tbuckley/cabot-search huggingface dataset:
Effects of Serelaxin in Patients with Acute Heart Failure
Authors: Marco Metra, John R. Teerlink, Gad Cotter, Beth A. Davison, G. Michael Felker, Gerasimos Filippatos, Barry H. Greenberg, Peter S. Pang, Piotr Ponikowski, Adriaan A. Voors, Kirkwood F. Adams, Stefan D. Anker, Alexandra Arias-Mendoza, Patricio Avendaño, Fernando Bacal, Michael Böhm, Guillermo Bortman, John G.F. Cleland, Alain Cohen-Solal, Maria G. Crespo-Leiro, Maria Dorobantu, Luis E. Echeverría, Roberto Ferrari, Sorel Goland, Eva Goncalvesová, Assen Goudev, Lars Køber, Juan Lema-Osores, Phillip D. Levy, Kenneth McDonald, Pravin Manga, Béla Merkely, Christian Mueller, Burkert Pieske, Jose Silva-Cardoso, Jindřich Špinar, Iain Squire, Janina Stępińska, Walter Van Mieghem, Dirk von Lewinski, Gerhard Wikström, Mehmet B. Yilmaz, Nicole Hagner, Thomas Holbro, Tsushung A. Hua, Shalini V. Sabarwal, Thomas Severin, Peter Szecsödy, Claudio Gimpelewicz
Journal: New England Journal of Medicine (2019)

Serelaxin is a recombinant form of human relaxin-2, a vasodilator hormone that contributes to cardiovascular and renal adaptations during pregnancy. Previous studies have suggested that treatment with serelaxin may result in relief of symptoms and in better outcomes in patients with acute heart failure.In this multicenter, double-blind, placebo-controlled, event-driven trial, we enrolled patients who were hospitalized for acute heart failure and had dyspnea, vascular congestion on chest radiography, increased plasma concentrations of natriuretic peptides, mild-to-moderate renal insufficiency, and a systolic blood pressure of at least 125 mm Hg, and we randomly assigned them within 16 hours after presentation to receive either a 48-hour intravenous infusion of serelaxin (30 μg per kilogram of body weight per day) or placebo, in addition to standard care. The two primary end points were death from cardiovascular causes at 180 days and worsening heart failure at 5 days.A total of 6545 patients were included in the intention-to-treat analysis. At day 180, death from cardiovascular causes had occurred in 285 of the 3274 patients (8.7%) in the serelaxin group and in 290 of the 3271 patients (8.9%) in the placebo group (hazard ratio, 0.98; 95% confidence interval [CI], 0.83 to 1.15; P = 0.77). At day 5, worsening heart failure had occurred in 227 patients (6.9%) in the serelaxin group and in 252 (7.7%) in the placebo group (hazard ratio, 0.89; 95% CI, 0.75 to 1.07; P = 0.19). There were no significant differences between the groups in the incidence of death from any cause at 180 days, the incidence of death from cardiovascular causes or rehospitalization for heart failure or renal failure at 180 days, or the length of the index hospital stay. The incidence of adverse events was similar in the two groups.In this trial involving patients who were hospitalized for acute heart failure, an infusion of serelaxin did not result in a lower incidence of death from cardiovascular causes at 180 days or worsening heart failure at 5 days than placebo. (Funded by Novartis Pharma; RELAX-AHF-2 ClinicalTrials.gov number, NCT01870778.).
The higher school of oncology: An educational program adopting the western oncology experience in Russia.
Authors: Ekaterina Baron, Michelle Sittig, Vadim Gushchin
Journal: Journal of Clinical Oncology (2019)

