tbuckley/cabot-search huggingface dataset:
Abstract 12897: Coenzyme Q10 in the Treatment of Heart Failure With Preserved Ejection Fraction: A Prospective, Randomized, Double-blind Trial
Authors: Tal Y Samuel, Tal Hasin, Israel Gotsman, Tanya Weitsman, Fanny Ben Ivgi, Ziv Dadon, Elad Asher, Ronny Alcalai, David Leibowitz
Journal: Circulation (2020)

Background: Heart failure with preserved ejection fraction (HFpEF) is the most common form of heart failure (HF) in the elderly and is increasing in prevalence. No specific treatment for this condition appears to be effective. Coenzyme Q10 (CoQ10) is an essential cofactor for energy production and reduced levels have been noted in HF. Previous studies have suggested a possible role for CoQ10 in the treatment of HF in particular in the elderly. Aim: To evaluate the effect of CoQ10 supplementation on diastolic function in patients with HFpEF. Methods: A prospective, randomized, double-blind, placebo-controlled trial. Inclusion criteria were age &gt; 50 years, New York Heart Association class II-IV, ejection fraction &gt; 50%, and evidence of impaired diastolic function defined as lateral e' &lt; 0.09 cm/sec, average E/e' &gt; 13 or average E/e' &gt; 8 with additional markers of impaired diastolic function such as delayed relaxation (E/A &lt; 0.5), elevated left atrial volume index (&gt; 40ml / m 2 ) elevated left ventricular mass index ( &gt; 122 gr/ m 2 ♀ or 149 gr/ m 2 ♂) or pulmonary hypertension. Patients with other forms of cardiomyopathies or treated with chronic renal replacement therapy were excluded. Echocardiographic studies and levels of N-terminal pro-B type natriuretic peptide (NT-proBNP) were completed at baseline and following 4 months of CoQ10 (300 mg daily) or placebo supplementation. Results: A total of 39 patients were enrolled, 19 patients in the CoQ10 and 20 patients in the placebo group. Groups were similar in baseline clinical characteristics. Compliance was high and similar between groups (average 208 ± 108 mg/day for the CoQ10 versus 212 ± 95 mg/day for the placebo group). No significant effect was observed on indices of diastolic function or NT-proBNP levels following 4 months of CoQ10 use. Conclusions: Treatment with CoQ10 did not affect indices of diastolic function or NT-proBNP levels in patients with HFpEF. Our study does not support the routine use of CoQ10 in patients with HFpEF.
Incidence of acute complications of herpes zoster among immunocompetent adults in England: a matched cohort study using routine health data*
Authors: H.J. Forbes, K. Bhaskaran, D. Grint, V.H. Hu, S.M. Langan, H.I. McDonald, C. Morton, L. Smeeth, J.L. Walker, C. Warren‐Gash
Journal: British Journal of Dermatology (2020)

Herpes zoster can cause rare but serious complications; the frequency of these complications has not been well described.
Abstract 13435: Characterization of Open Chromatin in Human Mitral Valves to Identify Regulatory Mechanisms at Mitral Valve Prolapse Genetic Loci
Authors: Sergiy Kyryachenko, Adrien Georges, Mengyao Yu, Takiy Berrandou, Tony Rubio, Judith Gronwald, Hassina Baraki, Ingo Kutschka, Russel Norris, Niels Voigt, Nabila Bouatia-Naji
Journal: Circulation (2020)

Introduction: Mitral valve prolapse (MVP) is a common valve disease that leads to mitral insufficiency, heart failure, and sudden death. The identification of genetic risk loci provided insight into its genetic architecture, although the causal variants and target genes need to be fully characterized. Hypothesis: Functional genomic annotation, including chromatin accessibility profiles of human mitral valves, allows the characterization of variants and target genes at MVP loci. Methods: We determined open chromatin regions using the assay for transposase-accessible chromatin with high-throughput sequencing (ATAC-Seq) from surgically removed human valves and primary cultures of fibroblasts. We analyzed the spatial conformation of MVP-associated loci using circular chromatin conformation capture (4C-Seq) with candidate causal variants as viewpoints. Candidate causal variants were followed-up using reporter assays and in silico analyses. Results: We mapped the open chromatin from 11 human mitral valves and 3 primary cell cultures. We found that mitral valve-specific ATAC-Seq peaks were enriched near genes involved in extracellular matrix organization, chondrocyte differentiation, and connective tissue development. We also found that MVP-associated variants (p&lt;10 -5 ) observed in the MVP GWAS were significantly enriched (p&lt;0.05) in mitral valve open chromatin regions, but not in heart tissue from ENCODE. We found that rs6723013 on Chr2 belongs to a valve-specific enhancer at the IGFBP5/TNS1 locus and is the most likely causal variant at this locus. We also identified several plausible causal SNPs and, by using 4C-Seq, potential target genes ( HIC1 and DPH1 ) at the SMG6/SRR locus. Conclusions: Here we describe unprecedented genome-wide open chromatin profiles from human mitral valves that indicate specific gene regulation profiles, compared to the heart. We also report in vitro functional evidence for potential causal variants and target genes at MVP risk loci involving established and new biological mechanisms relevant to mitral valve disease.
2009 Distinguished Scientist Lecture—Highlights of Hormones and Heart Disease: Forty Years in Forty Minutes: The Rancho Bernardo Study
Authors: Elizabeth Barrett-Connor
Journal: Circulation (2009)

