tbuckley/cabot-search huggingface dataset:
Diagnosis of osteoporosis in statin-treated patients is dose-dependent
Authors: Michael Leutner, Caspar Matzhold, Luise Bellach, Carola Deischinger, Jürgen Harreiter, Stefan Thurner, Peter Klimek, Alexandra Kautzky-Willer
Journal: Annals of the Rheumatic Diseases (2019)

Objective Whether HMG-CoA-reductase inhibition, the main mechanism of statins, plays a role in the pathogenesis of osteoporosis, is not entirely known so far. Consequently, this study was set out to investigate the relationship of different kinds and dosages of statins with osteoporosis, hypothesising that the inhibition of the synthesis of cholesterol could influence sex-hormones and therefore the diagnosis of osteoporosis. Methods Medical claims data of all Austrians from 2006 to 2007 was used to identify all patients treated with statins to compute their daily defined dose averages of six different types of statins. We applied multiple logistic regression to analyse the dose-dependent risks of being diagnosed with osteoporosis for each statin individually. Results In the general study population, statin treatment was associated with an overrepresentation of diagnosed osteoporosis compared with controls (OR: 3.62, 95% CI 3.55 to 3.69, p&lt;0.01). There was a highly non-trivial dependence of statin dosage with the ORs of osteoporosis. Osteoporosis was underrepresented in low-dose statin treatment (0–10 mg per day), including lovastatin (OR: 0.39, CI 0.18 to 0.84, p&lt;0.05), pravastatin (OR: 0.68, 95% CI 0.52 to 0.89, p&lt;0.01), simvastatin (OR: 0.70, 95% CI 0.56 to 0.86, p&lt;0.01) and rosuvastatin (OR: 0.69, 95% CI 0.55 to 0.87, p&lt;0.01). However, the exceeding of the 40 mg threshold for simvastatin (OR: 1.64, 95% CI 1.31 to 2.07, p&lt;0.01), and the exceeding of a 20 mg threshold for atorvastatin (OR: 1.78, 95% CI 1.41 to 2.23, p&lt;0.01) and for rosuvastatin (OR: 2.04, 95% CI 1.31 to 3.18, p&lt;0.01) was related to an overrepresentation of osteoporosis. Conclusion Our results show that the diagnosis of osteoporosis in statin-treated patients is dose-dependent. Thus, osteoporosis is underrepresented in low-dose and overrepresented in high-dose statin treatment, demonstrating the importance of future studies’ taking dose-dependency into account when investigating the relationship between statins and osteoporosis.
Chronic Kidney Disease and Coronary Artery Disease
Authors: Mark J. Sarnak, Kerstin Amann, Sripal Bangalore, João L. Cavalcante, David M. Charytan, Jonathan C. Craig, John S. Gill, Mark A. Hlatky, Alan G. Jardine, Ulf Landmesser, L. Kristin Newby, Charles A. Herzog, Michael Cheung, David C. Wheeler, Wolfgang C. Winkelmayer, Thomas H. Marwick, Debasish Banerjee, Carlo Briguori, Tara I. Chang, Chien-Liang Chen, Christopher R. deFilippi, Xiaoqiang Ding, Charles J. Ferro, Jagbir Gill, Mario Gössl, Nicole M. Isbel, Hideki Ishii, Meg J. Jardine, Philip A. Kalra, Günther Laufer, Krista L. Lentine, Kevin Lobdell, Charmaine E. Lok, Gérard M. London, Jolanta Małyszko, Patrick B. Mark, Mohamed Marwan, Yuxin Nie, Patrick S. Parfrey, Roberto Pecoits-Filho, Helen Pilmore, Wajeh Y. Qunibi, Paolo Raggi, Marcello Rattazzi, Patrick Rossignol, Josiah Ruturi, Charumathi Sabanayagam, Catherine M. Shanahan, Gautam R. Shroff, Rukshana Shroff, Angela C. Webster, Daniel E. Weiner, Simon Winther, Alexander C. Wiseman, Anthony Yip, Alexander Zarbock
Journal: Journal of the American College of Cardiology (2019)

