tbuckley/cabot-search huggingface dataset:
Management of adverse effects of topical PDT
Authors: S.H. Ibbotson, T.H. Wong, C.A. Morton, N.J. Collier, A. Haylett, K.E. McKenna, R. Mallipeddi, H. Moseley, L.E. Rhodes, D.C. Seukeran, K.A. Ward, M.F. Mohd Mustapa, L.S. Exton
Journal: British Journal of Dermatology (2019)

Photodynamic therapy (PDT) is commonly used to treat certain types of low risk non‐melanoma skin cancer and pre‐cancerous sun damage and is available in many dermatology services. The purpose of this review was to examine the published evidence in the medical literature about side effects of this form of treatment and approaches to preventing and treating these side effects. This was part of a larger process to review and update the guidelines for use of PDT and its place in dermatology practices, which is published separately in the British Journal of Dermatology (Wong et al., Br J Dermatol 2018 https://doi.org/10.1111/bjd.16838). The current article reviewed all published evidence concerning the side effects of PDT and also put this into context based on the wide experience of the authors who are actively involved in the undertaking of PDT in the dermatology clinic. The authors found that discomfort and pain during PDT treatment were the only main side effects of note but that these could be reduced considerably by using modified low intensity treatment protocols, and that usually this therefore did not limit treatment or its outcomes. Rare side effects included becoming allergic to the drugs used in PDT and this was most likely if patients had multiple treatments to large areas. There were no other notable side effects and it was overall concluded that treatment was well tolerated and that PDT was important to have available in dermatology practices. This reinforces the role and importance of PDT as a safe and effective treatment option for certain skin conditions, in particular thin non‐melanoma skin cancers and pre‐cancerous sun damage
Leukemic blast cell colony formation in semisolid culture with erythropoietin: a case report of acute poorly differentiated erythroid leukemia
Authors: M Tomonaga, I Jinnai, M Tagawa, T Amenomori, K Nishino, E Yao, H Nonaka, K Kuriyama, Y Yoshida, T Matsuo
Journal: Blood (1987)
Quality of Outpatient Care With Internal Medicine Residents vs Attending Physicians in Veterans Affairs Primary Care Clinics
Authors: Samuel T. Edwards, Hyunjee Kim, Sarah Shull, Elizabeth R. Hooker, Meike Niederhausen, Anäis Tuepker
Journal: JAMA Internal Medicine (2019)

of which included an ethicist.Only 89 patients (36.0%) were informed that their care included rationing.Discussion | Pharmacy practice managers reported frequent medication shortages with variation in allocation and rationing methods during shortages.Many respondents described little forewarning of upcoming shortages and a lack of administrative mechanisms with which to guide medication conservation, and although discouraged, hoarding was widespread. 3,4Rationing was prevalent, particularly in large hospitals and academic or academically affiliated hospitals.Most respondents noted that rationing decisions were generally made by the care team without the involvement of hospital committees or ethicists.Disclosing rationing to patients was not common.This survey of PPMs suggests that more systematic approaches are needed to address the common problem of drug shortages and consequent drug rationing.Progress in this area would be furthered by research to better understand patient and physician preferences for disclosure and the association of different management strategies with the outcomes of high-risk groups.
Tuberculosis Presenting as Cutaneous Erythema Nodosum on 18F-FDG PET/CT
Authors: Tarun Kumar Jain
Journal: Clinical Nuclear Medicine (2019)

Abstract The present article presented a 47-year-old woman with areas of nodular swelling and discoloration involving bilateral lower limbs since 12 months. Biopsy from skin lesions revealed erythema nodosum. As erythema nodosum can be secondary to multiple etiologies, whole-body 18 F-FDG PET/CT was performed to assess the disease distribution and guide the site of biopsy. 18 F-FDG PET/CT revealed metabolically active mediastinal lymphadenopathy in addition to the skin lesions. Endobronchial ultrasound–guided biopsy from subcarinal lymph node revealed tuberculosis.
Abstract P365: Objectively Measured Snoring is Associated with Carotid Vascular Remodeling in Overweight and Obese Adults
Authors: Christy Taylor, Chunzhe Duan, Christopher Kline, Emma Barinas-Mitchell
Journal: Circulation (2018)

