tbuckley/cabot-search huggingface dataset:
Impact of Preexisting Heart Failure on Treatment and Outcomes in Older Patients With Hodgkin Lymphoma
Authors: Jenica N. Upshaw, Jason Nelson, Benjamin Sweigart, Angie Mae Rodday, Anita J. Kumar, Marvin A. Konstam, John B. Wong, Bonnie Ky, Samuel Karmiy, Jonathan W. Friedberg, Andrew M. Evens, David M. Kent, Susan K. Parsons
Journal: JACC CardioOncology (2024)

Older patients with Hodgkin lymphoma (HL) often have comorbid cardiovascular disease; however, the impact of pre-existing heart failure (HF) on the management and outcomes of HL is unknown. The aim of this study was to assess the prevalence of pre-existing HF in older patients with HL and its impact on treatment and outcomes. Linked Surveillance, Epidemiology, and End Results (SEER) and Medicare data from 1999 to 2016 were used to identify patients 65 years and older with newly diagnosed HL. Pre-existing HF, comorbidities, and cancer treatment were ascertained from billing codes and cause-specific mortality from SEER. The associations between pre-existing HF and cancer treatment were estimated using multivariable logistic regression. Cause-specific Cox proportional hazards models adjusted for comorbidities and cancer treatment were used to estimate the association between pre-existing HF and cause-specific mortality. Among 3,348 patients (mean age 76 ± 7 years, 48.6% women) with newly diagnosed HL, pre-existing HF was present in 437 (13.1%). Pre-existing HF was associated with a lower likelihood of using anthracycline-based chemotherapy regimens (OR: 0.42; 95% CI: 0.29-0.60) and a higher likelihood of lymphoma mortality (HR: 1.25; 95% CI: 1.06-1.46) and cardiovascular mortality (HR: 2.57; 95% CI: 1.96-3.36) in models adjusted for comorbidities. One-year lymphoma mortality cumulative incidence was 37.4% (95% CI: 35.5%-39.5%) with pre-existing HF and 26.3% (95% CI: 25.0%-27.6%) without pre-existing HF. The cardioprotective medications dexrazoxane and liposomal doxorubicin were used in only 4.2% of patients. Pre-existing HF in older patients with newly diagnosed HL is common and associated with higher 1-year mortality. Strategies are needed to improve lymphoma and cardiovascular outcomes in this high-risk population.
Anthracycline Cardiotoxicity Induces Progressive Changes in Myocardial Metabolism and Mitochondrial Quality Control
Authors: Anabel Díaz-Guerra, Rocío Villena-Gutiérrez, Agustín Clemente-Moragón, Mónica Gómez, Eduardo Oliver, Miguel Fernández-Tocino, Carlos Galán-Arriola, Laura Cádiz, Borja Ibáñez
Journal: JACC CardioOncology (2024)