Chronic kidney disease (CKD) is a major risk factor for coronary artery disease (CAD). As well as their high prevalence of traditional CAD risk factors, such as diabetes and hypertension, persons with CKD are also exposed to other nontraditional, uremia-related cardiovascular disease risk factors, including inflammation, oxidative stress, and abnormal calcium-phosphorus metabolism. CKD and end-stage kidney disease not only increase the risk of CAD, but they also modify its clinical presentation and cardinal symptoms. Management of CAD is complicated in CKD patients, due to their likelihood of comorbid conditions and potential for side effects during interventions. This summary of the Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference on CAD and CKD (including end-stage kidney disease and transplant recipients) seeks to improve understanding of the epidemiology, pathophysiology, diagnosis, and treatment of CAD in CKD and to identify knowledge gaps, areas of controversy, and priorities for research.
Association of Early, High Plasma-to–Red Blood Cell Transfusion Ratio With Mortality in Adults With Severe Bleeding After Trauma
Authors: Florian Roquet, Arthur Neuschwander, Sophie Hamada, Gersende Favé, Arnaud Follin, David Marrache, Bernard Cholley, Romain Pirracchio
Journal: JAMA Network Open (2019)

Optimal transfusion management is crucial when treating patients with trauma. However, the association of an early, high transfusion ratio of fresh frozen plasma (FFP) to packed red blood cells (PRBC) with survival remains uncertain.To study the association of an early, high FFP-to-PRBC ratio with all-cause 30-day mortality in patients with severe bleeding after trauma.This cohort study analyzes the data included in a multicenter national French trauma registry, Traumabase, from January 2012 to July 2017. Traumabase is a prospective, active, multicenter adult trauma registry that includes all consecutive patients with trauma treated at 15 trauma centers in France. Overall, 897 patients with severe bleeding after trauma were identified using the following criteria: (1) received 4 or more units of PRBC during the first 6 hours or (2) died from hemorrhagic shock before receiving 4 units of PRBC.Eligible patients were divided into a high-ratio group, defined as an FFP-to-PRBC ratio more than 1:1.5, and a low-ratio group, defined as an FFP-to-PRBC ratio of 1:1.5 or less. The ratio was calculated using the cumulative units of FFP and PRBC received during the first 6 hours of management.A Cox regression model was used to analyze 30-day survival with the transfusion ratio as a time-dependent variable to account for survivorship bias.Of the 12 217 patients included in the registry, 897 (7.3%) were analyzed (median [interquartile range] age, 38 (29-54) years; 639 [71.2%] men). The median (interquartile range) injury severity score was 34 (22-48), and the overall 30-day mortality rate was 33.6% (301 patients). A total of 506 patients (56.4%) underwent transfusion with a high ratio and 391 (43.6%) with a low ratio. A high transfusion ratio was associated with a significant reduction in 30-day mortality (hazard ratio, 0.74; 95% CI, 0.58-0.94; P = .01). When only analyzing patients who had complete data, a high transfusion ratio continued to be associated with a reduction in 30-day mortality (hazard ratio, 0.57; 95% CI, 0.33-0.97; P = .04).In this analysis of the Traumabase registry, an early FFP-to-PRBC ratio of more than 1:1.5 was associated with increased 30-day survival among patients with severe bleeding after trauma. This result supports the use of early, high FFP-to-PRBC transfusion ratios in patients with severe trauma.
TCT-559 In-Hospital Outcomes and Trends of Endovascular Intervention Versus Surgical Revascularization Among Octogenarian Patients With Peripheral Artery Disease
Authors: Homam Moussa Pacha, Fahed Darmoch, Yasser Al-khadra, Mohamad Soud, Salman Arain, M. Chadi Alraies
Journal: Journal of the American College of Cardiology (2019)
TCT-537 Electrophysiological Complications With Transcatheter Versus Surgical Aortic Valve Replacement in Low-Risk Patients: Evidence From a Meta-Analysis of Randomized Controlled Trials
Authors: Amartya Kundu, Partha Sardar, Rohit Malhotra, Waqas Qureshi, Nikolaos Kakouros
Journal: Journal of the American College of Cardiology (2019)
Plasma extracellular vesicle long RNA profiling identifies a diagnostic signature for the detection of pancreatic ductal adenocarcinoma
Authors: Shulin Yu, Yuchen Li, Zhuan Liao, Zheng Wang, Zhen Wang, Yan Li, Ling Qian, Jingjing Zhao, Huajie Zong, Bin Kang, Wen-Bin Zou, Kun Chen, Xianghuo He, Zhiqiang Meng, Zhen Chen, Shenglin Huang, Peng Wang
Journal: Gut (2019)

