tbuckley/cabot-search huggingface dataset:
만성 C형간염에서 인터페론/페그인터페론과 리바비린 병합요법 후 지속바이러스반응 유지에 대한 고찰
Authors: 김철현 ( Chul Hyun Kim ), 박병도 ( Byung Do Park ), 이진우 ( Jin Woo Lee ), 김영수 ( Young Soo Kim ), 정석 ( Seok Jeong ), 이돈행 ( Don Haeng Lee ), 김형길 ( Hyung Gil Kim ), 신용운 ( Yong Woon Shin ), 권계숙 ( Key Sook Kwon ), 이정일 ( Jung Il Lee )
Journal: Clinical and Molecular Hepatology (2009)

목적: 만성 C형간염 환자에서 인터페론과 리바비린을 이용한 병합요법의 효과는 잘 알려져 있으며 현재 페그인터페론과 리바비린 병합요법이 표준치료로서 사용되고 있다. 이 경우 42~82% 정도의 지속바이러스반응(SVR)을 보이며 이후 재현은 1% 미만으로 알려져 있다. 그러나 국내에서 다수의 환자를 대상으로 한 보고는 많지 않으며, 특히 치료 후 SVR 유지 여부와 관찰기간 등에 대해서는 명확한 연구가 없는 실정이다. 본 연구에서는 병합요법을 시행한 만성 C형간염 환자의 치료반응과 경과에 대하여 조사하였다. 대상과 방법: 2002년 1월부터 2008년 10월까지 인터페론 혹은 페그인터페론과 리바비린을 사용하여 치료를 종결한 총 156명의 만성 C형간염 환자를 후향적으로 조사하였다. 인터페론 알파는 300만 단위를 주 3회, 페그인터페론은(-2a: 180 μg, -2b: 80~100 μg) 주 1회 피하주사하였고, 리바비린은 체질량지수에 따라 600~1,200 mg을 매일 투여하였다. 유전자형 1형은 48주간, 비1형은 24주를 표준치료기간으로 하였고, 치료 효과는 SVR로 판정하였다. 결과: 82명의 환자가 인터페론과 리바비린 병합요법을, 74명이 페그인터페론과 리바비린 병합요법을 받았다. 이들 총 156명 중 73명이 SVR을 보였으며(83/156, 53%). SVR 달성 환자 중 8명에서 SVR 이후 재현을 보였고(8/73, 11.0%), 이 중 1명에서는 지속적인 바이러스혈증이 나타났다(1/73, 1.4%). 결론: 본원에서 만성 C형간염에 대해 인터페론/페그인터페론과 리바비린을 사용한 병합요법을 시행한 경우 다른 연구들과 비슷한 치료 성적을 나타냈다(SVR: 53%). 그러나 병합치료의 SVR 지속 여부는 그 재현율이 일반적으로 알려진 것보다 높아 SVR 이후에도 지속적인 경과관찰이 필요하다.
プロタンパク質転換酵素サブチリシンKexin9型(PCSK9)に対する完全ヒトモノクローナル抗体AMG145は,ハイリスク患者におけるNCEP低密度リポタンパク質-コレステロール目標値の達成を促進する
Authors: R Desai Nihar, Kohli Payal, P Giugliano Robert, B Kim Jae, Mohanavelu Satishkumar, Hoffman Elaine, Liu Thomas, Scott Robert, Wasserman Scott, S Sabatine Marc
Journal: Circulation (2012)
Abstract 15368: Index Admission and Thirty-day Readmission Outcomes of Cancer Patients Presenting With Stemi
Authors: Mohammed Osman, Mina M Benjamin, Sudarshan Balla, Babikir Kheiri, Christopher Bianco, Partho sengupta, Ramesh Daggubati, midhun malla, Stephen Liu, Mamas Mamas, Brijesh Patel
Journal: Circulation (2020)

