tbuckley/cabot-search huggingface dataset:
Abstract 233: Prehospital End-Tidal CO2 Measurement in Non-Intubated Traumatic Brain Injury Patients: Concordance Between EMS Provider Documentation and Non-Invasive Monitor Data Tracking
Authors: Octavio Perez, Daniel W Spaite, Eric Helfenbein, Saeed Babaeizadeh, Dawn B Jorgenson, Chengcheng Hu, Joshua B Gaither, Amber Rice, Samuel M Keim, Bruce J Barnhart
Journal: Circulation (2018)

Background: End-Tidal CO2 (ETCO2) monitoring is valuable in the management of traumatic brain injury (TBI). In intubated patients it helps prevent hyper/over-ventilation. In non-intubated patients, placing a sensor in the nares allows accurate monitoring of respiratory rate and has other promising uses (e.g. monitoring ETCO2 trends in worsening TBI, COPD, etc). Study Objective: To identify how accurately EMS providers document ETCO2, we compared the values recorded in EMS patient care records (PCR) to monitor data in non-intubated TBI patients. Methods: Cases from 6 EMS agencies reporting continuous monitor data (Philips MRx) in the EPIC Study (NIH 1R01NS071049) were evaluated (4/13-3/17). All ETCO2 data available for this post-hoc review were displayed and accessible to the EMS providers during care. Concordance was defined in two ways (for both highest and lowest ETCO2): ≤5 and ≤3 mmHg difference between the monitor data and PCR-documented values. Results: 106 cases were included [median age: 47 (range: 9-91), 66% male]. The figure shows concordance between PCR documentation and monitor data for both the lowest and highest recorded ETCO2 values. Conclusion: The highest PCR-recorded vs monitor ETCO2 values had excellent concordance for a difference ≤5 mmHg (85.9%) and it was good (76.4%) even when defined at the limits of instrument precision (≤3 for ETCO2 compared to actual pCO2). However, for lowest ETCO2, concordance was very poor (only 42.5% for ≤5). The failure to accurately document low ETCO2 in a “passive-ventilation” setting may also have significant implications for improving ventilatory care among intubated patients because identifying and correcting hypocapnia/hyperventilation in actively-ventilated cases is extraordinarily important. The low concordance rates may be due to the emphasis on discreet, intermittent vital sign documentation rather than ongoing identification and documentation of significant ETCO2 variation.
General practice public relations storm: shaped in broadcast, fixed in narrowcast
Authors: Richard Pratt
Journal: BMJ (2020)

General practice is in the throes of a public relations storm.1 We have come a long way from the Thursday evening clapping in the spring to the anti-GP graffiti in recent weeks. Without swift action on our part we risk widening the gap between patients and GPs in understanding access and the changed services we provide.

Broadcast media has played a role in shaping the …
Association of a New Trauma Center With Racial, Ethnic, and Socioeconomic Disparities in Access to Trauma Care
Authors: Ali B. Abbasi, Jay Dumanian, Samuel Okum, Darlington Nwaudo, Daniel Lee, Priya Prakash, Peter Bendix
Journal: JAMA Surgery (2020)

This observational study assesses the association of a new trauma center with transport times for trauma patients as a measure of prompt access to care and specifically examines changes in racial, ethnic, and income disparities in transport times.
Resident Physician Experiences With and Responses to Biased Patients
Authors: Shalila S. de Bourmont, Arun Burra, Sarah S. Nouri, Neveen El-Farra, Dinushika Mohottige, Caroline Sloan, Sarah Schaeffer, Jodi Friedman, Alicia Fernandez
Journal: JAMA Network Open (2020)