Introduction: Snoring is often used as a surrogate measure for obstructive sleep apnea (OSA), a sleep disorder associated with elevated cardiovascular disease (CVD) risk. Although the literature supports a link between snoring and CVD, it is not clear if this association is independent of OSA. The objective of our study was to explore the association between snoring and subclinical CVD in adults with and without OSA. We hypothesized that snorers would have a greater burden of subclinical CVD, including thicker carotid intima media thickness (CIMT) and higher pulse wave velocity (PWV). Methods: Cross-sectional analyses were conducted using 24-month follow up data from the Slow Adverse Vascular Effects (SAVE) study, a randomized controlled trial evaluating the effects of weight loss, increased physical activity, and reduced dietary sodium intake on vascular health. The original population included 349 men and women aged 20-45 years and BMI 25-40 kg/m 2 . Participants (n=122) with objective measures of sleep-disordered breathing from a home-based sleep assessment (ResMed ApneaLink) were grouped into three categories using the snoring index (SI) and oxygen desaturation index (ODI). SI is defined as the number of vibratory snoring events per hour of recording time . ODI is the number of oxyhemoglobin desaturations of ≥ 4% per hour of recording . The snoring categories were: OSA (ODI≥5; n=41), heavy snoring (ODI&lt;5, above-median SI; n=40), and normal snoring (ODI&lt;5, below-median SI; n=41). Vascular measures such as carotid-femoral PWV (cfPWV), femoral-ankle PWV (faPWV), brachial-ankle PWV (baPWV), CIMT, and carotid inter-adventitial diameter were compared across snoring groups. We used multiple linear regression to assess the association between snoring and subclinical CVD independent of age, sex, BMI, mean arterial pressure, and intervention group. Results: Participants were on average 40.1 ± 5.9 years old (BMI of 31.6 ± 4.4 kg/m 2 ; 76.2% women and 82% white). Across snoring severity categories, most CVD risk factors worsened including age, blood pressure, BMI, lipids, and fasting glucose (ANOVA; all p &lt;.05). Similarly, vascular measures including faPWV, baPWV, CIMT, inter-adventitial diameter and bulb IMT differed across snoring categories with differences occurring mainly between the normal snoring and OSA groups. Differences in carotid inter-adventitial diameter and CIMT were noted between normal and heavy snoring groups (6.52 ± 0.49 vs. 6.83 ± 0.49; 0.58 ± 0.06 vs. 0.63 ± 0.07; mm), respectively. Following covariate adjustment, differences in carotid inter-adventitial diameter and IMT persisted between normal and heavy snoring categories (p &lt;.05). Conclusion: Our findings suggest that, in overweight and obese adults, objectively measured snoring is related to indices of local vascular remodeling and aging, even in those without OSA. Snoring severity may be associated with CVD risk.
Mobile technology offers novel insights into the control and treatment of allergic rhinitis: The MASK study
Authors: Annabelle Bédard, Xavier Basagaña, Josep M. Anto, Judith Garcia-Aymerich, Philippe Devillier, Sylvie Arnavielhe, Anna Bedbrook, Gabrielle L. Onorato, Wienczyslawa Czarlewski, Ruth Murray, Rute Almeida, Joao Fonseca, Elisio Costa, Joao Malva, Mario Morais-Almeida, Ana Margarida Pereira, Ana Todo-Bom, Enrica Menditto, Cristiana Stellato, Maria Teresa Ventura, Alvaro A. Cruz, Rafaël Stelmach, Jane da Silva, Désirée Larenas-Linnemann, José M. Fuentes-Pérez, Yunuen R. Huerta-Villalobos, Regina Emuzyte, Violeta Kvedariene, Arunas Valiulis, Piotr Kuna, Boleslaw Samolinski, Ludger Klimek, Ralph Mösges, Oliver Pfaar, Sara Shamai, Isabelle Annesi-Maesano, Isabelle Bosse, Pascal Demoly, Jean-François Fontaine, Vicky Cardona, Joaquim Mullol, Antonio Valero, Regina E. Roller-Wirnsberger, Peter Valentin Tomazic, Niels H. Chavannes, Wytske J. Fokkens, Sietze Reitsma, Mike Bewick, Dermot Ryan, Aziz Sheikh, Tari Haahtela, Sanna Toppila-Salmi, Erkka Valovirta, Michael Makris, Nikos G. Papadopoulos, Emmanuel P. Prokopakis, Fotis Psarros, Cemal Cingi, Bilun Gemicioğlu, Arzu Yorgancioglu, Sinthia Bosnic-Anticevich, Robyn E. O'Hehir, Claus Bachert, Peter W. Hellings, Benoit Pugin, Carsten Bindslev-Jensen, Esben Eller, Ingrid Kull, Erik Melén, Magnus Wickman, Gert De Vries, Michiel van Eerd, Ioana Agache, Ignacio J. Ansotegui, Mark S. Dykewicz, Thomas Casale, Dana Wallace, Susan Waserman, Daniel Laune, Jean Bousquet
Journal: Journal of Allergy and Clinical Immunology (2019)
Abstract 17250: Results From the IHM Fontan Feasibility Study
Authors: Anudeep Jassal, Curt Daniels, Darren Berman, Elisa A Bradley
Journal: Circulation (2017)

