tbuckley/cabot-search huggingface dataset:
Convicted breast surgeon Paterson has sentence increased to 20 years
Authors: Clare Dyer
Journal: BMJ (2017)

The rogue breast surgeon Ian Paterson, who mutilated patients with unnecessary operations, has had his 15 year prison sentence increased to 20 years by the Court of Appeal.

The solicitor general, Robert Buckland, referred the case to the court, arguing that the sentence was unduly lenient for offences that were “so serious and exceptional” and should be increased to 20 years or more.

Lady Justice Hallett, sitting in London with Mrs Justice Carr and Mr Justice Goss, said, “Both the harm and culpability here were exceptionally high.” She said a …
THU0440 Temporal trends of venous thromboembolism risk before and after diagnosis of gout. a general population-based study
Authors: L Li, N McCormick, EC Sayre, J Esdaile, D Lacaille, H Xie, HK Choi, JA Avina-Zubieta
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Data on the risk of venous thromboembolism (VTE, including deep venous thrombosis and pulmonary embolism) in patients with gout are scarce. <h3>Objectives</h3> 1) To estimate the overall risk of VTE in an incident gout cohort; 2) To estimate the temporal trends of VTE before and after gout diagnosis compared with the general population. <h3>Methods</h3> We conducted a matched cohort study using a population based administrative health database that includes all outpatient visits, hospital admissions, vital statistics, and dispensed medications for all residents in British Columbia, Canada. Gout cases were defined using one ICD-9/10 code (274/M10) from a physician or hospital visit. To ensure incident gout, we required that all cases have ≥10 years of prior registration without a gout diagnosis. Gout cases were matched 1:1 with controls on age, sex, and cohort entry time. Prior VTE events were excluded after matching. VTE was defined using ICD-9/ICD-10 codes plus use of oral anti-coagulant. We calculated incidence rate ratios (IRRs) and age, sex, and entry time matched multivariable hazard ratios (HRs) for the risk of VTE. Sensitivity analyses were conducted to assess for unmeasured confounders (e.g., obesity). <h3>Results</h3> Among 105,307 individuals with newly diagnosed gout (61% male, mean age of 58 yrs), we observed 1,212 VTE events (mean follow-up time of 5.3 yrs). The fully adjusted HR was 1.27 (95% CI, 1.16–1.39) (Table 1). Our results remained significant in the sensitivity analyses (OR of 2.0 between gout and unmeasured confounder and a 50% prevalence for obesity). There were 437 incident VTE events within 3 yrs prior to the gout diagnosis. Compared to controls, during the 3rd, 2nd, and 1st yrs before gout diagnosis, the fully adjusted HRs for VTE in patients with imminent gout were 1.51, 1.58 and 1.73. The corresponding HRs in the 1st, 2nd, 3rd, 4th, and 5th yrs after gout diagnosis were 1.54, 1.39, 1.38, 1.37, and 1.32, respectively. <h3>Conclusions</h3> Patients with gout have an increased risk of VTE. The risk increases gradually before gout diagnosis, peaks in the year prior to gout diagnosis, and then progressively declines. Our findings suggest that hyperuricemia or gout associated inflammation may be a contributing factor for VTE. <h3>Disclosure of Interest</h3> None declared
Reply to Ugo De Giorgi, Vincenza Conteduca, and Emanuela Scarpi's Letter to the Editor re: Marzia Del Re, Elisa Biasco, Stefania Crucitta, et al. The Detection of Androgen Receptor Splice Variant 7 in Plasma-derived Exosomal RNA Strongly Predicts Resistance to Hormonal Therapy in Metastatic Prostate Cancer Patients. Eur Urol 2017;71:680–7