Anthracycline-induced cardiotoxicity (AIC) debilitates quality of life in cancer survivors. Serial characterizations are lacking of the molecular processes occurring with AIC. The aim of this study was to characterize AIC progression in a mouse model from early (subclinical) to advanced heart failure stages, with an emphasis on cardiac metabolism and mitochondrial structure and function. CD1 mice received 5 weekly intraperitoneal doxorubicin injections (5 mg/kg) and were followed by serial echocardiography for 15 weeks. At 1, 9, and 15 weeks after the doxorubicin injections, mice underwent fluorodeoxyglucose positron emission tomography, and hearts were extracted for microscopy and molecular analysis. Cardiac atrophy was evident at 1 week post-doxorubicin (left ventricular [LV] mass 117 ± 26 mg vs 97 ± 25 mg at baseline and 1 week, respectively; P < 0.001). Cardiac mass nadir was observed at week 3 post-doxorubicin (79 ± 16 mg; P = 0.002 vs baseline), remaining unchanged thereafter. Histology confirmed significantly reduced cardiomyocyte area (167 ± 19 μm2 in doxorubicin-treated mice vs 211 ± 26 μm2 in controls; P = 0.004). LV ejection fraction declined from week 6 post-doxorubicin (49% ± 9% vs 61% ± 9% at baseline; P < 0.001) until the end of follow-up at 15 weeks (43% ± 8%; P < 0.001 vs baseline). At 1 week post-doxorubicin, when LV ejection fraction remained normal, reduced cardiac metabolism was evident from down-regulated markers of fatty acid oxidation and glycolysis. Metabolic impairment continued to the end of follow-up in parallel with reduced mitochondrial adenosine triphosphate production. A transient early up-regulation of nutrient-sensing and mitophagy markers were observed, which was associated with mitochondrial enlargement. Later stages, when mitophagy was exhausted, were characterized by overt mitochondrial fragmentation. Cardiac atrophy, global hypometabolism, early transient-enhanced mitophagy, biogenesis, and nutrient sensing constitute candidate targets for AIC prevention.
Artificial Intelligence Electrocardiography to Predict Atrial Fibrillation in Patients With Chronic Lymphocytic Leukemia
Authors: Georgios Christopoulos, Zachi I. Attia, Sara J. Achenbach, Kari G. Rabe, Timothy G. Call, Wei Ding, Jose F. Leis, Eli Muchtar, Saad S. Kenderian, Yucai Wang, Paul J. Hampel, Amber B. Koehler, Neil E. Kay, Prashant Kapoor, Susan L. Slager, Tait D. Shanafelt, Peter A. Noseworthy, Paul A. Friedman, Joerg Herrmann, Sameer A. Parikh
Journal: JACC CardioOncology (2024)

The use of an artificial intelligence electrocardiography (AI-ECG) algorithm has demonstrated its reliability in predicting the risk of atrial fibrillation (AF) within the general population. This study aimed to determine the effectiveness of the AI-ECG score in identifying patients with chronic lymphocytic leukemia (CLL) who are at high risk of developing AF. We estimated the probability of AF based on AI-ECG among patients with CLL extracted from the Mayo Clinic CLL database. Additionally, we computed the Mayo Clinic CLL AF risk score and determined its ability to predict AF. Among 754 newly diagnosed patients with CLL, 71.4% were male (median age = 69 years). The median baseline AI-ECG score was 0.02 (range = 0-0.93), with a value ≥0.1 indicating high risk. Over a median follow-up of 5.8 years, the estimated 10-year cumulative risk of AF was 26.1%. Patients with an AI-ECG score of ≥0.1 had a significantly higher risk of AF (HR: 3.9; 95% CI: 2.6-5.7; P < 0.001). This heightened risk remained significant (HR: 2.5; 95% CI: 1.6-3.9; P < 0.001) even after adjusting for the Mayo CLL AF risk score, heart failure, chronic kidney disease, and CLL therapy. In a second cohort of CLL patients treated with a Bruton tyrosine kinase inhibitor (n = 220), a pretreatment AI-ECG score ≥0.1 showed a nonsignificant increase in the risk of AF (HR: 1.7; 95% CI: 0.8-3.6; P = 0.19). An AI-ECG algorithm, in conjunction with the Mayo CLL AF risk score, can predict the risk of AF in patients with newly diagnosed CLL. Additional studies are needed to determine the role of AI-ECG in predicting AF risk in CLL patients treated with a Bruton tyrosine kinase inhibitor.
A Biomarker-Based Diagnostic Model for Cardiac Dysfunction in Childhood Cancer Survivors
Authors: Jan M Leerink, Elizabeth A M Feijen, Esmee C de Baat, Remy Merkx, Helena J H van der Pal, Wim J E Tissing, Marloes Louwerens, Marry M van den Heuvel-Eibrink, A Birgitta Versluys, Elvira C van Dalen, Margriet van der Heiden-van der Loo, Dorine Bresters, Cécile M Ronckers, Andrica C H de Vries, Sebastian Neggers, Livia Kapusta, Jacqueline Loonen, Yigal M Pinto, Leontien C M Kremer, Annelies M C Mavinkurve-Groothuis, Wouter E M Kok
Journal: JACC CardioOncology (2024)

