tbuckley/cabot-search huggingface dataset:
Abstract P047: US Asian Indians Dying With Atherosclerosis Are More Likely To Have Concurrent Diabetes Mellitus
Authors: Deepak R Nair, Abhyuday Chauhan, Dhananjay Vaidya
Journal: Circulation (2021)

Background: Asian Indians (AI) in the US are known to have a high prevalence of atherosclerotic diseases and diabetes mellitus (DM). However, it is not known if these two cluster as causes of death in AI compared to the rest of US population. Methods: Using 2017 Multiple Cause-of-Death Data from the National Centre for Health Statistics, we included deaths at age ≥ 45 years among US residents where AI vs not-AI could be ascertained (n = 7940 AI; n = 2.6 million not-AI). DM (ICD-10 range: E10-E14) and any atherosclerosis (either of: ischemic heart disease, ischemic stroke, atherosclerosis; ICD-10 range: I20-I25, I69, I70, respectively) as contributing causes of death were identified in AI and not-AI. We calculated dichotomous tetrachoric correlation (Rho) between DM and atherosclerosis as co-occurring contributing causes. To examine whether this association differed by age decade and sex, we calculated the difference in fraction of deaths with DM in those with atherosclerosis versus those without atherosclerosis as a co-occurring cause of death. Results: There were 114,210 atherosclerosis deaths and 24,331 DM deaths in 2017 in the sample. DM and atherosclerosis as contributing causes correlated more strongly in AI (Rho = 0.36, p &lt; 0.001) as compared to not-AI (Rho = 0.31, p &lt; 0.001; difference between groups, p &lt; 0.001). The excess fraction of deaths due to DM when atherosclerosis also contributed vs when atherosclerosis did not contribute was higher in AI men of all ages and in most ages for AI women, except for a group where AI death numbers were smaller (Figure). Conclusion: Our findings highlight the increased burden of co-occurring DM and atherosclerotic disease together contributing as causes of death in AI compared to not-AI in the US. Public health strategies targeted to AI should focus on prevention and clinical treatment of both conditions jointly, in both men and women, especially during young adulthood and middle age.
Abstract 15618: Cardiac Magnetic Resonance Evaluation of Diastolic Indices in Boys With Duchenne Muscular Dystrophy
Authors: Jeffrey Weiner, Kristen GeorgeDurrett, Kimberly Crum, Joshua Chew, Christopher Spurney, Kan N Hor, Linda Cripe, David Parra, Larry W Markham, Jonathan H Soslow
Journal: Circulation (2020)

Introduction: Cardiomyopathy (CM) is the leading cause of death in boys with Duchenne Muscular Dystrophy (DMD). Diastolic dysfunction precedes systolic dysfunction in DMD, but while CMR is used routinely to assess fibrosis and left ventricular ejection fraction (LVEF), CMR measures of DMD diastolic dysfunction have not been reported. Hypothesis: Boys with DMD have diastolic dysfunction based on CMR indices when compared with healthy controls. Methods: Prospectively enrolled DMD patients (n = 54) and healthy male controls (n = 40) underwent CMR. Standard volumes and function were calculated. LV filling curves were generated by contouring every phase in the short axis. Indices were compared between groups using a Wilcoxon rank sum and within DMD using a Spearman’s rho test. Results: There was no difference in LVEF between DMD and controls, though DMD patients had significantly smaller indexed left ventricular end diastolic volume (LVEDVi) (see data in Table 1). Peak ventricular filling rates (PFR) were significantly slower in DMD vs controls as were peak ventricular emptying rates (PER). Mean time to PFR (tPFR) and mean time to PER (tPER) were significantly shorter in DMD patients vs controls. In a subset analysis excluding patients with LVEF &lt; 55%, observed differences in PFR, PER, tPFR and TPER remain statistically significant. In DMD patients, tPER correlates negatively with LVEF (rho = -0.57, p &lt;0.001). PER corrected to LVEDVi correlated strongly with LVEF (rho = 0.74, p &lt;0.001). PFR corrected to LVEDVi also correlated strongly with LVEF (rho = 0.75, p &lt;0.001). Conclusions: Despite having normal baseline systolic function, boys with DMD have significantly different CMR diastolic indices compared with controls. CMR diastolic indices may help detect subclinical dysfunction in DMD. Future analyses should evaluate for correlation between diastolic dysfunction and clinical outcomes.
Abstract 17438: Sex Differences and Temporal Trends in Revascularization and Outcomes of ST-Elevation Myocardial Infarction in Older Adults in the United States
Authors: Varun Pattisapu, Hua Hao
Journal: Circulation (2020)

