tbuckley/cabot-search huggingface dataset:
Abstract MP68: Association Of Multiparity With Carotid Artery Plaque Prevalence: The Multi-Ethnic Study Of Atherosclerosis (MESA)
Authors: Carla Rodriguez, Oluseye Ogunmoroti, Brian Rodriguez, Dhananjay Vaidya, Anum A Minhas, Brigitte Kazzi, Colleen Harrington, Lara Kovell, Michael Honigberg, James H Stein, Michael D Shapiro, Erin D Michos
Journal: Circulation (2022)

Background: Multiparity may be associated with an increased risk of cardiovascular disease (CVD); however, responsible mechanisms are incompletely understood. Carotid artery plaque is a marker of subclinical atherosclerosis and an indicator of CVD risk. We hypothesized that multiparity would be independently associated with greater atherosclerosis, as measured by carotid plaque. Methods: We included women in MESA free of CVD who had data on parity ascertained by questionnaire and carotid plaque measured by B-mode ultrasound at baseline. Parity was categorized as nulliparity (ref), 1-2, 3-4 and ≥5 live births. Multivariable logistic and linear regression were performed to evaluate the association of parity categories with carotid plaque presence (yes/no) and extent [carotid plaque score (CPS)], respectively. Results: Of 2789 women included, 38% were White, 29% Black, 12% Chinese, and 22% Hispanic with a mean (SD) age of 62±10 yrs. Carotid plaque prevalence increased with greater parity ( Figure) . Compared to nulliparity, a history of 1-2 live births, 3-4 live births, and grand multiparity (≥5 live births) were significantly associated with carotid plaque presence after adjustment for demographics ( Table, Model 1 ) . Grand multiparity remained significantly associated with carotid plaque presence after full covariate adjustment [OR 1.42 (95% 1.01-2.01), Model 2]. In addition, a history of 1-2 live births and grand multiparity was associated with a greater CPS compared to nulliparity after adjustment for demographics (Model 1). The association of parity with CPS was attenuated and no longer significantly associated with CPS after further adjustment for lifestyle and CVD risk factors (Model 2). Conclusion: In a multiethnic cohort of US women, grand multiparity was independently associated with carotid plaque presence. Further studies are needed to understand the increased risk and prognostic significance of subclinical atherosclerosis among parous women.
Pulmonary Vasculitis on Dual-Phase 18F-FDG PET/CT in SAPHO Syndrome
Authors: Takashi Norikane, Yuka Yamamoto, Hanae Arai-Okuda, Hiroaki Dobashi, Yoshihiro Nishiyama
Journal: Clinical Nuclear Medicine (2022)

Abstract Pulmonary vasculitis is an uncommon type of vasculitis that may cause pulmonary artery stenosis with ensuing ischemic damage to lung tissue. 99m Tc–macroaggregated albumin scintigraphy and iodine lung perfusion mapping are useful imaging modalities for assessment of lung perfusion but are not useful for assessing disease activity. On the other hand, 18 F-FDG PET/CT is widely used for assessment of vasculitis activity but cannot provide perfusion information. We reported the clinical utility of dual-phase 18 F-FDG PET/CT for pulmonary vasculitis in patients with SAPHO (synovitis-acne-pustulosis-hyperostosis-osteitis) syndrome.
Abstract EP42: Effects Of Bariatric Surgery On Acute Coronary Syndrome
Authors: Pyi Phyo Aung, Kyeeun Park, Fangcheng Wu, Navy Konidala, Htoo Myat Nge
Journal: Circulation (2022)

