tbuckley/cabot-search huggingface dataset:
Management of paediatric hernia
Authors: Kirk Bowling, Natasha Hart, Phil Cox, Gandrapu Srinivas
Journal: BMJ (2017)

#### What you need to know

A hernia is the protrusion of an organ, such as the bowel, through the wall of the cavity in which it normally resides.1 Paediatric hernias are common developmental abnormalities which have different management from their adult equivalents. Conducting research in the management of paediatric hernias is challenging because of ethical considerations and variations in treatment practice. This article provides the generalist with essential information, enabling them to educate parents, alleviate anxiety, and where appropriate enable management of hernias in primary care. We discuss three types of common paediatric hernias.

### How common is it?

Umbilical hernia affects an estimated 10-30% of all white children at birth, reducing to 2-10% at one year.23 Rates in the African population have been estimated at 23-85%.456 The exact aetiology predisposing African populations at increased risk is unknown.47 Risk factors can be seen in table 1⇓.

View this table:

Table 1 
Risk factors for paediatric hernia 



### What is the anatomy?

The umbilical ring exists to allow passage of vessels through the abdominal wall muscles between mother and fetus. After birth and disintegration of the cord, the ring remains, with spontaneous closure typically by the child’s fifth year through growth of the abdominal muscles and fusion of peritoneal and fascial layers. A failure or delay in this …
Casos agrupados de Salmonella enteritidis en Suecia en 2005-2006. Presunto origen: almendras
Authors: L Ledet Muller, M Hjertqvist, L Payne, H Pettersson, A Olsson, L Plym-Forshell, Y Andersson
Journal: Eurosurveillance (2007)

Los anteriores brotes epidemicos de infeccion por Salmonella enteritidis constatados en Canada y los Estados Unidos se asociaron al consumo de almendras. Entre diciembre de 2005 y agosto de 2006 se notificaron en Suecia 15 casos de infeccion por Salmonella enteritidis NST3+.
Effect of chemotherapy on cosmetic outcomes in patients with silicon implants undergoing breast conservation.
Authors: Gustavo Ferraris, Maria Fernanda Diaz Vazquez, Francisco A. Myslicki, Monica Brunetto, Jorge Escobar, Diego Flores, Jesse Shulman, Eduardo Fernandez
Journal: Journal of Clinical Oncology (2014)

e17576 Background: To evaluate the impact of chemotherapy on cosmetic outcome in patients with breast conservation therapy (BCT) that had previous silicone implants (SI). Methods: We reviewed the records of 95 patients with stages I and II adenocarcinoma treated with BCT who had retromuscularly placed SI prior to their diagnosis. Treatment consisted of partial mastectomy, sentinel node biopsy and / or axillary dissection followed by RT. Adjuvant chemotherapy (Group A) was administered in 45 patients, prior to radiation. Group B was composed of 50 patients not receiving chemotherapy. The cosmetic results of each patient were recorded using the Baker classification system (grade 1-4) before and after chemotherapy and radiotherapy. Statistical analysis was done by Fisher exact test (two sides) and appropriate grouping. The results of the comparisons were considered as statistically significant in case of a p value <0.05. Results: Median follow-up for all patients was 70 months. median age was 48 years (range 35-60). Overall, 80 patients (85%) had a positive cosmetic result (Baker Grades 1-2). 15 patients (15%) had an unfavorable cosmetic outcome (Baker Grades 3-4). Only 1 patient had a severe contracture that required implant removal. (Group A). Overall complication rates in the 2 groups were non-significant (p = 0.981) when comparing grades 1-2 vs. 3-4 Baker´s categories, pre and post chemotherapy. Multivariate analysis showed no effect of other variables such as radiotherapy (2 versus 3 fields), type of chemotherapy (taxanes, anthracyclines), hormonal therapy, and smoking (p = 0.604). 6 patients in group A and two in group B developed distant disease. 3 of these died of the disease (11%). Dosimetric analysis demonstrated that the presence of S.I. significantly increases the D2% value to 7% of the prescription dose (p = 0.0035). Conclusions: With proper radiation techniques, excellent local control with optimal cosmesis can be obtained in patients with previous S.I. that opt for BCT. Adjuvant chemotherapy does not influence cosmetic outcome. Our analysis shows a higher dose than expected due to the presence of the S.I., as evidenced by increased D2%, but it does not correlate with a worse cosmetic outcome.
Cobertura de la vacunación antigripal en personas de la tercera edad, Campania (Italia), 1999
Authors: P D'Argenio, B Adamo, R Coluccio, A D'Apice, M. A. Ferrara, F Giugliano, R Parrella, F Peluso, V Romeo, C Ronga, A Simonetti, A Citarella
Journal: Eurosurveillance (2001)

