tbuckley/cabot-search huggingface dataset:
Abstract 13077: Higher Occurrence of Right Ventricular Fibrosis in Right Ventricular Outflow Tract-dominant Than Diffuse Hypertrophic Types: A Pulmonary Hypertension Study Using Cardiac Computed Tomography
Authors: Nobusada FUNABASHI, Koya Ozawa, Yoshio Kobayashi
Journal: Circulation (2020)

Introduction: On cardiac CT of pulmonary hypertension (PH), two right ventricular (RV) hypertrophic (RVH) morphological types are seen, namely RV outflow tract-dominant and RV-diffuse. However, clinical significance of this difference is unclear. Hypothesis: These two morphological RVH types have different effects on myocardial characteristics, clinical severity and prognosis in PH patients. Methods: We retrospectively analyzed 43 PH patients (33 females, 55±15yrs, 31 chronic thromboembolic PH (CTEPH), 7 idiopathic pulmonary arterial (PA) hypertension). On CT, RV fibrosis was defined as contrast defects in early phase and abnormal enhancement in late phase. Cases were divided into 3 groups: RV outflow tract-dominant RVH (gp 1), RVH-diffuse (gp 2), and no RVH (gp 3). Mean follow up was 39.3±20.1, 58.3±17.7, 68.2±11.9 months, respectively. Results: There were 6, 26, 11 patients in gps 1, 2, 3, respectively. There were no significant differences in these percentages between CTEPH and idiopathic PA hypertension or between ages ≥60 and &lt;60 yrs. There were no significant differences of R/S wave ratio on ECG V1 lead, maximum RV wall thickness on end-diastole (CT), plasma BNP and estimated PA systolic pressure (PASP) on TTE between gps 1 and 2. There were significant positive correlations between maximum RV wall thickness in end-diastole and plasma BNP in gp 1 (R=0.44) but no correlations in gp 2 (R=0.05). Similarly, there were significant positive correlations between maximum RV wall thickness in end-diastole and estimated PASP in gp 1 (R=0.38) but no correlations in gp 2 (R= -0.08). RV fibrosis was detected in 3 patients (50%) (gp1) and 1 patient (4%) (gp2) (P=0.003). Zero, 2, and 1 patients died due to PH during follow-up periods in gps 1, 2, 3 , respectively, and there were no significant differences in these percentages on Kaplan Meier analysis and log rank testing. Interobserver agreement between two observers was 91% in gp 1 and 77% in both gps 2 and 3. Conclusions: In PH patients, RV outflow tract-dominant RVH was relatively easy to diagnose and manifested with greater occurrence of RV fibrosis than diffuse-type. RV outflow tract-dominant RVH showed significant positive correlations of maximum RV wall thickness in end-diastole with plasma BNP and estimated PASP.
Abstract 16183: Predictors of Myocardial Injury in Patients With Negative Stress Echocardiogram
Authors: Rody G Bou Chaaya, Edward A El-Am, Mohamad Sabra, Rayan Jo Rachwan, Fakilahyel S Mshelbwala, ziad jaradat, Omar Batal
Journal: Circulation (2020)

