tbuckley/cabot-search huggingface dataset:
Abstract 14384: Light Therapy Improves Circadian Blood Pressure Control and Glucose Homeostasis in Rotating Night Shift Workers via Mechanisms Independent of Melatonin
Authors: Juliane Hannemann, Anika Laing, Benita Middleton, Jonathan Cridland, Bart Staels, Nikolaus Marx, Peter J Grant, Massimo Federici, Tarja Stenberg, Debra J Skene, Rainer Boeger
Journal: Circulation (2020)

Introduction: Night shift work is associated with high rates of hypertension, heart disease, and metabolic syndrome. These cardiometabolic diseases have been linked to the disruption of circadian rhythms in night shift workers. Rotating night shift work is increasingly common in the working population worldwide. Hypothesis: We hypothesized that light therapy might help to normalize disrupted circadian rhythms and stabilize diurnal control of blood pressure and glucose tolerance in rotating night shift workers. Methods: We randomized 24 rotating night shift workers (mean age, 36±13 years, 7 males) who had spent a median of 6 years on rotating night shifts with a median of 6 night shifts/month to 12 weeks of light therapy (light during first half of each night shift and in the morning of off-work days) or no intervention and compared them with 12 daytime workers (37±11 years, 6 males). We measured oral glucose tolerance (OGTT), 24h blood pressure and arterial stiffness, and the circadian profiles of melatonin, cortisol, metanephrine and normetanephrine at baseline, after 12 weeks of intervention, and 12 weeks after the end of intervention. Results: At baseline, fewer night shift workers showed dipper status of blood pressure as compared to daytime workers (21% vs. 55%; p&lt;0.001). After 12 weeks of light therapy, there was a highly significant increase in the proportion of dippers (to 42%; p&lt;0.0001). We also observed a significant decrease in serum glucose during OGTT in the light therapy group (-22%; p&lt;0.05), with no change in serum insulin. Whilst circadian profiles of melatonin and cortisol were unchanged, there was a significant reduction in nighttime plasma metanephrine and normetanephrine levels in the light therapy group (p&lt;0.01). Conclusions: Chronotherapeutic light therapy significantly improves diurnal blood pressure control and glucose tolerance in rotating night shift workers. This effect is unrelated to mechanisms traditionally linked to the circadian clock like melatonin and cortisol, but it is paralleled by reduced catecholamine levels. Our data suggest that chronotherapeutic light therapy may improve the adjustment to atypical working hours in rotating night shift workers, thereby reducing stress and improving cardiometabolic function.
Pregravid contraceptive use and fecundability: prospective cohort study
Authors: Jennifer J Yland, Kathryn A Bresnick, Elizabeth E Hatch, Amelia K Wesselink, Ellen M Mikkelsen, Kenneth J Rothman, Henrik T Sørensen, Krista F Huybrechts, Lauren A Wise
Journal: BMJ (2020)

Abstract Objective To evaluate the association between pregravid use of a variety of contraceptive methods and subsequent fecundability. Design Prospective cohort study. Setting Denmark and North America, 2007-19. Participants 17 954 women who had tried to conceive for up to six menstrual cycles at study entry. At baseline, participants reported their contraceptive histories, and personal, medical, and lifestyle characteristics. Main outcome measures Pregnancy, determined by bimonthly follow-up questionnaires for up to 12 months. Results Approximately 38% (n=6735) of participants had recently used oral contraceptives, 13% (n=2398) had used long acting reversible contraceptive methods, and 31% (n=5497) had used barrier methods. Women who had recently stopped using oral contraceptives, the contraceptive ring, and some long acting reversible contraceptive methods experienced short term delays in return of fertility compared with users of barrier methods. Use of injectable contraceptives was associated with decreased fecundability compared with use of barrier methods (fecundability ratio 0.65; 95% confidence interval 0.47 to 0.89). Users of injectable contraceptives had the longest delay in return of normal fertility (five to eight menstrual cycles), followed by users of patch contraceptives (four cycles), users of oral and ring contraceptives (three cycles), and users of hormonal and copper intrauterine devices and implant contraceptives (two cycles). Lifetime length of use of hormonal contraceptive methods was not associated with fecundability. Conclusions Use of some hormonal contraceptive methods was associated with delays in return of fertility, with injectable contraceptives showing the longest delay. The findings indicated little or no lasting effect of long term use of these methods on fecundability.
Cost-effectiveness of intermittent preventive treatment with dihydroartemisinin-piperaquine versus single screening and treatment for the control of malaria in pregnancy in Papua, Indonesia: a provider perspective analysis from a cluster-randomised trial
Authors: Lucy Paintain, Jenny Hill, Rukhsana Ahmed, Chandra Umbu Reku Landuwulang, Ansariadi Ansariadi, Jeanne Rini Poespoprodjo, Din Syafruddin, Carole Khairallah, Faustina Helena Burdam, Irene Bonsapia, Feiko O ter Kuile, Jayne Webster
Journal: The Lancet Global Health (2020)

