tbuckley/cabot-search huggingface dataset:
Endovascular Therapy for Stroke Due to Basilar-Artery Occlusion
Authors: Lucianne C.M. Langezaal, Erik J.R.J. van der Hoeven, Francisco J.A. Mont’Alverne, João J.F. de Carvalho, Fabrício O. Lima, Diederik W.J. Dippel, Aad van der Lugt, Rob T.H. Lo, Jelis Boiten, Geert J. Lycklama à Nijeholt, Julie Staals, Wim H. van Zwam, Paul J. Nederkoorn, Charles B.L.M. Majoie, Johannes C. Gerber, Mikael Mazighi, Michel Piotin, Andrea Zini, Stefano Vallone, Jeannette Hofmeijer, Sheila O. Martins, Christian H. Nolte, Kristina Szabo, Francisco A. Dias, Daniel G. Abud, Marieke J.H. Wermer, Michel J.M. Remmers, Hauke Schneider, Christina M. Rueckert, Karlijn F. de Laat, Albert J. Yoo, Pieter-Jan van Doormaal, Adriaan C.G.M. van Es, Bart J. Emmer, Patrik Michel, Volker Puetz, Heinrich J. Audebert, Octavio M. Pontes-Neto, Jan-Albert Vos, L. Jaap Kappelle, Ale Algra, Wouter J. Schonewille
Journal: New England Journal of Medicine (2021)

The effectiveness of endovascular therapy in patients with stroke caused by basilar-artery occlusion has not been well studied.We randomly assigned patients within 6 hours after the estimated time of onset of a stroke due to basilar-artery occlusion, in a 1:1 ratio, to receive endovascular therapy or standard medical care. The primary outcome was a favorable functional outcome, defined as a score of 0 to 3 on the modified Rankin scale (range, 0 to 6, with 0 indicating no disability, 3 indicating moderate disability, and 6 indicating death) at 90 days. The primary safety outcomes were symptomatic intracranial hemorrhage within 3 days after the initiation of treatment and mortality at 90 days.A total of 300 patients were enrolled (154 in the endovascular therapy group and 146 in the medical care group). Intravenous thrombolysis was used in 78.6% of the patients in the endovascular group and in 79.5% of those in the medical group. Endovascular treatment was initiated at a median of 4.4 hours after stroke onset. A favorable functional outcome occurred in 68 of 154 patients (44.2%) in the endovascular group and 55 of 146 patients (37.7%) in the medical care group (risk ratio, 1.18; 95% confidence interval [CI], 0.92 to 1.50). Symptomatic intracranial hemorrhage occurred in 4.5% of the patients after endovascular therapy and in 0.7% of those after medical therapy (risk ratio, 6.9; 95% CI, 0.9 to 53.0); mortality at 90 days was 38.3% and 43.2%, respectively (risk ratio, 0.87; 95% CI, 0.68 to 1.12).Among patients with stroke from basilar-artery occlusion, endovascular therapy and medical therapy did not differ significantly with respect to a favorable functional outcome, but, as reflected by the wide confidence interval for the primary outcome, the results of this trial may not exclude a substantial benefit of endovascular therapy. Larger trials are needed to determine the efficacy and safety of endovascular therapy for basilar-artery occlusion. (Funded by the Dutch Heart Foundation and others; BASICS ClinicalTrials.gov number, NCT01717755; Netherlands Trial Register number, NL2500.).
A nanocleaner specifically penetrates the blood‒brain barrier at lesions to clean toxic proteins and regulate inflammation in Alzheimer's disease
Authors: Ting Lei, Zhihang Yang, Xue Xia, Yuxiu Chen, Xiaotong Yang, Rou Xie, Fan Tong, Xiaolin Wang, Huile Gao
Journal: Acta Pharmaceutica Sinica B (2021)

