tbuckley/cabot-search huggingface dataset:
Abstract 14719: Prognostic Implications of Traditional and Non-traditional Cardiovascular Risk Factor Profiles in Patients With Non-valvular Atrial Fibrillation
Authors: Aditya Bhat, Gary Gan, Henry Chen, Shaun Khanna, Sumreen Nawaz, C. Raina MacIntyre, Timothy Tan
Journal: Circulation (2020)

Introduction: Atrial fibrillation (AF) is a prevalent disease with an associated mortality risk, mediated in large part through its associated cardiovascular risk factors. Standard Modifiable Cardiovascular Risk Factors (SMuRFs; hypercholesterolaemia, hypertension, diabetes and smoking) are established drivers of cardiovascular disease, however the importance of non-traditional mediators of cardiovascular risk such as chronic renal impairment, obstructive sleep apnoea and obesity (NTRFs) is emerging in the literature. The differential impact of these risk factor groups on outcomes in patients with AF is not well studied. Hypothesis: SMuRFs and emerging NTRFs will have a differential impact on prognosis in patients with AF. Methods: Consecutive patients admitted to our service between 2013-2017 with a primary diagnosis of non-valvular AF were assessed. The clinical course of these patients was followed for up to five years for the composite outcome of all-cause death and major adverse cardiovascular events. We excluded patients with valvular AF, incomplete clinical data and baseline comorbid conditions limiting lifespan to &lt;6 months. Results: Of the 1010 patients (62.29±16.81 years, 52% men) included, 154 (15.2%) had no risk factors, 478 (47.3%) had only SMuRFs, 59 (5.8%) had only NTRFs and 319 (31.6%) had both SMuRFs and NTRFs. Over a mean follow-up period of 33.18±21.27 months, a total of 288 patients met the composite outcome. On log rank tests, grouping of risk factor profiles was a significant predictor of the composite outcome (see Kaplan Meier curve). On multi-variable analysis, the coexistence of SMuRFs and NTRFs was an independent predictor of the composite outcome (HR 1.40; 95%CI 1.09-1.82, p=0.01). Other independent predictors included age, heart failure, CHA2DS2VASc score, persistent AF and anaemia. Conclusions: Presence of both traditional and emerging NTRFs has prognostic implications in patients with AF.
AB0966 PREVALENCE OF SARCOPENIA IN PATIENTS WITH RHEUMATOLOGICAL DISEASES
Authors: Y. Lavrishcheva, A. Jakovenko
Journal: Annals of the Rheumatic Diseases (2020)

Background: The presence of sarcopenia in rheumatological patients is an independent predictor of morbidity and mortality in this cohort of patients. Patients with sarcopenia are characterized by lower physical activity, a tendency to depression and poor social adaptation. Objectives: To assess the prevalence of sarcopenia in rheumatological patients. Methods: 317 patients were examined, including 79 with systemic lupus erythematosus, 98 with rheumatoid arthritis, 72 with systemic scleroderma, 68 with spondyloarthritis. Among them, 201 women and 116 men, the age of patients ranged from 21 to 58 years, the average age at the time of inclusion of patients in the study was 41.1 ± 7.3 years. Sarcopenia was diagnosed using the method recommended by The European Working Group on Sarcopenia in Older People2. Results: The frequency of occurrence of a decrease in the total mass of skeletal muscle according to the skeletal muscle mass index (ISMM) was 31.2% (99 patients), a decrease in muscle strength according to the wrist dynamometry was observed in 44.5% (141 patients), low skeletal muscle performance according to the results NIH Toolbox 4 Meter Walk Gait Speed Test in 42.8% (135 patients). The prevalence of suspected sarcopenia (probable sarcopenia) was 13.3% (42 patients) and sarcopenia 31.2% (99 patients), no cases of severe sarcopenia were detected. Statistically significant differences were obtained between groups of patients depending on the duration of rheumatological disease and the prevalence of sarcopenia (χ2=19.328 p=0.001). Conclusion: The prevalence of sarcopenia in rheumatological patients in the general population was 31.2%. Disclosure of Interests: None declared
Economics of Teledermatology—Does the Math Add Up?
Authors: April W. Armstrong, Indira Singh
Journal: JAMA Dermatology (2020)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Dermatology HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Dermatology journal
The Urgency of Justice in Research: Beyond COVID-19
Authors: Andrea Gilmore-Bykovskyi, Jonathan D. Jackson, Consuelo H. Wilkins
Journal: Trends in Molecular Medicine (2020)