Childhood cancer survivors at risk for heart failure undergo lifelong echocardiographic surveillance. Previous studies reported the limited diagnostic accuracy of N-terminal pro–B-type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin T (hs-cTnT) in detecting left ventricular (LV) dysfunction. However, potential enhanced diagnostic accuracy through the combination of biomarkers and clinical characteristics has been suggested. The aim of this study was to develop and internally validate a diagnostic model that combines cardiac biomarkers with clinical characteristics for effectively ruling in or ruling out LV dysfunction in childhood cancer survivors. A multicenter cross-sectional study included 1,334 survivors (median age 34.2 years) and 278 siblings (median age 36.8 years). Logistic regression models were developed and validated through bootstrapping, combining biomarkers with clinical characteristics. Abnormal NT-proBNP levels were observed in 22.1% of survivors compared with 5.4% of siblings, whereas hs-cTnT levels exceeding 10 ng/L were uncommon in both survivors (5.9%) and siblings (5.0%). The diagnostic models demonstrated improvement upon the addition of NT-proBNP and hs-cTnT to clinical characteristics, resulting in an increased C statistic from 0.69 to 0.73 for LV ejection fraction (LVEF) <50% and a more accurate prediction of more severe LV dysfunction, with the C statistic increasing from 0.80 to 0.86 for LVEF <45%. For LVEF <50% (prevalence 10.9%), 16.9% of survivors could be effectively ruled out with high sensitivity (95.4%; 95% CI: 90.4%-99.3%) and negative predictive value (97.5%; 95% CI: 94.6%-99.7%). Similarly, for LVEF <45% (prevalence 3.4%), 53.0% of survivors could be ruled out with moderate to high sensitivity (91.1%; 95% CI: 79.2%-100%) and high negative predictive value (99.4%; 95% CI: 98.7%-100%). The biomarker-based diagnostic model proves effective in ruling out LV dysfunction, offering the potential to minimize unnecessary surveillance echocardiography in childhood cancer survivors. External validation is essential to confirm these findings. (Early Detection of Cardiac Dysfunction in Childhood Cancer Survivors; A DCOG LATER Study; https://onderzoekmetmensen.nl/nl/trial/23641)
Clinical Risks for Chronic Lymphocytic Leukemia
Authors: Jennifer R. Brown
Journal: Journal of the National Comprehensive Cancer Network (2024)

Our understanding of risk factors for the development of chronic lymphocytic leukemia (CLL) is still incomplete and includes genetic and environmental factors. CLL is one of the most familial of all cancers, yet common high-penetrance risk alleles have not been identified. Genome-wide association studies have identified many common variants with low relative risks, whereas exome-wide rare variant analysis has implicated ATM in CLL causation. Environmental factors have also been challenging to identify given the limited understanding of the relevant time period of exposure relative to diagnosis, and the inability to quantify past exposures. Agent Orange and glyphosate herbicides have perhaps the most data to support their role. CLL is preceded by a precursor condition called monoclonal B-cell lymphocytosis (MBL), which could therefore be considered a risk factor, but which itself is likely caused by the same risk factors that ultimately give rise to CLL. Although virtually all people with CLL have a preceding MBL phase, most people with MBL will not develop CLL.
Effect of Tafamidis on Renal Function in Patients With Transthyretin Amyloid Cardiomyopathy in ATTR-ACT
Authors: Brett W. Sperry, Marla B. Sultan, Balarama Gundapaneni, Sandi See Tai, Ronald M. Witteles
Journal: JACC CardioOncology (2024)

Chronic kidney disease (CKD) is common among patients with amyloid cardiomyopathy. Tafamidis was approved for the treatment of transthyretin amyloid cardiomyopathy (ATTR-CM) based on findings from ATTR-ACT (Safety and Efficacy of Tafamidis in Patients With Transthyretin Cardiomyopathy).
Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma, Version 2.2024
Authors: William G. Wierda, Jennifer Brown, Jeremy S. Abramson, Farrukh Awan, Syed F. Bilgrami, Greg Bociek, Danielle Brander, Matthew Cortese, Larry Cripe, Randall S. Davis, Herbert Eradat, Bita Fakhri, Christopher D. Fletcher, Sameh Gaballa, Muhammad Saad Hamid, Brian Hill, Paul Kaesberg, Brad Kahl, Manali Kamdar, Thomas J. Kipps, Shuo Ma, Claudio Mosse, Shazia Nakhoda, Sameer Parikh, Andrew Schorr, Stephen Schuster, Madhav Seshadri, Tanya Siddiqi, Deborah M. Stephens, Meghan Thompson, Chaitra Ujjani, Riccardo Valdez, Nina Wagner-Johnston, Jennifer A. Woyach, Hema Sundar, Mary Dwyer
Journal: Journal of the National Comprehensive Cancer Network (2024)

Chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) are essentially different manifestations of the same disease that are similarly managed. A number of molecular and cytogenetic variables with prognostic implications have been identified. Undetectable minimal residual disease at the end of treatment with chemoimmunotherapy or venetoclax-based combination regimens is an independent predictor of improved survival among patients with previously untreated or relapsed/refractory CLL/SLL. The selection of treatment is based on the disease stage, presence or absence of del(17p) or TP53 mutation, immunoglobulin heavy chain variable region mutation status, patient age, performance status, comorbid conditions, and the agent’s toxicity profile. This manuscript discusses the recommendations outlined in the NCCN Guidelines for the diagnosis and management of patients with CLL/SLL.
Re: First-in-Human Safety, Imaging, and Dosimetry of a Carbonic Anhydrase IX-Targeting Peptide, [68Ga]Ga-DPI-4452, in Patients with Clear Cell Renal Cell Carcinoma
Authors: Alice Thomson, Carlotta Castillo, Henrike Graefen, Sachin Perera, Nathan Lawrentschuk, Marlon Perera, Renu Eapen, Declan G. Murphy
Journal: European Urology (2024)
Re: Enfortumab Vedotin and Pembrolizumab in Untreated Advanced Urothelial Cancer
Authors: David C. Chen, Haidar AlSaffar, Henrike Graefen, Sachin Perera, Elio Mazzone, Marlon L. Perera, Nathan Lawrentschuk, Declan G. Murphy
Journal: European Urology (2024)
Transbronchial cryobiopsy followed by as-needed surgical lung biopsy versus immediate surgical lung biopsy for diagnosing interstitial lung disease (the COLD study): a randomised controlled trial
Authors: Kirsten A Kalverda, Maarten K Ninaber, Lizzy Wijmans, Jan von der Thüsen, René E Jonkers, Johannes M Daniels, Jelle R Miedema, Chris Dickhoff, Jürgen Hölters, David Heineman, Merijn Kant, Teodora Radonic, Ghada Shahin, Danielle Cohen, Bart Boerrigter, Suzan Nijman, Esther Nossent, Jerry Braun, Bas Mathot, Venerino Poletti, Jürgen Hetzel, Marcel Dijkgraaf, Daniel A Korevaar, Peter I Bonta, Jouke T Annema
Journal: The Lancet Respiratory Medicine (2024)
Measurement tools for behaviours that challenge and behavioural function in people with intellectual disability: A systematic review and meta-analysis of internal consistency, inter-rater reliability, and test-retest reliability
Authors: Lauren Shelley, Chris Jones, Effie Pearson, Caroline Richards, Hayley Crawford, Arianna Paricos, Courtney Greenhill, Alixandra Woodhead, Joanne Tarver, Jane Waite
Journal: Clinical Psychology Review (2024)