Authors: Marzia Del Re, Elisa Biasco, Stefania Crucitta, Lisa Derosa, Eleonora Rofi, Cinzia Orlandini, Mario Miccoli, Luca Galli, Alfredo Falcone, Guido W. Jenster, Ron H. van Schaik, Romano Danesi
Journal: European Urology (2017)
03.18 Cd40-mediated activation of noncanonical NF-κB signalling in dendritic cells induces extrathymic autoimmune regulator (aire) expression
Authors: Leonie Huitema, Jan Piet van Hamburg, Boy Helder, Toni van Capel, Luc Pilotte, Cristina Lebre, Louis Boon, Ola Winqvist, Esther de Jong, Sander Tas
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Nuclear factor (NF)-κB signalling plays an important role in the regulation of immune responses. We have previously demonstrated that CD40-mediated noncanonical NF-κB signalling in dendritic cells (DC) induces the immunoregulatory enzyme indoleamine 2,3-dioxygenase (IDO). Noncanonical NF-κB signalling is also important for AIRE expression in the thymus, which is essential for establishment of central tolerance. In the periphery, extrathymic AIRE-expressing antigen presenting cells (including DC) can induce or maintain peripheral tolerance. However, stimuli that induce extrathymic AIRE expression in DC are hitherto unknown. <h3>Materials and methods</h3> AIRE expressing cells were characterised by confocal microscopy in tonsil tissue and inflamed tissues from patients with rheumatoid arthritis (RA) and primary Sjögren's Syndrome (pSS). Monocyte-derived DC (moDC), peripheral blood conventional DC (cDC) and plasmacytoid DC (pDC) were stimulated by anti-CD40 to induce NF-κB activation. Gene transcription and protein expression levels of AIRE, IDO and noncanonical NF-κB signalling components were detected by real time-PCR, Western blot and confocal microscopy. Expression of NF-κB-inducing kinase (NIK), the main activating kinase of the noncanonical pathway, was modulated by siRNA-mediated silencing. <h3>Results</h3> First, we identified AIRE expressing cells in inflamed tonsil tissue, RA synovial tissue and pSS glandular tissue and could demonstrate that these cells have DC characteristics, including MHCII, CD40 and CD11c expression. Next, we demonstrated that CD40-stimulation of moDC and pDC, but not cDC was accompanied by upregulation of AIRE expression. This upregulation was crucially dependent on noncanonical NF-κB signalling, since AIRE expression was abrogated by NIK siRNA-mediated silencing and was not affected by either inhibition or induction of canonical NF-κB signalling. Furthermore, preliminary data show that CD40-stimulated moDC from APECED (AIRE deficient) patients exhibited increased T cell proliferation in a mixed lymphocyte reaction compared to healthy individuals. <h3>Conclusions</h3> Collectively, our data demonstrate that AIRE expression in DC is critically dependent on CD40-mediated noncanonical NF-κB signalling. These findings suggest a role for peripheral AIRE expression in controlling T cell proliferation during adaptive immune responses, including the inflamed target tissues of patients with RA and pSS. These findings could potentially be exploited as a novel approach to boost peripheral tolerance and induce immune regulation.
18F-DCFBC Prostate-Specific Membrane Antigen–Targeted PET/CT Imaging in Localized Prostate Cancer
Authors: Baris Turkbey, Esther Mena, Liza Lindenberg, Stephen Adler, Sandra Bednarova, Rose Berman, Anita T. Ton, Yolanda McKinney, Philip Eclarinal, Craig Hill, George Afari, Sibaprasad Bhattacharyya, Ronnie C. Mease, Maria J. Merino, Paula M. Jacobs, Bradford J. Wood, Peter A. Pinto, Martin G. Pomper, Peter L. Choyke
Journal: Clinical Nuclear Medicine (2017)