Background: Prior studies have suggested that women with ST-elevation myocardial infarction (STEMI) have higher in-hospital mortality risk than younger men with STEMI. However, there is a significant STEMI risk in older patients. We analyzed temporal trends and sex differences in revascularization and other in-hospital outcomes in older STEMI patients. Methods: National Inpatient Sample databases from 2005 to 2014 were utilized to identify all STEMI patients with age greater than 60 years old. We studied the temporal trends and sex differences in revascularization therapies and in-hospital mortality. Results: There were N=192,204 older adults diagnosed with STEMI. Older women with STEMI were less likely to undergo coronary angiography (adjusted OR: 0.90; 95% CI: 0.88 to 0.93) and receive reperfusion (percutaneous coronary intervention (PCI) adjusted OR: 0.90; 95% CI: 0.87 to 0.92) compared to older men. Also, the adjusted odds ratio comparing the likelihood of receiving PCI between women and men decreased by an annual average of 0.9% (P=0.028). Older men were more likely to receive PCI on Hospital Day 0 compared to older women. There was a decreasing trend in both sexes for use of coronary artery bypass graft (CABG), though older men consistently underwent CABG more often than older women (Figure). Older women had higher in-hospital mortality than men (adjusted OR: 1.12; 95% CI: 1.08 to 1.17). However, the differences decreased with increasing patient age. There was no significant change in adjusted in-hospital mortality in both genders (all P&gt;0.05). Conclusions: Older women were less likely to receive revascularization for STEMI than men, and this gap increased over the study period. Older women had higher in-hospital mortality compared with older men, but there was no significant temporal change for both genders. Further research is needed to identify the reasons why older women receive less revascularization.
Accidental gastrocolonic anastomosis by apposition stent: a one-month healing delay makes it possible to treat a stabilized gastrocolonic fistula rather than a double perforation
Authors: Alexia Laroyenne, Pierre Lafeuille, Thomas Lambin, Timothée Wallenhorst, Benjamin Hamel, Jérôme Rivory, Mathieu Pioche
Journal: Endoscopy (2021)

Misplacement of self-expandable apposition stent in the colon during endoscopic ultrasound (EUS) transgastric drainage of a post-pancreatitis necrotic collection is a rare adverse event [1] leading to a double perforation (stomach and colon) if the stent is removed immediately. Therefore, we proposed a waiting strategy to transform gastrocolonic anastomosis into a gastrocolonic fistula.
51P The development of a predictive model for risk results of the 70-gene signature
Authors: L. Slembrouck, I. Sebastian, A.A. Martinez, I. Vanden Bempt, H. Wildiers, A. Smeets, A-S. Van Rompuy, C. Weltens, K. Punie, E. Van Nieuwenhuysen, S. Han, I. Nevelsteen, P. Neven, G. Floris
Journal: Annals of Oncology (2021)
RETROSPECTIVE STUDY REGARDING THE EFFICACY OF 2ND OR HIGHER LINE CHEMOTHERAPY OF PATIENTS IN ADVANCED OR RECURRENT GASTRIC CANCER (ARGC) AFTER THE FAILURE OF S-1 OR S-1 COMBINATION CHEMOTHERAPY (S plus alpha)
Authors: Horimi T, Morita S, Hata Y, Tsuji A, Kobayashi K
Journal: Annals of Oncology (2010)
Rituximab versus Mycophenolate Mofetil in Patients with Pemphigus Vulgaris
Authors: Victoria P. Werth, Pascal Joly, Daniel Mimouni, Emanual Maverakis, Frédéric Caux, Patricia Lehane, Liudmila Gearhart, Audrey Kapre, Pooneh Pordeli, Diana M. Chen
Journal: New England Journal of Medicine (2021)