The Rancho Bernardo Study began in 1972 as one of 12 Lipid Research Clinic Prevalence Studies sponsored by the National Heart Institute. Each site was allowed to select its own epidemiologist, who could then select a cohort of 5000 to 6000 individuals. I was given the great opportunity to choose the San Diego LRC cohort. I chose Rancho Bernardo for several reasons, of which perhaps the most important was that it was a new town with many “old people” over the age 50 years. Beyond any expectation, Rancho Bernardo is now in its fortieth year of continuous funding from the NIH, plus intermittent and critically important additional grants to junior faculty and visiting scholars from the American Heart Association. In the beginning, I knew little about cohort studies or heart disease epidemiology. I did know that heart disease had 6 accepted risk factors: age, male sex, cholesterol, smoking, blood pressure, and diabetes. Every clinician knew male sex was a strong heart disease risk factor, but clinical studies of sex differences were few. The LRC had not planned to study diabetes, which “belonged to another institute,” but I managed to add fasting glucose and 2 pages about noncholesterol risk factors, including diabetes, to the baseline 2-page questionnaire. During the next 40 years, that small beginning allowed me and many new colleagues the opportunity to try to understand the interface between sex differences in coronary heart disease and diabetes. This talk summarizes cardiovascular insights based on epidemiological data from the Rancho Bernardo Study. I am grateful to the many scholars at diverse levels of training who began their careers using Rancho Bernardo data and the many who continue to do so.
Abstract 14637: In-hospital Outcomes of Transcatheter Aortic Valve Replacement (TAVR) in Patients With a History of Malignancy
Authors: Jelani Grant, Bertrand Ebner, Louis Vincent, Jennifer Maning, neal olarte, Odunayo P Olorunfemi, Eduardo Saul, Igor Vaz, Rosario A Colombo, joao Braghiroli
Journal: Circulation (2020)

Introduction: A history of malignancy is incorporated in the Society of Thoracic Surgeons (STS) Score to assess presurgical risk in patients undergoing surgical aortic valve replacement (SAVR), however data on the prognostic importance in those undergoing TAVR remains limited. Methods: The National Inpatient Sample Database was queried from 2012 to 2017 to identify patients who underwent TAVR using International Classification of Diseases (ICD) 9 and 10 procedure codes. These patients were classified into those who had a history of malignancy or not using ICD 9 and 10 diagnostic codes. Results: There were 24,615 patients who underwent TAVR, of these 4,735 patients had a prior history of malignancy whereas 19,880 patients had no prior history of malignancy. Patients with a history of malignancy were older than those without (81.1±7.9 vs. 80.1± 6.7 years old, p&lt;0.001). Baseline characteristics are shown in Table 1. Patients with a history of malignancy had similar rates of post-TAVR pacemaker implantation (7.6% vs. 6.8%,p=0.05), deep vein thrombosis/pulmonary embolism (2.8% vs.3.1%, p=0.231), paravalvular leak (0.9% vs. 1.1%, p=0.312) and cardiogenic shock (0.3% vs. 0.3%, p=0.828) as those without. The occurrence of post TAVR ischemic strokes were higher in those without a history of malignancy ( 4.8% vs. 3.6%, p&lt;0.001). Using a multivariate logistic regression model to adjust for confounding factors such as age, gender, hypertension, diabetes, heart failure, chronic kidney disease and coronary artery disease, a history of malignancy was predictive of decreased odds of death in patients undergoing TAVR (odds ratio: 0.69, 95% confidence interval 0.53-0.90, p=0.007). Conclusions: In patients with severe symptomatic AS and a history of malignancy, TAVR appears safe with comparable in-hospital outcomes. A history of malignancy should not preclude TAVR in patients with severe symptomatic AS, however larger studies are needed to confirm this finding.
Abstract 15845: Heart Heroes: A Gamified Mhealth Platform to Measure Continuous Cardiac Health Data in the Outpatient Setting of Adolescent Patients With Known and Suspected Heart Disease
Authors: Jennifer C Miller, Trevor Barrett, Neil Patel, Andrew Souza, John Wood, Leslie A Saxon
Journal: Circulation (2020)

