tbuckley/cabot-search huggingface dataset:
Abstract PO-017: Targeting NF-kB pathway through IRAK4 renders immune checkpoint blockade effective in pancreatic cancer
Authors: Daoxiang Zhang, Vikas Somani, Paarth B. Dodhiawala, Patrick M. Grierson, Lin Li, Kuljeet Seehra, Xiuting Liu, Brett L. Knolhoff, Marianna B. Ruzinova, David G. DeNardo, Kian-Huat Lim
Journal: Cancer Research (2020)

Abstract Effective immunotherapy in pancreatic ductal adenocarcinoma (PDAC) is impeded by multiple barriers in the tumor microenvironment. These include the dense extracellular matrix (ECM), excessive inhibitory myeloid cells, cytokines and chemokines, which collectively incapacitate anti-tumour T cells. Constitutive activation the NF-kB pathway is a mechanism that drives intrinsic survival of PDAC cells and stromal fibrosis, but its impact on anti-tumour immunity has not been investigated. Using The Cancer Genome Atlas database, we found that expression of RELA, a canonical NF-kB factor, in PDAC samples is associated with activated stroma and lower cytotoxic T cell signatures. In a PDAC tissue microarray, the staining intensity of activated IRAK4, the innate immune kinase that drives NF-kB signaling, negatively correlates with T cell abundance. Based on these findings, we investigated the immunological impact role of IRAK4 in PDAC. Transcriptomic analysis showed that ablation of IRAK4 in PDAC cells downregulates NF-kB and inflammatory signatures, and markedly decreases transcription of hyaluronan synthase 2 (HAS2). Accordingly, pharmacologic inhibition of IRAK4 significantly decreased intratumoral hyaluronan, as well as collagen, in autochthonous PDAC mice and potentiated standard chemotherapy. Furthermore, IRAK4 inhibition also significantly reduced production of several suppressive chemokines and checkpoint ligands PD-L1 and Nectin2, leading to revitalization of infiltrative CD4+ and CD8+ T cells. These effects were partly mediated through reduction of intratumoural hyaluronan, which we recapitulated with HAS inhibitor, 4-MU. Accordingly, combined IRAK4 inhibitors with immune checkpoint blockade (ICB) especially anti-CTLA4, were highly efficacious in abrogating tumour growth in autochthonous PDAC mice and doubling their survival. In summary, we showed that targeting the NF-kB pathway through IRAK4 renders ICB effective via multiple mechanisms and should be tested in clinical trials for PDAC patients. Citation Format: Daoxiang Zhang, Vikas Somani, Paarth B. Dodhiawala, Patrick M. Grierson, Lin Li, Kuljeet Seehra, Xiuting Liu, Brett L. Knolhoff, Marianna B. Ruzinova, David G. DeNardo, Kian-Huat Lim. Targeting NF-kB pathway through IRAK4 renders immune checkpoint blockade effective in pancreatic cancer [abstract]. In: Proceedings of the AACR Virtual Special Conference on Pancreatic Cancer; 2020 Sep 29-30. Philadelphia (PA): AACR; Cancer Res 2020;80(22 Suppl):Abstract nr PO-017.
Impact of Duration of Induction Therapy on Progression-Free Survival in Patients with Newly Diagnosed Multiple Myeloma Undergoing Upfront Autologous Stem Cell Transplantation
Authors: Rajshekar Chakraborty, Eli Muchtar, Shaji K Kumar, Francis K Buadi, David Dingli, Angela Dispenzieri, Suzanne Haymann, William J. Hogan, Prashant Kapoor, Martha Q Lacy, Nelson Leung, Rahma Warsame, Taxiarchis Kourelis, Wilson I Gonsalves, Morie A. Gertz
Journal: Blood (2017)
포스터 발표 : Neural Network을 이용한 Hepatitis C Virus Nonstructural 5A Region의 단백서열과 인터페론 치료 반응과의 관련성 분석
Authors: 김진욱, 이동호, 김나영, 황진혁
Journal: Clinical and Molecular Hepatology (2003)

