tbuckley/cabot-search huggingface dataset:
Percutaneous radiofrequency versus microwave ablation for the treatment of colorectal liver metastases.
Authors: Lawrence Bonne, Katja De Paepe, Nicos Fotiadis, Naureen Starling, Ian Chau, Marco Gerlinger, Sheela Rao, David J. Watkins, James McCall, Dow-Mu Koh, Gina Brown, David Cunningham
Journal: Journal of Clinical Oncology (2018)

401 Background: Microwave (MWA) and radiofrequency (RFA) ablation are commonly used for the treatment of unresectable liver metastases from colorectal cancer (CRC). MWA has a few theoretical advantages over RFA (active heating, less affected by heat sink effect, larger ablation zones, faster) however limited data exists on this field. Our aim was to analyse the safety and efficacy of MWA and RFA in the treatment of CRC liver metastases. Methods: All patients with unresectable CRC liver metastasis who were treated with RFA or MWA in a single center between March 2006 and December 2016 were included. Medical records and imaging studies were reviewed retrospectively for demographic data, to assess for local tumour recurrence and overall survival and to evaluate ablation-related adverse events. Results: 456 ablations were performed in 193 patients (123 men) with a median age of 66 (range 32-91). The majority of patients had a history of surgery of the primary tumour (n=170, 88,1%) and systemic chemotherapy (n=183, 94,8%). 68 patients had a history of liver surgery (35,2%). RFA was used in 343 procedures (75,2%) and MWA in 113 (24,8%). Median number of procedures per patient was 2 (range 1-10). Median lesion size was 17mm (range 3-80mm). Mean follow-up per lesion was 2.0 years in the RFA group and 1.3 years in the MWA group. Local tumour recurrence rate was 45% for RFA and 28% for MWA, with a hazard ratio of 0.6 in favour of MWA (95% CI 0.4-0.9). Two and five year overall survival rates from diagnosis of liver metastasis were 88% and 35% for RFA and 89% and 66% for MWA, respectively. Complications were reported in 43 of 456 procedures (9,4%); In 8,2% of RFAs (n=28) and 13,3% of MWAs (n=15). Complications classified as CTCAE grade 3 or higher were: haemothorax requiring surgery (n=1 for RFA), biloma (n=2 for RFA &amp; MWA), biliary stricture (n=2 for RFA and n=1 MWA), liver failure (n=2 for RFA), liver abscess (n=1 RFA), pneumonia (n=2 for RFA) and pulmonary embolism (n=1 RFA). Segmental portal vein occlusion was only seen with MWA (n=2; 1,8%). One patient died due to multi-organ failure post RFA. Conclusions: MWA could achieve better local tumour control compared with RFA in the treatment of CRC liver metastasis, with slightly higher complication rate.
Child mortality in England compared with Sweden: a birth cohort study
Authors: Ania Zylbersztejn, Ruth Gilbert, Anders Hjern, Linda Wijlaars, Pia Hardelid
Journal: The Lancet (2018)

