tbuckley/cabot-search huggingface dataset:
A lung full of Cheerios
Authors: Sze Shyang Kho, Mei Ching Yong, Swee Kim Chan, Siew Teck Tie
Journal: Thorax (2018)

A 38-year-old previously fit smoker of 10 pack-years presented with 1 month of progressive worsening exertional dyspnoea. He had no cough, chest pain nor constitutional symptoms. Auscultation of the chest revealed widespread crepitations. Oxygen saturation was 96% on room air, desaturating to 88% after mild exertion. Chest radiograph showed diffuse nodular interstitial infiltrates with significant peribronchial cuffing. CT thorax revealed multiple Cheerio signs of varying sizes and wall thickness, distributed evenly bilaterally (figure 1). There was significant interlobular septal thickening with thickened peribronchovascular bundles, and a thick-walled cavitation in the left lower lobe. Flexible bronchoscopy was performed under fluoroscopy via endotracheal tube. Radial endobronchial ultrasound (R-EBUS) examination at all visible subsegmental branches of the lateral segment of the right lower lobe demonstrated multiple scattered hyperechoic linear arcs and dots, representing patent airspaces (figure 2A,B, arrow). Transbronchial lung cryobiopsy was performed uneventfully at the site of the R-EBUS examination. Histopathological examination revealed invasive lung adenocarcinoma with predominantly micropapillary and …
INDICATIONS FOR COLONOSCOPY SURVEILLANCE IN THE MANAGEMENT OF POST-POLYPECTOMY BLEEDING
Authors: M Hernandez-Tejero, L Rivero-Sanchez, L Llovet, G Jung, P Olivas, O Ortiz, O Sendino, H Córdova, J Llach, M Pellise
Journal: Endoscopy (2018)

Postpolypectomy bleeding (PPB) is the most common complication of colonoscopic polypectomy. The treatment algorithm for the management of PPB is not well established. We aim to evaluate the indications for colonoscopy in the treatment of PPB.
OCCURRENCE OF GASTRIC PRECANCEROUS CONDITIONS IN A NATION-WIDE CONSECUTIVE ENDOSCOPIC POPULATION PRESENTING WITH UPPER GASTROINTESTINAL SYMPTOMS
Authors: E Lahner, M Carabotti, G Esposito, C Hassan, A Zullo, B Annibale
Journal: Endoscopy (2018)

Metaplastic atrophic (MAG) and autoimmune gastritis (AIG) predispose to gastric neoplasias, but are mainly clinically silent. This study aimed to assess MAG occurrence in an endoscopic population with upper-GI-symptoms.
A Gain-of-Function CCR4 Mutations in Adult T-Cell Leukemia/Lymphoma (ATLL) Enhance the Chemotactic Abilities and PI3K/AKT Activation
Authors: Masao Nakagawa, Roland Schmitz, Wenming Xiao, Carolyn K Goldman, Weihong Xu, Yandan Yang, Thomas A Waldmann, Louis M. Staudt
Journal: Blood (2014)
INTRADUCTAL ULTRASOUND FOR SECOND-LEVEL EVALUATION OF BILIARY AND AMPULLARY STENOSES: EXPERIENCE FROM THE TURIN CENTER
Authors: L Venezia, P Cortegoso Valdivia, S Rizza, M Bruno, CG De Angelis
Journal: Endoscopy (2018)

Standard diagnostic approach for biliary strictures like MRCP or CT often is not enough to evaluate biliary strictures and needs to be completed with second level techniques such as EUS and/or IDUS. Aim of this study is to assess sensitivity and specificity of IDUS and brushing in differentiating between malignant and benign lesions compared with standard techniques.
Nivolumab for Relapsed/Refractory Classic Hodgkin Lymphoma After Failure of Autologous Hematopoietic Cell Transplantation: Extended Follow-Up of the Multicohort Single-Arm Phase II CheckMate 205 Trial
Authors: Philippe Armand, Andreas Engert, Anas Younes, Michelle Fanale, Armando Santoro, Pier Luigi Zinzani, John M. Timmerman, Graham P. Collins, Radhakrishnan Ramchandren, Jonathon B. Cohen, Jan Paul De Boer, John Kuruvilla, Kerry J. Savage, Marek Trneny, Margaret A. Shipp, Kazunobu Kato, Anne Sumbul, Benedetto Farsaci, Stephen M. Ansell
Journal: Journal of Clinical Oncology (2018)

