tbuckley/cabot-search huggingface dataset:
PTH-006 Repeat bi-directional endoscopy for recurrent iron deficiency anaemia – is it worth it?
Authors: A Rej, I Al-Talib, JM Hebden
Journal: Endoscopy (2017)

<h3>Introduction</h3> The BSG guidelines for iron deficiency anaemia (IDA) advise investigation with bi-directional endoscopy, with imaging of the small bowel reserved for patients failing to respond to iron or patients with a recurrence of anaemia within 2 years and failing to respond to iron. There is no guidance on when repeat endoscopic investigation should be considered. <h3>Method</h3> We searched our endoscopic database for patients who had undergone repeat bi-directional endoscopy for the indication 'anaemia' over the last 12 years (2005–2016). Diagnoses at index and repeat endoscopies were compared. Significant findings accountable for recurrent anaemia were classified as: carcinoma; polyp &gt;1.5 cm; ulcer &gt;1 cm; angiodysplasia &gt;5/requiring APC; severe oesophagitis (LA grade C/D); coeliac disease. <h3>Results</h3> 232 patients (median age 66 [range 38–84]; 120 female) were identified. Findings responsible for anaemia at index investigation were noted in 16 (6.9%) patients at gastroscopy and 24 (10.3%) patients at colonoscopy (see Table 1). Repeat investigations were performed at a median of 41 months (range 3–106). Findings accounting for anaemia on repeat investigation were detected in 12 (5.2%) patients at gastroscopy (1 angiodysplasia was also present at index) and 10 (4.3%) patients at colonoscopy (3 out of 4 with angiodysplasia were present at index; 1 was a recurrence of malignancy). Thus, new findings occurred in 11 (4.7%) patients at gastroscopy, and 7 (3.0%) patients at colonoscopy. Three gastric carcinomas arose 19, 20 and 52 months after initial gastroscopy (one was a GOJ carcinoma arising in an index case of Barrett's oesophagus). The 2 colorectal carcinomas occurred 20 and 41 months (the former a recurrence) after index colonoscopy (bowel preparation was adequate in both initial colonoscopies). <h3>Conclusion</h3> The findings suggest a small but significant yield from repeat bi-directional endoscopy in recurrent anaemia, with malignancy being identified in 1.3% at repeat gastroscopy and 0.9% at repeat colonoscopy. <h3>Reference</h3> 1. Goddard AF, James MW, McIntyre AS, et al. Guidelines for the management of iron deficiency anaemia. Gut2011;60:1309–16. <h3>Disclosure of Interest</h3> None Declared
Outbreak of intestinal amoebiasis among men who have sex with men, Barcelona (Spain), October 2016 and January 2017
Authors: Laura Escolà-Vergé, Maider Arando, Martí Vall, Roger Rovira, Mateu Espasa, Elena Sulleiro, Pere Armengol, Francesc Zarzuela, María-Jesús Barberá
Journal: Eurosurveillance (2017)

Entamoeba histolytica has been recently recognised as an emerging sexually transmissible pathogen in men who have sex with men (MSM), causing sporadic outbreaks in countries where it is not endemic. Here we report two closed clusters of invasive amoebiasis occurring in Barcelona, Spain, in October 2016 (four cases) and in January 2017 (four cases).
マウスに強力で持続性免疫応答を誘導する注入可能な低毒性りん脂質相分離ゲル【Powered by NICT】
Authors: Han Lu, Xue Jiao, Wang Luyao, Peng Ke, Zhang Zhirong, Gong Tao, Sun Xun
Journal: Biomaterials (2016)
Cell Alignment: Control of Cell Alignment and Morphology by Redesigning ECM‐Mimetic Nanotopography on Multilayer Membranes (Adv. Healthcare Mater. 15/2017)
Authors: Maria P. Sousa, Sofia G. Caridade, João F. Mano
Journal: Advanced Healthcare Materials (2017)

