tbuckley/cabot-search huggingface dataset:
Abstract 12598: Stress Testing During Long-term Follow-up After Kawasaki Disease
Authors: Audrey Dionne, Meaghan Beattie, Thomas Giorgio, Annette L Baker, Ming Hui Chen, Keri M Shafer, Andrew J Powell, Sarah de Ferranti, David R Fulton, Jane W Newburger, Kevin G FRIEDMAN
Journal: Circulation (2020)

Introduction: The American Heart Association (AHA) guidelines recommend testing for inducible myocardial ischemia in all patients with a history of coronary artery aneurysm (CAA) after Kawasaki disease (KD). Because the prevalence of clinical coronary complications is exceedingly low in patients whose worst-ever CAA dimension was &lt;large/giant, we examined the yield of stress testing in KD over a 20-year period. Methods: Retrospective study including patients &lt;18 yo with KD who underwent cardiac imaging to evaluate for inducible ischemia between 2000-2019. Patients with a prior coronary artery intervention were excluded. Inducible ischemia was defined as stress-induced reversible wall motion abnormalities on echocardiogram or cardiac MRI, or reversible defect on nuclear myocardial perfusion imaging. Results: A total of 588 stress tests were performed in 208 patients at median age of 12.4 [IQR 8.8, 16.8] years, 8.3 [IQR 5.0, 12.9] years after diagnosis (Table). Tests were performed using either exercise stress (545 [93%] tests) or pharmacologic stress with dobutamine (43 [7%] tests). Echocardiography was the most frequently used modality (n=481, 82%), followed by nuclear imaging (n=133, 23%) and cardiac MRI (n=53, 9%). Inducible ischemia was found on 11 (2%) tests in 6 (3%) patients. All patients with inducible ischemia had a history of giant CAA with persistent CAA at time of testing (moderate CAA in 2 (18%) tests, giant CAA in 9 (82%) tests). After finding inducible ischemia on stress test, coronary artery bypass grafting was performed in 3 cases, cardiac catheterization in 4, stress testing using a different imaging modality in 1, and careful clinical monitoring without intervention in 3. Conclusions: Inducible ischemia was found in 2% of test after KD, and only in patients with a history of giant CAA. Recommendations in the 2017 AHA guidelines for KD for testing for myocardial ischemia in patients with non-giant CAA should be reconsidered in light of these findings.
Abstract 14434: Identification and Predictors for Cardiovascular Disease Risk Equivalents Among Adults With Diabetes Mellitus
Authors: Yanglu Zhao, Shaista Malik, Matthew J Budoff, Adolfo Correa, Kellan E Ashley, Elizabeth Selvin, Karol E Watson, Nathan D Wong
Journal: Circulation (2020)

Background: It is not well quantified if diabetes mellitus (DM) as a cardiovascular disease (CVD) risk equivalent depends on DM severity and other CVD risk factors. Methods: We pooled 4 US community-based cohorts (ARIC, JHS, MESA, FHS Offspring) and classified subjects by baseline DM/CVD status. DM+/CVD- was further classified by DM duration, HbA1c control or DM medication. Hazard ratios (HR) were estimated for CVD during a median follow-up of 14 years. Subgroup analysis comparing the HR of DM+/CVD- vs. DM-/CVD+ was done by CVD risk factors. We integrated all factors that impacted DM-conferred CVD risk and defined one with DM+/CVD- as CVD risk equivalent when his/her CVD risk was as high or higher than that if he/she had DM-/CVD+. CVD risk profile and event risk were compared between the CVD risk equivalent subgroups in DM+/CVD-. Results: The pooled cohort included 27,732 adults (mean age of 58 years, 45% males). CVD event rates per 1000 P-Y were 16.3, 33.3, 40.9 and 69.0 among those with DM-/CVD-, DM+/CVD-, DM-/CVD+ and DM+/CVD+, respectively. DM participants with HbA1c≥7%, DM duration over 10 years, or DM medication use had similar CVD risk as those with DM-/CVD+ while those without these factors had lower CVD risk; DM+/CVD- had similar CVD risk as those DM-/CVD+ among women, age &lt;55 years, White race, or high triglyceride groups (Figure). Among those with DM+/CVD-, 17.5% were found to be CVD risk equivalents. Compared to those non-CVD risk equivalent DM, they had lower 10-year PCE scores (14.8% vs. 22.7%, p&lt;0.0001) however higher actual CVD event rates (44.9 vs. 31.0 per 1000 P-Y). Conclusion: Among CVD-free adults with DM, fewer than 20% are actually CVD risk equivalents. Poor HbA1c control, long DM duration, and current diabetes medication use were identified as predictors of CVD risk equivalent status and DM was more detrimental for CVD risk if one is female, younger age, White, or with high triglycerides. These risk enhancing factors should be considered in the treatment decision.
Predicting the risk of post-hepatectomy portal hypertension using a digital twin: A clinical proof of concept
Authors: Nicolas Golse, Florian Joly, Prisca Combari, Maïté Lewin, Quentin Nicolas, Chloe Audebert, Didier Samuel, Marc-Antoine Allard, Antonio Sa Cunha, Denis Castaing, Daniel Cherqui, René Adam, Eric Vibert, Irene E. Vignon-Clementel
Journal: Journal of Hepatology (2020)
Children’s prolonged exposure to the toxic stress of war trauma in the Middle East
Authors: Muthanna Samara, Sara Hammuda, Panos Vostanis, Basel El-Khodary, Nader Al-Dewik
Journal: BMJ (2020)