10512 Background: Disparities in current global oncology care are a major concern for many societies. Two-year oncological training in Russia is deficient in evidence-based medicine (EBM) and effective patient communication skills, despite the fact that these dictate the ability to provide optimal cancer care. We report a 3.5-year sustained program aimed at implementing Western-oriented education among young Russian oncologists to combat these educational deficiencies. Methods: The Higher School of Oncology (HSO) is a 5-year national competitive program established to supplement the traditional 2-year Russian oncology curriculum with an emphasis on patient communication, critical appraisal of oncologic articles, multidisciplinary cancer care, and program development. A total of 35 PGY1-4 residents (8-9 residents annually) have enrolled in the program. Expatriate Russian physicians practicing in the US led 140 online educational seminars with journal clubs and clinical case presentations. Communication skills were evaluated by an independent private educational group. Results: Significant improvement of EBM knowledge was marked among HSO residents, from inability to explain basic concepts to practicing and teaching EBM. Beginning in the 3rd year of the program, residents organized educational courses and conducted journal clubs for HSO and non-HSO colleagues. Residents of the program had higher patient communication scores compared to that of residents of standard Russian programs. HSO residents promoted the spread and popularization of EBM and a patient-centered approach among attending physicians, improving the quality of cancer care. The HSO also triggered imitation of similar projects in other residency programs. Conclusions: The HSO project has pioneered EBM training and led to systemic changes in cancer patient care for Russian oncologists. This model has shown success and may be useful in overcoming global medical educational disparities in other specialties and in other countries facing similar challenges.
The Impact of Diabetes Mellitus As Comorbid Condition, in Patients with Lower-Risk Myelodysplastic Syndromes (MDS)— a Study of the European Leukemianet-Based MDS (EUMDS) Registry
Authors: Argiris Symeonidis, Ge Yu, Alexandra Smith, Pierre Fenaux, Moshe Mittelman, Reinhard Stauder, Guillermo Sanz, Jaroslav Cermak, Eva Hellstrom-Lindberg, Luca Malcovati, Saskia Langemeijer, Ulrich Germing, Krzysztof Madry, Mette Skov Holm, Aurelia Tatic, Antonio Medina de Almeida, Aleksandar Savic, Njetocka Gredelj Simec, Agnes Guerci-Bresler, Jackie Droste, T. M. M de Witte, David T. Bowen
Journal: Blood (2017)
Abstract 16748: Induction of Hypercholesterolemia and Atherosclerosis in Mice by Adeno-Associated Viral Vectors Encoding the PCSK9 Gene
Authors: Martin M Bjoerklund, Anne K Hollensen, Frederik Dagnaes-Hansen, Jacob G Mikkelsen, Jacob F Bentzon
Journal: Circulation (2013)

Background: Induction of advanced atherosclerosis in small animals has mostly been achieved in germline genetically modified mice, such as apolipoprotein E or LDL receptor deficient mice. However, ...
Apoptotic disseminated tumor cells reflect response to primary chemotherapy in breast cancer
Authors: T. N. Fehm, S. Becker, D. Wallwiener, G. Gebauer, E. Solomayer
Journal: Journal of Clinical Oncology (2006)

654 Background: Primary chemotherapy (pCHT) is an established method to reduce tumor size (downstaging) in breast cancer patients before performing breast conserving therapy. The consequences of pCHT on tumor cell dissemination in these patients are not known. The aim of this study was to investigate (1) the incidence of disseminated tumor cells (DTC) including apoptotic DTC in patients with breast cancer after primary chemotherapy and (2) its correlation with pathological therapy response. Methods: Bone marrow aspiration was performed in 157 patients after primary chemotherapy. Cytokeratin-positive cells were detected by immunocytochemistry using the AB45-B/B3 anti-cytokeratin antibody. For detection of apoptotic tumor cells the antibody M30 (Roche Diagnostics, Germany) was used. M30 reacts with a neo-epitope expressed only after caspase cleavage of CK 18 during early apoptosis. Results: The incidence of disseminated tumor cells in breast cancer patients was 57% (84 of 157 pts) after completion of primary systemic therapy. Tumor dissemination was observed more frequently in patients with no change/progressive disease (NC+PD: 63%) than in those who showed partial (PR) or complete remission (CR) of the primary tumor (PR+CR: 43%) (p&lt;0.05). However, 9 of 23 (40%) patients with complete response were still bone marrow positive. Apoptotic tumor cells were present in 36 of 157 (23%) breast cancer patients. The positivity rate of apoptotic cells was higher in bone marrow positive patients with PR or CR (42%) compared to those with stable disease (SD) (26%). No apoptotic tumor cells were detected in patients with tumor progression (n=5). Conclusions: The pathological therapy response is reflected by the presence of apoptotic tumor cells in the bone marrow of breast cancer patients. However, patients with complete response may still have non apoptotic disseminated tumor cells. Patients with tumor cell dissemination after primary systemic therapy may be benefit from additional secondary adjuvant treatment (e.g. bisphosphonates, antibody based strategies). No significant financial relationships to disclose.
Myocardial Viability and Long-Term Outcomes in Ischemic Cardiomyopathy
Authors: Julio A. Panza, Alicia M. Ellis, Hussein R. Al-Khalidi, Thomas A. Holly, Daniel S. Berman, Jae K. Oh, Gerald M. Pohost, George Sopko, Lukasz Chrzanowski, Daniel B. Mark, Tomasz Kukulski, Liliana E. Favaloro, Gerald Maurer, Pedro S. Farsky, Ru-San Tan, Federico M. Asch, Eric J. Velazquez, Jean L. Rouleau, Kerry L. Lee, Robert O. Bonow
Journal: New England Journal of Medicine (2019)