Rituximab and mycophenolate mofetil are used to treat pemphigus vulgaris, but they have not been adequately compared in clinical trials.In a randomized, controlled trial, we assigned patients with moderate-to-severe pemphigus vulgaris in a 1:1 ratio to receive intravenous rituximab (1000 mg on days 1, 15, 168, and 182) or oral mycophenolate mofetil (2 g per day), in addition to an oral glucocorticoid administered on the same tapering schedule in the two groups. The primary end point was sustained complete remission at week 52, defined as the healing of lesions with no new active lesions, as reflected by a Pemphigus Disease Area Index (PDAI) activity score of 0 (on a scale of 0 to 250, with higher scores indicating greater disease severity), for at least 16 weeks without the use of glucocorticoids. Secondary end points were the cumulative dose of glucocorticoids, the number of disease flares, and the change from baseline in the score on the Dermatology Life Quality Index (DLQI; scores range from 0 to 30, with higher scores indicating greater impairment).Of the 135 patients who underwent randomization, 67 were assigned to receive rituximab and 68 to receive mycophenolate mofetil. The primary outcome was assessed in the modified intention-to-treat population: 62 patients in the rituximab group and 63 in the mycophenolate mofetil group. The median PDAI activity scores at baseline were 22.7 in the rituximab group and 18.3 in the mycophenolate mofetil group. At week 52, sustained complete remission was observed in 25 patients (40%) in the rituximab group and in 6 (10%) in the mycophenolate mofetil group (difference, 31 percentage points; 95% confidence interval [CI], 15 to 45; P<0.001). The mean cumulative glucocorticoid dose during the 52-week treatment period was 3545 mg in the rituximab group and 5140 mg in the mycophenolate mofetil group (difference, -1595 mg; 95% CI, -2838 to -353; P<0.001). There were 6 disease flares in the rituximab group and 44 in the mycophenolate mofetil group (adjusted rate ratio, 0.12; 95% CI, 0.05 to 0.29; P<0.001). The mean change in DLQI score was -8.87 points and -6.00 points, respectively (difference, -2.87 points; 95% CI, -4.58 to -1.17; P = 0.001). Serious adverse events occurred in 15 of 67 patients (22%) in the rituximab group and in 10 of 68 (15%) in the mycophenolate mofetil group.Rituximab was superior to mycophenolate mofetil in producing sustained complete remission at 52 weeks in patients with pemphigus vulgaris. Rituximab resulted in a greater reduction in glucocorticoid use than mycophenolate mofetil, but more patients in the rituximab group had serious adverse events. Further trials are needed to determine the comparative efficacy and safety of rituximab and mycophenolate mofetil beyond 52 weeks of treatment. (Funded by F. Hoffmann-La Roche; PEMPHIX ClinicalTrials.gov number, NCT02383589.).
Between Usual and Crisis Phases of a Public Health Emergency: The Mediating Role of Contingency Measures
Authors: David Alfandre, Virginia Ashby Sharpe, Cynthia Geppert, Mary Beth Foglia, Kenneth Berkowitz, Barbara Chanko, Toby Schonfeld
Journal: The American Journal of Bioethics (2021)

