tbuckley/cabot-search huggingface dataset:
Abstract 18613: Utilization of High-Potency Statin Therapy Following Hospitalization for CHD Among Medicare Beneficiaries
Authors: Robert S Rosenson, Shia Kent, Todd Brown, Michael Farkouh, Emily Levitan, Huifeng Yun, Pradeep Sharma, Monika Safford, Meredith Kilgore, Paul Muntner, Vera Bittner
Journal: Circulation (2013)

Background: Evidence-based guidelines recommend high-potency statins for secondary prevention in high-risk patients including individuals hospitalized for coronary heart disease (CHD) events. In these patients, initiation of this therapy is recommended upon hospital discharge. Aim: Investigate the proportion of Medicare beneficiaries who fill a prescription for a high potency statin following discharge and within 365 days after hospital discharge for an incident CHD event. Methods: This study included Medicare beneficiaries ≥ 65 years with no documented CHD history in the prior year who were hospitalized and filled a statin following an incident CHD event (myocardial infarction or coronary revascularization procedure) in 2007, 2008 or 2009. High-potency statins included atorvastatin 20 mg to 80 mg, rosuvastatin 10 mg to 40 mg and simvastatin 40 to 80 mg daily. Results: Among 9,455 Medicare beneficiaries filling a statin following an incident CHD hospitalization, 33.8% and 40.2% filled prescriptions for high-potency statins within 90 and 365 days, respectively. The proportion filling a prescription for a high-potency statin declined between 2007 and 2009. After multivariable adjustment, more recent calendar time, progressively older age and higher Charlson scores were associated with a lower likelihood of filling a prescription for a high potency statins and Asians were more likely to fill a prescription for a high potency statin (Table). Conclusions: The majority of Medicare beneficiaries who will a statin following hospitalization for CHD do not fill a high potency statin. The under-utilization of high-potency statin therapy represents a major obstacle to lowering the burden of recurrent cardiovascular events.
Real Life Evaluation of Efficacy and Safety of Bosutinib Therapy in Chronic Myeloid Leukemia Patients
Authors: Imma Attolico, Roberto Latagliata, Massimo Breccia, Elisabetta Abruzzese, Alessandra Iurlo, Isabella Capodanno, Mario Annunziata, Sara Galimberti, Mario Tiribelli, Bruno Martino, Antonella Gozzini, Anna Rita Scortechini, Chiara Elena, Fausto Castagnetti, Luigia Luciano, Carmen Fava, Patrizia Pregno, Fabio Stagno, Micaela Bergamaschi, Gianni Binotto, Massimiliano Bonifacio, Giovanni Caocci, Monica Crugnola, Francesco Tarantini, Giorgina Specchia, Francesco Albano
Journal: Blood (2018)
Abstract 15248: Comparison of the Effects of Two Low-Density Lipoprotein Cholesterol Goals on Secondary Prevention After Acute Myocardial Infarction: ≥50% Reduction From Baseline versus &lt;70 mg/dL
Authors: Kyung Hoon Cho, Kyoung Jin Lee, Kyung Hwan Kim, Woo-Jin Kim, Min Chul Kim, Cheol Hwan Kim, Seung Jin Jun, Hyun Kuk Kim, Hae-Chang Jeong, Keun-Ho Park, Doo Sun Sim, Kyung Woo Park, Sang Rok Lee, Young Joon Hong, Youngkeun Ahn, Jei Keon Chae, Hyo-Soo Kim, Jeong Gwan Cho, Jong Chun Park, Myung Ho Jeong
Journal: Circulation (2014)

