tbuckley/cabot-search huggingface dataset:
Abstract 18823: The Prognostic Impact of Changing Renal Function in Hospitalized Patients With Acute Decompensated Heart Failure
Authors: Masafumi Ono, Atsushi Mizuno, Syun Kohsaka, Ryoma Fukuoka, Nobuyuki Komiyama, Yasuyuki Shiraishi, Takashi Kohno, Yuji Nagatomo, Ayumi Goda, Tsutomu Yoshikawa
Journal: Circulation (2017)

Background: Worsening Renal Function (WRF) has been associated with worse outcomes in patients with acute decompensated heart failure (ADHF). Furthermore, recent study revealed improved renal function (IRF), which was defined as decrease of serum creatinine level (sCr) greater than 0.3 mg/dl, was also associated with adverse prognosis in ADHF. However, it remains unclear about the impact of the absolute sCr-change during hospitalization on prognosis. Methods: We retrospectively analyzed using database of the West Tokyo Heart Failure (WET-HF) Registry (total 3545 hospitalized patients with ADHF). We excluded the patients who needed dialysis during the hospitalization, and patients whose data was not available. Patients were divided into five groups according to the sCr-change from hospitalization to discharge; stable renal function (SRF; <0.3mg/dl absolute sCr-change), lower WRF (l-WRF; 0.3-0.59 increased sCr), higher WRF (h-WRF; ≥0.6 increased sCr), lower IRF (l-IRF; 0.3-0.59 decreased sCr) and higher IRF...
The BET Inhibitor INCB054329 Primes AML Cells for Venetoclax-Induced Apoptosis
Authors: Haley Ramsey, Susu Zhang, Yue Zhao, Melissa Ann Fischer, Agnieszka Ewa Gorska, Maria Arrate, Londa Fuller, Dalton Greenwood, Matthew C. Stubbs, Phillip Liu, Jeffrey C Rathmell, Scott Hiebert, Michael R. Savona
Journal: Blood (2018)
Annals Consult Guys - Surgery With Aortic Stenosis?
Authors: Geno J. Merli, Howard H. Weitz
Journal: Annals of Internal Medicine (2019)

Web Exclusives19 February 2019Annals Consult Guys - Surgery With Aortic Stenosis?FREEGeno J. Merli, MD and Howard H. Weitz, MDGeno J. Merli, MDThomas Jefferson University, Philadelphia, Pennsylvania (G.J.M., H.H.W.)Search for more papers by this author and Howard H. Weitz, MDThomas Jefferson University, Philadelphia, Pennsylvania (G.J.M., H.H.W.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/W18-0041 SectionsSupplemental MaterialAboutVisual Abstract ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Annals Consult Guys brings a new perspective to the art and science of medicine with lively discussion and analysis of real-world cases and situations. They address medically relevant topics—whether they be poignant, thought-provoking, or just plain entertaining.For more videos from and information on Annals Consult Guys, visit go.annals.org/ConsultGuys. Comments0 CommentsSign In to Submit A Comment Maria petroulakisUPMC13 March 2019 What about the DAPT after TAVR. DAPT or anticoagulation s/p TAVR will increase the risk of bleeding after any surgery so it is not worth waiting anyway to fix the hip. Author, Article, and Disclosure InformationAffiliations: Thomas Jefferson University, Philadelphia, Pennsylvania (G.J.M., H.H.W.)Disclosures: Geno J. Merli, MD, reports the following: Research grants/contracts: Bristol-Myers Squibb. Howard H. Weitz, MD, reports that he has no financial relationships or interests to disclose.Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that her spouse has stock options/holdings with Targeted Diagnostics and Therapeutics. Darren B. Taichman, MD, PhD, Executive Editor, reports that he has no financial relationships or interests to disclose. Cynthia D. Mulrow, MD, MSc, Senior Deputy Editor, reports that she has no relationships or interests to disclose. Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Catharine B. Stack, PhD, MS, Deputy Editor for Statistics, reports that she has stock holdings in Proctor & Gamble, Pfizer, and Johnson & Johnson. Christina C. Wee, MD, MPH, Deputy Editor, reports employment with Beth Israel Deaconess Medical Center. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Yu-Xiao Yang, MD, MSCE, Deputy Editor, reports that he has no financial relationships or interest to disclose. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 19 February 2019Volume 170, Issue 4Page: CG1KeywordsDiagnostic techniquesDisclosureResearch grantsResearch reporting guidelinesStenosisSurgery ePublished: 19 February 2019 Issue Published: 19 February 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.Loading ...
Resection margin distance in extrahepatic cholangiocarcinoma: How much is enough?
Authors: Amir A. Rahnemai-Azar, Sean Ronnekleiv-Kelly, Daniel Abbott, Cecilia Grace Ethun, George A. Poultsides, Thuy Tran, Ryan Fields, Bradley Aaron Krasnick, Robert C. G. Martin, Charles Raben Scoggins, Kamran Idrees, Chelsea A Isom, Ioannis Hatzaras, Rivfka Shenoy, Perry Shen, James D. Perkins, Timothy M. Pawlik, Shishir K. Maithel, Sharon M. Weber
Journal: Journal of Clinical Oncology (2019)