The role of assessment of myocardial viability in identifying patients with ischemic cardiomyopathy who might benefit from surgical revascularization remains controversial. Furthermore, although improvement in left ventricular function is one of the goals of revascularization, its relationship to subsequent outcomes is unclear.Among 601 patients who had coronary artery disease that was amenable to coronary-artery bypass grafting (CABG) and who had a left ventricular ejection fraction of 35% or lower, we prospectively assessed myocardial viability using single-photon-emission computed tomography, dobutamine echocardiography, or both. Patients were randomly assigned to undergo CABG and receive medical therapy or to receive medical therapy alone. Left ventricular ejection fraction was measured at baseline and after 4 months of follow-up in 318 patients. The primary end point was death from any cause. The median duration of follow-up was 10.4 years.CABG plus medical therapy was associated with a lower incidence of death from any cause than medical therapy alone (182 deaths among 298 patients in the CABG group vs. 209 deaths among 303 patients in the medical-therapy group; adjusted hazard ratio, 0.73; 95% confidence interval, 0.60 to 0.90). However, no significant interaction was observed between the presence or absence of myocardial viability and the beneficial effect of CABG plus medical therapy over medical therapy alone (P = 0.34 for interaction). An increase in left ventricular ejection fraction was observed only among patients with myocardial viability, irrespective of treatment assignment. There was no association between changes in left ventricular ejection fraction and subsequent death.The findings of this study do not support the concept that myocardial viability is associated with a long-term benefit of CABG in patients with ischemic cardiomyopathy. The presence of viable myocardium was associated with improvement in left ventricular systolic function, irrespective of treatment, but such improvement was not related to long-term survival. (Funded by the National Institutes of Health; STICH ClinicalTrials.gov number, NCT00023595.).
Epidemiology of tuberculosis among children and adolescents in the USA, 2007–17: an analysis of national surveillance data
Authors: Tori L Cowger, Jonathan M Wortham, Deron C Burton
Journal: The Lancet Public Health (2019)

Understanding tuberculosis epidemiology among children and adolescents informs treatment and prevention efforts, and efforts to eliminate disparities in tuberculosis incidence and mortality. We sought to describe the epidemiology of children and adolescents with tuberculosis disease in the USA, including tuberculosis incidence rates by parental country of birth and for US territories and freely associated states, which have not been previously described.We analysed data for children aged younger than 15 years and adolescents aged 15-17 years with tuberculosis disease reported to the National Tuberculosis Surveillance System during 2007-17, and calculated tuberculosis incidence rates using population estimates from the US Census Bureau.During 2010-17, 6072 tuberculosis cases occurred among children and adolescents; of these, 5175 (85%) of 6072 occurred in the 50 US states or the District of Columbia and 897 (15%) of 6072 in US-affiliated islands. In US states, 3520 (68%) of 5175 cases occurred among US-born people overall, including 2977 (76%) of 3896 children and 543 (42%) of 1279 adolescents. The incidence rate among children and adolescents was 1·0 per 100 000 person-years during 2007-17 and declined 47·8% (95% CI -51·4 to -44·1) during this period. We observed disproportionately high tuberculosis rates among children and adolescents of all non-white racial or ethnic groups, people living in US-affiliated islands, and children born in or with parents from tuberculosis-endemic countries.Overall, tuberculosis incidence among children and adolescents in the USA is low and steadily declining, but additional efforts are needed to eliminate disparities in incidence and mortality.US Centers for Disease Control and Prevention.
FRI0249 Correlation between serum muscle enzymes, muscle weakness and muscle pathology in patients with polymyositis
Authors: W Louthrenoo, N Weerayutwattana, N Lertprasertsuke, W Sukitawut
Journal: Annals of the Rheumatic Diseases (2001)