Introduction: National-level data of cancer patients’ readmissions after a ST-segment elevation myocardial infarction (STEMI) are lacking. Objectives: The primary aim of this study was to describe rates and causes of 30-day readmissions in this population. Methods: Among patients who were admitted with STEMI in the United States National Readmission Database (NRD) from October 2015-December 2017, we identified patients with the diagnosis of active breast, colorectal, lung or prostate cancer. The primary endpoint was 30-day unplanned readmission rate. Secondary endpoints included in-hospital outcomes during the index admission and causes of readmissions. A propensity score model was used to compare the outcomes of cancer and no cancer patients. Results: A total of 385,522 patients were included in the current analysis (Cancer= 5,956, No Cancer=379,566). After propensity score matching, 23,880 patients were compared (Cancer=5,949, No Cancer=17,931). Cancer patients had higher 30-day readmission (19% vs 14%, p&lt;0.01). The most common causes for readmission among cancer patients were cardiac (31%), followed by infectious (21%), hematological and oncological (17%), respiratory (4%), stroke (4%) and renal (3%). During the first readmission, cancer patients had higher in-hospital mortality (15% vs 7%; p&lt;0.01) and bleeding complications (31% vs 21%; p&lt;0.01). In multivariate logistic regression, cancer status (OR 1.5, 95% CI 1.2-1.6, p&lt;0.01) was an independent predictor for 30-day readmission. Conclusions: About one in five cancer patients presenting with STEMI will be readmitted within 30 days. Cancer patients’ 30-day readmissions are still predominantly cardiac-related but with a higher proportion of admissions for infectious, cancer-related and bleeding and than those without cancer.
Pheochromocytoma Presenting as Hypertrophic Obstructive Cardiomyopathy
Authors: Adil Wani, Amina Adil, Syed Ali A. Gardezi, Renuka Jain, Patrycja Galazka, Mark J. Waples, A. Jamil Tajik
Journal: JAMA Cardiology (2021)

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Quantitative Analysis of Tyrosine Phosphorylation from FFPE Tissues Reveals Patient-Specific Signaling Networks
Authors: Ishwar N. Kohale, Danielle M. Burgenske, Ann C. Mladek, Katrina K. Bakken, Jenevieve Kuang, Judy C. Boughey, Liewei Wang, Jodi M. Carter, Eric B. Haura, Matthew P. Goetz, Jann N. Sarkaria, Forest M. White
Journal: Cancer Research (2021)

Abstract Human tissue samples commonly preserved as formalin-fixed paraffin-embedded (FFPE) tissues after diagnostic or surgical procedures in the clinic represent an invaluable source of clinical specimens for in-depth characterization of signaling networks to assess therapeutic options. Tyrosine phosphorylation (pTyr) plays a fundamental role in cellular processes and is commonly dysregulated in cancer but has not been studied to date in FFPE samples. In addition, pTyr analysis that may otherwise inform therapeutic interventions for patients has been limited by the requirement for large amounts of frozen tissue. Here we describe a method for highly sensitive, quantitative analysis of pTyr signaling networks, with hundreds of sites quantified from one to two 10-μm sections of FFPE tissue specimens. A combination of optimized magnetic bead–based sample processing, optimized pTyr enrichment strategies, and tandem mass tag multiplexing enabled in-depth coverage of pTyr signaling networks from small amounts of input material. Phosphotyrosine profiles of flash-frozen and FFPE tissues derived from the same tumors suggested that FFPE tissues preserve pTyr signaling characteristics in patient-derived xenografts and archived clinical specimens. pTyr analysis of FFPE tissue sections from breast cancer tumors as well as lung cancer tumors highlighted patient-specific oncogenic driving kinases, indicating potential targeted therapies for each patient. These data suggest the capability for direct translational insight from pTyr analysis of small amounts of FFPE tumor tissue specimens. Significance: This study reports a highly sensitive method utilizing FFPE tissues to identify dysregulated signaling networks in patient tumors, opening the door for direct translational insights from FFPE tumor tissue banks in hospitals.
Mortality From Drug Overdoses, Homicides, Unintentional Injuries, Motor Vehicle Crashes, and Suicides During the Pandemic, March-August 2020
Authors: Jeremy S. Faust, Chengan Du, Katherine Dickerson Mayes, Shu-Xia Li, Zhenqiu Lin, Michael L. Barnett, Harlan M. Krumholz
Journal: JAMA (2021)