Introduction: Adolescents with heart disease report difficulty in communication about their health as a major inhibiting factor in their care. MHealth technologies collect health data in daily life and enable health data sharing between the provider and patient. The adolescent population has a high level of engagement with mobile devices and a willingness to use them for health-related activities. Hypothesis: We hypothesized that our novel gamified mHealth platform Heart Hero can engage adolescent patients in the collection of cardiac health data in their daily life. Methods: We designed the research app using ResearchKit to collect continuous physiological data from the Apple Watch and daily survey data on well-being, stress, medical adherence, and cardiac symptoms. Patients were provided the app, iPhone, and Apple Watch and enrolled for 27 days. A final in-app survey was provided to assess feedback. We enrolled 28 patients total who were scheduled for outpatient cardiopulmonary exercise testing. Results: Mean age was 14.3 years old (SD +/-3.08) with a 1:1 M:F ratio. 61% of patients were ≥ 15 years of age. 94% of patients completed the final survey. Subjects on average completed 64% (SEM +/-5) of the daily quizzes with an average daily adherence of over 50% wearing the watch. 100% reported they liked using the watch and app, and 89% would like to continue wearing the Apple Watch. 53% reported the study encouraged them to exercise more while 21% reported encouragement to walk more. Fig 1 demonstrates A) Apple Watch and b) daily survey data collected from a patient throughout the study. Conclusions: In conclusion, Heart Hero is a mHealth platform which can successfully be used to collect continuous health data from the adolescent population with high engagement characterized by adherence and positive patient feedback. Adherence to the app was notably superior to the initial 5 ResearchKit applications enrolling adult patients.
Abstract 281: The Association of Left and Right Atrial Volume Indices on Survival Time Post-cardiac Arrest
Authors: Sami H Ibrahim, Matt S Miller, Olivia J Blazek, Jarred E Strickling, Comfort Elumogo, Olusola Laja, Sahar Mohammadi, Syed Ahmad, Kenneth C Bilchick, Sula Mazimba
Journal: Circulation (2020)

Introduction: Left and right atrial volume indices (LAVI and RAVI) are markers of cardiac remodeling. LAVI and RAVI are associated with worse outcomes in other cardiac conditions. This study aimed to determine the association of LAVI and RAVI with survival time post-cardiac arrest. Hypothesis: Atrial volumes are associated with survival time post-cardiac arrest. Methods: This was a single center, retrospective study of patients with a cardiac arrest event during index hospitalization from 2014-2018. LAVI was calculated using the biplane Simpson’s method, while RAVI was calculated using a single plane summation in the 4-chamber view. Patients were further stratified into either having a Vfib/pulseless VT (pVT) event or a PEA arrest/asystole event. Survival time was measured in days from event to death date. Kaplan-Meier plots were used to evaluate differences in survival time for patients based on mean LAVI and RAVI. Results: Of 305 patients studied (64 +/- 14 years, 37% female (112 out of 305)), 162 had a reliable LAVI measurement with a mean of 34.1 mL/m 2 (SD=15.8) and 163 had a reliable RAVI measurement with a mean of 25.1 mL/m 2 (SD=15.5). In patients who had sustained a VFib/pVT event, those with reduced LAVI (p=0.045) and RAVI (p=0.041) values below the mean had significantly improved survival time. No association was found in the PEA/asystole subgroup. KM plots of patient survival for both LAVI and RAVI compared to mean are presented in figures 1a and 1b. Conclusion: Among patients presenting with Vifb/pVT arrest, increased LAVI and RAVI were associated with decreased survival time. More studies are needed to better prognosticate cardiac arrest using atrial volumes.
Automated Identification of Adults at Risk for In-Hospital Clinical Deterioration
Authors: Gabriel J. Escobar, Vincent X. Liu, Alejandro Schuler, Brian Lawson, John D. Greene, Patricia Kipnis
Journal: New England Journal of Medicine (2020)