Objective Pancreatic ductal adenocarcinoma (PDAC) is difficult to diagnose at resectable stage. Recent studies have suggested that extracellular vesicles (EVs) contain long RNAs. The aim of this study was to develop a diagnostic (d-)signature for the detection of PDAC based on EV long RNA (exLR) profiling. Design We conducted a case-control study with 501 participants, including 284 patients with PDAC, 100 patients with chronic pancreatitis (CP) and 117 healthy subjects. The exLR profile of plasma samples was analysed by exLR sequencing. The d-signature was identified using a support vector machine algorithm and a training cohort (n=188) and was validated using an internal validation cohort (n=135) and an external validation cohort (n=178). Results We developed a d-signature that comprised eight exLRs, including FGA, KRT19, HIST1H2BK, ITIH2, MARCH2, CLDN1, MAL2 and TIMP1, for PDAC detection. The d-signature showed high accuracy, with an area under the receiver operating characteristic curve (AUC) of 0.960, 0.950 and 0.936 in the training, internal validation and external validation cohort, respectively. The d-signature was able to identify resectable stage I/II cancer with an AUC of 0.949 in the combined three cohorts. In addition, the d-signature showed superior performance to carbohydrate antigen 19-9 in distinguishing PDAC from CP (AUC 0.931 vs 0.873, p=0.028). Conclusion This study is the first to characterise the plasma exLR profile in PDAC and to report an exLR signature for the detection of pancreatic cancer. This signature may improve the prognosis of patients who would have otherwise missed the curative treatment window.
TCT-620 The Association Between Long-Term Worsening Renal Function and Mortality After Transcatheter Aortic Valve Replacement in Patients With Chronic Kidney Disease
Authors: Derek Phan, Ming-Sum Lee, Vicken Aharonian, Prakash Mansukhani, Naing Moore, Somjot Brar, Ray Zadegan
Journal: Journal of the American College of Cardiology (2019)
TCT-303 Efficacy and Safety of the Biodegradable Polymer Sirolimus-Eluting Stents in Routine Clinical Practice: Data From the IRIS-DES Registry
Authors: KyungJin Choe, Junho Hyun, Yeongjin Jeong, Junghoon Lee, Yujin Yang, Ju Hyeon Kim, Sangwoo Park, Hanbit Park, Sang-Cheol Cho, Euihong Ko, Do-Yoon Kang, Pil Hyung Lee, Jung-Min Ahn, Duk-Woo Park, Seung-Whan Lee, Seong-Wook Park, Seung-Jung Park
Journal: Journal of the American College of Cardiology (2019)
Management of severe asthma: a European Respiratory Society/American Thoracic Society guideline
Authors: Fernando Holguin, Juan Carlos Cardet, Kian Fan Chung, Sarah Diver, Diogenes S. Ferreira, Anne Fitzpatrick, Mina Gaga, Liz Kellermeyer, Sandhya Khurana, Shandra Knight, Vanessa M. McDonald, Rebecca L. Morgan, Victor E. Ortega, David Rigau, Padmaja Subbarao, Thomy Tonia, Ian M. Adcock, Eugene R. Bleecker, Chris Brightling, Louis-Philippe Boulet, Michael Cabana, Mario Castro, Pascal Chanez, Adnan Custovic, Ratko Djukanovic, Urs Frey, Betty Frankemölle, Peter Gibson, Dominique Hamerlijnck, Nizar Jarjour, Satoshi Konno, Huahao Shen, Cathy Vitary, Andy Bush
Journal: European Respiratory Journal (2019)

This document provides clinical recommendations for the management of severe asthma. Comprehensive evidence syntheses, including meta-analyses, were performed to summarise all available evidence relevant to the European Respiratory Society/American Thoracic Society Task Force's questions. The evidence was appraised using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach and the results were summarised in evidence profiles. The evidence syntheses were discussed and recommendations formulated by a multidisciplinary Task Force of asthma experts, who made specific recommendations on six specific questions. After considering the balance of desirable and undesirable consequences, quality of evidence, feasibility, and acceptability of various interventions, the Task Force made the following recommendations: 1) suggest using anti-interleukin (IL)-5 and anti-IL-5 receptor α for severe uncontrolled adult eosinophilic asthma phenotypes; 2) suggest using a blood eosinophil cut-point ≥150 μL −1 to guide anti-IL-5 initiation in adult patients with severe asthma; 3) suggest considering specific eosinophil (≥260 μL −1 ) and exhaled nitric oxide fraction (≥19.5 ppb) cut-offs to identify adolescents or adults with the greatest likelihood of response to anti-IgE therapy; 4) suggest using inhaled tiotropium for adolescents and adults with severe uncontrolled asthma despite Global Initiative for Asthma (GINA) step 4–5 or National Asthma Education and Prevention Program (NAEPP) step 5 therapies; 5) suggest a trial of chronic macrolide therapy to reduce asthma exacerbations in persistently symptomatic or uncontrolled patients on GINA step 5 or NAEPP step 5 therapies, irrespective of asthma phenotype; and 6) suggest using anti-IL-4/13 for adult patients with severe eosinophilic asthma and for those with severe corticosteroid-dependent asthma regardless of blood eosinophil levels. These recommendations should be reconsidered as new evidence becomes available.
Association of Urinary Tract Infection Guidelines With Vesicoureteral Reflux Screening
Authors: Ted Lee, Daniel Triner, Tanima Basu, John M. Park, Julian Wan
Journal: JAMA Pediatrics (2019)