Conflict leads to toxic stress and health problems in childhood and beyond. Long term investment in evidence informed mitigation strategies is needed to end the devastating cycles of violence, write <b>Muthanna Samara and colleagues</b>
Covid-19: Government ramps up “Moonshot” mass testing
Authors: Gareth Iacobucci
Journal: BMJ (2020)

With covid diagnostic testing set to be rolled out across England, Gareth Iacobucc i examines the latest developments Last week the UK government announced that 67 more areas in England will be given access to rapid diagnostic tests for covid-19 in a major expansion of its Operation Moonshot mass testing programme.1 Manchester, Newcastle, Birmingham, Bristol, and parts of London will be among the areas (box 1) given access to lateral flow tests, which give results in 10 to 30 minutes, to test asymptomatic populations for covid-19. The expansion follows a pilot of mass testing in Liverpool that began on 6 November.2 Box 1 ### The 67 areas in England set to get mass testingRETURN TO TEXT The latest figures, shared with The BMJ , show that as at 16 November the Liverpool pilot had tested 100 000 asymptomatic people, of whom 700 (0.7%) tested positive for covid-19 (box 2). Box 2 ### How is Liverpool's pilot working? In the first 10 days of mass testing in Liverpool 100 000 asymptomatic people were tested across 34 sites. Of this group, 700 (0.7%) tested positive for covid-19. The pilot has expanded to include children and adolescents, and there are now 48 sites in the Liverpool City Region, open from 7 am to 7 pm. Liverpool's director of public health, Matt Ashton, said the pilot was measuring the … RETURN TO TEXT
Abstract 12826: Age-related Sestrin2 Maintains OXPHOS Integrity to Modulate Cardiac Substrate Metabolism During Ischemia and Reperfusion
Authors: Di Ren, Julia Fedorova, Jingwen Zhang, Zhibin He, Ji Li
Journal: Circulation (2020)

Introduction: Sestrin2 (Sesn2) is a stress-inducible protein that declines with aging in the heart. We have reported that rescue Sesn2 levels of aged mouse hearts through gene therapy improves the resistance of aged hearts to ischemic insult caused by ischemia and reperfusion (I/R). Hypothesis: Sestrin2 as a scaffold protein maintains mitochondrial integrity to protect heart from ischemic injury during I/R. Methods: Young C57BL/6J (3-6 months), aged C57BL/6J (24-26 months), and young Sesn2-KO (3-6 months, C57BL/6J background) mice were subjected to 45 min of regional ischemia and 24 hours of reperfusion. The left ventricle of hearts were collected for transcriptomics, proteomics and metabolomics analysis. Results: The protein level of Sesn2 was declined in aged versus young heart. Seahorse measurements demonstrated that Sesn2 deficiency in aged versus young hearts lead to an impaired mitochondrial respiration rate with defects in Complex I and Complex II activity. The Sesn2 targeted proteomics revealed that Sesn2 plays a critical role in maintaining mitochondrial functional integrity through modulating mitochondrial biosynthesis and maintaining oxidative phosphorylation (OXPHOS) complexes. RNA-Sequencing analysis demonstrated that significant alterations in expression of mitochondrial compositional genes and metabolic regulation related genes occurred in both Sesn2 KO and aged hearts versus young hearts. Metabolomics data showed that Sesn2 deficiency in Sesn2 KO and aged versus young hearts augmented glycolysis but compromised citrate cycle process during I/R. The immunoprecipitation data showed that Sesn2 is translocated into mitochondria and directly interacts with OXPHOS components to maintain mitochondrial integrity in response to I/R stress. Furthermore, biochemical analysis revealed that Sesn2 is associated with citrate cycle components to modulate pyruvate dehydrogenase and isocitrate dehydrogenase activities in the mitochondria during I/R stress. Conclusions: Sesn2 serves as a scaffold protein to stabilize mitochondrial OXPHOS in the hearts under I/R stress conditions. Age-related downregulation of cardiac Sesn2 degraded mitochondrial functional integrity in response to ischemic stress in the elderly.
Case 35-2020: A 59-Year-Old Woman with Type 1 Diabetes Mellitus and Obtundation
Authors: David N. Caplan, Otto Rapalino, Amel Karaa, Rachel P. Rosovsky, Sacha Uljon
Journal: New England Journal of Medicine (2020)

