tbuckley/cabot-search huggingface dataset:
Abstract P341: Poor Sleep Patterns Are Associated With Decreased Performance on the Montreal Cognitive Assessment in Both Younger and Older Women
Authors: Brooke Aggarwal, Adam M Brickman, Ming Liao, Molly E Zimmerman
Journal: Circulation (2018)

Introduction: Poor cardiovascular health has been linked to an increased likelihood of cognitive impairment in older adults. Cognitive impairment has also been identified as an emerging co-morbidity of obstructive sleep apnea, a highly prevalent sleep disorder, particularly in patients with neurological conditions. Whether other aspects of sleep, including sleep duration, sleep quality, sleep onset latency, and insomnia are associated with cognition is not established. Objective: The aim of this study was to evaluate whether specific sleep patterns were associated with cognitive function in a diverse population of both younger and older, neurologically healthy women, and to determine whether this association is mediated by cardiovascular disease (CVD) risk factors. Methods: This was a baseline analysis of 392 women (59% racial/ethnic minority, mean age=39±16.53y, range 20-76y) participating in the ongoing American Heart Association Go Red for Women Strategically Focused Research Network population-based study at Columbia University Medical Center (CUMC). Cognitive function was assessed by the validated Montreal Cognitive Assessment (MoCA) screening instrument. Sleep duration, sleep quality, and time to sleep onset were assessed using the Pittsburgh Sleep Quality Index; insomnia was assessed using the Insomnia Severity Index. Blood lipids and glucose were measured in the biomarker core laboratory at CUMC. Multivariable linear regression models were used to evaluate associations between sleep, CVD risk factors, and MoCA scores, adjusted for age, race/ethnicity, education, health insurance, and tested for interactions between age and sleep. Results: The prevalence of abnormal MoCA (score &lt;26) was 38%; mean scores were lower in adults ≥55y vs. &lt;55y (p&lt;0.0001), and racial/ethnic minorities vs. whites (p&lt;0.0001). Average nightly sleep duration was 6.75±1.29 h, and 50% of women had poor sleep quality. In multivariable models testing for interactions, lower MoCA scores were associated with shorter sleep duration (p=0.007), worse quality sleep (p=0.0005), and higher insomnia level (p=0.04). In stratified analyses, associations between MoCA scores and sleep duration, sleep quality, and insomnia persisted among both younger (&lt;55y) and older (≥55y) groups. Lower MoCA scores were also associated with higher triglycerides (p=0.0001) and lower HDL-cholesterol (p=0.0006); formal tests of mediation suggested that the relation between cognition and insomnia was mediated by triglyceride level. Conclusions: Poor sleep patterns were highly prevalent and associated with lower cognitive function, even in younger women in this diverse population. Sleep patterns should be further investigated as a potential mechanism to identify individuals at risk of cognitive decline. Whether the relation is causal or mediated through traditional CVD risk factors deserves further study.
COMPLICATIONS OF ENDOSCOPIC RETROGRAPHY CHOLANGIOPANCREATOGRAPHY (ERCP) IN PATIENTS WITH LIVER CIRRHOSIS
Authors: M Alcivar-Leon, M Guaranda-Maya, A Serrano-Suarez, J Carrillo-Ubidia, ML Jara-Alba, M Caballero-Giler, L Frugone-Morla, L Aynaguano-Colcha, A Gallegos-Lozano, E Vera-Pozo, D Marriott-Blum, E Villacis-Coronel, I Nieto-Orellana, K Mönkemüller, E Marriott-Diaz
Journal: Endoscopy (2018)

To evaluate the safety and efficacy of ERCP for common bile duct stones in liver cirrhotic patients and to determine risk factors, rate and type of complications.
CLINICAL IMPACT OF ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY TIMING IN ACUTE CHOLANGITIS
Authors: B Miutescu, I Ratiu, M Strain, A Goldis, E Hajdarmataj, A Popescu, R Sirli, F Bende, I Sporea
Journal: Endoscopy (2018)

Acute cholangitis is a life threatening disease that needs antibiotic therapy and biliary decompression. Endoscopic retrograde cholangiopancreatography (ERCP) is the first line procedure used for biliary drainage. Our aim was to evaluate the clinical impact of ERCP timing in patients diagnosed with acute cholangitis.
ENDOSCOPIC PANCREATIC STENTING IN THE TREATMENT OF ACUTE POST-ERCP PANCREATITIS
Authors: S Shapovalianz, A Kotieva, E Fedorov, S Budzinskiy
Journal: Endoscopy (2018)

