tbuckley/cabot-search huggingface dataset:
Abstract P168: Vascular Stiffness in Young Men Subject to Presence of Chronic Decompensated Tonsillitis
Authors: Maria Evsevyeva, Mikhail Eremin, Elena Italyantseva, Vladimir Koshel
Journal: Circulation (2019)

The main role in atherosclerotic damage of the vascular wall is given now to the inflammatory process, the development of which is facilitated by a variety of risk factors (RF). Many of these factors begin to affect on the cardiovascular (CV) system in youth and even in childhood. Some authors refer to RF infectious-inflammatory diseases (IID), which were transferred earlier. The aim is to evaluate some parameters of vascular status in young people in the presence of such focal infection (FI) as chronic decompensated tonsillitis (CDT). Material and methods. Within the main group, 52 young patients aimed at performing surgery due to the presence of IID (age from 18 to 27 years) were examined. 76 persons of comparable sex, age and profile of the main RF without any IID were served as control. The control group was formed from the number of students according to the results of the annual preventive examination in the framework of the Federal Program "University of healthy lifestyle". Both groups were quite comparable in age, sex and profile of the main RF. In addition to the assessment RF-profile it was carried out the determination of indicators of the central pressure and vascular stiffness with the help of hardware-diagnostic complex BPLab ("Petr Telegin", Nizhny-Novgorod, Russia) with the use of programs set Vasotens Office. This program involves an in-depth contour analysis of the properties of pulse waves at the level of both the aorta and peripheral arteries. Statistical processing was carried out using the software "Statistica 10.0" (StatSoft Inc, USA). Results: It was found that in the main group compared with the control group, the pulse wave propagation velocity in the aorta PWVao equal to 10.61±0.25 versus 9.73±0.15 m/s (p=0.004), the augmentation index in the aorta AIxao was 3.88±0.31 versus -1.04±0.08%. In discussing two groups augmentation index in the brachial artery AIx made up of 32.15±2,70 against -48,89±1,52% (p=0.05), arterial augmentation index, AIx normalized to heart rate heart rate was equal to -35,23±vs -49,67 of 5.39±2.56%. In this case, the values of both peripheral and aortic SBP, DBP, Medium BP and Puls BP in patients with DHT were slightly lower than in persons of the control group. Conclusion: The data of the youth study of the dense-elastic vascular potential in different parts of the arterial bed showed a marked increase in vascular rigidity from both the peripheral arteries and the aorta in presence of CDT. In this case, aortic remodeling was more pronounced. It is useful to consider these findings in process of planning and implementing individualized prevention programmes among young people, taking into account the availability of FI.
Can curcumin induces selective packaging of miRNAs in exosomes? A pilot study in chronic myelogenous leukemia cells.
Authors: Christian Diego Rolfo, Simona Taverna, Marco Giallombardo, Mariano Provencio, Jorge Jorge Chacartegui, Marc Peeters, Patrick Pauwels, Riccardo Alessandro
Journal: Journal of Clinical Oncology (2015)

e13563 Background: Chronic myeloid leukemia is a myeloproliferative disorder that comes from a hematopoietic stem cell or a multipotent progenitor. Exosomes are biological nanovescicles (40-100 nm) able to modulate intercellular communication and tumour microenvironment; they also contain miRNAs that can influence gene expression in target cells. OncomiRNAs, such as miR-21, are often increased in cancer. Some observation indicate a possible cellular disposal of miRNAs by exosomes. Curcumin affects the expression of microRNAs in CML cells and according to our data may play a role in this process. Methods: Exosomes were collected by K562 and LAMA84 conditioned medium by ultracentrifugation. CML cells were treated with Curcumin. To study the anticancer effects of curcumin, in vitro, were assessed miR-21 expression, PTEN, and VEGF mRNA expression by Real time PCR; RNU6-2 was used as endogenous control and the fold change was calculated according the formula 2-ΔΔCq. VEGF secretion and pAKT were evaluated by ELISA. Anticancer effects of Curcumin, in vivo, were evaluated with a xenograft CML tumor model. Results: Nanovesicles of CML cells treated with curcumin were characterized by dimensional and biochemical methods. DLS-analyses indicated that isolated exosomes had an average size of 80 nm and contained Alix and TSG-101. Curcumin treatment caused miR-21 decrease in CML cells, but a greater amount was observed in exosomes. In order to prove that decreasing miR-21 was determined by a selective enrichment of this miRNA in CML exosomes, we treated CML cells with GW4869, an inhibitor of exosome release. GW4869 treatment induced an increase of miR-21 in CML cells compared with curcumin-treated cells. The addition of Curcumin, to CML cells, caused a dose-dependent increase in PTEN, target of miR-21, at mRNA and protein level. Curcumin treatment decreased AKT phosphorylation and VEGF expression. The effects of Curcumin on a xenograft CML tumor model, confirmed the in vitro results and the anticancer effects of curcumin. Conclusions: Our data suggest that Curcumin caused a decrease of miR-21 in CML cells through a selective packaging of miR-21 in exosomes. A potential role of curcumin as a new drug could be feasible.
Abstract P418: Association of Cardiometabolic Risk Factors on Left Ventricular Hypertrophy and Diastolic Dysfunction in Mexican Americans
Authors: Miryoung Lee, Neha M Paul, Susan P Fisher-Hoch, Joseph B McCormick, Susan T Laing
Journal: Circulation (2019)