Much of the sustained attention on pandemic preparedness has focused on the ethical justification for plans for the “crisis” phase of a surge when, despite augmentation efforts, the demand for life-saving resources outstrips supply. The ethical frameworks that should guide planning and implementation of the “contingency” phase of a public health emergency are less well described. The contingency phase is when strategies to augment staff, space, and supplies are systematically deployed to forestall critical resource scarcity, reduce disproportionate harm to patients and health care providers, and provide patient care that remains functionally equivalent to conventional practice. We describe an ethical framework to inform planning and implementation for COVID-19 contingency surge responses and apply this framework to 3 use cases. Examining the unique ethical challenges of this mediating phase will facilitate proactive ethics conversations about healthcare operations during the contingency phase and ideally lead to ethically stronger health care practices.
Показатели ультразвуковой гистографии поджелудочной железы в динамике лечения больных с хроническим панкреатитом на фоне ожирения
Authors: N.B. Gubergrits, O.A. Bondarenko
Journal: GASTROENTEROLOGY (2013)

Авторы привели в статье результаты собственного исследования больных хроническим панкреатитом на фоне ожирения. В лечение таких больных целесообразно включать кардонат и цефасель, которые способствуют положительной динамике структурных изменений поджелудочной железы по данным ультразвуковой гистографии.
Abstract 16507: Complex Percutaneous Coronary Intervention Features Worsen Prognosis in Diabetic Patients: Insights From a Large Single-center Registry
Authors: Johny Nicolas, Davide Cao, Bimmer E Claessen, Mauro Chiarito, Samantha Sartori, Hanbo Qiu, Matteo Nardin, David Power, Anastasios Roumeliotis, Ridhima Goel, Rishi Chandiramani, Zhongjie Zhang, Usman Baber, Joseph Sweeny, Prakash Krishnan, Annapoorna Kini, Samin K Sharma, George Dangas, Roxana Mehran
Journal: Circulation (2020)

Introduction: Despite the increasing number of complex percutaneous coronary interventions (CPCI), data regarding outcomes following CPCI in patients with diabetes mellitus (DM) are scarce. Hypothesis: Compared to the general population, diabetic patients undergoing CPCI have worse prognosis. Methods: We analyzed data of patients who underwent PCI in a tertiary-care center between 2009 and 2017. Patients were divided into 2 groups (CPCI and non-CPCI) stratified by presence of DM. CPCI was defined as having ≥1 of the following: stent length &gt;60 mm, ≥3 stents implanted, ≥3 lesions, ≥3 target vessels, bifurcation with ≥2 stents, or chronic total occlusion. The main outcome was major adverse cardiac events (MACE), a composite of death, myocardial infarction (MI) and target vessel revascularization (TVR) at 1 year. Results: Out of 20,412 patients included, 5,038 (24.7%) underwent CPCI. Patients with DM constituted 46.5% (n=9,494) of the overall cohort and 44.5% (n=2,240) of CPCI group. Among patients undergoing CPCI, diabetics were younger, more likely to be female, and had more cardiovascular risk factors (kidney disease, dyslipidemia, and hypertension) than non-diabetics. In addition, diabetic patients had more advanced coronary disease (multivessel disease, high syntax score, and longer lesion length). At 1 year, diabetic patients had higher risk of MACE than non-diabetic, regardless of PCI complexity ( Figure 1 ). Nonetheless, there was a significant interaction between CPCI and diabetes in terms of mortality at 1 year (p-interaction=0.009). In contrast, compared to non-diabetics, a higher risk of TVR ( adj HR 1.49, 95% CI [1.24 - 1.78], p &lt;0.001) and bleeding ( adj HR 1.45, 95% CI [1.05 - 1.98], p=0.02) was observed in diabetics undergoing non-CPCI but not CPCI. Conclusion: Diabetic patients are at higher risk of MACE than the general population regardless of PCI complexity. Yet, 1-year mortality is substantially higher in diabetics undergoing CPCI than non-CPCI.
Tympanostomy Tubes or Medical Management for Recurrent Acute Otitis Media
Authors: Alejandro Hoberman, Diego Preciado, Jack L. Paradise, David H. Chi, MaryAnn Haralam, Stan L. Block, Diana H. Kearney, Sonika Bhatnagar, Gysella B. Muñiz Pujalt, Timothy R. Shope, Judith M. Martin, Daniel E. Felten, Marcia Kurs-Lasky, Hui Liu, Kristin Yahner, Jong-Hyeon Jeong, Norman L. Cohen, Brian Czervionke, Jennifer P. Nagg, Joseph E. Dohar, Nader Shaikh
Journal: New England Journal of Medicine (2021)