Biased patient behavior negatively impacts resident well-being. Data on the prevalence and frequency of these encounters are lacking and are needed to guide the creation of institutional trainings and policies to support trainees.To evaluate the frequency of resident experiences with and responses to a range of biased patient behaviors.A retrospective survey was sent via email to 331 second- and third-year internal medicine residents from 3 academic medical centers in California and North Carolina. First-year residents were excluded owing to their limited interactions with patients at the time of participant recruitment. Data were collected from August 21 to November 25, 2019.Descriptive statistics were used to report the frequency of experience of various types of biased patient behavior, residents' responses, the factors impeding residents' responses, and residents' experiences and beliefs regarding training and policies.Overall, 232 of 331 residents (70%) participated; 116 (50%) were women; 116 of 247 (47%) were White (participants had the option of selecting >1 race/ethnicity); and 23 (10%) identified as lesbian, gay, bisexual, transgender, or queer. The frequency of resident-reported experience of types of biased patient behaviors varied. The most common behaviors-belittling comments and assumption of nonphysician status-were reported to be experienced 1 or more times per week by 14% of residents (32 of 231) and 17% of residents (38 of 230), respectively. Women, Black or Latinx, and Asian residents reported experiencing biased behavior more frequently. Forty-five percent of Black or Latinx residents (17 of 38) encountered instances of explicit epithets or rejection of care. All 70 Asian residents reported experiencing inquiries into their ethnic origins. Most women residents (110 of 115 [96%]) experienced role questioning behaviors, and 87% (100 of 115) experienced sexual harassment. The need to prioritize clinical care and a sense of futility in responding were the most common factors (cited by 34% of residents [76 of 227] and 25% of residents [56 of 227], respectively) significantly impeding responses to biased behaviors. Eighty-five percent of residents (191 of 226) never reported incidents to their institution. Eighty-nine percent of residents (206 of 232) identified training and policies as necessary or very necessary.This survey study suggests that biased patient behavior is experienced frequently by internal medicine residents. Non-White and women residents reported experiencing a disproportionate burden of these incidents. Residents' responses rarely included institutional involvement. Residency programs and health care systems should prioritize training and policies to address biased patient behavior and support affected residents.
Covid-19: Moderna applies for US and EU approval as vaccine trial reports 94.1% efficacy
Authors: Elisabeth Mahase
Journal: BMJ (2020)

A treatment target for progressive left ventricular (LV) remodeling prevention following myocardial infarction (MI) is to affect structural changes directly within the MI region. One approach is through targeted injection of biocomposite materials, such as calcium hydroxyapatite microspheres (CHAM), into the MI region. In this study, the effects of CHAM injections upon key cell types responsible for the MI remodeling process, the macrophage and fibroblast, were examined. MI was induced in adult pigs before randomization to CHAM injections (20 targeted 0.1-ml injections within MI region) or saline. At 7 or 21 days post-MI (<i>n</i> = 6/time point per group), cardiac magnetic resonance imaging was performed, followed by macrophage and fibroblast isolation. Isolated macrophage profiles for monocyte chemotactic macrophage inflammatory protein-1 as measured by real-time polymerase chain reaction increased at 7 days post-MI in the CHAM group compared with MI only (16.3 ± 6.6 versus 1.7 ± 0.6 cycle times values, <i>P</i> &lt; 0.05), and were similar by 21 days post-MI. Temporal changes in fibroblast function and smooth muscle actin (SMA) expression relative to referent control (<i>n</i> = 5) occurred with MI. CHAM induced increases in fibroblast proliferation, migration, and SMA expression—indicative of fibroblast transformation. By 21 days, CHAM reduced LV dilation (diastolic volume: 75 ± 2 versus 97 ± 4 ml) and increased function (ejection fraction: 48 ± 2% versus 38 ± 2%) compared with MI only (both <i>P</i> &lt; 0.05). This study identified that effects on macrophage and fibroblast differentiation occurred with injection of biocomposite material within the MI, which translated into reduced adverse LV remodeling. These unique findings demonstrate that biomaterial injections impart biologic effects upon the MI remodeling process over any biophysical effects.
Cardiopulmonary Hemodynamics in Pulmonary Hypertension and Heart Failure
Authors: Bradley A. Maron, Gabor Kovacs, Anjali Vaidya, Deepak L. Bhatt, Rick A. Nishimura, Susanna Mak, Marco Guazzi, Ryan J. Tedford
Journal: Journal of the American College of Cardiology (2020)
Risk factors and outcomes associated with the carriage of tigecycline- and vancomycin-resistant
Authors: Johanna Kessel, Jennifer Bender, Guido Werner, Matas Griskaitis, Eva Herrmann, Annette Lehn, Hubert Serve, Kai Zacharowski, Stefan Zeuzem, Maria J.G.T. Vehreschild, Thomas A. Wichelhaus, Volkhard A.J. Kempf, Michael Hogardt
Journal: Journal of Infection (2020)
Abstract PO-051: Metabolic alterations reveal epigenetic vulnerabilities in breast cancer
Authors: Genevieve Deblois
Journal: Cancer Research (2020)

