tbuckley/cabot-search huggingface dataset:
The Effect of Door-to-Diuretic Time on Clinical Outcomes in Patients With Acute Heart Failure
Authors: Jin Joo Park, Sun-Hwa Kim, Il-Young Oh, Dong-Ju Choi, Hyun-Ah Park, Hyun-Jai Cho, Hae-Young Lee, Jae-Yeong Cho, Kye Hun Kim, Jung-Woo Son, Byung-Su Yoo, Jaewon Oh, Seok-Min Kang, Sang Hong Baek, Ga Yeon Lee, Jin Oh Choi, Eun-Seok Jeon, Sang Eun Lee, Jae-Joong Kim, Ju-Hee Lee, Myeong-Chan Cho, Se Yong Jang, Shung Chull Chae, Byung-Hee Oh
Journal: JACC Heart Failure (2018)

This study sought to examine the impact of door-to-diuretic (D2D) time on mortality in patients with acute heart failure (AHF) who were presenting to an emergency department (ED). Most patients with AHF present with congestion. Early decongestion with diuretic agents could improve their clinical outcomes. The Korea Acute Heart Failure registry enrolled 5,625 consecutive patients hospitalized for AHF. For this analysis, the study included patients who received intravenous diuretic agents within 24 h after ED arrival. Early and delayed groups were defined as D2D time ≤60 min and D2D time >60 min, respectively. The primary outcomes were in-hospital death and post-discharge death at 1 month and 1 year on the basis of D2D time. A total of 2,761 patients met the inclusion criteria. The median D2D time was 128 min (interquartile range: 63 to 243 min), and 663 (24%) patients belonged to the early group. The baseline characteristics were similar between the groups. The rate of in-hospital death did not differ between the groups (5.0% vs. 5.1%; p > 0.999), nor did the post-discharge 1-month (4.0% vs. 3.0%; log-rank p = 0.246) and 1-year (20.6% vs. 19.3%; log-rank p = 0.458) mortality rates. Get With the Guidelines-Heart Failure risk score was calculated for each patient. In multivariate analyses with adjustment for Get With the Guidelines-Heart Failure risk score and other significant clinical covariates and propensity-matched analyses, D2D time was not associated with clinical outcomes. The D2D time was not associated with clinical outcomes in a large prospective cohort of patients with AHF who were presenting to an ED. (Registry [Prospective Cohort] for Heart Failure in Korea [KorAHF]; NCT01389843)
Endoscopic Ultrasonography for the diagnosis of Chronic Pancreatitis
Authors: I Mainie, S Faias, R Vaughan, M Mann, B Hoffman, J Romagnuolo, R Hawes
Journal: Endoscopy (2006)

Aims: EUS has been shown to be sensitive in the detection of morphologic abnormalities due to chronic pancreatitis (CP). Unfortunately there are uncertainties about the specificity of EUS findings, particularly in the early stages of CP. Since the “gold standard“ for the diagnosis of CP (tissue diagnosis) is lacking, one way to validate findings is to do a clinical follow-up.
EXTREME ENDOSCOPY: A NEW PARADIGM IN THERAPEUTIC ENDOSCOPY
Authors: PT Kröner, A Martínez-Alcalá García, AM Ahmed, K Kyanam Kabir Baig, MA D'Assunçâo, I Jovanovic, K Mönkemüller
Journal: Endoscopy (2018)

Observational, single-center, cohort retrospective study during an 18-months period. Extreme endoscopy comprises five key elements:
Abstract 15435: Myocardial Deformation at Rest Predicts Exercise-induced Elevation in Left Ventricular Filling Pressure in Patients With Exertional Dyspnea
Authors: Tor Biering-Sørensen, Mário Santos, Jose Rivero, Shane D McCullough, Erin West, Alexander R Opotowsky, Aaron B Waxman, David M Systrom, Amil M Shah
Journal: Circulation (2015)