Left ventricular diastolic dysfunction (LVDD) and left ventricular hypertrophy (LVH) are key components of clinical diastolic heart failure, and are associated with obesity, hypertension and diabetes mellitus (DM), which are highly prevalent in Mexican Americans. Our study aim was to determine the prevalence of subclinical left ventricular abnormalities (LVH and LVDD) and how cardiometabolic risk is associated with them in a sample of Mexican Americans in south Texas. Methods: Demographic, metabolic biomarkers, and body composition data were obtained in 591 participants (66.2% females, mean age 54.0±1.1 years) from a community-based Cameron County Hispanic Cohort study. LVH and LVDD were evaluated from echocardiography using national guidelines. Abdominal adiposity was determined by waist circumference (WC) or abdominal visceral fat mass (VAT) from dual energy X-ray absorptiometry. Weighted ordinal logistic regression analyses were conducted comparing individual (LVH only or LVDD only) or joint (LVH and LVDD both) outcome groups to normal groups while adjusting for demographic and clinical covariates. Results: Weighted prevalence rates of obesity (45.4%), DM (29.5%), hypertension (49.6%), LVH (31.0%) and LVDD (21.3%) were high in the sample studied. BMI (p=0.03) and WC (p&lt;0.01), but not VAT, were significantly related to LV abnormalities in models adjusted for age and gender. WC, but not BMI, was statistically significant (p&lt;0.01) in models further adjusted for cardiometabolic conditions. WC was related to higher odds of having LVH [OR=1.03 (1.01, 1.05)]. Having high cholesterol was associated with having LVH and LVDD jointly [OR=2.5 (1.2, 5.2)]. Hypertension was robustly associated with LVDD (p&lt;0.05). Participants who were hypertensive were 2.3 times (95%CI 1.1-4.9) more likely to have LVDD than normotensive subjects. Conclusion: There is a high prevalence of Stage B heart failure among Mexican Americans with 39% showing LVDD and/or LVH. This study presents evidence of independent differential relationships of abdominal adiposity, dyslipidemia, and hypertension on LVH and LVDD in this asymptomatic Mexican American cohort. Targeted intervention strategies to control individual cardiometabolic risk factors is important to prevent early cardiac abnormalities.
Correlation of myeloid-derived suppressor cells (MDSC) with pathologic complete response (pCR), recurrence free survival (RFS), and overall survival (OS) in patients with urothelial carcinoma (UC) undergoing cystectomy.
Authors: Jaleh Fallah, C. Marcela Diaz-Montero, Patricia A. Rayman, Wei (Auston) Wei, Iris Yeong- Fung Sheng, James Finke, Jin Sub Kim, Paul G. Pavicic, Priscilla Dann, Donna Company, Andrew J. Stephenson, Steven Campbell, Georges-Pascal Haber, Byron H Lee, Omar Y. Mian, Timothy D. Gilligan, Brian I. Rini, Jorge A. Garcia, Petros Grivas, Moshe Chaim Ornstein
Journal: Journal of Clinical Oncology (2019)