BackgroundChild mortality is almost twice as high in England compared with Sweden. We aimed to establish the extent to which adverse birth characteristics and socioeconomic factors explain this difference.MethodsWe developed nationally representative cohorts of singleton livebirths between Jan 1, 2003, and Dec 31, 2012, using the Hospital Episode Statistics in England, and the Swedish Medical Birth Register in Sweden, with longitudinal follow-up from linked hospital admissions and mortality records. We analysed mortality as the outcome, based on deaths from any cause at age 2–27 days, 28–364 days, and 1–4 years. We fitted Cox proportional hazard regression models to estimate the hazard ratios (HRs) for England compared with Sweden in all three age groups. The models were adjusted for birth characteristics (gestational age, birthweight, sex, and congenital anomalies), and for socioeconomic factors (maternal age and socioeconomic status).FindingsThe English cohort comprised 3 932 886 births and 11 392 deaths and the Swedish cohort comprised 1 013 360 births and 1927 deaths. The unadjusted HRs for England compared with Sweden were 1·66 (95% CI 1·53–1·81) at 2–27 days, 1·59 (1·47–1·71) at 28–364 days, and 1·27 (1·15–1·40) at 1–4 years. At 2–27 days, 77% of the excess risk of death in England was explained by birth characteristics and a further 3% by socioeconomic factors. At 28–364 days, 68% of the excess risk of death in England was explained by birth characteristics and a further 11% by socioeconomic factors. At 1–4 years, the adjusted HR did not indicate a significant difference between countries.InterpretationExcess child mortality in England compared with Sweden was largely explained by the unfavourable distribution of birth characteristics in England. Socioeconomic factors contributed to these differences through associations with adverse birth characteristics and increased mortality after 1 month of age. Policies to reduce child mortality in England could have most impact by reducing adverse birth characteristics through improving the health of women before and during pregnancy and reducing socioeconomic disadvantage.FundingThe Farr Institute of Health Informatics Research (through the Medical Research Council, Arthritis Research UK, British Heart Foundation, Cancer Research UK, Chief Scientist Office, Economic and Social Research Council, Engineering and Physical Sciences Research Council, National Institute for Health Research, National Institute for Social Care and Health Research, and the Wellcome Trust).
Detection of Creutzfeldt-Jakob disease prions in skin: implications for healthcare
Authors: Akin Nihat, Simon Mead
Journal: Genome Medicine (2018)

Evidence has recently been reported of prion seeding activity in skin tissue from patients with sporadic Creutzfeldt-Jakob disease (sCJD). This is relevant information for infection control measures during surgery. The work uses very sensitive prion assays now available for medical research, and may soon be adapted to related neurodegenerative disorders.
P160Sex differences in the flow-mediated epidermal fluorescence during forearm ischemia and reperfusion
Authors: P Filberek, J Nizinski, G Sibrecht, T Krauze, J Zielinski, K Kusy, J Piskorski, S Michalak, A Wykretowicz, P Guzik
Journal: Cardiovascular Research (2018)

antagonist SR59203A (100nM).The role of the adipokine, adiponectin, was examined using exogenous adiponectin (5mg/ml) and a blocking peptide for adiponectin receptor 1 (5mg/ml).Immunohistochemistry was used to examine b3-adrenoceptor expression.Results: During EFS PVAT elicited a reproducible anti-contractile effect, which was lost in obesity.Solution transfer from stimulated exogenous PVAT to a -PVAT vessel significantly reduced contraction, confirming that stimulated healthy PVAT releases a transferable anti-contractile factor.Pharmacological denervation using 6-hydroxydopamine abolished the anti-contractile effect.In health, the b3-adrenoceptor antagonist SR59203A reduced the anti-contractile effect; however b3-adrenoceptor agonist CL-316,243 could not restore function in obesity.Using immunohistochemistry, expression of b3-adrenoceptors was reduced in obesity.Exogenous application of adiponectin induced vasodilation of healthy vessels, and a blocking peptide for adiponectin receptor-1 significantly reduced the anti-contractile effect of PVAT in health.However, in obese vessels exogenous adiponectin no longer exerted a vasodilator effect.In obese exercised mice, the PVAT anticontractile was restored, and the development of hypertension and type-II diabetes was reversed, although the mice remained obese.Exercise increased b3-adrenoceptor expression, and restored the vasodilator effects of adiponectin.Conclusions: In conclusion, sympathetic nerve stimulation elicits an anti-contractile effect via activation b3-adrenoreceptors and release of adiponectin.This effect was lost in obesity, which may contribute to development of hypertension and type-II diabetes.Exercise restored PVAT dysfunction in obesity, and normalised glucose, insulin, and blood pressure independent of weight loss. P158Red blood cells from patients with type 2 diabetes mellitus induce endothelial dysfunction through NADPH oxidase-derived reactive oxygen species
Low-dose corticosteroids for adult patients with septic shock: a systematic review with meta-analysis and trial sequential analysis
Authors: Sofie Louise Rygård, Ethan Butler, Anders Granholm, Morten Hylander Møller, Jeremy Cohen, Simon Finfer, Anders Perner, John Myburgh, Balasubramanian Venkatesh, Anthony Delaney
Journal: Intensive Care Medicine (2018)
Time to viral suppression does not impact SVR in patients treated with Glecaprevir/Pibrentasvir for 8 weeks
Authors: C. Sarrazin, T. Tran, D. Dylla, J. Feld, S. Arora, D. Victor, Y. Hu, S. Wang, F. Mensa, D. Wyles
Journal: Journal of Hepatology (2018)
Sustained virological suppression and improved renal function with reduced dose tenofovir disoproxil fumarate in renally compromised patients with chronic hepatitis B
Authors: S. Liem, D. Wong, S. Fung, A. Zahirieh, C. Yim, H.A. Shah, J. Feld, B. Hansen, H. Janssen
Journal: Journal of Hepatology (2018)
HCC recurrence under all-oral DAAs-based antiviral therapy in HCV-infected patients: data from Navigatore web platform
Authors: M. Gambato, F.P. Russo, S. Piovesan, A. Romano, A. Zanetto, G. Anastassopoulos, F. Capra, V. Paon, I. Franceschet, A. Carlotto, S. Storato, M. De Bona, P. Rovere, C. Manuppelli, M.T. Giordani, L. Lomonaco, P. Angeli, A. Alberti, P. Burra
Journal: Journal of Hepatology (2018)
Effectiveness of Low Doses of Hyaluronidase to Remove Hyaluronic Acid Filler Nodules
Authors: Murad Alam, Rosemara Hughart, Amelia Geisler, Kapila Paghdal, Amanda Maisel, Alexandra Weil, Dennis P. West, Emir Veledar, Emily Poon
Journal: JAMA Dermatology (2018)