Background: A negative result on stress echocardiography (SE) is generally associated with a low risk of cardiovascular events and carries a favorable prognosis. The present study was conducted to identify clinical and echocardiographic characteristics associated with increased risk of myocardial injury following a negative SE (NSE). Methods: We retrospectively identified a total of 4130 SEs performed between 2013 and 2017 at a tertiary care center. NSE was defined as the absence of a new or worsening wall motion abnormality (WMA) with stress. Patients with resting WMA on SE were excluded. The occurrence of myocardial injury following index SE within 1 year was then recorded. Myocardial injury was defined as an elevated (&gt;99 th percentile of the upper reference limit of normal) and changing troponin value (a rise and/or fall of the troponin value observed) following index SE. Results: During the study period, 2962 patients with NSE met inclusion criteria (median age 58 years-old; 50% females). Baseline characteristics were as follows: 35% diabetic, 49% hyperlipidemic, 62% hypertensive, 41% had a history of smoking, 21% had a history of coronary artery disease (CAD), 24% had end-stage liver disease (ESLD), 5% had end-stage renal disease (ESRD) and 1.5% had a left ventricular ejection fraction (LVEF) &lt; 50%. Around 5% of patients developed myocardial injury within 1 year of NSE. Age, diabetes mellitus, ESLD and a LVEF &lt;50% were significantly associated with an increased risk of myocardial injury on univariate and multivariate analysis (p&lt;0.013) (Table). Conclusion: Patients with age &gt; 65 years, diabetes mellitus, ESLD and a LVEF &lt;50% were found to be at increased risk of myocardial injury within 1 year of a NSE. These characteristics should be accounted for during the interpretation of SE as these patients warrant intensive risk factor modification and close follow-up.
Abstract 17060: Machine Learning and Video Recognition for Automated Detection of Fluid Status in Heart Failure Patients
Authors: Pratik Doshi, John Tanaka, Jedrek Wosik, Natalia M Gil, Martin Bertran, Stuart D Russell, Guillermo Sapiro
Journal: Circulation (2020)

Introduction: There is a need for innovative solutions to better screen and diagnose the 7 million patients with chronic heart failure. A key component of assessing these patients is monitoring fluid status by evaluating for the presence and height of jugular venous distension (JVD). We hypothesize that video analysis of a patient’s neck using machine learning algorithms and image recognition can identify the amount of JVD. We propose the use of high fidelity video recordings taken using a mobile device camera to determine the presence or absence of JVD, which we will use to develop a point of care testing tool for early detection of acute exacerbation of heart failure. Methods: In this feasibility study, patients in the Duke cardiac catheterization lab undergoing right heart catheterization were enrolled. RGB and infrared videos were captured of the patient’s neck to detect JVD and correlated with right atrial pressure on the heart catheterization. We designed an adaptive filter based on biological priors that enhances spatially consistent frequency anomalies and detects jugular vein distention, with implementation done on Python. Results: We captured and analyzed footage for six patients using our model. Four of these six patients shared a similar strong signal outliner within the frequency band of 95bpm – 200bpm when using a conservative threshold, indicating the presence of JVD. We did not use statistical analysis given the small nature of our cohort, but in those we detected a positive JVD signal the RA mean was 20.25 mmHg and PCWP mean was 24.3 mmHg. Conclusions: We have demonstrated the ability to evaluate for JVD via infrared video and found a relationship with RHC values. Our project is innovative because it uses video recognition and allows for novel patient interactions using a non-invasive screening technique for heart failure. This tool can become a non-invasive standard to both screen for and help manage heart failure patients.
Internet-Delivered Cognitive Behavior Therapy for Atopic Dermatitis
Authors: Erik Hedman-Lagerlöf, Jens Fust, Erland Axelsson, Marianne Bonnert, Maria Lalouni, Olof Molander, Petter Agrell, Anna Bergman, Nils Lindefors, Maria Bradley
Journal: JAMA Dermatology (2021)

