tbuckley/cabot-search huggingface dataset:
Abstract 16906: Cangrelor versus Standard Therapy in Patients With ST-Segment Elevation Myocardial Infraction
Authors: Mohamed Abo-Aly, Bennett George, Susan S Smyth, Ahmed Abdel-Latif, Khaled Ziada
Journal: Circulation (2018)

Introduction: ST-segment myocardial infraction (STEMI) is associated with intense platelet (PLT) activation resulting in microvascular obstruction, inflammation and myocardial damage. Hypothesis: The impact of intense PLT inhibition with cangrelor during primary percutaneous coronary intervention (PPCI) in STEMI patients on PLT mediated inflammatory response has not been studied. Methods: We randomized 20 STEMI patients undergoing PPCI and who received aspirin + ticagrelor to receive intravenous cangrelor (n=11) or placebo (n=9) prior to PPCI. PLT reactivity units (PRU) were evaluated at baseline (prior to randomization), 10 minutes after initiating therapy and at the end of PPCI. Circulating inflammatory cells and PLT-inflammatory cell aggregates (cells/μl of peripheral blood) were evaluated using flow cytometry. Results: Compared to placebo, cangrelor significantly reduced PRU starting 10 minutes after administration. Cangrelor significantly reduced classical (inflammatory) monocytes: CD14++/CD16- (1193 ± 205.7 vs. 2024 ± 312.8; p&lt;0.05), classical monocyte-PLT aggregates: CD14++/CD16-/ CD42+ (334.1 ± 50.35 vs. 580.6 ± 112.2; p&lt;0.05), granulocytes (11040 ± 1545 vs. 24991 ± 7511; p&lt;0.05), and granulocytes-PLT aggregates (1646 ± 203.1 vs. 3949 ± 985.1; p&lt;0.05) compared to the control group ( Figure ). Cangrelor was associated with a trend towards a reduction in cardiac enzyme and inflammatory cytokine levels. Conclusion: Adding Cangrelor to standard antiplatelets in STEMI patients undergoing PPCI provided more intense platelet inhibition and reduced inflammation. This strategy may result in less myocardial damage. The clinical impact of intense platelet inhibition is currently being evaluated in our full cohort (NCT0304327).
“Loss of Bone Signal” on 99mTc-Labeled Pyrophosphate Scintigraphy in a Patient With Wild-Type Transthyretin Amyloidosis
Authors: Koji Takahashi, Daisuke Sasaki, Takaaki Iwamura, Tomoki Sakaue, Takafumi Okura
Journal: Clinical Nuclear Medicine (2024)

Abstract 99m Tc-3,3-diphosphono-1,2-propanedicarboxylic acid (DPD) scintigraphy and 99m Tc-pyrophosphate (PYP) scintigraphy are highly sensitive modalities for imaging both myocardial and extracardiac amyloid transthyretin in patients with wild-type transthyretin (ATTRwt) amyloidosis. “Loss of bone signal” on planar imaging of 99m Tc-DPD scintigraphy, in which the tracer uptake in bone is obscured by marked tracer uptake in the overlying skeletal muscles, is reported. However, this phenomenon has not yet been documented on 99m Tc-PYP scintigraphy. We describe an 89-year-old woman with ATTRwt amyloidosis in whom “loss of bone signal” together with marked tracer uptake into the skeletal muscles was clearly demonstrated on 99m Tc-PYP scan.
Reducing False-Positives Due to Urinary Stagnation in the Prostatic Urethra on 18F-DCFPyL PSMA PET/CT With MRI
Authors: David G. Gelikman, Esther Mena, Liza Lindenberg, William S. Azar, Nityam Rathi, Enis C. Yilmaz, Stephanie A. Harmon, Kyle C. Schuppe, Jessica Y. Hsueh, Hannah Huth, Bradford J. Wood, Sandeep Gurram, Peter L. Choyke, Peter A. Pinto, Baris Turkbey
Journal: Clinical Nuclear Medicine (2024)