Behaviours that challenge (BtC) are common in people with intellectual disability (ID) and associated with negative long-term outcomes. Reliable characterisation of BtC and behavioural function is integral to person-centred interventions. This systematic review and meta-analytic study quantitatively synthesised the evidence-base for the internal consistency, inter-rater reliability, and test-retest reliability of measures of BtC and behavioural function in people with ID (PROSPERO: CRD42021239042). Web of Science, Embase, PsycINFO and MEDLINE were searched from inception to March 2024. Retrieved records (n = 3691) were screened independently to identify studies assessing eligible measurement properties in people with ID. Data extracted from 83 studies, across 29 measures, were synthesised in a series of random-effects meta-analyses. Subgroup analyses assessed the influence of methodological quality and study-level characteristics on pooled estimates. COSMIN criteria were used to evaluate the measurement properties of each measure. Pooled estimates ranged across measures: internal consistency (0.41–0.97), inter-rater reliability (0.29–0.93) and test-retest reliability (0.52–0.98). The quantity and quality of evidence varied substantially across measures; evidence was frequently unavailable or limited to a single study. Based on current evidence, candidate measures with the most evidence for internal consistency and reliability are discussed; however, continued assessment of measurement properties in ID populations is a key priority.
Long-term neurocognitive, psychosocial, and physical outcomes after prenatal exposure to radiotherapy: a multicentre cohort study of the International Network on Cancer, Infertility, and Pregnancy
Authors: Indra A Van Assche, Kristel Van Calsteren, Jurgen Lemiere, Jana Hohmann, Jeroen Blommaert, Evangeline A Huis in 't Veld, Elyce Cardonick, Charlotte LeJeune, Nelleke P B Ottevanger, Els P O Witteveen, Martine van Grotel, Marry M van den Heuvel-Eibrink, Lieven Lagae, Maarten Lambrecht, Frédéric Amant
Journal: The Lancet Child & Adolescent Health (2024)
Comparison of non-contrast abbreviated MRI and ultrasound as surveillance modalities for HCC
Authors: Dong Hwan Kim, Jeong Hee Yoon, Moon Hyung Choi, Chang Hee Lee, Tae Wook Kang, Hyun A. Kim, Young-Mi Ku, Jeong Min Lee, Seong Hyun Kim, Kyung Ah Kim, Su Lim Lee, Joon-Il Choi
Journal: Journal of Hepatology (2024)
A novel self-inflatable balloon for treating refractory benign esophageal strictures: a prospective, single-arm, multicenter study
Authors: Longsong Li, Ning Xu, Pengju Wang, Li Liu, Wei Gong, Yawei Bi, Nan Ru, Song Su, Nanjun Wang, Jingyuan Xiang, Ke Han, Ningli Chai, Enqiang Linghu
Journal: International Journal of Surgery (2024)

Background and Aim: Current treatments for refractory benign esophageal strictures (BESs) often take several years and have poor effects. The authors propose a novel method of self-help inflatable balloon (SHIB) and evaluate its efficacy and safety. Methods: A prospective, multicenter study was conducted from January 2019 to March 2022. All enrolled patients were diagnosed with refractory BESs and received SHIB. The primary endpoint was the clinical success rate at 12 months after removing SHIB. The secondary endpoints were the number of days of placing SHIB, and changes from baseline in BMI and health-related quality of life at 1, 3, 6, and 12 months. Results: The clinical success rate was 51.2% (21/41) with the median days of placing SHIB being 104.0 days (range: 62.0–134.5 days), which was higher in the endoscopic group compared to the caustic and surgery groups (63.3 vs. 28.6% vs. 0, P =0.025). All patients (100%) showed significant improvement in dysphagia scores during placing SHIB. Although 20 patients (48.8%) experienced recurrent stricture, the median stricture length was decreased ( P &lt;0.001) and the median intervention-free interval was prolonged ( P &lt;0.001). In all patients, the mean BMI at and health-related quality of life at 1, 3, 6, and 12 months were significantly increased compared with baseline ( P &lt;0.05). On multivariate analysis, stricture etiology and wearing time were independent predictors of recurrent stricture. Conclusions: The SHIB has high efficacy and safety in treating refractory BESs of different origins, especially for endoscopic resection. Stricture etiology and wearing time were independent predictors of recurrent stricture.
Association of hemorrhage-to-treatment time with outcomes in patients with brainstem cavernous malformations: a nationwide cohort study
Authors: Zongze Li, Junlin Lu, Mingjian Liu, Li Ma, Kai Quan, Hongfei Zhang, Peixi Liu, Yuan Shi, Xuchen Dong, Chao You, Rui Tian, Wei Zhu
Journal: International Journal of Surgery (2024)

