tbuckley/cabot-search huggingface dataset:
Abstract PS14-06: Changes in management of breast cancer patients during first wave of COVID19, throughout the area of Kent, United Kingdom. An audit of ESMO guideline implementation
Authors: Simon N Rodney, Charlotte Abson, Russell Burcombe, Rema Jyothirmayi, Catherine Harper-Wynne
Journal: Cancer Research (2021)

Abstract Background: The global COVID-19 pandemic has placed unprecedented burden on individual oncology patients, oncology departments, hospitals and national health systems. In order to protect individual patients from the risk of COVID-19 infection as well as improve capacity for COVID-19 patient management, a series of national and internationally agreed measures were proposed. During the first wave of infections the virulence and effect on cancer patients was not known. It is vitally important that the measures implemented to combat these risks are assessed and evaluated in order to learn best how to manage potential future waves of known and unknown viral infections.Methods: The international ESMO COVID-19 guidelines and national (NICE) guidelines were implemented across Kent, UK. All changes to treatment regimens were audited to assess what were the most frequent changes and in which patient groups could these be implemented. Data was subdivided for both early and advanced breast cancer as well as ER+, HER2+ or triple negative disease.Results: We collected full treatment history from 1,718 breast cancer patients currently receiving active oncology treatments. We were able to change treatment regimens due to COVID19 for 32.8% of patients. Of these 27.1% were early breast cancer patients compared with 43.7% were those with advanced metastatic disease. The most common changes for neoadjuvant changes were proceeding to surgery before completion of planned chemotherapy (10.2%), switch to 3 weekly Paclitaxel (10%) and chemotherapy break (8%). For adjuvant patients the most common changes included postponement of bisphosphonates (70.8%), chemotherapy break (13.5%), and curtailment to 6 months of adjuvant Trastuzumab (10.4%). For our palliative patients the most common changes included delay CDK4/6 inhibitor treatment (79.2%), postponement of bisphosphonates (24.8%), break in HER2 antibody (9.6%) and break in chemotherapy (8%).Conclusions: A large proportion of breast cancer oncology patients were deemed suitable to have a change in original planned treatment. We are fortunate to have comparatively large number of treatment options that can be customised on a patient basis to individual reduce risk of COVID-19. Further analysis is needed over time to compare the oncological outcomes of those in whom treatment was changes from the current gold standards of care. Citation Format: Simon N Rodney, Charlotte Abson, Russell Burcombe, Rema Jyothirmayi, Catherine Harper-Wynne. Changes in management of breast cancer patients during first wave of COVID19, throughout the area of Kent, United Kingdom. An audit of ESMO guideline implementation [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS14-06.
The Yin and Yang of traditional Chinese and Western medicine
Authors: Rao Fu, Jie Li, Huatao Yu, Yang Zhang, Zhihong Xu, Cathie Martin
Journal: Medicinal Research Reviews (2021)

Abstract The success of Western Scientific approaches to medicine, over the last 150 years, can be measured by substantial increases in life expectancy, reductions in infant mortality and the virtual elimination of many infectious diseases accompanied by development of effective management practices for noncommunicable diseases. However, major challenges remain in the form of infectious diseases that evolve resistance to pharmaceuticals rapidly, new diseases, particularly those caused by viruses and effective long‐term treatments for chronic, noncommunicable diseases. Traditional Chinese Medicine (TCM) can offer complementary treatments based on personalised interventions, informed by knowledge accumulated from empirical observations gathered over centuries of practice, that address the impact of disease on the whole body. We provide examples of both infectious and noncommunicable diseases where the combination of Western Scientific Medicine (WSM) and TCM can benefit patients in terms of the speed and efficacy of recovery or disease management. TCM is a healing skill based on practice, while WSM is scientific, based on experiments. Against this background, an understanding of the mechanisms of action of traditional Chinese medicinal preparations will offer fresh routes to discovery and development of new therapeutics as well as patented medical prescriptions, which will rely heavily on modern scientific methodologies for their adoption and success, particularly those in plant genomics, plant breeding and synthetic biology.
COVID‐19 vaccination intention among patients with psoriasis compared with immunosuppressed patients with other skin diseases and factors influencing their decision
Authors: E. Sotiriou, K. Bakirtzi, I. Papadimitriou, E. Paschou, E. Vakirlis, A. Lallas, D. Ioannides
Journal: British Journal of Dermatology (2021)