Although hyaluronidase is known to remove hyaluronic acid fillers, use of low doses has not been well studied.To assess the effectiveness and dose-related effect of small quantities of hyaluronidase to treat hyaluronic acid filler nodules.Split-arm, parallel-group, randomized clinical trial at an urban academic center. Participants were 9 healthy women. Recruitment and follow-up occurred from February 2013 to March 2014; data analysis occurred from February to July 2016.Each participant received aliquots (buttons) of either of 2 types of hyaluronic acid fillers into bilateral upper inner arms, respectively. At 1, 2, and 3 weeks each button was treated with a constant volume (0.1 mL) of variable-dose hyaluronidase (1.5, 3.0, or 9.0 U per 0.1 mL) or saline control.Both a blinded dermatologist and the participant independently assessed detectability.Seventy-two treatment sites on 9 women (mean [SD] age, 45.8 [15.7] years) received all interventions and were analyzed. There was a significant difference in physician rater assessment between saline and hyaluronidase at 4 weeks (visual detection: mean difference = 1.15; 95% CI, 0.46-1.80; P < .001; palpability: mean difference = 1.22; 95% CI, 0.61-1.83; P < .001) and 4 months (visual detection: mean difference = 0.77; 95% CI, 0.33-1.26; P = .001; palpability: mean difference = 0.82; 95% CI, 0.38-1.25; P < .001) that was mirrored by participant self-assessment at 4 weeks (visual detection: mean difference = 0.87; 95% CI, 0.26-1.48; P = .006; palpability: mean difference = 1.59; 95% CI, 1.41-1.77; P < .001) and 4 months (visual detection: mean difference = 1.31; 95% CI, 1.09-1.53; P < .001; palpability: mean difference = 1.52; 95% CI, 1.03-2.01; P < .001), and hyaluronidase was associated with greater resolution of buttons compared with normal saline. The 9.0-unit hyaluronidase injection sites were significantly less palpable than the 1.5-unit sites at both 4 weeks (mean difference = 0.50; 95% CI, 0.01-.99; P = .045) and 4 months (mean difference = 0.47; 95% CI, 0.14-0.81; P = .007). Dose dependence was more notable for Restylane-L.Although very small doses of hyaluronidase can remove hyaluronic acid fillers from patient skin, slightly higher doses often result in more rapid resolution.clinicaltrials.gov Identifier: NCT01722916.
P481The involvement of purinergic signaling of peripheral T-lymphocytes in aortic stenosis formation
Authors: A Golovkin, I Kudryavtsev, M Serebryakova, E Zhiduleva, O Irtuga, P Murtazalieva, O Moiseeva
Journal: Cardiovascular Research (2018)