Se ha realizado un estudio de la cobertura de la vacunacion antigripal en personas de la tercera edad. Un cincuenta y seis por ciento de las personas entrevistadas habian sido vacunadas (tasa ponderada de vacunacion del 50%) frente al objetivo marcado del 75%, si bien las tasas de vacunacion en personas mayores de 74 anos y en personas con enfermedades cronicas fueron mas altas.
Epidémie de cryptosporidiose associée à des attractions aquatiques au Royaume-Uni : l’importance de recommandations
Authors: M Jones, D Boccia, M Kealy, B Salkin, A Ferrero, G Nichols, J M Stuart
Journal: Eurosurveillance (2006)

Le besoin de recommandations nationales concernant les attractions aquatiques a ete souligne suite a trois epidemies de cryptosporidiose au Royaume-Uni, toutes associees a de telles attractions. En aout 2003, une epidemie de cryptosporidiose a ete signalee a l’institut de sante publique du sud-ouest de l’Angleterre. Elle etait associee a un jeu d’eau interactif dans un parc d’attractions. Le jeu en question a ete incrimine suite a la mise en evidence d’un nombre important de coliformes dans les echantillons et la presence de coliformes fecaux. 
Un cas etait defini comme tout enfant de moins de 16 ans ayant visite le parc en aout, et ayant ensuite presente des symptomes gastrointestinaux ainsi qu’un echantillon fecal positif pour cryptosporidium. Soixante et onze enfants ont ete identifies dans la cohorte. 
Cette epidemie de cryptosporidiose s’est caracterisee par un taux d’attaque tres eleve (89%), une duree relativement longue (mediane de huit jours) et un taux d’hospitalisation assez eleve (16% des cas). La courbe epidemique montrait une seule source d’infection, correspondant a la date a laquelle 80% des cas avaient visite le parc. Cette epidemie a des points communs avec deux autres epidemies de cryptosporidiose rapportees en 2003 ou des jeux d’eau etaient impliques. Ces epidemies soulevent le probleme de la gestion et de la maintenance des attractions comportant de l’eau, tres prisees des enfants. L’article en question donne un apercu des mesures de controle elementaires qui peuvent etre prises et souligne la necessite de recommandations, compte-tenu du fait que ce type d’attractions est de plus en plus repandu. De telles recommandations ont ete publiees au Royaume-Uni par un groupe d’experts sur le traitement de l’eau des bassins, le Pool Water Treatment Advisory Group.
A retrospective analysis of S-1 in patients with Gemcitabine plus nab-Paclitaxel refractory pancreatic cancer
Authors: Hidetaka Tsumura, Hideki Sakai, Nagahiro Tokuyama, Saeko Kushida, Aya Sakai, Takuya Mimura, Takeshi Sakamoto, Yoshinobu Yamamoto, Ikuya Miki, Masahiro Tsuda
Journal: Annals of Oncology (2017)

