tbuckley/cabot-search huggingface dataset:
New Persistent Opioid Use After Minor and Major Surgical Procedures in US Adults
Authors: Chad M. Brummett, Jennifer F. Waljee, Jenna Goesling, Stephanie Moser, Paul Lin, Michael J. Englesbe, Amy S. B. Bohnert, Sachin Kheterpal, Brahmajee K. Nallamothu
Journal: JAMA Surgery (2017)

<h3>Importance</h3> Despite increased focus on reducing opioid prescribing for long-term pain, little is known regarding the incidence and risk factors for persistent opioid use after surgery. <h3>Objective</h3> To determine the incidence of new persistent opioid use after minor and major surgical procedures. <h3>Design, Setting, and Participants</h3> Using a nationwide insurance claims data set from 2013 to 2014, we identified US adults aged 18 to 64 years without opioid use in the year prior to surgery (ie, no opioid prescription fulfillments from 12 months to 1 month prior to the procedure). For patients filling a perioperative opioid prescription, we calculated the incidence of persistent opioid use for more than 90 days among opioid-naive patients after both minor surgical procedures (ie, varicose vein removal, laparoscopic cholecystectomy, laparoscopic appendectomy, hemorrhoidectomy, thyroidectomy, transurethral prostate surgery, parathyroidectomy, and carpal tunnel) and major surgical procedures (ie, ventral incisional hernia repair, colectomy, reflux surgery, bariatric surgery, and hysterectomy). We then assessed data for patient-level predictors of persistent opioid use. <h3>Main Outcomes and Measures</h3> The primary outcome was defined a priori prior to data extraction. The primary outcome was new persistent opioid use, which was defined as an opioid prescription fulfillment between 90 and 180 days after the surgical procedure. <h3>Results</h3> A total of 36 177 patients met the inclusion criteria, with 29 068 (80.3%) receiving minor surgical procedures and 7109 (19.7%) receiving major procedures. The cohort had a mean (SD) age of 44.6 (11.9) years and was predominately female (23 913 [66.1%]) and white (26 091 [72.1%]). The rates of new persistent opioid use were similar between the 2 groups, ranging from 5.9% to 6.5%. By comparison, the incidence in the nonoperative control cohort was only 0.4%. Risk factors independently associated with new persistent opioid use included preoperative tobacco use (adjusted odds ratio [aOR], 1.35; 95% CI, 1.22-1.50), alcohol and substance abuse disorders (aOR, 1.36; 95% CI, 1.02-1.80), mood disorders (aOR, 1.25; 95% CI, 1.10-1.43), anxiety (aOR, 1.24; 95% CI, 1.09-1.42), and preoperative pain disorders (back pain: aOR, 1.21; 95% CI, 1.08-1.36; arthritis: aOR, 1.24; 95% CI, 1.12-1.37; and centralized pain: aOR, 1.28; 95% CI, 1.16-1.41). <h3>Conclusions and Relevance</h3> New persistent opioid use after surgery is common and is not significantly different between minor and major surgical procedures but rather associated with behavioral and pain disorders. This suggests its use is not due to surgical pain but addressable patient-level predictors. New persistent opioid use represents a common but previously underappreciated surgical complication that warrants increased awareness.
Gastrointestinal safety of celecoxib versus naproxen in patients with cardiothrombotic diseases and arthritis after upper gastrointestinal bleeding (CONCERN): an industry-independent, double-blind, double-dummy, randomised trial
Authors: Francis K L Chan, Jessica Y L Ching, Yee Kit Tse, Kelvin Lam, Grace L H Wong, Siew C Ng, Vivian Lee, Kim W L Au, Pui Kuan Cheong, Bing Y Suen, Heyson Chan, Ka Man Kee, Angeline Lo, Vincent W S Wong, Justin C Y Wu, Moe H Kyaw
Journal: The Lancet (2017)
Shared and Divergent Stimulatory Effects of S100A4 and Uric Acid on Proliferation and Chemotaxis of Mesenchymal Stem Cells (MSCs). Interplay Between Necrotic Tumor Material and Immunosuppressive MSCs within Tumor Microenvironment,
Authors: Judith Luiza Eisenbacher, Tatjana Yildiz, Hubert Schrezenmeier, Ramin Lotfi
Journal: Blood (2011)
Toward Noninvasive Assessment of CVP Variations Using Real-Time and Quantitative Liver Stiffness Estimation
Authors: Olivier Villemain, Fidelio Sitefane, Mathieu Pernot, Sophie Malekzadeh-Milani, Mickael Tanter, Damien Bonnet, Younes Boudjemline
Journal: JACC. Cardiovascular imaging (2017)
Comparing immediate‐type food allergy in humans and companion animals—revealing unmet needs
Authors: I. Pali‐Schöll, M. De Lucia, H. Jackson, J. Janda, R. S. Mueller, E. Jensen‐Jarolim
Journal: Allergy (2017)

