tbuckley/cabot-search huggingface dataset:
<scp>COVID</scp> ‐19 vaccine acceptance and hesitancy in patients with immunobullous diseases: a cross‐sectional study of the International Pemphigus and Pemphigoid Foundation
Authors: M. Kasperkiewicz, R. Strong, K. Mead, M. Yale, D. Zillikens, D.T. Woodley, A. Recke
Journal: British Journal of Dermatology (2021)

Journal Article COVID‐19 vaccine acceptance and hesitancy in patients with immunobullous diseases: a cross‐sectional study of the International Pemphigus and Pemphigoid Foundation Get access M. Kasperkiewicz, M. Kasperkiewicz Department of Dermatology, Keck School of Medicine University of Southern California Los Angeles CA USA https://orcid.org/0000-0003-0146-1661 Search for other works by this author on: Oxford Academic Google Scholar R. Strong, R. Strong International Pemphigus and Pemphigoid Foundation Sacramento CA USA Search for other works by this author on: Oxford Academic Google Scholar K. Mead, K. Mead International Pemphigus and Pemphigoid Foundation Sacramento CA USA Search for other works by this author on: Oxford Academic Google Scholar M. Yale, M. Yale International Pemphigus and Pemphigoid Foundation Sacramento CA USA Search for other works by this author on: Oxford Academic Google Scholar D. Zillikens, D. Zillikens Department of Dermatology University of Lübeck Lübeck Germany Search for other works by this author on: Oxford Academic Google Scholar D.T. Woodley, D.T. Woodley Department of Dermatology, Keck School of Medicine University of Southern California Los Angeles CA USA Search for other works by this author on: Oxford Academic Google Scholar A. Recke A. Recke Department of Dermatology University of Lübeck Lübeck Germany Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 186, Issue 4, 1 April 2022, Pages 737–739, https://doi.org/10.1111/bjd.20906 Published: 01 April 2022
Association of COVID-19 Vaccination With SARS-CoV-2 Infection in Patients With Cancer
Authors: Julie Tsu-Yu Wu, Jennifer La, Westyn Branch-Elliman, Linden B. Huhmann, Summer S. Han, Giovanni Parmigiani, David P. Tuck, Mary T. Brophy, Nhan V. Do, Albert Y. Lin, Nikhil C. Munshi, Nathanael R. Fillmore
Journal: JAMA Oncology (2021)

<h3>Importance</h3> Patients with cancer are at increased risk for severe COVID-19, but it is unknown whether SARS-CoV-2 vaccination is effective for them. <h3>Objective</h3> To determine the association between SARS-CoV-2 vaccination and SARS-CoV-2 infections among a population of Veterans Affairs (VA) patients with cancer. <h3>Design, Setting, and Participants</h3> Retrospective, multicenter, nationwide cohort study of SARS-CoV-2 vaccination and infection among patients in the VA health care system from December 15, 2020, to May 4, 2021. All adults with solid tumors or hematologic cancer who received systemic cancer-directed therapy from August 15, 2010, to May 4, 2021, and were alive and without a documented SARS-CoV-2 positive result as of December 15, 2020, were eligible for inclusion. Each day between December 15, 2020, and May 4, 2021, newly vaccinated patients were matched 1:1 with unvaccinated or not yet vaccinated controls based on age, race and ethnicity, VA facility, rurality of home address, cancer type, and treatment type/timing. <h3>Exposures</h3> Receipt of a SARS-CoV-2 vaccine. <h3>Main Outcomes and Measures</h3> The primary outcome was documented SARS-CoV-2 infection. A proxy for vaccine effectiveness was defined as 1 minus the risk ratio of SARS-CoV-2 infection for vaccinated individuals compared with unvaccinated controls. <h3>Results</h3> A total of 184 485 patients met eligibility criteria, and 113 796 were vaccinated. Of these, 29 152 vaccinated patients (median [IQR] age, 74.1 [70.2-79.3] years; 95% were men; 71% were non-Hispanic White individuals) were matched 1:1 to unvaccinated or not yet vaccinated controls. As of a median 47 days of follow-up, 436 SARS-CoV-2 infections were detected in the matched cohort (161 infections in vaccinated patients vs 275 in unvaccinated patients). There were 17 COVID-19–related deaths in the vaccinated group vs 27 COVID-19–related deaths in the unvaccinated group. Overall vaccine effectiveness in the matched cohort was 58% (95% CI, 39% to 72%) starting 14 days after the second dose. Patients who received chemotherapy within 3 months prior to the first vaccination dose were estimated to have a vaccine effectiveness of 57% (95% CI, –23% to 90%) starting 14 days after the second dose vs 76% (95% CI, 50% to 91%) for those receiving endocrine therapy and 85% (95% CI, 29% to 100%) for those who had not received systemic therapy for at least 6 months prior. <h3>Conclusions and Relevance</h3> In this cohort study, COVID-19 vaccination was associated with lower SARS-CoV-2 infection rates in patients with cancer. Some immunosuppressed subgroups may remain at early risk for COVID-19 despite vaccination, and consideration should be given to additional risk reduction strategies, such as serologic testing for vaccine response and a third vaccine dose to optimize outcomes.
Updated Results of a Phase II Study of Ponatinib and Blinatumomab for Patients with Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia
Authors: Nicholas J. Short, Hagop Kantarjian, Marina Konopleva, Sai Prasad Prasad Desikan, Nitin Jain, Farhad Ravandi, Xuelin Huang, William G. Wierda, Gautam Borthakur, Koji Sasaki, Ghayas C. Issa, Yesid Alvarado, Naveen Pemmaraju, Guillermo Garcia-Manero, Courtney D. DiNardo, Jennifer Thankachan, Ricardo Delumpa, Anna Milton, Juan Rivera, Lourdes Waller, Rebecca Garris, Elias J. Jabbour
Journal: Blood (2021)
Abstract 10549: Clinical Significances of Left Atrial Volume vs Function in Nonischemic Cardiomyopathy
Authors: Mana Okune, Masakazu Yasuda, Naoko Soejima, Kakehi Kazuyoshi, Takayuki Kawamura, Takashi Kurita, Gaku Nakazawa, Yoshitaka Iwanaga
Journal: Circulation (2021)