The idea of regulatory impact of purinergic signaling in the functioning of different type of cells and in this way in the pathogenesis of many diseases is now very popular and finds confirmations in different investigations.The aim of the study was to compare subsets of peripheral T-lymphocytes and the expression on their surface ectonucleotidases CD39 and CD73 in patients with severe and mild aortic stenosis and to assume the involvement of T-cell immunity in valve calcification process.We examined 33 patients with severe calcified aortic stenosis (AS) undergoing surgical heart valve replacement (Median of flow gradient was 48.3 (44.0;54.9))(1 group), 47 patients with moderate AS (Median of flow gradient was 20.5 (14.0;28.0))(2 group) and 42 healthy volunteers (3 group).Median age in the first group was 62.5 (57.0;66.0), in the second -58.0 (45.0;66.0), in the third -48.5 (43.0;53.0)years.The relative number of peripheral naı ¨ve (N, CD45RAþCD62Lþ), central memory (CM, CD45RA-CD62Lþ), effector memory (EM, CD45RA-CD62L-) and terminally differentiated CD45RA-positive effector memory (TEMRA, CD45RAþCD62L-) CD45þCD3þCD4þ (Th), CD45þCD3þCD8þ (Tcyt) and CD45þCD3þCD4þCD25bright (Treg) cells as well as the percentages of CD39-and CD73-positive cell within above-mentioned T cell subsets were measured using multicolor flow cytometry.The levels of Tcyt (p¼0.04) and TEMRA Tcyt (p¼0.007) were increased in patients with severe stenosis comparing with mild stenosis.Meanwhile level of Naı ¨ve Treg (p¼0.01) and TEMRA Treg (p<0.001) were decreased.Analyzing the total expression level of ectonucleotidases on T-cells we found that level of CD73þCD39-was decreased in patients with mild stenosis comparing with severe (p<0.001) and with healthy donors (p<0.001).Changes in peripheral T-cells subpopulations in patients with severe aortic stenosis were more pronounced than in healthy donors and patients with moderate stenosis.Taking all the data together we propose that patients with severe stenosis have overexpressed proinflammatory status than the patients with moderate stenosis.Meanwhile decreased number of CD73þCD39-(anti-inflammatory) T-cells in the case of mild stenosis proves this statement and indicates the participation of purinergic signaling in regulation of T-cells inflammation.
Persistent hepatitis C virus infection after liver transplantation: Clinical and virological features*1
Authors: D GRETCH
Journal: Hepatology (1995)

We report a prospective clinical and virological study of 18 patients undergoing orthotopic liver transplantation, selected because of hepatitis C virus (HCV) RNA positivity before transplantation. Nine of the 18 patients (50%) developed chronic active hepatitis (CAH) in liver allografts during the first year posttransplantation; hepatitis was first observed between 6 and 25 weeks posttransplantation. HCV viremia was measured for all patients before transplantation and on posttransplantation days 3, 7, and 14, and months 1, 6, 12, and 24 to 41, by quantitative competitive RNA polymerase chain reaction (QC-PCR). HCV RNA levels on posttransplantation days 3, 7, and 14 were significantly higher among patients who subsequently developed CAH versus those who did not (P < .02 by t-test and Mann-Whitney test on all three dates). However, HCV RNA levels in sera obtained at 1, 6, and 12 months posttransplantation did not correlate with CAH at 1 year or with HCV genotype determined in posttransplantation sera. At least two serial liver biopsy specimens from each patient were stained for HCV nonstructural 4 (NS4) antigen by immunohistochemistry. The intensity of cytoplasmic staining of NS4 antigen was significantly higher for specimens with CAH versus those without CAH (P = .028 by χ2). Three patients developed bridging fibrosis in liver allografts during the first year after transplantation; all three patients had intense (3+) immunostaining for NS4 antigen, and the infecting genotypes were la, lb, and la plus lb, respectively. In summary, the 18 patients all developed high-titer viremia by 1 month after liver transplantation, whereas CAH developed in 50% of allografts during the first year after transplantation. Patients with recurrent CAH were characterized by higher HCV RNA titers during the first 2 weeks posttransplantation and increased staining of HCV NS4 antigen in diseased liver biopsy specimens; however, the role of virological factors in the recurrence of CAH after liver transplantation remains uncertain.
Junk food advertising ban is failing children, MPs hear
Authors: Adrian O’Dowd
Journal: BMJ (2018)

Rules introduced to prevent advertising of unhealthy “junk” food to children are too limited and are failing to stop children seeing such advertisements, experts and campaigners have told MPs.