Insurmountable blood‒brain barrier (BBB) and complex pathological features are the key factors affecting the treatment of Alzheimer's disease (AD). Poor accumulation of drugs in lesion sites and undesired effectiveness of simply reducing Aβ deposition or TAU protein need to be resolved urgently. Herein, a nanocleaner is designed with a rapamycin-loaded ROS-responsive PLGA core and surface modification with KLVFF peptide and acid-cleavable DAG peptide [R@(ox-PLGA)-KcD]. DAG can enhance the targeting and internalization effect of nanocleaner towards neurovascular unit endothelial cells in AD lesions, and subsequently detach from nanocleaner in response to acidic microenvironment of endosomes to promote the transcytosis of nanocleaner from endothelial cells into brain parenchyma. Then exposed KLVFF can capture and carry Aβ to microglia, attenuating Aβ-induced neurotoxicity. Strikingly, rapamycin, an autophagy promoter, is rapidly liberated from nanocleaner in the high ROS level of lesions to improve Aβ degradation and normalize inflammatory condition. This design altogether accelerates Aβ degradation and alleviates oxidative stress and excessive inflammatory response. Collectively, our finding offers a strategy to target the AD lesions precisely and multi-pronged therapies for clearing the toxic proteins and modulating lesion microenvironment, to achieve efficient AD therapy.
SP0048 CASE 1 PRESENTER: ALL THESE PAINKILLERS AND STILL NOT GOING ANYWHERE
Authors: Kristine Røren Nordén
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> The session will present a case history of a 24 year-old male presenting with axial Spondyloarthritis and extensive pain problems. He had been treated with biological medication for a while, had a low inflammatory burden, but experienced persistent pain. Furthermore, he was on sick leave from his job as an electrician and had a very low physical activity level. The patient was admitted for a 3-week in-patient rehabilitation stay at the Norwegian National Unit for Rehabilitation for Rheumatic Patients with Special Needs. The unit offers person-centered, specialized interdisciplinary in-patient rehabilitation for patients with inflammatory rheumatic disease. Target group is patients with complex illness challenges and increasing function- or activity problems. The rehabilitation was planned and organized through close cooperation between the patient and the specialized interdisciplinary team. Relationship between analgesics, pain and physical activity was a central issue in the rehabilitation process. The session will outline the patient response to comprehensive treatment modalities including changes in medication and participation in physical activity and exercise. <h3>Objectives:</h3> · To present the patient history · To present results of the interdisciplinary examination · To present the patient"s specific goals for the rehabilitation process · To present experiences with pharmacological and non-pharmacological treatment modalities for this patient <h3>Disclosure of Interests:</h3> None declared
Abstract 12676: Regular Intake of Pepper Decreases Cardiovascular Mortality: A Meta-Analysis
Authors: Sunil Upadhaya, Seetharamprasad Madala, Kanchan Tiwari
Journal: Circulation (2020)

Introduction: Cardiovascular disease is one of the leading causes of morbidity and mortality. Spice consumption has been shown to be beneficial on lipid and fasting glucose profile. However, there is no clear evidence regarding long-term effects of spice consumption. Methods: Systematic electronic search of PubMed and EMBASE databases was performed for studies, both randomized and non-randomized, that studied association of pepper consumption with total and cause-specific mortality. A random-effects model was used to calculate hazard ratio (HR). Results: Our search identified 4 observational studies (259,184 participants in regular pepper consumption group and 305,563 participants in low or no pepper consumption group). Regular pepper consumption was associated with significant reduction in all-cause mortality (HR: 0.87 [0.84-0.91], I 2 = 25%, p value &lt;0.00001) (Figure 1). In addition, pepper consumption was associated with significant reduction in cardiovascular mortality (HR 0.84 [0.77-0.91], I 2 = 66 %, p value &lt; 0.0001) (Figure 2), mortality related to ischemic heart disease (HR: 0.76 [0.66 -0.87], I 2 = 0%, p value = 0.0001) and cancer (HR: 0.91 [ 0.85-0.97], I 2 = 0%, p value = 0.003). However, stroke related mortality was similar in both groups (HR: 0.78 [0.56-1.10], I 2 = 61%, p value = 0.15). Conclusions: This study showed that regular intake of pepper significantly decreases rates of all-cause, cancer-related and cardiovascular mortality.
Personalizing Risk for Sudden Cardiac Death Among Patients With Dilated Cardiomyopathies
Authors: Sadiya S. Khan, Jane E. Wilcox
Journal: JAMA Cardiology (2021)

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Abstract 15622: Impact of Cardiac Rehabilitation on Six-Month Adherence to Cardiovascular Pharmacotherapy: Insights From the Ami-Optima 2 Study
Authors: Alexandre La Fontaine, Gladys Bruyninx, Michel Nguyen, Martine Montigny, Samer Mansour, Melinda Barabas, Jean-Claude Tardif, Thao Huynh
Journal: Circulation (2020)