Abstract Tumor progression and therapeutic resistance in cancer are characterized by changes in cell identity, which is regulated in part by the epigenetic landscape of the cells. Alterations in metabolic profiles can contribute to changes in cell fate during tumor progression through remodelling of chromatin landscapes. We show that chemoresistance in triple-negative breast cancer is characterized by altered cellular metabolism, impacting the levels of metabolites required for DNA and histone methylation. Using models of chemotherapy resistance breast cancer, we have identified metabolic and epigenetic dependencies specific to drug-resistant breast cancer cells. We show that the remodelling of epigenetic states upon chemotherapy-induced metabolic stress can contribute to drug resistance in breast cancer cells by enabling the maintenance of transposable element repression and preventing the induction of cytotoxic stress-induced viral mimicry. While these metabolic and epigenetic changes contribute to the enhanced tumorigenic fitness of chemo resistant breast cancer, they reveal epigenetic vulnerabilities that can be therapeutically targeted in drug-resistant tumors. Citation Format: Genevieve Deblois. Metabolic alterations reveal epigenetic vulnerabilities in breast cancer [abstract]. In: Abstracts: AACR Special Virtual Conference on Epigenetics and Metabolism; October 15-16, 2020; 2020 Oct 15-16. Philadelphia (PA): AACR; Cancer Res 2020;80(23 Suppl):Abstract nr PO-051.
心サルコイドーシス診断における 18 F-FDG PETとMRI併用の有用性
Authors: 大平洋, 辻野一三, 渡部拓, 五十嵐正, 池田大輔, 伊東直史, 神垣光徳, 坂上慎二, 西村正治, 石丸伸司, 三浦真健, 大山徳子, 玉木長良
Journal: Circulation (2006)
299MO Efficacy and safety of entrectinib in an Asian population with NTRK fusion-positive (fp) solid tumours or ROS1-fp NSCLC
Authors: D.S.W. Tan, M-J. Ahn, C-H. Chiu, Y. Ohe, H.H.F. Loong, C.E. Chee, S-W. Kim, M. Takeda, Y-C. Li, A. Cheng, T. Hida, D-W. Kim, N. Nogami, W-C. Su, H. Tanaka, S. Osborne, R. Freund, D. Chen, T. Seto
Journal: Annals of Oncology (2020)
A Performance Comparison of Commonly Used Assays to Detect RET Fusions
Authors: Soo-Ryum Yang, Umut Aypar, Ezra Y. Rosen, Douglas A. Mata, Ryma Benayed, Kerry Mullaney, Gowtham Jayakumaran, Yanming Zhang, Denise Frosina, Alexander Drilon, Marc Ladanyi, Achim A. Jungbluth, Natasha Rekhtman, Jaclyn F. Hechtman
Journal: Clinical Cancer Research (2020)