Background: An exaggerated rise in the pulmonary arterial wedge pressure (PAWP) with exercise is a hallmark of heart failure. However, conventional resting-state measures of cardiac structure and function poorly predict exercise hemodynamics. We determined whether LV longitudinal strain (LS) and circumferential strain (CS) predict exercise-induced rise in PAWP. Methods: We studied 85 patients referred for cardiopulmonary exercise testing with invasive hemodynamic monitoring for evaluation of dyspnea. Patients with an LVEF&lt;50% or moderate or greater valvular disease were excluded. All patients underwent rest echocardiography followed by exercise testing with invasive hemodynamic monitoring. Global longitudinal strain (LS), global circumferential strain (CS) and the CS/LS-ratio were measured by 2D speckle-tracking echocardiography. Results: Mean age was 53±18 years, 25% were male, 41% had hypertension, and 9% had diabetes mellitus. Lower absolute LS at rest was associated with greater increase in PAWP during exercise (r=0.23, p=0.033). In contrast, higher absolute CS at rest predicted a greater increase in PAWP (r=-0.27, p=0.025) and greater increase in stroke volume with exercise (r=-0.26, p=0.044). Higher CS/LS-ratio was most predictive of elevation in PAWP with exercise (r=0.27, p=0.023; Figure). Conclusion: Myocardial deformation at rest predicts exercise-induced rise in PAWP among patients with dyspnea and a preserved LVEF. A pattern of rest deformation characterized by worse LS and exaggerated CS is most strongly associated with exercise-induced rise in PAWP.
ENDOSCOPIC RESECTION OF A LARGE SUB-EPITHELIAL TUMOR
Authors: JC Branco, LC Lourenço, MF Cardoso, V Anapaz, CG Rodrigues, JA Reis
Journal: Endoscopy (2018)

Brunner's glands hamartomas (BGH) are rare and benign tumors that occur mainly in the duodenal bulb. They represent about 5 to 10% of benign duodenal tumors and have an estimated incidence of less than 0.01%. Most cases of GH have been reported between the ages of 40 – 60 years, with no gender predominance. BGH consist of an abnormal proliferation of Brunner's glands embedded in a fibrous stroma with bundles of smooth muscle and contain cystic dilated ducts. They appear pedunculated in the majority of cases and arise from the deep mucosa or submucosa. Although often asymptomatic, patients can also present anemia, gastrointestinal bleeding or obstruction. Removal of the suspected BGH, whether endoscopic or surgical, is recommended to both confirm the diagnosis and to avoid potential complications.
Personalized vaccine for advanced HCC.
Authors: Wirote Lausoontornsiri, Michael Har-Noy, Jitraporn Wongwiwatcha, Miriam Bloch, Supaporn Suparak, Anucha Ahooja, Michael Bishop, Wattana Sukeepaisarnjaroen
Journal: Journal of Clinical Oncology (2018)

TPS527 Background: The chronic inflammation and viral infection associated with HCC combined with liver tolerogenic mechanisms creates a profoundly immunosuppressive microenvironment. Modulating the microenvironment with checkpoint blockade benefits ~20% of patients. The non-responders and those with poor liver function are an unmet need. Checkpoint blockade requires effector cells to be resident within tumors. However, the majority of HCC lesions lack effector cells. Therefore, a strategy for amplifying the tumor-specific immune response, while counteracting the immunosuppressive mechanisms may provide an improved immunotherapy. Endogenous heat shock proteins (HSP) chaperone tumor neoantigens. A concentrated composition of calreticulin, hsp70, hsp90 and gr94/gp96 (CRCL) is purified from biopsy samples. In addition, a bioengineered allograft (BAG) derived from healthy blood donors with a Th1 memory phenotype, CD3/CD28-coated microbeads and high expression of CD40L has potent immunomodulatory and counter-regulatory properties. The combination of CRCL with BAG is being evaluated as a strategy to amplify tumor-specific immunity and counter-regulate the immunosuppressive microenvironment. Methods: An open-label Phase II clinical trial evaluating the safety and efficacy of CRCL+BAG vaccine in Child-Pugh A/B advanced/metastatic HCC w/o Sorafenib. Approximately 6-10 cores of tumor are collected at baseline. The tumor is lysed and CRCL purified using an isoelectric focusing technique. Subjects are primed with multiple intradermal injections of BAG cells alone to increase the titer of allo-specific Th1/Tc1 cells. Next, multiple intradermal injections of BAG+CRCL are administered to elicit increased titers of tumor-specific Th1/Tc1 cells. Subsequent intravenous infusions of BAG cells activate allo- and tumor-specific memory cells, enabling their infiltration into tumor lesions. The BAG allo-rejection response creates a type I cytokine storm which serves to down-regulate suppressor circuits. Response is evaluated by mRECIST and experimental biomarkers. Longitudinal CT scans with concurrent biopsies as well as multiple collections of PBMC and plasma permits immunomonitoring of these immune mechanisms. Clinical trial information: NCT02409524.
EXPANDABLE METALLIC STENTS IN ESOPHAGEAL: EXPERIENCE IN THE NATIONAL CENTER FOR MINIMAL ACCESS SURGERY
Authors: JF Ruiz Torres, RA Brizuela Quintanilla, FN Piñol Jiménez, JL García-Menocal Hernández, NA Contino
Journal: Endoscopy (2018)