This study uses national death certificate data to characterize trends in death and excess mortality from drug overdoses, homicides, unintentional injuries, motor vehicle crashes, and suicide during the first 6 months of the pandemic in the US.
A Manual of the Practice of Medicine.
Journal: JAMA (1901)

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
Familial thrombocytopenia: The long and short of it
Authors: Lauren Murphy, Adam J. Mead
Journal: The Journal of Experimental Medicine (2021)

In this issue, Wahlster, Verboon, and colleagues (2021. J. Exp. Med.https://doi.org/10.1084/jem.20210444) describe a multigenerational family with inherited thrombocytopenia where the causal variant was not identified using conventional genome sequencing approaches. Long-read sequencing and RNA sequencing revealed a complex structural variant, causing overexpression of a pathogenic gain-of-function WAC-ANKRD26 fusion transcript.
COVID-19 Testing to Sustain In-Person Instruction and Extracurricular Activities in High Schools — Utah, November 2020–March 2021
Authors: William A. Lanier, Kendra D. Babitz, Abigail Collingwood, Maggie F. Graul, Sydnee Dickson, Lexi Cunningham, Angela C. Dunn, Duncan MacKellar, Adam L. Hersh
Journal: MMWR Morbidity and Mortality Weekly Report (2021)

Cessation of kindergarten through grade 12 in-person instruction and extracurricular activities, which has often occurred during the COVID-19 pandemic, can have negative social, emotional, and educational consequences for children (1,2). Although preventive measures such as masking, physical distancing, hand hygiene, and improved ventilation are commonly used in schools to reduce transmission of SARS-CoV-2, the virus that causes COVID-19, and support in-person instruction (3-6), routine school-based COVID-19 testing has not been as widely implemented. In addition to these types of standard preventive measures, Utah health and school partners implemented two high school testing programs to sustain extracurricular activities and in-person instruction and help identify SARS-CoV-2 infections: 1) Test to Play,* in which testing every 14 days was mandated for participation in extracurricular activities; and 2) Test to Stay,† which involved school-wide testing to continue in-person instruction as an alternative to transitioning to remote instruction if a school crossed a defined outbreak threshold (3). During November 30, 2020-March 20, 2021, among 59,552 students tested through these programs, 1,886 (3.2%) received a positive result. Test to Play was implemented at 127 (66%) of Utah's 193 public high schools and facilitated completion of approximately 95% of scheduled high school extracurricular winter athletics competition events.§ Test to Stay was conducted at 13 high schools, saving an estimated 109,752 in-person instruction student-days.¶ School-based COVID-19 testing should be considered as part of a comprehensive prevention strategy to help identify SARS-CoV-2 infections in schools and sustain in-person instruction and extracurricular activities.
Abstract 16941: Diagnostic Performance of NephroCheck™ in the Prediction of Acute Kidney Injury in Neonates Undergoing Surgery for Congenital Heart Disease
Authors: Michelle Ramirez, Sujata Chakravarti, Gefen Ashley, McKinstry Jaclyn, Sahulee Raj, Yasir Alqaqaa, Melissa Busovsky-McNeal, T K Kumar, Laura Malaga-Dieguez
Journal: Circulation (2020)