Official recommendations differ regarding tympanostomy-tube placement for children with recurrent acute otitis media.
Adipose Tissue Insulin Resistance Is Longitudinally Associated With Adipose Tissue Dysfunction, Circulating Lipids, and Dysglycemia: The PROMISE Cohort
Authors: Zhila Semnani-Azad, Philip W. Connelly, Richard P. Bazinet, Ravi Retnakaran, David J.A. Jenkins, Stewart B. Harris, Bernard Zinman, Anthony J. Hanley
Journal: Diabetes Care (2021)

OBJECTIVE To determine the association of adipose tissue insulin resistance with longitudinal changes in biomarkers of adipose tissue function, circulating lipids, and dysglycemia. RESEARCH DESIGN AND METHODS Adults at risk for type 2 diabetes in the Prospective Metabolism and Islet Cell Evaluation (PROMISE) cohort had up to four assessments over 9 years (n = 468). Adipose tissue insulin resistance was determined using a novel validated index, Adipo-IR, calculated as the product of fasting insulin and nonesterified fatty acids measured at baseline. Fasting serum was used to measure biomarkers of adipose tissue function (adiponectin and soluble CD163 [sCD163]), circulating lipids (total cholesterol, HDL, LDL, triglyceride [TG]), and systemic inflammation (interleukin-6 [IL-6] and tumor necrosis factor-α [TNF-α]). Incident dysglycemia was defined as the onset of impaired fasting glucose, impaired glucose tolerance, or type 2 diabetes at follow-up. Generalized estimating equation (GEE) models were used to assess the relationship of Adipo-IR with longitudinal outcomes. RESULTS GEE analyses showed that elevated Adipo-IR was longitudinally associated with adipose tissue dysfunction (adiponectin −4.20% [95% CI −6.40 to −1.95]; sCD163 4.36% [1.73–7.06], HDL −3.87% [−5.15 to −2.57], TG 9.26% [5.01–13.69]). Adipo-IR was associated with increased risk of incident dysglycemia (odds ratio 1.59 [95% CI 1.09–2.31] per SD increase). Associations remained significant after adjustment for waist circumference and surrogate indices for insulin resistance. There were no significant longitudinal associations of Adipo-IR with IL-6, TNF-α, total cholesterol, or LDL. CONCLUSIONS Our findings demonstrate that adipose tissue insulin resistance is prospectively associated with adipose tissue function, HDL, TG, and incident dysglycemia.
Acquired resistance to reoviral oncolysis
Authors: Manbok Kim, Catherine Egan, Patrick W. K. Lee, Peter A. J. Forsyth, Randal N. Johnston
Journal: Cancer Research (2005)