Background: There haven’t been well-designed studies conducted to know an optimal goal for low-density lipoprotein cholesterol (LDL-C) after acute myocardial infarction (AMI). Methods: Of 2,409 consecutive patients (62.7 ± 12.4 years, 74.1% men) with AMI who had baseline LDL-C levels ≥70mg/dL and received discharge statin prescriptions after successful percutaneous coronary intervention, 1,305 patients (61.0 ± 11.8 years, 77.0% men) who had LDL-C levels tested at 1 year (mean baseline LDL-C, 126.5 ± 33.5 mg/dL; mean LDL-C reduction at 1 year, 53.1 ± 29.3 mg/dL) were analyzed in this study. Patients were categorized into 2 groups according to the values of LDL-C at 1 year in two different ways using percent change from baseline (≥50% reduction, n=428 versus &lt;50% reduction, n=877) and fixed levels (&lt;70 mg/L, n=625 versus ≥70 mg/dL, n=680). The primary endpoint was the composite of major cardiac events (MCEs) including cardiac deaths, non-fatal myocardial infarctions and coronary revascularizations (angioplasty or bypass grafting) after hospital discharge. A median follow-up duration was 2.0 years (interquartile range, 1.9 to 2.1 years). Results: At 2 years, MCEs occurred in 139 patients (10.7%). Kaplan-Meier estimates of the MCEs rates at 2 years revealed that patients with ≥50% LDL-C reduction from baseline had fewer MCEs compared with &lt;50% LDL-C reduction (8.2% versus 11.9%; Log rank P =0.026), while those with LDL-C levels &lt;70 mg/dL at 1 year did not (&lt;70 mg/L, 10.7% versus ≥70 mg/dL, 10.6%; Log rank P =0.998). In a multivariable Cox proportional hazard model, patients with ≥50% LDL-C reduction from baseline had a 39% reduction in the risk of MCEs compared with &lt;50% LDL-C reduction (adjusted hazard ratio [HR], 0.61; 95% confidence interval [CI], 0.41 to 0.90; P =0.012). But, compared with LDL-C levels ≥70 mg/dL at 1 year, patients with LDL-C levels &lt;70 mg/dL didn’t have a significant reduction in the risk of MCEs (adjusted HR, 0.98; 95% CI, 0.69 to 1.37; P =0.975). Conclusions: Obtaining a ≥50% reduction in LDL-C was associated with a significant reduction in the risk of MCEs after AMI, whereas achieving a &lt;70 mg/dL was not. Our study suggests that obtaining a ≥50% reduction from baseline could be an optimal goal for LDL-C after AMI, not achieving a &lt;70 mg/dL.
Consider alternative evidence sources for medical devices
Authors: Neil Smart
Journal: BMJ (2018)

Equity of access is an underpinning theme of the NHS. Concerns raised in accessing the FreeStyle Libre flash glucose monitor encapsulate many of the wider problems facing technologies that are not medicines.1 Unlike medicines, the published evidence base is often weak, and this is unlikely to change.

Should resources be allocated only to areas where strong evidence exists from randomised controlled trials (RCTs) and meta-analyses, even …
Defective glycosylation leads to defective gp130-dependent STAT3 signaling in PGM3-deficient patients
Authors: Meriem Ben-Ali, Leila Ben-Khemis, Najla Mekki, Roukaya Yaakoubi, Rym Ouni, Chaouki Benabdessalem, Imen Ben-Mustapha, Mohamed-Ridha Barbouche
Journal: Journal of Allergy and Clinical Immunology (2018)
Phase 3 Randomized Study of Daratumumab Plus Bortezomib, Melphalan, and Prednisone (D-VMP) Versus Bortezomib, Melphalan, and Prednisone (VMP) in Newly Diagnosed Multiple Myeloma (NDMM) Patients (Pts) Ineligible for Transplant (ALCYONE)
Authors: Maria-Victoria Mateos, Meletios A. Dimopoulos, Michele Cavo, Kenshi Suzuki, Andrzej J. Jakubowiak, Stefan Knop, Chantal Doyen, Paulo Lucio, Zsolt Nagy, Polina Kaplan, Ludek Pour, Mark Cook, Sebastian Grosicki, Andre H Crepaldi, Anna Marina Liberati, Philip Campbell, Tatiana Shelekhova, Sung-Soo Yoon, Genadi Iosava, Tomoaki Fujisaki, Mamta Garg, Christopher Chiu, Jianping Wang, Robin Carson, Wendy Crist, William Deraedt, Marie Nguyen, Ming Qi, Jesus F. San-Miguel
Journal: Blood (2017)
Ginseng constituent interactions in the ability of ginseng and ginsenosides to inhibit human breast cancer MCF-7 cell proliferation
Authors: Laura Murphy, Mandy King
Journal: Cancer Research (2007)