Introduction: It remains unclear whether cardiac rehabilitation (CR) can enhance adherence to cardiovascular (CV) medications. We aim to determine the impact of CR on 6-month adherence to CV pharmacotherapy. Methods: We conducted a prospective observational cohort study of patients hospitalized for acute coronary syndromes (ACS) in Quebec, Canada, during 2016-2018. The primary endpoint was 6-month adherence to all of these drugs (dual anti-platelets, beta-blockers, hypocholesterolemiants, angiotensin pathway inhibitors). The secondary endpoints were adherence to each individual class of CV medication. Adherence was determined by measuring the proportion of days covered (PDC) (evaluated by pharmacies refills). PDC was measured both as continuous and categorical variables. Suboptimal adherence was defined as PDC&lt; 80%. We used inverse probability weighting to adjust for various factors which may have influenced the referral for CR and confounded the impact of CR on 6-month adherence (age, sex, coronary angioplasty, marital status, education, and occupation). All patients signed informed consent. Results: We enrolled 318 patients. Their mean age was 66±12 years; 30% were females. Of these patients, 152 undertook CR and 166 received standard follow-up. The mean age was 68 and 64 years, respectively. The proportions of females were similar in both groups. Overall PDC were 96%±13% vs 93%±17%; 7.2% and 11.2% patients had 6-month suboptimal adherence, respectively in patients who had CR vs patients without CR. After inverse weighting adjustment, CR was independently associated with improved adherence only with hypocholesterolemiants (Table 1). Conclusion: CR was not associated with improved 6-month overall adherence. However, patients who undertook CR were more adherent to hypocholesterolemiants than patients who did not undergo CR. CR programs should reinforce further to patients the importance of adherence to all ACS medications.
Decreased Ca 2+ Sensitivity of the Myofilament is Critical for the Development of Cardiac Dysfunction in Mouse Model of Dilated Cardiomyopathy
Authors: Hongo Kenichi, Morimoto Satoshi, Komukai Kimiaki, Kawai Makoto, O-Uchi Jin, Yoshimura Michihiro, Kurihara Satoshi
Journal: Circulation (2008)
Abstract 17427: Electrophysiological Characteristics and Results of Catheter Ablation for Septal Flutter After Pulmonary Vein Isolation
Authors: Nitish Badhwar, Ridhima Kapoor, Colleen Johnson, Emily Deckert, Mohan N Viswanathan, Santosh Oommen, Chad Brodt, Melvin M SCHEINMAN
Journal: Circulation (2020)

Background: Septal left atrial flutter has been described de novo and has been associated with lower catheter ablation success rate. Objective: To describe the electrophysiological characteristics and results of catheter ablation in patients with septal atrial flutter presenting after atrial fibrillation (AF) ablation. Methods: We retrospectively reviewed patients who presented with atrial flutter after PVI at 3 different centers. These included patients who had undergone surgical ablation and extensive catheter ablation for AF. Results: The study included 13 patients with septal atrial flutter. 6 patients presented after surgical ablation (including LAA clipping). All patients had undergone PVI and posterior wall isolation. Figure shows the 12 lead ECG and 3D electroanatomic map in one patient after surgical ablation of AF. The 12 lead ECG shows positive P waves in inferior leads, flat in I and avL with early precordial transition. The 3D map shows early activation on both sides of the septum with early meets late on septal side of the mitral annulus. The voltage map showed lack of voltage in posterior wall. Entrainment mapping was helpful in identifying both sides of the septum including septal mitral annulus, anterior roof and coronary sinus as part of the circuit. Catheter ablation was acutely successful in terminating flutter in 70% of the patients. The cycle length prolonged in the remaining patients. There was early recurrence leading to success rate of 50% after single ablation. Conclusion: Septal flutter after extensive catheter ablation and surgical ablation for AF is associated with low voltage in posterior wall. It involves a large circuit including both sides of the septum, anterior roof and CS.
Abstract 16837: Exosomes Derived From Podoplanin Positive Cells Induce Serum Amyloid A3 Amyloidosis in Healthy Mouse Heart
Authors: Maria Cimini, venkata naga srikanth garikipati, Andrea Elia, Chunlin Wang, MAY TRUONGCAO, Grace Huang, Vandana Mallaredy, Cindy Benedict, Raj Kishore
Journal: Circulation (2020)