Prostate-specific membrane antigen (PSMA)-targeting PET radiotracers reveal physiologic uptake in the urinary system, potentially misrepresenting activity in the prostatic urethra as an intraprostatic lesion. This study examined the correlation between midline 18 F-DCFPyL activity in the prostate and hyperintensity on T2-weighted (T2W) MRI as an indication of retained urine in the prostatic urethra.
The Monocle Sign on 18F-FDG PET Indicates Contralateral Peripheral Facial Nerve Palsy
Authors: Fatemeh Dana, Alexander Maurer, Urs J. Muehlematter, Lars Husmann, Jan Schaab, Cäcilia E. Mader, Stephan Beintner-Skawran, Michael Messerli, Bert-Ram Sah, Masih Dana, Mohsen Dana, Sjunne H. Duhnsen, Simon A. Mueller, Thomas Stadler, Grégoire B. Morand, Christian Meerwein, Erika Orita, Philipp A. Kaufmann, Martin W. Huellner
Journal: Clinical Nuclear Medicine (2024)

Background The aim of our study was to retrospectively analyze FDG PET/CT data in patients with facial nerve palsy (FNP) for the presence of the monocle sign. Patients and Methods A total of 85 patients with unilateral FNP were included into our study, thereof 73 with peripheral FNP and 12 with central FNP. FDG uptake (SUV max , SUV mean , total lesion glycolysis) was measured in both orbicularis oculi muscles (OOMs). FDG uptake of paretic and nonparetic muscles was compared in patients with FNP (Wilcoxon test and Mann-Whitney U test) and was also compared with FDG uptake in 33 patients without FNP (Mann-Whitney U test). SUV max ratios of OOM were compared. A receiver operating characteristic curve and Youden Index were used to determine the optimal cutoff SUV max ratio for the prevalence of contralateral peripheral FNP. Results The SUV max ratio of OOM was significantly higher in patients with peripheral FNP compared with patients with central FNP and those without FNP (1.70 ± 0.94 vs 1.16 ± 0.09 vs 1.18 ± 0.21, respectively; P &lt; 0.001). The SUV max ratio of OOM yielded an area under the curve (AUC) of 0.719 (95% confidence interval, 0.630–0.809), with an optimal cutoff of 1.41, yielding a specificity of 94.4% and a sensitivity of 44.1% for identifying contralateral peripheral FNP. One hundred percent specificity is achieved using a cutoff of 1.91 (sensitivity, 29.4%). Conclusions Asymmetrically increased FDG uptake of the OOM (the “monocle sign”) indicates contralateral peripheral FNP. A nearly 2-fold higher SUV max represents a practically useful cutoff.
Bilateral Multiple Fractures Obstruct Quantitation of 99mTc-Pyrophosphate Imaging for Cardiac Amyloidosis
Authors: Qin Zhou, Jiahong Zuo, Liu Xiao, Lisha Jiang, Zhen Zhao
Journal: Clinical Nuclear Medicine (2024)

A 57-year-old woman who had persistent symptoms of transthyretin cardiac amyloidosis underwent 99m Tc-pyrophosphate ( 99m Tc-PYP) scintigraphy. The 99m Tc-PYP planar and SPECT/CT fusion image showed diffuse myocardial uptake and multiple fractures of the sternum and ribs. These fractures interfered with semiquantitative scores of 99m Tc-PYP uptake, leading to false positive in 99m Tc-PYP imaging.
Ruptured Baker Cyst on 18F-FDG PET/CT
Authors: Emilie Mariëtte de Groot, Martinus Johannes van Amerongen, Marieke Janneke Martine Ploegmakers, Ingrid Henrica Antonia Zegers, Anne Isabelle Juliette Arens
Journal: Clinical Nuclear Medicine (2024)

