tbuckley/cabot-search huggingface dataset:
Hotline: A Poem
Authors: Sadhana Kalidindi
Journal: Annals of Internal Medicine (2019)

Ad Libitum19 February 2019Hotline: A PoemSadhana KalidindiSadhana KalidindiUniversity of Bristol Medical School, Bristol, United Kingdom (S.K.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M18-2649 Audio Reading - “Hotline: A Poem” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "Hotline: A Poem," by S. Kalidindi. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The first time I ever read about how pearls were formed,“the world is your oyster” took on a whole new meaning.How was I to know that the moment your handextinguished the flames from my lungs,would coincide with my reincarnation.The girl on the other end of the hotlinetells me a story I know only too well.How do I begin to tell herthat the venom he injected her withwould soon become the grain of sandcaught between her shell and her mantle.There's a line in the Mahabharata that says... Author, Article, and Disclosure InformationAffiliations: University of Bristol Medical School, Bristol, United Kingdom (S.K.)Current Author Address: Sadhana Kalidindi; e-mail, [email protected]bristol.ac.uk. PreviousarticleNextarticle Advertisement Audio Reading - “Hotline: A Poem” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "Hotline: A Poem," by S. Kalidindi. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics 19 February 2019Volume 170, Issue 4Page: 273KeywordsEmotionsLungsPharynxPlateletsVenoms ePublished: 19 February 2019 Issue Published: 19 February 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Multiple Interventions Can Reduce Rates of False Penicillin “Allergy” Relabeling After Negative Testing
Authors: Shazia Lutfeali, Felicia Kasra, Sheenal Patel, Shyam Joshi, Scott A. Tarver, Kristin Alvarez, Wenjing Wei, David A. Khan
Journal: Journal of Allergy and Clinical Immunology (2019)
Abstract 19034: Safety and Efficacy of Non-Vitamin K Antagonist Oral Anticoagulants During Transcatheter Ablation of Atrial Fibrillation
Authors: Zhen Ge, Michela Faggioni, Baber Usman, Serdar Farhan, Sabato Sorrentino, Birgit Vogel, Jaya Chandrasekhar, Clayton Snyder, Samantha sartori, Abdul Qadeer, Vivek Reddy, Srinivas Dukkipati, George Dangas, Roxana Mehran
Journal: Circulation (2017)

Background: Catheter ablation for atrial fibrillation (AF) is associated with a transitory increase in the risk of both thromboembolic and bleeding events. Evidence on the use of non-vitamin K anta...
Risk of Incident Obstructive Sleep Apnea Among Patients With Type 2 Diabetes
Authors: Anuradhaa Subramanian, Nicola J. Adderley, Alexander Tracy, Tom Taverner, Wasim Hanif, Konstantinos A. Toulis, G. Neil Thomas, Abd A. Tahrani, Krishnarajah Nirantharakumar
Journal: Diabetes Care (2019)