The extra-cellular-matrix (ECM) composition of scar tissue after myocardial infarction (MI)has been largely investigated; although fibronectin and collagen are favorable for newmyocyte formation there is a missing component that increase the stiffness and reducethe remodeling of the ischemic area. We identified a primary Serum Amyloid A3 (Saa3)extracellular accumulation that contribute to the chronic alteration of the tissue. Serumamyloid amyloidosis (AA) are characterized by deposition of hepatic misfolded protein,Saa3 is the only amyloid protein that is released locally after inflammation, mostly bymesenchymal progenitor cells. We already described that two days after MI,mesenchymal and endothelial progenitor cells express Podoplanin (PDPN) a plateletaggregation-inducing type I transmembrane glycoprotein as a signal of activation. Exosomes derived from this cohort of cells actively release Saa3 in the ECM affecting thebiology of fibrosis beyond the inflammation. Specific histological staining such asthioflavin t and Congo red, showed amyloid deposition in mouse hearts 1 month after MI;furthermore, immunohistochemistry for Saa3 detected the deposition of the misfoldedprotein alongside fibronectin and collagen. PDPN+ cells were isolated 2 days after MI,cultured expanded and activated with TNFα and AngiotensinII. Activated PDPN positivecells highly expressed Saa3 and exosomes derived from activated PDPN+ cellsconditioned media were used in vivo for the treatment of healthy mouse hearts. Treatedmice developed an extended epicardial fibrosis and amyloidosis with a subsequentimpairment in the contractility and increase of the end diastolic and systolic volumes. Thefibrotic area was characterized by infiltrating CD45+ cells. Novel therapies aimed atpromoting clearance of existing amyloid deposits may be an effective approach in thenear future in the treatment of scar remodeling after MI.
Follow-up Evaluation after Risk Stratification Using EPS in Patients with Low-EF and Non-sustained Ventricular Tachycardia Associated with Structural Heart Disease
Authors: Ueno A, Kobayashi Y, Shinoda A, Ogano M, Okazaki R, Tateoka K, Taniguchi H, Horie T, Abe J
Journal: Circulation (2005)
Effects of insomnia and restless legs syndrome on sleep arterial blood pressure: A systematic review and meta-analysis
Authors: Giuseppe Maiolino, Valeria Bisogni, Davide Soranna, Martino F. Pengo, Giacomo Pucci, Roberto Vettor, Cristiano Fava, Gian Luca Colussi, Grzegorz Bilo, Carolina Lombardi, Gianfranco Parati, Gian Paolo Rossi, Alessandro Silvani
Journal: Sleep Medicine Reviews (2021)
Abstract MP32: The Level Of Adherence To The Dietary Approaches To Stop Hypertension Diet Is Associated With The Severity Of Insulin Resistance Among Community-Dwelling Heart Failure Patients: A National Health And Nutrition Examination Survey Analysis
Authors: Yuta Ishikawa, Emma M Laing, Alex K Anderson, Donglan Zhang, Rupal Trivedi-Kapoor, Elisabeth L Sattler
Journal: Circulation (2021)

Introduction: Heart failure (HF) patients are at risk of new-onset diabetes. In non-HF populations, adherence to the Dietary Approaches to Stop Hypertension (DASH) diet has shown to be associated with the delayed onset of insulin resistance; however, such effect remains unknown in HF patients without history of diabetes. Methods: Using data from 1999-2016 National Health and Nutrition Examination Survey cycles, we included 348 HF participants (20+ years) without history of diabetes or diabetes medication use and with data on at least one 24-hour dietary recall. Participants were classified by DASH dietary index score quartiles: quartile 1 indicated lowest DASH index scores and lowest DASH adherence, whereas quartile 4 indicated highest DASH index scores and highest DASH adherence. The severity of insulin resistance was examined using the Homeostatic Model Assessment of Insulin Resistance and was further classified by tertiles, where the upper tertile showed the most severe insulin resistance. Associations between the severity of insulin resistance and DASH dietary adherence and its linear trends were examined using logistic regression models. Results: Participants had a mean age of 65±1 (SE) years, 44.2% were female, and 10.5% were non-Hispanic black. The age-, gender-, and race/ethnicity-adjusted odds ratio for the most severe insulin resistance group in participants with highest DASH adherence was 0.32 (95% CI, 0.11-0.99), compared to participants with lowest DASH adherence. A significant trend of more severe insulin resistance was observed as participants showed less adherence to the DASH diet (p=0.02). Conclusion: Adherence to a DASH dietary pattern was associated with improved insulin resistance among community-dwelling HF patients in the U.S. Heart healthy dietary patterns may protect HF patients against new-onset diabetes. Future research is needed to test dietary interventions aimed at the prevention of HF complications and comorbidities.
Systematic review and meta-analysis of tocilizumab in persons with coronavirus disease-2019 (COVID-19)
Authors: Chong-xiang Chen, Fang Hu, Jin Wei, Le-tao Yuan, Tian-meng Wen, Robert Peter Gale, Yang Liang
Journal: Leukemia (2021)