To evaluate the results of endoscopic stenting of the main pancreatic duct (MPD) in the treatment of acute post-ERCP pancreatitis (PEP).
WATER-POCKET ENDOSCOPIC SUBMUCOSAL DISSECTION FOR SUPERFICIAL COLORECTAL NEOPLASMS
Authors: H Harada, D Murakami, Y Amano
Journal: Endoscopy (2018)

It is essential to obtain a clear view during the endoscopic submucosal dissection (ESD) to dissect the appropriate submucosal layer. Some advantages of underwater techniques for endoscopic resection compared with air insufflation have been reported. Therefore, we aimed to investigate the feasibility and safety of water-pocket ESD (WP-ESD) for superficial colorectal neoplasms.
INTRABILIARY HEPATIC METASTASIS OF COLORECTAL CARCINOMA MIMICKING HEPATOLITHIASIS, SUCCESSFULLY DIAGNOSED USING SINGLE-OPERATOR CHOLANGIOSCOPY – A CASE REPORT
Authors: P Karagyozov, I Tishkov, I Boeva
Journal: Endoscopy (2018)

We report a case of intrabiliary hepatic metastasis of CRC that was confirmed by single-operator cholangioscopy.
Comparison of Time-to-First Event and Recurrent-Event Methods in Randomized Clinical Trials
Authors: Brian Claggett, Stuart Pocock, L.J. Wei, Marc A. Pfeffer, John J.V. McMurray, Scott D. Solomon
Journal: Circulation (2018)

Background: Most phase-3 trials feature time-to-first event end points for their primary and secondary analyses. In chronic diseases, where a clinical event can occur &gt;1 time, recurrent-event methods have been proposed to more fully capture disease burden and have been assumed to improve statistical precision and power compared with conventional time-to-first methods. Methods: To better characterize factors that influence statistical properties of recurrent-event and time-to-first methods in the evaluation of randomized therapy, we repeatedly simulated trials with 1:1 randomization of 4000 patients to active versus control therapy, with true patient-level risk reduction of 20% (ie, relative risk=0.80). For patients who discontinued active therapy after a first event, we assumed their risk reverted subsequently to their original placebo-level risk. Through simulation, we varied the degree of between-patient heterogeneity of risk and the extent of treatment discontinuation. Findings were compared with those from actual randomized clinical trials. Results: As the degree of between-patient heterogeneity of risk increased, both time-to-first and recurrent-event methods lost statistical power to detect a true risk reduction and confidence intervals widened. The recurrent-event analyses continued to estimate the true relative risk (0.80) as heterogeneity increased, whereas the Cox model produced attenuated estimates. The power of recurrent-event methods declined as the rate of study drug discontinuation postevent increased. Recurrent-event methods provided greater power than time-to-first methods in scenarios where drug discontinuation was ≤30% after a first event, lesser power with drug discontinuation rates of ≥60%, and comparable power otherwise. We confirmed in several actual trials of chronic heart failure that treatment effect estimates were attenuated when estimated via the Cox model and that increased statistical power from recurrent-event methods was most pronounced in trials with lower treatment discontinuation rates. Conclusions: We find that the statistical power of both recurrent-events and time-to-first methods are reduced by increasing heterogeneity of patient risk, a parameter not included in conventional power and sample size formulas. Data from real clinical trials are consistent with simulation studies, confirming that the greatest statistical gains from use of recurrent-events methods occur in the presence of high patient heterogeneity and low rates of study drug discontinuation.
Effect of postoperative morbidity on survival after cytoreductive surgery (CRS) with heated intraperitoneal chemotherapy (HIPEC) for peritoneal metastasis in a series of 700 cases.
Authors: Clarisse Eveno, Roberto Schiavone, Marc Pocard, Thierry Andre, Marie-Josee Caballero, Etienne Gayat
Journal: Journal of Clinical Oncology (2017)