Atopic dermatitis is a common and debilitating skin condition characterized by intense itching and chronic inflammation. Research on behavioral treatments with high accessibility is needed.To investigate the efficacy of a highly scalable internet-delivered cognitive behavior therapy (CBT) for adults with atopic dermatitis.This randomized clinical trial from a medical university in Stockholm, Sweden, included 102 adults with atopic dermatitis, recruited from across Sweden, who received 12 weeks of internet-delivered CBT (March 29, 2017, to February 16, 2018). The first participant provided screening data on November 27, 2016, and the last 1-year follow-up assessment was conducted on June 28, 2019.Participants were randomized in a 1:1 ratio to 12 weeks of therapist-guided internet-delivered CBT (n = 51) or a control condition (n = 51) that gave instructions about standard care.The primary outcome was the between-group difference in mean reduction of atopic dermatitis symptoms as measured by the Patient-Oriented Eczema Measure and modeled intention to treat during the 12-week treatment period.A total of 102 participants (mean [SD] age, 37 [11] years; 83 [81%] female) were recruited and randomized. The primary analysis indicated that participants receiving internet-delivered CBT, relative to the controls, had a significantly larger mean weekly reduction in symptoms of atopic dermatitis as measured with the Patient-Oriented Eczema Measure (B = 0.32; 95% CI, 0.14-0.49; P < .001), with a moderate to large, controlled effect size after treatment (d = 0.75; 95% CI, 0.32-1.16). Secondary analyses indicated that internet-delivered CBT also produced significantly larger reductions in itch intensity, perceived stress, sleep problems, and depression. Gains were sustained at 12 months of follow-up. Treatment satisfaction was high, and therapists spent a mean (SD) of 39.7 (34.7) minutes per treated patient providing internet-delivered CBT.Internet-delivered CBT appears to be efficacious for reducing symptoms of atopic dermatitis, despite requiring minimal therapist resources. Thus, internet-delivered CBT has the potential to increase access to effective adjunct behavioral treatment for patients with this common skin condition.ClinicalTrials.gov Identifier: NCT03051958.
ACC/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non–ST-Elevation Myocardial Infarction: Executive Summary
Authors: Jeffrey L. Anderson, Cynthia D. Adams, Elliott M. Antman, Charles R. Bridges, Robert M. Califf, Donald E. Casey, William E. Chavey, Francis M. Fesmire, Judith S. Hochman, Thomas N. Levin, A. Michael Lincoff, Eric D. Peterson, Pierre Theroux, Nanette Kass Wenger, R. Scott Wright
Journal: Circulation (2007)
Management of Hepatocellular Carcinoma in Japan: JSH Consensus Statements and Recommendations 2021 Update
Authors: Masatoshi Kudo, Yusuke Kawamura, Kiyoshi Hasegawa, Ryosuke Tateishi, Kazuya Kariyama, Shuichiro Shiina, Hidenori Toyoda, Yasuharu Imai, Atsushi Hiraoka, Masafumi Ikeda, Namiki Izumi, Michihisa Moriguchi, Sadahisa Ogasawara, Yasunori Minami, Kazuomi Ueshima, Takamichi Murakami, Shiro Miyayama, Osamu Nakashima, Hirohisa Yano, Michiie Sakamoto, Etsuro Hatano, Mitsuo Shimada, Norihiro Kokudo, Satoshi Mochida, Tetsuo Takehara
Journal: Liver Cancer (2021)

The Clinical Practice Manual for Hepatocellular Carcinoma was published based on evidence confirmed by the Evidence-based Clinical Practice Guidelines for Hepatocellular Carcinoma along with consensus opinion among a Japan Society of Hepatology (JSH) expert panel on hepatocellular carcinoma (HCC). Since the JSH Clinical Practice Guidelines are based on original articles with extremely high levels of evidence, expert opinions on HCC management in clinical practice or consensus on newly developed treatments are not included. However, the practice manual incorporates the literature based on clinical data, expert opinion, and real-world clinical practice currently conducted in Japan to facilitate its use by clinicians. Alongside each revision of the JSH Guidelines, we issued an update to the manual, with the first edition of the manual published in 2007, the second edition in 2010, the third edition in 2015, and the fourth edition in 2020, which includes the 2017 edition of the JSH Guideline. This article is an excerpt from the fourth edition of the HCC Clinical Practice Manual focusing on pathology, diagnosis, and treatment of HCC. It is designed as a practical manual different from the latest version of the JSH Clinical Practice Guidelines. This practice manual was written by an expert panel from the JSH, with emphasis on the consensus statements and recommendations for the management of HCC proposed by the JSH expert panel. In this article, we included newly developed clinical practices that are relatively common among Japanese experts in this field, although all of their statements are not associated with a high level of evidence, but these practices are likely to be incorporated into guidelines in the future. To write this article, coauthors from different institutions drafted the content and then critically reviewed each other’s work. The revised content was then critically reviewed by the Board of Directors and the Planning and Public Relations Committee of JSH before publication to confirm the consensus statements and recommendations. The consensus statements and recommendations presented in this report represent measures actually being conducted at the highest-level HCC treatment centers in Japan. We hope this article provides insight into the actual situation of HCC practice in Japan, thereby affecting the global practice pattern in the management of HCC.
Abstract 18851: RAGE/sRAGE Antagonism Unveils a Novel Therapeutic Target and Biomarker of Thoracic Aortic Aneurysm and Dissection
Authors: Josephine Galatioto, Eric Lai, Bartosz Rylski, Tao Wang, Reed E Pyeritz, Joseph E Bavaria, Emanuela Branchetti
Journal: Circulation (2017)