Natural-based and biomimetic multilayer membranes, whose surface resembles the nanotopography of the native extracellular matrix, are able to induce cellular alignment along with the pattern direction. João F. Mano and co-workers use a simple layer-by-layer technology to produce such platforms, that can be a promising system to control cell behavior and to regenerate tissues, in article number 1601462.
ASXL2 Is Required for Normal Hematopoiesis and Loss of asxl2 Leads to Myeloid Malignancies in Mice
Authors: Jianping Li, Fuhong He, Peng Zhang, Shi Chen, Hui Shi, Yanling Sun, Guo Ying, Hui Yang, Stephen D. Nimer, Qian-Fei Wang, Mingjiang Xu, Feng-Chun Yang
Journal: Blood (2016)
Abstract 13140: Effectiveness of Rivaroxaban among Patients Diagnosed With Pulmonary Embolism
Authors: Li Wang, Onur Baser, Phil Wells, W. F Peacock, Craig Coleman, Gregory J Fermann, Jeff Schein, Concetta Crivera
Journal: Circulation (2016)

Introduction: Rivaroxaban is a fixed-dose anticoagulant that facilitates earlier hospital discharge, potentially reducing patient exposure to hospital-acquired complications (HAC). Due to the recent introduction of rivaroxaban and limited evidence on its impact in real world settings, we compared the effectiveness of rivaroxaban vs. standard of care (SOC) among pulmonary embolism (PE) patients in the Veterans Health Administration. Methods: Adult patients with continuous enrollment for ≥12 months before and 3 months after an inpatient diagnosis of PE between 10/1/11 and 6/30/15, and a prescription claim for an anticoagulant during the index hospitalization were included. SOC drugs were low molecular weight heparin, unfractionated heparin, and warfarin. Propensity score matching (PSM) compared PE-related outcomes (recurrent venous thromboembolism (VTE), major bleeding and death), HAC, healthcare utilization, and costs among patients receiving SOC and rivaroxaban. We defined net clinical benefit as 1 minus the combined rate of PE-related outcomes and HAC. Results: Among 6,746 PE patients, 208 received rivaroxaban and 4,641 received SOC during the index hospitalization. Most (95%) were male; 22% were African American. After 1:3 PSM, there were 203 rivaroxaban and 609 SOC patients. Mean length of stay (LOS) was 6.3 days for rivaroxaban and 10.4 days for SOC (p=0.0402). In the 90-day post-discharge period, rivaroxaban users (vs. SOC) had similar rates of PE-related outcomes (recurrent VTE: 3.0% vs. 5.3%, p=0.1793, major bleeding: 2.0% vs. 2.6%, p=0.6011, death: 2.5% vs. 4.1%, p=0.2828), fewer HAC (10.3% vs. 15.9%, p=0.0506), and fewer bacterial pneumonias (10.3% vs. 17.2%, p=0.0188). Rivaroxaban users had better net clinical benefit (82.8% vs. 71.1%, p=0.0010). Rivaroxaban users had fewer outpatient visits per patient (17.0 vs. 19.9, p=0.0005), similar rehospitalization rates (0.18 vs. 0.26, p=0.0836), lower inpatient costs ($3,501 vs. $6,189, p&lt;0.0001), and lower total costs ($10,545 vs. $14,192, p=0.0002). When the sample was limited to low-risk PE patients, we found similar patterns. Conclusions: PE patients prescribed rivaroxaban had similar PE-related outcomes but shorter LOS, fewer HACs, and lower total costs than patients on SOC.
Usefulness of serum lactate dehydrogenase/pleural fluid adenosine deaminase ratio for differentiating Mycoplasma pneumoniae parapneumonic effusion and tuberculous pleural effusion
Authors: Chang Ho Kim, Ji Eun Park, Seung Soo Yoo, Shin Yup Lee, Seung Ick Cha, Jae Yong Park, Jaehee Lee
Journal: Journal of Infection (2017)
Cell Culture: Clickable Microgel Scaffolds as Platforms for 3D Cell Encapsulation (Adv. Healthcare Mater. 15/2017)
Authors: Alexander S. Caldwell, Gavin T. Campbell, Kelly M. T. Shekiro, Kristi S. Anseth
Journal: Advanced Healthcare Materials (2017)