Background: Implantable invasive hemodynamic monitoring (IHM) using the CardioMEMS™ HF system has been shown to reduce heart failure (HF) hospitalizations. IHM has not yet been used in congenital h...
Macrophage-targeted, enzyme-triggered fluorescence switch-on system for detection of embolism-vulnerable atherosclerotic plaques
Authors: Yudai Narita, Kosuke Shimizu, Keisuke Ikemoto, Ryuji Uchino, Mutsumi Kosugi, Marten B. Maess, Yasuhiro Magata, Naoto Oku, Mikako Ogawa
Journal: Journal of Controlled Release (2019)
Abstract 12810: Beta Blockers and Mortality Benefit in Patients With Heart Failure and End Stage Renal Disease on Hemodialysis
Authors: Chakradhari Inampudi, Vlad Cotarlan
Journal: Circulation (2015)

Background: Post-hoc analysis of Randomized control trials have established safety and efficacy of Beta blockers (BB) in patients with systolic heart failure (HF) and mild to moderate Chronic kidney disease (CKD). However, the mortality benefit in patients with advanced CKD especially those approaching end stage renal disease (ESRD) is limited. The study was sought to identify mortality benefit in patients with Heart failure (HF) and ESRD who progressed to dialysis. Methods: Using electronic medical records, we identified 1,817 patients with end stage renal dialysis(ESRD) who progressed to dialysis over a 6 year period between 2004 and 2011. Kaplan Meyer survival curves were used to assess the association between BB use and mortality. Results: Of 1817 patients (mean age 61+/-15, 57% males) with ESRD who progressed to dialysis, 1329 (73.1%) were treated with BB and 488 (26.5%) were never treated with a BB. Kaplan Meyer Survival curves showed that patients who received treatment with BB had better survival than patients who were never treated with BB despite more HTN and diabetes present in the former group (mean survival time 4.9 years versus 4.4 years, p&lt;0.001, Fig 1). Survival graphs were similar for those with an encounter diagnosis of HF (n=547, Fig 2) and those without an encounter diagnosis of HF (n=1270, graph not shown) with stronger association between BB and survival among those with HF (mean survival 3.1 versus 4.8 years, p=0.001, Fig 2). Conclusion: Treatment with BB is associated with improved survival in heart failure patients with ESRD who progressed to dialysis.
Abstract 16486: Tlr3 is Necessary for Direct Cardiac Reprogramming
Authors: Conrad Hodgkinson, Richard Pratt, Imke Kirste, John Cooke, Victor Dzau
Journal: Circulation (2017)

Reprogramming fibroblasts directly into cardiomyocytes holds great promise for cardiac regenerative medicine. We have recently shown that delivery of a specific combination of miRNAs called miR combo into the infarcted heart reprograms fibroblasts into cardiomyocytes; regenerating heart muscle and improving cardiac function. However, the mechanism by which fibroblasts are reprogrammed into cardiomyocytes is unclear. To that end, we investigated the possibility that Toll-like receptor 3 (TLR3), a receptor more commonly associated with regulating innate immunity, plays a key role in miR combo reprogramming. We found that TLR3 inhibition as well as TLR3 knockdown completely blocked miR combo reprogramming (N=4, P<0.01). Using pharmacological and siRNA-mediated knockdown approaches we found that the ability of TLR3 to mediate miR combo reprogramming was dependent upon the RelA subunit of NFκB (N=4, P<0.01). Interestingly, TLR3 activation enhanced miR combo reprogramming at the RNA and protein level (N=4, P<0....
CRRL269
Authors: Yang Chen, Gail J. Harty, Ye Zheng, Seethalakshmi R. Iyer, Shinobu Sugihara, S. Jeson Sangaralingham, Tomoko Ichiki, Joseph P. Grande, Hon-Chi Lee, Xiaoli Wang, John C. Burnett
Journal: Circulation Research (2019)