Obesity is one of the most common and modifiable risk factors of cardiovascular diseases. Bariatric surgery (BS) is a fast-growing procedure being used to treat patients with morbid obesity, obesity with significant comorbidities or failed dietary and pharmacological therapy. We assessed the hypothesis that bariatric surgery has positive effects on acute coronary syndrome (ACS) in obese population. We conducted a retrospective analysis of 3 years of the National Inpatient Sample (NIS) database, 2016 to 2018. Study populations were selected using ICD-10 diagnosis code. Discharge-level weight analysis was used to produce a national estimate. We conducted multivariate regression analysis to calculate odds ratio with STATA 17. During the study period, 106,970,745 patients were discharged, and 2,996,629 patients experienced acute coronary artery syndrome during the hospitalization. Total 962,780 (0.90%) patients had history of bariatric surgery. Patients with BS tended to be female (77.84 % v 56.21 %), older (54.91± 0.30 v 49.43 ± 0.01), diabetic (28.47% v 22.50%) and hypertensive (42.60% v 29.23%) but prevalence of hyperlipidemia was similar in both groups (3.73% v 3.23%). The prevalence of ACS was significantly reduced with BS in patient with obesity (1.51% v 2.81%). After adjusting for age, sex, race and comorbid burden, obesity was associated with higher risk of ACS (OR 1.13, 1.13 - 1.15, p&lt;0.0001), whereas patients with obesity who underwent BS was associated with lower risk for ACS (OR 0.61, 0.59 - 0.64, p&lt; 0.0001). After adjusting for comorbidities, BS decreased the risk of in-hospital mortality (OR 0.67, 0.56-0.80, p&lt; 0.0001) and major cardiovascular events (OR 0.59, 0.48-0.72, p&lt; 0.0001). In conclusion, bariatric surgery is associated with lower risk of acute coronary syndrome as well as better outcomes including lower in-hospital mortality and lower major cardiovascular events in obese population.
Hypoxia Increases the Potential for Neutrophil-mediated Endothelial Damage in Chronic Obstructive Pulmonary Disease
Authors: Katharine M. Lodge, Arlette Vassallo, Bin Liu, Merete Long, Zhen Tong, Paul R. Newby, Danya Agha-Jaffar, Koralia Paschalaki, Clara E. Green, Kylie B. R. Belchamber, Victoria C. Ridger, Robert A. Stockley, Elizabeth Sapey, Charlotte Summers, Andrew S. Cowburn, Edwin R. Chilvers, Wei Li, Alison M. Condliffe
Journal: American Journal of Respiratory and Critical Care Medicine (2022)

Rationale: Patients with chronic obstructive pulmonary disease (COPD) experience excess cardiovascular morbidity and mortality, and exacerbations further increase the risk of such events. COPD is associated with persistent blood and airway neutrophilia and systemic and tissue hypoxia. Hypoxia augments neutrophil elastase release, enhancing capacity for tissue injury. Objective: To determine whether hypoxia-driven neutrophil protein secretion contributes to endothelial damage in COPD. Methods: The healthy human neutrophil secretome generated under normoxic or hypoxic conditions was characterized by quantitative mass spectrometry, and the capacity for neutrophil-mediated endothelial damage was assessed. Histotoxic protein concentrations were measured in normoxic versus hypoxic neutrophil supernatants and plasma from patients experiencing COPD exacerbation and healthy control subjects. Measurements and Main Results: Hypoxia promoted PI3Kγ-dependent neutrophil elastase secretion, with greater release seen in neutrophils from patients with COPD. Supernatants from neutrophils incubated under hypoxia caused pulmonary endothelial cell damage, and identical supernatants from COPD neutrophils increased neutrophil adherence to endothelial cells. Proteomics revealed differential neutrophil protein secretion under hypoxia and normoxia, and hypoxia augmented secretion of a subset of histotoxic granule and cytosolic proteins, with significantly greater release seen in COPD neutrophils. The plasma of patients with COPD had higher content of hypoxia-upregulated neutrophil-derived proteins and protease activity, and vascular injury markers. Conclusions: Hypoxia drives a destructive “hypersecretory” neutrophil phenotype conferring enhanced capacity for endothelial injury, with a corresponding signature of neutrophil degranulation and vascular injury identified in plasma of patients with COPD. Thus, hypoxic enhancement of neutrophil degranulation may contribute to increased cardiovascular risk in COPD. These insights may identify new therapeutic opportunities for endothelial damage in COPD.
An Evanishing Thyroid During Immune Checkpoint Inhibitor Therapy
Authors: Marco Cuzzocrea, Gaetano Paone, Luca Ceriani, Luca Giovanella
Journal: Clinical Nuclear Medicine (2021)