Clickable microgel scaffolds as platforms for 3D cell encapsulation are described in article number 1700254 by Kristi S. Anseth and co-workers. Microgel “building blocks” are designed and assembled in the presence of cells to create polymer-cell composites. Cell growth within the network can be controlled and directed by altering microgel size.
Preventing chemotherapy-induced myelosuppression by repurposing the FLT3 inhibitor quizartinib
Authors: Samuel J. Taylor, Johanna M. Duyvestyn, Samantha A. Dagger, Emma J. Dishington, Catherine A. Rinaldi, Oliver M. Dovey, George S. Vassiliou, Carolyn S. Grove, Wallace Y. Langdon
Journal: Science Translational Medicine (2017)

A small-molecule tyrosine kinase inhibitor protects the bone marrow from chemotherapy.
Colonoscopic full-thickness resection using an over-the-scope device: a prospective multicentre study in various indications
Authors: Arthur Schmidt, Torsten Beyna, Brigitte Schumacher, Alexander Meining, Hans-Juergen Richter-Schrag, Helmut Messmann, Horst Neuhaus, David Albers, Michael Birk, Robert Thimme, Andreas Probst, Martin Faehndrich, Thomas Frieling, Martin Goetz, Bettina Riecken, Karel Caca
Journal: Gut (2017)

Objective Endoscopic full-thickness resection (EFTR) is a novel treatment of colorectal lesions not amenable to conventional endoscopic resection. The aim of this prospective multicentre study was to assess the efficacy and safety of the full-thickness resection device. Design 181 patients were recruited in 9 centres with the indication of difficult adenomas (non-lifting and/or at difficult locations), early cancers and subepithelial tumours (SET). Primary endpoint was complete en bloc and R0 resection. Results EFTR was technically successful in 89.5%, R0 resection rate was 76.9%. In 127 patients with difficult adenomas and benign histology, R0 resection rate was 77.7%. In 14 cases, lesions harboured unsuspected cancer, another 15 lesions were primarily known as cancers. Of these 29 cases, R0 resection was achieved in 72.4%; 8 further cases had deep submucosal infiltration &gt;1000 µm. Therefore, curative resection could only be achieved in 13/29 (44.8%). In the subgroup with SET (n=23), R0 resection rate was 87.0%. In general, R0 resection rate was higher with lesions ≤2 cm vs &gt;2 cm (81.2% vs 58.1%, p=0.0038). Adverse event rate was 9.9% with a 2.2% rate of emergency surgery. Three-month follow-up was available from 154 cases and recurrent/residual tumour was evident in 15.3%. Conclusion EFTR has a reasonable technical efficacy especially in lesions ≤2 cm with acceptable complication rates. Curative resection rate for early cancers was too low to recommend its primary use in this indication. Further comparative studies have to show the clinical value and long-term outcome of EFTR in benign colorectal lesions. Trial registration number NCT02362126; Results.
Notes from the Field: Epidemic Keratoconjunctivitis Outbreak Associated with Human Adenovirus Type 8 — U.S. Virgin Islands, June–November 2016
Authors: Marie E. Killerby,, Matthew J. Stuckey,, Irene Guendel,, Senthilkumar Sakthivel,, Xiaoyan Lu,, Dean D. Erdman,, Eileen Schneider,, Ryan Fagan,, Michelle S. Davis,, John T. Watson,, Susan I. Gerber,, Holly M. Biggs,, Esther M. Ellis,
Journal: MMWR Morbidity and Mortality Weekly Report (2017)
PTH-042 Outcomes of endoscopic resection of recurrent colorectal lesions treated at a uk tertiary referral centre
Authors: A Emmanuel, S Gulati, M Burt, B Hayee, A Haji
Journal: Endoscopy (2017)