Purpose Genetic alterations causing overexpression of programmed death-1 ligands are near universal in classic Hodgkin lymphoma (cHL). Nivolumab, a programmed death-1 checkpoint inhibitor, demonstrated efficacy in relapsed/refractory cHL after autologous hematopoietic cell transplantation (auto-HCT) in initial analyses of one of three cohorts from the CheckMate 205 study of nivolumab for cHL. Here, we assess safety and efficacy after extended follow-up of all three cohorts. Methods This multicenter, single-arm, phase II study enrolled patients with relapsed/refractory cHL after auto-HCT treatment failure into cohorts by treatment history: brentuximab vedotin (BV)-naïve (cohort A), BV received after auto-HCT (cohort B), and BV received before and/or after auto-HCT (cohort C). All patients received nivolumab 3 mg/kg every 2 weeks until disease progression/unacceptable toxicity. The primary end point was objective response rate per independent radiology review committee. Results Overall, 243 patients were treated; 63 in cohort A, 80 in cohort B, and 100 in cohort C. After a median follow-up of 18 months, 40% continued to receive treatment. The objective response rate was 69% (95% CI, 63% to 75%) overall and 65% to 73% in each cohort. Overall, the median duration of response was 16.6 months (95% CI, 13.2 to 20.3 months), and median progression-free survival was 14.7 months (95% CI, 11.3 to 18.5 months). Of 70 patients treated past conventional disease progression, 61% of those evaluable had stable or further reduced target tumor burdens. The most common grade 3 to 4 drug-related adverse events were lipase increases (5%), neutropenia (3%), and ALT increases (3%). Twenty-nine deaths occurred; none were considered treatment related. Conclusion With extended follow-up, responses to nivolumab were frequent and durable. Nivolumab seems to be associated with a favorable safety profile and long-term benefits across a broad spectrum of patients with relapsed/refractory cHL.
DEVELOPMENT OF CLINICAL PHOTOACOUSTIC ENDOSCOPIC PROBE FOR THE GASTROINTESTINAL TRACT: DESIGN AND IMPLEMENTATION
Authors: SJ Choi, HJ Chun, G Min, W Kim, JM Lee, SH Kim, JM Lee, HS Choi, ES Kim, B Keum, YT Jeen, HS Lee, CD Kim
Journal: Endoscopy (2018)

To improve diagnostic accuracy of gastrointestinal diseases, such as gastric and colorectal cancers, it is essential to develop advanced tomographic endoscopic techniques. The major limit of conventional video endoscopy is that it cannot provide such useful diagnostic information as the depth of invasion or vascular connections for advanced high-stage cancers because it solely relies on the visual inspection based on the surface-mapped camera images. At present, endoscopic ultrasound is the only available option for delineating tumor margin and visualizing surrounding structures. However, this technique is still insufficient for evaluating the mentioned diagnostic information due to the poor image contrast for soft tissues.
Nivolumab treatment for patients with non-clear cell renal cell carcinoma: A multicenter retrospective analysis.
Authors: Vadim S. Koshkin, Pedro C. Barata, Nicholas J. Vogelzang, Sumanta K. Pal, Joann Hsu, Kimberly D Allman, Timothy D. Gilligan, Brian I. Rini
Journal: Journal of Clinical Oncology (2017)