437 Background: MDSCs play an important role in maintaining a tumor immunosuppressive microenvironment. The association of circulating levels of MDSCs with pCR (pT0N0) and outcomes was investigated in patients (pts) with non-metastatic UC undergoing cystectomy. Methods: Peripheral blood samples from pts with non-metastatic UC was collected. MDSCs were measured in freshly purified peripheral blood mononuclear cells, using flow cytometry. Total (T) MDSC was defined as CD33+/HLADR-. T-MDSC subtypes were polymorphonuclear (PMN-MDSC: CD15+/CD14-), monocytic (M-MDSC: CD15-/CD14+], and uncommitted (UC-MDSC: CD15-/CD14-]. MDSC populations were presented as % of live nucleated blood cells. Wilcoxon rank sum test was used to compare MDSCs between pCR groups. Kaplan-Meier and log-rank test were used to analyze RFS and OS. Results: MDSC data were available for 124 pts (106 male, 18 female), median age 68, 28 (23%) never smokers, 93 (75%) pure UC. Thirty four pts (27%) received intravesical BCG; 49 (39%) received neoadjuvant chemotherapy (NAC); 22 (19%) had pCR (pT0N0) following surgery. PMN-MDSC was the dominant subtype (42%) and frequency of UC-MDSC and M-MDSC was 40% and 17%, respectively. Circulating levels of T-MDSC and PMN-MDSC were significantly lower in pCR patients than those in non-pCR patients (Table). Sixteen deaths were observed and 21 pts recurred after surgery. The median follow-up time of patients alive was 18.7 months (range 0.3-42.4). The median OS or RFS of all patients was not reached. One-year and two-year OS rates were 94% and 83%, respectively. One-year and two-year RFS rates were 82% and 69%, respectively. There was no association between MDSC subtypes with OS or RFS. Conclusions: Total- and PMN-MDSC subtypes in blood were significantly correlated with pCR in pts with non-metastatic UC who undergo cystectomy. The relatively short follow-up may impact the association with RFS and OS; additional follow-up is needed. [Table: see text]
Genetic counseling rates for high risk breast cancer patients in Eastern North Carolina.
Authors: Jessica R. Hildebrand, Nasreen A. Vohra, Jan H. Wong, Allyson Meyer, Mahvish Muzaffar
Journal: Journal of Clinical Oncology (2015)

e12504 Background: National guidelines recommend referral of individuals at increased risk of hereditary cancer syndrome for genetic counseling (GC). GC effectively delivers complex information and facilitates informed decision making for prevention, early detection, and treatment. Eastern North Carolina lags socioeconomically, has a higher African American (AA) population, and has a triple negative breast cancer (TNBC) rate of approximately 30% compared with national average of 15-20%. We sought to evaluate our current GC system at Leo Jenkins Cancer Center (LJCC) in order to improve our referral and genetic testing rates for this high risk population. Methods: We performed a chart review of patients diagnosed with breast cancer at LJCC between 2010 and 2014. Patients who qualified for GC based on current guidelines were identified. We then determined if patients were appropriately referred for GC and tested if applicable. Descriptive analysis was performed. Results: 671 patients were diagnosed with breast cancer between 2010 and 2014. 262 (39%) patients qualified for GC referral. 52% of patients who qualified for counseling had TNBC. More AA qualified for genetic counseling than individuals from other races 56% (p = 0.001). 62% of patients with TNBC were AA (p = 0.001). Only 58% of qualified patients were referred for counseling, and of those referred, 64 % were tested. There was not a significant difference in referral rate or testing according to race. Reasons cited for not obtaining genetic testing included: patient declined (14%), patient failed to keep appointment (14%), and financial obstacle (43%). Conclusions: Not all patients who meet criteria for GC are actually referred by providers. Additionally, a substantial number of patients who undergo GC do not get tested. Socioeconomic factors are the most common obstacles to testing. We plan to develop an effective intervention to improve our referral and testing rates as part of this ongoing quality improvement project.
Levels of Evidence Supporting American College of Cardiology/American Heart Association and European Society of Cardiology Guidelines, 2008-2018
Authors: Alexander C. Fanaroff, Robert M. Califf, Stephan Windecker, Sidney C. Smith, Renato D. Lopes
Journal: JAMA (2019)

Clinical decisions are ideally based on evidence generated from multiple randomized controlled trials (RCTs) evaluating clinical outcomes, but historically, few clinical guideline recommendations have been based entirely on this type of evidence.
The association between hospitals’ risk-adjusted emergency department visits and survival and costs in kidney cancer patients.
Authors: Joel E Segel, Eric W. Schaefer, Jay D. Raman, Christopher S. Hollenbeak
Journal: Journal of Clinical Oncology (2019)