A 78-year-old woman with diffuse large B-cell lymphoma was referred for an 18 F-FDG PET/CT to evaluate therapy response after 6 cycles of R-mini-CHOP. A new 18 F-FDG accumulation was noticed medial in the upper part of the right lower leg, spreading along the medial head of the gastrocnemius muscle. The shaft-bow-looking curvature, arch sign, of 18 F-FDG revealed a fluid collection on CT. This typical pattern and its specific location are indicative of a ruptured Baker's cyst. It can manifest in 1 or both legs.
Response of sputum periostin to <scp>anti‐T2</scp> biologics treatment in severe asthma
Authors: Parameswaran Nair, Katherine Radford, Satoshi Nunomura, Manali Mukherjee, Kenji Izuhara
Journal: Allergy (2024)

The data that support the findings of this study are available from the corresponding author upon reasonable request.
Prevalence of hypersensitivity reactions in various forms of mastocytosis: A pilot study of 2485 adult patients with mastocytosis collected in the ECNM registry
Authors: Marek Niedoszytko, Aleksandra Gorska, Knut Brockow, Patrizia Bonadonna, Magdalena Lange, Hanneke Kluin‐Nelemans, Hanneke Oude‐Elberink, Vito Sabato, Khalid Shoumariyeh, Dagmar von Bubnoff, Sabine Müller, Anja Illerhaus, Michael Doubek, Irena Angelova‐Fischer, Olivier Hermine, Michel Arock, Chiara Elena, Luca Malcovati, Akif Selim Yavuz, Tanja Daniela Schug, Anna Belloni Fortina, Várkonyi Judit, Jason Gotlib, Jens Panse, Vladan Vucinic, Andreas Reiter, Juliana Schwaab, Massimo Triggiani, Mattias Mattsson, Christine Breynaert, Jan Romantowski, Roberta Zanotti, Elisa Olivieri, Alexander Zink, Annick van de Ven, Alex Stefan, Stephane Barete, Francesca Caroppo, Cecelia Perkins, Vanessa Kennedy, Deborah Christen, Mohamad Jawhar, Johannes Luebke, Roberta Parente, Kerstin Levedahl, Emir Hadzijusufovic, Karin Hartmann, Boguslaw Nedoszytko, Wolfgang R. Sperr, Peter Valent
Journal: Allergy (2024)

Hypersensitivity reactions (HR) are common in mastocytosis. However, little is known about triggers and risk factors. The registry of the European Competence Network on Mastocytosis (ECNM) enables reliable studies in a larger cohort of mastocytosis patients. We assessed prevalence, triggers and risk factors of HR in adults with mastocytosis in the ECNM registry.
Gene-environmental regulation of the postnatal post-mitotic neuronal maturation
Authors: Gabrielle S. Prince, Molly Reynolds, Verdion Martina, HaoSheng Sun
Journal: Trends in Genetics (2024)

Embryonic neurodevelopment, particularly neural progenitor differentiation into post-mitotic neurons, has been extensively studied. While the number and composition of post-mitotic neurons remain relatively constant from birth to adulthood, the brain undergoes significant postnatal maturation marked by major property changes frequently disrupted in neural diseases. This review first summarizes recent characterizations of the functional and molecular maturation of the postnatal nervous system. We then review regulatory mechanisms controlling the precise gene expression changes crucial for the intricate sequence of maturation events, highlighting experience-dependent versus cell-intrinsic genetic timer mechanisms. Despite significant advances in understanding of the gene-environmental regulation of postnatal neuronal maturation, many aspects remain unknown. The review concludes with our perspective on exciting future research directions in the next decade.
Educate, not kill: treating cancer without triggering its defenses
Authors: Aneta Škarková, Mariano Bizzarri, Radoslav Janoštiak, Jan Mašek, Daniel Rosel, Jan Brábek
Journal: Trends in Molecular Medicine (2024)