BackgroundMalaria infection during pregnancy is associated with serious adverse maternal and birth outcomes. A randomised controlled trial in Papua, Indonesia, comparing the efficacy of intermittent preventive treatment with dihydroartemisinin-piperaquine with the current strategy of single screening and treatment showed that intermittent preventive treatment is a promising alternative treatment for the reduction of malaria in pregnancy. We aimed to estimate the incremental cost-effectiveness of intermittent preventive treatment with dihydroartemisinin-piperaquine compared with single screening and treatment with dihydroartemisinin-piperaquine.MethodsWe did a provider perspective analysis. A decision tree model was analysed from a health provider perspective over a lifetime horizon. Model parameters were used in deterministic and probabilistic sensitivity analyses. Simulations were run in hypothetical cohorts of 1000 women who received intermittent preventive treatment or single screening and treatment. Disability-adjusted life-years (DALYs) for fetal loss or neonatal death, low birthweight, moderate or severe maternal anaemia, and clinical malaria were calculated from trial data and cost estimates in 2016 US dollars from observational studies, health facility costings and public procurement databases. The main outcome measure was the incremental cost per DALY averted.FindingsRelative to single screening and treatment, intermittent preventive treatment resulted in an incremental cost of US$5657 (95% CI 1827 to 9448) and 107·4 incremental DALYs averted (–719·7 to 904·1) per 1000 women; the average incremental cost-effectiveness ratio was $53 per DALY averted.InterpretationIntermittent preventive treatment with dihydroartemisinin-piperaquine offers a cost-effective alternative to single screening and treatment for the prevention of the adverse effects of malaria infection in pregnancy in the context of the moderate malaria transmission setting of Papua. The higher cost of intermittent preventive treatment was driven by monthly administration, as compared with single-administration single screening and treatment. However, acceptability and feasibility considerations will also be needed to inform decision making.FundingMedical Research Council, Department for International Development, and Wellcome Trust.
Financial Penalties Imposed on Large Pharmaceutical Firms for Illegal Activities
Authors: Denis G. Arnold, Oscar Jerome Stewart, Tammy Beck
Journal: JAMA (2020)

Financial Penalties Imposed on Large Pharmaceutical Firms for Illegal ActivitiesSome pharmaceutical companies have received criticism for engaging in illegal activities, such as providing kickbacks and bribes, knowingly shipping adulterated or contaminated drugs to pharmacies, and marketing drugs for unapproved uses.This study examined financial penalties for illegal activities among large pharmaceutical firms in relation to annual revenues.
Rapidly Progressive Stiffness and Nodularity of Both Hands in a Middle-aged Woman
Authors: Pin-Hsuan Chiang, Ren-Feng Liu
Journal: JAMA Dermatology (2020)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Dermatology HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Dermatology journal
Looking to Long-term Survivors for Improved Pancreatic Cancer Treatment
Authors: Bridget M. Kuehn
Journal: JAMA (2020)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Abstract 12722: Cardiac Resynchronization Therapy in Pacing Induced Cardiomyopathy: A Higher Right Ventricle Pacing Percentage Predicts Greater Improvement in Left Ventricle Ejection Fraction
Authors: Sean Lacy, Jonathan Chandler, NACHIKET MADHAV APTE, Seth Sheldon, Madhu Reddy, Raghuveer Dendi, Rhea C Pimentel, Loren D Berenbom, Martin Emert, Rigoberto Ramirez, Amit Noheria
Journal: Circulation (2020)