배경/목적: C형 간염바이러스(HCV)는 유전형에 따라 인터페론에 대한 감수성의 차이가 있으며, HCV group Ib는 인터페론 치료에 잘 반응하지 않음이 알려져있다. HCV nonstructural 5A protein (NS5A) 부위의 아미노산 변이가 인터페론에 대한 치료반응과 관련이 있다는 보고가 있어 interferon- sensitivity-determining region(ISDR)이라고 알려졌으나 이후의 보고들은 상반되는 결과를 보였는데, 기존의 분석에서는 단백서열 변이의 개수만 고려되었고 변이의 위치가 고려되지 않았다. Artificial neural network은 복잡한 패턴을 인식하는 문제 해결에 이용되는 model로서, 많은 양의 자료를 이용하여 network을 training시킴으로써 새로운 자료를 판별하거나 예측하는 데에 이용되는 분석기법이다. 연자 등은 인터페론과 ISDR의 변이에 관한 기존의 보고들을 neural network 기법으로 meta-analysis하여 치료반응과의 관련성을 분석하였다. 대상과 방법: PubMed에서 HCV genotype Ib ISDR의 단백서열과 인터페론 치료에 대한 반응 결과를 확인할 수 있었던 25편의 논문에 등재된 단백서열 1159 건을 분석하였다. 통계분석은 단백변이가 없는 wild type, 변이의 수가 1-3개인 intermediate type, 4개 이상인 mutant type으로 구분하여 Chi-square test로 유의성을 검정하였으며, neural network 분석은 supervised training으로는 multilayer perception(MLP), radial basis function(RBF), linear network을, unsupervised training으로는 Kohonen network(SOFM)를 사용하였다. 1999년 이후에 보고된 658건의 서열을 이용하여 training : selection : test를 2:1:1로 시행한 후 1999년 이전에 보고된 501건의 서열을 이용하여 neural network의 판별력을 확인하였다. 결과: 아미노산 변이의 개수를 3개 이하와 4개 이상을 기준으로 나누었을 때 인터페론 치료의 반응여부는 82%의 정확도를 보였으며, 변이의 수와 인터페론 치료반응도 간에는 p＜0.0001의 유의한 상관성이 관찰되었다. 인터페론 반응에 대한 민감도와 특이도는 각각 42.8%, 94.7% 이었으며, 아미노산 변이의 수가 1-3개 사이인 경우가 49.5%로서 이 경우 위음성율은 22.7%이었다. Neural network중 RBF network이 가장 우수한 성적을 보였으며 이 모델로 예측한 인터페론 반응도의 정확도(correct classificatioin)는 73.8% 이었다. 아미노산 변이가 1-3개인 군에 국한하여 neural network training을 시행한 결과, 이용된 모든 network에서 인터페론 치료 반응여부를 재현성있게 판별할 수 없었다. 결론: HCV NS 5A region의 변이는 통계적으로 인터페론 치료의 반응과 유의한 상관관계가 있으나, 약 반수에서는 변이의 수가 1-3개로서 예측이 어려워 임상적 효용이 적다고 판단되었다. 이 경우 neural network을 이용한 패턴 분석 결과 치료 반응과 관련된 특정 패턴을 찾을 수 없었으며, 따라서 단백 치환의 위치를 고려하더라도 Intermediate group에서는 인터페론 치료의 반응을 예견하는 데에 ISDR의 분석이 도움이 되지 않는 것으로 판단된다.
Will Baseline Total Lesion Glycolysis Play a Role in Improving the Prognostic Value of the NCCN-IPI in Primary Gastric Diffuse Large B-Cell Lymphoma Patients Treated With the R-CHOP Regimen?
Authors: Chong Jiang, Chongyang Ding, Jingyan Xu, Yue Teng, Jieyu Chen, Zhen Wang, Zhengyang Zhou
Journal: Clinical Nuclear Medicine (2020)