OBJECTIVE This study compared the incidence of obstructive sleep apnea (OSA) in patients with and without type 2 diabetes and investigated risk factors for OSA in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS A retrospective cohort study was performed to compare OSA incidence between adult patients with and without type 2 diabetes matched for age, sex, and BMI. Patients with a prevalent OSA diagnosis were excluded. The study cohort was derived from The Health Improvement Network (THIN), a U.K. primary care database, from 1 January 2005 to 31 December 2017. RESULTS There were 3,110 (0.88%) and 5,968 (0.46%) incident OSA cases identified in the 360,250 exposed and 1,296,489 unexposed patient cohorts, respectively. Adjusted incidence rate ratio (aIRR) of OSA in patients with type 2 diabetes compared with those without was 1.48 (95% CI 1.42–1.55; P &amp;lt; 0.001). In a multivariate regression analysis of patients with type 2 diabetes, significant predictors of OSA were diabetes-related foot disease (1.23 [1.06–1.42]; P = 0.005), being prescribed insulin in the last 60 days (1.58 [1.42–1.75]; P &amp;lt; 0.001), male sex (2.27 [2.09–2.46]; P &amp;lt; 0.001), being overweight (2.02 [1.54–2.64]; P &amp;lt; 0.001) or obese (8.29 [6.42–10.69]; P &amp;lt; 0.001), heart failure (1.41 [1.18–1.70]; P &amp;lt; 0.001), ischemic heart disease (1.22 [1.11–1.34]; P &amp;lt; 0.001), atrial fibrillation (1.23 [1.04–1.46]; P = 0.015), hypertension (1.32 [1.23–1.43]; P &amp;lt; 0.001), and depression (1.75 [1.61–1.91]; P &amp;lt; 0.001). CONCLUSIONS When considered alongside previous evidence, this study indicates that the association between type 2 diabetes and OSA is bidirectional. In addition to known predictors of OSA, diabetes-related foot disease and insulin treatment were identified as risk factors in patients with type 2 diabetes.
Abstract 19009: The Association Between Clinical and Echocardiographic Imaging Findings and T2* in End Stage Liver Disease
Authors: Gabriel Brooks, Kathryn Brown, Neil Mehta, Karen Ordovas, Nevah Rubin, Elyse Foster, Atif Qasim
Journal: Circulation (2015)

Background: Cirrhosis can lead to cardiac iron deposition (cardiac siderosis), a risk factor for heart failure (CHF) and ventricular arrhythmia. Cardiac magnetic resonance (CMR) T2* analysis is utilized to detect cardiac siderosis prior to liver transplantation (LT). Clinical and TTE correlates with T2* values in patients with end-stage liver disease are not well characterized. Methods and Results: We present a case series of 130 patients with cirrhosis undergoing LT evaluation with T2* and TTE analysis at our institution between 2008-2014. We compared clinical, TTE and functional CMR measures to T2* measures across three categories: &lt;10 (excluded from LT due to high-risk for heart failure or arrhythmia), 10-20 -(cardiac siderosis of indeterminate clinical significance) and ≥20 (normal) using fisher exact test for categorical variables and ANOVA for continuous variables. Clinical characteristics associated with lower values of T2* were: lower body mass index (p=0.01), lower systolic blood pressure (p&lt;0.01). MELD score was higher in those with T2* values between 10-20 (p &lt;0.01). Echocardiographic findings associated with lower T2* values included lower left ventricular (LV), ejection fraction (p&lt;0.01), higher LV end systolic volume index (p &lt;0.01), and higher global longitudinal strain (GLS) in the 4-Chamber, 3-chamber and the overall average GLS (all p &lt; 0.01), though there were fewer participants that had 3-chamber GLS measurements. Conclusions: In this exploratory analysis of LT candidates, lower T2* values correlated with more advanced liver disease including lower BMI, lower systolic blood pressure and MELD score. Intriguingly, higher global longitudinal strain demonstrated a strong correlation with lower T2* in 4 and 3 chambers as well as overall average GLS and may be a valuable tool in the LT evaluation of suspected cardiac iron overload.
The Impact of Marital Status on Hematopoietic Stem Cell Transplant (HCT) Recipient Outcomes: A Surrogate for Consistent Caregiver. a CIBMTR Registry Study
Authors: Jason Tay, Ruta Brazauskas, Naya He, Sara Beattie, Christopher Bredeson, Jignesh Dalal, Shahrukh K. Hashmi, Theresa E. Hahn, Nandita Khera, William A. Wood, Wael Saber
Journal: Blood (2018)
Abstract 12901: Removal of Dabigatran Using Sorbent Hemadsorption
Authors: George O Angheloiu, Joanne van Ryn, Ashley M Goss
Journal: Circulation (2015)