Introduction: Cardiac resynchronization therapy (CRT) upgrade is indicated for improvement of cardiac function in patients with chronic right ventricular (RV) pacing burden &gt;40% and heart failure with reduced ejection fraction. It is uncertain whether the CRT response is different among patients with high (≥90%) versus intermediate (&lt;90%) burden of baseline RV pacing. Hypothesis: To assess the impact of baseline RV pacing percent on ECG and echocardiographic response after CRT upgrade for pacing induced cardiomyopathy. Methods: We conducted a retrospective study of all CRT upgrades for pacing induced cardiomyopathy at our hospital from January 2017 to December 2018. Cohorts were grouped by RV pacing burden ≥90% or &lt;90%. QRS duration, left ventricle ejection fraction (LVEF), and left ventricular internal dimension systolic (LVIDs) were assessed at baseline and 3-12 months post CRT upgrade. Results: We included 82 patients (age 74 ± 12 yr., 71% male) who underwent CRT upgrade for pacing induced cardiomyopathy. The RV pacing burden was ≥90% [median 99% (IQR 98-99%)] in 61 patients, and &lt;90% [median 79% (IQR 69-88%)] in 21 patients. There was a trend towards greater reduction in QRS duration in the ≥90% RV pacing group (28 ± 29 ms vs. 22 ± 38 ms, p=0.5). Improvement in LVEF was greater in ≥90% vs. &lt;90% RV pacing group (14.3 ± 10.1% vs. 6.3 ± 10.1%, p=0.003). The association persisted on multivariable adjustment for age, sex and baseline LVEF (p=0.004). There was a trend towards greater % reduction in LVIDs in the ≥90% vs. &lt;90% RV pacing group (6.4 ± 15.5 % vs. 3.9 ± 14.3 %, p=0.5) [Figure]. Conclusions: A higher baseline RV pacing burden predicts a greater improvement in LVEF after CRT upgrade for pacing induced cardiomyopathy.
Abstract 13916: Quality of Life Measured in First-line Therapy for Paroxysmal Atrial Fibrillation: A Comparison Between Cryoballoon Catheter Ablation versus Antiarrhythmic Drug Therapy
Authors: Nikola Pavlovic, Malte Kuniss, Vedran Velagic, Jean-Sylvain Hermida, Stewart Healey, Giuseppe Arena, Nicolas Badenco, Christian Meyer, Jian Chen, Saverio Iacopino, Frédéric Anselme, Gian-Battista Chierchia
Journal: Circulation (2020)

Introduction: The Cryo-FIRST study (NCT01803438) demonstrated that pulmonary vein isolation (PVI) with cryoballoon catheter ablation (CA) is superior to antiarrhythmic drug (AAD) therapy as a first line treatment for the prevention of atrial arrhythmia recurrence in patients with paroxysmal atrial fibrillation (PAF). Earlier CA may also be beneficial for improving quality of life (QoL). Hypothesis: We hypothesized that PVI with cyroballoon CA is superior to AAD therapy for improving QoL in treatment naïve patients with PAF. Methods: Patients with symptomatic PAF free of heart disease who had not been administered AAD therapy for &gt;48 hours were enrolled at 18 sites in 9 countries. Patients were randomized (1:1) to cryoballoon CA (Arctic Front Advance, Medtronic) or AAD therapy (Class IC or III). Subjects were followed at 1, 3, 6, 9, and 12 months. QoL was evaluated using the Atrial Fibrillation Effect on Quality of Life (AFEQT) and SF-36 v2 questionnaires. Health domains and component scores from the SF-36 were transformed to norm-based T scores. Mean adjusted differences between arms were compared at each follow-up. Results: Of the 218 patients randomized (age 52±13 years, 68% male) 86% completed the 12-month follow-up. Crossovers occurred in 9% of subjects (N=20, CA-to-AAD: N=1, AAD-to-CA: N=19). There were no group differences in baseline AFEQT or SF-36 scores. The mean AFEQT summary score was more favorable in the CA vs. AAD group at 12 months (88.9 vs. 78.1 points, respectively). The adjusted difference was 9.9 points (95%CI: 5.5-14.2; P &lt; .0001, Figure). A significant adjusted mean difference favoring CA was observed for the SF-36 physical component score at months 3 (1.8 points, p=0.031) and 9 (2.0 points, p=0.018). No other differences were observed in the physical or mental component scores between groups. Conclusions: Cryoballoon CA was superior to AAD therapy for improving AF-specific QoL in treatment naïve patients with symptomatic PAF.
Abstract 13288: Risk of Thrombotic Events After Respiratory Infection Requiring Hospitalization
Authors: Nathaniel R Smilowitz, Varun Subashchandran, Jonathan D Newman, Michael E Barfield, Thomas S Maldonado, Shari B Brosnahan, Eugene Yuriditsky, James M Horowitz, Binita Shah, Harmony R Reynolds, Judith S Hochman, Jeffrey S Berger
Journal: Circulation (2020)