Introduction: Left atrium (LA) structure/function is reported to provide incremental prognostic information in patients with heart failure. However, its clinical impact is not fully elucidated in nonischemic cardiomyopathy (NICM). Therefore, we explored the clinical significance in patients with NICM, especially by clarifying the different roles between LA volume and emptying fraction. Methods: Consecutive patients with NICM who underwent cardiac magnetic resonance were analyzed and followed. Cox regression models were used to estimate hazard ratios (HRs) for major cardiovascular events (MACE) related to LA volume and emptying fraction. Results: Among the 625 patients with NICM including left ventricle non-compaction, dilated cardiomyopathy, hypertrophic cardiomyopathy, cardiac sarcoidosis, and cardiac amyloidosis (mean age; 64.4 ± 14.2 years, and female; 39.7%), 133 had a history of AF at baseline. Baseline AF was associated with both higher LA volume and lower emptying fraction independently; however, it was not associated with increased MACE (P = 0.245). New-onset AF developed in 5.9% of the patients during a median follow-up of 20.3 months, with maximum LA volume as its strong and independent predictor (P &lt; 0.001, the area under the ROC curve AUC of 0.795). It was superior to LA emptying fraction (Figure A). In Kaplan-Meier analysis, patients with new-onset AF showed increased MACE compared with those of sinus rhythm or baseline AF (P = 0.002). New-onset AF and LA emptying fraction were independent predictors of MACE (HR: 2.28, 95% CI: 1.20-3.97, and HR: 0.98, 95% CI: 0.96-0.99, respectively) after adjusting for age, gender, body mass index, and diagnosis. Maximum LA volume alone was not associated with MACE (Figure B). Conclusions: Both LA volume and function were independently associated with baseline AF in patients with NICM. Maximum LA volume predicted the incidence of new-onset AF best, and only LA emptying fraction was associated with a worse prognosis.
Abstract 12869: Left Atrial Contractile Strain Predicts Recurrence of Atrial Tachyarrhythmia After Catheter Ablation
Authors: Anne B Nielsen, Kristoffer G Skaarup, Kasper Djernæs, Raphael Hauser, Raul S Estepar, Samuel K Sørensen, Martin H Ruwald, Morten L Hansen, René H Worck, Arne Johannesen, Jim Hansen, Tor Biering-Sørensen
Journal: Circulation (2021)