Introduction: Acute kidney injury (AKI) is a common and serious complication in patients undergoing cardiac surgery and is associated with adverse outcomes. TIMP-2 and IGFBP-7 are cell cycle arrest proteins that are detected in urine during periods of kidney stress or injury. The NephroCheck™ system measures urine concentrations of these two biomarkers and calculates a score which has been validated in adults as a predictor of AKI. The utility of these markers in identifying AKI in neonates after congenital heart surgery (CHS) has not been determined. Hypothesis: Concentrations of TIMP-2 and IGFBP-7 as measured by the NephroCheck™ system will be elevated in neonates with AKI following CHS requiring cardiopulmonary bypass (CPB). Methods: We conducted a single center, prospective, observational study in neonates less than 31 days old undergoing CHS requiring CPB between 9/2017 and 5/2019. Urine samples were collected and analyzed using the NephroCheck™ system prior to surgery and at 6, 12, 24 and 96 hours (h) post CPB. All patients were evaluated for staging of AKI using the Acute Kidney Injury Network criteria (AKIN). Wilcoxon Rank Sum tests were used to compare the medians of the NephroCheck™ values in the AKIN negative and positive groups for each of the time points. ROC curves and AUCs with 95% CIs were used to measure how well the NephroCheck™ values predict the AKIN negative and positive status of the patients. Results: Thirty-six patients were included, 56% were male. Median age and weight were 7 days and 3.14 kg. Pre-surgically, no patients met AKI definition by AKIN criteria or by NephroCheck™ values. Post surgically, 52% of patients had AKI by AKIN criteria. All patients with AKI had elevated biomarkers. The presence of elevated biomarkers as determined by NephroCheck™ had a statistically significant association for the presence of AKI at the 6 h (p = 0.036) and 24 h (p = 0.00037) time points. Of all time points analyzed, samples obtained at 24h were best at predicting the development of AKI in the post-surgical period (AUC: 0.848). Conclusions: Elevation in urine concentration of TIMP-2 and IGFBP-7 is associated with AKI in neonates after CHS requiring CPB. Urinary biomarkers levels 24 h after CPB are good predictors of AKI in this population.
Doxorubicin-Dexrazoxane from Day 1 for Soft-tissue Sarcomas: The Road to Cardioprotection
Authors: Robert S. Benjamin, Giorgio Minotti
Journal: Clinical Cancer Research (2021)

Doxorubicin cardiac toxicity is widely misunderstood, largely preventable, and starts with the first dose. This article reviews the history of doxorubicin cardiac toxicity and strategies for minimizing it. Dexrazoxane cardioprotection can safely be initiated on day 1 without compromising antitumor activity, allowing doxorubicin administration beyond the reported maximum lifetime dose.See related articles by Van Tine et al., p. 3854 and Jones et al., p. 3861.
Abstract P213: Characterizing The Distribution Of Coronary Artery Calcification In The 75-and-older Population: The Atherosclerosis Risk In Communities Study
Authors: Frances M Wang, Miguel Cainzos-Achirica, Shoshana Ballew, Aaron R Folsom, Lynne E Wagenknecht, Candace M Howard-Claudio, Josef Coresh, Matthew J Budoff, Michael J Blaha, Kunihiro Matsushita
Journal: Circulation (2021)

Introduction: The coronary artery calcium (CAC) score is a strong predictor of atherosclerotic cardiovascular disease (ASCVD) events. Current clinical practice guidelines recommend using a CAC score of 100 or age-, sex-, and race-specific 75 th percentile as thresholds of high risk for guiding preventive therapy for ASCVD. On the low end of the spectrum, zero CAC attracts attention as a potent negative predictor of ASCVD and may be used to “de-risk” individuals who may safely defer aggressive preventive therapy. However, due to sparse data on CAC in the age 75+ population, the value of these CAC thresholds in older adults is uncertain. Objective: To understand the distribution of CAC (75 th percentile, CAC 100, and zero CAC) in adults aged 75+. Methods: We assessed 2,303 ARIC Visit 7 (2018-2019) participants age 75+ years without clinical coronary heart disease (CHD) who underwent CAC scanning (median age 80 years, 39% males). Demographic-specific percentiles of the CAC distribution across age were estimated nonparametrically with pooled residual ranking and locally weighted regressions. Results: Male-white and male-black participants had lower prevalence of zero CAC than female-white and female-black participants (4% and 10% versus 13% and 16%, respectively). CAC scores tended to increase with age across race and sex strata but appeared to peak at an old age threshold (between age~85-95) ( Figure ). Regardless of age, sex, and race, a majority of individuals in this age range had CAC &gt;100 ( Figure , green 50 th percentile line exceeds red dashed CAC 100 line at most ages). Conclusions: In the largest US cohort of community-dwelling adults aged 75+ free of clinical CHD with CAC data, the prevalence of zero CAC was approximately 4-16%. We also confirmed a general age-dependent increase in CAC. Using CAC &gt;100 as a threshold for high ASCVD risk would categorize the majority of older adults age 75+ as high risk. Alternatively, our demographic-specific CAC percentiles may be a valuable tool for interpreting CAC in the age 75+ population.
Abstract 15362: Epicardial Adipose Tissue Effects on Systolic Function: A Direct or Systemic Metabolic Effect?
Authors: Shiva Reddy, Aditi Shankar, Katrin A Dias, James P Macnamara, Christopher M Hearon, Benjamin D LEVINE, Satyam Sarma
Journal: Circulation (2020)