The striking imbalance between disease incidence and mortality among minorities across health conditions, including coronavirus disease 2019 (COVID-19) highlights their under-inclusion in research. Here, we propose actions that can be adopted by the biomedical scientific community to address long-standing ethical and scientific barriers to equitable representation of diverse populations in research.
Abstract 302: First of It's Kind Capillary Refill Monitoring Device to Guide Resuscitation
Authors: David C Sheridan
Journal: Circulation (2020)

Background: Capillary refill is an early reflection of decreased end organ perfusion resulting in shunt of blood from the extremities to vital organs. Physicians rate this as the most important factor to guide therapeutic resuscitation efforts. However, literature shows that providers have significant variability in their bedside measurement of capillary refill. Objective: The objective of this study was to develop and evaluate a novel technology to detect capillary refill in a noninvasive and rapid manner through an iterative, problem-based innovation approach. Methods: This was a prospective study at a level 1 tertiary care hospital of patients presenting to an emergency department. The research team used in a new technology that utilizes light transmission and pressure to objectively quantify extremity capillary refill time. This measurement was compared to manual refill time performed by a trained study provider. Results: Through an iterative approach the team developed a platform technology and enrolled 63 subjects in this prospective trial. 9 subjects had inadequate data and so the final cohort consisted of 54 subjects with both manual capillary refill time and the new novel technology measurement. The device measured capillary refill time showed a high degree of correlation to manual estimate of capillary refill time with a Pearson coefficient of 0.7. Conclusions: Novel technology to measure capillary refill time can significantly improve the treatment and care of multiple medical conditions that rely on timely diagnosis and initiation of resuscitation in the emergency department and other care settings. This study shows a modest correlation of technology with automated signal processing algorithms for noninvasive measurement of capillary refill. Integration of this technology into standard hospital monitors has broad applicability to make capillary refill a standard vital sign.
TREATMENT OF CHOLERA
Authors: Hobart A. Reimann
Journal: Annals of Internal Medicine (1968)

Letters and Comments1 November 1968TREATMENT OF CHOLERAHOBART A. REIMANN, M.D.HOBART A. REIMANN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-69-5-1074_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editor: According to the editorial note entitled "Antibiotic Drugs in Cholera" by Wallace and Gangarosa (Ann. Intern. Med. 69: 166, 1968), ". . . the concept that the cholera patient requires only physiologic intravenous replacement of lost isotonic fluid and electrolytes" was introduced in 1959. Refinements indeed have been made, but the concept was in mind and the procedure was crudely used first by Latta in about 1834, improved by Rogers in 1909 (1, 2), and widely applied by Chinese physicians in 1945. The amount of fluid lost can be determined when it is possible to measure the...References1. BLOOMFIELD AL: A bibliography of internal medicine, cholera. Arch. Intern. Med. (Chicago) 96: 734, 1955. CrossrefGoogle Scholar2. REIMANN HA: Cholera, in the Oxford Loose Leaf Medicine, vol. 24, Oxford University Press, New York, 1947, pp. 784-813. Google Scholar3. REIMANNCHANG HAGC: Asiatic cholera. Clinical study and experimental therapy with streptomycin. Amer. J. Trop. Med. 26: 631, 1946. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: HOBART A. REIMANN, M.D.Affiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 November 1968Volume 69, Issue 5Page: 1074-1075KeywordsAntibioticsCholeraDrugsIsotonicitySalts ePublished: 1 December 2008 Issue Published: 1 November 1968 PDF downloadLoading ...
Abstract 12535: Adjunctive Vorapaxar Therapy in Patients With Prior Myocardial Infarction Treated With Newer Generation P2y12 Receptor Inhibitors Prasugrel and Ticagrelor (VORA-PRATIC): A Prospective, Randomized, Pharmacodynamic Study
Authors: Francesco Franchi, Fabiana Rollini, Gabriel Faz, Jose Rivas, Andrea Rivas, Malhar Agarwal, Maryuri Briceno, Mustafa Wali, Ahmed Nawaz, Gabriel Silva, Zubair Shaikh, Naji Maaliki, Kerolos Fahmi, Latonya Been, Andres Pineda, Siva Suryadevara, Daniel Soffer, Martin Zenni, Lisa K Jennings, Theodore Bass, Dominick J Angiolillo
Journal: Circulation (2019)