Background: Dabigatran is a direct thrombin inhibitor that has been demonstrated to be superior to warfarin in protecting against stokes in patients with atrial fibrillation. The risk of a major bleed is lower with dabigatran than with warfarin, however 1.5% of patients treated with the former drug experience gastro-intestinal bleeding episodes versus 1.02% per year for warfarin. While a reversal agent for Dabigatran has been developed, we designed and tested an alternative removal method that in addition to novel anticoagulants can remove antiplatelets (100% removal rate of Ticagrelor from blood; results submitted in parallel abstract) and radiocontrast agents (96% removal rate), two other classes of agents frequently used in cardiology and known to lead to unwanted events such as bleeding or acute kidney injury respectively. Hypothesis: Dabigatran can be adsorbed by Cytosorb sorbent beads. Methods: We performed first-pass bench experiments using a mix of 0.35 mg of Dabigatran in 1000 ml 4% bovine serum albumin (BSA) saline solution rendering a dilution of 350 ng/ml similar with therapeutic concentration levels of Dabigatran in patients with non-valvular atrial fibrillation. 100 ml solution was passed through 10 ml, 20 ml and 40 ml sorbent at an injection rate of 1 ml/min for 100 minutes. Dabigatran concentration was measured in the affluent and effluent solution using a liquid chromatography technique with tandem mass spectrometric detection (LC/MS/MS). Results: The Dabigatran removal rate was 100% using a 40 cc column of Cytosorb, and approximately 94% with the 10 ml and 20 ml columns. Conclusion: Sorbent adsorption demonstrates robust removal of Dabigatran from BSA solution. This creates the premises of an all-including method possibly able to remove three classes of agents frequently used in cardiology: anticoagulants, antiplatelets and radiocontrast agents.
In vitro and in vivo activity of d-serine in combination with β-lactam antibiotics against methicillin-resistant Staphylococcus aureus
Authors: Qing Wang, Yuemeng Lv, Jing Pang, Xue Li, Xi Lu, Xiukun Wang, Xinxin Hu, Tongying Nie, Xinyi Yang, Yan Q. Xiong, Jiandong Jiang, Congran Li, Xuefu You
Journal: Acta Pharmaceutica Sinica B (2019)

As d-amino acids play important roles in the physiological metabolism of bacteria, combination of d-amino acids with antibiotics may provide synergistic antibacterial activity. The aim of the study was to evaluate in vitro and in vivo activity of d-serine alone and in combination with β-lactams against methicillin-resistant Staphylococcus aureus (MRSA) strains, and to explore the possible sensitization mechanisms. The activity of d-serine, β-lactams alone and in combinations was evaluated both in vitro by standard MICs, time-kill curves and checkerboard assays, and in vivo by murine systemic infection model as well as neutropenic thigh infection model. An in vitro synergistic effect was demonstrated with the combination of d-serine and β-lactams against MRSA standard and clinical strains. Importantly, the combinations enhanced the therapeutic efficacy in the animal models as compared to β-lactam alone groups. Initial mechanism study suggested possible revision of d-alanine-d-alanine residue to d-alanine-d-serine in peptidoglycan by adding of d-alanine in the medium, which may cause decreased affinity to PBPs during transpeptidation. In conclusion, d-serine had synergistic activity in combination with β-lactams against MRSA strains both in vitro and in vivo. Considering the relatively good safety of d-serine alone or in combination with β-lactams, d-serine is worth following up as new anti-MRSA infection strategies.
Abstract 18860: The Quest for Precision Medicine: Unidentified Patient Factors Predict Mortality After Congenital Heart Surgery
Authors: Michael Gaies, Mousumi Banerjee, Wenying Zhang, Mark Russell, J. William Gaynor, Sara Pasquali
Journal: Circulation (2017)

Introduction: Defining the unique patient characteristics that impact disease manifestation and response to therapy is essential for “precision medicine strategies and personalized care. For child...
Germline DNA Repair Gene Mutations in Young-onset Prostate Cancer Cases in the UK: Evidence for a More Extensive Genetic Panel
Authors: Daniel A. Leongamornlert, Edward J. Saunders, Sarah Wakerell, Ian Whitmore, Tokhir Dadaev, Clara Cieza-Borrella, Sarah Benafif, Mark N. Brook, Jenny L. Donovan, Freddie C. Hamdy, David E. Neal, Kenneth Muir, Koveela Govindasami, David V. Conti, Zsofia Kote-Jarai, Rosalind A. Eeles
Journal: European Urology (2019)