Gemcitabine plus nab-Paclitaxel (GnP) has been one of the standard first-line therapy in patient with advanced pancreatic cancer. In order to improve the prognosis of such patients, there is an urgent need to establish an effective second-line therapy. Although various second-line therapies have been studied, any phase III data do not support a particular regimen. In Japan, S-1 is commonly used for the treatment of pancreatic cancer patients. But there were few reports about S-1 as the second line treatment of pancreatic cancer patients who failed GnP treatment. To evaluate the efficacy and safety of S-1 in patients with GnP-refractory pancreatic cancer as a second-line setting. Patients with confirmed progressive disease following the first-line treatment with a GnP regimen received S-1 (80/100/120 mg/day based on body surface area (BSA), orally, days 1-28, every 6 weeks). We evaluated retrospectively the efficacy and safety of S-1 in patients with GnP-refractory pancreatic cancer as a second-line setting. Between January 2015 and December 2016, 19 patients were received S-1 therapy as second line in our hospital. Median age: 68(58-77), Male/Female:10/9, PS 0/1/2=5/11/3, locally advanced/metastatic/reccurence:2/14/3, head/body/tail:8/5/6, number of metastatic sites 0/1/2: 2/11/6, median CA19-9 was 4463. Only one patient was placed biliary stent before first line therapy. Median progression free survival was 3.7 months. Median overall survival was not reached. The response rate was 14%. (CR/PR/SD/PD/NE:0/2/8/4/3) The major garade3/4 toxicities were leukopenia(5%), neutropenia(5%), anemia(5%) and thrombocytopenia(5%), nausea (5%), vomiting(5%), anorexia(11%), stomatitis(5%) and fatigue(5%). S-1 showed a moderate efficacy with acceptable toxicities for patients with GnP-refractory pancreatic cancer as a second-line setting.
Effect of Oral Semaglutide Compared With Placebo and Subcutaneous Semaglutide on Glycemic Control in Patients With Type 2 Diabetes
Authors: Melanie Davies, Thomas R. Pieber, Marie-Louise Hartoft-Nielsen, Oluf K. H. Hansen, Serge Jabbour, Julio Rosenstock
Journal: JAMA (2017)

Glucagon-like peptide-1 (GLP-1) receptor agonists are effective therapies for the treatment of type 2 diabetes and are all currently available as an injection.To compare the effects of oral semaglutide with placebo (primary) and open-label subcutaneous semaglutide (secondary) on glycemic control in patients with type 2 diabetes.Phase 2, randomized, parallel-group, dosage-finding, 26-week trial with 5-week follow-up at 100 sites (hospital clinics, general practices, and clinical research centers) in 14 countries conducted between December 2013 and December 2014. Of 1106 participants assessed, 632 with type 2 diabetes and insufficient glycemic control using diet and exercise alone or a stable dose of metformin were randomized. Randomization was stratified by metformin use.Once-daily oral semaglutide of 2.5 mg (n = 70), 5 mg (n = 70), 10 mg (n = 70), 20 mg (n = 70), 40-mg 4-week dose escalation (standard escalation; n = 71), 40-mg 8-week dose escalation (slow escalation; n = 70), 40-mg 2-week dose escalation (fast escalation, n = 70), oral placebo (n = 71; double-blind) or once-weekly subcutaneous semaglutide of 1.0 mg (n = 70) for 26 weeks.The primary end point was change in hemoglobin A1c (HbA1c) from baseline to week 26. Secondary end points included change from baseline in body weight and adverse events.Baseline characteristics were comparable across treatment groups. Of the 632 randomized patients (mean age, 57.1 years [SD, 10.6]; men, 395 (62.7%); diabetes duration, 6.3 years [SD, 5.2]; body weight, 92.3 kg [SD, 16.8]; BMI, 31.7 [SD, 4.3]), 583 (92%) completed the trial. Mean change in HbA1c level from baseline to week 26 decreased with oral semaglutide (dosage-dependent range, -0.7% to -1.9%) and subcutaneous semaglutide (-1.9%) and placebo (-0.3%); oral semaglutide reductions were significant vs placebo (dosage-dependent estimated treatment difference [ETD] range for oral semaglutide vs placebo, -0.4% to -1.6%; P = .01 for 2.5 mg, <.001 for all other dosages). Reductions in body weight were greater with oral semaglutide (dosage-dependent range, -2.1 kg to -6.9 kg) and subcutaneous semaglutide (-6.4 kg) vs placebo (-1.2 kg), and significant for oral semaglutide dosages of 10 mg or more vs placebo (dosage-dependent ETD range, -0.9 to -5.7 kg; P < .001). Adverse events were reported by 63% to 86% (371 of 490 patients) in the oral semaglutide groups, 81% (56 of 69 patients) in the subcutaneous semaglutide group, and 68% (48 of 71 patients) in the placebo group; mild to moderate gastrointestinal events were most common.Among patients with type 2 diabetes, oral semaglutide resulted in better glycemic control than placebo over 26 weeks. These findings support phase 3 studies to assess longer-term and clinical outcomes, as well as safety.clinicaltrials.gov Identifier: NCT01923181.
Children under 5 years are at risk for tuberculosis after occasional contact with highly contagious patients: outbreak from a smear-positive healthcare worker
Authors: Roberto Luzzati, Giovanni Battista Migliori, Matteo Zignol, Daniela Maria Cirillo, Massimo Maschio, Riccardo Tominz, Giovanna Ventura, Valentino Patussi, Lia D'Ambrosio, Rosella Centis, Franco Michieletto, Alberto Trovato, Francesco Salton, Marina Busetti, Manuela Di Santolo, Mario Raviglione, Marco Confalonieri
Journal: European Respiratory Journal (2017)