Background: Vorapaxar used in adjunct to dual antiplatelet therapy (DAPT) with aspirin and clopidogrel reduced thrombotic events in prior myocardial infarction (MI) patients at the expense of incre...
Abstract 13738: Longitudinal Changes and Remodeling in the Right Atrium: The Multi-ethnic Study of Atherosclerosis
Authors: Eric Xie, Nnena Kalu, Bharath Ambale-Venkatesh, Graham Barr, Colin Wu, Elzbieta Chamera, David A Bluemke, Susan R Heckbert, Joseph Yeboah, Shelby Kutty, Joao Ac Lima
Journal: Circulation (2020)

Introduction: The role of the right atrium (RA) in the pathogenesis and prediction of cardiovascular disease has been increasingly recognized, however the effects of aging on the RA remain unknown. In this longitudinal study we sought to describe the structural and functional changes in the RA over approximately ten years and explore their association with demographic and clinical risk factors. Methods: We included 1509 participants who had cardiovascular magnetic resonance at Exam 1 (2000-2002) and follow-up at Exam 5 (2009-2010) with adequate quality RA imaging at both timepoints. Quantification was performed using multimodality tissue tracking software, which has been extensively validated previously. Volumes were indexed to body-surface area. Adjusted multivariate linear regression used for analysis. Results: Participants were on average 58 years old at study onset, 54% female, 43% white, 14% Chinese American, 25% black, and 18% Hispanic. Over 10 years, RA indexed maximum and minimum volumes increased by 32% (8.8 mL/m2) and 37% (5.2 mL/m2) respectively. RA emptying fraction (EF) decreased by 1.3% and global strain trended towards a 0.7% decrease. Older age was associated with greater increases in volume but smaller decreases in function. Men had greater increase in volume and decrease in function, as did black and white races. Baseline obesity (BMI≥30), smoking, and diabetes status were all associated with greater decreases in function. Baseline use of ACE-inhibitors, lipid-lowering medications, and antihypertensives were not associated with larger or smaller changes in structure or function. Conclusions: In this large, diverse participant cohort, RA volumes substantially increased and function decreased over 10 years of follow-up. These differences were generally more prominent among men, older individuals, and white and black participants, and were further associated with baseline clinical risk factors.
AB0019 GENETIC POLYMORPHISM OF THE INFLAMMATORY MARKER SAA1 RS12218 (-13 T/C) IS ASSOCIATED WITH AN APTITUDE TO CLINICAL PHENOTYPES OF JUVENILE IDIOPATHIC ARTHRITIS
Authors: E. Fedorov, S. Salugina, M. Krylov, I. Guseva, E. Samarkina
Journal: Annals of the Rheumatic Diseases (2020)

Background: Juvenile idiopathic arthritis (JIA) is one of the most widely-spread immuno-inflammatory diseases of an unknown etiology, the leading manifestation of which is chronic joint inflammation, occuring in children under the age of 16. The disease is a complex of chronic arthropathies with various phenotypic manifestations. Objectives: To verify the hypothesis about the role of SAA1 rs12218 T / C gene polymorphism in the aptitude to various clinical JIA phenotypes. Methods: The study included 132 children, of whom 66 were diagnosed with JIA and 66 were healthy unrelated volunteers (the college students) as a control group, comparable by gender and age. The group of patients with JIA consisted of 44 girls and 22 boys, with an average age of 11.7 ± 4.2 years and an average disease duration of 4.8 ± 3.8 years. The diagnosis and classification of JIA was established according to ILAR-2004 criteria. The JIA group included 30 (45%) patients with oligoarthritis (oJIA), of which 20 patients (67%) were positive for the HLA-B27 antigen (JIA-B27 +) and 10 (33%) patients with anterior uveitis (uJIA); 20 (30%) patients were assigned to the group with the polyarticular variant (pJIA), while all of them were seronegative for the rheumatoid factor; 16 (24%) patients were diagnosed with JIA with a systemic onset (sJIA). The frequencies of the T / C polymorphism of the SAA1 gene were assessed using an allele-specific polymerase chain reaction in a real time mode (RT-PCR). Results: In the group of patients diagnosed with oJIA and (JIA-B27 +), the frequency of the C allele was significantly higher compared to the control (53.3% and 57.5% versus 37.1%, p = 0.035 and 0.022, respectively). No significant differences were detected in the frequencies of the mutant C allele between sJIA and pJIA and the control group. The logistics analysis of the frequency distribution of the alleles of the SAA1 gene demonstrated an increased risk of the C allele in formation of an aptitude to the oJIA variant (OR 1.94, 95% CI 1.00-3.76, p = 0.035). In the oJIA-B27 (+) group, the risk of an aptitude was also increased compared to the control (OR 2.29, 95% CI 1.05-5.04, p = 0.022). Conclusion: The data obtained confirm for the first time the involvement of the rs12218 polymorphism of the SAA1 gene in an aptitude to the oligoarthritis JIA clinical phenotype. The presented results require further replication researches using an enlarged number of patients from different population groups. Disclosure of Interests: None declared
Abstract 15943: Health Status and Quality of Life With Early Invasive and Non-invasive Treatment Strategies for Patients With Claudication
Authors: Suveen Angraal, Vittal Hejjaji, Yuanyuan Tang, Laith Derbas, Manesh R Patel, Jan Heyligers, Christopher J White, Rudolf Tutein Nolthenius, Carlos Mena-hurtado, Herbert D Aronow, Gregory L Moneta, William R Hiatt, Robert Fitridge, Peter A Soukas, Jinnette D Abbott, John Spertus, Kim G Smolderen
Journal: Circulation (2020)