609 Background: As payers turn to alternative payment models, including the CMS Oncology Care Model, risk-adjusted emergency department (ED) visits are being incorporated as a quality. Yet little is know about this metric compares to existing metrics such as risk-adjusted mortality rates and costs. Methods: Using 2007-2012 SEER-Medicare data, we used logistic regression to model occurrence of an ED visit within 30 and 365 days for all kidney cancer patients receiving initial surgery. Our model controlled for demographics, stage, histology, systemic targeted therapy, and comorbidities. Based on model predictions, we created a ratio of actual versus predicted ED visits for hospitals to identify hospitals with higher and lower than predicted ED visit rates. We estimated the association between the hospitals’ ED visit ratio and hospitals’ risk-adjusted 365-day mortality rates, and 6- and 12-month total costs and total costs (less ED visits). Results: In our sample of 6,078 patients, 15.5% had an ED visit within 30 days of surgery and 43.5% within 365 days. For hospitals with ≥10 patients, we found no statistically significant association between 30-day or 365-day risk-adjusted ED visit rate and their 365-day risk-adjusted mortality rate. While hospitals’ 30-day ED visit rates were significantly associated with 6- and 12-month costs, the association was largely driven by the cost of the ED visit itself. Conversely, hospitals’ 365-day ED visit rates were significantly associated with 12-month costs after excluding the cost of the ED visit. Conclusions: Our results suggest hospitals’ risk-adjusted ED visit rates capture a qualitatively different measure of quality than the more commonly reported mortality rates and is significantly associated with patient cost.
Associations of rurality and disease outcomes in urologic malignancies.
Authors: Alejandro Abello, Marianne Casilla-Lennon, Patrick Aloysius Kenney, Michael Leapman
Journal: Journal of Clinical Oncology (2019)

661 Background: Patients residing in rural regions have comparatively worse outcomes for many cancers. However there is less known about treatment and outcome for patients with urologic cancers. The objective of this study is to evaluate differences in treatments and outcomes among patients with urologic malignancies when coming from rural compared to metropolitan communities using national, population-level data. Methods: We queried the Surveillance, Epidemiology and End-Results database to identify patients with urological cancers from 1973 to 2015. We compiled patient clinical, demographic, and outcome data, including rurality at the county level. Rural counties is defined as those with &gt; 50% population living in rural areas. We evaluated the association of rurality with treatment received and cancer-specific death using Cox proportional hazard models. Results: We identified 989,239 patients including those with Kidney (112,477) Bladder (208,230), Prostate (637,005), and Testis cancer (28,527). Among all, 898,050 (90.4%) were male and 64,992 (6.55%) lived in rural counties. Overall, rural patients were older at cancer diagnosis (mean 70 ± 12.1 vs 67.41 ± 12.7) and more frequently of white race (97.1% vs 82.46%) vs urban counterpart. Patients residing in rural counties were less likely to undergo definitive treatment with surgery for stage 1 or stage 2 disease P &lt; 0.001). In multivariable regression, rural status was associated with greater risk of cancer-specific death in kidney cancer (HR: 1.1, 95% CI: 1.02-1.24; P: 0.03) but was not seen in other cancers. Based on % of rurality, adjusted kidney cancer-specific death increased among most rural populations: 15% rurality or more (HR: 1.16, 95% CI: 1.05-1.27; P: 0.03), 40% rurality or more (HR: 1.31, 95% CI: 1.15-1.49; P &lt; 0.001) and 70% or more (HR: 1.32, 95% CI: 1.05-1.67; P: 0.01). Conclusions: There are notable differences in cancer incidence, treatment and outcome for patients residing in rural areas. Rural status was associated with poorer cancer-specific survival for kidney cancer but was not seen in other genitourinary malignancies, independent of stage at diagnosis and treatment received. Further research is warranted to understand the factors underlying these differences in outcome.
FRI0110 Bowel perforation in systemic lupus erithematosus
Authors: ME Pombo, L Diez, JI Bernardino, F García, M Mora, P Lavilla, A Gil
Journal: Annals of the Rheumatic Diseases (2001)