4586 Background: Nivolumab (Nivo) is approved for metastatic renal cell carcinoma (mRCC) refractory to prior antiangiogenic therapy. However, the clinical activity of Nivo in non-clear cell RCC subtypes remains unknown as these patients were not part of the trial population. Methods: Patients (pts) from 3 centers who received at least one dose of Nivo as monotherapy for mRCC between 12/2015 and 01/2017 were identified. All patients had histologically-confirmed non-clear cell histology. A retrospective analysis focusing on patient and treatment characteristics, objective response according to RECIST v1.1 and adverse events (AEs) was undertaken. Results: Twenty-three patients were identified. Median age was 59 years (33-82), 78% were male, 61% were white, 30% black and 9% Hispanic. MSKCC risk groups were 19% favorable, 67% intermediate, 14% poor. Most common histologies were Unclassified (48%) and Papillary (44%), followed by Collecting duct and Mucinous tubular and spindle cell carcinoma (MTSCC) (4% each). The majority of pts had ECOG PS 0 (57%) or 1 (33%). At diagnosis, 65% had metastatic disease; most common sites were lung (57%), retroperitoneal lymph nodes (35%), and liver or bone (26% each). Most pts (74%) had prior nephrectomy and had received one (74%) or &gt; 1 (26%) prior systemic therapy, most commonly sunitinib (65%), pazopanib (30%) or axitinib (17%). No pts had prior IL-2, but one pt had atezolizumab on trial. After a median follow-up of 6.5 months (mos) and 8 Nivo doses, median PFS was 4.2 mos and median OS was not reached. Among 21 pts evaluable for best response, 6 (29%) had PR and 4 (19%) had SD. Median time to best response was 5.1 mos. At the time of analysis, 9 pts were still on Nivo, 2 were on treatment break, 8 pts had subsequent treatment after PD on Nivo, and 2 were lost to follow-up. Two of 23 pts died. Most common AEs ( &gt; 10%, any grade) were fever (13%) and fatigue (13%). Nivo treatments were postponed in 6 pts due to intolerance and stopped in3 pts. There were no treatment-related deaths. Conclusions: Nivolumab monotherapy demonstrated a substantial objective response rate and was well tolerated in a heterogeneous population of treatment-refractory patients who had mRCC with non-clear cell histology.
Application des recommandations ANAES de la Coloscopie en France: Enquête de pratique
Authors: J Huppertz, R Coriat, U Chaput, M Gaudric, C Brezault, M Bensoussan, D Lamarque, F Prat, S Chaussade
Journal: Endoscopy (2009)

Introduction: En avril 2004, l'ANAES a édité des recommandations pour la pratique clinique des indications de la coloscopie. En France, aucune enquête de pratique n'a évalué la connaissance par les gastroentérologues des recommandations de l'ANAES.
Benefits of Moderate Physical Activity Despite Frailty
Authors: Anita Slomski
Journal: JAMA (2018)

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 HomeNew OnlineCurrent IssueFor Authors 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) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal
Talking to others' selves: Why a valuational paradigm of agency fails to provide an adequate theoretical framework for moral responsibility, social accountability, and legal liability
Authors: Tobias A Mattei
Journal: Behavioral and Brain Sciences (2018)

Abstract In this commentary, I highlight the importance of a proper discussion of the pragmatic implications of John Doris's paradigm for allocation of personal responsibility proposed in his new book Talking to Our Selves . By employing some classic concepts of the American common law tradition, I discuss why Doris's valuational understanding of agency fails to provide an adequate framework for moral responsibility, social accountability, and legal liability.
Sustained remissions with CD19-specific chimeric antigen receptor (CAR)-modified T cells in children with relapsed/refractory ALL.
Authors: Shannon L. Maude, David T. Teachey, Susan R. Rheingold, Pamela A Shaw, Richard Aplenc, David Maxwell Barrett, Christine S Barker, Colleen Callahan, Noelle V. Frey, Farzana Nazimuddin, Simon F. Lacey, Zhaohui Zheng, Bruce Levine, Jan Joseph Melenhorst, Laura Motley, David L. Porter, Carl H. June, Stephan A. Grupp
Journal: Journal of Clinical Oncology (2016)