Traditionally, anticancer therapies focus on restraining uncontrolled proliferation. However, these cytotoxic therapies expose cancer cells to direct killing, instigating the process of natural selection favoring survival of resistant cells that become the foundation for tumor progression and therapy failure. Recognizing this phenomenon has prompted the development of alternative therapeutic strategies. Here we propose strategies targeting cancer hallmarks beyond proliferation, aiming at re-educating cancer cells towards a less malignant phenotype. These strategies include controlling cell dormancy, transdifferentiation therapy, normalizing the cancer microenvironment, and using migrastatic therapy. Adaptive resistance to these educative strategies does not confer a direct proliferative advantage to resistant cells, as non-resistant cells are not subject to eradication, thereby delaying or preventing the development of therapy-resistant tumors.
Abstract 15854: Prognostic Value of Coronary CT Angiography and Coronary Artery Calcium Score Performed Before Revascularization
Authors: Kazuhisa Takamura, Shinichiro Fujimoto, Takeshi Kondo, Kanako Kumamaru, Yuko Kawaguchi, Shoko Suda, Rie matsumori, Etsuro Kato, Makoto Hiki, Shinichi Takase, Frank J Rybicki, Hiroyuki Daida
Journal: Circulation (2015)

Introduction: Cardiac events after revascularization are equally attributable to recurrence at site of culprit lesions and development of non-culprit lesions. Because coronary CT angiography (CCTA) performed before revascularization can evaluate all plaque, including non-culprit lesions, and in theory can serve as a predictor of cardiac events after treatment. We evaluated the hypothesis that CCTA and coronary artery calcium score (CACS) performed before revascularization predicts cardiac events after treatment. Methods: Among 2238 consecutive patients without known coronary artery disease who underwent coronary CCTA and CACS, 359 patients underwent revascularization within 30 days after CT; in 337 of 359 (93.9%) follow-up clinical information was available. In addition to known cardiac risk factors, CT findings were evaluated as predictors of cardiac events after revascularization: CACS and the presence of CT-verified high risk plaque (CT-HRP). Improvement of predictive accuracy by including CT findings was evaluated from discrimination (Harrell’s C-statistics) and reclassification (net reclassification indices (NRI)) standpoints. Results: During the follow-up period (median: 673, interquartile range: 47-1529 days), a total of 98 cardiac events occurred. Cox proportional hazard model revealed that age, diabetes, triglyceride, CACS and non-culprit CT-HRP were significant predictors of overall cardiac events. Although not statistically significant, discriminatory power was greater for the model with CACS (C-stat: 63.2%) and the model with both CACS and CT-HRP (65.8%) compared to the model including neither CACS nor CT-HRP (60.7%). Reclassification improved by including CACS into the model when compared to the model without it (NRI=12.7%; category-free NRI=40.7%) and CT-HRP added to CACS further improved the classification (NRI=6.9%; category-free NRI=14.3%). Conclusions: High CACS and the presence of non-culprit CT-HRP performed before revascularization are significant predictors of cardiac events after revascularization.
Abstract 9413: A Feasibility Study of Non-Invasive Ablation of Ventricular Tachycardia Using High-Intensity Focused Ultrasound
Authors: Fei Lu, Wei Huang, Fengpeng Jia, David G Benditt, Zhibiao Wang, Han Lei, Richard G Trohman
Journal: Circulation (2013)