Expandable metallic stents are one of the treatment alternatives currently palliative treating benign and malignant stenosis of the gastrointestinal tract and biliopancreátic order to improve the quality of life of patients. Our aims are to show the results achieved by our group in the placement of self-expanding metal stents in patients with malignant or benign strictures of the upper digestive tracts referred from different parts of the country.
Application de mitomycine C dans les sténoses oesophagiennes de l'enfant: devenir à moyen terme
Authors: S Coopman, L Michaud, P Fayoux, D Guimber, A Delattre, D Turck, F Gottrand
Journal: Endoscopy (2009)

Introduction: La mitomycine C est un antibiotique utilisé en application locale pour son action antifibrosante dans la prise en charge des sténoses trachéales récidivantes et, plus récemment, des sténoses œsophagiennes. Des résultats favorables à court terme (suivi moyen de 22 mois) de son application sur des sténoses oesophagiennes acquises récidivantes de l'enfant ont récemment été rapportés. Le but de cette étude est de décrire le devenir à moyen terme de ces enfants.
Trends in Diabetic Ketoacidosis Hospitalizations and In-Hospital Mortality — United States, 2000–2014
Authors: Stephen R. Benoit, Yan Zhang, Linda S. Geiss, Edward W. Gregg, Ann Albright
Journal: MMWR Morbidity and Mortality Weekly Report (2018)

Diabetes is a common chronic condition and as of 2015, approximately 30 million persons in the United States had diabetes (23 million with diagnosed and 7 million with undiagnosed) (1). Diabetic ketoacidosis (DKA) is a life-threatening but preventable complication of diabetes characterized by uncontrolled hyperglycemia (>250 mg/dL), metabolic acidosis, and increased ketone concentration that occurs most frequently in persons with type 1 diabetes (2). CDC's United States Diabetes Surveillance System* (USDSS) indicated an increase in hospitalization rates for DKA during 2009-2014, most notably in persons aged <45 years. To explore this finding, 2000-2014 data from the Agency for Healthcare Research and Quality's National Inpatient Sample (NIS)† were assembled to calculate trends in DKA hospitalization rates and in-hospital case-fatality rates. Overall, age-adjusted DKA hospitalization rates decreased slightly from 2000 to 2009, then reversed direction, steadily increasing from 2009 to 2014 at an average annual rate of 6.3%. In-hospital case-fatality rates declined consistently during the study period from 1.1% to 0.4%. Better understanding the causes of this increasing trend in DKA hospitalizations and decreasing trend in in-hospital case-fatality through further exploration using multiple data sources will facilitate the targeting of prevention efforts.
UNDERWATER ENDOSCOPIC MUCOSAL RESECTION
Authors: J Fernandes, R Ramos, C Vicente, C Casteleiro
Journal: Endoscopy (2018)

