tbuckley/cabot-search huggingface dataset:
TIMING OF UPPER ENDOSCOPY IN GASTROESOPHAGEAL VARICELLA BLEEDING
Authors: M Sousa, S Fernandes, L Proença, AP Silva, S Leite, J Rodrigues, J Silva, J Carvalho
Journal: Endoscopy (2018)

Current guidelines for treatment of gastroesophageal variceal bleeding recommend that upper endoscopy should be performed within the first 12 hours. The objective of this study was to evaluate the outcomes bleeding recurrence rate, 6 weeks mortality rate and 1 year mortality rate in relation to endoscopy timing.
Molecular Minimal Residual Disease in Acute Myeloid Leukemia
Authors: Mojca Jongen-Lavrencic, Tim Grob, Diana Hanekamp, François G. Kavelaars, Adil al Hinai, Annelieke Zeilemaker, Claudia A.J. Erpelinck-Verschueren, Patrycja L. Gradowska, Rosa Meijer, Jacqueline Cloos, Bart J. Biemond, Carlos Graux, Marinus van Marwijk Kooy, Markus G. Manz, Thomas Pabst, Jakob R. Passweg, Violaine Havelange, Gert J. Ossenkoppele, Mathijs A. Sanders, Gerrit J. Schuurhuis, Bob Löwenberg, Peter J.M. Valk
Journal: New England Journal of Medicine (2018)

Patients with acute myeloid leukemia (AML) often reach complete remission, but relapse rates remain high. Next-generation sequencing enables the detection of molecular minimal residual disease in virtually every patient, but its clinical value for the prediction of relapse has yet to be established.We conducted a study involving patients 18 to 65 years of age who had newly diagnosed AML. Targeted next-generation sequencing was carried out at diagnosis and after induction therapy (during complete remission). End points were 4-year rates of relapse, relapse-free survival, and overall survival.At least one mutation was detected in 430 out of 482 patients (89.2%). Mutations persisted in 51.4% of those patients during complete remission and were present at various allele frequencies (range, 0.02 to 47%). The detection of persistent DTA mutations (i.e., mutations in DNMT3A, TET2, and ASXL1), which are often present in persons with age-related clonal hematopoiesis, was not correlated with an increased relapse rate. After the exclusion of persistent DTA mutations, the detection of molecular minimal residual disease was associated with a significantly higher relapse rate than no detection (55.4% vs. 31.9%; hazard ratio, 2.14; P<0.001), as well as with lower rates of relapse-free survival (36.6% vs. 58.1%; hazard ratio for relapse or death, 1.92; P<0.001) and overall survival (41.9% vs. 66.1%; hazard ratio for death, 2.06; P<0.001). Multivariate analysis confirmed that the persistence of non-DTA mutations during complete remission conferred significant independent prognostic value with respect to the rates of relapse (hazard ratio, 1.89; P<0.001), relapse-free survival (hazard ratio for relapse or death, 1.64; P=0.001), and overall survival (hazard ratio for death, 1.64; P=0.003). A comparison of sequencing with flow cytometry for the detection of residual disease showed that sequencing had significant additive prognostic value.Among patients with AML, the detection of molecular minimal residual disease during complete remission had significant independent prognostic value with respect to relapse and survival rates, but the detection of persistent mutations that are associated with clonal hematopoiesis did not have such prognostic value within a 4-year time frame. (Funded by the Queen Wilhelmina Fund Foundation of the Dutch Cancer Society and others.).
DOES THE WITHDRAWAL TIME AFFECT ADENOMA DETECTION IN NON-SCREENING COLONOSCOPIES?
Authors: A Al-Rifaie, M El-Feki, I Al-Talib, M Abdulwahid, A Hopper, M Thoufeeq
Journal: Endoscopy (2018)