To assess the ability of (N-[N-[(S)-1,3-dicarboxypropyl]carbamoyl]-4-F-fluorobenzyl-L-cysteine) (F-DCFBC), a prostate-specific membrane antigen-targeted PET agent, to detect localized prostate cancer lesions in correlation with multiparametric MRI (mpMRI) and histopathology.
Minimal Residual Disease Assessment of Common and Rare NPM1 Mutations Using a Single Massively Multiplex Digital PCR Assay
Authors: Nuria Mencia-Trinchant, Aya Youssef, Yang Hu, Fatima Ali, Ellen K. Ritchie, Monica L. Guzman, Gail J. Roboz, Duane C Hassane
Journal: Blood (2016)
Première évaluation française de l’image 3D virtuelle en temps réel pour la réalisation de coloscopies
Authors: P Faure, G Rateb, J Moreau, L Buscail, J Escourrou
Journal: Endoscopy (2004)

Introduction: Même pour des opérateurs avertis, la progression du coloscope jusqu’au cæcum est rendue parfois difficile par la présence de boucles. Le nouveau endoscope ScopeGuide Olympus® contient un procédé électromagnétique permettant d’obtenir en temps réel une image en 3D virtuelle de son endoscope, facilitant ainsi la visualisation des boucles. Notre objectif était d’évaluer l’apport de cette nouvelle technique dans la pratique quotidienne de la coloscopie par des opérateurs entraînés. Patients et Méthodes: Une coloscopie sous anesthésie générale (propofol) était réalisée chez 79 patients consécutifs répartis en 2 groupes. Chez 40 patients (groupe 1), la coloscopie était réalisée avec un vidéo coloscope ScopeGuide® alors que chez 39 patients (groupe 2) la coloscopie était pratiquée avec une vidéo coloscope sans imageur 3D. Les opérateurs (n = 4) avaient tous une expérience > 5 ans. Les 2 groupes de patients étaient comparables concernant l’age, le sexe, les antécédents chirurgicaux ou l’indication de l’examen. L’évaluation était basée sur le temps de progression, le nombre de boucles et de compressions abdominales. Résultats: Le temps total de progression jusqu’au cæcum n’était pas inférieur dans le groupe 1 par rapport au groupe 2. Au contraire une augmentation significative du temps de réalisation de l’examen était observé au début (9 min 20 vs 7 min 45); ce résultat correspondant au temps d’apprentissage de chaque opérateur avec ce nouvel endoscope. Dans la groupe 1, toutes les coloscopies étaient complètes jusqu’au cæcum sans échec. Dans le groupe 2 sans imageur 3D, 1 endoscopie n’a pu être réalisée jusqu’au caecum en raison de boucles chez un patient acromégale. La progression jusqu’au cæcum sans boucle était significativement augmentée dans le groupe 1 par rapport au groupe 2.
Intérêts de la Sédation contrôlée par le patient pendant la coloscopie
Authors: T Crépeau, L Poincloux, C Bonny, F Artigue, P Walleckx, JE Bazin, M Dapoigny, G Bommelaer
Journal: Endoscopy (2004)