Underwater endoscopic mucosal ressection corresponds to a variation of the classical technique of mucosectomy, in which excision of lesions in the colon occurs after repletion of the lumen of the colon with water. The basis of the technique is based on the mucosal fluctuation effect.
Determinants of Outcomes of Adenoviral Keratoconjunctivitis
Authors: Cecilia S. Lee, Aaron Y. Lee, Lakshmi Akileswaran, David Stroman, Kathryn Najafi-Tagol, Steve Kleiboeker, James Chodosh, Amalia Magaret, Anna Wald, Russell N. Van Gelder, Gregg J. Berdy, James D. Branch, El-Roy Dixon, Sherif M. El-Harazi, Jack V. Greiner, Joshua Herz, Larry L. Lothringer, Damien Macaluso, Andrew L. Moyes, George Nardin, Bernard R. Perez, Lawerence E. Roel, Syamala H.K. Reddy, Stephanie Becker, Neil Shmunes, Stephen Smith, Michael Tepedino, Jonathan Macy, Prashant Garg, Nivedita Patil, Yasmin Bhagat, Malavika Krishnaswamy, Nagappa Somshekhar, Manisha Acharya, Shree Kumar Reddy, Mary Abraham, Shobha Kini, Nita Shanbag, P.N. Biswas, Virendra Agarwal, Anshu Sahai, P.S. Girija Devi, Vupputuri Venkata Lakshmi, Narasimha Rao, Radhika Tandon, Priti Kapadia, Deepak Mehta, Anju Kochar, Adriana dos Santos Forseto, Rubens Belfort, Jacob Moyses Cohen, Ramon Coral Ghanem, Roberta De Ventura, Sergio Luis Gianotti Pimentel, Sergio Kwitko, Maria Cristina Nishiwaki Dantas, Anna Maria Hofling-Lima, Walton Nose, D. Wariyapola, M. Wijetunge, Charith Fonseka, Champa Banagala, K.A. Salvin, D.R. Kodikara
Journal: Ophthalmology (2018)
“Defeaters” don't matter
Authors: Zina B Ward, Edouard Machery
Journal: Behavioral and Brain Sciences (2018)

We argue that the exercise of agency is compatible with the presence of what Doris calls "defeaters." In order to undermine reflectivist theories of agency and support his valuational alternative, Doris must not simply show that defeaters exist but rather establish that some agentive behaviors do express a person's values without involving reflection.
First-in-Human, First-in-Class Phase I Trial of the Anti-CD47 Antibody Hu5F9-G4 in Patients With Advanced Cancers
Authors: Branimir I. Sikic, Nehal Lakhani, Amita Patnaik, Sumit A. Shah, Sreenivasa R. Chandana, Drew Rasco, A. Dimitrios Colevas, Timothy O’Rourke, Sujata Narayanan, Kyriakos Papadopoulos, George A. Fisher, Victor Villalobos, Susan S. Prohaska, Maureen Howard, Muralidhar Beeram, Mark P. Chao, Balaji Agoram, James Y. Chen, Jie Huang, Matthew Axt, Jie Liu, Jens-Peter Volkmer, Ravindra Majeti, Irving L. Weissman, Chris H. Takimoto, Dana Supan, Heather A. Wakelee, Rhonda Aoki, Mark D. Pegram, Sukhmani K. Padda
Journal: Journal of Clinical Oncology (2019)

PURPOSE To evaluate the safety, pharmacokinetics, and pharmacodynamics of Hu5F9-G4 (5F9), a humanized IgG4 antibody that targets CD47 to enable phagocytosis. PATIENTS AND METHODS Adult patients with solid tumors were treated in four cohorts: part A, to determine a priming dose; part B, to determine a weekly maintenance dose; part C, to study a loading dose in week 2; and a tumor biopsy cohort. RESULTS Sixty-two patients were treated: 11 in part A, 14 in B, 22 in C, and 15 in the biopsy cohort. Part A used doses that ranged from 0.1 to 3 mg/kg. On the basis of tolerability and receptor occupancy studies that showed 100% CD47 saturation on RBCs, 1 mg/kg was selected as the priming dose. In subsequent groups, patients were treated with maintenance doses that ranged from 3 to 45 mg/kg, and most toxicities were mild to moderate. These included transient anemia (57% of patients), hemagglutination on peripheral blood smear (36%), fatigue (64%), headaches (50%), fever (45%), chills (45%), hyperbilirubinemia (34%), lymphopenia (34%), infusion-related reactions (34%), and arthralgias (18%). No maximum tolerated dose was reached with maintenance doses up to 45 mg/kg. At doses of 10 mg/kg or more, the CD47 antigen sink was saturated by 5F9, and a 5F9 half-life of approximately 13 days was observed. Strong antibody staining of tumor tissue was observed in a patient at 30 mg/kg. Two patients with ovarian/fallopian tube cancers had partial remissions for 5.2 and 9.2 months. CONCLUSION 5F9 is well tolerated using a priming dose at 1 mg/kg on day 1 followed by maintenance doses of up to 45 mg/kg weekly.
L'incidence du cancer colorectal après coloscopie est faible
Authors: P Strock, J Mossong, R Scheiden, J Weber, JM Weydert, A Kerschen
Journal: Endoscopy (2009)