Introduction: Improving health status; symptoms, function, and quality of life (QoL) are key treatment goals in patients with peripheral arterial disease (PAD) and claudication. Hypothesis: Compared with medical management only, early revascularization in patients with claudication is associated with greater improvements in disease-specific health status. Methods: Patients with new or worsening claudication, who underwent revascularization within 3 months of enrolment or were treated non-invasively (statin, aspirin, cilostazol, supervised exercise therapy, risk factor management) were identified from 16 vascular medicine clinics in the US, Netherlands and Australia participating in the PORTRAITregistry. Patients were propensity-matched on the likelihood of receiving invasive therapy. The Peripheral Artery Questionnaire (PAQ) was used to assess patients’ disease-specific health status at enrollment, and at 3, 6 and 12 months of follow-up using hierarchical Generalized Linear Models for repeated measures. Results: Among 1142 patients (mean age of 67.7 years, 63.0% male), 229 (20.1%) underwent early revascularization while 913 (79.9%) were managed non-invasively. At baseline, patients who underwent invasive vs. non-invasive management had lower PAQ summary (mean ± SD; 44.41 ± 19.98 vs 50.98 ± 21.79, P&lt;0.001) and quality of life scores (45.52 ± 23.95 vs 52.43 ± 26.19, P&lt;0.001). Compared with patients treated non-invasively, patients who underwent revascularization reported improved health status over time, through 1 year of follow up (P &lt;0.001 for all PAQ domains) ( Figure 1 ). Conclusion: Patients who underwent early revascularization had worse baseline health status but a greater improvement over 1 year of follow-up when compared with patients managed without revascularization. Summarizing real-world health status benefits following a PAD diagnosis can support preference-sensitive decisions for PAD management.
Liver Abscess With High 18F-FDG Uptake and No 18F-Fluorothymidine Uptake
Authors: Kengo Fujimoto, Takashi Norikane, Katsuya Mitamura, Yuka Yamamoto, Keiichi Okano, Yasuyuki Suzuki, Yoshihiro Nishiyama
Journal: Clinical Nuclear Medicine (2020)

Abstract 18 F-FDG accumulates not only in malignant lesions but also in infectious and inflammatory ones. 3′-deoxy-3′- 18 F-fluorothymidine (FLT) has been investigated as a promising PET tracer for evaluating tumor proliferating activity. We report a case of liver abscess during therapy of pancreatic cancer that underwent FDG PET/CT and FLT PET/CT studies. Although FDG PET/CT demonstrated several regions of increased uptake in the liver, FLT PET/CT showed no increased uptake in the liver.
Abstract 13506: Reduced Mortality After Implementation of a Multidisciplinary Pulmonary Embolism Response Team
Authors: Colin M Wright, Ilan Goldenberg, Susan Schleede, Scott McNitt, Igor Gosev, Anthony Pietropaoli, Bryan Barrus, Ayman Elbadawi, Yu Lin Chen, Justin Mazillo, Nicole Acquisto, Joseph Van Galen, Annelise Hamer, Mark Marinescu, Joseph M Delehanty, Scott J CAMERON
Journal: Circulation (2020)