Background: Thrombosis is a major concern in respiratory infections such as influenza and now COVID-19. We investigated the magnitude and duration of risk for arterial and venous thrombosis following discharge after respiratory infections. Methods: Patients with respiratory infections were identified using the United States Nationwide Readmission Database from 2012-2014. Patients admitted with asthma or cellulitis served as comparators. Readmissions for myocardial infarction (MI) and venous thromboembolism (VTE) were evaluated at 30 to 180 days. The likelihood of a thrombotic event after hospital discharge was compared with a 30-day period prior to hospitalization using conditional logistic regression. Results: Among 5,271,068 patients discharged after a respiratory infection, 0.56% and 0.78% were readmitted within 30-days with MI and VTE, respectively. Relative to asthma and cellulitis, respiratory infection was associated with a greater age and sex-adjusted hazard of 30-day readmission for MI (adjusted HR [aHR] 1.58 [95% CI 1.52-1.64] vs. asthma; aHR 1.43 [95% CI 1.38-1.48] vs. cellulitis) and VTE (aHR 1.65 [95% CI 1.60-1.69] vs. asthma; aHR 1.45, [95% CI 1.41-1.50] vs. cellulitis). Risks of MI and VTE after respiratory infection attenuated over time, yet remained higher than asthma and cellulitis over 90 and 180 days (Figure). In a crossover-cohort analysis, the odds of MI (OR 1.68 [95% CI 1.62-1.73]) and VTE (OR 3.30 [95% 3.19-3.41]) were higher in the 30 days following discharge after respiratory infection than during the baseline period. The odds of MI (OR 2.44 [95% CI 1.95-3.05]) and VTE (OR 4.49 [95% 3.50-5.76]) at 30-days appeared highest when a viral respiratory pathogen was identified. Conclusions: Hospitalization for respiratory infection, particularly when of viral etiology, was associated with an increased risk of myocardial infarction and venous thrombosis that was highest in the first 30-days after discharge and declined over time.
Differences in Physiological Responses to Cardiopulmonary Exercise Testing in Adults With and Without Type 1 Diabetes: A Pooled Analysis
Authors: Max L. Eckstein, Juliano Boufleur Farinha, Olivia McCarthy, Daniel J. West, Jane E. Yardley, Lia Bally, Thomas Zueger, Christoph Stettler, Winston Boff, Alvaro Reischak-Oliveira, Michael C. Riddell, Dessi P. Zaharieva, Thomas R. Pieber, Alexander Müller, Philipp Birnbaumer, Faisal Aziz, Laura Brugnara, Hanne Haahr, Eric Zijlstra, Tim Heise, Harald Sourij, Michael Roden, Peter Hofmann, Richard M. Bracken, Dominik Pesta, Othmar Moser
Journal: Diabetes Care (2020)

To investigate physiological responses to cardiopulmonary exercise (CPX) testing in adults with type 1 diabetes compared with age-, sex-, and BMI-matched control participants without type 1 diabetes.
18F-FDG PET/CT in Initial Diagnosis and Treatment Response Evaluation of Anti-NMDAr and Anti-GAD Dual Antibody Autoimmune Encephalitis
Authors: Nikhil Seniaray, Ritu Verma, Rajeev Ranjan, Ethel Belho, Harsh Mahajan
Journal: Clinical Nuclear Medicine (2020)

Abstract We report a case of 34-year-old woman presenting with complaints of abnormal posturing of hand and tonic-clonic seizures of few days’ duration, which soon progressed to psychotic episodes and injuries secondary to fall/abnormal movements. She underwent 18 F-FDG PET for a suspicion of encephalitis, which revealed increased FDG uptake in the bilateral parietotemporal lobes (right more than left), anterior cingulate cortex, bilateral basal ganglia, thalami, and cerebellum. This atypical pattern did not conform to any known pattern of encephalitis, which was later attributed to the presence of both anti-NMDAr and anti-GAD antibodies in blood and cerebrospinal fluid.
2-Hydroxylation of Fatty Acids Represses Colorectal Tumorigenesis and Metastasis via the YAP Transcriptional Axis
Authors: Liang Sun, Xiaoqin Yang, Xiaoheng Huang, Yizhou Yao, Xiangyu Wei, Shugao Yang, Diyuan Zhou, Wei Zhang, Zhimin Long, Xiaoyan Xu, Xinguo Zhu, Songbing He, Xiong Su
Journal: Cancer Research (2020)