5549  Ginseng consists of over twenty different ginsenosides and ginseng polysaccharides. We hypothesized that ginseng′s recognized ability to inhibit cancer cell proliferation may be due to the net effect of its major bioactive constituents. First we determined the anti-cancer role of ginseng′s major constituents by testing the effects of a ginsenoside or ginseng polysaccharide extract, alone or in combination, on MCF-7 cell proliferation in vitro. We next examined the effects of ginsenoside combinations on MCF-7 proliferation and determined cellular mechanisms of action. Powdered root of Panax quinquefolium (American ginseng; Sigma-Aldrich, St. Louis, MO) was subjected to 48 hr of methanol extraction (ginsenoside fraction), followed by hot water extraction (polysaccharide fraction) and purity was verified. We determined that ginseng root contains approximately 15% ginsenosides and 10% total ginseng polysaccharides by weight. After 6 days of treatment, MCF-7 cell proliferation was inhibited by either the ginsenoside fraction (IC50=0.18 μg/μl) or the polysaccharide fraction (0.12 μg/μl), in a more potent manner than a crude ginseng extract that contains both ginsenosides and polysaccharides (0.6 μg/μl), suggesting an antagonism between the two fractions at the cellular level. When MCF-7 cells were then co-treated with the ginseng polysaccharide fraction + ginsenoside Rb1, the major ginsenoside found in ginsenoside fraction. efficacy of the polysaccharide fraction was reduced (IC50= 0.28 vs 0.13 μg/μl), indicating that Rb1 may be responsible, in part, for the antagonism between the ginsenoside and polysaccharide fractions. Several ginsenosides have been identified that exhibit anti-cancer activity, including ginsenosides Rc, Rg3 and Rh2. When MCF-7 cells were treated with an IC50 dose of Rc (50μM), co-treatment with another major ginsenoside, Rg1 (25μM), completely prevented the ability of Rc to inhibit cell proliferation. However, Rb1, Rg3 and Rh2 enhanced the efficacy of Rc on MCF-7 cells. In fact, combining three anti-cancer ginsenosides in sub-therapeutic concentrations [Rc(10μM):Rg3(10μM):Rh2 (20μM)] produced a synergistic inhibition of MCF-7 cell proliferation. Mechanistic studies revealed that this ginsenoside ′cocktail′ potently inhibited pRb and arrested cell cycle progression at the G1/S phase, while producing a >4-fold increase in the pro-apoptotic Bax/Bcl-2 ratio when compared to ginsenoside alone. Together, these data show that interactions exist between ginsenosides and ginseng polysaccharides that can contribute to or attenuate ginseng′s anti-cancer activity, and may be responsible for the ′net′ effect of ginseng on breast cancer cells. Finding ginseng components that work together to prevent breast cancer progression has potential therapeutic value in breast cancer treatment. (funded by grant # CA121074)
Real-World Risk Assessment and Treatment of Patients with Myelofibrosis at Community Oncology Practices in the United States
Authors: Srdan Verstovsek, Jingbo Yu, Jonathan K. Kish, Dilan Chamikara Paranagama, Jill Kaufman, Jessica Chung, Michael R. Grunwald, Philomena Colucci, Ruben A. Mesa
Journal: Blood (2018)
Structural Differential — A 32-Year-Old Man with Persistent Wrist Pain
Authors: Cheryl K. Seymour, Carrie Griffin, Seth M. Holmes, Carlos Martinez
Journal: New England Journal of Medicine (2018)

Interview with Dr. Cheryl Seymour on critical thinking about the social structures that affect patients' health. (13:28)Download In a Case Study in Social Medicine, a man presents to a mobile clinic in Maine with pain in his right wrist. Recognizing that he has a repetitive motion injury from raking blueberries, a physician ventures out into the field to analyze the causes and collaborate in finding solutions.
Abstract MP15: Aspirin is Effective in Preventing Venous Thromboembolism After Knee or Hip Arthroplasty
Authors: Christine Baumgartner, Judith Maselli, Andrew D Auerbach, Margaret C Fang
Journal: Circulation (2018)