<h3>Introduction</h3> Endoscopic resection of large colorectal lesions, especially by piecemeal EMR, carries a significant risk of recurrence. Although several series examine the outcomes and risk of recurrence following endoscopic resection, few focus on the outcomes of patients being treated for recurrence after initial expert resection, and these mostly focus on one technique to deal with recurrence. We evaluated the outcomes after recurrence of colorectal lesions after apparent successful endoscopic resection in a specialised UK tertiary institution employing a range of resection techniques. <h3>Method</h3> Consecutive patients who underwent endoscopic resection of colorectal lesions≥2 cm were included. All lesions were assessed with magnification chromoendoscopy supplemented by colonoscopic ultrasound in selected cases. A lesion specific approach was used to decide on resection technique. Outcomes were evaluated for patients treated for recurrent lesions. <h3>Results</h3> Of 396 colorectal lesions≥2 cm successfully resected at our institution, recurrence occurred in 50. 36% of these patients had already had a mean of 1.6 previous failed attempts at resection prior to referral to our institution, and 66% had had either a failed attempt at resection or extensive sampling involving ≥6 biopsies or tattoo placed under the lesion. 69% of patients were successfully treated with further endoscopic resection and avoided surgery. 27 patients had endoscopic resection of a recurrence larger than 20 mm, with a mean lesion size of 48.3+/-19.1 mm. Techniques used were EMR (n=16), ESD (n=2), Hybrid ESD and EMR (n=9). The remaining lesions&lt;2 cm were resected using EMR. A mean of 1.4+/-0.75 procedures were required to achieve successful endoscopic treatment of recurrence. 24 patients who were ultimately successfully treated with endoscopic resection required a single further endoscopic resection after recurrence, 10 patients required 2 or more further resections. 8 patients required surgery, 4 as a result of developing invasive adenocarcinoma with the recurrence. There were no perforations as a result of endoscopic resection of recurrent lesions and only 1 patient was readmitted with post-procedural bleeding which was managed conservatively. <h3>Conclusion</h3> These data demonstrate the challenges of an advanced endoscopic resection service in much of western practice where patients with recurrent lesions represent a particularly complex cohort, most of whom have already had extensive prior manipulation or attempts at resection. Familiarity with a range of resection techniques and appropriate equipment is essential to successfully treat recurrent lesions in this group with endoscopic resection, which can be achieved in the majority of patients without significant complications. <h3>Disclosure of Interest</h3> None Declared
La préparation colique influence-t-elle la qualité et le rendement diagnostique de la coloscopie: l’étude européenne multicentrique EPAGE
Authors: F Froehlich, JJ Gonvers, JP Vader, V Wietlisbach, B Burnand
Journal: Endoscopy (2004)