A 59-year-old woman with type 1 diabetes and a 2-year history of cognitive decline presented with obtundation. There was diffuse, symmetric hypointensity in the brain on T2-weighted images and abnormal susceptibility signal throughout the basal ganglia, thalami, dentate nuclei, and cortical surfaces of the cerebral hemispheres on susceptibility-weighted images. A diagnostic test was performed.
Covid-19: Pfizer and BioNTech submit vaccine for US authorisation
Authors: Elisabeth Mahase
Journal: BMJ (2020)

Mast cells (MC) are innate immune cells involved in many physiological and pathological processes. However, studies of MC function and biology are hampered by the difficulties to obtain human primary MC. To solve this problem, we established a new method to produce easily and rapidly high numbers of MC for in vitro studies using human adipose tissue, which is an abundant and easy access tissue. Stromal vascular fraction of adipose tissue, obtained from human abdominal dermolipectomy, was cultured as spheroids in serum free medium supplemented in stem cell factor. Using this method, we generated, within 3 wk, a highly pure population of connective tissue–type MC expressing MC typical peptidases (tryptase, chymase, and carboxypeptidase-A3) with a yield increasing over time. Stem cell factor was required for this culture, but unlike MC derived from CD34<sup>+</sup> cells, this culture did not depend on IL-3 and -6. MC obtained with this method degranulated following FcεRI cross-linking or stimulation by C5a, compound 48/80, and substance P. Interestingly, activation by anti-IgE of both white adipose tissue–MC and MC obtained from peripheral blood–derived CD34<sup>+</sup> pluripotent progenitor cells induced the production of PGs as well as proinflammatory cytokines (TNF-α, Il-6, and GM-CSF). In conclusion, we developed a new time saving and reproducible method to produce highly pure and functional human MC in 3 wk from human adipose tissue.
Abstract PO-031: Repurposing of alexidine dihydrochloride as an apoptosis-initiator and cell cycle inhibitor in human pancreatic cancer
Authors: Ezgi Kasikci, Esra Aydemir, Bekir Mustafa Yogurtcu, Fikrettin Sahin, Omer Faruk Bayrak
Journal: Cancer Research (2020)

Abstract Purpose: Highly aggressive and resistant to chemotherapy, pancreatic cancers are the fourth leading cause of cancer-related deaths in the western world. The absence of effective chemotherapeutics is leading researchers to develop novel drugs or repurpose existing chemicals. Alexidine dihydrochloride (AD), an orally bioavailable bis-biguanide compound, is an apoptosis stimulating reagent. It induces mitochondrial damage by inhibiting a mitochondrial-specific protein tyrosine phosphatase, PTPMT1. The aim of this study was to test AD as a novel compound to induce apoptosis in a human pancreatic adenocarcinoma cell lines, Panc-1, MIA PaCa-2, AsPC-1, and Psn-1. Methods: After IC50 value of the AD was determined by cytotoxicity assay, apoptosis was observed by a variety of methods including the detection of early apoptosis marker Annexin V and the proteomic profile screening by apoptosis array. Multicaspase and mitochondrial depolarization were measured and changes in cell cycle were analyzed. Results: AD is found to initiate apoptosis by activating the intrinsic pathway and inhibit cell cycle in pancreatic cancer cell lines. Conclusions: As a conclusion, considering its anti-cancer properties and bioavailability, Alexidine dihydrochloride can be considered as a potential candidate against pancreatic adenocarcinomas. Citation Format: Ezgi Kasikci, Esra Aydemir, Bekir Mustafa Yogurtcu, Fikrettin Sahin, Omer Faruk Bayrak. Repurposing of alexidine dihydrochloride as an apoptosis-initiator and cell cycle inhibitor in human pancreatic cancer [abstract]. In: Proceedings of the AACR Virtual Special Conference on Pancreatic Cancer; 2020 Sep 29-30. Philadelphia (PA): AACR; Cancer Res 2020;80(22 Suppl):Abstract nr PO-031.
Assessment of SARS-CoV-2 RNA Test Results Among Patients Who Recovered From COVID-19 With Prior Negative Results
Authors: Flora Marzia Liotti, Giulia Menchinelli, Simona Marchetti, Brunella Posteraro, Francesco Landi, Maurizio Sanguinetti, Paola Cattani
Journal: JAMA Internal Medicine (2020)