Introduction: Venous thromboembolism (VTE) is a known complication of major orthopedic surgery. Although guidelines now allow the use of aspirin as an alternative to anticoagulants as VTE prophylaxis after knee or hip arthroplasty, there is limited data on contemporary use and outcomes with aspirin. We conducted a retrospective cohort study to describe antithrombotic agents used after knee and hip arthroplasty and post-operative VTE outcomes. Hypothesis: We assessed the hypothesis that VTE prevention with aspirin was not related to an increased risk of postoperative VTE after knee or hip arthroplasty compared to anticoagulation. Methods: We used data from MedAssets, which is an administrative database containing billing details on the patient-level from about 400 hospitals in the U.S., and included all adults with a principal hospital discharge diagnosis of knee or hip arthroplasty based on International Classification of Diseases, 9 th edition (ICD-9) codes between January 1, 2013, and December 31, 2014. We identified charges for medications used for VTE prophylaxis within 7 days after the index surgery. The primary outcome was postoperative VTE, identified by searching for VTE-specific ICD-9 codes from the index hospitalization, rehospitalization within 30 days, or during an outpatient visit within 90 days. We compared postoperative VTE risk between patients receiving aspirin-only and those receiving anticoagulants using propensity score-adjusted multivariable logistic regression models adjusted for VTE risk factors, hospital characteristics and length of stay. Results: We identified 74,234 patients who underwent knee arthroplasty and 36,192 with hip arthroplasty who received pharmacologic VTE prophylaxis. The most common post-operative anticoagulant medications were warfarin (25.2%; 27,850 of 110,426) and enoxaparin (24.1%; 26,560 of 110,426). Aspirin was used as the sole agent in 27.0% (20,047 of 74,234) of knee and 29.8% (10,769 of 36,192) of hip arthroplasties. Patients receiving only aspirin were younger and had fewer comorbidities compared to those who received anticoagulants. Postoperative VTE events occurred in 495 of 74,234 (0.67%) patients undergoing knee arthroplasty and 145 of 36,192 (0.40%) undergoing hip arthroplasty. Patients who received only aspirin after surgery did not have a higher risk for postoperative VTE compared to patients who received anticoagulants: adjusted odds ratio 0.92; 95% CI, 0.61-1.39 for knee and adjusted odds ratio 0.73; 95% CI, 0.56-0.95 for hip arthroplasty. Conclusions: In conclusion, aspirin was the most frequently administered individual antithrombotic agent in a large contemporary sample of U.S. patients undergoing knee or hip arthroplasty. Postoperative VTE prophylaxis with aspirin-only may be a safe option in this population and was not associated with a higher risk of postoperative VTE compared to anticoagulants.
Are scripts or deception necessary when repeated trials are used? On the social context of psychological experiments
Authors: Adam S. Goodie
Journal: Behavioral and Brain Sciences (2001)

Scripts and deception are alternative means, both imperfect, to the goal of simulating an environment that cannot be created readily. Under scripts, participants pretend they are in that environment, while deception convinces participants they are in that environment although they are not. With repeated trials, they ought to be unnecessary. But they are not, which poses challenges to behavioral sciences.
Abstract 181: Comparison of Defibrillation Efficacy Between Two Pads Placements in a Pediatric Pig Model of Cardiac Arrest
Authors: Yongqin Li, Tao Yu, Giuseppe Ristagno, Weilun Quan, Gary Freeman, Joe Bisera, Max H Weil, Wanchun Tang
Journal: Circulation (2010)

Background: Placement of defibrillation pads at ideal anatomical sites constitutes an integral aspect of optimal defibrillation. However, the optimal placements of pediatric pads are still undetermined. In the current study, we compared the effects of two different pads positions on defibrillation success rate in a pediatric pig model of cardiac arrest. Methods: Eight male pigs, 13.5±1.0 kg, were randomized to receive shocks using either anterior-anterior or anterior-posterior pads position. The ZOLL pediatric pads, pedi-padz II, were used in the study. For each animal, ventricular fibrillation (VF) was induced and untreated for 30 secs. A randomized 10, 20 30, 50 or 70 J biphasic electrical shock was then attempted. If the defibrillation failed to terminate VF, a 100 J rescuer shock was delivered. After a recovery interval of 5 mins, the sequence was repeated for a total of 30 test shocks for each animal, with 6 shocks for each of the energy settings. The dose response curves were constructed and the def...
Abstract 17097: Substantial Improvement of Primary Cardiovascular Prevention by a Systematic Score-based Multimodal and Lifestyle Approach: A Randomized Endpoint-Study - The Preford-Study
Authors: Hans Georg Predel, Detlef B Gysan, Christian Albus, Birna Bjarnason-Wehrens, Helmut Gohlke, Joachim Latsch, Stefanie Millentrup, Christian Heming, Gerd Herold
Journal: Circulation (2015)