Introduction: Multidisciplinary Pulmonary Embolism Response Teams (PERTs) improve the care of patients with high risk pulmonary embolism (PE). The effect of a PERT on long-term mortality has never been evaluated. Hypothesis: We assessed the hypothesis that PERT would improve mortality of patients with high risk PE. Methods: An observational analysis was conducted of patients before PERT (pre-PERT, N = 137, between 2014 and 2015) after PERT (post-PERT, N = 231, from 2016 to 2019) presenting to the emergency department of a large academic medical center with submassive and massive PE. The primary outcome was six-month mortality with univariate and multivariate analyses. Results: PERT was associated with a sustained reduction in Kaplan-Meier mortality estimates (Figure) through six months (six-month mortality rates of 14% post-PERT vs. 24% pre-PERT, unadjusted HR of 0.57, RRR of 43%, NNT of 10, log-rank p=0.025). A Cox proportional hazards model demonstrated no difference in mortality from diagnosis through 1 month after presentation (HR 1.11 vs pre-PERT, 95% CI 0.55-2.26, p=0.766), but confirmed a reduction in mortality 1-6 months after diagnosis post-PERT (HR 0.42 vs pre-PERT, 95% CI 0.19-0.95, p=0.037). There was a reduced length of stay post-PERT (9.1± 10.8 vs 6.5 ± 9.8 days pre-PERT, P=0.007). Time from triage to diagnosis of PE was independently predictive of mortality, and the risk of mortality was reduced by 4.6% for each hour earlier that the diagnosis was made. Conclusions: In conclusion, this study is the first to demonstrate an association between PERT implementation and reduction in 6-month mortality in patients with high risk PE. This effect of reduced time to PE diagnosis associated with a multidisciplinary PERT may be a mechanism for the reduction in mortality.
PTH-085 Are ibd patients getting appropriate surveillance colonoscopies?
Authors: KM Hussain, L Watt, C Hillemand, SJ Murphy
Journal: Gut (2017)

Introduction  2009 BSG and 2011 NICE guideline recommend offering colonoscopic surveillance to people with inflammatory bowel disease (IBD) whose symptoms started 10 years ago and who have ulcerative colitis or Crohn’s colitis. Further surveillance colonoscopies are suggested at intervals based on risk stratification i.e. low, intermediate and high risk. Pan-colonic dye spray with targeted or 2–4 random biopsies every 10 cm should be taken.  Aim of this study is to compare our current practice of surveillance colonoscopies of IBD patients with BSG and NICE guidance.  Method  50 consecutive IBD patients were identified from Unisoft Endoscopy Reports who had an IBD surveillance colonoscopy performed in the Southern Trust during the time period February 2014 to December 2014. Data collection involved reviewing clinical notes and histology reports from electronic care record and colonoscopy reports from Unisoft.  Results  Out of 50 patients, 56% were male. 82% were over 40 years of age and 82% had a diagnosis of UC whereas only 18% had Crohn’s colitis. Repeat surveillance colonoscopies being booked by clinician/endoscopist were appropriate in 60% of cases (30/50). In just above one third (17/50) of cases booking details were not available on previous colonoscopy report or electronic care record. Only 3 out of 50 patients had surveillance colonoscopy requested earlier than due time (2 cases 1 year and 1 case 3 years early). Half (25/50) of patients had surveillance colonoscopy performed at the correct time interval whereas just below half of patients (24/50) had delays ranging from 1–18 years with average delay of 3.2 years. Only one out of 50 had colonoscopy performed earlier than required (9 years). No patient had chromoendoscopy performed and only one patient had >30 biopsies taken. Only 44% (22/50) of patients had minimum required number (16-29) of biopsies taken whereas less than 16 biopsies were taken in 50% of patients (25/50) and 2 patients did not have any biopsies taken.  Conclusion  Our current practice is far from meeting the criteria set by NICE and BSG. Clinicians and endoscopists need awareness of current guidelines for colonoscopy surveillance. More research regarding low uptake of chromoendoscopy among endoscopists is required.  References  . Stuart R Cairns, John H Scholeceld et al. Guidelines for colorectal cancer screening and surveillance in moderate and high risk groups (update from 2002). Gut 2010;59:666e690. doi:10.1136/gut.2009.179804  . Colorectal cancer prevention: colonoscopic surveillance in adults with ulcerative colitis, Crohn’s disease or adenomas. NICE Clinical guideline [CG118] Published date: March 2011  Disclosure of Interest  None Declared