Abstract Alteration in lipid composition is an important metabolic adaptation by cancer cells to support tumorigenesis and metastasis. Fatty acid 2-hydroxylase (FA2H) introduces a chiral hydroxyl group at the second carbon of fatty acid (FA) backbones and influences lipid structures and metabolic signaling. However, the underlying mechanisms through which FA 2-hydroxylation is coupled to metabolic adaptation and tumor growth remain elusive. Here, we show that FA2H regulates specific metabolic reprogramming and oncogenic signaling in the development of colorectal cancer. FA2H is highly expressed in normal colorectal tissues. Assessments through deciphering both published high-throughput data and curated human colorectal cancer samples revealed significant suppression of FA2H in tumors, which is correlated with unfavorable prognosis. Experiments with multiple models of genetic manipulation or treatment with an enzymatic product of FA2H, (R)-2-hydroxy palmitic acid, demonstrated that FA 2-hydroxylation inhibits colorectal cancer cell proliferation, migration, epithelial-to-mesenchymal transition progression, and tumor growth. Bioinformatics analysis suggested that FA2H functions through AMP-activated protein kinase/Yes-associated protein (AMPK/YAP) pathway, which was confirmed in colorectal cancer cells, as well as in tumors. Lipidomics analysis revealed an accumulation of polyunsaturated fatty acids in cells with FA2H overexpression, which may contribute to the observed nutrient deficiency and AMPK activation. Collectively, these data demonstrate that FA 2-hydroxylation initiates a metabolic signaling cascade to suppress colorectal tumor growth and metastasis via the YAP transcriptional axis and provides a strategy to improve colorectal cancer treatment. Significance: These findings identify a novel metabolic mechanism regulating the tumor suppressor function of FA 2-hydroxylation in colorectal cancer.
Abstract 16787: Calcium Channel Blockers and Nitrates in 5-FU Vasospasm
Authors: Amna Zafar, Zsofia Drobni, Raza Alvi, Matthew Lei, Uvette Lou, Ramya Mosarla, Sean Murphy, Maeve Jones-O'Connor, ali mahmood, Sarah Hartmann, Hannah K Gilman, Colin D Weekes, Ryan Nipp, John R Clark, Jeffrey W Clark, Lawrence Blaszkowsky, Erica Tavares, Tomas G Neilan
Journal: Circulation (2020)

Introduction: Coronary vasospasm is a side effect of 5-FU (fluorouracil). Beyond switching chemotherapy regimens, there are no established treatments for vasospasm. Limited data exist regarding the efficacy of calcium channel blockers (CCBs) and/or nitrates with 5-FU vasospasm. Methods: We conducted a retrospective analysis of all patients at Massachusetts General Hospital who were diagnosed with 5-FU coronary vasospasm. As part of institutional practice, those referred to cardio-oncology receive pre-treatment with vasospasm therapies (either combination [nitrates and CCBs] or single agent therapy [nitrates or CCBs]) prior to re-challenge with 5-FU. Our primary outcomes were the safety and effectiveness of this cardiac pre-treatment approach. Results: Among 7,711 patients who received 5-FU from Jan 2001 to Jul 2017, 86 (1.11%) developed coronary vasospasm. Overall 64 patients continued to receive subsequent 5-FU, while 22 stopped. Of the 64 who continued, 60 were referred to cardio-oncology and prescribed CCBs and/or nitrates prior to subsequent 5-FU. Of these 60, 52% (31/60) received both nitrates and CCBs, 20% (12/60) received CCBs alone, and 28% (17/60) received nitrates alone, while 4 continued 5-FU without cardiac pre-treatment. Chest pain (without a myocardial infarct) recurred in 11.7% (7/60) among those who received cardiac pre-treatment vs. 50% (2/4) among those who did not (P=0.033). When those who stopped were compared to those who continued 5-FU (with cardiac pre-treatment), the cardiovascular profile, stage and type of cancer were similar. As compared to patients who stopped 5-FU, those who continued after nitrates/CCBs had improved progression free (HR 0.56, P=0.076 [95% CI 0.30-1.06]) and overall (HR 0.29, P&lt;0.001 [95% CI 0.15-0.57]) survival. Conclusion: In the largest report of 5-FU associated vasospasm, re-challenge after pre-treatment with CCBs and nitrates was safe and effective, thus allowing patients to receive additional 5-FU.