Adverse food reactions occur in human as well as veterinary patients. Systematic comparison may lead to improved recommendations for prevention and treatment in both. In this position paper, we summarize the current knowledge on immediate-type food allergy vs other food adverse reactions in companion animals, and compare this to the human situation. While the prevalence of food allergy in humans has been well studied for some allergens, this remains to be investigated for animal patients, where owner-reported as well as veterinarian-diagnosed food adverse reactions are on the increase. The characteristics of the disease in humans vs dogs, cats, and horses are most often caused by similar, but sometimes species-dependent different pathophysiological mechanisms, prompting the specific clinical symptoms, diagnoses, and treatments. Furthermore, little is known about the allergen molecules causative for type I food allergy in animals, which, like in human patients, could represent predictive biomarkers for risk evaluation. The definite diagnosis of food allergy relies-as in humans-on elimination diet and provocation tests. Besides allergen avoidance in daily practice, novel treatment options and tolerization strategies are underway. Taken together, numerous knowledge gaps were identified in veterinary food allergy, which need to be filled by systematic comparative studies.
Recent acute prerace systemic illness in runners increases the risk of not finishing the race: SAFER study V
Authors: Leigh Gordon, Martin Schwellnus, Sonja Swanevelder, Esme Jordaan, Wayne Derman
Journal: British Journal of Sports Medicine (2017)

There are limited data on the negative effects of exercise in athletes with acute infective illness. The aim of this study was to determine whether a recently diagnosed prerace acute illness in runners affects the ability to finish a race.Runners were prospectively evaluated in the 3 days before the race for acute infective illness and then received participation advice using clinical criteria based on systemic or localised symptoms/signs. We compared the did-not-start and the did-not-finish frequencies of ill runners (Ill=172: localised=58.7%; systemic=41.3%) with that of a control group of runners (Con=53 734).Runners with a systemic illness were 10.4% more likely not to start compared with controls (29.6% vs 19.2%) (p=0.0073). The risk difference of not starting the race in runners who were advised not to run the race compared with controls was 37.3% (56.5% vs 19.2%, p<0.0001). Compared with controls, runners with illness had a significantly (p<0.05) greater risk (any illness (5.2% vs 1.6%), systemic illness (8.0% vs 1.6%), illness <24 hours before the race (11.1% vs 1.6%)) and relative risk (prevalence risk ratio) (any illness=3.4, systemic illness=4.9, systemic illness <24 hours before the race=7.0) of not finishing the race.Runners with prerace acute systemic illness, and particularly those diagnosed <24 hours before race day, are less likely to finish the race, indicating a reduction in race performance.
Potentially Curable Pancreatic Cancer: American Society of Clinical Oncology Clinical Practice Guideline Update
Authors: Alok A. Khorana, Pamela B. Mangu, Jordan Berlin, Anitra Engebretson, Theodore S. Hong, Anirban Maitra, Supriya G. Mohile, Matthew Mumber, Richard Schulick, Marc Shapiro, Susan Urba, Herbert J. Zeh, Matthew H.G. Katz
Journal: Journal of Clinical Oncology (2017)

Purpose To update the Potentially Curable Pancreatic Cancer: American Society of Clinical Oncology Clinical Practice Guideline published on May 31, 2016. The October 2016 update focuses solely on new evidence that pertains to clinical question 4 of the guideline: What is the appropriate adjuvant regimen for patients with pancreatic cancer who have undergone an R0 or R1 resection of their primary tumor? Methods The recently published results of a randomized phase III study prompted an update of this guideline. The high quality of the reported evidence and the potential for its clinical impact prompted the Expert Panel to revise one of the guideline recommendations. Results The ESPAC-4 study, a multicenter, international, open-label randomized controlled phase III trial of adjuvant combination chemotherapy compared gemcitabine and capecitabine with gemcitabine monotherapy in 730 evaluable patients with resected pancreatic ductal adenocarcinoma. Median overall survival was improved in the doublet arm to 28.0 months (95% CI, 23.5 to 31.5 months) versus 25.5 months (95% CI, 22.7 to 27.9 months) for gemcitabine alone (hazard ratio, 0.82; 95% CI, 0.68 to 0.98; P = .032). Grade 3 and 4 adverse events were similar in both arms, although higher rates of hand-foot syndrome and diarrhea occurred in patients randomly assigned to the doublet arm. Recommendations All patients with resected pancreatic cancer who did not receive preoperative therapy should be offered 6 months of adjuvant chemotherapy in the absence of medical or surgical contraindications. The doublet regimen of gemcitabine and capecitabine is preferred in the absence of concerns for toxicity or tolerance; alternatively, monotherapy with gemcitabine or fluorouracil plus folinic acid can be offered. Adjuvant treatment should be initiated within 8 weeks of surgical resection, assuming complete recovery. The remaining recommendations from the original 2016 ASCO guideline are unchanged.
SUA levels should not be maintained &lt;3 mg/dL for several years. Response to ‘EULAR gout treatment guidelines by Richette <i>et al</i>: uric acid and neurocognition by Singh <i>et al</i>’
Authors: Pascal Richette, Michael Doherty, Eliseo Pascual, Thomas Bardin
Journal: Annals of the Rheumatic Diseases (2017)