Selpercatinib and pralsetinib induce deep and durable responses in patients with advanced RET fusion-positive lung and thyroid cancer. RET fusion testing strategies with rapid and reliable results are critical given recent FDA approval. Here, we assess various clinical assays in a large pan-cancer cohort.Tumors underwent DNA-based next-generation sequencing (NGS) with reflex to RNA-based NGS if no mitogenic driver or if a RET structural variant of unknown significance (SVUS) were present. Canonical DNA-level RET fusions and RNA-confirmed RET fusions were considered true fusions. Break-apart FISH and IHC performance were assessed in subgroups.A total of 171 of 41,869 patients with DNA NGS harbored RET structural variants, including 139 canonical fusions and 32 SVUS. Twelve of 32 (37.5%) SVUS were transcribed into RNA-level fusions, resulting in 151 oncogenic RET fusions. The most common RET fusion-positive tumor types were lung (65.6%) and thyroid (23.2%). The most common partners were KIF5B (45%), CCDC6 (29.1%), and NCOA4 (13.3%). DNA NGS showed 100% (46/46) sensitivity and 99.6% (4,459/4,479) specificity. FISH showed 91.7% (44/48) sensitivity, with lower sensitivity for NCOA4-RET (66.7%, 8/12). A total of 87.5% (7/8) of RET SVUS negative for RNA-level fusions demonstrated rearrangement by FISH. The sensitivity of IHC varied by fusion partner: KIF5B sensitivity was highest (100%, 31/31), followed by CCDC6 (88.9%, 16/18) and NCOA4 (50%, 6/12). Specificity of RET IHC was 82% (73/89).Although DNA sequencing has high sensitivity and specificity, RNA sequencing of RET SVUS is necessary. Both FISH and IHC demonstrated lower sensitivity for NCOA4-RET fusions.
Cell-Extracellular Matrix Interactions Play Multiple Essential Roles in Aortic Arch Development
Authors: Michael Warkala, Dongying Chen, AnnJosette Ramirez, Ali Jubran, Michael Schonning, Xia Wang, Huaning Zhao, Sophie Astrof
Journal: Circulation Research (2020)

Defects in the morphogenesis of the fourth pharyngeal arch arteries (PAAs) give rise to lethal birth defects. Understanding genes and mechanisms regulating PAA formation will provide important insights into the etiology and treatments for congenital heart disease.
Venetoclax-based chemotherapy in acute and chronic myeloid neoplasms: literature survey and practice points
Authors: Naseema Gangat, Ayalew Tefferi
Journal: Blood Cancer Journal (2020)

Abstract Venetoclax (VEN), a small-molecule inhibitor of B cell leukemia/lymphoma-2, is now FDA approved (November 2018) for use in acute myeloid leukemia (AML), specific to newly diagnosed elderly or unfit patients, in combination with a hypomethylating agent (HMA; including azacitidine or decitabine) or low-dose cytarabine. A recent phase-3 study compared VEN combined with either azacitidine or placebo, in the aforementioned study population; the complete remission (CR) and CR with incomplete count recovery (CRi) rates were 28.3% and 66.4%, respectively, and an improvement in overall survival was also demonstrated. VEN-based chemotherapy has also shown activity in relapsed/refractory AML (CR/CRi rates of 33–46%), high-risk myelodysplastic syndromes (CR 39% in treatment naïve, 5–14% in HMA failure), and blast-phase myeloproliferative neoplasm (CR 25%); in all instances, an additional fraction of patients met less stringent criteria for overall response. Regardless, venetoclax-induced remissions were often short-lived (less than a year) but long enough to allow some patients transition to allogeneic stem cell transplant. Herein, we review the current literature on the use of VEN-based combination therapy in both acute and chronic myeloid malignancies and also provide an outline of procedures we follow at our institution for drug administration, monitoring of adverse events and dose adjustments.
Nodular thyroid disease
Authors: G L Sayer, M K. Jones
Journal: BMJ (2001)