Introduction: The Receptor for Advanced Glycation End Products (RAGE), when activated, induces irreversible vascular tissue injury and the release of soluble RAGE (sRAGE) in the circulation. We dem...
177P COVID-19 pandemic impact in newly diagnosed breast cancer patients (BCP) at a third level hospital
Authors: M.C. Guillen Sacoto, E. Núñez-Manchón, X. Bargalló, B. Adamo, I. Alonso, M. Mollà, M. Vidal, G. Oses González, X. Caparrós, B. Gonzalez-Farre, N. Chic, O. Martínez-Sáez, B. Ubeda, R. Moreno, I. Cebrecos, J. Fontdevila Font, S. Vidal-Sicart, A. Rodríguez, A. Prat, M. Muñoz
Journal: Annals of Oncology (2021)
Abstract 14857: Outcomes of Bloodless Congenital Cardiac Surgery on Cardiopulmonary Bypass
Authors: anas abdul kayoum, Estefania Rivera, Marcelle Reyes, Saleem Almasarweh, Jorge ojito, Redmond Burke, Jun Sasaki
Journal: Circulation (2020)

Introduction: Bloodless cardiac surgery defined as blood transfusion-free open-heart surgery, where cardiopulmonary bypass (CPB) circuits primed with crystalloid only and no intraoperative blood transfusion. Limited data have been published in this field. Hypothesis: We asked whether blood conservative surgery is feasible in congenital heart disease. Methods: We retrospectively reviewed patients who underwent bloodless cardiac surgery for congenital heart disease on CPB between January 2016 and December 2018. Our unique CPB system utilizes assisted venous drainage, bioactive coating, and reduced tubing size to decrease priming volume, and complement activation. Results: A total of 164 patients were reviewed (86 male and 78 female) at a median age of 9.6 years (range, 13 months-55 years), weight of 32 kg (IQR, 16-55), preoperative hemoglobin 13.7 g/dl (IQR, 12.6-14.9), and preoperative hematocrit of 40.3% (IQR, 37.2-44.3). Median CPB time was 81.5 minutes (IQR, 58-125), and median hematocrit coming off CPB was 26% (IQR, 23-29.7). Congenital Heart Surgery risk (STAT) category distributed in STAT 1 for 70 (43%), STAT 2 for 80 (49%), STAT 3 for 9 (5%), and STAT 4 for 5 (3%) of the patients. The majority (95%) of patients were extubated in the operating room with low complications rate during the hospital stay (7%). Only 6 (4%) patients needed a blood transfusion in the postoperative period with higher incidence of complications during the hospital course (LR 14.9; p&lt;0.001). The median length of hospital stay was 3.6 days (IQR 2.6-5.6). There was no in-hospital mortality or 30 days mortality after surgery. Conclusions: Bloodless congenital cardiac surgery has a high success rate in selected low to medium surgical risk and even higher risk patients (STAT 3 and 4). Our patients had a low rate of complications and short hospital course. The blood product transfusion correlated significantly with a higher rate of complications during the postoperative course.
Prediction of Differential Pharmacologic Response in Chronic Pain Using Functional Neuroimaging Biomarkers and a Support Vector Machine Algorithm: An Exploratory Study
Authors: Eric Ichesco, Scott J. Peltier, Ishtiaq Mawla, Daniel E. Harper, Lynne Pauer, Steven E. Harte, Daniel J. Clauw, Richard E. Harris
Journal: Arthritis & Rheumatology (2021)