Introduction: Conventional catheter ablation of ventricular tachycardia (VT) is limited in part by its invasiveness and associated complications, particularly when an epicardial approach is needed. This study evaluated the feasibility of targeted ablation of cardiac tissues using high-intensity focused ultrasound (HIFU) as a potential means for non-invasive VT ablation. Methods &amp; Results: Ablation of ventricular myocardium was performed in anesthetized closed-chest dogs using a HIFU therapeutic system that is being used clinically for ablation of human solid tumors. The animal was placed onto the HIFU system with its left chest immersed in a tank filled with specially treated water. Ventricular pacing using a quadripolar catheter via the internal carotid artery was performed at a rate slightly higher than intrinsic sinus rate to mimic VT. The myocardium at the tip of the pacing catheter (Figure 1) was targeted for ablation (400 watts for 2-4 s). Ablation end-point was loss of ventricular capture at twice pacing threshold. In 5 separate preparations, pacing could be terminated successfully (Figure 2). No subsequent capture was seen at 5 times baseline pacing threshold but capture could be obtained at different locations using the same pacing catheter. Both transmural and localized lesions could be created in a controlled fashion without evident injury to the skin, lung, or pericardium on postmortem examination. Conclusion: This pilot study suggests that HIFU is potentially useful for non-invasive ablation of targeted, localized myocardial tissue; and may be applicable for VT ablation, particularly those of intramyocardial / epicardial origin.
Abstract 9320: Ultrafiltration is Associated With Improved Clinical Symptoms but not Rehospitalization or Mortality When Compared to Intravenous Diuretics in Acute Decompensated Heart Failure: A Meta-Analysis of Randomized Controlled Trials
Authors: Sachil Shah, Georges Joseph, Elie M Donath, Noah Moss, Rosenstein S Robert
Journal: Circulation (2013)

Introduction: Acute decompensated heart failure (ADHF) is a leading cause for hospitalizations in the US. Intravenous loop diuretics are the first-line therapy for ADHF but 40% of patients are discharged with unresolved congestion resulting in higher re-hospitalization and mortality rates. Ultrafiltration (UF) is a promising intervention that allows rapid removal of isotonic fluid in patients with ADHF. Studies comparing UF to diuretics have been inconsistent in their results regarding clinical outcomes. In this meta-analysis we aim to demonstrate that UF is associated with improvements in decongestion, clinical symptoms and mortality compared to diuretic use. Methods: A comprehensive literature search was performed to identify all RCTs from PubMed, EMBASE and Cochrane. Trials were included if they met following criteria: (1) randomization with a control group (2) comparison of UF with a loop diuretic and (3) a diagnosis of ADHF. The pooled odds ratio (OR) and 95% confidence intervals (CI) were calculated by using a fixed-effects model if no heterogeneity was detected among the studies. A random effects model was applied if significant heterogeneity remained using the fixed effects analysis. A p-value of 0.05 was used to denote statistical significance. Results: Nine RCTs, including 605 patients (303 received diuretics, 302 received UF), were included in meta-analysis. When compared to diuretics, UF was associated with a reduced risk of clinical worsening (OR 0.57, 95% CI: 0.38-0.86, p-value 0.007), an increased likelihood for clinical decongestion (OR 2.32, 95% CI: 1.09-4.91, p-value 0.03), greater weight reduction (0.97 Kg, 95% CI: 0.52 - 1.42, p-value &lt;0.0001) and greater volume reduction (1.11 L, 95% CI: 0.68-1.54, p-value &lt;0.0001). The overall risk of re-hospitalization (OR 0.92, 95% CI: 0.62-1.38, p-value 0.70) and risk of return to emergency department (OR 0.69, 95% CI: 0.44-1.08, p-value 0.10) were not significantly improved by UF treatment. UF was not associated with a reduced risk of mortality (OR 0.99, 95% CI: 0.60-1.62, p-value 0.97). Conclusions: UF is associated with significant improvements in clinical decongestion and volume reduction but not in rates of re-hospitalization, return to emergency department or mortality.
Abstract 347: Experimental use of a Pediatric Fluid Resuscitation Model: Evaluating Test-retest Reliability and Inter-subject Variability
Authors: Melissa J Parker, Frank M Lee, Lehana Thabane
Journal: Circulation (2013)