3565 Background: Major morbidity (MM) after cytoreductive surgery with heated intraperitoneal chemotherapy (CRS/HIPEC) is associated with worsening of disabilities and length of the hospital stay. This study aimed to identify MM prognostic factors and to measure its impact on oncological outcomes. Methods: A post-hoc analysis of a prospective cohort of 734 patients with peritoneal metastasis (PM) from 2006 to 2015 was undertaken. Five hundred and two patients who had complete CRS and HIPEC for PM were included. Results: Major morbidity was identified in 31% (156/502) of CRS/HIPEC procedures, including 67 hemorrhagic complication (13.3%), 87 anastomotic leaks (17.4%), 121 reoperation (24.1%), and 65 pulmonary complication (12.9%). The multivariate predictors of MM were American Society of Anesthesiologists (ASA) score (ASA 3 vs. 1-2, 0R 95%CI: 3.58 [1.54 – 8.34]), origin of PM colorectal adenocarcinoma vs. other, OR 95%CI: 1.62 [1.06 – 2.48]), type of HIPEC drug (oxaliplatin vs. other, OR 95%CI: 2.85 [1.28 – 6.32]), number of anastomosis (no vs. at least 1, HR 95%CI: 1.85 [1.19 – 2.88]), blood transfusion (OR 95%CI: 1.84 [1.05 – 3.23]) and length of surgery longer than the median value (OR 95%CI: 1.88 [1.22 – 2.91]). The in-hospital mortality rate for the entire cohort was 1.7% (9/502). Rate of adjuvant chemotherapy after CRS/HIPEC was comparable between the two groups (70.3% vs. 72.4%, p = 0.64). The median duration of follow-up was 18 months. The MM group had worst OS and DFS comparing non-MM (Hazard ratio and 95% confidence interval at 3.48 [1.90 ; 6.35] and 1.91 [1.43 ; 2.57], respectively). Conclusions: Major morbidity after CRS/HIPEC for peritoneal metastasis is a source of significant reoperation and longer hospital and intensive care unit stay; with a decrease in overall survival and disease free survival even after complete CRS. Preoperative ASA score, number of anastomoses, colorectal origin of PM, HIPEC with oxaliplatin, blood transfusion and length of surgery are independent predictors of MM for CRS/HIPEC patients.
EFFECTIVITY AND SAFETY OF DOUBLE BALLOON ENDOSCOPY IN PATIENTS WITH OVERT ONGOING OBSCURE GASTROINTESTINAL BLEEDING IN EMERGENCY FASHION
Authors: S Hülagu, G Sirin, AE Duman, H Yılmaz, Z Islamoglu, A Celebi
Journal: Endoscopy (2018)

Double balloon endoscopy (DBE) has been transforming the diagnostic and therapeutic approach for small intestinal diseases. Among the various modalities, emergency BAE examination is allegedly effective in diagnosing and treating patients with overt ongoing obscure gastrointestinal bleeding (OGIB). We aimed that to evaluate whether there is a really demonstrative efficacy and safety of the emergency DBE examination.
QUALITY INDICATORS OF ENDOSCOPIC ULTRASONOGRAPHY: A NATIONWIDE SURVEY
Authors: A Amato, M Bianchi, C Fabbri, S Carrara, S De Lisi, I Tarantino
Journal: Endoscopy (2018)

Specific quality indicators for endoscopic ultrasonography (EUS) were published and updated in 2015 by a joint American Society of Gastrointestinal Endoscopy/American College of Gastroenterology Task Force. However, most of the papers in the literature a focus on the technical aspects of the procedure while poor interest has been paid at evaluating the quality provided. The aim of this survey was to evaluate the quality of EUS performances provided in Italy
Careers Clinic: What do I need to know when I retire?
Authors: Abi Rimmer
Journal: BMJ (2018)

Benjamin Holdsworth, director of Cavendish Medical, says, “From a financial perspective you need to focus first on what your ideal retirement might look like. What are your aspirations for the future and how will you reach them?

“If you want to keep working, consider what this will involve and whether your trust is amenable to ‘retiring and returning’ or job sharing. If you have a private practice, will this be your focus and do you have an ‘exit strategy’?

“Start planning as early as possible—preferably within at least five years of your desired retirement. As a busy doctor, the temptation to ignore important financial choices is great and the time available to focus on what needs to be done is short. However, making well considered decisions now will have a positive impact on your future.

“If you already have a retirement plan in place, check if it’s still an accurate reflection of your objectives. Has it kept …
First-in-class oral small molecule inhibitor of the tyrosine kinase ROR1 (KAN0439834) induced significant apoptosis of chronic lymphocytic leukemia cells
Authors: M. Hojjat-Farsangi, A. H. Daneshmanesh, A. S. Khan, J. Shetye, F. Mozaffari, P. Kharaziha, L.-S. Rathje, P. Kokhaei, L. Hansson, J. Vågberg, S. Byström, E. Olsson, C. Löfberg, C. Norström, J. Schultz, M. Norin, T. Olin, A. Österborg, H. Mellstedt, A. Moshfegh
Journal: Leukemia (2018)
Three-Year Follow-up of a Trial of Close Contact Casting vs Surgery for Initial Treatment of Unstable Ankle Fractures in Older Adults
Authors: David J. Keene, Sarah E. Lamb, Dipesh Mistry, Elizabeth Tutton, Ranjit Lall, Robert Handley, Keith Willett
Journal: JAMA (2018)