Objective There is increasing demand for prediction of chronic pain treatment outcomes using machine‐learning models, in order to improve suboptimal pain management. In this exploratory study, we used baseline brain functional connectivity patterns from chronic pain patients with fibromyalgia (FM) to predict whether a patient would respond differentially to either milnacipran or pregabalin, 2 drugs approved by the US Food and Drug Administration for the treatment of FM. Methods FM patients participated in 2 separate double‐blind, placebo‐controlled crossover studies, one evaluating milnacipran (n = 15) and one evaluating pregabalin (n = 13). Functional magnetic resonance imaging during rest was performed before treatment to measure intrinsic functional brain connectivity in several brain regions involved in pain processing. A support vector machine algorithm was used to classify FM patients as responders, defined as those with a ≥20% improvement in clinical pain, to either milnacipran or pregabalin. Results Connectivity patterns involving the posterior cingulate cortex (PCC) and dorsolateral prefrontal cortex (DLPFC) individually classified pregabalin responders versus milnacipran responders with 77% accuracy. Performance of this classification improved when both PCC and DLPFC connectivity patterns were combined, resulting in a 92% classification accuracy. These results were not related to confounding factors, including head motion, scanner sequence, or hardware status. Connectivity patterns failed to differentiate drug nonresponders across the 2 studies. Conclusion Our findings indicate that brain functional connectivity patterns used in a machine‐learning framework differentially predict clinical response to pregabalin and milnacipran in patients with chronic pain. These findings highlight the promise of machine learning in pain prognosis and treatment prediction.
Abstract 16471: Lipoprotein(a) Cholesterol and Cardiovascular Events in the VITamin D and OmegA 3 TriaL (Vital)
Authors: Zareen Farukhi, Heike Gibson, Nancy R Cook, Olga Demler, Krishnaji R Kulkarni, Oluremi N Ajala, Julie E Buring, Joann E Manson, Jacqueline Danik, Samia Mora
Journal: Circulation (2020)

Background: It is unclear if lipoprotein(a) cholesterol (LpaC), the cholesterol carried by Lpa, is associated with CVD similar to Lpa mass, and if omega-3 fatty acids (n-3 FA) modify risk. Methods: 13,175 participants of the VITAL trial (NCT01169259) had baseline LpaC measured by density-gradient ultracentrifugation and were examined for incident CVD (n=416) by Cox models adjusted for risk factors. In a subset of participants (N=1639) with baseline and 1 year samples, we also analyzed randomized n-3 FA effects (1 g/d EPA+DHA) vs. placebo. Results: In unadjusted models, LpaC was associated with increased CVD risk (Table). After adjustment, risk was somewhat attenuated, with borderline significant association for LpaC &gt;30 mg/dL (HR 1.37 [0.99, 1.90), p=0.056). N-3 FA increased median LpaC from 7 mg/dL (IQR, 5-10) at baseline to 8 mg/dL [IQR, 5-10] at 1 year (mean increase of 4.05% vs placebo, p=0.006 using natural logarithmic transformation for mean LpaC percent change). There was no effect modification (P interaction&gt;0.05) by n-3 FA, race, sex or LDL-C. Conclusion: Very high LpaC had borderline significant increased risk for incident CVD, without diminution of levels or associated risk by n-3 FA treatment.
Abstract 16591: The Impact of African Ancestry on the Pooled Cohort Equation Atherosclerotic Cardiovascular Disease Risk Estimation: Insights From the Hispanic Community Health Study/study of Latinos
Authors: Karen P Flores, Amit Khera, Daniela Sotres-Alvarez, Anurag Mehta, Amber Pirzada, Katrina Swett, Martha L DAVIGLUS, Robert C, Pedro Engel Gonzalez, Linda Gallo, Gregory A Talavera, Tamar Sofer, Parag H Joshi, Carlos J Rodriguez
Journal: Circulation (2020)

