteria were: age = 18 years old, histological diagnosis of transitional cell carcinoma (TCC) of bladder (Cis and pT1) confirmed by transurethral resection (TUR), no prior chemotherapy, a performance status (PS) &lt; 2, good bone marrow reserve, adequate renal and liver function and informed consent. Three weeks after a total TUR, pts receive intravesical instillation of 2,000 mg G every wk for 6 wks, than every month for six months. Evaluation is performed 3–4 wks after the last instillation (CT scan and/or US pelvis, urinary cytology and cystoscopy with biopsy). Results: From February 2003 to June 2004, 60 pts (57M/3F) were enrolled in the study (M/F = 57/3). The median age was 59,5 years old (24–84). Nine pts had a carcinoma in situ (Cis) and 51 had pT1 lesions. They received a total of 720 instillations. All pts were evaluable for toxicity and response Toxicity (CTC/NCI scale) is evaluated over the 720 instillations. Non haematological toxicity was grade 1: irritate bladder reaction (4.7%), asthenia (2.9%), nausea and vomiting (1.8%) and hot flashes (2%). Grade 1 haematological toxicity: anaemia (6.8%), leucopenia (4.5%) and thrombocytopenia (0.4%). After a follow-up time of 30 to 48 months, all pts were evaluable for tumor response: 53 patient had a persistant complete remission after TUR. Five patients (8.3%) had a superficial relapse of TCC (one at six months, 2 at 9 months and 2 others at 12 months). Two patients had progressive disease at 18 months and 27 months. Conclusion: Intravesical G is an active and well tolerated treatment even after repeated instillation in pts with superficial TCC carcinoma of the bladder. No significant financial relationships to disclose.
Abstract P264: Cardiovascular and Cardiometabolic Post-hospitalization Mortality Rates are Not Associated With Traditional Risk Factors and Socioeconomic Status at the Population Level in Canada
Authors: Sarah Singh, Saverio Stranges, Piotr Wilk, Stephanie J Frisbee
Journal: Circulation (2020)

Background: While existing literature has established individual risk factors for early death post-hospitalization in patients with cardiovascular and cardiometabolic disease (CVD/CMD), few studies to date have examined whether the known effects of these risk factors are maintained at the population level. The aim of this study was to determine whether traditional CVD risk factors and socioeconomic factors at the population level impacted CVD/CMD post-hospitalization mortality rates in Canada over time. Methodology: We conducted an ecological, cross-sectional analysis using merged data from two sources: 1) the Canadian Community Health Survey 2000-2011 and, 2) the Canadian Vital Statistics Death Database linked to the Discharge Abstract Database 2000-2012. The study outcome was 1-year mortality rate after hospital discharge for CVD/CMD, calculated by census division (CD) using ICD-9-CA codes for hospitalizations and deaths. The first stage of the statistical analysis reported age- and sex-standardized 1-year mortality rates after hospital discharge for CVD/CMD, across CDs in Canada. The second stage utilized Poisson regression to model associations between traditional CVD risk factors and socioeconomic factors at the CD level and CVD/CMD post-hospitalization mortality rates in Canada over time. Results: National 1-year mortality rates in patients with CVD/CMD increased from 146.5 per 100,000 in 2000 to 150.4 in 2012, peaking at 202.4 in 2006, with no significant trend observed over time. Maps of average 1-year mortality rates over the time period (2000-2012) show wide variations in rates across census divisions (CDs) in Canada. Nova Scotia and Ontario had the highest proportion of CDs with worsening rates of mortality over time (3% and 7% respectively) that remained below the national average. Traditional CVD risk factors, demographic factors and socioeconomic factors at the census division level were not associated with 1-year mortality rates after hospital discharge for CVD/CMD over time. Potential implication: Reductions in the CVD/CMD post-hospitalization mortality burden at the individual level may benefit from treatment targeted towards traditional risk factors and socioeconomic factors however; reduction in post-hospitalization burden at the population level can benefit from policy focused towards other societal elements such as healthcare and community care resources.
Erratum: Corrigendum: IgG Fc domains that bind C1q but not effector Fcγ receptors delineate the importance of complement-mediated effector functions
Authors: Chang-Han Lee, Gabrielle Romain, Wupeng Yan, Makiko Watanabe, Wissam Charab, Biliana Todorova, Jiwon Lee, Kendra Triplett, Moses Donkor, Oana I Lungu, Anja Lux, Nicholas Marshall, Margaret A Lindorfer, Odile Richard-Le Goff, Bianca Balbino, Tae Hyun Kang, Hidetaka Tanno, George Delidakis, Corrine Alford, Ronald P Taylor, Falk Nimmerjahn, Navin Varadarajan, Pierre Bruhns, Yan Jessie Zhang, George Georgiou
Journal: Nature Immunology (2017)
Abstract P261: Rheumatoid Arthritis And Coronary Artery Disease: Are We Considering The Real Risk?
Authors: Rania Al Asmar, Sudha Penumala, Kanaan Mansoor, Emilia Leigh, Bisher Mustafa, Ralph Webb
Journal: Circulation (2020)

Background: Rheumatoid arthritis (RA) is one of the most common inflammatory conditions linked to premature coronary artery disease (CAD). West Virginia (WV) has abundance of population that has metabolic syndrome and RA. We aimed to study the demographics of the RA in patient population of WV. Primary end points included the incidence of coexisting metabolic syndrome and RA, secondary end point was whether these patients were prescribed Aspirin and Statins for primary prevention of CAD. Methods: In our observational, retrospective study, we reviewed electronic medical records of patients diagnosed with RA and CAD. Charts were collected based on ICD-10 codes of the diagnoses; RA (M05.79, M06.09, M06.9), and CAD (I25.10, I21.9). SPSS version 20 was used for statistical analysis. Results: Out of 2275 patients with RA, 233 patients had coexisting diagnosis of CAD and RA. 20 patients were excluded due to incomplete charts. Mean BMI of the patients was 29.6 kg/m2. Sixty four percent were smokers, and 66% had family history of CAD. Coexisting comorbidities were prevalent; there were 37% diabetic, 88% hypertensive, 80% dyslipidemic, and while 33% had other autoimmune disease. Of note, primary prevention of CAD was only provided to 5% of patients by using a statin, and 5% of patients by using low dose aspirin, and 37% using both. Conclusion: Rheumatoid arthritis remains one of the important risk factors for premature coronary artery disease, especially in the predisposed patient population. More studies are needed to assess the exact risk of premature CAD in RA patients with metabolic syndrome, and perhaps consider RA as one additional determinant of the Atherosclerotic Cardiovascular Disease (ASCVD) risk.