We thank Drs Singh and Edwards for their interest in our 2016 revised EULAR recommendations for the management of gout.1 Drs Singh and Edwards were concerned about the latter part of our sixth recommendation, in which we indicate that a serum uric acid (SUA) level <3 mg/dL (<180 µmol/L) is not recommended in the long term. They consider that this part of the recommendation was not evidence based and that it might present a barrier to care. Specifically, they fear that it could make general practitioners (GPs) less engaged and less likely to use urate-lowering therapy (ULT) in the long term.2 

First, in the care of people with gout, do we suggest that it is necessary to maintain such low levels of SUA indefinitely? No; we do not. In the discussion following recommendation 6 in our paper, we qualified that ‘long term’ stands for ‘several years’. Recommendation 6 clearly specifies that there is a therapeutic window during which physicians can clear crystals faster by lowering the SUA levels well below, rather than …
Glasgow Blatchford score predicted intervention or death better than 4 other prediction models in upper GI bleeding
Authors: Nicholas Talley, Michael Potter
Journal: Annals of Internal Medicine (2017)

Source Citation Stanley AJ, Laine L, Dalton HR, et al; International Gastrointestinal Bleeding Consortium. Comparison of risk scoring systems for patients presenting with upper gastrointestinal bleeding: international multicentre prospective study. BMJ. 2017;356:i6432. 28053181
Advanced biomaterials and microengineering technologies to recapitulate the stepwise process of cancer metastasis
Authors: Nitish Peela, Danh Truong, Harpinder Saini, Hunghao Chu, Samaneh Mashaghi, Stephanie L. Ham, Sunil Singh, Hossein Tavana, Bobak Mosadegh, Mehdi Nikkhah
Journal: Biomaterials (2017)
Risk Stratification for Patients in Cardiogenic Shock After Acute Myocardial Infarction
Authors: Janine Pöss, Jelena Köster, Georg Fuernau, Ingo Eitel, Suzanne de Waha, Taoufik Ouarrak, Johan Lassus, Veli-Pekka Harjola, Uwe Zeymer, Holger Thiele, Steffen Desch
Journal: Journal of the American College of Cardiology (2017)
Cost-effectiveness of Common Diagnostic Approaches for Evaluation of Asymptomatic Microscopic Hematuria
Authors: Joshua A. Halpern, Bilal Chughtai, Hassan Ghomrawi
Journal: JAMA Internal Medicine (2017)