455 Background: Surgical resection is required for curative treatment of patients with extra-hepatic cholangiocarcinoma (EH-CCA). The objective of this study was to determine if the distance of surgical margin was associated with outcome. Methods: Patients who underwent curative-intent resection for EH-CCA between 2000 and 2015 at 10 hepatobiliary centers across the U.S. were evaluated using prospectively collected data. Cox proportional hazard model was utilized to evaluate the influence of the extent of the margin on outcome. Results: 538 patients with EH-CCA who underwent curative-intent resection were included: 383 (71%) undergoing R0 resection, 153 (28%) undergoing R1 resection, and 2 with R2 resection. A negative surgical margin (R0) was associated with improved recurrence-free (RFS) and overall survival (OS) (RFS: 10.5% vs. 3.6% (R1) and OS: 25.8% vs. 9.3% (R1). Subsequently, further analysis on 161 patients with complete data on distance of resection margin, all undergoing R0 resection, was performed to assess the impact of extent of margin on outcome. On multi-variable analysis, the resection margin distance, analyzed as a continuous variable, was not associated with either improved RFS (RR 1.00, 95% CI 0.96-1.05; p 0.71) or OS (RR 0.99, 95% CI 0.96-1.01; p 0.49). Increasing age, increased tumor size, and LN metastasis were identified as independent predictors of OS; while RFS were mainly dependent on tumor size and LN metastasis (Table). Conclusions: Achieving R0 resection is acceptable for EH-CCA tumors, and obtaining additional margin does not confer a benefit on overall survival. Increasing age, tumor size, and LN metastasis are independent predictors of RFS and OS, but increased margin width is not associated with improvement in either. Multivariable analysis of factors affecting OS of patients with extra-hepatic CCA who underwent surgical resection, with significant factors noted in bold. [Table: see text]
Behavioral Health and Burnout Among Physician Mothers Who Care for a Person With a Serious Health Problem, Long-term Illness, or Disability
Authors: Veronica Yank, Carolyn Rennels, Eleni Linos, Esther K. Choo, Reshma Jagsi, Christina Mangurian
Journal: JAMA Internal Medicine (2019)

Behavioral Health and Burnout Among Physician Mothers Who Care for a Person With a Serious Health Problem, Long-term Illness, or Disability Many physician mothers care for their children as well as their patients.Some also care for a child, spouse, parent, friend, or others with a major health problem, illness, or disability.Such additional caregiving responsibilities may have consequences for the woman's health, well-being, and career longevity.We sought to determine the proportion of physician mothers with caregiving responsibilities beyond their patients and children and how these additional responsibilities affected the women's health and practice.Methods | Methods for studying physician mothers have been previously described. 1 In 2016, a survey directed to the Physicians Moms Group online community was posted.The present study was conducted from June 17 to July 30, 2016.The University of California San Francisco institutional review board approved the study.Agreement online to participate in the survey was considered consent.The participants did not receive financial compensation.Members of the Physicians Moms Group identify themselves as physician mothers, including adoptive and foster mothers.Among an estimated 16 059 members who viewed the post, 5613 (35.0%) based in the United States completed questions about caregiving responsibilities.To identify physician mothers with additional caregiving responsibilities, we used a question from the Behavioral Risk Factor Surveillance System, "During the last year, did you provide regular care or assistance to a friend or family member with a serious health problem, long-term illness, or disability?" 2 To screen for risky drinking, we used the Alcohol Use Disorders Identification Test-Clinicians. 3 To assess substance abuse, we asked, "How often have you used or do you use the following: prescription drugs for nonmedical reasons/illegal drugs (excluding marijuana)/marijuana?" We asked a mental health question, "Have you ever had a mood or anxiety disorder?"We also asked a career dissatisfaction question, "Are you generally satisfied with your career?"To identify burnout, we used the Mini Z Burnout Survey. 4 We used 2-tailed t tests and Pearson χ 2 tests for comparisons and multivariate logistic regression models to determine adjusted relative risks (aRRs).Findings were considered significant at P < .05.
Dynamins 2 and 3 Are Required for Human Megakaryocytes Directional Migration
Authors: Praveen K Suraneni, Seth J. Corey, Michael Hession, Rameez Ishaq, Arinola Awomolo, Shirin Hasan, Najet Debili, John D. Crispino, Elizabeth A. Eklund, Yolande Chen
Journal: Blood (2018)
Long-term Potential Implications of Immigration Barriers for Medical Education
Authors: Carrie L. Radabaugh, Catherine M. Welcher, Susan E. Skochelak
Journal: JAMA (2019)