There are no studies looking at the relationship between the colonoscopy withdrawal time (CWT) and adenoma detection rate (ADR) in non-screening patients. The aim of the study was to explore the relationship between the CWT and ADR, particularly in the right colon where colonoscopy has been thought to miss cancers.
EXTENDED COLD SNARE POLYPECTOMY FOR SMALL COLORECTAL POLYPS INCREASES THE R0 RESECTION RATE
Authors: Y Abe, S Shinozaki, H Nabeta, R Koyanagi, T Nakamichi, A Lefor, H Hirashima
Journal: Endoscopy (2018)

Despite the widespread use of cold snare polypectomy (CSP), the R0 resection rate is not well documented. The aim of this study is to compare the R0 resection rate of extended CSP with conventional CSP and to assess safety.
The Emerging Clinical Neuroscience of Autism Spectrum Disorder
Authors: Rebecca A. Muhle, Hannah E. Reed, Katharine A. Stratigos, Jeremy Veenstra-VanderWeele
Journal: JAMA Psychiatry (2018)

Autism spectrum disorder (ASD) is a highly prevalent disorder, and community psychiatrists are likely to treat many individuals with ASD during their clinical practice. This clinical case challenge describes a routine evaluation of irritability and self-injury in a preschool-aged child who meets the criteria for ASD. The case also illustrates the importance of known risk factors for ASD, such as chromosomal deletion and prematurity. This clinical neuroscience article seeks to educate the clinician of current avenues of research that can inform and may already affect clinical practice for this patient, while providing a preview of research that may yield biological treatments for ASD within the next decade.A diagnosis of ASD is defined behaviorally; therefore, many genetic and environmental risk factors, working singly or in concert, are linked to ASD. The prenatal period of brain development is particularly sensitive to risk factors such as gene mutation or drug exposure that affect brain development and circuitry formation. Currently, neuroimaging researchers can detect changes in brain connectivity of children with ASD as young as 6 months, followed by an atypical trajectory of brain development through preschool age and ongoing connectivity inefficiencies across the lifespan. Animal and cellular model systems have provided a means for defining the molecular and cellular changes associated with risk factors for ASD. The ability to connect specific treatments to particular subgroups of people with ASD is the defining hope of precision medicine initiatives.The advent of next-generation sequencing technology, advanced imaging techniques, and cutting-edge molecular techniques for modeling ASD has allowed researchers to define ASD risk-related biological pathways and circuits that may, for the first time, unify the effects of disparate risk factors into common neurobiological mechanisms. The path from these mechanisms to biological treatments that improve the lives of individuals with autism remains unclear, but the cumulative output of multiple lines of research suggests that subtyping by genetic risk factors may be a particularly tractable way to capitalize on individual differences amenable to specific treatments.
Use of a Variable-Stiffness Colonoscope Allows Completion of Colonoscopy after Failure with the Standard Adult Colonoscope
Authors: D. A. Shumaker, A. Zaman, R. M. Katon
Journal: Endoscopy (2002)

Experts fail to reach the cecum in 2 - 10% of colonoscopies. The purpose of this case series was to evaluate the efficacy of a small-caliber, variable-stiffness colonoscope in patients with incomplete colonoscopy.The variable-stiffness colonoscope (Olympus America XPCF-140AL) was used by the same examiner to reattempt colonoscopy immediately in all patients in whom colonoscopy to the cecum with the standard colonoscope was incomplete.Sixteen of 385 attempted colonoscopies (4.2%) did not reach the cecum with the standard colonoscope due to looping (n = 12), fixed angulation of the sigmoid colon (n = 3), and diverticulosis (n = 1). The procedures were deemed a failure after a mean of 28 min, despite the use of abdominal pressure and positional change in all patients. Fifteen of the 16 patients (94 %) had a complete colonoscopy with the variable-stiffness colonoscope. One patient had an incomplete colonoscopy with the variable-stiffness colonoscope due to an obstructing mass in the transverse colon that was not reached by the standard colonoscope. With the variable-stiffness colonoscope, the mean time to cecal intubation was 10.3 min; four patients (25 %) required a change in patient position, and six patients (37.5 %) required abdominal pressure.A variable-stiffness colonoscope allowed completion of colonoscopy in all patients without obstruction who had an incomplete colonoscopy with the standard colonoscope. Further study is needed to determine whether the variable-stiffness colonoscope should be used routinely for colonoscopy.
Lung cancer risk to personalise annual and biennial follow-up computed tomography screening
Authors: Anton Schreuder, Cornelia M Schaefer-Prokop, Ernst T Scholten, Colin Jacobs, Mathias Prokop, Bram van Ginneken
Journal: Thorax (2018)