Psoriasis (Ps) is a chronic, immune-mediated skin disease with systemic involvement. Therapeutic advancements in its management have considerably improved disease activity and quality of life, and reduced hospitalization rates. Nevertheless, prolonged immunosuppression in psoriatic patients may increase their susceptibility to opportunistic infections.
Systematic review of pharmacokinetics and potential pharmacokinetic interactions of flavonolignans from silymarin
Authors: Václav Tvrdý, Jana Pourová, Eduard Jirkovský, Vladimír Křen, Kateřina Valentová, Přemysl Mladěnka
Journal: Medicinal Research Reviews (2021)

Silymarin is an extract from the seeds (fruits) of Silybum marianum that contains flavonolignans and flavonoids. Although it is frequently used as a hepatoprotective agent, its application remains somewhat debatable, in particular, due to the low oral bioavailability of flavonolignans. Moreover, there are claims of its potential interactions with concomitantly used drugs. This review aims at a systematic summary and critical assessment of known information on the pharmacokinetics of particular silymarin flavonolignans. There are two known major reasons for poor systemic oral bioavailability of flavonolignans: (1) rapid conjugation in intestinal cells or the liver and (2) efflux of parent flavonolignans or formed conjugates back to the lumen of the gastrointestinal tract by intestinal cells and rapid excretion by the liver into the bile. The metabolism of phase I appears to play a minor role, in contrast to extensive conjugation and indeed the unconjugated flavonolignans reach low plasma levels after common doses. Only about 1%-5% of the administered dose is eliminated by the kidneys. Many in vitro studies tested the inhibitory potential of silymarin and its components toward different enzymes and transporters involved in the absorption, metabolism, and excretion of xenobiotics. In most cases, effective concentrations are too high to be relevant under real biological conditions. Most human studies showed no silymarin-drug interactions explainable by these suggested interferences. More interactions were found in animal studies, likely due to the much higher doses administered.
Expanding controlled donation after the circulatory determination of death: statement from an international collaborative
Authors: Beatriz Domínguez-Gil, Nancy Ascher, Alexander M. Capron, Dale Gardiner, Alexander R. Manara, James L. Bernat, Eduardo Miñambres, Jeffrey M. Singh, Robert J. Porte, James F. Markmann, Kumud Dhital, Didier Ledoux, Constantino Fondevila, Sarah Hosgood, Dirk Van Raemdonck, Shaf Keshavjee, James Dubois, Andrew McGee, Galen V. Henderson, Alexandra K. Glazier, Stefan G. Tullius, Sam D. Shemie, Francis L. Delmonico
Journal: Intensive Care Medicine (2021)

A decision to withdraw life-sustaining treatment (WLST) is derived by a conclusion that further treatment will not enable a patient to survive or will not produce a functional outcome with acceptable quality of life that the patient and the treating team regard as beneficial. Although many hospitalized patients die under such circumstances, controlled donation after the circulatory determination of death (cDCDD) programs have been developed only in a reduced number of countries. This International Collaborative Statement aims at expanding cDCDD in the world to help countries progress towards self-sufficiency in transplantation and offer more patients the opportunity of organ donation. The Statement addresses three fundamental aspects of the cDCDD pathway. First, it describes the process of determining a prognosis that justifies the WLST, a decision that should be prior to and independent of any consideration of organ donation and in which transplant professionals must not participate. Second, the Statement establishes the permanent cessation of circulation to the brain as the standard to determine death by circulatory criteria. Death may be declared after an elapsed observation period of 5 min without circulation to the brain, which confirms that the absence of circulation to the brain is permanent. Finally, the Statement highlights the value of perfusion repair for increasing the success of cDCDD organ transplantation. cDCDD protocols may utilize either in situ or ex situ perfusion consistent with the practice of each country. Methods to accomplish the in situ normothermic reperfusion of organs must preclude the restoration of brain perfusion to not invalidate the determination of death.
Panbio™ rapid antigen test for SARS-CoV-2 has acceptable accuracy in symptomatic patients in primary health care
Authors: Oana Bulilete, Patricia Lorente, Alfonso Leiva, Eugenia Carandell, Antonio Oliver, Estrella Rojo, Pau Pericas, Joan Llobera
Journal: Journal of Infection (2021)