Presidential proclamation 9645 (Enhancing VettingCapabilities and Processes for Detecting Attempted Entry Into the United States by Terrorists or other Public-Safety Threats), upheld by the US Supreme Court in June 2018, has received substantial attention in the medical community.This proclamation introduced uncertainty into the lives of some physicians in training, physician-scientists, physician-teachers, and patients, including concerns about access to care, the diversity of the physician workforce, and physician shortages in some specialties.The proclamation applies only to a small percentage of international medical graduates (IMGs).In its final iteration, the proclamation generally bans travelers from Iran, Libya, North Korea, Somalia, Syria, and Yemen, and all Venezuelan government officials.The health care community was concerned enough to express unease regarding its immediate potential effects such as the possibility of residency training programs not being able to rank the most qualified candidates due to visa restrictions and predicted physician shortages (related
Ibrutinib-Based Therapy Improves Anti-Tumor T Cell Killing Function Allowing Effective Pairing with Anti-PD-L1 Immunotherapy Compared to Traditional FCR Chemoimmunotherapy; Implications for Therapy and Correlative Immune Functional Data from the Phase III E1912 Trial
Authors: Despoina Papazoglou, Connie E. Lesnick, Victoria Wang, Neil E. Kay, Tait D. Shanafelt, Alan G. Ramsay
Journal: Blood (2018)
Antithrombotic Agents
Authors: Noel C. Chan, Jeffrey I. Weitz
Journal: Circulation Research (2019)

Recent advances in our understanding of the contribution of thrombin generation to arterial thrombosis and the role of platelets in venous thrombosis have prompted new treatment paradigms. Nonetheless, bleeding remains the major side effect of such treatments spurring the quest for new antithrombotic regimens with better benefit-risk profiles and for safer anticoagulants for existing and new indications. The aims of this article are to review the results of recent trials aimed at enhancing the benefit-risk profile of antithrombotic therapy and explain how these findings are changing our approach to the management of arterial and venous thrombosis. Focusing on these 2 aspects of thrombosis management, this article discusses 4 advances: (1) the observation that in some indications, lowering the dose of some direct oral anticoagulants reduces the risk of bleeding without compromising efficacy, (2) the recognition that aspirin is not only effective for secondary prevention of atherothrombosis but also for prevention of venous thromboembolism, (3) the finding that dual pathway inhibition with the combination of low-dose rivaroxaban to attenuate thrombin generation plus aspirin to reduce thromboxane A2-mediated platelet activation is superior to aspirin or rivaroxaban alone for prevention of atherothrombosis in patients with coronary or peripheral artery disease, and (4) the development of inhibitors of factor XI or XII as potentially safer anticoagulants.
Development of a nomogram to predict overall survival in patients presenting with gastrointestinal neuroendocrine carcinoma (WHO G3).
Authors: Zhenyu Lin, Haihong Wang, Dejun Zhang, Dandan Yu, Tao Zhang
Journal: Journal of Clinical Oncology (2019)

197 Background: To evaluate the prognostic factors in patients with gastrointestinal neuroendocrine carcinoma (WHO G3) (GI-NEC) and develop a nomogram to predict 1-year overall survival (OS). Methods: We performed a retrospective analysis of 122 patients with GI-NEC. Nomogram for 1-year OS was created as visualizations of Cox proportional hazards regression models and internally validated by use of bootstrap and cross-validation. We assessed nomogram model performance by examining overall accuracy (Brier score), calibration (calibration plot), and discrimination (Harrell C index). Results: The median survival was 9 months in 122 patients, and 51 (41.8%) patients died in the development cohort. A 1-year OS was chosen because 82% of the patients who died from disease did so within 1 year. Multivariable analysis identified prognostic factors including performance status, stage, Ki-67 index and LDH, all of which were included in the final model. In the development cohort, the Harrell C index for overall survival was 0·887 (95% CI 0·810-0·964), and calibration curves showed adequate calibration (judged by eye) of the observed and predicted probabilities. Conclusions: Prognostic factors were used to develop nomograms for 1-year OS for GI-NEC. The nomogram can be offered to clinicians to improve their abilities to assess patient prognosis, strengthen the prognosis-based decision making, enhance patient stratification, and inform patients in the clinic.
Incidence of gastroesophageal junction cancer continues to rise: Analysis of Surveillance, Epidemiology, and End Results (SEER) database.
Authors: Michael Bartel, Bhaumik Brahmbhatt, Abhishek Bhurwal
Journal: Journal of Clinical Oncology (2019)