3381  The naturally occurring human reovirus has shown considerable potential as an oncolytic agent for Ras-dependent tumor cells in vitro and in animal model systems and is currently in human clinical trials. However, the potential for virus-susceptible tumor cell lines that contain activating mutations of Ras to develop resistance to reovirus has not been fully explored. To address this, we exposed the human fibrosarcoma HT1080 cell line, which contains an activated N-Ras gene and is highly sensitive to viral oncolysis, to several rounds of exposure to reovirus. Most but not all cells were killed on first exposure, and after three rounds of selection we derived populations that were highly resistant to viral oncolysis. The resistant cells were persistently infected by reovirus, producing functional reovirus continuously. The resistant cells retained the activating N-Ras mutation and high levels of Ras activity, suggesting that reduced Ras activity is not required for viral resistance. Reovirus generated from the resistant cells contains several mutations and shows reduced but still significant apoptotic potential in HT1080 cells compared to wild type reovirus. In addition, virus-resistant cells showed reduced cellular cathepsin B activity, which is associated with the viral infection cycle. The persistently infected cells can be cured of virus by growth in the presence of reovirus antibody for 3 weeks, generating virus-free ‘cured’ cells. The persistently infected cells and cured cells were then tested for tumor formation in SCID mice. In sharp contrast to the highly tumorigenic parental and cured cells, the persistently infected cells were not tumorigenic in vivo. Furthermore, the persistently infected cells were able to suppress the cured cells’ tumorigenic activity when co-injected, suggesting that reoviral persistence plays an important role in tumor suppression. To determine whether the reovirus-resistant cells can still be killed by chemotherapeutic agents or other oncolytic viruses, we challenged them with apoptotic inducers and E1B-negative adenovirus, resulting in significant apoptosis following both approaches. These findings suggest that both reovirus and host tumor cells can co-adapt during the acquisition of viral resistance. Even so, the virus-resistant tumor cells can still be killed by other anti-tumor strategies, and have not lost the capacity for apoptosis.
Homeopathy UK told to take down articles saying remedies can help depression and asthma
Authors: Clare Dyer
Journal: BMJ (2021)

The Advertising Standards Authority has told Homeopathy UK to remove articles from its website that state that homeopathy can help such conditions as depression, diabetes, infertility, psoriasis, and asthma.

The website took consumers who clicked on a link to pages in which doctors described how they had applied homeopathic methods to the particular condition.

The authority ruled that the articles breached the provision in the advertising …
Abstract P184: Cardioprotective Effects Of Ivabradine After Coronary Revascularization: A Systematic Review
Authors: Jooyoung Moon, Hanna Moon
Journal: Circulation (2021)

Background: The perioperative management of cardiac risk for patients undergoing coronary revascularization has mostly centered around beta-blockers (BB). Ivabradine is a much newer drug that has been approved for stable angina and heart failure not fully controlled by BB. Emerging evidence suggests that it may have cardioprotective effects in high-risk cardiac patients. The objective of this study was to summarize the evidence on the use and effects of ivabradine in coronary revascularization patients. Methods: We performed a systematic review using the PubMed, EMBASE, and Google Scholar databases for studies published between 2010 and 2020. Two independent investigators reviewed studies reporting information on ivabradine use following coronary revascularization. We excluded articles written in languages other than English. Results: Eleven studies met our inclusion criteria, including a total of 3,847 patients (1994 with percutaneous coronary intervention [51.8%], 1680 with coronary artery bypass graft [43.7%], and 173 with other type of intervention [4.5%]). The studies were from seven different countries: Egypt, France, Germany, Greece, Italy, Romania, and Spain. The mean age ranged from 56.5 to 74.3. Males accounted for 70.9% of the patients, resulting in an M:F ratio of 1.4:1. For studies that compared the use of ivabradine to placebo/control, the latter being defined as standard medical therapy that either did or did not include BB, the results showed that the use of ivabradine resulted in significant reduction of heart rate, decreased number of angina attacks, lower nitrate consumption, improvement in quality of life, and increased cardiac index. Studies that compared the effects of ivabradine monotherapy to BB monotherapy showed that the former was associated with a higher rate of atrial fibrillation, but an overall better quality of life as measured by the EuroQol questionnaire. When combined therapy with ivabradine and BB was compared to BB monotherapy, the former was associated with a significant increase in diastolic function, improvement in left ventricular ejection fraction, and a decrease in incidence of arrhythmias. Eight of the eleven studies reported adverse events related to ivabradine use, the most frequent being bradycardia (range: 0 to 7.1%), phosphenes (range: 0 to 0.3%), and blurred vision (range: 0 to 0.2%). Conclusions: This study demonstrates that ivabradine may be used alone or in addition to BB to reduce adverse cardiac events and improve the quality of life in patients undergoing coronary revascularization. However, there is no evidence that ivabradine is superior to BB when used alone. Further studies are needed to determine the optimal medical management for patients undergoing coronary revascularization.