Background All lung cancer CT screening trials used fixed follow-up intervals, which may not be optimal. We developed new lung cancer risk models for personalising screening intervals to 1 year or 2 years, and compared these with existing models. Methods We included participants in the CT arm of the National Lung Screening Trial (2002–2010) who underwent a baseline scan and a first annual follow-up scan and were not diagnosed with lung cancer in the first year. True and false positives and the area under the curve of each model were calculated. Internal validation was performed using bootstrapping. Results Data from 24 542 participants were included in the analysis. The accuracy was 0.785, 0.693, 0.697, 0.666 and 0.727 for the polynomial, patient characteristics, diameter, Patz and PanCan models, respectively. Of the 24 542 participants included, 174 (0.71%) were diagnosed with lung cancer between the first and the second annual follow-ups. Using the polynomial model, 2558 (10.4%, 95% CI 10.0% to 10.8%), 7544 (30.7%, 30.2% to 31.3%), 10 947 (44.6%, 44.0% to 45.2%), 16 710 (68.1%, 67.5% to 68.7%) and 20 023 (81.6%, 81.1% to 92.1%) of the 24 368 participants who did not develop lung cancer in the year following the first follow-up screening round could have safely skipped it, at the expense of delayed diagnosis of 0 (0.0%, 0.0% to 2.7%), 8 (4.6%, 2.2% to 9.2%), 17 (9.8%, 6.0% to 15.4%), 44 (25.3%, 19.2% to 32.5%) and 70 (40.2%, 33.0% to 47.9%) of the 174 lung cancers, respectively. Conclusions The polynomial model, using both patient characteristics and baseline scan morphology, was significantly superior in assigning participants to 1-year or 2-year screening intervals. Implementing personalised follow-up intervals would enable hundreds of participants to skip a screening round per lung cancer diagnosis delayed.
SAPPHIRE: A randomized phase II study of mFOLFOX6 + panitumumab versus 5-FU/LV + panitumumab after 6 cycles of frontline mFOLFOX6 + panitumumab in patients with colorectal cancer.
Authors: Masato Nakamura, Yoshinori Munemoto, Masazumi Takahashi, Masahito Kotaka, Hiroaki Kuroda, Takeshi Kato, Noritaka Minagawa, Shingo Noura, Mutsumi Fukunaga, Hidekazu Kuramochi, Tetsuo Touyama, Takao Takahashi, Yoshito Akagi, Hironaga Satake, Shuichi Kurosawa, Tomoko Miura, Hideyuki Mishima, Junichi Sakamoto, Koji Oba, Naoki Nagata
Journal: Journal of Clinical Oncology (2018)