3011 Background: Targeted immunotherapy with chimeric antigen receptor (CAR)-modified T cells can produce potent anti-tumor responses. We previously reported complete remissions (CR) and prolonged persistence in children and adults with relapsed/refractory (r/r) acute lymphoblastic leukemia (ALL) treated with CD19-specific CART cells (CTL019). We now report on outcomes and longer follow-up of 59 children with r/r ALL. Methods: T cells collected from the patient were transduced with a lentiviral vector encoding a CAR composed of anti-CD19 scFv, CD3z, and 4-1BB domains, activated/expanded ex vivo with anti-CD3/CD28 beads, and then infused at a dose of 107 to 108cells/kg with a transduction efficiency of 2.3-45%. 54/59 patients received lymphodepleting chemotherapy the week prior to cell infusion. Results: Of 59 patients aged 20mo-24y with CD19+ ALL, 44 had detectable disease prior to CTL019 cell infusion, while 15 were MRD-. 39 were treated for relapse after prior stem cell transplant (SCT). 15 patients had CNS disease within a year of infusion. At assessment 1 month after infusion, 55/59 (93%) were in CR. MRD < 0.01% by flow cytometry was achieved in 52 patients. CTL019 cells were detected in the CSF and no CNS relapses have been seen. With median follow-up 12 mo (1-43 mo), 34 patients had ongoing CR, with only 6 receiving subsequent therapy (5 SCT, 1 donor lymphocyte infusion), RFS was 76% (95% CI, 65-89%) at 6 mo and 55% at 12 mo (95% CI, 42-73%), and OS was 79% (95% CI, 69-91%) at 12 mo. 20 patients subsequently relapsed, 13 with CD19- disease. CTL019 persistence was accompanied by B cell aplasia, which continued up to last assessment (1-39 mo) in 24/34 patients with ongoing CR. Cytokine release syndrome (CRS) was seen in 88% of patients. Severe CRS requiring hemodynamic or respiratory support occurred in 27%, was associated with high disease burden, and was reversed with the anti-IL6R agent tocilizumab. We could predict development of severe CRS through regression modeling using IFNγ, sgp130, and sIL1RA measured in the first 72h (sens 86%, spec 89%, AUC 0.93). Conclusions: Single-agent CTL019 immunotherapy can induce durable responses with control of CNS disease in patients with r/r ALL. Clinical trial information: NCT01626495.
Piperine ameliorates SCA17 neuropathology by reducing ER stress
Authors: Jifeng Guo, Yiting Cui, Qiong Liu, Yang Yang, Yujing Li, Ling Weng, Beisha Tang, Peng Jin, Xiao-Jiang Li, Su Yang, Shihua Li
Journal: Molecular Neurodegeneration (2018)

Spinocerebellar ataxia 17 (SCA17) belongs to the family of neurodegenerative diseases caused by polyglutamine (polyQ) expansion. In SCA17, polyQ expansion occurs in the TATA box binding protein (TBP) and leads to the misfolding of TBP and the preferential degeneration in the cerebellar Purkinje neurons. Currently there is no effective treatment for SCA17. Mesencephalic astrocyte-derived neurotrophic factor (MANF) is a recently identified neurotrophic factor, and increasing MANF expression ameliorated SCA17 neuropathology in TBP-105Q knock-in (KI) mouse model, indicating that MANF could be a therapeutic target for treating SCA17. In this study, we screened a collection of 2000 FDA-approved chemicals using a stable cell line expressing luciferase reporter, which is driven by MANF promoter. We identified several potential candidates that can induce the expression of MANF. Of these inducers, piperine is an agent that potently induces the luciferase expression or MANF expression. Addition of piperine in both cellular and mouse models of SCA17 alleviated toxicity caused by mutant TBP. Although mutant TBP is primarily localized in the nuclei, the polyQ expansion in TBP is able to induce ER stress, suggesting that nuclear misfolded proteins can also elicit ER stress as cytoplasmic misfolded proteins do. Moreover, piperine plays its protective role by reducing toxicity caused by the ER stress. Our study established piperine as a MANF-based therapeutic agent for ER stress-related neuropathology in SCA17.
Role of Sarcopenia in Nonalcoholic Fatty Liver Disease: Definition Is Crucially Important
Authors: Tao‐Chun Peng
Journal: Hepatology (2018)