Angelo Carfì, MD; Roberto Bernabei, MD; Francesco Landi, MD, PhD; for the Gemelli Against COVID-19 Post-Acute Care Study Group
Abstract 15052: Association of Thiazide Diuretics Usage and Clinical Outcomes in Chronic Kidney Disease: Analysis of the Nationwide Cohort Study
Authors: Hugo Y Lin
Journal: Circulation (2020)

Introduction: Hypertension (HTN) is not uncommon in patients with chronic kidney disease (CKD). Thiazide diuretics (THZ) are widely used for the management of HTN. The clinical outcomes of THZ usage in patients with CKD remain uncertain. Hypothesis: The aim of this study is to examine the clinical effects of THZ usage in patients with CKD by utilizing a nationwide cohort. Methods: The THZ cohort included 8501 patients; each patient was age- and sex-matched with one THZ nonuser in the CKD population. The Cox proportional hazard regression analysis was conducted to estimate the effects of THZ on the mortality, incidence of end-stage renal disease (ESRD), congestive heart failure (CHF), acute myocardial infarction (AMI), peripheral arterial occlusive disease (PAOD) and stroke. Results: The mortality rate was significantly lower in THZ users than in THZ nonusers (hazard ratio [HR] = 0.65; 95% confidence interval [CI] = 0.60-0.71, p &lt;0.001). The HR for the incidences of ESRD, AMI, PAOD and stroke were significantly ( p &lt;0.05) lower in THZ users (HR=0.71, CI= 0.66-0.77; HR=0.82, CI=0.76-0.89; HR=0.68, CI=0.63-0.74; HR=0.91, CI=0.84-0.98) than in THZ nonusers. In THZ subgroup analysis, clothalidone users had significantly lower incidences of mortality, ESRD, and PAOD (HR=0.62, CI= 0.40-0.97, p =0.037; HR=0.54, CI=0.36-0.82, p =0.004; HR=0.60, CI=0.39-0.94, p =0.026) than nonusers. Indapamide users had significant lower incidences of mortality, ESRD, AMI and PAOD (HR=0.64, CI= 0.57-0.71, p &lt;0.001; HR=0.72, CI=0.65-0.79, p &lt;0.001; HR=0.89, CI=0.81-0.98, p =0.018; HR=0.69, CI=0.62-0.78, p &lt;0.001) than nonusers. However, Metolazone users had significantly higher incidences of ESRD, CHF, and AMI (HR=1.28, CI= 1.06-1.54, p =0.009; HR=1.60, CI=1.33-1.92, p &lt;0.001; HR=1.41, CI=1.08-1.59, p =0.007) than nonusers. Conclusions: In patients with CKD who receive therapy with THZ, both clothalidone and Indapamide users exhibit significantly beneficial effects of mortality, ESRD, and PAOD. Indapamide users revealed significantly advantageous results of AMI. However, Metolazone users had significantly higher incidences of ESRD, CHF, and AMI. A further randomized control trial to clarify the effect of THZ usage in patients with CKD is a necessity.
Psychiatric disorders and risk of infections: early lessons from COVID-19
Authors: Meghan L Smith, Jaimie L Gradus
Journal: The Lancet Healthy Longevity (2020)