<h3>Background</h3> Polymyositis (PM) is a chronic inflammatory myopathy of unclear aetiology. Clinical features of PM have been well described, but the study of the correlation between serum muscle enzymes, muscle weakness and muscle pathology is limited. <h3>Objectives</h3> We reported the clinical correlation between serum muscle enzymes, muscle weakness and muscle pathology in Thai patients with PM. <h3>Methods</h3> A retrospective chart review was carried out in patients with PM, age &gt;16, who had muscle biopsy available for review, and seen during January 1986 – December 1999. The diagnosis of PM followed Bohan and Peter's criteria. The degree of muscle weakness was graded 0–5. The degree of muscle inflammation was scored 0–4 (0%, 1–10%, 11–25%, 26–50% and &gt;50% of inflammatory cell infiltration, respectively), and the degree of muscle destruction was scored 0–4 (0%, 1–10%, 11–25%, 26–50% and &gt;50% of muscle fibre destruction respectively). Serum muscle enzymes including CPK, LDH and AST, which determined within 7 days prior to muscle biopsy, were used for analysis. <h3>Results</h3> Of 163 patients, 123 had muscle biopsy performed. Only 102 specimens were available for review, of which 2 that showed granulomatous myositis were excluded due to the possibility of tuberculous myositis. Therefore, 100 charts were included for analysis. There were 22 males and 78 females, with their mean ± SD age and duration of disease of 45.0 ± 13.9 years and 6.3 ± 13.4 months, respectively. The clinical diagnoses were idiopathic PM in 37 cases, idiopathic dermatomyositis in 13, myositis associated with malignancy in 5, and PM associated with connective tissue disease in 45 (SLE in 16 cases, scleroderma in 22, MCTD in 6, and PAN in 1). The mean ± SD scores of proximal muscle weakness, muscle inflammation and destruction were 3.2 ± 0.8, 1.5 ± 1.6 and 2.2 ± 1.7, respectively. Serum muscle enzymes including CPK, LDH and AST were elevated in 87%, 92% and 82%, respectively, with a mean ± SD level of 2,352 ± 3,239 U/L, 750 ± 420 U/L and 196 ± 193 U/L, respectively. Seventy-six percent had abnormal EMG findings that were compatible with myositis. There was a good correlation between the level of serum muscle enzymes and the degree of muscle inflammation and destruction (p &lt; 0.02). The degree of weakness correlated well with the degree of muscle inflammation and destruction (p &lt; 0.05 and &lt;0.01, respectively). There was no significant correlation between ESR and serum muscle enzymes, muscle weakness or muscle pathology. Patients with idiopathic PM had more severe muscle pathology than patients with PM associated with connective tissue disease. <h3>Conclusion</h3> Serum muscle enzymes showed a good correlation with muscle pathology. The degree of muscle weakness correlated well with the degree of muscle destruction. ESR had a limited value in patients with PM.
Targeting integrins for cancer management using nanotherapeutic approaches: Recent advances and challenges
Authors: Khurshid Ahmad, Eun Ju Lee, Sibhghatulla Shaikh, Anuj Kumar, Kummara Madhusudana Rao, So-Yong Park, Jun O Jin, Sung Soo Han, Inho Choi
Journal: Seminars in Cancer Biology (2019)
Aspirin before fecal immunochemical testing did not increase sensitivity for detecting advanced colorectal neoplasms
Authors: Robert H. Fletcher
Journal: Annals of Internal Medicine (2019)

Source Citation Brenner H, Calderazzo S, Seufferlein T, et al. Effect of a single aspirin dose prior to fecal immunochemical testing on test sensitivity for detecting advanced colorectal neoplasms: a randomized clinical trial. JAMA. 2019;321:1686-92. 31063574
Annals Graphic Medicine - Progress Notes: 24-Hour Call
Authors: Michael Natter
Journal: Annals of Internal Medicine (2019)

Web Exclusives20 August 2019Annals Graphic Medicine - Progress Notes: 24-Hour CallFREEMichael Natter, MDMichael Natter, MDNYU School of Medicine, New York, New York (M.N.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/G19-0051 SectionsAboutVisual AbstractPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Download figure Download PowerPoint Comments0 CommentsSign In to Submit A Comment Author, Article, and Disclosure InformationAffiliations: NYU School of Medicine, New York, New York (M.N.)Disclosures: The author has disclosed no conflicts of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=G19-0002.Author/Illustrator Information: Michael Natter, MD, is a current internal medicine resident at NYU School of Medicine and a graduate of Sidney Kimmel Medical College of Thomas Jefferson University in Philadelphia. His artwork is inspired by his medical training, patient encounters, and the human condition. A type 1 diabetic, Dr. Natter views himself as a patient as well as a doctor and plans to pursue a fellowship in endocrinology to help others who also share his disease. You can find more of his illustrations, stories, and comics on Instagram (www.instagram.com/mike.natter) and Twitter (@mike_natter).About Progress Notes: Progress Notes explores the everyday emotional, clinical, humorous, and ethical challenges of the medical residency training process. As implied by the title of the series, these pieces act as a visual bildungsroman, graphically dissecting the subtext of what it means to be a young doctor in today's medical world. Progress Notes appears monthly in Annals Graphic Medicine at Annals.org. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byNavigating and Leveraging Social Media 20 August 2019Volume 171, Issue 4Page: W11-W12KeywordsConflicts of interestDisclosureEmotionsEndocrinologyFellowshipsGraduate medical educationResidency ePublished: 20 August 2019 Issue Published: 20 August 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Delay in time from diagnosis to treatment in metastatic melanoma, lung, and colon cancer.
Authors: Muhammad Salman Faisal, Ahmed Khattab, Vida Jahangiri, Hira Shaikh, Soorih Shaikh, Abhishek Chaturvedi, Moses S. Raj, Gene Grant Finley
Journal: Journal of Clinical Oncology (2019)