Background: The optimization of primary preventive cardiovascular (CV) strategies is urgently needed. The objective of the present study was to evaluate the long-term effects of a standardized multimodal and lifestyle based therapeutic approach in high-risk-subjects according to the ESC-SCORE on predefined cardiovascular end-points. The ESC-SCORE allows a systematic estimation of the 10-year-risk for fatal CV events. Methods: The individual CV risk was assessed in a cohort of 4.196 employees of the Ford-Company, Germany, using the ESC-SCORE. Subjects were subsequently classified into three risk-groups. Subjects at high-risk, (ESC-SCORE ≥ 5%; n=447), were randomized either into a multimodal 15-week lifestyle based outpatient intervention program (INT n=224) or into a usual care group (UC n=223) and followed up for 36 months. The primary endpoint was a reduction of the ESC-SCORE in the INT as compared to the UC at the end of the trial. Secondary endpoints were a composite of fatal and non-fatal CV events (coronary artery disease, cerebrovascular or peripheral arterial disease, CV death and total mortality) and the time to the first CV event. An intention to treat analysis was performed. Results: After 36 months a difference of the ESC-SCORE development favoring the INT was achieved (INT: 8.70 to 10.03% vs. UC: 8.49 to 12.09%; p&lt;0.016). Moreover, a reduction in the composite secondary endpoint was observed (INT: n=11 vs. UC: n=27; p=0.032; HR 0.45 (CI 0.22 - 0.94). Conclusions: Our results demonstrate an intermediate-term improvement of the ESC-SCORE as well as a reduction of predefined CV endpoints by a primary CV prevention program within 36 months in a cohort of persons determined to be at high CV risk by assessment with the ESC-SCORE.
Christmas, national holidays, sport events, and time factors as triggers of acute myocardial infarction: SWEDEHEART observational study 1998-2013
Authors: Moman A Mohammad, Sofia Karlsson, Jonathan Haddad, Björn Cederberg, Tomas Jernberg, Bertil Lindahl, Ole Fröbert, Sasha Koul, David Erlinge
Journal: BMJ (2018)

Abstract Objectives To study circadian rhythm aspects, national holidays, and major sports events as triggers of myocardial infarction. Design Retrospective observational study using the nationwide coronary care unit registry, SWEDEHEART. Setting Sweden. Participants 283 014 cases of myocardial infarction reported to SWEDEHEART between 1998 and 2013. Symptom onset date was documented for all cases, and time to the nearest minute for 88%. Interventions Myocardial infarctions with symptom onset on Christmas/New Year, Easter, and Midsummer holiday were identified. Similarly, myocardial infarctions that occurred during a FIFA World Cup, UEFA European Championship, and winter and summer Olympic Games were identified. The two weeks before and after a holiday were set as a control period, and for sports events the control period was set to the same time one year before and after the tournament. Circadian and circaseptan analyses were performed with Sunday and 24:00 as the reference day and hour with which all other days and hours were compared. Incidence rate ratios were calculated using a count regression model. Main outcome measures Daily count of myocardial infarction. Results Christmas and Midsummer holidays were associated with a higher risk of myocardial infarction (incidence rate ratio 1.15, 95% confidence interval 1.12 to 1.19, P&lt;0.001, and 1.12, 1.07 to 1.18, P&lt;0.001, respectively). The highest associated risk was observed for Christmas Eve (1.37, 1.29 to 1.46, P&lt;0.001). No increased risk was observed during Easter holiday or sports events. A circaseptan and circadian variation in the risk of myocardial infarction was observed, with higher risk during early mornings and on Mondays. Results were more pronounced in patients aged over 75 and those with diabetes and a history of coronary artery disease. Conclusions In this nationwide real world study covering 16 years of hospital admissions for myocardial infarction with symptom onset documented to the nearest minute, Christmas, and Midsummer holidays were associated with higher risk of myocardial infarction, particularly in older and sicker patients, suggesting a role of external triggers in vulnerable individuals.
Systemic mastocytosis in adults: 2019 update on diagnosis, risk stratification and management
Authors: Animesh Pardanani
Journal: American Journal of Hematology (2018)