This cohort study assesses the rates of routine voiding cystourethrogram testing in children with febrile urinary tract infection before and after screening guidelines were issued by the American Academy of Pediatrics.
TCT-186 Preclinical Evaluation of a Novel Thin-Strut PLLA Bioresorbable Scaffold in Porcine Coronary Artery at 6-Month Follow-Up
Authors: Kuniaki Takahashi, Yuki Katagiri, Mariusz Tomaniak, Ply Chichareon, Rodrigo Modolo, Norihiro Kogame, Chun-Chin Chang, Masafumi Ono, Hideyuki Kawashima, Chao Gao, Nial Bullett, Naveed Ahmed, Kadem Al-Lamee, Rasha Al-Lamee, Patrick Serruys, Yoshinobu Onuma
Journal: Journal of the American College of Cardiology (2019)
TCT-150 Impact of Physiological and Molecular Markers on the Progression of Calcific Aortic Valve Stenosis as Measured by Change in Aortic Valve Area: A Meta-Analysis and Meta-Regression
Authors: Ramsey Kalil, Sareena George, Prateek Sharma, Paul Kim, Navneet Sharma, Puja Parikh
Journal: Journal of the American College of Cardiology (2019)
TCT-745 Insights Into Sex Differences in Transfemoral Transcatheter Aortic Valve Implantation From 2007–2018: From the CENTER Collaboration, A Global Patient-Level Analysis of 12,381 Patients
Authors: Jaya Chandrasekhar, Wieneke Vlastra, Didier Tchetche, Fabio Brito, Marco Barbanti, Ran Kornowski, Azeem Latib, Augusto D’Onofrio, Flavio Ribichini, Jan Baan, Jan Tijssen, Raul Moreno, Nicolas Dumonteil, Flávio Tarasoutchi, Samantha Sartori, Paola D’Errigo, Giuseppe Tarantini, Mattia Lunardi, Katia Orvin, Matteo Pagnesi, Alberto Berenguer, Thomas Modine, George Dangas, Roxana Mehran, Jan Piek, Ronak Delewi
Journal: Journal of the American College of Cardiology (2019)
Unrecognized Obstructive Sleep Apnea in Patients Undergoing Surgery—Reply
Authors: Matthew T. V. Chan, Frances Chung
Journal: JAMA (2019)

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Motions from Brighton: Labour Party conference roundup
Authors: Gareth Iacobucci, Elisabeth Mahase
Journal: BMJ (2019)

The Labour Party made a series of key policy announcements on health and social care at its annual conference in Brighton, which took place between Saturday 21 September and Wednesday 25 September.

Labour said it would introduce free personal care in England for those people aged over 65 who are most in need, the shadow chancellor, John McDonnell, announced on 23 September. The policy, which will cost an estimated £6bn, will double the number of people …
Three-year follow-up after peanut food challenges: Accidental reactions in allergic children and introduction failure in tolerant children
Authors: Hannah M. Kansen, Thuy-My Le, André C. Knulst, Diana M.W. Gorissen, Cornelis K. van der Ent, Yolanda Meijer, Francine C. van Erp
Journal: Journal of Allergy and Clinical Immunology (2019)
E-cigarette Product Use, or Vaping, Among Persons with Associated Lung Injury — Illinois and Wisconsin, April–September 2019
Authors: Isaac Ghinai, Ian W. Pray, Livia Navon, Kevin O’Laughlin, Lori Saathoff-Huber, Brooke Hoots, Anne Kimball, Mark W. Tenforde, Jennifer R. Chevinsky, Mark Layer, Ngozi Ezike, Jonathan Meiman, Jennifer E. Layden
Journal: MMWR Morbidity and Mortality Weekly Report (2019)