729 Background: FOLFOX therapy, an infusion of 5-fluorouracil (5-FU) with leucovorin in combination with oxaliplatin (OXA), is a common first-line chemotherapy regimen for unresectable, advanced or recurrent colorectal carcinoma (CRC). However, long-term administration of OXA is associated with peripheral neuropathy (PN); decreasing treatment length of OXA may be beneficial without reducing its efficacy. Methods: Chemotherapy-naïve pts aged ≥20 yrs with RAS wild-type advanced/recurrent CRC were enrolled to receive 6 cycles of panitumumab (Pmab) + mFOLFOX6 once every 2 wks. Pts who completed 6 cycles of Pmab + mFOLFOX6 and confirmed no progressive disease were subsequently randomized 1:1 to continue to receive Pmab + mFOLFOX6 (arm 1) or Pmab + 5-FU/LV (arm 2). The primary endpoint was progression-free survival (PFS) rate at 9 mos after randomization. The threshold PFS rate was defined as 30%, and the expected rate was set at 50%, with a 90% power and a 1-sided alpha value of 0.10. In the primary analysis, a binomial test was conducted separately for each arm. This study was designed as a phase II randomized screening comparison study which does not use direct comparison for the primary analysis. Results: Of 164 enrolled pts who received initial Pmab + mFOLFOX6 treatment, 56 were randomized to arm 1 and 57 to arm 2. PFS rates at 9 mos after randomization were significantly higher than the defined threshold at 44.6% (80% CI, 36.4–53.2) in arm 1 and 47.4% (39.1–55.8) in arm 2. Median PFS after randomization was 9.1 (8.6–11.2) and 9.3 (6.0–13.0) mos, respectively. Grade ≥2 PNs occurred in 6 (10.7%) and 1 (1.8%) pts in arms 1 and 2, respectively. Serious AEs occurred in 14 (25.0%) pts in arm 1 and in 9 (16.7%) pts in arm 2. Conclusions: The results of this trial suggest that Pmab + 5-FU/LV after 6 fixed-cycles of Pmab + mFOLFOX6 may be a treatment option in pts with RAS wild type chemotherapy-naïve advanced/recurrent CRC. Pts treated with Pmab + 5-FU/LV had a lower occurrence of grade ≥2 PNs compared with Pmab + mFOLFOX6. Clinical trial information: NCT02337946.
Detecting Signatures of Positive Selection along Defined Branches of a Population Tree Using LSD
Authors: Pablo Librado, Ludovic Orlando
Journal: Molecular Biology and Evolution (2018)

Identifying the genomic basis underlying local adaptation is paramount to evolutionary biology, and bears many applications in the fields of conservation biology, crop, and animal breeding, as well as personalized medicine. Although many approaches have been developed to detect signatures of positive selection within single populations and population pairs, the increasing wealth of high-throughput sequencing data requires improved methods capable of handling multiple, and ideally large number of, populations in a single analysis. In this study, we introduce LSD (levels of exclusively shared differences), a fast and flexible framework to perform genome-wide selection scans, along the internal and external branches of a given population tree. We use forward simulations to demonstrate that LSD can identify branches targeted by positive selection with remarkable sensitivity and specificity. We illustrate a range of potential applications by analyzing data from the 1000 Genomes Project and uncover a list of adaptive candidates accompanying the expansion of anatomically modern humans out of Africa and their spread to Europe.
FINAL RESULTS OF MULTI-CENTER, PROSPECTIVE, CONTROLLED TRIAL OF THE DUODENO-JEJUNAL BYPASS LINER FOR THE TREATMENT OF TYPE 2 DIABETES MELLITUS IN OBESE PATIENTS
Authors: M Benes, P Drastich, T Hucl, J Spicak
Journal: Endoscopy (2018)

To determine the effectiveness of EB and to identify factors associated with a sub-optimal outcome of EB.
Syndrome de Mallory-Weiss avec saignement actif: l'hémostase endoscopique par ligature est associée à une diminution significative de la récidive hémorragique comparée à l'hémostase par hémoclips plus adrénaline
Authors: S Lecleire, S Ramirez, M Antonietti, V Blondin, E Ben-Soussan, I Iwanicki-Caron, S Hervé, E Lerebours, P Ducrotté
Journal: Endoscopy (2009)