In recent years, a large number of articles have described the endocrine-related adverse events associated with immune checkpoint inhibitors, especially affecting the thyroid. A 37-year-old man affected by nasopharyngeal carcinoma (stage IVb) underwent serial 18F-FDG PET/CT evaluations during treatment with nivolumab (480 mg every 4 weeks) after first-line chemoradiotherapy. The patient had no history of thyroid disease and before starting immunotherapy the thyroid-stimulating hormone value was normal at 0.9 mU/L (reference range, 0.27-4.2 mIU/L). FDG PET/CT studies revealed involution of the thyroid gland following immune checkpoint inhibitor-induced thyroiditis.
Genetic Counseling and Testing in African American Patients With Breast Cancer: A Nationwide Survey of US Breast Oncologists
Authors: Foluso O. Ademuyiwa, Patricia Salyer, Yu Tao, Jingqin Luo, Whitney L. Hensing, Abisola Afolalu, Lindsay L. Peterson, Katherine Weilbaecher, Ashley J. Housten, Ana A. Baumann, Monica Desai, Susan Jones, Erin Linnenbringer, Jennifer Plichta, Laura Bierut
Journal: Journal of Clinical Oncology (2021)

To determine if physicians' self-reported knowledge, attitudes, and practices regarding genetic counseling and testing (GCT) vary by patients' race.We conducted a nationwide 49-item survey among breast oncology physicians in the United States. We queried respondents about their own demographics, clinical characteristics, knowledge, attitudes, practices, and perceived barriers in providing GCT to patients with breast cancer.Our survey included responses from 277 physicians (females, 58.8%; medical oncologists, 75.1%; academic physicians, 61.7%; and Whites, 67.1%). Only 1.8% indicated that they were more likely to refer a White patient than refer an African American patient for GCT, and 66.9% believed that African American women with breast cancer have lower rates of GCT than White women. Regarding perceived barriers to GCT, 63.4% of respondents indicated that African American women face more barriers than White women do and 21% felt that African American women require more information and guidance during the GCT decision-making process than White women. Although 32% of respondents indicated that lack of trust was a barrier to GCT in all patients, 58.1% felt that this was a greater barrier for African American women (P < .0001). Only 13.9% believed that noncompliance with GCT is a barrier for all patients, whereas 30.6% believed that African American women are more likely than White women to be noncompliant (P < .0001).We demonstrated that racial differences exist in oncology physicians' perceived barriers to GCT for patients with breast cancer. This nationwide survey will serve as a basis for understanding physicians' determinants of GCT for African American women and highlights the necessity of education and interventions to address bias among physicians. Awareness of such physician biases can enable further work to address inequities, ultimately leading to improved GCT equity for African American women with breast cancer.
Abstract MP46: Adverse Childhood Experiences Are Linked To Disrupted Sleep And Diurnal Cortisol Concentrations In Young Adult Women.
Authors: Nathaniel D Jenkins, Emily Rogers, Nile Banks, Patrick Tomko, Christina Sciarrillo, Sam Emerson, Ashlee Taylor, Kent Teague
Journal: Circulation (2022)