Background: Despite improvement in treatment strategies of atrial fibrillation (AF), a considerable number of patients still experience recurrence of atrial tachyarrhythmia (ATA) following catheter ablation (CA). We hypothesized that baseline myocardial impairment of the left atrium (LA) is useful in identifying patients at high risk of ATA recurrence. Methods: This retrospective study included 921 patients with AF who underwent CA. Echocardiography including two-dimensional speckle tracking echocardiography (2DSTE) was performed in all patients prior to CA. Logistic regression analysis was used to assess the association between ATA recurrence and peak atrial longitudinal strain (PALS), peak atrial contraction strain (PACS), and left atrial conduit strain (LACS). Results: During one-year follow-up, 375 (41%) experienced ATA recurrence. The median age of the included study population was 63.5 years (IQR: 55.6, 69.6) and 665 (72%) were male. Patients with recurrence had lower PALS (19.6% vs. 22.0%, p=0.004) and PACS (10.7% vs. 12.4%, p &lt; 0.001). No difference in LACS was observed. After adjusting for potential clinical and echocardiographic confounders PALS (OR = 1.04, CI95% [1.01; 1.06], p = 0.011, per 1% decrease) and PACS (OR = 1.06, CI95% [1.02; 1.11], p = 0.007, per 1% decrease) remained independent predictors of recurrence. However, in patients with a normal-sized LA (LA volume index &lt; 34 mL/m 2 ), only PACS remained an independent predictor of recurrence (OR = 1.06, CI95% [1.01; 1.12], p = 0.013, per 1% decrease). Figure 1 displays the increasing risk of recurrence with decreasing PALS, PACS, and LACS. Conclusion: In patients undergoing CA for AF, LA deformation analysis by 2DSTE could be of use in risk stratification in clinical practice regarding ATA recurrence, even in patients with a normal-sized LA.
Trial in Progress: A Phase 2, Open-Label Study Evaluating the Safety and Efficacy of the PKR Activator Etavopivat (FT-4202) in Patients with Thalassemia or Sickle Cell Disease
Authors: Ashutosh Lal, R. Clark Clark Brown, Thomas D. Coates, Theodosia A. Kalfa, Janet L. Kwiatkowski, Julie Brevard, Von Potter, Ken W. Wood, Sujit Sheth
Journal: Blood (2021)
Abstract 12432: Hypertension is Associated With Increased Hospitalization and Not Mortality Among COVID-19 Patients
Authors: Aaron Douen, Wesley Romney, Jeremy Oh, Ryan Panetti, Prakash Ramdass, Winston Lee, Aleksandre Toreli, George Juang
Journal: Circulation (2021)

Introduction: Hypertension (HTN) is associated with cardiovascular mortality risk. The risk of mortality or hospitalization amongst COVID-19 patients with HTN remains unclear. Hypothesis: There is increased risk of hospitalization and mortality amongst COVID-19 patients with HTN. Methods: The electronic health database at Coney Island Hospital was queried retrospectively for a cohort of patients, 18 or older, between 3/1/2020 and 4/1/2020. We included SARS-CoV-2 positive patients divided into two groups, hypertensive and non-hypertensive. We examined baseline characteristics including comorbidities. The primary outcomes were all-cause mortality and hospitalization. The secondary outcomes were acute kidney injury, ventricular arrhythmia, myocardial infarction, heart failure, and intubation. We also examined the use of antihypertensives. Results: We identified 23,102 patients positive for SARS-CoV-2; 3,507 with HTN and 19,595 without. Patients in the HTN group had a higher incidence of underlying comorbidities (p&lt;0.001). The mean age in years was 64.69 +- 16.2 (SEM 0.109) and 41.9+-15.3, (SEM 0.273) for HTN and non-HTN respectively (p&lt;0.117). The unadjusted odds of death, OR 59.54 (46.51-76.22), p&lt;0.001, and hospitalization, OR 41.781 (37.6-46.2), p&lt;0.001, were significantly higher in the HTN group, however only hospitalization was significantly higher in the HTN group, OR 8.86 (7.61-10.32), p&lt;0.001, when adjusted for comorbidities using multivariate logistic regression; mortality was not significant, OR 1.16 (0.83-1.62), p=0.391. For the secondary outcomes, hypertensive patients had significantly increased unadjusted odds of all outcomes (p&lt;0.001). Discussion: In this cohort of patients, the unadjusted odds of death for COVID19 patients with HTN is significantly increased compared to non-hypertensive patients. Despite the increased age, using multivariate logistic regression, we found that HTN does not significantly increase mortality. Hospitalization remains significantly elevated with multivariate regression in hypertensive patients. Conclusions: This retrospective cohort study suggests that HTN alone does not increase the odds of death amongst COVID-19 patients, however hospitalization may be increased.
Tisagenlecleucel Therapy Is Safe and Effective for Children with Down Syndrome with ALL in First Relapse
Authors: Joerg Krueger, Johann K Hitzler, Stephanie Audrey Mourad, Mylene Bassal, Elizabeth Cairney, Bruce N. Crooks, Angela Punnett, Sarah Alexander, Muhammad Ali, Henrique Bittencourt, James A. Whitlock, Sumit Gupta
Journal: Blood (2021)
Abstract 11004: Activated Protein C Protects Human Cardiomyocytes Against Hypoxia Reoxygenation Stress-Induced Injury Through Maintaining Mitochondrial Integrity
Authors: Kayla Davitt, Julia Fedorova, Van Le, Cole Logan, Yi Yang, Di Ren, Ji Li
Journal: Circulation (2021)