Background: Brainstem cavernous malformations (BSCMs) often present with haemorrhage, but the optimal timing for microsurgical intervention remains unclear. This study aims to explore how intervention timing relates to neurological outcomes in haemorrhagic BSCM patients undergoing microsurgery, offering insights for clinical decisions. Methods: A total of 293 consecutive patients diagnosed with BSCMs, who underwent microsurgery were identified between March 2011 and January 2023 at two comprehensive centres in China, with a postoperative follow-up duration exceeding 6 months. Utilizing logistic regression models with restricted cubic splines, distinct time groups were identified. Subsequently, matching weight analysis compared these groups in terms of outcomes, new haemorrhage rates, cranial nerve deficits, and perioperative complications. The primary outcome was an unfavourable outcome, which was defined as a mRS score greater than 2 at the latest follow-up. Results: Among the 293 patients, 48.5% were female, median age was (39.9±14.3) years, and median haemorrhage-to-treatment time was 42 days. Patients were categorized into acute (≤21 days), subacute (22–42 days), and delay (&gt;42 days) intervention groups. After matching, 186 patients were analyzed. Adjusted analysis showed lower unfavourable outcome rates for acute [adjusted odds ratio (OR), 0.73; 95% CI, 0.65–0.82; P &lt;0.001] and subacute (adjusted OR, 0.83; 95% CI, 0.72–0.95; P =0.007) groups compared to the delay group. Subacute intervention led to fewer cranial nerve deficits (adjusted OR, 0.76; 95% CI, 0.66–0.88, P &lt;0.001). New haemorrhage incidence didn’t significantly differ among groups. Conclusions: For haemorrhagic BSCMs patients, delayed microsurgical intervention that exceeded 42 days after a prior haemorrhage were associated with an increased risk of unfavourable neurological outcomes.
Impact of immediate postrecanalization cooling on outcome in acute ischemic stroke patients with a large ischemic core: prospective cohort study
Authors: Xuesong Bai, Xin Qu, Raul G. Nogueira, Wenhuo Chen, Hao Zhao, Wenbo Cao, Peng Gao, Bin Yang, Yabing Wang, Jian Chen, Yanfei Chen, Yuxin Wang, Feng Shang, Weitao Cheng, Yueqiao Xu, Meng Qi, Lidan Jiang, Wenjin Chen, Jie Lu, Qingfeng Ma, Ning Wang, Liqun Jiao
Journal: International Journal of Surgery (2024)

Background: Patients with large acute ischemic strokes (AIS) often have a poor prognosis despite successful recanalization due to multiple factors including reperfusion injury. The authors aim to describe our preliminary experience of endovascular cooling in patients with a large AIS after recanalization. Methods: From January 2021 to July 2022, AIS patients presenting with large infarcts (defined as ASPECTS ≤5 on noncontrast CT or ischemic core ≥50 ml on CT perfusion) who achieved successful recanalization after endovascular treatment were analyzed in a prospective registry. Patients were divided into targeted temperature management (TTM) and non-TTM group. Patients in the TTM group received systemic cooling with a targeted core temperature of 33° for at least 48 h. The primary outcome is 90-day favorable outcome [modified Rankin Scale (mRS) 0–2]. The secondary outcomes are 90-day good outcome (mRS 0–3), mortality, intracranial hemorrhage and malignant cerebral edema within 7 days or at discharge. Results: Forty-four AIS patients were recruited (15 cases in the TTM group and 29 cases in the non-TTM group). The median Alberta Stroke Program Early CT Score (ASPECTS) was 3 (2–5). The median time for hypothermia duration was 84 (71.5–147.6) h. The TTM group had a numerically higher proportion of 90-day favorable outcomes than the non-TTM group (46.7 vs. 27.6%, P =0.210), and no significant difference were found regarding secondary outcomes (all P &gt;0.05). The TTM group had a numerically higher rates of pneumonia (66.7 vs. 58.6%, P =0.604) and deep vein thrombosis (33.3 vs. 13.8%, P =0.138). Shivering occurred in 4/15 (26.7%) of the TTM patients and in none of the non-TTM patients ( P =0.009). Conclusions: Postrecanalization cooling is feasible in patients with a large ischemic core. Future randomized clinical trials are warranted to validate its efficacy.