Introduction: Early life psychosocial stress and adversity - referred to as adverse childhood experiences (ACEs) - are highly prevalent, with ~60% of American adults reporting exposure to at least one ACE. ACEs occur during critical developmental periods and are related to cardiovascular morbidity and mortality in a graded, dose-dependent manner. Sleep is an emerging lifestyle behavior that has been associated with cardiometabolic morbidity and mortality, and poor sleep has been associated with ACEs. Hypothesis: We hypothesized that ACEs would be associated with disrupted sleep and altered diurnal cortisol slopes in young adult women. Methods: Forty-two young adult women (mean ± SD, age = 21 ± 3 y) completed this study. Twenty-eight women reported an ACE score ≥4 and were classified as having moderate to severe ACEs, while 14 women reported an ACE score of 0. Women provided saliva samples collected using the passive drool technique upon waking and 8 h later. Cortisol concentrations were then quantified from the saliva samples by ELISA and diurnal cortisol slopes (DCS) were calculated by expressing the difference between morning and afternoon concentrations relative to the time between sampling (μg/dL/h). The participants also completed the Center for Epidemiologic Studies Depression Scale Revised (CESD-R), from which a composite sleep score (CSS; range = 0 - 12) was created from the three sleep-related items and reverse-scored such that a higher score indicated better sleep. Women also completed the Maltreatment and Abuse Chronology of Exposure Scale, from which a total maltreatment and abuse severity score was calculated (MACE TSS ). Mann-Whitney tests were used to examine differences in DCS and CSS between those with versus without a history of ACEs. Median values are reported. Spearman correlations were used to examine associations among DCS, CSS, and MACE TSS . Results: DCS was greater (-0.0396 vs. -0.0661 μg/dl/h; U = 94, p = 0.01), indicating lower variability, and CSS was lower (5 vs. 7; U = 118.5, p = 0.04), indicating poorer sleep, in the women with versus without a history of ACEs. Further, MACE TSS was related to DCS (ρ = 0.397, p = 0.007) and to CSS (ρ = -0.358, p = 0.011). The relationship between DCS and CSS (ρ = -0.218, p = 0.092) was not significant. Conclusions: Our preliminary evidence indicates that ACEs are associated with poorer sleep and disrupted diurnal cortisol patterns. While we are limited by subjective sleep assessments and small sample size, these findings suggest a link between early life psychosocial stress, poor sleep and circadian disruption that could contribute to lifetime cardiometabolic disease risk. Future, large-scale studies are needed to further explore these associations.
Hepatic Arterial Infusion of Oxaliplatin, Fluorouracil, and Leucovorin Versus Transarterial Chemoembolization for Large Hepatocellular Carcinoma: A Randomized Phase III Trial
Authors: Qi-Jiong Li, Min-Ke He, Huan-Wei Chen, Wan-Qiang Fang, Yuan-Min Zhou, Li Xu, Wei Wei, Yao-Jun Zhang, Ying Guo, Rong-Ping Guo, Min-Shan Chen, Ming Shi
Journal: Journal of Clinical Oncology (2021)

In a previous phase II trial, hepatic arterial infusion chemotherapy (HAIC) with infusional fluorouracil, leucovorin, and oxaliplatin (FOLFOX) yielded higher treatment responses than transarterial chemoembolization (TACE) in large unresectable hepatocellular carcinoma. We aimed to compare the overall survival of patients treated with FOLFOX-HAIC versus TACE as first-line treatment in this population.In this randomized, multicenter, open-label trial, adults with unresectable hepatocellular carcinoma (largest diameter ≥ 7 cm) without macrovascular invasion or extrahepatic spread were randomly assigned 1:1 to FOLFOX-HAIC (oxaliplatin 130 mg/m2, leucovorin 400 mg/m2, fluorouracil bolus 400 mg/m2 on day 1, and fluorouracil infusion 2,400 mg/m2 for 24 hours, once every 3 weeks) or TACE (epirubicin 50 mg, lobaplatin 50 mg, and lipiodol and polyvinyl alcohol particles). The primary end point was overall survival by intention-to-treat analysis. Safety was assessed in patients who received ≥ 1 cycle of study treatment.Between October 1, 2016, and November 23, 2018, 315 patients were randomly assigned to FOLFOX-HAIC (n = 159) or TACE (n = 156). The median overall survival in the FOLFOX-HAIC group was 23.1 months (95% CI, 18.5 to 27.7) versus 16.1 months (95% CI, 14.3 to 17.9) in the TACE group (hazard ratio, 0.58; 95% CI, 0.45 to 0.75; P < .001). The FOLFOX-HAIC group showed a higher response rate than the TACE group (73 [46%] v 28 [18%]; P < .001) and a longer median progression-free survival (9.6 [95% CI, 7.4 to 11.9] v 5.4 months [95% CI, 3.8 to 7.0], P < .001). The incidence of serious adverse events was higher in the TACE group than in the FOLFOX-HAIC group (30% v 19%, P = .03). Two deaths in the FOLFOX-HAIC group and two in the TACE group were deemed to be treatment-related.FOLFOX-HAIC significantly improved overall survival over TACE in patients with unresectable large hepatocellular carcinoma.
Abstract P238: Stroke-belt Residence And Post-stroke Statin Use
Authors: Phoebe M Tran, Cenjing Zhu, Tiffany E Chang, Larry B Goldstein, Judith H Lichtman
Journal: Circulation (2022)