The World Health Organization (WHO), jointly with experts from tuberculosis (TB) low-incidence countries, developed a framework for TB elimination [1, 2]. Children under 5 years of age are at risk for tuberculosis after occasional contact with highly contagious patients <http://ow.ly/RqAn30fKdGk>
lncRNA MIR100HG-derived miR-100 and miR-125b mediate cetuximab resistance via Wnt/β-catenin signaling
Authors: Yuanyuan Lu, Xiaodi Zhao, Qi Liu, Cunxi Li, Ramona Graves-Deal, Zheng Cao, Bhuminder Singh, Jeffrey L Franklin, Jing Wang, Huaying Hu, Tianying Wei, Mingli Yang, Timothy J Yeatman, Ethan Lee, Kenyi Saito-Diaz, Scott Hinger, James G Patton, Christine H Chung, Stephan Emmrich, Jan-Henning Klusmann, Daiming Fan, Robert J Coffey
Journal: Nature Medicine (2017)
Sensitivity to sequencing depth in single-cell cancer genomics
Authors: João M. Alves, David Posada
Journal: Genome Medicine (2018)

Querying cancer genomes at single-cell resolution is expected to provide a powerful framework to understand in detail the dynamics of cancer evolution. However, given the high costs currently associated with single-cell sequencing, together with the inevitable technical noise arising from single-cell genome amplification, cost-effective strategies that maximize the quality of single-cell data are critically needed. Taking advantage of previously published single-cell whole-genome and whole-exome cancer datasets, we studied the impact of sequencing depth and sampling effort towards single-cell variant detection. Five single-cell whole-genome and whole-exome cancer datasets were independently downscaled to 25, 10, 5, and 1× sequencing depth. For each depth level, ten technical replicates were generated, resulting in a total of 6280 single-cell BAM files. The sensitivity of variant detection, including structural and driver mutations, genotyping, clonal inference, and phylogenetic reconstruction to sequencing depth was evaluated using recent tools specifically designed for single-cell data. Altogether, our results suggest that for relatively large sample sizes (25 or more cells) sequencing single tumor cells at depths > 5× does not drastically improve somatic variant discovery, characterization of clonal genotypes, or estimation of single-cell phylogenies. We suggest that sequencing multiple individual tumor cells at a modest depth represents an effective alternative to explore the mutational landscape and clonal evolutionary patterns of cancer genomes.
TCT-390 Impact of air-pollution on AMI occurrence
Authors: Kamil Derbisz, Krzysztof Milewski, Przemyslaw Kwasiborski, Patrycja Chrząszcz, Magdalena Mularska, Mateusz Kachel, Piotr Buszman, Paweł Buszman
Journal: Journal of the American College of Cardiology (2017)
Corrigendum to “96 weeks combination of adefovir dipivoxil plus emtricitabine vs. adefovir dipivoxil monotherapy in the treatment of chronic hepatitis B”
Authors: Chee-Kin Hui, Hai-Ying Zhang, Scott Bowden, Stephen Locarnini, John M. Luk, Kar-Wai Leung, Yui-Hung Yueng, April Wong, Frank Rousseau, Kwok-Yung Yuen, Nikolai N. Naoumov, George K.K. Lau
Journal: Journal of Hepatology (2009)
The non-neuronal and nonmuscular effects of botulinum toxin: an opportunity for a deadly molecule to treat disease in the skin and beyond
Authors: S.A. Grando, C.B. Zachary
Journal: British Journal of Dermatology (2017)