Asymptomatic microscopic hematuria (AMH) is highly prevalent and may signal occult genitourinary (GU) malignant abnormality. Common diagnostic approaches differ in their costs and effectiveness in detecting cancer. Given the low prevalence of GU malignant abnormality among patients with AMH, it is important to quantify the cost implications of detecting cancer for each approach.To estimate the effectiveness, costs, and incremental cost per cancer detected (ICCD) for 4 common diagnostic approaches evaluating AMH.A decision-analytic model-based cost-effectiveness analysis using inputs from the medical literature. PubMed searches were performed to identify relevant literature for all key model inputs, each of which was derived from the clinical study with the most robust data and greatest applicability. Analysis included adult patients with AMH on routine urinalysis with subgroups of high-risk patients (males, smokers, age ≥50 years) seen in the primary care or urologic referral setting.Four diagnostic approaches were evaluated relative to the reference case of no evaluation: (1) computed tomography (CT) alone; (2) cystoscopy alone; (3) CT and cystoscopy combined; and (4) renal ultrasound and cystoscopy combined.At termination of the diagnostic period, cancers detected, costs (payer perspective), and ICCD per 10 000 patients evaluated for AMH.Of the 4 diagnostic approaches analyzed, CT alone was dominated by all other strategies, detecting 221 cancers at a cost of $9 300 000. Ultrasound and cystoscopy detected 245 cancers and was most cost-effective with an ICCD of $53 810. Replacing ultrasound with CT detected just 1 additional cancer at an ICCD of $6 480 484. Ultrasound and cystoscopy remained the most cost-effective approach in subgroup analysis. The model was not sensitive to any inputs within the proposed ranges. Using probabilistic sensitivity analysis, ultrasound and cystoscopy was the dominant strategy in 100% of simulations.The combination of renal ultrasound and cystoscopy is the most cost-effective among 4 diagnostic approaches for the initial evaluation of AMH. The use of ultrasound in lieu of CT as the first-line diagnostic strategy will optimize cancer detection and reduce costs associated with evaluation of AMH. Given our findings, we need to critically evaluate the appropriateness of our current clinical practices, and potentially alter our guidelines to reflect the most effective screening strategies for patients with AMH.
Global kidney health 2017 and beyond: a roadmap for closing gaps in care, research, and policy
Authors: Adeera Levin, Marcello Tonelli, Joseph Bonventre, Josef Coresh, Jo-Ann Donner, Agnes B Fogo, Caroline S Fox, Ron T Gansevoort, Hiddo J L Heerspink, Meg Jardine, Bertram Kasiske, Anna Köttgen, Matthias Kretzler, Andrew S Levey, Valerie A Luyckx, Ravindra Mehta, Orson Moe, Gregorio Obrador, Neesh Pannu, Chirag R Parikh, Vlado Perkovic, Carol Pollock, Peter Stenvinkel, Katherine R Tuttle, David C Wheeler, Kai-Uwe Eckardt, Dwomoa Adu, Sanjay Kumar Agarwal, Mona Alrukhaimi, Hans-Joachim Anders, Gloria Ashuntantang, Shakti Basnet, Aminu K. Bello, Worawon Chailimpamontree, Ricardo Correa-Rotter, Jonathan Craig, Walter G. Douthat, Harold I. Feldman, Mohammad Reza Ganji, Guillermo Garcia-Garcia, Mohammed Benghanem Gharbi, David C. Harris, Vivekanand Jha, David W. Johnson, Rumeyza Kazancioglu, Robyn Langham, Zhi-Hong Liu, Ziad A. Massy, Masaomi Nangaku, Robert G. Nelson, Donal O'Donoghue, Ikechi Okpechi, Roberto Pecoits-Filho, Neil R. Powe, Giuseppe Remuzzi, Charlotte Roberts, Jerome Rossert, Laura Sola, Benedicte Stengel, Ernest K. Sumaili M, Yusuke Suzuki, Tetsuhiro Tanaka, Sajja Tatiyanupanwong, Bernadette Thomas, Katrin Uhlig, Robert Walker, Sarah L. White, Andrzej Wiecek, Chih-Wei Yang
Journal: The Lancet (2017)
TCTAP A-140 Effect of Addition of Coenzyme Q 10 to High Dose Statins on Oxidative Stress in Post PCI Patients
Authors: Malleswara Rao Dangeti, Maddury Jyotsna, Vijay Kumar Kultala, Indrani Garre, Janaswamy Vibhav Sri Narayana
Journal: Journal of the American College of Cardiology (2017)
Effects of Vinorelbine on Quality of Life and Survival of Elderly Patients With Advanced Non-Small-Cell Lung Cancer
Journal: JNCI Journal of the National Cancer Institute (1999)

Vinorelbine, a semisynthetic vinca alkaloid, represents a well-tolerated treatment for elderly patients with advanced non-small-cell lung cancer (NSCLC). We explored the quality of life (QoL) of such patients in a multicenter randomized trial that compared vinorelbine treatment with supportive care alone.Eligible patients were 70 years of age or older, had stage IV or IIIB NSCLC that was ineligible for radiotherapy, and had a performance status of 0-2 (a status of fully active to a status of capable of all self-care but unable to work). Vinorelbine was given intravenously on days 1 and 8 of a 21-day treatment cycle, for a total of six cycles. QoL was evaluated with European Organization for Research and Treatment of Cancer questionnaires QLQ-C30 and QLQ-LC13, and the QoL data were analyzed by fitting a linear mixed model for each QoL scale. Survival curves were plotted and were compared with the Mantel-Haenszel test. Relative hazards of death and 95% confidence intervals (CIs) were estimated by the Cox model.Investigators, blinded to the results, stopped the trial early because of a low enrollment rate. (From April 1996 to November 1997, 191 of the 350 targeted patients were randomly assigned.) Data from 161 patients have been analyzed. Vinorelbine-treated patients scored better than control patients on QoL functioning scales, and they reported fewer lung cancer-related symptoms but reported worse toxicity-related symptoms. There was a statistically significant (two-sided P = .03) survival advantage for patients receiving vinorelbine; median survival increased from 21 to 28 weeks in the vinorelbine-treated group. The relative hazard of death for vinorelbine-treated patients was 0.65 (95% CI = 0.45-0.93).Vinorelbine improves survival of elderly patients with advanced NSCLC and possibly improves overall QoL.
Perioperative Hepatic Arterial Infusion Pump Chemotherapy Is Associated With Longer Survival After Resection of Colorectal Liver Metastases: A Propensity Score Analysis
Authors: Bas Groot Koerkamp, Eran Sadot, Nancy E. Kemeny, Mithat Gönen, Julie N. Leal, Peter J. Allen, Andrea Cercek, Ronald P. DeMatteo, T. Peter Kingham, William R. Jarnagin, Michael I. D’Angelica
Journal: Journal of Clinical Oncology (2017)