Psychiatric disorders and risk of infections: early lessons from COVID-19In The Lancet Healthy Longevity, Huazhen Yang and colleagues 1 used community-based longitudinal data from 421 014 UK Biobank participants to assess the risk of COVID-19 morbidity and mortality among middle-aged and older adults (mean age 67•80 years) with pre-pandemic clinical diagnoses of psychiatric disorders.The authors used logistic regression to estimate odds ratios (ORs) for the associations between pre-pandemic hospitalisation for a psychiatric disorder and three separate COVID-19-related outcomes: any diagnosis of COVID-19 (regardless of severity), inpatient hospitalisation for COVID-19, and COVID-19-related death.The authors also estimated ORs for hospitalisation for other infections, unrelated to COVID-19.Yang and colleagues showed that pre-pandemic psychiatric hospitalisation was associated with elevated odds of any COVID-19 diagnosis (OR 1•44, 95% CI 1•28-1•62), COVID-19 inpatient hospitalisation (1•55, 1•34-1•78), and COVID-19-related death (2•03, 1•59-2•59).This association was greater for individuals with hospitalisation for more than one psychiatric disorder.People with pre-pandemic psychiatric hospitalisation also had an elevated risk of hospitalisation for other infections, possibly suggesting shared underlying mechanisms.These findings provide crucial information for understanding who is at greatest risk for COVID-19, and also add to a growing body of evidence suggesting that mental and somatic health are closely intertwined.Research has shown that psychological stress, 2 as well as specific psychiatric disorders (eg, post-traumatic stress disorder, 3,4 depression, 5 and adjustment disorder 4,6 ), are associated with increased incidence of various infections (eg, respiratory infections, sepsis, and herpes zoster).As Yang and colleagues note, potential mechanisms explaining these associations involve immune dysregulation processes such as proinflammatory cytokine production and heightened hypothalamic-pituitaryadrenal axis activity. 7Changes to health behaviours in response to stress (eg, altered diet and exercise patterns) are also possible explanations for the observed associations. 8A crucial next step in this area of research
Abstract 14599: Association of Fibrillation Cycle Length on the Surface Electrocardiogram With Clinical Outcomes in Atrial Fibrillation Patients: The Fushimi AF Registry
Authors: Hisashi Ogawa, Yoshimori An, Masahiro Esato, Kenjiro Ishigami, Syuhei Ikeda, KOSUKE DOI, Yasuhiro Hamatani, Akiko Fujino, MITSURU ISHII, Moritake Iguchi, Nobutoyo Masunaga, Hiromichi Wada, Koji Hasegawa, Mitsuru Abe, Masaharu Akao
Journal: Circulation (2020)

Background: It is unknown whether fibrillation cycle length (FCL) on the surface electrocardiogram is associated with clinical outcomes in patients with atrial fibrillation (AF). Methods: The Fushimi AF Registry, a community-based prospective survey, was designed to enroll all of the AF patients in Fushimi-ku, Kyoto. The FCL was calculated using spectral analysis of the fibrillation waves on the surface electrocardiogram in 966 patients (mean age; 73.2 years, female; 40.9%, mean CHA 2 DS 2 -VASc score; 3.21) with AF at baseline. We assessed the association of FCL with the demographics and clinical outcomes. Results: Median FCL was 163.8 ms (interquartile range; 148.0, 195.0 ms). We divided the patients into 2 groups: 524 patients with FCL ≥163 ms and 442 patients with FCL&lt;163 ms. Patients with longer FCL were older (74.6 vs. 71.7 years of age; p&lt;0.01), more often female (49.6% vs. 30.5%; p&lt;0.01), more often paroxysmal type of AF (55.2% vs. 33.3%; p&lt;0.01), had lower body weight (58.6 vs. 61.8 kg; p&lt;0.01), higher heart rate (93.1 vs. 86.3 /min; p&lt;0.01), higher CHA 2 DS 2 -VASc score (3.41 vs. 2.98; p&lt;0.01). They were more likely to have history of heart failure (HF) (25.8% vs. 19.5%; p=0.02), valvular heart disease (24.1% vs. 15.6%; p&lt;0.01), coronary artery disease (18.9% vs. 12.7%; p&lt;0.01), and chronic kidney disease (38.6% vs. 26.2%; p&lt;0.01). During the median follow-up of 2,194 days, all-cause mortality occurred in 99 patients (3.5 /100 person-years) with longer FCL and 55 patients (2.2 /100 person-years) with shorter FCL, with an adjusted hazard ratio of 1.46 (95% confidence interval [CI], 1.01-2.13; p=0.043), adjusted by age, sex, body weight, heart rate, type of AF and comorbidities. Adjusted hazard ratios of stroke or systemic embolism and hospitalization for HF for longer FCL were 1.23 (95%CI, 0.73-2.11; p=0.44) and 2.29 (95%CI, 1.52-3.50; p&lt;0.01), respectively. Conclusion: The FCL on surface electrocardiogram was associated with higher mortality and incidence of hospitalization for HF in Japanese AF patients enrolled in the Fushimi AF Registry.
Randomized Trials of e-Cigarettes for Smoking Cessation
Authors: Nancy A. Rigotti
Journal: JAMA (2020)

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The Role of Bariatric Surgery in Prevention of Kidney Disease Progression in Moderately Obese Patients With Type 2 Diabetes
Authors: Dimitrios Patoulias, Christodoulos Papadopoulos, Michael Doumas
Journal: JAMA Surgery (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 Surgery 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 Surgery journal