Introduction: En France, la coloscopie est pratiquement toujours réalisée sous anesthésie ce qui n’est pas le cas dans d’autres pays. Cette pratique alourdit la procédure et augmente les coûts. Notre objectif était d’évaluer la possibilité d’alléger la prise en charge anesthésique en utilisant la Sédation Contrôlée par le Patient (SCP). Patients et Méthodes: L’étude s’est déroulée durant 41 semaines consécutives. Sur 402 patients devant bénéficier d’une coloscopie, on a proposé à 173 d’entre eux de participer: 72 ont accepté et ont été randomisés. Ceux du groupe contrôle recevaient une »sédation intra-veineuse continue« (C) administrée par un anesthésiste. Dans le groupe »SCP«, les patients commandaient eux-même l’injection de bolus de Propofol à l’aide d’une pompe d’auto-administration et sous la surveillance d’un anesthésiste. Le critère de jugement principal était la satisfaction du malade évaluée sur une échelle visuelle analogique (de 0 mm = pas du tout satisfait à 100 mm = très satisfait) 4 heures après la coloscopie. Résultats: Il n’y avait pas de différence concernant l’âge, le sexe, l’indice de masse corporelle, les antécédents de coloscopie et de chirurgie pelvienne ou colique entre les deux groupes. Il y a eu 2 échecs de la SCP (5,7%), nécessitant l’intervention de l’anesthésiste pour terminer l’examen. Les scores moyens de satisfaction des 2 groupes n’étaient pas significativement différents: 91,5 mm (C) vs 84,7 mm (SCP). Les doses moyennes de Propofol délivrées (60 mg vs 248 mg; p < 0,001), la profondeur de sédation et le nombre d’heures de surveillance (1,75 vs 4,45) étaient significativement plus faibles pour les patients du groupe SCP; 9 (25,7%) d’entre eux n’ont eu aucune anesthésie. Les temps d’examen (19,4 min (SCP) vs 18 min (C)), la difficulté de réalisation et le nombre de polypectomies n’étaient pas différent entre les deux groupes. A 15 jours, 96,5% des patients du groupe SCP acceptaient un futur examen dans les mêmes conditions contre 72,5% dans le groupe »sédation continue« (p = 0,03). Conclusion: Cette étude montre que la SCP est une méthode satisfaisante pour les patients et applicable en pratique courante. Elle démontre que les besoins en anesthésie sont largement surestimés. Nos résultats apportent des arguments de poids dans la discussion sur la sédation par des non-anesthésistes et devraient nous inciter à proposer plus souvent aux patients ce mode de sédation.
Vulnerability for Alcohol Use Disorder and Rate of Alcohol Consumption
Authors: Joshua L. Gowin, Matthew E. Sloan, Bethany L. Stangl, Vatsalya Vatsalya, Vijay A. Ramchandani
Journal: American Journal of Psychiatry (2017)

Although several risk factors have been identified for alcohol use disorder, many individuals with these factors do not go on to develop the disorder. Identifying early phenotypic differences between vulnerable individuals and healthy control subjects could help identify those at higher risk. Binge drinking, defined as reaching a blood alcohol level of 80 mg%, carries a risk of negative legal and health outcomes and may be an early marker of vulnerability. Using a carefully controlled experimental paradigm, the authors tested the hypothesis that risk factors for alcohol use disorder, including family history of alcoholism, male sex, impulsivity, and low level of response to alcohol, would predict rate of binging during an individual alcohol consumption session.
Mobile Apps for the Management of Diabetes
Authors: Sarah Chavez, David Fedele, Yi Guo, Angelina Bernier, Megan Smith, Jennifer Warnick, François Modave
Journal: Diabetes Care (2017)

Approximately 29 million Americans are diagnosed with diabetes. The increased prevalence of type 2 diabetes (T2D) and required intensity of disease management programs are straining health systems, especially in primary care where physicians often lack adequate time with patients. Mobile technologies (e.g., smartphones, wearable devices) provide highly scalable new approaches to T2D management. Approximately 77% of American adults have access to a smartphone regardless of socioeconomic status or ethnicity (1), and more than 50% of smartphone owners use their mobile devices to obtain health information (2). However, mobile health (mHealth) applications (apps) have been found to lack evidence-based support when functionalities and information provided in apps are compared with clinical guidelines for specific disease management (3). The objective of this study was to assess whether popular apps for diabetes management were of sufficient quality to complement clinical care. We used the Mobile App Rating Scale (MARS) (4), a reliable and validated scoring instrument of mHealth app quality, to assess the quality of the most popular free …
Quality and Safety in Health Care, Part XXXI
Authors: Jay A. Harolds
Journal: Clinical Nuclear Medicine (2017)

The Transcatheter Valve Therapy Registry has been very helpful in providing data to better understand patient risk factors for transcatheter aortic valve replacement (TAVR). The outcome of TAVR depends on many patient indicators, some of which are given in this article, including the age, dependence on oxygen, classification of pulmonary disease, gender, and the speed of walking. Patient characteristics also help determine which approach will be used to place the device. There are models for the outcome of the TAVR procedure now and more being developed.
Subclinical Atrial Fibrillation in Older Patients
Authors: Jeff S. Healey, Marco Alings, Andrew Ha, Peter Leong-Sit, David H. Birnie, Jacob J. de Graaf, Michel Freericks, Atul Verma, Jia Wang, Darryl Leong, Hisham Dokainish, Francois Philippon, Walid Barake, William F. McIntyre, Kim Simek, Michael D. Hill, Shamir R. Mehta, Mark Carlson, Frank Smeele, A. Shekhar Pandey, Stuart J. Connolly
Journal: Circulation (2017)