Rare germline mutations in DNA repair genes are associated with prostate cancer (PCa) predisposition and prognosis. To quantify the frequency of germline DNA repair gene mutations in UK PCa cases and controls, in order to more comprehensively evaluate the contribution of individual genes to overall PCa risk and likelihood of aggressive disease. We sequenced 167 DNA repair and eight PCa candidate genes in a UK-based cohort of 1281 young-onset PCa cases (diagnosed at ≤60 yr) and 1160 selected controls. Gene-level SKAT-O and gene-set adaptive combination of p values (ADA) analyses were performed separately for cases versus controls, and aggressive (Gleason score ≥8, n = 201) versus nonaggressive (Gleason score ≤7, n = 1048) cases. We identified 233 unique protein truncating variants (PTVs) with minor allele frequency <0.5% in controls in 97 genes. The total proportion of PTV carriers was higher in cases than in controls (15% vs 12%, odds ratio [OR] = 1.29, 95% confidence interval [CI] 1.01–1.64, p = 0.036). Gene-level analyses selected NBN (pSKAT-O = 2.4 × 10−4) for overall risk and XPC (pSKAT-O = 1.6 × 10−4) for aggressive disease, both at candidate-level significance (p < 3.1 × 10−4 and p < 3.4 × 10−4, respectively). Gene-set analysis identified a subset of 20 genes associated with increased PCa risk (OR = 3.2, 95% CI 2.1–4.8, pADA = 4.1 × 10−3) and four genes that increased risk of aggressive disease (OR = 11.2, 95% CI 4.6–27.7, pADA = 5.6 × 10−3), three of which overlap the predisposition gene set. The union of the gene-level and gene-set-level analyses identified 23 unique DNA repair genes associated with PCa predisposition or risk of aggressive disease. These findings will help facilitate the development of a PCa-specific sequencing panel with both predictive and prognostic potential. This large sequencing study assessed the rate of inherited DNA repair gene mutations between prostate cancer patients and disease-free men. A panel of 23 genes was identified, which may improve risk prediction or treatment pathways in future clinical practice.
Estimates of the Number of Brand-name Drugs Affected by the Medicaid Rebate Cap in 2017
Authors: Sean Dickson
Journal: JAMA Internal Medicine (2019)

included a modifier indicating that consumers' out-of-pocket cost might be zero.Although many challenges remain in designing the ultimate US Food and Drug Administration regulation, 6 our results suggest that requiring pharmaceutical companies to disclose the price in DCTPA can be potentially effective in reducing consumer interest in high-priced drugs, but the inclusion of modifiers in these disclosures can reduce or eliminate the influence of disclosure.
Ibrutinib, Fludarabine, Cyclophosphamide, and Obinutuzumab (iFCG) for Firstline Treatment of Patients with CLL with Mutated IGHV and without TP53 Aberrations
Authors: Nitin Jain, Philip A. Thompson, Jan A. Burger, Alessandra Ferrajoli, Gautam Borthakur, Prithviraj Bose, Zeev E. Estrov, Tapan M. Kadia, Koichi Takahashi, Naveen Garg, Xuemei Wang, Rashmi Kanagal-Shamanna, Keyur Patel, Wanda Lopez, Ana Ayala, William Plunkett, Varsha Gandhi, Hagop M. Kantarjian, Susan M. O'Brien, Michael J Keating, William G. Wierda
Journal: Blood (2018)
Prevalence of JAK2 V617F in Individuals That Meet World Health Organization Erythrocytosis Criteria for Polycythemia Vera
Authors: Miguel Piris-Villaespesa, Gloria Muñoz-Martin, Ricardo Sanchez, Claudia Nuñez-Torron, Adolfo Saez-Martin, Borja Fernandez-Felix, Javier Zamora, Francisco Javier del Castillo, Jose Manuel del Rey, Javier Lopez Jimenez, Jesus Villarrubia, Joaquin Martinez Lopez, Valentín García Gutiérrez
Journal: Blood (2018)
Response to Comment on Laiteerapong et al. The Legacy Effect in Type 2 Diabetes: Impact of Early Glycemic Control on Future Complications (The Diabetes &amp; Aging Study). Diabetes Care 2019;42:416–426
Authors: Neda Laiteerapong, Sandra A. Ham, Elbert S. Huang, Andrew J. Karter
Journal: Diabetes Care (2019)