In July 2019, the Illinois Department of Public Health and the Wisconsin Department of Health Services launched a coordinated epidemiologic investigation after receiving reports of several cases of lung injury in previously healthy persons who reported electronic cigarette (e-cigarette) use, or vaping (1). This report describes features of e-cigarette product use by patients in Illinois and Wisconsin. Detailed patient interviews were conducted by telephone, in person, or via the Internet with 86 (68%) of 127 patients. Overall, 75 (87%) of 86 interviewed patients reported using e-cigarette products containing tetrahydrocannabinol (THC), and 61 (71%) reported using nicotine-containing products. Numerous products and brand names were identified by patients. Nearly all (96%) THC-containing products reported were packaged, prefilled cartridges, and 89% were primarily acquired from informal sources (e.g., friends, family members, illicit dealers, or off the street). In contrast, 77% of nicotine-containing products were sold as prefilled cartridges, and 83% were obtained from commercial vendors. The precise source of this outbreak is currently unknown (2); however, the predominant use of prefilled THC-containing cartridges among patients with lung injury associated with e-cigarette use suggests that they play an important role. While this investigation is ongoing, CDC recommends that persons consider refraining from using e-cigarette, or vaping, products, particularly those containing THC. Given the diversity of products reported and frequency of patients using both THC- and nicotine-containing e-cigarette products, additional methods such as product testing and traceback could help identify the specific cause of this outbreak.
Nintedanib in Progressive Fibrosing Interstitial Lung Diseases
Authors: Kevin R. Flaherty, Athol U. Wells, Vincent Cottin, Anand Devaraj, Simon L.F. Walsh, Yoshikazu Inoue, Luca Richeldi, Martin Kolb, Kay Tetzlaff, Susanne Stowasser, Carl Coeck, Emmanuelle Clerisme-Beaty, Bernd Rosenstock, Manuel Quaresma, Thomas Haeufel, Rainer-Georg Goeldner, Rozsa Schlenker-Herceg, Kevin K. Brown
Journal: New England Journal of Medicine (2019)

Preclinical data have suggested that nintedanib, an intracellular inhibitor of tyrosine kinases, inhibits processes involved in the progression of lung fibrosis. Although the efficacy of nintedanib has been shown in idiopathic pulmonary fibrosis, its efficacy across a broad range of fibrosing lung diseases is unknown.
TCT-54 The Application of Predefined Optimization Criteria for Intravascular Ultrasound Guidance of Left Main Coronary Artery Stenting Improves Outcomes
Authors: Jose de la Torre Hernandez, Tamara Garcia Camarero, Joan Antoni Gomez-Hospital, Jose Antonio Baz Alonso, Sofia Gonzalez Lizarbe, Lola Gutierrez Alonso, Fernando Alfonso, Gerard Roura Ferrer, Angel Sanchez Recalde, Dae-Hyun Lee, Fermin Sainz Laso, Armando Perez de Prado, Felipe Hernandez, Gabriela Veiga, Iñigo Lozano, Aritz Gil Ongay, Javier Zueco
Journal: Journal of the American College of Cardiology (2019)
What Is Sepsis?
Authors: Hasan Shanawani, Catherine Chen
Journal: American Journal of Respiratory and Critical Care Medicine (2017)

How does sepsis develop?Sepsis is caused by severe infection resulting in overwhelming inflammation.Infections can be due to bacteria, viruses, or fungi.Common types of infections include: ■ ■ Cellulitis, a skin infection ■ ■ Urinary tract infection, an infection of the bladder or kidneys ■ ■ Dental abscess, an infection of the gums ■ ■ Viral respiratory illness, an infection caused by a common cold virus ■ ■ Pneumonia, a bacterial infection of the lungs.Also see ATS fact sheet on pneumonia at www.thoracic.org/patients/Most often, we have infections that our body's immune system can manage, along with simple self-care strategies, such as resting, drinking fluids, or cleaning cuts and scrapes well.Some infections may require extra care, like pulling a tooth or opening up an infected wound so that it can drain.Your immune system uses white blood cells and proteins in your blood to fight infection.More serious infections are more difficult for your immune system to fight alone, and may need medications such as antibiotics to kill bacteria.