Introduction: L’impact de la préparation colique sur la qualité et le rendement diagnostique de la coloscopie n’a, à notre connaissance, jamais été étudié prospectivement dans le cadre d’une grande étude multicentrique. Patients et Méthodes: 21 centres (20 européens, 1 canadien) ont participé à cette étude prospective observationnelle. La qualité de la préparation colique (QP) a été jugée par l’endoscopiste sur une échelle de 5 points formant 3 niveaux: qualité élevée = côlon propre/selles liquides claires aspirables; qualité moyenne = selles liquides et solides aspirables; qualité basse = selles liquides + selles solides pas totalement aspirables/ou selles solides seulement. Paramètres supplémentaires: indication à la coloscopie, statut ASA du patient, durée de l’examen jusqu’au bas-fond cæcal, durée du retrait, difficulté de la procédure et diagnostics endoscopiques. Résultats: Les données de 5832 des 6004 patients qui ont été inclus dans l’étude ont été disponibles (hommes 48,7%, âge moyen 57,6 ± 15,9 ans). Les principales indications ont été: hématochésie (17%), douleurs abdominales (13%), screening pour cancer colique (12%) et surveillance après polypectomie (11%). La QP a été élevée dans 74,2%, moyenne dans 15,5% et basse dans 10,3% sans différence entre hommes et femmes. La QP a montré une corrélation inverse avec un âge plus avancé pour les hommes (p < 0,001) et pour les femmes (p = 0,004). Une QP plus médiocre a été observée plus souvent chez les patients hospitalisés (15,7% vs 8,5%, p < 0,001). Un risque plus élevé selon ASA était associé à une QP plus mauvaise. Quant à la durée de l’examen, les catégories QP élevée/moyenne/basse ont eu l’impact suivant: durée totale de l’examen 21,7/25,6/27,5 minutes; durée de l’arrivée au caecum 12,0/14,4/16,3 minutes; durée du retrait de l’instrument 9,7/11,1/11,1 minutes, respectivement (p < 0,001). Une QP mauvaise était observée plus souvent lors de coloscopies difficiles et incomplètes (24,4% contre 8,3% pour les coloscopies complètes, p < 0,001). Les examens avec QP élevée ont permis plus souvent la résection de polypes (26,3%) que les coloscopies mal préparées (16,4%, p < 0,001; résection de > 1 polype: 11,8% si QP élevé et 6,8% si QP basse, p < 0,001). En revanche, un cancer colique a été décelé chez 2,7% des patients avec une QP élevée, 6,0% avec une QP moyenne et 5,5% avec une QP basse (p < 0,001). Conclusion: La qualité de la préparation (QP) détermine la qualité, la difficulté, la durée, la proportion d’examens complets et le rendement diagnostique de la coloscopie. La QP est moins bonne chez des patients âgés et hospitalisés. Une meilleure QP permet de détecter et de réséquer davantage de polypes alors qu’elle n’influence pas la détection du cancer.
Association of Systemic Inflammation and Sarcopenia With Survival in Nonmetastatic Colorectal Cancer
Authors: Elizabeth M. Cespedes Feliciano, Candyce H. Kroenke, Jeffrey A. Meyerhardt, Carla M. Prado, Patrick T. Bradshaw, Marilyn L. Kwan, Jingjie Xiao, Stacey Alexeeff, Douglas Corley, Erin Weltzien, Adrienne L. Castillo, Bette J. Caan
Journal: JAMA Oncology (2017)

Systemic inflammation and sarcopenia are easily evaluated, predict mortality in many cancers, and are potentially modifiable. The combination of inflammation and sarcopenia may be able to identify patients with early-stage colorectal cancer (CRC) with poor prognosis.To examine associations of prediagnostic systemic inflammation with at-diagnosis sarcopenia, and determine whether these factors interact to predict CRC survival, adjusting for age, ethnicity, sex, body mass index, stage, and cancer site.A prospective cohort of 2470 Kaiser Permanente patients with stage I to III CRC diagnosed from 2006 through 2011.Our primary measure of inflammation was the neutrophil to lymphocyte ratio (NLR). We averaged NLR in the 24 months before diagnosis (mean count = 3 measures; mean time before diagnosis = 7 mo). The reference group was NLR of less than 3, indicating low or no inflammation.Using computed tomography scans, we calculated skeletal muscle index (muscle area at the third lumbar vertebra divided by squared height). Sarcopenia was defined as less than 52 cm2/m2 and less than 38 cm2/m2 for normal or overweight men and women, respectively, and less than 54 cm2/m2 and less than 47 cm2/m2 for obese men and women, respectively. The main outcome was death (overall or CRC related).Among 2470 patients, 1219 (49%) were female; mean (SD) age was 63 (12) years. An NLR of 3 or greater and sarcopenia were common (1133 [46%] and 1078 [44%], respectively). Over a median of 6 years of follow-up, we observed 656 deaths, 357 from CRC. Increasing NLR was associated with sarcopenia in a dose-response manner (compared with NLR < 3, odds ratio, 1.35; 95% CI, 1.10-1.67 for NLR 3 to <5; 1.47; 95% CI, 1.16-1.85 for NLR ≥ 5; P for trend < .001). An NLR of 3 or greater and sarcopenia independently predicted overall (hazard ratio [HR], 1.64; 95% CI, 1.40-1.91 and HR, 1.28; 95% CI, 1.10-1.53, respectively) and CRC-related death (HR, 1.71; 95% CI, 1.39-2.12 and HR, 1.42; 95% CI, 1.13-1.78, respectively). Patients with both sarcopenia and NLR of 3 or greater (vs neither) had double the risk of death, overall (HR, 2.12; 95% CI, 1.70-2.65) and CRC related (HR, 2.43; 95% CI, 1.79-3.29).Prediagnosis inflammation was associated with at-diagnosis sarcopenia. Sarcopenia combined with inflammation nearly doubled risk of death, suggesting that these commonly collected biomarkers could enhance prognostication. A better understanding of how the host inflammatory/immune response influences changes in skeletal muscle may open new therapeutic avenues to improve cancer outcomes.
Sédation pour endoscopie digestive haute pédiatrique: enquête du Groupe Francophone d’Hépatologe, Gastroentérologie et Nutrition Pédiatrique
Authors: L Michaud
Journal: Endoscopy (2004)