<h3>Background</h3> <h3>Objectives</h3> Bowel perforation is a rare but serious complication in SLE. Although several processes not related to SLE (diverticulitis, tumours) may be the cause of this complication, it has been previously considered to be associated to small-vessel vasculitis in active lupus disease. Nowadays, a vascular damage induced by antiphospholipid antibodies (aPL) and steroids seems to play an important role. <h3>Methods</h3> Seven patients with intestinal perforation were observed in 220 SLE patients during a period of 26 years (1974–2000). In all cases, the diagnosis of intestinal perforation was confirmed by surgery or autopsy and pathological examination. <h3>Results</h3> All patients were females, with a mean age at the diagnoses of bowel perforation of 45 years, and a mean time of SLE evolution of 13 years. The site of perforation was in the colon in 4 patients and in the small bowel in the other 3. Six patients had lupus nephropathy, one of them with renal transplantation. Central nervous system and cutaneous involvement was observed in 4 patients and Sjögren's syndrome, Libman-Sachs endocarditis and haemolytic anaemia in two patients. aPL were present in 5 patients. All patients were on steroid therapy at the moment of the intestinal perforation. Abdominal pain was present in all cases but the mean time of diagnosis delay was 11 days. Two patients died from peritonitis and septic shock. A local cause of perforation was found in four patients: diverticulitis (3) and adenocarcinoma of the rectum (1). Necrotizing vasculitis was not observed in any case of pathological examinations. <h3>Conclusion</h3> Bowel perforation, although uncommon in SLE, has to be taken into account as a differential diagnosis in a patient with abdominal pain. Disease severity, antiphospholipid antibodies and previous steroid therapy are important risk factors for this complication.
Response by Siontis et al to Letter Regarding Article, “Outcomes Associated With Apixaban Use in Patients With End-Stage Kidney Disease and Atrial Fibrillation in the United States”
Authors: Konstantinos C. Siontis, Xiaosong Zhang, Douglas E. Schaubel, Xiaoxi Yao, Peter A. Noseworthy, Nilay D. Shah, Rajiv Saran, Brahmajee K. Nallamothu
Journal: Circulation (2019)
Prevalence of cancer-related pain in different tumor entities: ATLAS Study in Spanish oncology units.
Authors: Manuel Constenla, Francisco Cevas, Luis Cabezón Gutierrez, Berta Maria Jiménez, Vicente Alonso, Sergio Vazquez-Estevez, Noemí Villanueva, Jesus Garcia Mata, Javier Ballesteros, Eduardo Triguboff
Journal: Journal of Clinical Oncology (2015)

e12609 Background: There are numerous surveys on prevalence of cancer-related pain. However, given the limitation of small patient samples, results are not strong enough to determine pain prevalence in uncommon tumors. The primary objective of the ATLAS study was therefore to collect data needed to assess the prevalence of cancer-related pain in all different tumor entities. A second aim was to determine the patient satisfaction with the analgesic treatment. Methods: Non-interventional, post-authorization, observational study, with an initial screening period for up to one month, performed by 35 investigators in Spanish oncology units. During the screening period, data assessing primary tumor location, presence of metastases and pain, pain intensity as well as step in the analgesic ladder was collected from a consecutive sample of oncology patients. Results: 5,166 patients with solid tumors were screened. Main results are shown in the table, which reflects the pain prevalence in a wide range of tumors. The most frequent cancer types, colorectal (24.7%), breast (16.6%) and lung (16.4%) reported less pain prevalence, and less common tumors reported a higher pain incidence such as nasopharyngeal (64.5%), lip and oral cavity (46.7%) and vesicle (46.2%) cancer. It is also to highlight that, when present, cancer pain is moderate to severe, as it occurs in cancers such as melanoma, larynx, pharynx, kidney, liver, lip and oral cavity with a frequency > 60%. Among the most common cancer types, the highest prevalence of pain was reported in lung cancer (49.9%) with 57.7% of cases with moderate to severe pain. Additionally, only 68.6% of patients with moderate to severe pain were treated with opioids. Conclusions: This study allowed to quantify the prevalence of pain and its intensity in less frequent tumors, identifying high pain rates ( > 45%) in nasopharyngeal, vesicle, and lip and oral cavity cancers. Among the most common tumor types, lung cancer is the most painful. Furthermore, more than 30% of patients were receiving inappropriate opioid therapy according to their reported pain intensity and prescribed treatment.