Purpose The aim was to explore whether baseline total lesion glycolysis (TLG) can improve the prognostic value of the National Comprehensive Cancer Network International Prognostic Index (NCCN-IPI) in primary gastric diffuse large B-cell lymphoma (PG-DLBCL) patients treated with an R-CHOP–like regimen. Materials and Methods Ninety-four PG-DLBCL patients who underwent baseline PET/CT between July 2010 and May 2019 were included in this retrospective study. FDG-avid lesions in each patient were segmented to calculate the SUV max , total metabolic tumor volume (TMTV), and TLG. Progression-free survival (PFS) and overall survival (OS) were used as end points to evaluate prognosis. Results During the follow-up period of 5 to 108 months (35.3 ± 23.5 months), high TLG and a high NCCN-IPI were significantly associated with poor PFS and OS. Total lesion glycolysis and the NCCN-IPI were independent predictors of PFS and OS. Patients were stratified into 3 groups according to the combination of TLG and the NCCN-IPI for PFS ( P &lt; 0.001) and OS ( P &lt; 0.001): high-risk group (TLG &gt; 1159.1 and NCCN-IPI 4–8) (PFS and OS, 57.7% and 61.5%, respectively, n = 42), intermediate-risk group (TLG &gt; 1159.1 or NCCN-IPI 4–8) (PFS and OS, both 76.9%, n = 26), and low-risk group (TLG ≤ 1159.1 and NCCN-IPI 0–3) (PFS and OS, 97.6% and 100.0%, respectively, n = 26). Conclusions Both TLG and the NCCN-IPI are independent predictors of PG-DLBCL patient survival. Moreover, the combination of TLG and the NCCN-IPI improved patient risk stratification and might help personalize therapeutic regimens.
The influence of Ca and Cu additions on the microstructure, mechanical and degradation properties of Zn–Ca–Cu alloys for absorbable wound closure device applications
Authors: Nan Yang, Nagasivamuni Balasubramani, Jeffrey Venezuela, Sharifah Almathami, Cuie Wen, Matthew Dargusch
Journal: Bioactive Materials (2020)

Novel ternary Zn–Ca–Cu alloys were studied for the development of absorbable wound closure device material due to Ca and Cu's therapeutic values to wound healing. The influence of Ca and Cu on the microstructure, mechanical and degradation properties of Zn were investigated in the as-cast state to establish the fundamental understanding on the Zn–Ca–Cu alloy system. The microstructure of Zn-0.5Ca-0.5Cu, Zn-1.0Ca-0.5Cu, and Zn0.5Ca-1.0Cu is composed of intermetallic phase CaZn13 distributed within the Zn–Cu solid solution. The presence of CaZn13 phase and Cu as solute within the Zn matrix, on the one hand, exhibited a synergistic effect on the grain refinement of Zn, reducing the grain size of pure Zn by 96%; on the other hand, improved the mechanical properties of the ternary alloys through solid solution strengthening, second phase strengthening, and grain refinement. The degradation properties of Zn–Ca–Cu alloys are primarily influenced by the micro-galvanic corrosion between Zn–Cu matrix and CaZn13 phase, where the 0.5% and 1.0% Ca addition increased the corrosion rate of Zn from 11.5 μm/y to 19.8 μm/y and 29.6 μm/y during 4 weeks immersion test.
Abstract 16749: Prevalence, Predictors, and Prognostic Implications of Left Ventricular Systolic Dysfunction Among Patients With STEMI in India: The Prospective NORIN-STEMI Registry
Authors: Ambarish Pandey, Shreya Rao, Girish MP, Puneet Gupta, Sameer Arora, Michael Hendrickson, Arman Qamar, ANKIT BANSAL, Vishal Batra, Vimal Mehta, Jamal Yusuf, Sanjeev Kathuria, Muthiah Vaduganathan, Deepak L Bhatt, Mohit Gupta
Journal: Circulation (2020)

Introduction: Left ventricular (LV) systolic dysfunction (LVSD) and HF are important complications of ST-elevation myocardial infarction (STEMI). The prevalence and prognostic implications of LVSD in patients with STEMI in low/middle-income countries such as India are not well established. Methods: The present analysis was performed using data from the ongoing , prospective NORIN-STEMI registry of patients presenting with STEMI to 2 tertiary care medical centers in New Delhi, India from January to November 2019. LV ejection fraction (EF) was assessed at STEMI presentation using transthoracic echocardiography. Covariate-adjusted logistic regression models were constructed to evaluate the association of LVSD (mild: EF = 40-50%; moderate/severe: EF&lt;40%; ref: EF&gt;50%) with risk of in-hospital and 30-day mortality. Results: Among 3,635 patients with STEMI (age: 55[45-62], 33%≤50 years, 16% women), 1,489 (41%) had mild and 1,675 (46%) had moderate/severe LVSD on presentation. Patients with greater LVSD more commonly presented with anterior wall STEMI and had more frequent involvement of the left anterior descending artery as the culprit vessel. Among those with no, mild or moderate/severe LVSD, PCI was performed in 70% and 62% of patients, respectively. Hypertension, prior myocardial infarction, physical inactivity, greater time since symptom onset, and lower literacy levels were each independently associated with higher likelihood of LVSD. In adjusted analysis, LVSD was significantly associated with higher likelihood of in-hospital but not 30-day mortality ( See Table ). Conclusion: Among patients presenting to tertiary care centers in India with STEMI, LVSD is common, with 87% demonstrating LVEF&lt;50%. LVSD was significantly associated with higher risk of in-hospital and 30-day mortality. Future studies are needed to determine if quality improvement efforts to standardize pathways for primary PCI may lessen occurrence of LVSD.
Abstract 13537: Similar Long-term Survival in Patients Bridged With Biventricular Devices or Extracorporeal Membrane Oxygenation in the Contemporary Era of Heart Transplantation
Authors: Abhishek Jaiswal, Naga Vaishnavi Gadela, Ayesha Azmeen, Jason A Gluck, Joseph Radojevic, Sabeena Arora, Jonathan Hammond, Ayyaz Ali, Douglas Jennings, William Baker
Journal: Circulation (2020)