Introduction: Health Care Providers (HCPs) report that manual techniques of intravascular fluid resuscitation are commonly used to deliver isotonic fluid to young children. At present, it is unclear how manual fluid resuscitation is optimally performed by HCPs. A non-clinical experimental setting can be used to evaluate HCP fluid resuscitation performance outcomes, however test-retest reliability is unknown. Objectives: To determine HCP test-retest reliability (repeatability) and inter-subject variability of fluid resuscitation performance outcomes to inform the design of future studies. Hypothesis: We hypothesized that good test-retest reliability would be demonstrated, but that significant inter-subject variability would exist. Methods: We conducted an interventional study involving 15 consenting HCP subjects from McMaster Children’s Hospital in Hamilton, Canada. Subjects were oriented to a non-clinical model of a 15 kg toddler. The model incorporated a 22-gauge IV catheter and extension tubing affixed to the hand in typical clinical fashion. Following a standardization procedure, subjects were asked to rapidly administer 600 mL (40 mL/kg) of 0.9% normal saline to the model using prefilled 60 mL syringes. Subjects were advised to consider that this was urgently required treatment for decompensated septic shock. Each subject repeated the intervention 5 times with a 10-minute washout period between trials. All testing was video recorded, with fluid administration time outcome data (in seconds) extracted from trial videos by two blinded outcome assessors. The primary outcome of fluid administration time test-retest reliability was analyzed by one-way ANOVA and ICC as per our a priori plan. Results: Differences in HCP fluid administration times are attributable to inter-subject variability rather than intra-subject variability based on one-way ANOVA analysis, F(14,60)=43.125 (p&lt;0.001). Test-retest reliability of subjects was excellent, with ICC=0.97 [95% CI 0.95; 0.99] (p&lt;0.001). Conclusions: Our findings demonstrate excellent test-retest reliability of HCP fluid resuscitation performance in an experimental setting involving a non-clinical model. Use of a single HCP trial in future comparative studies is justified.
Abstract 15790: Neurologic Impact of Left Atrial Appendage Exclusion in Mitral Valve Surgery, a Retrospective Study
Authors: Emmeline Ruka, Émile Voisine, François Dagenais, Vincent Chauvette, Pierre Voisine
Journal: Circulation (2015)

Context: Up to 40% of patients undergoing isolated mitral valve surgery develop atrial fibrillation (AF). AF is a significant risk factor for stroke and 90% of clots responsible for AF-related neurological events form in the left atrial appendage (LAA). LAA exclusion (LAAe) could potentially reduce post-operative neurological complications in patients undergoing mitral valve surgery. Methodology: Single center retrospective cohort study with prospectively collected data including all patients undergoing mitral valve surgery between January 2003 and April 2014. Univariate analysis and multivariate analysis with stepwise approach were performed. Results: Results were obtained for 2728 patients who met the inclusion criteria. Of these, 406 (14.9%) had a LAAe. This group of patients suffered more frequently from pre-operative AF (86.7% vs 35.1%, p&lt;0.0001) and had more concomitant Maze procedures (78.3% vs 12.3%, p&lt;0.0001) than the group of patients who did not have LAAe (n-LAAe). By univariate analysis, in-hospital mortality was comparable in the LAAe vs n-LAAe groups (4.7% vs 6.5%, p=0.18). The risks of post-operative stroke (3.0% vs 3.5%, p=0.77) and transient ischemic attack (0.5% vs 0.4%, p=0.70) were also comparable. No difference in reoperation for bleeding between the two groups was observed (5.9% vs 6.8%, p=0.59). By univariate analysis, the presence of AF (pre- or post-operative) did not have a significant impact on mortality (p=0.48 and p=0.89, respectively). There was a significant difference in long-term survival between the LAAe group and the n-LAAe group (p=0.0007, median follow-up 2.4 years). By multivariate analysis, LAAe was identified as an independent protective factor from long-term mortality [OR 0.47; CI95% (0.25-0.89)]. The performance of an isolated Maze procedure [OR 0.66; CI95% (0.36-1.21)] did not have a significant impact on mortality. Conclusion: LAAe during mitral valve surgery is an independent protective factor from long-term mortality, without increasing peri-operative risks of bleeding or new onset AF. However, LAAe does not protect from neurologic events in the peri-operative period. Unlike LAAe, an isolated Maze procedure did not have an impact on long-term survival.