Introduction: Obesity is associated with increased epicardial adipose tissue (EAT). It is unknown if this ectopic fat deposit has direct cardiotoxic paracrine effects on regional systolic function. We have previously shown that EAT mediates diastolic dysfunction via systemic effects, rather than localized effects. We similarly hypothesized regional EAT deposits would have no effect on the left ventricular (LV) strain of adjoining myocardial segments. Methods: We studied 28 obese healthy adults (mean age 48 ± 5 yrs, BMI 38.2 ± 5.0 kg/m 2 ). EAT was quantified on each individual MRI slice from base to apex and summed to obtain total volume. It was then separated into anterior, lateral, and inferior regions corresponding to the adjacent LV segments. Using MRI feature tracking, global longitudinal LV strain (GLS) and peak regional anterior, inferior, and lateral LV strain were quantified. Associations between total EAT and GLS, and between regional EAT and corresponding regional strain were determined by linear regression. Results: Mean total EAT volume was 69.6 ± 29.8 mL and mean GLS was -19.4 ± 2.0%. Individual data points for EAT and longitudinal strain are shown in the figure. Greater total EAT volume was modestly associated with decreased GLS (r2 = 0.127). However, anterior, lateral, and inferior EAT volume did not correlate with a decrease in corresponding regional strain (r2 = 0.003, r2 = 0.088, r2 = 0.016, respectively). Conclusion: In obese adults, total EAT volume was associated with a decrease in global LV systolic function measured by GLS. There was no association between regional EAT depots and corresponding regional LV function to suggest localized metabolic cardiotoxic effect. These preliminary results support our previous findings that EAT has little paracrine effect on cardiac function. Rather, EAT likely represents an additional depot of ectopic fat reflective of a general metabolic abnormality.
Abstract 16505: Sinus Node Sparing Surgical Hybrid Thoracoscopic Ablation for Inappropriate Sinus Tachycardia: Results of a Prospective Multicenter Registry (the Susruta Registry)
Authors: Dhanunjaya Lakkireddy, Carlo De Asmundis, Mohit K Turagam, Mark Lameir, ahmed romeya, Justin Van Meeteren, Yoaav Krauthammer, Scott M Koerber, Krishna Akella, Rakesh Gopinathannair, Gaurang Gandhi, Eric Okum, Hemal Shah, Marshall W Winner, Dilesh Patel, Elijah Beaty, Edward Kincaid, Anson M LEE, Chad Brodt, Margot E Vloka, Ilyas K Colombowala, Matthew Romano, Fred Morady
Journal: Circulation (2020)