Introduction: Le syndrome de Mallory-Weiss (SMW) est une cause fréquente d'hémorragie digestive haute, habituellement bénigne et de résolution spontanée. Le SMW peut aussi se présenter sous la forme d'une hémorragie sévère avec déglobulisation et saignement actif à l'endoscopie, nécessitant une hémostase endoscopique. Les modalités de l'hémostase endoscopique dans le SMW avec saignement actif ne sont pas codifiées, pouvant associer injection d'adrénaline, ligature élastique, coagulation thermique, mise en place d'hémoclips, ou un traitement combiné. Le but de l'étude était d'évaluer rétrospectivement l'efficacité du traitement du SMW avec saignement actif par ligature élastique comparéà un traitement combiné par adrénaline et hémoclips.
ROLE OF SEMIQUANTITATIVE ELASTOGRAPHY BY STRAIN RATIO IN PREDICTING MALIGNANCY OF PANCREATIC MASSES
Authors: D Vasile Balaban, C Marina, A Zoican, G Robu, I Enache, P Nuta, RS Costache, FI Radu, M Jinga
Journal: Endoscopy (2018)

Endoscopic ultrasound (EUS) is a very useful tool for diagnosing solid pancreatic masses (SPM). Add-on modules such as elastography or contrast-enhanced are used complementary for the evaluation of these lesions. Our aim was to assess the accuracy of semiquantitative elastography by strain ratio (SR) in predicting malignacy of pancreatic masses.
Methods Used to Assess Pharmaceutical Research and Development Costs
Authors: Fred D. Ledley
Journal: JAMA Internal Medicine (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 Internal Medicine HomeNew OnlineCurrent IssueFor Authors Podcast 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) 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 Internal Medicine journal
THE USE OF BIODEGRADABLE ELLA STENT IN THE TREATMENT OF BENIGH ESOPHAGEAL STENOSIS
Authors: D Esposito, F Calabrese, L Fanti, E Viale, PA Testoni
Journal: Endoscopy (2018)

A refractory or recurrent esophageal stenosis is defined when a diameter of the lumen of 14 mm or more can not be obtained over 5 dilatations at 2 week intervals or when it can not be maintained for 4 weeks.
Phase II Study of Crizotinib in East Asian Patients With ROS1-Positive Advanced Non–Small-Cell Lung Cancer
Authors: Yi-Long Wu, James Chih-Hsin Yang, Dong-Wan Kim, Shun Lu, Jianying Zhou, Takashi Seto, Jin-Ji Yang, Noboru Yamamoto, Myung-Ju Ahn, Toshiaki Takahashi, Takeharu Yamanaka, Allison Kemner, Debasish Roychowdhury, Jolanda Paolini, Tiziana Usari, Keith D. Wilner, Koichi Goto
Journal: Journal of Clinical Oncology (2018)

Purpose Approximately 1% to 2% of non-small-cell lung cancers (NSCLCs) harbor a c-ros oncogene 1 ( ROS1) rearrangement. Crizotinib, an inhibitor of anaplastic lymphoma kinase (ALK), ROS1, and MET, has shown marked antitumor activity in a small expansion cohort of patients with ROS1-positive advanced NSCLC from an ongoing phase I study. We assessed the efficacy and safety of crizotinib in the largest cohort of patients with ROS1-positive advanced NSCLC. Patients and Methods This phase II, open-label, single-arm trial enrolled East Asian patients with ROS1-positive (assessed through validated AmoyDx assay [Amoy Diagnostics, Xiamen, China] at three regional laboratories) advanced NSCLC who had received three or fewer lines of prior systemic therapies. Patients were to receive oral crizotinib at a starting dose of 250 mg twice daily and continued treatment until Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1-defined progression (by independent radiology review [IRR]), unacceptable toxicity, or withdrawal of consent. The primary end point was objective response rate (ORR) by IRR. Results In the efficacy and safety analyses, 127 patients were included, with 49.6% still receiving treatment at data cutoff. ORR by IRR was 71.7% (95% CI, 63.0% to 79.3%), with 17 complete responses and 74 partial responses. ORRs were similar irrespective of the number of prior lines of therapy, and responses were durable (median duration of response, 19.7 months; 95% CI, 14.1 months to not reached). Median progression-free survival by IRR was 15.9 months (95% CI, 12.9 to 24.0 months). No new safety signals associated with crizotinib were reported. Conclusion This study demonstrated clinically meaningful benefit and durable responses with crizotinib in East Asian patients with ROS1-positive advanced NSCLC. Crizotinib was generally well tolerated, with a safety profile consistent with previous reports.
COMBINATION OF POCKET-ESD WITH COUNTERTRACTION AND PARTIAL FULL THICKNESS EXCISION FOR AN ADVANCED COLONIC ADENOMA IN THE SETTING OF SEVERE FIBROSIS
Authors: G Mavrogenis, D Ntourakis, I Tsevgas, L Kaklamanis, K Gemos, O Chiotelis, S Tsiakos, D Zachariadis
Journal: Endoscopy (2018)