Introduction: Activated protein C (APC) is a vitamin-K-dependent plasma serine protease that functions as a natural anticoagulant to downregulate thrombin generation in the clotting cascade. Endothelial protein C receptor (EPCR) mediates APC's cytoprotective properties. We found that cardiac EPCR expression is downregulated in aging, leading to cardiac intolerance to ischemic insults. However, the role of APC in the human heart under ischemic stress remains unclear. Hypothesis: APC-EPCR axis protects human cardiomyocytes against hypoxia-reoxygenation stress-induced damage through maintaining mitochondrial integrity. Methods: The left ventricles of 38 adult human donor hearts underwent proteomic analysis of myocardial EPCR. Viable human cardiomyocytes were isolated and challenged by 30 min hypoxia/30 min reoxygenation (H/R) with or without APC treatment. Cardiomyocyte contractile properties were determined by IonOptix Imaging System, while the mitochondrial functional integrity and reactive oxygen species (ROS) were determined with Seahorse XF analyzer and MitoSox staining. Results: Immunoblotting data demonstrated that EPCR expression levels are declined in human hearts along with aging. H/R-stress reduced contractile functions of human cardiomyocytes, and the cardiomyocytes from aged adults (&gt;65 years) versus cardiomyocytes from young adults (&lt;65 years) were more vulnerable to H/R-induced insults. Interestingly, the administration of APC significantly improved the contractile functions of both young and aged human cardiomyocytes under H/R stress. APC also stabilizes EPCR levels and modulates the calcium flux homeostasis in both young and aged human cardiomyocytes under H/R. The mitochondrial respiration experimental data demonstrated that APC treatment ameliorates the mitochondrial dysfunction induced by H/R stress in both young and aged human cardiomyocytes. Since the ROS generations in human cardiomyocytes during H/R stress were attenuated with APC administration. Conclusions: Cardiac EPCR levels are downregulated with aging. The administration of APC can rescue the cardiac intolerance to ischemic insults in aging through stabilizing receptor EPCR and maintaining cardiomyocyte mitochondrial integrity.
Abstract 10050: Reliability and Validity of the Self-Efficacy in Palliative Care Scale in Korean Nurses: A Cross-Sectional
Authors: Seongkum Heo, Minjeong An, MIYEONG KIM, HyunMi You, Jisun Yang, Sun Woo Hong, Hee Jung Kim, JaeLan Shim, SaeHyun Chon, JinShil Kim
Journal: Circulation (2021)

Introduction: In patients with advanced chronic diseases, such as heart failure, provision of appropriate palliative care is critically important to improve or maintain good quality of life until the end of their lives. To provide appropriate palliative care, nurses need to have appropriate level of self-efficacy in palliative care (self-efficacy). However, assessment methods of nurses’ self-efficacy are limited in Korea. Hypothesis: The reliability and validity of the Self-Efficacy in Palliative Care Scale would be supported in Korean nurses. Methods: Data on self-efficacy, advanced directive (AD) counseling, and AD education were collected from 272 nurses (Mean age: 30 years). Validity was assessed by exploratory and confirmatory factor analyses (SPSS and Mplus) and the relations of AD counseling and education to self-efficacy (independent t-tests). Reliability was assessed by Cronbach’s alpha and item analyses (SPSS). Results: The exploratory and confirmatory factor analyses (Figure 1) supported the four-factor structure (communication, patient management-physical, patient management-psycho-spiritual, and multiprofessional teamworking) with factor loadings &gt; .60 and with good model fit: root mean square error of approximation = .07, Tucker-Lewis Index = .94, comparative fit index =.95, and standardized root mean square residual = .04. The scores of self-efficacy were higher in nurses with experiences of AD counseling (p &lt; .001) and AD education (p = .009) compared to nurses without the experiences. Cronbach’s alphas for the total scale and each of the subscales ranged from .883 to .965. The corrected item-total correlation coefficients of all items in the total scale and each subscale ranged from .61 to .90. Conclusions: The findings of this study supported the hypothesis. This instrument can be used to assess nurses’ self-efficacy in palliative care and to test the intervention effects on nurses’ self-efficacy in palliative care.
Medical Mentoring—Critique Me, Please
Authors: Harry Doernberg
Journal: JAMA Internal Medicine (2021)