<h2>Summary</h2><h3>Objectives</h3> We aimed to evaluate the accuracy of the Panbio™ Ag-RDT at primary health care (PHC) centers and test sites in symptomatic patients and close contacts, using the Reverse-Transcription Polymerase Chain Reaction (RT-PCR) test as the gold standard. <h3>Methods</h3> The study was conducted in four PHC centers and two test sites in Mallorca, Spain. Consecutive patients older than 18 years, attending the sites for RT-PCR testing were included. Two nasopharyngeal samples were collected, one for RT-PCR and the other was processed on-site using the Panbio™ rapid antigen test kit for SARS-CoV-2. The sensitivity and specificity were calculated using RT-PCR as the reference, and the predictive values using the pretest probability results for each analyzed group. <h3>Findings</h3> A total of 1369 participants were included; mean age 42.5 ± 14.9 years and 54.3% women. The overall prevalence was 10.2%. Most participants (70.6%) presented within 5 days of the onset of symptoms. The overall sensitivity was of 71.4% (95% CI: 63.1%, 78.7%), the specificity of 99.8% (95% CI: 99.4%, 99.9%), the positive predictive value of 98.0% (95% CI: 93.0%, 99.7%) and a negative predictive value of 96.8% (95% CI: 95.7%, 97.7%). The sensitivity was higher in symptomatic patients, in those arriving within 5 days since symptom onset and in those with high viral load. <h3>Interpretation</h3> Ag-RDT had relatively good performance characteristics in suspected symptomatic patients within five days since the onset of symptoms. However, our data do not support the sole use of Panbio™ Ag-RDT in asymptomatic individuals. <h3>Funding</h3> None
The gut virome in Irritable Bowel Syndrome differs from that of controls
Authors: S. Coughlan, A. Das, E. O’Herlihy, F. Shanahan, P.W. O’Toole, I.B. Jeffery
Journal: Gut Microbes (2021)

Irritable Bowel Syndrome (IBS), the most common gastrointestinal disorder, is diagnosed solely on symptoms. Potentially diagnostic alterations in the bacterial component of the gut microbiome (the bacteriome) are associated with IBS, but despite the known role of the virome (particularly bacteriophages), in shaping the gut bacteriome, few studies have investigated the virome in IBS. We performed metagenomic sequencing of fecal Virus-Like Particles (VLPs) from 55 patients with IBS and 51 control individuals. We detected significantly lower alpha diversity of viral clusters comprising both known and novel viruses (viral 'dark matter') in IBS and a significant difference in beta diversity compared to controls, but not between IBS symptom subtypes. The three most abundant bacteriophage clusters belonged to the Siphoviridae, Myoviridae, and Podoviridae families (Order Caudovirales). A core virome (defined as a cluster present in at least 50% of samples) of 5 and 12 viral clusters was identified in IBS and control subjects, respectively. We also identified a subset of viral clusters that showed differential abundance between IBS and controls. The virome did not co-vary significantly with the bacteriome, with IBS clinical subtype, or with Bile Acid Malabsorption status. However, differences in the virome could be related back to the bacteriome as analysis of CRISPR spacers indicated that the virome alterations were at least partially related to the alterations in the bacteriome. We found no evidence for a shift from lytic to lysogenic replication of core viral clusters, a phenomenon reported for the gut virome of patients with Inflammatory Bowel Disease. Collectively, our data show alterations in the virome of patients with IBS, regardless of clinical subtype, which may facilitate development of new microbiome-based therapeutics.
Standardized IGH-Based Next-Generation Sequencing for MRD Detection in Follicular Lymphoma
Authors: Christiane Pott, Henrik Knecht, Arved Herzog, Elisa Genuardi, Michael Unterhalt, Barbara Mantoan, Irene Dogliotti, Wolfgang Hiddemann, Mario Boccadoro, Dietrich Herrmann, Michael Kneba, Anton W Langerak, Nikos Darzentas, Patricia Groenen, Monika Brüggemann, Eva Hoster, Marco Ladetto, Simone Ferrero
Journal: Blood (2017)
Relationship Between Myocardial Injury, Wall Motion Abnormalities and Mortality in Patients With Covid-19: The Circ-19 Registry
Authors: A. Camaj, G. Giustino, M. Miller, A. Kini, G. Stefanini, S. Bienstock, R. Bragato, J. Silbiger, M. Vicenzi, T. Danilov, N. Kukar, N. Shaban, C. Oates, S. K. Sharma, S. Lerakis, L. B. Croft, M. E. Goldman
Journal: Circulation (2020)
GP academic can practise again after suspension for dishonesty is cut short
Authors: Clare Dyer
Journal: BMJ (2021)

A professor of general practice who was suspended from the UK medical register for trying to hide from his employers the extent of his outside work has been allowed to return to practice.