A 68-year-old female patient with history of surgery and radiotherapy for rectal cancer, was referred for ESD of a flat non-granular polyp (Paris IIa+IIc) located in a sub-stenotic segment of the sigmoid colon. A small incision was made at the anal side and the endoscope was gently pushed in the submucosal space. A submucosal pocket was created following the external markers. Dissection of the right side of the lesion was challenging due to thick fibrosis. A snare was loaded over the extremity of the scope, a clip was placed at the edge of the mucosal flap and then the snare was released and grasped the clip. Back and forward movements of the snare changed the direction of the countertraction as desired. After copious dissection of about 90% of the lesion, the specimen was now hanging from a band of scar tissue fused with the muscle layer. It was hard to recognize the dissection plane; therefore, we proceed to blind dissection taking into account the risk of perforation. Finally, en bloc resection was achieved, leaving a circumferential mucosal defect. A 2 cm long transmural defect was recognized leading into a small blind cavity that was completely closed with clips. The next day the patient developed diffuse abdominal pain and we proceeded to laparoscopy that showed generalized peritonitis. The site of perforation was firmly closed with the endoscopic clips. The abdomen was washed and one surgical drain was placed. The patient was discharged home on day 2 and had an uneventful recovery. Histology showed R0 resection of a tubulo-villous adenoma with high grade dysplasia. The muscular layer was identified in a small portion of the specimen, corresponding to the area with severe fibrosis. At 6 months of follow up, the patient remains asymptomatic.
DOES THE TELEPHONE-BASED REPEATED EDUCATION IMPROVE THE BOWEL PREPARATION QUALITY?
Authors: ES Kim, SJ Choi, G Min, W Kim, JM Lee, SH Kim, JM Lee, HS Choi, B Keum, YT Jeen, HJ Chun, HS Lee, CD Kim
Journal: Endoscopy (2018)

High quality bowel preparation is essential for successful colonoscopy. Bowel preparation quality depends on patient adherence to the preparation instructions. Especially, dietary restrictions and administration method of preparation solution are important. This study aimed to assess the impact of reinforced education for preparation instruction by telephone.
IS MULTIPLE BILIARY STENTS PLACEMENT SUPERIOR TO SINGLE STENT IN THE TREATMENT OF DIFFICULT COMMON BILE DUCT STONES?
Authors: JK Lee, DK Jang, SH Lee, WH Paik, DW Ahn, JM Lee, JK Ryu, YT Kim
Journal: Endoscopy (2018)

Although temporary endoscopic biliary stenting is regarded as an effective procedure in patients with difficult common bile duct (CBD) stones, there have been few studies the effectiveness of multiple stents. This study was to investigate the effectiveness of multiple biliary stents in the treatment of difficult CBD stones.
Hard truths: pictures of crisis and conflict
Authors: Ingrid Torjesen
Journal: BMJ (2018)

Meridith Kohut

This image of a malnourished patient at a state run psychiatric hospital in Barquisimeto, Venezuela, has featured in an exhibition of work by five New York Times photojournalists, held at Sotheby’s in London.

The image is one of several taken by Meridith Kohut illustrating the impact of Venezuela’s severe economic crisis on psychiatric …