Potential conflict of interest: Nothing to report. To the Editor: I read with interest the review by Bhanji et al.1 linking sarcopenia with nonalcoholic fatty liver disease (NAFLD). Muscle dysfunction is expected to promote nonalcoholic steatohepatitis and vice versa. We recently reported the importance of defining sarcopenia when exploring the relationship between sarcopenia and NAFLD.2 Thus, I would like to offer the following comments on this topic. I reviewed the data in several articles,3 exploring sarcopenia and NAFLD (Fig. 1). The results indicate that body mass index (BMI) is higher in the sarcopenic group when studies present a positive correlation between sarcopenia and NAFLD. However, BMI is lower in the sarcopenic group when studies present a positive correlation between sarcopenia and end‐stage liver disease (ESLD). BMI is an important risk factor of NAFLD, and it confounds the relationship between sarcopenia and NAFLD in studies using different definitions of sarcopenia. The studies might actually define a population of sarcopenia obesity instead of true sarcopenia. Therefore, it is important to clarify the definition of sarcopenia. However, the heterogeneity of diagnosis methods may make defining sarcopenia challenging. Furthermore, measurements that define sarcopenia are required to identify pathophysiologic mechanisms for targeted therapeutic strategies to NAFLD.Figure 1: Studies regarding the potential association of sarcopenia and NAFLD. Abbreviations: IQR, interquartile range; SD, standard deviation.The muscle function parameters, such as walking speed and grip strength, are also important components of sarcopenia. Although the 6‐minute walking distance is an important predictive factor in liver transplant candidates, slow gait speeds were not found to be associated with NAFLD after controlling for other confounders in our study. Therefore, the true relationship between muscle function and NAFLD requires further investigation. Based on these results, it might be appropriate to discuss NAFLD and ESLD separately in studies evaluating sarcopenia despite the finding that a fraction of patients with NAFLD will progress to ESLD. In addition, a definition of sarcopenia including low muscle mass and function is critically important for future studies related to NAFLD and ESLD.
ACETIC ACID GUIDED BIOPSIES VERSUS MAPPING BIOPSIES FOR BARRETT'S SURVEILLANCE: THE ABBA STUDY
Authors: G Longcroft-Wheaton, C Fogg, A Dewey, J DeCaestecker, H Barr, A Li, P Basford, C Gordon, S Green, D Poller, B Higgins, L Gadeke, M Mccord, J Jankowski, P Bhandari
Journal: Endoscopy (2018)

To compare neoplasia detection with AA targeted biopsies and protocol guided non-targeted biopsies during Barrett's surveillance.
Hepatitis C in Injection-Drug Users — A Hidden Danger of the Opioid Epidemic
Authors: T. Jake Liang, John W. Ward
Journal: New England Journal of Medicine (2018)

Hepatitis C in Injection-Drug Users Hidden beneath the escalating crisis of opioid-overdose deaths in the United States lies another danger: the increasing spread of hepatitis C virus associated with injection-opioid use. The social and economic costs of this epidemic could be staggering.
Propofol Sedation for Endoscopic Procedures in Children
Authors: Y Elitsur, P Blankenship, Z Lawrence
Journal: Endoscopy (2000)