40 Background: Gastroesophageal junction (GEJ) cancer can be endoscopically resected and/or ablated in its early tumor stage. Despite significant effort to address the epidemiology and populations at risk for distal esoaphgeal cancer, very limited effort has been undertaken to assess such in GEJ cancer. Methods: A SEER database analysis was performed for the study period 1973 – 2013. Inclusion criteria were GEJ cancer (microscopically confirmed primary site of malignancy with ICD-O-3 histology of adenocarcinoma). Data was stratified by years 1973-82, 1983-92, 1993-2002 and 2003-2012, patient age, gender, and race. A Kaplan-Meier curve for the 5-year survival analysis of GEJ cancer was calculation. Further, GEJ cancer data was compared with the epidemiology of distal esophageal cancer (ICD-10). Results: 32,073 patients with GEJ cancer were included in the SEER database between 1973 and 2015 (female 19%, Caucasian race 88.7%). The incidence of GEJ cancer increased significantly over the four decades between 1973 and 2013, 15.7%, 25.3%, 26.9% and 32% (p = 0.001). The rising prevalence was particularly accounted in the patient age cohorts 65-74 years and 75+ years and in white male patients followed by black male patients. The 5-year survival analysis showed a median survival during the four analyzed decades of 8, 10, 11, and 14 months, respectively (Log rank test p &lt; 0.001). During the last decades (1993-2002 and 2003-2012) GEJ cancer and distal esophageal cancer had comparable incidences. Conclusions: GEJ cancer incidence is rising over the last four decades and is in fact comparable with the incidence of distal esophageal cancer. This is particularly true for white male patients and patients older than 65 years. Given that early GEJ cancer is endoscopically treatable, more effort is warranted to address its risk factors and to identify populations at risk who could benefit from early cancer detection programs.
Johnson and Johnson will be first US pharma company to reveal a drug’s price in TV advertisement
Authors: Owen Dyer
Journal: BMJ (2019)

Johnson and Johnson will give pricing information for its most prescribed drug, the anticoagulant rivaroxaban (Xarelto) in direct-to-consumer US television ads starting in March, the company has announced.

Ads will display both the list price and “potential patient out-of-pocket costs,” the company said. Other drugs will be phased in later.

The plan is similar to a Trump administration proposal to demand that drug makers declare their list prices in ads, and is being widely seen as an attempt to forestall compulsory government measures.

It puts Johnson and Johnson a step ahead of the industry’s trade association, PhRMA, which has argued that displaying list prices …
Self-reported illness and health status among Gulf War veterans. A population-based study. The Iowa Persian Gulf Study Group
Journal: JAMA (1997)