Introduction: Il a été montré dans des études contrôlées que la coloscopie était un moyen efficace pour prévenir le cancer colorectal (CCR). Cependant, il n'y a que peu d'études de confirmation en pratique quotidienne, et les patients perdus de vue sont nombreux.
Association between asthma and lung function in adolescents born very preterm: results of the EPIPAGE cohort study
Authors: Alice Hadchouel, Jessica Rousseau, Jean-Christophe Rozé, Catherine Arnaud, Adèle Bellino, Laure Couderc, Stéphane Marret, Marie Mittaine, Didier Pinquier, Marie Verstraete, Pierre-Yves Ancel, Christophe Delacourt
Journal: Thorax (2018)

Prematurity and bronchopulmonary dysplasia (BPD) affect long-term lung function. We studied the respiratory outcome of adolescents born very preterm and controls from the Etude EPIdémiologique sur les Petits Ages Gestationnels cohort and analysed their current lung function in relation to asthma symptoms (categorised in three age groups) from birth. In models including BPD, asthma at each age and confounding factors in the preterm group, BPD and preschool wheeze were the only independent variables associated with FEV 1 . Preschool wheeze is an independent factor associated with FEV 1 impairment in adolescents born very preterm. These results highlight the need for optimal management of early respiratory symptoms in preterm-born infants. Trial registration number Results, NCT01424553 .
THE IMPACT OF WEEKEND ADMISSION ON ACUTE CHOLANGITIS OUTCOMES: A NATIONWIDE ANALYSIS OF 67,630 PATIENTS
Authors: PT Kröner, A Martínez-Alcalá García, MA D'Assuncao, M Wallace, K Mönkemüller
Journal: Endoscopy (2018)

Retrospective cohort study using the National Inpatient Sample, the largest publically available inpatient database in the United States. The primary outcome was in-hospital mortality. Secondary outcomes were morbidity (shock, ICU stay and multi-organ failure); resource utilization, length of stay, hospitalization costs. Multivariate logistic regression analysis was adjusted for age, sex, race, income, Charlson Comorbidity Index, hospital region, rural location, size and teaching status. Patients were propensity-matched in a 1:1 fashion and regressed against gender, age, race and Charlson Comorbidity Index.
NEEDLE TRACT SEEDING OF PANCREATIC CANCER AFTER EUS-FNA: SYSTEMATIC REVIEW OF THE LITERATURE, DISCUSSION OF ITS MANAGEMENT AND REPORT OF A CASE
Authors: L Archibugi, M Chiara Petrone, G Balzano, C Doglioni, PG Arcidiacono
Journal: Endoscopy (2018)

EUS-FNA is commonly used for tissue acquisition of pancreatic cancer (PC). Needle-tract cancer seeding (NTCS) has been reported with few sporadic case reports as a rare EUS-FNA long-term complication, but is a poorly investigated entity. However, with the increased incidence of PC and the spreading use of EUS-FNA, its recognition and standardized management seems necessary. Management of NTCS localization varies in reported cases from treatment with chemotherapy and palliation, considering the case as metastatic with expected survival< 12 months, to surgical excision of the NTCS nodule, considering it a de-novo T2N0M0 patient with a potential median survival of 34 months when resected. The aim was to conduct a systematic review of cases of EUS-FNA NTCS of PC and analyze their management and outcome, including a report from our center.
Abstract P369: Relation of Breast Arterial Calcification With Ankle Brachial Index
Authors: Carlos Iribarren, Tory Levine-Hall, Gabriela Sanchez, Bahman Sadeghi, Hanna Javan, Hyo-Min Cho, Huanjun Ding, Sabee Molloi
Journal: Circulation (2018)