Hospitalized adults whose condition deteriorates while they are in wards (outside the intensive care unit [ICU]) have considerable morbidity and mortality. Early identification of patients at risk for clinical deterioration has relied on manually calculated scores. Outcomes after an automated detection of impending clinical deterioration have not been widely reported.On the basis of a validated model that uses information from electronic medical records to identify hospitalized patients at high risk for clinical deterioration (which permits automated, real-time risk-score calculation), we developed an intervention program involving remote monitoring by nurses who reviewed records of patients who had been identified as being at high risk; results of this monitoring were then communicated to rapid-response teams at hospitals. We compared outcomes (including the primary outcome, mortality within 30 days after an alert) among hospitalized patients (excluding those in the ICU) whose condition reached the alert threshold at hospitals where the system was operational (intervention sites, where alerts led to a clinical response) with outcomes among patients at hospitals where the system had not yet been deployed (comparison sites, where a patient's condition would have triggered a clinical response after an alert had the system been operational). Multivariate analyses adjusted for demographic characteristics, severity of illness, and burden of coexisting conditions.The program was deployed in a staggered fashion at 19 hospitals between August 1, 2016, and February 28, 2019. We identified 548,838 non-ICU hospitalizations involving 326,816 patients. A total of 43,949 hospitalizations (involving 35,669 patients) involved a patient whose condition reached the alert threshold; 15,487 hospitalizations were included in the intervention cohort, and 28,462 hospitalizations in the comparison cohort. Mortality within 30 days after an alert was lower in the intervention cohort than in the comparison cohort (adjusted relative risk, 0.84, 95% confidence interval, 0.78 to 0.90; P<0.001).The use of an automated predictive model to identify high-risk patients for whom interventions by rapid-response teams could be implemented was associated with decreased mortality. (Funded by the Gordon and Betty Moore Foundation and others.).
An understanding of mitochondria and its role in targeting nanocarriers for diagnosis and treatment of cancer
Authors: Devendra Choudhary, Hanmant Goykar, Tukaram Karanwad, Suraj Kannaujia, Vedant Gadekar, Manju Misra
Journal: Asian Journal of Pharmaceutical Sciences (2020)

Nanotechnology has changed the entire paradigm of drug targeting and has shown tremendous potential in the area of cancer therapy due to its specificity. In cancer, several targets have been explored which could be utilized for the better treatment of disease. Mitochondria, the so-called powerhouse of cell, portrays significant role in the survival and death of cells, and has emerged as potential target for cancer therapy. Direct targeting and nanotechnology based approaches can be tailor-made to target mitochondria and thus improve the survival rate of patients suffering from cancer. With this backdrop, in present review, we have reemphasized the role of mitochondria in cancer progression and inhibition, highlighting the different targets that can be explored for targeting of disease. Moreover, we have also summarized different nanoparticulate systems that have been used for treatment of cancer via mitochondrial targeting.
Abstract 352: Development of a Novel Tool for Data Abstraction From 911 Calls for Out-of-hospital Cardiac Arrest
Authors: Nathanial Hunt, Stephen Dowker, Brad Trumpower, Michael O'Leary, Neil Kamdar, Graham Smith, Woodrow Sams, Emilee Coulter-thompson, Randy Bloom, Cindy Polydoras, Kevin Irwin, Robert Swor, Mahshid Abir, Robert Domeier, Charles Friedman, Robert W Neumar, Brahmajee K Nallamothu
Journal: Circulation (2020)