To assess the prevalence of self-reported symptoms and illnesses among military personnel deployed during the Persian Gulf War (PGW) and to compare the prevalence of these conditions with the prevalence among military personnel on active duty at the same time, but not deployed to the Persian Gulf (non-PGW).Cross-sectional telephone interview survey of PGW and non-PGW military personnel. The study instrument consisted of validated questions, validated questionnaires, and investigator-derived questions designed to assess relevant medical and psychiatric conditions.Population-based sample of military personnel from Iowa.A total of 4886 study subjects were randomly selected from 1 of 4 study domains (PGW regular military, PGW National Guard/Reserve, non-PGW regular military, and non-PGW National Guard/Reserve), stratifying for age, sex, race, rank, and branch of military service.Self-reported symptoms and symptoms of medical illnesses and psychiatric conditions.Overall, 3695 eligible study subjects (76%) and 91% of the located subjects completed the telephone interview. Compared with non-PGW military personnel, PGW military personnel reported a significantly higher prevalence of symptoms of depression (17.0% vs 10.9%; Cochran-Mantel-Haenszel test statistic, P<.001), posttraumatic stress disorder (PTSD) (1.9% vs 0.8%, P=.007), chronic fatigue (1.3% vs 0.3%, P<.001), cognitive dysfunction (18.7% vs 7.6%, P<.001), bronchitis (3.7% vs 2.7%, P<.001), asthma (7.2% vs 4.1%, P=.004), fibromyalgia (19.2% vs 9.6%, P<.001), alcohol abuse (17.4% vs 12.6%, P=.02), anxiety (4.0% vs 1.8%, P<.001), and sexual discomfort (respondent, 1.5% vs 1.1%, P=.009; respondent's female partner, 5.1% vs 2.4%, P<.001). Assessment of health-related quality of life demonstrated diminished mental and physical functioning scores for PGW military personnel. In almost all cases, larger differences between PGW and non-PGW military personnel were observed in the National Guard/Reserve comparison. Within the PGW military study population, compared with veterans in the regular military, veterans in the National Guard/Reserve only reported more symptoms of chronic fatigue (2.9% vs 1.0%, P=.03) and alcohol abuse (19.4% vs 17.0%, P=.004).Military personnel who participated in the PGW have a higher self-reported prevalence of medical and psychiatric conditions than contemporary military personnel who were not deployed to the Persian Gulf. These findings establish the need to further investigate the potential etiologic, clinical, pathogenic, and public health implications of the increased prevalence of multiple medical and psychiatric conditions in populations of military personnel deployed to the Persian Gulf.
Early Serum Free Light Chain (SFLC) Kinetics Is Highly Predictive of Renal Response in Carfilzomib/ Dexamethasone (Cfz/Dex) in Myeloma (MM) Patients with Renal Impairment (RI) — Interim Analysis of the Australian ALLG MM16 Trial
Authors: Phoebe Joy Ho, Andrew Spencer, Peter Mollee, Anoop K Enjeti, Noemi Horvath, Christian E Bryant, Judith Trotman, Simon Gibbs, Douglas E Joshua
Journal: Blood (2018)
Adjunctive vitamin D in tuberculosis treatment: meta-analysis of individual participant data
Authors: David A. Jolliffe, Davaasambuu Ganmaa, Christian Wejse, Rubhana Raqib, M. Ahsanul Haq, Nawal Salahuddin, Peter K. Daley, Anna P. Ralph, Thomas R. Ziegler, Adrian R. Martineau
Journal: European Respiratory Journal (2019)

Background Randomised controlled trials of adjunctive vitamin D in pulmonary tuberculosis (TB) treatment have yielded conflicting results. Individual participant data meta-analysis could identify factors explaining this variation. Methods We meta-analysed individual participant data from randomised controlled trials of vitamin D in patients receiving antimicrobial therapy for pulmonary TB. Primary outcome was time to sputum culture conversion. Secondary outcomes were time to sputum smear conversion, mean 8-week weight and incidence of adverse events. Pre-specified subgroup analyses were done according to baseline vitamin D status, age, sex, drug susceptibility, HIV status, extent of disease and vitamin D receptor genotype. Results Individual participant data were obtained for 1850 participants in eight studies. Vitamin D did not influence time to sputum culture conversion overall (adjusted HR 1.06, 95% CI 0.91–1.23), but it did accelerate sputum culture conversion in participants with multidrug-resistant pulmonary TB (adjusted HR 13.44, 95% CI 2.96–60.90); no such effect was seen in those whose isolate was sensitive to rifampicin and/or isoniazid (adjusted HR 1.02, 95% CI 0.88–1.19; p-value for interaction=0.02). Vitamin D accelerated sputum smear conversion overall (adjusted HR 1.15, 95% CI 1.01–1.31), but did not influence other secondary outcomes. Conclusions Vitamin D did not influence time to sputum culture conversion overall, but it accelerated sputum culture conversion in patients with multidrug-resistant pulmonary TB.
Subspecialty training in adult inherited metabolic diseases: a call to action for unmet needs
Authors: Fady Hannah-Shmouni, Constantine A Stratakis, Annalisa Sechi, Mirjam Langeveld, Tarekegn G Hiwot, Michel C Tchan, Fanny Mochel, Larry D Lynd, Sandra Sirrs
Journal: The Lancet Diabetes & Endocrinology (2019)
Evaluation of the effects of absorbable and nonabsorbable tacks on laparoscopic suprapubic hernia repair: A retrospective cohort study
Authors: Hasan Ediz Sikar, Kenan Çetin, Kemal Eyvaz, Mehmet Gökçeimam, Levent Kaptanoglu, Hasan Fehmi Küçük
Journal: International Journal of Surgery (2019)
Shareable 2-Wheeled Vehicles—A New Public Health Problem?
Authors: Frederick P. Rivara
Journal: JAMA Network Open (2019)

Tarak K. Trivedi, MD, MS; Charles Liu, MD; Anna Liza M. Antonio, DrPH; Natasha Wheaton, MD; Vanessa Kreger, MD, MPH; Anna Yap, MD; David Schriger, MD, MPH; Joann G. Elmore, MD, MPH