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Abstract 13179: Rates and Reasons for Emergency Department Use Among US Adults With Congenital Heart Disease
Authors: Jessica M Hong, Aarthi Sabanayagam, Ian S Harris, peter kouretas, Vaikom S Mahadevan, Shunji Sano, Anushree Agarwal
Journal: Circulation (2021)

Introduction: The adult congenital heart disease (ACHD) population is growing and highly comorbid, requiring increasing emergency department (ED) use. Data on the rates and characteristics of ED visits can inform appropriate care pathways for ACHD patients. Methods: We performed a retrospective study of 16,946 commercially insured beneficiaries with ACHD in the 2016 IBM MarketScan database. Main outcome measures were rates and types of ED visits. Exposures included age, gender, primary beneficiary status, employment status, ACHD severity, cardiovascular (CV) and non-CV comorbidities. Results: Mean age was 35.2±14.2 years, 48.8% were female, and 30.5% had severe CHD. 21.1% had at least one ED visit (23.0% for severe vs. 20.3% for non-severe CHD, p&lt;0.001) while 8.1% had &gt;1 ED visit. Patients with ED visits were more likely to be ≥40 years old (41.0% vs 39.1%, p=0.035), female (53.4% vs 47.6%, p&lt;0.001), have severe CHD (33.2% vs 30.0%, p&lt;0.001), CV (33.0% vs 21.8%, p&lt;0.001) and non-CV comorbidities (38.2% vs 23.6%, p&lt;0.001), and less likely to be the primary beneficiary (56.6% vs 51.4%, p&lt;0.001) or employed (29.0% vs 25.6%, p&lt;0.001). The top five conditions for ED visits for all ACHD patients were CV (33.9%), followed by symptoms, signs, and ill-defined (25.4%), injury and poisoning (25%), respiratory (20.8%), and nervous system issues (14.5%). Compared to adults with non-severe ACHD, severe ACHD patients had more ED visits for CV (36.5% vs. 32.6%, p=0.023) and respiratory conditions (24.0 vs. 19.2%, p=0.001). Variables independently associated with ED visits are listed in the table. Conclusions: One in five ACHD patients had an ED visit, with cardiac and respiratory conditions being more common among adults with severe than non-severe ACHD. Our findings about the factors associated with ED visits provides information about potential interventions and care pathways that might help reduce the burden of ED visits in this high-risk population.
Abstract 13023: Contemporary Echocardiography-Guided Pericardiocentesis Outcomes in a High-Volume Tertiary Teaching Hospital
Authors: Tudor Sturzoiu, Waleed Khan, Kirpal Kochar, Mark DeCaro, Matthew DeCaro, Gregary D Marhefka
Journal: Circulation (2021)

Introduction: First performed in the 1970s, echo-guided pericardiocentesis has become the preferred approach for draining pericardial effusions. After identifying the largest pocket, a cardiology attending and fellow use a micropuncture needle kit, confirm placement with agitated saline, and leave a side and end hole 8 French drain stocked with sterile saline. This is drained every 8 hours by nursing and never left to gravity or else it tends to clot. The drain is removed when output is &lt;25 cc in 24 hours, or by 7 days. Methods: We prospectively maintained an IRB approved database of pericardiocenteses performed by three experienced cardiology attendings directly supervising a multitude of fellows between 2009-2021 at Thomas Jefferson University Hospital. Results: Of 391 pericardiocenteses, 61% were for tamponade. 66% were done from an apical approach, 18% subcostal, 11% left parasternal, and 2% right parasternal. Drains were left in for an average of 3.1 days (range 1-10 days). An average of 578 mL were drained with the initial procedure (range 5-2670 mL), and 62% of effusions were bloody. A total of 42% were deemed idiopathic, without an identifiable cause, 27% were associated with malignancy (56% of these had positive cytology with remaining unlikely from any other cause), 9% after open heart surgery (valve replacement, heart transplant, dissection repair), 8% post-procedural (electrophysiology, cardiac catheterization, line placement), 5% were in chronic dialysis patients, and the remainder were due to a combination of hemorrhage not related to a procedure, rheumatic, post-radiation, or medication-induced. The rate of serious complications was 3% and included 4 pneumothoraces, 3 hemothoraces, 3 cases of pericardial decompression syndrome, 1 RV microperforation, and one PEA arrest resulting from cardiac perforation. There were no mortalities. The rate of non-serious complications was 4% and included pleural placement of drain in 8, severe pain remitting with drain removal in 5, prolonged bleeding from puncture site in 2, and SVT during placement in 1. Conclusion: Overall, echocardiography-guided pericardiocentesis by experienced providers supervising fellows-in-training is a safe and effective means of draining pericardial effusions.