Robert Walton, who was a professor at Warwick University medical school, was handed a 12 month suspension for dishonesty. Now a legally qualified chair of a medical practitioners tribunal, who reviewed his case on the papers, has decided that his fitness to practise is no longer impaired and has revoked the sanction.

The General Medical Council, …
Review of <i>Bioethics in Action</i> Baylis, Francoise and Dreger, Alice, eds. Bioethics in Action. Cambridge: Cambridge University Press, 2018. vii + 177 pp. $29.00 (978-1107543935)
Authors: Jacob M. Appel
Journal: The American Journal of Bioethics (2021)

"Review of Bioethics in Action Baylis, Francoise and Dreger, Alice, eds. Bioethics in Action. Cambridge: Cambridge University Press, 2018. vii + 177 pp. $29.00 (978-1107543935)." The American Journal of Bioethics, 21(3), pp. W1–W2
Surgical Interventions for Patients With Vitiligo
Authors: Hyun Jeong Ju, Jung Min Bae, Ro Woo Lee, Soo Hyung Kim, Davinder Parsad, Aunna Pourang, Iltefat Hamzavi, Jason Shourick, Khaled Ezzedine
Journal: JAMA Dermatology (2021)

Surgical interventions are a key part of the therapeutic arsenal, especially in refractory and stable vitiligo. Comparison of treatment outcomes between the different surgical procedures and their respective adverse effects has not been adequately studied.To investigate the reported treatment response following different surgical modalities in patients with vitiligo.A comprehensive search of the MEDLINE, Embase, Web of Science, and Cochrane Library databases from the date of database inception to April 18, 2020, was conducted. The key search terms used were vitiligo, surgery, autologous, transplantation, punch, suction blister, and graft.Of 1365 studies initially identified, the full texts of 358 articles were assessed for eligibility. A total of 117 studies were identified in which punch grafting (n = 19), thin skin grafting (n = 10), suction blister grafting (n = 29), noncultured epidermal cell suspension (n = 45), follicular cell suspension (n = 9), and cultured epidermal cell suspension (n = 17) were used.Three reviewers independently extracted data on study design, patients, intervention characteristics, and outcomes. Random effects meta-analyses using generic inverse-variance weighting were performed.The primary outcomes were the rates of greater than 90%, 75%, and 50% repigmentation response. These rates were calculated by dividing the number of participants in an individual study who showed the corresponding repigmentation by the total number of participants who completed the study. The secondary outcomes were the factors associated with treatment response to the surgical intervention.Among the 117 unique studies and 8776 unique patients included in the analysis, rate of repigmentation of greater than 90% for surgical interventions was 52.69% (95% CI, 46.87%-58.50%) and 45.76% (95% CI, 30.67%-60.85%) for punch grafting, 72.08% (95% CI, 54.26%-89.89%) for thin skin grafting, 61.68% (95% CI, 47.44%-75.92%) for suction blister grafting, 47.51% (95% CI, 37.00%-58.03%) for noncultured epidermal cell suspension, 36.24% (95% CI, 18.92%-53.57%) for noncultured follicular cell suspension, and 56.82% (95% CI, 48.93%-64.71%) for cultured epidermal cell suspension. The rate of repigmentation of greater than 50% after any surgical intervention was 81.01% (95% CI, 78.18%-83.84%). In meta-regression analyses, the treatment response was associated with patient age (estimated slope, -1.1418), subtype of vitiligo (estimated slope, 0.3047), and anatomical sites (estimated slope, -0.4050).The findings of this systematic review and meta-analysis suggest that surgical intervention can be an effective option for refractory stable vitiligo. An appropriate procedure should be recommended based on patient age, site and size of the lesion, and costs.
Abstract 15300: Pulse Wave Velocity as a Predictor of Stroke but not Coronary Artery Disease in Essential Hypertension: Data from a Greek 6-Year Follow-Up Study
Authors: Kyriakos Dimitriadis, Costas Tsioufis, Alexandros Kasiakogias, Michalis Giakoumis, Ioannis Andrikou, Konstantinos Kintis, Costas Thomopoulos, Christodoulos Stefanadis
Journal: Circulation (2012)