Long-term continuous electrocardiographic monitoring shows a substantial prevalence of asymptomatic, subclinical atrial fibrillation (SCAF) in patients with pacemakers and patients with cryptogenic stroke. Whether SCAF is also common in other patients without these conditions is unknown.We implanted subcutaneous electrocardiographic monitors (St. Jude CONFIRM-AF) in patients ≥65 years of age attending cardiovascular or neurology outpatient clinics if they had no history of atrial fibrillation but had any of the following: CHA2DS2-VASc score of ≥2, sleep apnea, or body mass index >30 kg/m2. Eligibility also required either left atrial enlargement (≥4.4 cm or volume ≥58 mL) or increased (≥290 pg/mL) serum NT-proBNP (N-terminal pro-B-type natriuretic peptide). Patients were monitored for SCAF lasting ≥5 minutes.Two hundred fifty-six patients were followed up for 16.3±3.8 months. Baseline age was 74±6 years; mean CHA2DS2-VASc score was 4.1±1.4; left atrial diameter averaged 4.7±0.8 cm; and 48% had a prior stroke, transient ischemic attack, or systemic embolism. SCAF ≥5 minutes was detected in 90 patients (detection rate, 34.4%/y; 95% confidence interval [CI], 27.7-42.3). Baseline predictors of SCAF were increased age (hazard ratio [HR] per decade, 1.55; 95% CI, 1.11-2.15), left atrial dimension (HR per centimeter diameter, 1.43; 95% CI, 1.09-1.86), and blood pressure (HR per 10 mm Hg, 0.87; 95% CI, 0.78-0.98), but not prior stroke. The rate of occurrence of SCAF in those with a history of stroke, systemic embolism, or transient ischemic attack was 39.4%/y versus 30.3%/y without (P=0.32). The cumulative SCAF detection rate was higher (51.9%/y) in those with left atrial volume above the median value of 73.5 mL.SCAF is frequently detected by continuous electrocardiographic monitoring in older patients without a history of atrial fibrillation who are attending outpatient cardiology and neurology clinics. Its clinical significance is unclear.URL: http://www.clinicaltrials.gov. Unique identifier: NCT01694394.
Specificities of the intestinal microbiota in patients with inflammatory bowel disease and <i>Clostridium difficile</i> infection
Authors: Harry Sokol, Sarah Jegou, Claire McQuitty, Marjolene Straub, Valentin Leducq, Cecilia Landman, Julien Kirchgesner, Guillaume Le Gall, Anne Bourrier, Isabelle Nion-Larmurier, Jacques Cosnes, Philippe Seksik, Mathias L. Richard, Laurent Beaugerie
Journal: Gut Microbes (2017)