Presence of breast arterial calcification (BAC) has been shown to be independently associated with increased risk of subclinical cardiovascular disease (CVD), angiographically-defined coronary disease and with incident coronary heart disease, stroke and heart failure. However, a relationship between BAC and peripheral vascular disease has not been established. The ankle brachial index (ABI) is an indicator of the severity of peripheral arterial disease (PAD) that predicts future CVD risk. We utilized cross-sectional data collected at the baseline examination (2012-15) of the MultIethNic Study of BrEast ARterial Calcium Gradation and CardioVAscular Disease (MINERVA Study), a cohort study of 5,145 post-menopausal women who were members of the Kaiser Permanente Medical Care Program of Northern California (KPNC) who were free of clinical CVD at baseline. Presence and gradation (in mg of calcium mass) of BAC in digital mammograms was ascertained with a validated densitometry method. ABI, the average of two ankle systolic pressure readings divided by the average of two brachial systolic pressure readings, was measured by trained and certified personnel after a ten-minute rest. A total of 3,693 women had complete data on all variables of interest; their mean (SD) age was 66 (4) years and 64% were white, 12% African-American, 14% Asian, 9% Latina and 1% mixed or other. While 28.2% presented with any detectable BAC (i.e., BAC mass &gt; 0 mg), 5.4% had an ABI &lt; 0.90. Three women had ABI&gt;1.40 and were excluded from analyses (none had BAC&gt;0). Prevalence of ABI &lt; 0.90 was 4.8% (27/2,653) in women with BAC=0 and 6.9% (72/1,040) in women with any detectable BAC. The Odds Ratio of ABI&lt;0.90 associated with any BAC was 1.39 (95% CI, 1.03-1.89) in a model adjusting for age and race/ethnicity, and was 1.38 (95% CI, 1.02-1.88) in a model with further adjustment for BMI, smoking status, diabetes, hypertension, LDL cholesterol, HDL cholesterol and hs-CRP. However, among women with any detectable BAC, standardized log_BAC mass (mg) was not significantly associated in bivariate linear regression analysis with ABI (slope=-0.0030 [SE=0.0031]; p=0.32). Our study demonstrates (for the first time) an independent association between presence of BAC and ABI indicative of PAD, with no apparent linear dose-response relationship.
EU doctors make up 9% of the UK medical workforce
Authors: Tom Moberly
Journal: BMJ (2018)

Doctors who qualified in other European countries make up 9% of those on the UK medical register, data released by the GMC show.

The GMC’s report, The State of Medical Education and Practice in the UK: 2017, shows that in some secondary care specialties over a quarter of registered doctors qualified outside the UK and more than one in eight qualified in other European countries.1 For instance, …
Transketolase Regulates the Metabolic Switch to Control Breast Cancer Cell Metastasis via the α-Ketoglutarate Signaling Pathway
Authors: Chien-Wei Tseng, Wen-Hung Kuo, Shih-Hsuan Chan, Hong-Lin Chan, King-Jen Chang, Lu-Hai Wang
Journal: Cancer Research (2018)

Although metabolic reprogramming is recognized as a hallmark of tumorigenesis and progression, little is known about metabolic enzymes and oncometabolites that regulate breast cancer metastasis, and very few metabolic molecules have been identified as potential therapeutic targets. In this study, the transketolase (TKT) expression correlated with tumor size in the 4T1/BALB/c syngeneic model. In addition, TKT expression was higher in lymph node metastases compared with primary tumor or normal tissues of patients, and high TKT levels were associated with poor survival. Depletion of TKT or addition of alpha-ketoglutarate (αKG) enhanced the levels of tumor suppressors succinate dehydrogenase and fumarate hydratase (FH), decreasing oncometabolites succinate and fumarate, and further stabilizing HIF prolyl hydroxylase 2 (PHD2) and decreasing HIF1α, ultimately suppressing breast cancer metastasis. Reduced TKT or addition of αKG mediated a dynamic switch of glucose metabolism from glycolysis to oxidative phosphorylation. Various combinations of the TKT inhibitor oxythiamine, docetaxel, and doxorubicin enhanced cell death in triple-negative breast cancer (TNBC) cells. Furthermore, oxythiamine treatment led to increased levels of αKG in TNBC cells. Together, our study has identified a novel TKT-mediated αKG signaling pathway that regulates breast cancer oncogenesis and can be exploited as a modality for improving therapy.Significance: These findings uncover the clinical significance of TKT in breast cancer progression and metastasis and demonstrate effective therapy by inhibiting TKT or by adding αKG. Cancer Res; 78(11); 2799-812. ©2018 AACR.