Nodular thyroid disease Abnormal thyroid function may be positive discriminator for malignancyEditor-Keston Jones states that testing of thyroid function is still one of the cornerstones of investigation in nodular thyroid disease. 1 He also states that overt thyroid dysfunction effectively rules out the possibility of malignancy.Thyroid function tests will not help in the discrimination of a nodule as they give no description of the nodule.In addition, malignancy may occur in patients with hyperthyroidism and a palpable thyroid nodule.Kraimps et al report that in patients with a cold nodule and Graves' disease the incidence of malignancy is as high as 15%, and that malignancy should be taken as an indication for total thyroidectomy, although in this group the nodules were mainly nonpalpable. 2ore impressively, Carnell and Valente report that 19% of palpable cold nodules were malignant in a retrospective review of 468 patients with Graves' disease. 3Thus in some instances abnormal thyroid function seems to be a positive discriminator for malignancy, although in the most euthyroid patients it will give no further diagnostic information.
Maternal and fetal outcomes in phaeochromocytoma and pregnancy: a multicentre retrospective cohort study and systematic review of literature
Authors: Irina Bancos, Elizabeth Atkinson, Charis Eng, William F Young, Hartmut P H Neumann, Marina Yukina, Debbie L Cohen, Steven G Waguespack, Maria Adelaide Albergaria Pereira, Xin He, Tushar Bandgar, Gianluca Donatini, Xiao-Ping Qi, Aviva Cohn, Anna Roslyakova, Claudio Letizia, Lauren Fishbein, Ravinder Jeet Kaur, Nicole Iniguez-Ariza, Mohammad H Murad, Lucinda Gruber, Heather Wachtel, Sergiy Cherenko, Camilo Jimenez, Tobias Else, Swati Ramteke-Jadhav, Xu-dong Fang, Anand Vaidya, Luigi Petramala, Dmitry Beltsevich, Martin K Walz, Eleonora P.M. Corssmit, Nelson Wohllk, Nicola Tufton, Thera P Links, Alfonso Massimiliano Ferrara, Uliana Tsoy, Diane Donegan, Mariola Peczkowska, Henri J Timmers, Valentina Morelli, Andreas Ebbehoj, Lawrence S Kirschner, Tada Kunavisarut, Catharina Larsson, Inna Kudlai, Kornelia Hasse-Lazar, Marcin Barczyński, Timo Deutschbein, Katharina Langton, Åse Krogh Rasmussen, Sarka Dvorakova, Julie A Miller, Longfei Liu, Bonita Bennett, Ya-Sheng Huang, Zhi-xian Yu, Sanjeet Kumar Jaiswal, Nalini Shah, Rene E Diaz, Robin P.F Dullaart, Scott A Akker, William M Drake, Francesca Boaretto, Stefania Zovato, Giovanni Barbon, Elisa Taschin, Francesca Schiavi, Elena Grineva, Maximilien Rappaport, Paul Skierczynski, Martin Fassnacht, Jan Calissendorff, C Christofer Juhlin, Petr Vlĕek, Minghao Li, Eric Jonasch, Larry Prokop, Milan Jovanovic, Ronald M Lechan, Feyza Erenler, Vishnu Garla, Maryna Bobryk, Andrey Y Kovalenko, Emma Hodson, Bernadette Jenner, Helen L Simpson, Ruth T Casey, Oliver Gimm, Joanne Ngeow Yuen Yie, Zulfiya Shafigullina, Maria João Martins Bugalho, Silvia Rizzati, Merav Fraenkel, Mark Sherlock, Dipti Sarma, Uma Kaimal Saikia, Anna Riester, Marcus Quinkler, Stefan Zschiedrich, Jochen Seufert, Birke Bausch, Nino Zavrashvili, Esben Søndergaard,, Jes Sloth Mathiesen, Maciej G Robaczyk, Per Løgstrup Poulsen, Volha Vasilkova, Flavia A Costa-Barbosa, Claudio E Kater, Ilgin Yildirim Simsir, M. Umit Ugurlu, Utku E Soyaltin, Özer Makay, Nikita V Ivanov, Giuseppe Opocher, Viacheslav I Egorov, Roman Petrov, Natalia V Khudiakova
Journal: The Lancet Diabetes & Endocrinology (2020)
Inflammatory Myositis in Cancer Patients Receiving Immune Checkpoint Inhibitors
Authors: Jeffrey Aldrich, Xerxes Pundole, Sudhakar Tummala, Nicolas Palaskas, Clark R. Andersen, Mahran Shoukier, Noha Abdel‐Wahab, Anita Deswal, Maria E. Suarez‐Almazor
Journal: Arthritis & Rheumatology (2020)