Acute kidney injury (AKI) has a high prevalence and mortality in critically ill patients. It is also a powerful risk factor for heart failure incidence driven by hemodynamic changes and neurohormonal activation. However, no drugs have been approved by the Food and Drug Administration. Endogenous pGC-A (particulate guanylyl cyclase A receptor) activators were reported to preserve renal function and improve mortality in AKI patients, although hypotension accompanied by pGC-A activators have limited their therapeutic potential.We investigated the therapeutic potential of a nonhypotensive pGC-A activator/designer natriuretic peptide, CRRL269, in a short-term, large animal model of ischemia-induced AKI and also investigated the potential of uCNP (urinary C-type natriuretic peptide) as a biomarker for AKI.We first showed that CRRL269 stimulated cGMP generation, suppressed plasma angiotensin II, and reduced cardiac filling pressures without lowering blood pressure in the AKI canine model. We also demonstrated that CRRL269 preserved glomerular filtration rate, increased renal blood flow, and promoted diuresis and natriuresis. Further, CRRL269 reduced kidney injury and apoptosis as evidenced by ex vivo histology and tissue apoptosis analysis. We also showed, compared with native pGC-A activators, that CRRL269 is a more potent inhibitor of apoptosis in renal cells and induced less decreases in intracellular Ca2+ concentration in vascular smooth muscle cells. The renal antiapoptotic effects were at least mediated by cGMP/PKG pathway. Further, CRRL269 inhibited proapoptotic genes expression using a polymerase chain reaction gene array. Additionally, we demonstrated that AKI increased uCNP levels.Our study supports developing CRRL269 as a novel renocardiac protective agent for AKI treatment.
Additional Data to Explain Childhood Obesity—Reply
Authors: Stephanie Schrempft, Moritz Herle, Clare H. Llewellyn
Journal: JAMA Pediatrics (2019)

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Strategies of adoptive T -cell transfer to treat refractory viral infections post allogeneic stem cell transplantation
Authors: Theresa Kaeuferle, Ramona Krauss, Franziska Blaeschke, Semjon Willier, Tobias Feuchtinger
Journal: Journal of Hematology & Oncology (2019)

Allogeneic hematopoietic stem cell transplantation (HSCT) can expose patients to a transient but marked immunosuppression, during which viral infections are an important cause of morbidity and mortality. Adoptive transfer of virus-specific T cells is an attractive approach to restore protective T -cell immunity in patients with refractory viral infections after allogeneic HSCT. This narrative review summarizes clinical evidence and developments of almost 30 years of adoptive T -cell transfer. The review is based on evidence extracted from PubMed searches and the clinical and experimental work of the authors. Viral infections after HSCT are frequently caused by the endogenous reactivation of persistent pathogens such as cytomegalovirus (CMV), Epstein-Barr virus (EBV), and adenovirus (AdV). Current antiviral medication is not satisfactory and does not treat the underlying pathophysiology which is the lack of specific T -cell immunity. Adoptive transfer of virus-specific T cells could be a potentially curative, pathogen-specific, and non-toxic treatment providing long-term immunity against the virus. The isolation of virus-specific T cells from a healthy donor and infusion into a recipient is known as adoptive T -cell transfer and has been performed in many patients using different treatment protocols. Based on basic research, new isolation protocols aim at a safe and fast availability of cellular products for adoptive T -cell transfer. We summarize preclinical and clinical data on each of the main pathogens and on the technical approaches currently available to target either single antigens or even multiple pathogens. Cellular therapy is considered as one of the major recent breakthroughs in medicine. Translation of this individualized treatment into first-line clinical routine is still limited. Main hurdles are availability of the technique, limited compatibility of classical phase III designs with cellular therapy, and regulatory restrictions. Multinational efforts are required to clarify the status of cellular treatment in first-line clinical routine with the overall objective to strengthen evidence-based treatment guidelines for the treatment of refractory viral infections post HSCT.
An unusual cause of headache
Authors: Omed Amin, David C Howlett
Journal: BMJ (2019)

A 64 year old woman presented to the emergency department with a history of sudden onset severe generalised headache after waking, associated with nausea. She had no medical history. On examination, the pain had not eased but she appeared alert with no other discernible features. She underwent a computed tomography scan of the head (fig 1). What is the diagnosis, and are further investigations warranted?