ACC/AHA 2018 guidelines recommend using Non-Hispanic (NH)-White pooled cohort equations (PCE) to estimate 10-year risk of atherosclerotic cardiovascular disease (ASCVD) among Hispanics. If African ancestry is present, the PCE for Blacks is recommended. African ancestry estimates among Hispanic Community Health Study/Study of Latinos (HCHS/SOL) background groups have been reported. 1 We applied the PCE based on fractional African ancestry to HCHS/SOL participants and compared risk estimates from NH-White and NH-Black PCE in these groups. HCHS/SOL participants aged 40-75 years were divided into two groups based on median fractional African ancestry of ~10%: groups with &gt;=10% or higher African Ancestry (Puerto Rican, Central Americans, and Dominicans) and those with &lt;10% or lower African ancestry (Mexicans, South Americans, Cubans). Mean predicted ASCVD incidence using both PCE's was assessed. ASCVD risk frequencies are weighted using survey methods. Differences were determined by Rao-Scott Chi-square test. The PCE was applied to 9091 HCHS/SOL participants. (mean age 53.5, 48% F) Applying the NH-White PCE to lower African ancestry groups led to 38% of participants being classified as intermediate/high (&gt;7.5%) ASCVD risk compared to 45% using the NH-Black PCE. Using the NH-White PCE in groups with higher African ancestry led to 36% of participants being classified as intermediate/high risk compared to 46% using the NH-Black PCE. ASCVD risk estimates per Hispanic background groups are shown. (Figure 1C ). Our study is the first to apply both NH-Black and NH-White PCE to Hispanics and assess differences based on fractional African ancestry. The NH-Black PCE provided consistently greater estimates in both groups with slightly greater differential of estimates relative to NH-White PCE in those with higher African Ancestry. Further studies with outcomes data are needed to determine optimal application of PCE in Hispanics based upon fractional African Ancestry.
First-in-class phase 2a study of anb020 (anti-il-33) in the treatment of moderate-to-severe atopic dermatitis
Authors: Y Chen, D Gutowska-Owsiak, M Westmoreland, T Mackenzie, L Cifuentes, A Lloyd-Lavery, A Marquette, B Kenney, M Londei, G Ogg
Journal: Allergy (2018)
Abstract 16627: Coronary Artery Calcium Scoring and Cardiovascular Events in Patients With Cancer: Analysis of CLARIFY Registry
Authors: Sadeer Al-Kindi, Nour Tashtish, Avirup Guha, Imran Rashid, Miguel Cainzos Achirica, Khurram Nasir, Sanjay Rajagopalan
Journal: Circulation (2020)

Introduction: Cardiovascular disease and cancer co-exist due to shared risk factors. The utility of coronary artery calcium (CAC) scoring in this population to predict cardiovascular events is not certain. Methods: We studied all patients enrolled in the CLARIFY registry of no-charge CAC (Clinicaltrials.gov NCT04075162) with diagnosis of any cancer. We followed patients for major adverse cardiovascular events (myocardial infarction, stroke, heart failure, coronary revascularization or mortality). Results: A total of 3,432 patients with cancer were identified. Mean age was 64±9 years, 1965 (57%) were women and 2937 (86%) were white. Overall distribution of CAC scores were as follows: CAC 0 in 35%, CAC 1-99 in 31%, CAC 100-399 in 20%, and CAC ≥ 400 in 15%. CAC distribution varied by cancer type (figure A). At a median follow-up of 663 [294-1086] days, 343 patients had MACE event. Compared with CAC 0, patients with CAC ≥ 400 had increased unadjusted risk of MACE (HR 2.57 [1.93-3.41], P&lt;0.001), which was not attenuated after adjusting for age and sex (HR 2.09 [1.50-2.90], P&lt;0.001). Conclusions: In this large cohort of patients with cancer, coronary artery atherosclerotic calcifications are common, vary by cancer type, and are associated with major adverse cardiovascular events, independently of age and sex. Further research should focus on utility of routine CAC for cardiovascular risk stratification in patients with cancer.