Abstract Overview Systemic mastocytosis (SM) results from a clonal proliferation of abnormal mast cells (MCs) in extra‐cutaneous organs. Diagnosis The major criterion is presence of multifocal clusters of abnormal MC in the bone marrow. Minor diagnostic criteria include elevated serum tryptase level, abnormal MC CD25 expression, and presence of KIT D816V mutation. Risk stratification Establishing SM subtype as per the World Health Organization classification system is an important first step. Broadly, patients either have indolent/smoldering SM (ISM/SSM) or advanced SM, the latter includes aggressive SM (ASM), SM with associated hematological neoplasm (SM‐AHN), and mast cell leukemia (MCL). Identification of poor‐risk mutations (ie, ASXL1, RUNX1, SRSF2, NRAS ) further refines the risk stratification. Recently, clinical and hybrid clinical‐molecular risk models have been developed to more accurately assign prognosis in SM patients. Management ISM patients have a normal life expectancy and treatment is generally limited to anaphylaxis prevention/symptom control/osteoporosis treatment. Patients with advanced SM frequently need MC cytoreductive therapy to ameliorate disease‐related organ dysfunction. High response rates have been seen with small‐molecule inhibitors that target mutant‐KIT, including midostaurin (Food and Drug Administration approved) or avapritinib (investigational). Other options for MC cytoreduction include cladribine or interferon‐α, although head‐to‐head comparisons are lacking. Treatment of SM‐AHN primarily targets the AHN component, if an aggressive disease such as acute myeloid leukemia is present. Allogeneic stem cell transplant can be considered in such patients, or in those with relapsed/refractory advanced SM. Imatinib has a limited therapeutic role in SM; effective cytoreduction is limited to those with imatinib‐sensitive KIT mutations.
Abstract 18819: Cardiac Fundc1 Ablation Protects Diabetic Cardiomyopathy
Authors: Shengnan Wu, Qiulun Lu, Yu Qiu, Ye Ding, Zejun Ma, Ming-Hui Zou, Zhonglin Xie
Journal: Circulation (2017)

Introduction: Defective mitochondrial function is considered to be a key mechanism underlying diabetic cardiomyopathy. FUN14 domain containing 1 (FUNDC1) is an outer mitochondrial membrane protein essential for mitochondrial dynamics and mitophagy. However, the roles of FUNDC1 in diabetic cardiomyopathy and mitochondrial dysfunction remain to be established. Hypothesis: The aims of this study were: 1) to determine the impacts of diabetes on FUNDC1 and mitochondria-associated endoplasmic reticulum (ER) membranes (MAMs) formation, and 2) if Fundc1 ablation ameliorates mitochondrial function and cardiomyopathy in vivo. Methods and Results: FUNDC1 protein expression, MAMs formation, mitochondrial function, and cardiac function were examined in a streptozotocin-induced mouse model and a genetic mouse model of type 1 diabetes. We found that FUNDC1 protein expression was significantly increased in the hearts of diabetic mice. Additionally, cardiac-specific deletion of Fundc1 in diabetic mice improved cardiac phe...
IFN-γ and CD25 drive distinct pathologic features during hemophagocytic lymphohistiocytosis
Authors: Stéphanie Humblet-Baron, Dean Franckaert, James Dooley, Fatima Ailal, Aziz Bousfiha, Caroline Deswarte, Carmen Oleaga-Quintas, Jean-Laurent Casanova, Jacinta Bustamante, Adrian Liston
Journal: Journal of Allergy and Clinical Immunology (2018)