Objectives: The aim of the present study was to assess the predictive role of arterial stiffness for the incidence of coronary artery disease (CAD) and stroke in a cohort of essential hypertensive ...
P-selectin deficiency promotes liver senescence in sickle cell disease mice
Authors: Ravi Vats, Tomasz W. Kaminski, Eun-Mi Ju, Tomasz Brozska, Egemen Tutuncuoglu, Jesús Tejero, Enrico M. Novelli, Prithu Sundd, Tirthadipa Pradhan-Sundd
Journal: Blood (2021)
HDAC11 Regulates Glycolysis through the LKB1/AMPK Signaling Pathway to Maintain Hepatocellular Carcinoma Stemness
Authors: Lei Bi, Yidan Ren, Maoxiao Feng, Peng Meng, Qin Wang, Weiping Chen, Qinlian Jiao, Yuli Wang, Lutao Du, Fuqiong Zhou, Yucui Jiang, Feiyan Chen, Chuanxin Wang, Bo Tang, Yunshan Wang
Journal: Cancer Research (2021)

Abstract Hepatocellular carcinoma (HCC) contains a subset of cancer stem cells (CSC) that cause tumor recurrence, metastasis, and chemical resistance. Histone deacetylase 11 (HDAC11) mediates diverse immune functions and metabolism, yet little is known about its role in HCC CSCs. In this study, we report that HDAC11 is highly expressed in HCC and is closely related to disease prognosis. Depletion of HDAC11 in a conditional knockout mouse model reduced hepatocellular tumorigenesis and prolonged survival. Loss of HDAC11 increased transcription of LKB1 by promoting histone acetylation in its promoter region, thereby activating the AMPK signaling pathway and inhibiting the glycolysis pathway, which in turn leads to the suppression of cancer stemness and HCC progression. Furthermore, HDAC11 overexpression reduced HCC sensitivity to sorafenib. Collectively, these data propose HDAC11 as a new target for combination therapy in patients with kinase-resistant HCC. Significance: This study finds that HDAC11 suppresses LKB1 expression in HCC to promote cancer stemness, progression, and sorafenib resistance, suggesting the potential of targeting HDAC11 to treat HCC and overcome kinase inhibitor resistance.
Persistence of SARS-CoV-2 viral RNA in nasopharyngeal swabs after death
Authors: Manuel Scimeca, Silvestro Mauriello, Francesca Servadei, Bartolo Caggiano, Marco Ciotti, Lucia Anemona, Manuela Montanaro, Erica Giacobbi, Michele Treglia, Sergio Bernardini, Luigi Tonino Marsella, Orazio Schillaci, Alessandro Mauriello
Journal: Journal of Infection (2021)
Author Correction: Genome-wide meta-analysis, fine-mapping and integrative prioritization implicate new Alzheimer’s disease risk genes
Authors: Jeremy Schwartzentruber, Sarah Cooper, Jimmy Z. Liu, Inigo Barrio-Hernandez, Erica Bello, Natsuhiko Kumasaka, Adam M. H. Young, Robin J. M. Franklin, Toby Johnson, Karol Estrada, Daniel J. Gaffney, Pedro Beltrao, Andrew Bassett
Journal: Nature Genetics (2021)
Intensive chemotherapy and sequential hematopoietic stem cell transplantation: Is it necessary for high‐risk T‐cell lymphoblastic lymphoma?
Authors: Ken H. Young
Journal: Cancer Communications (2021)

Adult T-cell lymphoblastic lymphoma (T-LBL) is characterized by its rarity and poor prognosis, however, it is currently being treated without any internationally recognized therapies [1].Acute lymphocytic leukemia (ALL)-like chemotherapy, such as the Berlin-Frankfurt-Muenster (BFM) regimen or the fractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone (hyperCVAD) regimen, is currently being widely used [2].The former regimen is more intensive, while the latter regimen is relatively less toxic and better tolerated by patients.The BFM regimen has been associated with improved complete remission (CR) (83.6% vs.71.4%) and survival rate (5-year progression-free survival [PFS]: 67.4% vs. 36.4%;5-year overall survival [OS]: 62.6% vs.31.8%) [3].Regarding the treatment of T-LBL, there are still two key issues to be resolved.First, the optimal patient subgroup for the above two regimens has not yet been determined.Second, accurate screening of patients who might benefit from hematopoietic stem cell transplantation (HSCT) after the first CR is urgently required [4,5].