Introduction: Il n’existe pas actuellement de consensus sur le mode de sédation idéale pour la réalisation des endoscopies digestives hautes chez l’enfant. Une enquête concernant le type de sédation utilisée pour la réalisation d’endoscopie digestive haute non interventionnelle chez l’enfant a été réalisée en juin 2002 parmi les membres du Groupe Francophone d’Hépatologie, Gastroentérologie et Nutrition (GFHGNP). Patients et Méthodes: Un questionnaire a été adressé à chaque membre du GFHGNP effectuant des endoscopies pédiatriques, concernant sa pratique de la sédation en endoscopie digestive haute: mode de sédation utilisée selon l’âge de l’enfant, type de drogues utilisées, disponibilité de l’équipe d’anesthésistes pour la réalisation des endoscopies. Résultats: Quarante trois questionnaires ont été analysés (CHRU n = 35, CHG n = 5, clinique n = 3). Quarante pour cent des endoscopistes proposent systématiquement aux patients et/ou aux parents de réaliser l’endoscopie digestive sous anesthésie générale (AG). Cependant, seuls 14% des endoscopistes réalisent l’ensemble des endoscopies digestives hautes sous AG, quel que soit l’âge de l’enfant et/ou l’indication de l’endoscopie. Avant 6 mois, 57% des endoscopistes ne réalisent ni sédation, ni anesthésie générale. Après 6 mois, 51% des endoscopistes réalisent les endoscopies sous AG; 39% sous sédation et moins de 10% sans sédation. L’âge de l’enfant, son souhait, la répétition des endoscopies sont les facteurs qui influencent le plus le choix du recours à l’anesthésie générale pour l’endoscopie digestive. Quarante six pour cent des endoscopistes sont satisfaits de la sédation utilisée pour l’endoscopie digestive haute et le degré de satisfaction est corrélé à la présence d’un anesthésiste. Le midazolam par voie intrarectale (50%) ou intraveineuse (22%) est la principale drogue utilisée pour la sédation consciente. Entre 3 et 5 ans, le protoxyde d’azote est utilisé par 12% des endoscopistes et l’anesthésie locale par 24%. Après l’âge de 5 ans, le protoxyde d’azote est utilisé par 19% et l’anesthésie locale par 42% des centres. Soixante quatorze pour cent des endoscopistes sont limités par la disponibilité de l’équipe d’anesthésie et 48% des centres ont le souhait de modifier le type de sédation pour les endoscopies digestives hautes. Conclusion: Il existe une grande variabilité dans le mode de sédation utilisé pour l’endoscopie digestive haute non interventionnelle chez l’enfant. Le recours à l’anesthésie générale augmente avec l’âge de l’enfant. La disponibilité d’un médecin anesthésiste semble être le principale facteur limitant de la réalisation d’une sédation adaptée.
Telomere Length and Risk of Cancer and Non-neoplastic Diseases: Is Survivin the Ariadne's Thread?—Reply
Authors: Philip C. Haycock, Gibran Hemani, Abraham Aviv
Journal: JAMA Oncology (2017)

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