Propofol sedation has been used successfully in various outpatient minor procedures in children. Limited data are available on the usefulness of propofol sedation during gastrointestinal endoscopic procedures in children. The aim of this study was to evaluate our experience of propofol sedation in pediatric gastrointestinal endoscopic procedures.The charts of all children who had undergone diagnostic endoscopic procedures, and were sedated by propofol, were retrospectively reviewed. Demographic data, cardiovascular monitoring, and drug dosages were recorded. Patients evaluated their sedation efficacy by answering a questionnaire before discharge.A total of 104 children underwent 107 procedures. Propofol alone was given in 19 procedures and in combination with midazolam and/or fentanyl in 88 procedures. All procedures were completed and significant complication occurred in only one patient. No significant difference was observed in the amount of sedative drugs or recovery time between upper and lower endoscopic procedures. A lower propofol dosage was needed when a combination of drugs was given compared to propofol drug alone. Patients' assessment of their sedation showed that the vast majority had experienced postendoscopic amnesia.Propofol sedation for endoscopic procedures is safe and acceptable for children. Propofol sedation should be offered to young children, especially those who express significant anxiety.
NURSE PHONE INTERVIEW PRIOR TO COLONOSCOPY – WHAT IS THE BENEFIT ON BOWEL PREPARATION RESULTS AND SAFETY?
Authors: F Taveira, M Craveiro, M Moreira, M Pedrosa, F Santos, P Simões, I Paiva, M Areia, AT Cadime
Journal: Endoscopy (2018)

To understand the added value of a nurse phone interview on the colonoscopy preparation process regarding bowel preparation results and medication safety.
Reframing the approach to patients with hepatocellular carcinoma: Longitudinal assessment with hazard associated with liver transplantation for HCC (HALTHCC) improves ablate and wait strategy
Authors: Daniel J. Firl, Shoko Kimura, John McVey, Koji Hashimoto, Heidi Yeh, Charles M. Miller, James F. Markmann, Kazunari Sasaki, Federico N. Aucejo
Journal: Hepatology (2018)

Patients with hepatocellular carcinoma (HCC) are screened at presentation for appropriateness of liver transplantation (LT) using morphometric criteria, which poorly specifies risk. Morphology is the crux of measuring tumor response to locoregional therapy (LRT) using modified Response Evaluation Criteria in Solid Tumors (mRECIST). This study investigated the utility of following a continuous risk score (hazard associated with liver transplantation in hepatocellular carcinoma; HALTHCC) to longitudinally assess risk. This multicenter, retrospective study from 2002 to 2014 enrolled 419 patients listed for LT for HCC. One cohort had LRT while waiting (n = 351), compared to the control group (n = 68) without LRT. Imaging studies (n = 2,085) were collated to laboratory data to calculate HALTHCC, MORAL, Metroticket 2.0, and alpha fetoprotein (AFP) score longitudinally. Cox proportional hazards evaluated associations of HALTHCC and peri‐LRT changes with intention‐to‐treat (ITT) survival (considering dropout or post‐LT mortality), and utility was assessed with Harrell's C‐index. HALTHCC better predicted ITT outcome (LT = 309; dropout = 110) when assessed closer to delisting ( P &lt; 0.0001), maximally just before delisting (C‐index, 0.742 [0.643‐0.790]). Delta‐HALTHCC post‐LRT was more sensitive to changes in risk than mRECIST. HALTHCC score and peri‐LRT percentage change were independently associated with ITT mortality (hazard ratio = 1.105 [1.045‐1.169] per point and 1.014 [1.004‐1.024] per percent, respectively). Conclusions: HALTHCC is superior in assessing tumor risk in candidates awaiting LT, and its utility increases over time. Peri‐LRT relative change in HALTHCC outperforms mRECIST in stratifying risk of dropout, mortality, and recurrence post‐LT. With improving estimates of post‐LT outcomes, it is reasonable to consider allocation using HALTHCC and not just waiting time. Furthermore, this study supports a shift in perspective, from listing to allocation, to better utilize precious donor organs. (H epatology 2018).