Background: AHA/ASA guidelines recommend statins in appropriate patients to reduce the risk of recurrent stroke. Previous studies have found disproportionately high stroke readmission rates in the Stroke Belt (SB) region in the southern portion of the United States. There is limited information about contemporary post-stroke statin use in SB residents and how this compares to other regions of the country. Methods: Stroke patients residing in or outside the SB who had a history of hyperlipidemia were identified from the nationally representative 2017 and 2019 Behavioral Risk Factor Surveillance System surveys. Current statin use (Yes/No) was ascertained. Survey-weighted estimates of overall and sex- and age-specific statin use were determined by SB resident status. Logistic regression with survey weighting was applied to calculate odds ratios of statin use without and with adjustment for stroke-related sociodemographic covariates. Results: The sample included 21,006 stroke survivors (16% SB residents). SB residence (80.8% vs. 78.9% in non-SB residents, Figure) was not associated with higher odds of post-stroke statin use without or with confounder adjustment. In sex- and age-specific analyses, SB residents were more likely than non-SB residents to use statins following a stroke in all subgroups, with this difference being most pronounced in those age 18-44y. Conclusions: Overall statin use was similar between stroke survivors residing in SB and non-SB states but was lowest among those aged 18-44 years regardless of residence. Our findings suggest other factors related to post-discharge care may more greatly impact recurrent stroke rates in rural US areas than statin medication use and warrant additional study.
Correction: Water exchange-assisted versus carbon dioxide-insufflated single-balloon enteroscopy: a randomized controlled trial
Authors: Shaopeng Liu, Tao Dong, Yupeng Shi, Hui Luo, Xianmin Xue, Yijin Zhu, Xiangping Wang, Biaoluo Wang, Shuhui Liang, Yanglin Pan, Xuegang Guo, Kaichun Wu
Journal: Endoscopy (2021)

Correction to: Water exchange-assisted versus carbon dioxide-insufflated single-balloon enteroscopy: a randomized controlled trialEndoscopy 2022; 54(03): 281-289DOI: 10.1055/a-1459-4571
Performances of 18F-FDOPA PET/CT in the Preoperative Evaluation of the Peritoneal Cancer Index in Small Intestine Neuroendocrine Tumors
Authors: David Morland, Pascaline Jallerat, Hedia Brixi, Guillaume Cadiot, Dimitri Papathanassiou, Sophie Deguelte
Journal: Clinical Nuclear Medicine (2022)

Purpose Peritoneal carcinomatosis (PC) concerns up to 30% of patients with a neuroendocrine tumor (NET), especially of the small intestine. Aggressive management of carcinomatosis seems to be justified, especially with regard to possible mechanical complications. 18 F-FDOPA PET/CT is known to be the most sensitive imaging modality for the detection of small bowel NET metastases, yet its performance in the detection of PC is not well studied. The main objective of our study is to evaluate the performances of preoperative 18 F-FDOPA PET/CT in the prediction of surgical peritoneal cancer index. Methods All patients referred to our center for an 18 F-FDOPA PET/CT from October 2017 to January 2021 were retrospectively screened. Images were analyzed by a blinded nuclear medicine physician, and peritoneal abnormalities were reported to comply with the surgical peritoneal cancer index standard. Per patient analysis and per region analysis were then conducted. Results Thirty-three patients were included; 6 patients (35 regions) presented a peritoneal carcinosis. Peritoneal Carcinomatosis Index (PCI) estimated on 18 F-FDOPA PET/CT was significantly and strongly correlated to surgical PCI ( r = 0.96, P &lt; 0.001). Patient-based sensitivity, specificity, negative predictive value, and positive predictive value for 18 F-FDOPA PET/CT were 100%, 93%, 100%, and 75%, respectively. The agreement between 18 F-FDOPA and surgery regarding PC was excellent (Cohen κ = 0.82 on per patient analysis, 0.74 on per region analysis). Conclusions A preoperative estimation of PCI is achievable based on 18 F-FDOPA PET/CT for small intestine NET and could allow to optimize surgical procedures and patient selection.
Inhaled Corticosteroids and Long-Acting β2 Receptor Agonists for Preterm-Born Children—New Insights but Still Many Questions
Authors: Luca Bonadies, Laura Moschino, Eugenio Baraldi
Journal: JAMA Pediatrics (2022)

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