Introduction: For out-of-hospital cardiac arrests (OHCAs) unwitnessed by emergency responders, contact with the 911 system provides the earliest point for consistent data collection. Building upon previous tools, we developed a 911 call data abstraction instrument and tested it to see if it reliably tracked key metrics from 911 calls for dispatch assisted CPR in order to guide quality initiatives for OHCA. Methods: Data abstractors applied this tool to a random sample of 23 emergency medical services (EMS)-confirmed, second-party, non-traumatic, non-overdose adult OHCAs occurring prior to first responder arrival from November 2017 to November 2019 in Washtenaw County, Michigan. For each call, data elements were collected by 2 independent reviewers. We focused on key variables: 1) whether the arrest was recognized by dispatch in eligible cases (n=23), 2) whether instructed compressions were provided in eligible cases (n=23), and 3) the 911-time-to-first-instructed-compression (n=11). To evaluate interrater reliability, we calculated kappa statistics for categorical variables and intraclass correlation coefficients (ICC) for continuous variables. Results: We included 23 calls with an average patient age of 64.2 (SD: 10.9) lasting an average of ~5 mins. Overall, 16 patients were men and 7 were women. Thirteen calls originated from private residences, 9 from a public place, and 1 could not be identified. We found that OHCA was recognized by dispatch in 18 of the 23 calls (78%). Reviewers reported instructed compressions occurred in 14 of 23 calls (61%). The median 911-time-to-first-instructed-compression of calls where consistent measurement was possible (n=11) was 197.5 seconds (IQR: 2:30.0-4:44.0). Among calls, kappa statistics for recognition of cardiac arrest and provision of instruction compressions was 1.00 (n=23) and 0.91 (n=23), respectively, while the ICC for time-to-first instructed compression was &gt;0.99 (n=11). Conclusions: Reviewing 911 calls with this tool was capable of collecting reliable information from independent reviewers on key events including critically important times. Collection of these data is a critical first step for evaluating system performance to improve survival from OHCA.
AB0205 Unusual aetiology of erythema nodosum, arthritis, and pleural effusion
Authors: U Steiger, M Weber, H Gerber
Journal: Annals of the Rheumatic Diseases (2001)

<h3>Background</h3> Association of erythema nodosum with giardia lamblia infection is only known for a few adult cases in the literature.<sup>1</sup> Several case reports discuss reactive arthritis or sacroiliitis with giardiasis.<sup>2</sup> Allergies and other immunological features such as pleural eosinophilic effusion have occasionally been reported as well. <h3>Objectives</h3> A 36-year-old male refugee from Sri Lanka was referred to our outpatient department for erythema nodosum and history of arthralgia of large and medium-size joints and low back pain not fully responsive to NSAID. He also had symptoms such as low grade fever, conjunctival injection, and headaches. He complained of a slight weight loss. Family history and system review was unremarkable except for intermittent chronic eye inflammation with itching, later classified as nodular episcleritic lesions. There were no gastrointestinal complaints. <h3>Methods</h3> Clinical examination revealed erythema nodosum and pleural effusion, but no synovialitis. Laboratory analysis showed mild inflammatory reaction with normal eosinophil count, no complement consumption nor significant auto-antibody titer. Serum IgE titer was high. Three-phase bone scintigraphy and x-ray of the sacroiliacal joints were normal. Chest x-ray showed a pleural effusion. Because of life style and origin of the patient, we ordered a stool sample examination, which was full of giardia lamblia. <h3>Results</h3> The prescribed metronidazole regimen was not taken for compliance problems. Five months later he was again referred for erythema nodosum and arthritis with swelling of ankle, wrist, knee and MCP joints. Chest x-ray revealed pleural effusion as before. Stool samples again showed giardia infestation with unchanged laboratory analyses. After a five days course of metronidazole 250 mg t.i.d., joint symptoms diminished dramatically, and erythema nodosum vanished. <h3>Conclusion</h3> Giardia lamblia infection typically presents with abdominal symptoms or malabsorption syndrome, some patients develop low grade fever and headaches. Hypersensitivity symptoms such as pleural effusion, reactive arthritis and erythema nodosum are very rarely reported. Diagnosis is confirmed by the good response of the joint symptoms to antiparasitic therapy. The presented case of relapsing erythema nodosum and arthritis and pleural effusion documents for the first time in the literature the coincidence of these three rare complications of giardiasis. <h3>References</h3> Giordano N, Fioravanti A, Mariani A, Marcolongo R. Erythema nodosum and giardia intestinalis. Clin Rheumatol. 1985;4:481–3 Tupchong M, Simor A, Dewar C. Beaver fever ? a rare cause of reactive arthritis. J Rheumatol. 1999;26:2701–2
David Eamonn Laws
Authors: Gwyn Williams, Michael Austin, Garry Shuttleworth
Journal: BMJ (2020)

David Eamonn Laws (“Dave”) was born in London and brought up in Kent. He was the first of his family to go to university. His medical career began in Cardiff but took him to Nottingham, Birmingham, Liverpool, and Brisbane (Australia), before he was appointed the first dedicated paediatric consultant ophthalmologist in Swansea in 1995. Exceptionally hardworking, in large part through his love of medicine in general and ophthalmology in particular, Dave worked full time until very recently. He was well known as being a very fit individual, kayaking around the island of Mull, cycling the length of Vietnam, and most recently beating his daughter’s partner …