Abstract We performed a meta-analysis to determine safety and efficacy of tocilizumab in persons with coronavirus disease-2019 (COVID-19). We searched PubMed, Web of Science and Medline using Boolean operators for studies with the terms coronavirus OR COVID-19 OR 2019-nCoV OR SARS-CoV-2 AND tocilizumab. Review Manager 5.4 was used to analyze data and the modified Newcastle–Ottawa and Jadad scales for quality assessment. We identified 32 studies in 11,487 subjects including three randomized trials and 29 cohort studies with a comparator cohort, including historical controls ( N = 5), a matched cohort ( N = 12), or concurrent controls ( N = 12). Overall, tocilizumab decreased risk of death (Relative Risk [RR] = 0.74; 95% confidence interval [CI], 0.59, 0.93; P = 0.008; I 2 = 80%) but not of surrogate endpoints including ICU admission (RR = 1.40 [0.64,3.06]; P = 0.4; I 2 = 88%), invasive mechanical ventilation (RR = 0.83 [0.57,1.22]; P = 0.34; I 2 = 65%) or secondary infections (RR = 1.30 [0.97,1.74]; P = 0.08; I 2 = 65%) and increased interval of hospitalization of subjects discharged alive(mean difference [MD] = 2 days [&lt;1, 4 days]; P = 0.006; I 2 = 0). RRs of death in studies with historical controls (RR = 0.28 [0.16,0.49; P &lt; 0.001]; I 2 = 62%) or a matched cohort (RR = 0.68 [0.53, 0.87]; P = 0.002; I 2 = 42%) were decreased. In contrast, RRs of death in studies with a concurrent control (RR = 1.10 [0.77, 1.56]; P = 0.60; I 2 = 85%) or randomized (RR = 1.18 [0.57,2.44]; P = 0.66; I 2 = 0) were not decreased. A reduced risk of death was not confirmed in our analyses which questions safety and efficacy of tocilizumab in persons with COVID-19.
Correspondence on ‘Second COVID-19 infection in a patient with granulomatosis with polyangiitis on rituximab’
Authors: Desiree Tampe, Peter Korsten, Samy Hakroush, Martin Sebastian Winkler, Björn Tampe
Journal: Annals of the Rheumatic Diseases (2021)

We read with great interest the recent article by Fiedman and Winthrop reporting a patient with granulomatosis with polyangiitis (GPA) being treated with rituximab (RTX), recurrent SARS-CoV-2 disease 2019 (COVID-19) and no detectable SARS-CoV-2 seroresponse after recovery.1 Anti-CD20 therapy impairs humoral response, theoretically increasing the risk of prolonged SARS-CoV-2 infection and shedding as well as subsequent reinfection.1–3 We have recently reported a patient with GPA under maintenance therapy with RTX and SARS-CoV-2 infection.4 Here, we report further details on anti-CD20 therapy with RTX, serological response to SARS-CoV-2 infection, virus elimination and corresponding B cell numbers. This case highlights that B cell numbers in patients with rheumatic diseases treated with RTX could associate with serological response to SARS-CoV-2 infection, which is particularly relevant as RTX may also impair the immunogenicity of SARS-CoV-2 vaccines.

An 80-year-old man had received a diagnosis of GPA in 2014 with biopsy-confirmed renal vasculitis and no history of pulmonary manifestation. After remission induction therapy, he received RTX at a dose of 500 mg every 6 months as maintenance therapy. The last …
Evaluation of Equitable Racial and Ethnic Representation Among Departmental Chairs in Academic Medicine, 1980-2019
Authors: Bismarck C. Odei, Reshma Jagsi, Dayssy Alexandra Diaz, Daniel Addison, Andrea Arnett, James B. Odei, Darrion Mitchell
Journal: JAMA Network Open (2021)

ResultsThe study examined data representing all faculty from 1980 (cohort size, 53 376 individuals) through 2019 (cohort size, 185 649 individuals), including all departmental chairs (3184 chairs in 1980 and 3311 chairs in 2019), from 122 (in 1980) to 153 (in 2019) MD-granting schools of medicine.Between 1980 and 2019, the proportion of Black, Hispanic, and Asian individuals among all faculty, senior faculty, and departmental chairs remained low compared with White cohorts (Figure).Among the represented specialties in 2019 (Table), White individuals were overrepresented in departmental chair positions across all specialties compared with the proportion of White faculty, except in family medicine.Conversely, Asian individuals were underrepresented as departmental