Introduction: A recent trend favoring donor allocation to sicker patients has led to a rise in the number of patients undergoing heart transplantation (HT) on ECMO or non-dischargeable biventricular mechanical circulatory devices (BiVAD). While suboptimal short-term outcomes of such patients have raised concerns, long-term outcomes are unknown. We examined long-term survival in patients bridged with BiVAD or ECMO in the contemporary era before the donor allocation policy changed. Methods: We identified the adult patients listed for HT and bridged with ECMO or BiVAD between 2000 and 2018 in the Scientific Registry of Transplant Recipients. We compared 3- and 5-year survival with the Kaplan-Meier method. Using overlap propensity score weighting, we constructed doubly-robust Cox proportional hazards regression models to determine the risk-adjusted influence of support type on survival. Results: Of the 1495 listings; 868 (58.1%) were bridged with BiVAD and 627 (41.9%) with ECMO. 730 underwent successful HT; 528 (72.3%) and 202 (27.7%) were bridged with BiVAD and ECMO, respectively. The ECMO group had higher prevalence of pre-transplant ventilator support (30.7% vs 6.3%, p&lt;0.0001), dialysis (15.8% vs 8.0%, p-0.005), inotrope use (36.6% vs 22.4%, p&lt;0.0001) and a higher IMPACT score (11.5 vs 5.5, p&lt;0.0001). Unadjusted 3- and 5-year estimated survival were similar in BiVAD vs. ECMO patients (Figure). After risk-adjustment, BiVAD and ECMO patients had a similar 3-year (HR 1.32, 95% CI 0.80-2.00; p=0.1849) and 5-year survival (HR 1.31, 95% CI 0.88-1.95; p=0.1878). Conclusions: A minority of patients on BiVAD and ECMO underwent HT suggesting high complication and waitlist mortality rates. Besides, the transplantation rate was disproportionately lower in patients on ECMO compared to BiVAD support. Patients with heart failure bridged with BiVAD or ECMO experienced similar long-term outcomes despite worse clinical and hemodynamic profile of patients in the ECMO group.
Abstract 10588: Medicare Part D Medication Use in a Community Cohort With Hypertension: The Atherosclerosis Risk in Communities (ARIC) Study
Authors: Jerome J Federspiel, Carla A Sueta, Anna M Kucharska-Newton, Salim S Virani, Jo E Rodgers, Patricia P Chang, Sally C Stearns
Journal: Circulation (2013)

Context: Despite proven benefits for reducing incidence of major cardiac events, antihypertensive drug therapy remains underutilized in the United States. Objectives: To identify antihypertensive d...
Abstract 362: Differential Effect of the Prehospital Traumatic Brain Injury Guidelines on Survival in Isolated and Multisystem Traumatic Brain Injury
Authors: Daniel W Spaite, Chengcheng Hu, Bentley J Bobrow, Bruce J Barnhart, Joshua B Gaither, Vatsal Chikani, Terry Mullins, Gail Bradley, Kurt R Denninghoff, Amber D Rice, Samuel M Keim
Journal: Circulation (2020)