Fig 1 
Axial unenhanced computed tomography section at the level of the pons



Perimesencephalic subarachnoid haemorrhage …
Intestinal development and homeostasis require activation and apoptosis of diet-reactive T cells
Authors: Alexander Visekruna, Sabrina Hartmann, Yasmina Rodriguez Sillke, Rainer Glauben, Florence Fischer, Hartmann Raifer, Hans Mollenkopf, Wilhelm Bertrams, Bernd Schmeck, Matthias Klein, Axel Pagenstecher, Michael Lohoff, Ralf Jacob, Oliver Pabst, Paul William Bland, Maik Luu, Rossana Romero, Britta Siegmund, Krishnaraj Rajalingam, Ulrich Steinhoff
Journal: Journal of Clinical Investigation (2019)

The impact of food antigens on intestinal homeostasis and immune function is poorly understood. Here, we explored the impact of dietary antigens on the phenotype and fate of intestinal T cells. Physiological uptake of dietary proteins generated a highly activated CD44+Helios+CD4+ T cell population predominantly in Peyer patches. These cells are distinct from regulatory T cells and develop independently of the microbiota. Alimentation with a protein-free, elemental diet led to an atrophic small intestine with low numbers of activated T cells, including Tfh cells and decreased amounts of intestinal IgA and IL-10. Food-activated CD44+Helios+CD4+ T cells in the Peyer patches are controlled by the immune checkpoint molecule PD-1. Blocking the PD-1 pathway rescued these T cells from apoptosis and triggered proinflammatory cytokine production, which in IL-10-deficient mice was associated with intestinal inflammation. In support of these findings, our study of patients with Crohn's disease revealed significantly reduced frequencies of apoptotic CD4+ T cells in Peyer patches as compared with healthy controls. These results suggest that apoptosis of diet-activated T cells is a hallmark of the healthy intestine.
Abstract 20115: Aggregation of Child Cardiac Progenitor Cells into Spheres Activates Notch Signaling and Improves Treatment of Right Ventricular Heart Failure
Authors: David Trac, Chunhui Xu, Michael E Davis
Journal: Circulation (2017)

Congenital heart disease is rarely cured by surgery and can lead to life-threatening, intractable right ventricular heart failure (HF). Recent stem cell-based clinical trials have been limited by p...
Endoscopic ultrasound-guided gastroenterostomy using a metal stent for the treatment of afferent loop syndrome
Authors: Yasunari Sakamoto, Susumu Hijioka, Yuta Maruki, Akihiro Ohba, Yoshikuni Nagashio, Takuji Okusaka, Yutaka Saito
Journal: Endoscopy (2019)

A 79-year-old man with a history of pylorus-preserving pancreaticoduodenectomy for pancreatic head cancer and Child's reconstruction underwent total pancreatectomy for remnant pancreatic recurrence 2 years later. Four months after total pancreatectomy, he developed cholangitis. Computed tomography (CT) ([Fig. 1]) showed afferent loop syndrome arising from disseminated peritoneal nodule formation. We attempted to place an intestinal stent at the afferent loop stenosis site to resolve the obstructive jaundice and cholangitis.
Anti‐TIF‐1β antibody in dermatomyositis
Authors: I. Ueda‐Hayakawa, Y. Hamaguchi, N. Okiyama, S. Motegi, T. Yamaoka, S. Miyake, A. Higashi, H. Okamoto, K. Takehara, M. Fujimoto
Journal: British Journal of Dermatology (2019)

Dermatomyositis is a disease where skin and muscles become inflamed. Sometimes it affects just muscles, sometimes just the skin. Most patients fall within a spectrum where both are inflamed. Elevations of the enzyme creatinine kinase (CK) are found in the bloodstream if muscles are inflamed, and tests such as an electromyogram may also be abnormal. Dermatomyositis is an autoimmune condition, with antibodies directed against the patient's own tissues (autoantibodies). Different patterns of such autoantibodies are associated with different subsets of the condition. There is also an underlying cancer in a minority of adults with dermatomyositis. One group of autoantibodies is specifically associated with muscle inflammation. Within it is a family called anti‐TIF (transcriptional intermediary factor) antibodies, including anti‐TIF‐1α and ‐1γ antibodies. Anti‐TIF‐1α antibodies always appear with anti‐TIF‐1γ. In this paper from Japan, the authors investigate which conditions result when patients have a third autoantibody, anti‐TIF‐1β, on its own, without either of the other two. From 3442 stored serum (blood) samples from patients with connective tissue diseases, they found seven such patients. Six had dermatomyositis, but in two, muscles were either not involved (one patient) or involved but producing no symptoms (one patient); the other four patients had classic dermatomyositis but muscle involvement was mild and only one of the four had an elevated CK. One of these four patients did, however, have an underlying cancer. The seventh patient had ‘undifferentiated connective tissue disease’. The authors conclude that anti‐TIF‐1β antibodies are associated with dermatomyositis where muscle inflammation is absent or only mild.