MPs on the parliamentary health and social care committee quizzed academics, industry figures, and third sector groups during an evidence session on 8 May for their inquiry into childhood obesity.

Rules enforced by the Advertising Standards Authority mean that advertisements for high fat, sugar, or salt products cannot be targeted at under 16s on any media. The authority has panels charged with developing codes of conduct for UK advertisers in this area—the Committee of Advertising Practice …
Abstract 18157: Impact of Betatrophin (ANGPTL8) R59W Mutation for Future Diabetes, and Minimal Modification of Circulating Betatrophin With Strong Statins
Authors: Atsushi Nohara, Masa-aki Kawashiri, Hiroaki Hattori, Tadao Iwasaki, Jianhui Liu, Kunimasa Yagi, Mie Yoshida, Mika Mori, Chiaki Nakanishi, Hayato Tada, Akihiro Inazu, Takeshi Kobayashi, Masakazu Yamagishi, Hiroshi Mabuchi
Journal: Circulation (2015)

Betatrophin (ANGPTL8), also known as “Lipasin” (lipoprotein lipase inhibitor), has been reported as a dual-regulator of glucose and lipid metabolism. Functional variant R59W in betatrophin gene is common in Japanese (minor allele 25%) compared with Caucasian (5%). Little is known about long-term impact of this gene variant, and also about the effect of lipid-lowering drugs on this hormone. Methods: A total of 205 cases with dyslipidemia evaluated with baseline 75gOGTT, and post-heparin lipoprotein lipase activities were registered as a long-term cohort. As lipid-lowering trial, a total of 44 patients (Male 21, Age 65±11 ys) with primary dyslipidemia, and 18 genetically confirmed heterozygous familial hypercholesterolemia (FH) (Male 12, Age 65±10 ys,) were analyzed. Non-FH dyslipidemia was treated with 10mg Atorvastatin, and FH was treated with 20mg Rosuvastatin for 8 weeks. Plasma TG and betatrophin levels were log-transformed for statistical analysis. Results: In long-term cohort, 57 cases already showed diabetic pattern at baseline, 148 cases (Male 82, age 56±15 ys, hetero-FH 48 cases, mean follow-up period 10±3 ys) without diabetes at baseline were finally analyzed. Sixty-two cases (42%) developed newly diabetes mellitus during the follow-up, significantly fewer in FH than non-FH (25% vs. 50%, p &lt;0.005). No differences in BMI, fasting glucose, HbA1c in baseline with R59W genotype. In low LPL activity group (n=31), W carriers showed significant increase in HbA1c compared with RR (2.1±0.5 vs. 0.9±0.4 %, p &lt;0.05), but no differences in normal LPL group. In lipid lowering trial, baseline betatrophin levels were lower in FH group (19±13 vs. 13±6 ng/mL, p &lt;0.05), but no difference with/without R59W variant. Statin treatment slightly decreased betatrophin in dyslipidemia group (-4%, p &lt;0.01) and in FH group (-5%, p &lt;0.01). Changes in betatrophin were positively correlated with changes in LDL-C with statins in both groups. Conclusion: Betatrophin R59W variant was a susceptibility factor of future diabetes mellitus with low LPL activity. Baseline betatrophin levels were lower in FH group than other primary dyslipidemia in lipid-lowering trial. Strong statin treatments slightly decreased betatrophin levels, but effect sizes were minimal.
Is There Validity in Propensity Score–Matched Estimates of Adjuvant Chemotherapy Effects for Patients With Rectal Cancer?
Authors: George J. Chang
Journal: JAMA Oncology (2018)

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