Introduction: The Prehospital TBI Guidelines (PTGs) are intended for both isolated and multisystem TBI (ITBI/MTBI). However, uncontrolled hemorrhage and potential detrimental effects of fluid resuscitation in MTBI may lead to differential effectiveness compared to ITBI. Methods: Preplanned subgroup analysis of PTG effectiveness in ITBI and MTBI from EPIC (before/after system study; 133 agencies, &gt;11,000 trained; NIH R01NS071049). Interventions: Prevention/treatment of hypoxia, hypotension, hyperventilation. Inclusion: Barell Matrix 1; 1/07-6/15. Severity subgroups [Head Region Severity Score (HRSS; AIS equivalent)]: Moderate = 1-2; Severe = 3-4; Critical = 5-6. Definitions: ITBI: TBI with no other RSS ≥3 injury. MTBI: TBI plus non-head region RSS ≥3 injuries. Pre (P1) and post-implementation (P3) cohorts were compared using logistic regression. Results: Cases: 21,852; median age 45 (IQR 24, 66); 67% male. ITBI: 16,663 (76.3%); P1 = 11,602, P3 = 5061. MTBI: 5189 (23.7%); P1 = 3626, P3 = 1563]. Hypotension occurred much more frequently in MTBI (15.8%) than ITBI (4.5%; OR = 3.9 (3.5, 4.4); p&lt;0.0001) and, after PTG implementation, MTBI patients were much more likely to receive a fluid bolus (10.7%; 167/1563) than ITBI (5.3%; 267/5061; p&lt;0.0001). There was highly significant improvement in aOR for survival in severe (HRSS 3-4) ITBI and MTBI (Fig 1). Furthermore, the severe ITBI and MTBI patients who were intubated or who received any positive pressure ventilation (PPV; basic or advanced) also improved dramatically (Fig 2). Conclusions: PTG implementation was independently associated with improved odds of survival in severe ITBI and MTBI. Despite a rate of hypotension 4 times higher in MTBI, survival improvement was at least as strong as for ITBI. Since the MTBI cohort was much more likely to receive fluid resuscitation, these findings support the PTG recommendation for aggressive treatment of hypotension in TBI even in patients with potential ongoing hemorrhage.
Abstract 17195: Hydroxychloroquine Associated Electrocardiographic Changes in Patients With COVID-19 Extend Beyond QTc Prolongation and Are Accentuated in Those With Myocardial Injury
Authors: Maen D Abou Ziki, Roy Taoutel, Jakob Park, Romy Chamoun, elio ragheb, Lynda D Rosenfeld
Journal: Circulation (2020)

Introduction: Hydroxychloroquine (HCQ) is known to cause QTc prolongation, however its association with other ECG changes and how those are related to markers of myocardial injury in COVID-19 patients (pts) are not well described. Hypothesis: To study ECG changes in COVID-19 pts with or without troponin (Tn) elevation &gt;3X normal (Tn +/-), who were or were not treated with HCQ (+/-). Methods: This is an observational study of pts admitted with COVID-19. All had at least 3 ECGs during admission; on day 1, day 2-3 and day 4-6. Pre-admission and final ECGs were included when available. Pts were excluded if they had atrial fibrillation, paced QRS, QRS&gt;120msec, STEMI, or end stage renal disease. QRS, QTc, PR, P wave duration, QRS amplitude and the sum of T wave deflections in both limb and precordial leads were measured. Data were collected on medical history, illness severity, electrolytes, and medications within the 12-hour window of each ECG. Results: A total of 116 pts were included: 85 HCQ+ (40% Tn+) and 31 HCQ- (48% Tn+). There were no differences between the two groups in baseline characteristics, illness severity or mortality. Significant QTc prolongation was noted only in the HCQ+ group (p&lt;0.001) peaking at +13.6 ms on day 5 compared to admission (p&lt;0.01) and was accentuated in the HCQ+/Tn+ group (peak of +23.7 ms, p&lt;0.01). QRS prolongation was seen in the HCQ+ group (p&lt;0.001) peaking at +3.5 ms on day 5, and was accentuated in Tn+ pts peaking at +5.2 ms compared to Tn- pts +2.5 ms (p&lt;0.05, both comparisons). The sum of precordial T-wave amplitude decreased in HCQ+ pts (-2.2 mm on final ECG, p=0.015) but this change was only significant in the Tn+ subgroup (peak of -3.6 mm, p&lt;0.01). Finally, the PR interval was prolonged in the HCQ+ group, peaking at +7.6 ms on day 5 (p&lt;0.01), but was again was more marked in the Tn+ subgroup (peak of +9.6 ms, p&lt;0.05). Conclusions: HCQ related ECG effects extend beyond QTc prolongation. These are most notable in pts with evidence of myocardial injury.
Abstract 17267: Outcomes of Patients With Non-ST-Segment Elevation Myocardial Infarction and High Degree Atrioventricular Block Treated With Early vs Delayed Invasive Strategy
Authors: Raj Patel, Harsh P Patel, Samarthkumar J Thakkar, Fadee Kutom, Dipesh Ludhwani, Chinmay Jani, Aakash Sheth, Shilpkumar Arora, Rajkumar P Doshi, Rushin Patel, Bhavin Patel, Hemal Nayak
Journal: Circulation (2020)