e23186 Background: Delay in cancer treatment is anxiety provoking both for the patient and clinician. We conducted the study to evaluate the patterns of delay in treatment of patients with metastatic colon cancer, lung cancer and melanoma from diagnosis to the initiation of the treatment, and to identify the causes of delay. Methods: In this retrospective study, patients with metastatic colon cancer, lung cancer and melanoma diagnosed between 01/01/2016 to 12/31/2016 in a tertiary care network in the United States were studied. Data was collected from electronic health record (EHR) database, ‘Epic’. Variables such as demographic data, including patient age and gender, and type of cancer, and treatment received were analyzed. The causes of the delay were also evaluated when available. Results: Total number of patients in the study was 288. Mean age was 68.3 years (median 69 years) and 36% were alive at the time of data analysis. Male to female ratio was 1.4:1. 66.7% people had lung cancer, 30% had colon cancer and 3% had melanoma. 67 (23.6%) of total analyzed patients had denied definitive treatment and chose to undergo palliative management. Of the rest, most started treatment with chemotherapy (39.5%), followed by surgery (22.6%) and then radiation (14.6%). With the time of pathological diagnosis of the tumor taken as the date of diagnosis, mean delay from the day of diagnosis to the start of treatment in this study population observed was 27.7 days. 67 patients (23.3%) had a delay of more than 30 days, with the most common reason being systemic factors in 39 patients (58.2%), followed by patient factors in 23 patients (34.3%) and physician factors in 5 patients (7.5%). On logistic regression analysis, time from diagnosis to treatment didn’t predict mortality (OR = 0.99, 95% CI P = 0.10(0.97-1.002). Conclusions: Delay in treatment is common and the system factors one of the common reasons as exhibited by our study. Time from diagnosis to treatment didn’t predict mortality.
Identification of urinary markers using proteomics analysis of urine in patients with bladder cancer
Authors: G. Nabi, P. Cash, J. N’Dow
Journal: Journal of Clinical Oncology (2006)

14605 Background: The discovery of new urinary markers for non-invasive detection and surveillance of bladder carcinoma remains an active field of current research with an aim to replace invasive investigations such as cystoscopy. We have analysed the urinary proteomes of patients with bladder tumor and compared them the urinary proteomes of a healthy volunteer control group to detect putative, tumour specific urinary markers for bladder tumor. Methods: 24 hour and midstream samples were collected from healthy volunteers and patients with newly diagnosed bladder tumours. Urinary proteins were isolated by a technique previously described by our group (Nabi G, N’Dow J, Hasan ST, Boot IR, Cash P. Proteomic analysis of urine in patients with intestinal segments transposed into the urinary tract. Proteomics. 2005 Apr;5(6):1729–33.) 1 . Proteins were resolved by 1-dimenional (1-DE) and two dimensional gel electrophoresis (2-DE). The proteins that differed when analysed by either 1-DE or 2-DE between patients and controls were identified using peptide mass mapping. Results: Six patients with newly diagnosed bladder cancer and 5 healthy volunteers were recruited into this study. All patients were found to have superficial transitional cell carcinoma with high grade (3 with grade 3, 3 with grade 2) on subsequent histopathological examination. For the same individual no detectable differences were observed in the protein profiles of midstream and 24 hour urinary samples when analysed by either 1DE or 2-DE. However, between patient and controls a number of proteins differed in abundance and these were identified. Proteins that were present in patients, but absent in controls, included FK506 binding protein 6 isoform, apolipoprotein A-IV, paraliprotein and lipid binding protein. Conclusions: The present study identified some of the novel urinary biomarkers in present with bladder cancer. Some of these have been shown to change their expression with deeper invasion of disease and might be useful in predicting behaviour of superficial bladder cancer. No significant financial relationships to disclose.