Clostridium difficile infection (CDI) is a common complication in inflammatory bowel disease (IBD) and has been associated with poor IBD outcome. Intestinal microbiota composition in IBD patients with CDI has not been specifically evaluated to date. The fecal microbiota of 56 IBD patients, including 8 in flare with concomitant CDI, 24 in flare without CDI, and 24 in remission, as well as 24 healthy subjects, was studied using 16S sequencing. Analysis was performed using the Qiime pipeline. Compared to IBD patients without CDI, IBD patients with CDI had more pronounced dysbiosis with higher levels of Ruminococcus gnavus and Enterococcus operational taxonomic units (OTUs) and lower levels of Blautia and Dorea OTUs. Correlation network analysis suggested a disrupted ecosystem in IBD patients in flare, particularly in those with CDI. In patients with IBD, CDI is associated with a more pronounced intestinal dysbiosis with specific alterations in intestinal microorganisms.
フィトステロール製品中の脂肪型はそのコレステロール低下の可能性に影響を及ぼす:RCTの系統的レビューとメタ分析【Powered by NICT】
Authors: J A Ferguson Jessica, Stojanovski Elizabeth, MacDonald-Wicks Lesley, L Garg Manohar
Journal: Progress in Lipid Research (2016)
PS01.80: Genome-Wide Screen of DNA Methylation Changes Reveals GABBR2 as a Novel Potential Target for EGFR 19 Deletion Adenocarcinoma with Erlotinib
Authors: Xiaomin Niu, Fatao Liu, Yi Zhou, Zhen Zhou, Yun Liu, Zhiwei Chen, Shun Lu
Journal: Journal of Thoracic Oncology (2016)
PTH-029 Multicentre european evaluation of a novel technology (blue light imaging) in the optical diagnosis of small colorectal polyps
Authors: S Subramaniam, K Kandiah, P Aepli, Wurm Johansson, E Schoon, M Stefanovic, P Bhandari
Journal: Endoscopy (2017)

<h3>Introduction</h3> The advent of image enhanced endosopic modalities have paved the way for better optical diagnosis of colorectal polyps. Fujifilm recently introduced a new technology – Blue Light Imaging (BLI) that utilises powerful light emitting diode (LED) technology and short wavelength absorption of haemoglobin with no post processor digital reconstruction to enhance mucosal surface and vessel patterns. This is a novel concept. The aim of this study was to investigate the diagnostic ability of BLI in the optical diagnosis of diminutive colorectal polyps. <h3>Method</h3> Images from a library of 32 polyps (size 1–9 mm, combination of 19 adenomas and 13 non adenomas) was used. 64 images with equal proportions of high definition white light (HDWL) and BLI were shown to a panel of 6 expert endoscopists with experience in using image enhanced endoscopy. The endoscopists were blinded to the proportion of adenomas in the images viewed. They independently classified each of the 64 images as adenoma or hyperplastic using the established Narrow band imaging International Colorectal Endoscopic (NICE) classification as no standard BLI classification exists. A level of confidence was assigned to each prediction. The sensitivity, specificity, negative (NPV) and positive predictive values (PPV) for adenoma detection on HDWL and BLI were calculated alongside the confidence levels. <h3>Results</h3> A total of 384 observations were made with an adenoma prevalence of 59.4%. The table below shows the sensitivity, specificity, NPV and PPV for adenoma detection on HDWL and BLI. The diagnostic accuracy using BLI was significantly higher (109/119, 91.6%) for high confidence predictions compared to 75.6% (59/78) for predictions made with low confidence (p=0.002). <h3>Conclusion</h3> We have demonstrated the feasibility of using novel BLI technology in the optical diagnosis of small colorectal polyps. BLI improves the accuracy and sensitivity of endoscopic diagnosis with accuracy rates reaching 92% when high confidence predictions were made. These gains can be maximised by developing a dedicated BLI specific classification system and training module to enable its validation and subsequent application in clinical practice. <h3>Disclosure of Interest</h3> S. Subramaniam: None Declared, K Kandiah: None Declared, P Aepli: None Declared, G Wurm Johansson: None Declared, E Schoon: None Declared, M Stefanovic: None Declared, P Bhandari Conflict with: Educational grants from Fujifilm, Olympus and Pentax
The intensive care medicine research agenda for airways, invasive and noninvasive mechanical ventilation
Authors: Samir Jaber, Giacomo Bellani, Lluis Blanch, Alexandre Demoule, Andrés Esteban, Luciano Gattinoni, Claude Guérin, Nicholas Hill, John G. Laffey, Salvatore Maurizio Maggiore, Jordi Mancebo, Paul H. Mayo, Jarrod M. Mosier, Paolo Navalesi, Michael Quintel, Jean Louis Vincent, John J. Marini
Journal: Intensive Care Medicine (2017)