This study reports 3-year outcomes of a randomized trial that compared close contact casting vs the usual surgery for unstable ankle fractures in older adults and that found equivalent ankle function outcomes at 6 months.
L'ampullectomie endoscopique est le traitement de première intention des ampullomes vatériens bénins et ampullocarcinomes T1N0: à propos d'une série de 30 cas consécutifs
Authors: L Poincloux, H Devaux, J Privat, A Abergel, M Dapoigny, G Bommelaer
Journal: Endoscopy (2009)

Objectif: Le but de ce travail était d'évaluer l'efficacité et la morbidité de l'ampullectomie endoscopique pour déterminer sa place dans le traitement des ampullomes vatériens bénins ou des ampullocarcinomes T1N0.
FRAGMENTATION OF A FOREIGN BODY IMPACTED IN THE OESOPHAGUS BY THE HOLMIUM:YAG LASER
Authors: C Mangas, J Martínez, L Compañy, FA Ruíz, JA Casellas, J Ramón Aparicio
Journal: Endoscopy (2018)

A 78-year-old man was admitted to the Emergency Department complaining about sialorrhea and retrosternal chest pain after swallowing a chicken bone. A CT scan was performed initially and no signs of entire esophagus wall perforation were seen. Under general anesthesia, an upper gastrointestinal endoscopy with CO2 was performed and an embedded crosswise flat and sharp foreign body was found lodged in the distal esophagus. It couldn't be removed after widening distally the esophageal lumen with a balloon.
BALLOON-OVERTUBE ENTEROSCOPY ASSISTED (BAE) VERSUS LAPAROSCOPY-ASSISTED ERCP IN BARIATRIC POST- ROUX-EN-Y GASTRIC BYPASS PATIENTS: A COMPARATIVE STUDY
Authors: A Martínez-Alcalá García, U Kumar, PT Kröner, I Jovanovic, AM Ahmed, G Schwingel, H Neumann, K Mönkemüller
Journal: Endoscopy (2018)

To compare on balloon enteroscopy-assisted ERCP (BEA-ERCP) versus laparoscopy-assisted ERCP (LA-ERCP) in post-Roux-en-Y gastric bypass (RYGB) patients.
Effect of Achieved Systolic Blood Pressure on Cardiovascular Outcomes in Patients With Type 2 Diabetes: A Population-Based Retrospective Cohort Study
Authors: Eric Yuk Fai Wan, Esther Yee Tak Yu, Weng Yee Chin, Colman Siu Cheung Fung, Daniel Yee Tak Fong, Edmond Pui Hang Choi, Anca Ka Chun Chan, Cindy Lo Kuen Lam
Journal: Diabetes Care (2018)

The objective of this study was to compare the incidence of cardiovascular disease (CVD) among patients with type 2 diabetes mellitus (T2DM) with treated hypertension who achieved systolic blood pressures (SBPs) of <120, <130, and <140 mmHg after an increase in their antihypertensive regimen.A retrospective cohort study was conducted on 28,014 primary care adult patients with T2DM with no prior diagnosis of CVD and who achieved SBP readings <140 mmHg after an increase in the number of antihypertensive medications prescribed. Using an extension of propensity score matching, a total of 2,079, 10,851, and 15,084 matched patients with achieved SBP measurements of <120, <130, and <140 mmHg were identified. The association between achieved SBP and incident CVD were evaluated using Cox regressions. Subgroup analyses were conducted by stratifying patients' baseline characteristics.Over a median follow-up period of 4.8 years, the incidence of CVD in patients with achieved SBP measures of <120, <130, and <140 mmHg were 318 (15.3%; incidence rate [IR] 34.3/1,000 person-years [PY]), 992 (9.1%; IR 20.4/1,000 PY), and 1,635 (10.8%; IR 21.4/1,000 PY). Achieved SBP <120 mmHg was associated with a higher risk of CVD compared with achieved SBP <130 mmHg (hazard ratio [HR] 1.75 [95% CI 1.53, 2.00]) and achieved SBP <140 mmHg (HR 1.67 [95% CI 1.46, 1.90]). There was a significant reduction in CVD risk in patients <65 years (HR 0.81 [95% CI 0.69, 0.96]) but no difference for other patients, including patients ≥65 years, who achieved SBP <130 mmHg when compared with the group that achieved SBP <140 mmHg.Our findings support a SBP treatment target of 140 mmHg and suspect no risk reduction attenuation on CVD for lower SBP targets (<120 or <130 mmHg) for most patients with uncomplicated T2DM. A randomized control trial is still needed to confirm these findings.
PURASTAT A NEW HEMOSTATIC DEVICE TO CONTROL MASSIVE GI BLEEDINGS: A DUAL CENTRE CASE SERIES
Authors: G de Nucci, B Omazzi, E Domenico Mandelli, R Alessandro, M Dinelli, D Redaelli, G Manes
Journal: Endoscopy (2018)