Purpose To investigate whether perioperative hepatic arterial infusion pump chemotherapy (HAI) was associated with overall survival (OS) in patients who had a complete resection of colorectal liver metastases (CLM). Methods Patients who underwent a complete resection of CLM between 1992 and 2012 were included from a single-center prospectively maintained database. All patients who received HAI also received perioperative systemic chemotherapy. Propensity score analysis was used to match patients for seven known prognostic factors. Results A total of 2,368 consecutive patients underwent a complete resection of CLM, with a median follow-up of 55 months. The median OS for patients with HAI (n = 785) was 67 months versus 44 months without HAI (n = 1,583; P < .001), despite more advanced disease in the HAI group. OS at 10 years was 38.0% versus 23.8% without HAI. For patients who received modern systemic chemotherapy (n = 1,442), the median OS was 67 months with HAI and 47 months without HAI ( P < .001). The hazard ratio adjusted by propensity score demonstrated longer OS with HAI: 0.67 (95% CI, 0.59 to 0.76; P < .001). A pronounced difference in median OS was found for patients with node-negative colorectal cancer (129 months with HAI v 51 months without; P < .001) and a low clinical risk score of 0 to 2 points (89 months with HAI v 53 months without; P < .001). Conclusion Patients who received HAI had a median OS of approximately 2 years longer than patients without HAI. The strong association was independent of the use of modern systemic chemotherapy and remained in propensity score analysis. Patients with node-negative primary tumors or a low clinical risk score seemed to benefit most from HAI.
Enhancing tissue permeability with MRI guided preclinical focused ultrasound system in rabbit muscle: From normal tissue to VX2 tumor
Authors: Yao Sun, Xiaobing Xiong, Darpan Pandya, Youngkyoo Jung, Akiva Mintz, Satoru Hayasaka, Thaddeus J. Wadas, King C.P. Li
Journal: Journal of Controlled Release (2017)
Efficient replication of blood‐borne hepatitis C virus in human fetal liver stem cells
Authors: Xuan Guo, Shu Wang, Zhi‐Gang Qiu, Ya‐Ling Dou, Wei‐Li Liu, Dong Yang, Zhi‐Qiang Shen, Zhao‐Li Chen, Jing‐Feng Wang, Bin Zhang, Xin‐Wei Wang, Xiang‐Fei Guo, Xue‐Lian Zhang, Min Jin, Jun‐Wen Li
Journal: Hepatology (2017)

The development of pathogenic mechanisms, specific antiviral treatments and preventive vaccines for hepatitis C virus (HCV) infection has been limited due to lack of cell culture models that can naturally imitate the entire HCV life cycle. Here, we established an HCV cell culture model based on human fetal liver stem cells (hFLSCs) that supports the entire blood-borne hepatitis C virus (bbHCV) life cycle. More than 90% of cells remained infected by various genotypes. bbHCV was efficiently propagated, and progeny virus were infectious to hFLSCs. The virus could be passed efficiently between cells. The viral infectivity was partially blocked by specific antibodies or small interfering RNA against HCV entry factors, whereas HCV replication was inhibited by antiviral drugs. We observed viral particles of approximately 55 nm in diameter in both cell culture media and infected cells after bbHCV infection.Our data show that the entire bbHCV life cycle could be naturally imitated in hFLSCs. This model is expected to provide a powerful tool for exploring the process and the mechanism of bbHCV infection at the cellular level and for evaluating the treatment and preventive strategies of bbHCV infection. (Hepatology 2017;66:1045-1057).