We appreciate the opportunity to discuss our work (1) further in response to Hulman et al. (2). While we understand and appreciate their four concerns, we respectfully disagree with their interpretation of our work and stand by our analytic approach and conclusions. One major concern was that the results were biased because we conditioned study inclusion on survival of 10 years. While we agree that conditioning on survival would be a concern if we were generalizing results to all patients with diabetes, we clearly specified that our results only apply to patients who survive a minimum of 10 years. It was necessary to condition the study population on some minimum years of survival because one must …
Thiotepa-Fludarabine-Treosulfan (TFT) Conditioning for 2nd Allogeneic Peripheral Blood Hematopoietic Cell Transplantation (HCT) from a Second Unrelated Donor in Patients with Acute Myeloid Leukemia (AML) Relapsed after Prior Allogeneic HCT: A Prospective Multicenter Phase II Trial
Authors: Jürgen Finke, Claudia Schmoor, Matthias Stelljes, Andreas Burchert, Peter Dreger, Eva-Maria Wagner, Martin Bornhäuser, Kristina Sohlbach, Natalie Schub, Christian Reicherts, Guido Kobbe, Bertram Glass, Hartmut Bertz, Olga Grishina
Journal: Blood (2018)
Abstract 18942: High Sensitivity Cardiac Troponin I Changes Within The Normal Range Do Not Predict Adverse Events In Patients Presenting With Suspected Myocardial Ischemia
Authors: Yader Sandoval, Stephen W Smith, Anne Sexter, Karen Schulz, Fred S Apple
Journal: Circulation (2017)

Introduction: High-sensitivity cardiac troponin (hs-cTn) assays are able to measure very low cTn concentrations with high precision. Whether cTn changes at these very low concentrations portend a w...
Small bowel adenocarcinoma: A single center experience.
Authors: Lindsay Marie Hannan, William Proctor Harris, Veena Shankaran, Andrew L. Coveler, Colin Pritchard, David Bing Zhen, Stacey Cohen, Eric Quentin Konnick, E. Gabriela Chiorean, Kit Man Wong
Journal: Journal of Clinical Oncology (2019)