Gastrointestinal (GI) bleeding from upper and the lower GI tract is a common cause for hospitalization, resulting in significant mortality and morbidity, Recently innovative topical hemostatic modalities have been developed for endoscopic use.
PROXIMAL EGCS HAVE DIFFERENT CLINICAL AND PATHOLOGIC CHARACTERISTICS COMPARED WITH DISTAL EGCS
Authors: MK Joo, SH Park, JS Koh, BJ Lee, JJ Park, HJ Chun, SW Lee, YT Bak
Journal: Endoscopy (2018)

Limited data have shown the different clinical and histopathologic characteristics of EGCs according to location. The purpose of this study was to evaluate the clinical and histopathologic features of the proximal EGCs by comparing those from distal EGCs.
Importance of Objectively Comparing Local VA and Non-VA Care and Outcomes
Authors: William B. Weeks
Journal: JAMA Cardiology (2018)

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SINGLE-SESSION EUS-GUIDED GASTRO-JEJUNOSTOMY AND CHOLEDOCHO-DUODENOSTOMY TO TREAT DUAL STENT DYSFUNCTION IN CONCURRENT MALIGNANT GASTRIC OUTLET AND BILIARY OBSTRUCTION
Authors: R Sanchez-Ocana, R Torres-Yuste, M Cimavilla-Roman, A Carbajo-Lopez, M de Benito-Sanz, I Peñas-Herrero, S Sevilla-Ribota, C De la Serna-Higuera, M Perez-Miranda
Journal: Endoscopy (2018)

Gastric Outlet Obstruction (GOO) usually occurs late in pancreatic cancer, typically associated with biliary obstruction. Combined duodenal and biliary self-expandable metal stents (SEMS) are not always effective whereas surgery often carries prohibitive risks
Cost Effectiveness of Early Insertion of Transjugular Intrahepatic Portosystemic Shunts for Recurrent Ascites
Authors: Nicole T. Shen, Yecheskel Schneider, Stephen E. Congly, Russell E. Rosenblatt, Yunseok Namn, Brett E. Fortune, Arun Jesudian, Robert S. Brown
Journal: Clinical Gastroenterology and Hepatology (2018)
Facile synthesis of semi-library of low charge density cationic polyesters from poly(alkylene maleate)s for efficient local gene delivery
Authors: Huijie Yan, Dingcheng Zhu, Zhuxian Zhou, Xin Liu, Ying Piao, Zhen Zhang, Xiangrui Liu, Jianbin Tang, Youqing Shen
Journal: Biomaterials (2018)
CONNECT YOUR NEEDLE TO YOUR SMARTPHONE TO INCREASE EUS-FNA DIAGNOSTIC YIELD? ESGE RESEARCH GRANT 2016 PRELIMINARY RESULTS
Authors: M Mitrut, A Bocaniala, E Tianu, F Obrocea, M Ciocirlan
Journal: Endoscopy (2018)

Diagnostic yield of endoscopic ultrasound fine needle aspiration (EUS-FNA) in solid pancreatic masses depends on the lesion's characteristics, needle diameter, presence of aspiration, number of passes and presence of rapid on site evaluation. We aim to prove that high needle acceleration through tissue significantly increases EUS FNA diagnostic yield.
NEW METHOD TO INSERT LARGE CALIBER PLASTIC AND SELF-EXPANDING METAL STENTS (SEMS) DURING BALLOON OVERTUBE ENTEROSCOPY (BAE) ASSISTED ERCP
Authors: PT Kröner, A Martínez-Alcalá García, G Schwingel, AM Ahmed, MA D'Assunção, LC Fry, K Mönkemüller
Journal: Endoscopy (2018)

To demonstrate a new method to deliver self-expanding metal and large diameter plastic stents during DBE-ERCP in patients with surgically altered upper GI tract anatomy.
ASSESSMENT OF COLONOSCOPY QUALITY IN CLINICAL PRACTICE
Authors: Á Patai, E Toth, A Agrawal, P Amaro, L Brink, W Fischbach, M Hünger, R Jover, U Kinnunen, A Koulaouzidis, A Ono, L Petruzziello, C Spada, B Amlani, JF Riemann
Journal: Endoscopy (2018)

The aim is to assess the quality of colonoscopy in current clinical practice, through the use of online questionnaires, compared with recently published European Society of Gastrointestinal Endoscopy (ESGE) key performance measures.