Introduction: High degree atrioventricular block (HDAVB) is an uncommon complication of non-ST-segment elevation myocardial infarction (NSTEMI), frequently necessitating pacemaker implantation. Hypothesis: This contemporary analysis compares the need for pacemaker implantation based on the timing of intervention in acute NSTEMI complicated by HDAVB. Methods: We used 2016-2017 National Inpatient Sample (NIS) database to identify all admissions with NSTEMI. Those without HDAVB were excluded from the study. Time to coronary intervention from initial admission was used to segregate the admissions into two groups: early invasive strategy (EIS) (&lt;24 hours) and delayed invasive strategy (DIS)(&gt;24 hours). A multivariate logistic and linear regression analysis was performed to compare in-hospital outcomes among both groups. Results: Out of 949,984 NSTEMI related admissions, coexistent HDAVB was present in 0.7% (n=6725) patients which were subsequently included in the study. Amongst those, 55.61% (n=3740) hospitalization included invasive intervention (EIS=1320, DIS=2420) (Figure1). Patients treated with EIS were younger (69.95 vs 72.38, p= &lt;0.05) and had a concomitant cardiogenic shock. Contrarily the prevalence of chronic kidney disease (CKD), heart failure (HF), and pulmonary hypertension was higher in DIS group. EIS was associated with lower length of stay and total hospitalization cost. Although statistical significance was not achieved, a trend towards higher in-hospital mortality and lower pacemaker implantation rates were seen in hospitalizations involving EIS (Table1). Conclusions: HDAVB is a rare complication of NSTEMI and it is associated with significant mortality. The timing of revascularization does not appear to influence the rate of pacemaker placement in NSTEMI complicated by HDAVB. Further studies are needed to assess if all patients presenting with HDAVB should be treated with an early invasive strategy.
Abstract 13313: Venous Thromboembolism as a Presenting Finding and Complication of Covid-19: A Case Series
Authors: Diego Celli, Thomas Plate, Amarilys Alarcon-Calderon, Jason Galo, Roger A Alvarez
Journal: Circulation (2020)

Background: Although not yet fully understood, the pathogenesis of the novel RNA betacoronavirus2 currently named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is thought to involve thrombotic microangiopathy, as evidenced by autopsy. To date, the number of pulmonary embolism (PE) reports in the setting of COVID-19 is increasing, with many presenting in acute cor pulmonale. In this case series, we aim to describe our center’s experience with COVID-19 and PE. Methods: A total of 10 patients with a diagnosis of PE in the setting of positive qualitative SARS-CoV-2 through RT-PCR were identified and managed by our service. Results: The mean age was 58 years old with 60% being males. The majority of the population was Hispanic (70%) with 30% self-identifying as black. All of our patients were middle-aged except for one elder and one young adult, and they had other risk factors for thromboembolism, (e.g. obesity, heart failure, COPD, and HIV). The mean time from presentation to diagnosis of PE was 100 hours. Hemodynamic instability was present in 30% of the cases. There was a whole spectrum of PE involvement, the vast majority of which were segmental and subsegmental (60%) compared to distal main arteries (20%) and saddle PE (20%). Mortality rate was 10% and the rest of the patients were successfully discharged on oral anticoagulation. Although our cohort comprised low-to-intermediate pretest probability for PE per Wells criteria (1.5-3), high clinical suspicion prompted further imaging studies with computed tomography angiography and 2D-echocardiogram. Currently, many hospital systems are avoiding advanced imaging for concerns of infection control, which likely contributes to the underdiagnosis of VTE in patients with COVID-19. Conclusion: As we continue to understand the pathophysiology of this emerging disease, clinicians should maintain a high degree of suspicion to differentiate causes of hypoxemic respiratory failure and hemodynamic instability in the setting of COVID-19. Overt PE may increase inpatient mortality and post-discharge mobility due to the burden of pulmonary hypertension in this population. Further research is required to elucidate the relationship between these entities and the best management approach.
発酵大豆(納豆)摂食後のIgE媒介遅発性アナフィラキシーの新しい臨床的経過:8例の患者の臨床的再調査
Authors: Inomata N, Osuna H, Kawano K, Yamaguchi J, Yanagimachi M, Ikezawa Z
Journal: Journal of Allergy and Clinical Immunology (2007)