To estimate the incidence of immune checkpoint inhibitor-related myositis (ICI-myositis) in cancer patients receiving ICIs, and to report associated clinical manifestations, patterns of care, and outcomes.We identified a retrospective cohort of patients receiving ICIs between 2016 and 2019 seen at the University of Texas MD Anderson Cancer Center. Cases of ICI-myositis were identified using International Classification of Disease codes and confirmed by reviewing medical records and pathology, as available.A total of 9,088 patients received an ICI. Thirty-six patients (0.40%) were identified as having ICI-myositis: 17 patients (47%) with ICI-myositis alone and 19 (53%) with overlap manifestations (5 patients with myocarditis, 5 with myasthenia gravis, and 9 with both). The incidence of ICI-myositis was 0.31% in those receiving ICI monotherapy and 0.94% in those receiving combination ICI therapy (relative risk 3.1 [95% confidence interval 1.5-6.1]). Twenty-five patients (69%) received ≥1 treatment in addition to glucocorticoids: plasmapheresis in 17 patients (47%), intravenous immunoglobulin in 12 (33%), and biologics in 11 (31%). Patients with overlap conditions had worse outcomes than those with myositis alone, and 79% of them developed respiratory failure. Eight patients died as a result of ICI-myositis, and all had overlap syndrome with myasthenia gravis or myocarditis (P < 0.05); 75% of these patients had a concomitant infection.ICI-myositis is a rare but severe adverse event. More than half of the patients presented with overlap manifestations and had deleterious outcomes, including respiratory failure and death. None of the patients with ICI-myositis alone died as a result of adverse events. Optimal treatment strategies have yet to be determined.
Role of FFR-CT for the Evaluation of Patients With Anomalous Aortic Origin of Coronary Artery
Authors: Warda Ferrag, François Scalbert, Julien Adjedj, Patrick Dupouy, Phalla Ou, Jean-Michel Juliard, Reza Farnoud, Ahmed A. Benadji, Xavier Halna Du Fretay, William Wijns, Pierre Aubry, Fabien Hyafil
Journal: JACC. Cardiovascular imaging (2020)
Evaluation of Circulating Cardiovascular Biomarker Levels for Early Detection of Congenital Heart Disease in Newborns in Sweden
Authors: Henning Clausen, Elisabeth Norén, Salla Valtonen, Aki Koivu, Mikko Sairanen, Petru Liuba
Journal: JAMA Network Open (2020)

<h3>Importance</h3> Congenital heart disease (CHD) is the most common congenital malformation in humans worldwide. Circulating cardiovascular biomarkers could potentially improve the early detection of CHD, even in asymptomatic newborns. <h3>Objectives</h3> To assess the performance of a dried blood spot (DBS) test to measure the cardiovascular biomarker amino terminal fragment of the prohormone brain-type natriuretic peptide (NT-proBNP) levels in newborns and to compare DBS with standard EDTA analysis in control newborns during the first week of life. <h3>Design, Setting, and Participants</h3> This diagnostic study was conducted in a single regional pediatric service in southern Sweden. Healthy, term neonates born between July 1, 2018, and May 31, 2019, were prospectively enrolled and compared against retrospectively identified newborns with CHD born between September 1, 2003, and September 30, 2019. Neonates who required inpatient treatment beyond the standard postnatal care were excluded. <h3>Exposure</h3> New DBS test for NT-proBNP quantification in newborns that used 3 μL of blood vs the current screening standard. <h3>Main Outcomes and Measures</h3> Performance of the new test and when combined with pulse oximetry screening was measured by receiver operating characteristic curve analysis. Performance of the new test and EDTA screening was compared using Pearson linear correlation analysis. <h3>Results</h3> The DBS samples of 115 neonates (81 control newborns and 34 newborns with CHD, of whom 63 were boys [55%] and the mean [SD] gestational age was 39.6 [1.4] weeks) were analyzed. The new NT-proBNP test alone identified 71% (n = 24 of 34) of all CHD cases and 68% (n = 13 of 19) of critical CHD cases as soon as 2 days after birth. Detection of any CHD type improved to 82% (n = 28 of 34 newborns) and detection of critical CHD improved to 89% (n = 17 of 19 newborns) when combined pulse oximetry screening and NT-proBNP test results were used. Performance of the NT-proBNP test was excellent when control newborns were matched to newborns with CHD born between July 1, 2018, and May 31, 2019 (area under the curve, 0.96; SE, 0.027; 95% CI, 0.908-1.0; asymptotic<i>P</i> &lt; .05). <h3>Conclusions and Relevance</h3> This study found that NT-proBNP assay using minimal DBS samples appears to be timely and accurate in detecting CHD in newborns and to discriminate well between healthy newborns and newborns with various types of CHD. This finding warrants further studies in larger cohorts and highlights the potential of NT-proBNP to improve neonatal CHD screening.