449 Background: Small bowel adenocarcinoma (SBA) represents only 2% of GI malignancies. There is limited data to guide clinical decisions, largely extrapolated from colorectal cancers (CRC). We evaluated treatment strategies and outcomes in patients (pts) with early and advanced SBA. Methods: We identified 56 pts with SBA diagnosed between 1/2005 - 1/2018 and treated at our institution. Demographics, pathological features, treatments, and molecular data were abstracted via medical record review. Data was analyzed with SAS statistical software. Results: Median age was 61, 54% male, site: duodenum (D 37.5%), duodenal ampula (A 17.9%), jejunum (J 19.6%), ileum (I 12.5 %), unknown (12.5%). Predisposing conditions were: IBD (6), Lynch (2), and Peutz-Jeghers syndromes (1). Stage (stg) at diagnosis was I (5%), II (20%), III (34%) and IV (41%). Primary tumor resection occurred in 33 pts: 21 received adjuvant chemotherapy, mostly FOLFOX; 17 developed metastatic disease. Treatment for metastatic SBA (n = 40) included 5FU-based chemotherapy without or with anti-VEGF (n = 18), or anti-EGFR therapies (n = 9). Median lines of therapy was 2 (range 1-7). For pts with stg I-III SBA, median DFS/OS was 21/38 mos. For stg IV pts, OS was 19.8 mos; 18/35/8/14 mos for D, A, J and I, respectively. Molecular biomarkers with targeted (28) or next generation sequencing (10) were available for 28 metastatic SBA pts: KRAS MUT (8), TP53 MUT (5), ERBB2 MUT (2), MSI-H (2), ERBB2, CCNE1 amplification (1 each), and NRAS, BRAF, CDKN2A, ERBB3, ATM, PIK3CA MUT (1 each). OS was 20 vs 19 mos for pts with KRAS WT vs MUT stg IV SBA, respectively. Among 16 pts with KRAS WT SBA, OS for those treated (9) or not (7) with anti-EGFR antibodies was 25 mos vs 21 mos. One pt with KRAS WT, ERBB2 amplification/ERBB2 V777L activating mutation is alive 5yrs+ from stg IV diagnosis on anti-EGFR plus chemotherapy (best response was 4 mos SD with trastuzumab/pertuzumab). Conclusions: This retrospective study demonstrates heterogeneity among SBA, overall inferior outcomes compared to CRC pts, and emphasizes genomic alterations which could be exploited therapeutically. Randomized studies for KRAS WT SBA pts should test the benefit from anti-EGFR targeted therapies in this rare tumor type.
Adjuvant gemcitabine versus 5-fluorouracil/folinic acid based on hENT1 immunostaining in curative resected pancreatic adenocarcinoma: A biomaker stratified trial.
Authors: Dong Woo Shin, Min Jae Kim, Se Yeol Yang, Jong-chan Lee, Jin-Hyeok Hwang
Journal: Journal of Clinical Oncology (2019)

308 Background: The human equilibrating nucleoside transporter (hENT1) protein transports gemcitabine into the cell. However, role of hENT1 as a predictive biomarker for gemcitabine responsiveness in pancreatic adenocarcinoma (PDA) is still needed to be elucidated, although several studies had been conducted. We investigated whether hENT1 has a predictable role on adjuvant chemotherapy responsiveness in PDA according to stratification of hENT1 immunostaining. Methods: The 44 patients who underwent curative surgery (R0 or R1) due to PDA at Seoul National University Bundang Hospital from May 2015 to June 2017 were enrolled prospectively. The hENT1 expressions were measured by immunochemical staining (SP120-rabbit monoclonal antibody, Ventana). According to hENT1 immunostaing (≥ 50% vs. &lt; 50%), higher hENT1 group received gemcitabine [1,000mg/m 2 (day 1, 8, 15) q 4 weeks x 6 cycles] and lower hENT1 group received [5-FU 425mg/m 2 (day 1-5) plus folinic acid 20 mg/m 2 (day 1) q 4 weeks x 6 cycles]. Primary outcome was overall survival (OS) and secondary outcomes were toxicity and recurrence free survival (RFS). Results: Among 44 patients, 5 patients were excluded due to withdrew consent (3 patients) and toxicities (2 patients in 5FU/LV group). Eighteen patients in the higher hENT1 group and twenty-six patients in the lower hENT1 group were followed up for 24.1 months. Our data showed OS was 97.4% at 12 months and 86.4% at 24 months. Moreover, RFS was 76.8% at 12 months and 64.2% at 24 months. Although it is preliminary data, it showed better OS and RFS compared to previous study (Neoptolemos JP et al., JAMA 2010) (OS, 61.3% at 12 months, 30.7% at 24 months; RFS, 58.7% at 12 months and 30.1% at 24 months). Conclusions: Adjuvant chemotherapy based on hENT1 immunostaining stratification provides excellent survival in resected PDA. Therefore, hENT1 immunostaining should be used for making a decision for adjuvant chemotherapy remimen in PDA. Clinical trial information: NCT02486497.