Background: Medical treatment for inappropriate sinus tachycardia (IST) remains suboptimal. Radiofrequency Sinus node Modification (RFSM) has been used for managing drug-refractory symptomatic IST. Although, acute success is reasonable, it is faced with high complications and recurrence rates. A novel Sinus Node sparing surgical thoracoscopic hybrid ablation (SUSRUTA) has been recently proposed. Objective: To report outcomes of SUSRUTA for IST patients from a prospective multicenter registry. Methods: This is a multicenter, prospective registry of patients who received SUSRUTA which is SN sparing hybrid ablation using surgical thoracoscopic video-assisted epicardial ablation comprised of a RF bipolar clamp which was used for sparing the SN region (identified by endocardial 3D mapping) and isolation of superior and inferior vena cava with creation of a lateral line across the crista terminalis during IST with isoproterenol challenge. Gaps in the epicardial lesion set are filled in by endocardial RFA. Patients were treated with post op Colchicine and were enrolled in cardiac rehabilitation program. Results: Of the 139 patients, mean age was 26±4 yrs, 91% women and mean duration of IST was 40±21.5 months. 90% were on ivabradine, 86% on beta-blocker, 77% on calcium channel blocker and 77% were on class IC antiarrhythmic agent. Heart rate post-procedure was significantly lower when compared with pre-procedure (110±10 vs. 64±11 bpm, p&lt;0.0001). After a blanking period of 3 months, normal sinus rhythm was restored in 100% of patients in the hybrid group. Postop pericarditis was the most common complication in 80%(severe-4%), severe bradycardia (HR &lt;35 bpm) in 5%, pneumothorax 3.5% and pleural effusion requiring drainage in 2.1% of cases. One patient required a permanent pacemaker. Hospital length of stay was 4.5±0.8 days. At 1041±541 days follow up 94.5% (131/139) were free of symptoms after a single procedure and the 8 patients required a redo-RF catheter ablation.95% patients are off all preprocedural rate controlling medications Conclusion: SUSRUTA appears to be efficacious and safe for the treatment of symptomatic drug resistant IST.
Abstract 17321: Guideline Recommended Statin Therapy Implementation and Cardiovascular Outcomes: Insights From a Multi-Site Healthcare Primary Prevention Cohort
Authors: Anum Saeed, Jianhui Zhu, Floyd W Thoma, Oscar C MARROQUIN, Aryan Aiyer, Martha Gulati, Salim S Virani, Steven Reis, Samir Saba, Joon Lee, Christie M Ballantyne, Suresh R Mulukutla
Journal: Circulation (2020)

Background: The 2013 and 2018 ACC/AHA cholesterol guidelines recommend using the 10-year ASCVD risk to guide statin therapy for primary prevention. Evidence of real-world consequences of non-adherence to these guidelines in primary prevention cohorts is limited. We investigated outcomes based on statin use in a large healthcare system, stratified by 10y ASCVD risk. Methods: Statin prescription practices in patients without CAD or ischemic stroke were evaluated ( 2013-2019). Patient categories constructed per the ASCVD risk were; Borderline (5%-7.4%), Intermediate (7.5%-19.9%) or High (≥20%). Guideline-directed statin intensity (GDSI) , at time of first event, was defined as; “none or any intensity” for borderline , “at least moderate” for Intermediate and high -risk groups. Mean (±SD) time to start/change to GD therapy from first interaction in healthcare, ASCVD incident rates [IR] and mortality were calculated across risk categories stratified by statin utilization. Results: Among 282,298 patients (mean age ~50y), 29,134 (10.3%), 63,299 (22.4%) and 26,687 (9.5%) were borderline, intermediate and high risk, respectively. Within intermediate-risk, 27,358 (43%) and 8,300 (31%) of high-risk never received any statin. Only 17,519 (65.6%) high-risk subjects who were prescribed statin, received GDSI [mean time ~1.8y]. A graded increase in ASCVD and mortality IRs was seen in all risk categories comparing statin versus no statin use (Table). Conclusions: In a multi-site healthcare network, over one-third of statin-eligible patients were not prescribed statin therapy. In eligible patients, who ultimately received statins, mean time to GDSI was ~2yrs. The consequences of non-adherence to guidelines is illustrated with greater incident ASCVD events and mortality among those patients not treated with statin therapy. Further research can define identify barriers and develop healthcare system strategies to optimize preventive therapies.