There is growing evidence that botulinum neurotoxins (BoNTs) exhibit biological effects on various human cell types with a host of associated clinical implications. This review aims to provide an update on the non-neuronal and nonmuscular effects of botulinum toxin. We critically analysed recent reports on the structure and function of cellular signalling systems subserving biological effects of BoNTs. The BoNT receptors and intracellular targets are not unique for neurotransmission. They have been found in both neuronal and non-neuronal cells, but there are differences in how BoNT binds to, and acts on, neuronal vs. non-neuronal cells. The non-neuronal cells that express one or more BoNT/A-binding proteins, and/or cleavage target synaptosomal-associated protein 25, include: epidermal keratinocytes; mesenchymal stem cells from subcutaneous adipose; nasal mucosal cells; urothelial cells; intestinal, prostate and alveolar epithelial cells; breast cell lines; neutrophils; and macrophages. Serotype BoNT/A can also elicit specific biological effects in dermal fibroblasts, sebocytes and vascular endothelial cells. Nontraditional applications of BoNT have been reported for the treatment of the following dermatological conditions: hyperhidrosis, Hailey-Hailey disease, Darier disease, inversed psoriasis, aquagenic palmoplantar keratoderma, pachyonychia congenita, multiple eccrine hydrocystomas, eccrine angiomatous hamartoma, eccrine sweat gland naevi, congenital eccrine naevus, Raynaud phenomenon and cutaneous leiomyomas. Experimental studies have demonstrated the ability of BoNT/A to protect skin flaps, facilitate wound healing, decrease thickness of hypertrophic scars, produce an anti-ageing effect, improve a mouse model of psoriasiform dermatitis, and have also revealed extracutaneous effects of BoNT arising from its anti-inflammatory and anticancer properties. BoNTs have a much wider range of applications than originally understood, and the individual cellular responses to the cholinergic impacts of BoNTs could provide fertile ground for future studies.
Abstract P242: Association of Polyunsaturated Fatty Acids With Body Mass Index: Results From the Multi-Ethnic Study of Atherosclerosis
Authors: Theresa Hastert, Marcia C de Oliveira Otto, Felice Le-Scherban, Brian Steffen, Lynn M Steffen, Michael Tsai, David Jacobs, Ha Nguyen, Ana Baylin
Journal: Circulation (2015)

Background: Although much previous research has focused on the association between total dietary fat and body weight, body mass index (BMI), and weight loss, the contributions of different types of...
Abstract 15752: Coarse Appearance of Atrial Fibrillation Associated With Greater Percentage of Low Left Atrial Voltage and Higher Post-ablation Arrhythmia Recurrence
Authors: Sunil Kapur, Calum A MacRae, Gregory F Michaud
Journal: Circulation (2016)

Introduction:  Atrial fibrillation (AF) is the most common clinical dysrhythmia, however our understanding of various subtypes of this umbrella diagnosis remain limited. One readily apparent categorizing variable is the appearance of fibrillatory waves on the surface electrocardiogram which classically divides AF into fine or coarse. The mechanistic underpinnings and clinical implications of this distinction remain unclear.   Hypothesis:  We aimed to determine the natural history, the electroanatomic underpinnings and ablation implications of fine versus coarse AF.   Methods:  We searched the Partners Healthcare system for patients with a diagnosis of long-standing persistent AF who had follow up electrocardiography and clinical evaluation. After excluding patients who were treated with catheter ablation, anti-arrhythmic therapy or underwent cardiac surgery, we identified a 135 patient cohort. We subsequently evaluated a separate cohort of patients with coarse (n=40) as well as fine (n=40) persistent AF referred for electroanatomic mapping and ablation and identified mapping findings, ablation characteristics and follow up outcomes. Fine versus coarse was classified based on surface EKG V1 fibrillatory wave amplitude.   Results:  Patients with fine persistent AF at baseline were older (75 ± 13 vs 68 ±14 years; p = 0.04), while patients with coarse persistent AF were more likely to have hypertension, congestive heart failure, and valvular heart disease. Over an average follow up of 4.2 years, fine AF progressed to coarse AF in 25% of patients whereas coarse AF progressed to fine AF in 33% of patients. At the time of electroanatomic mapping, patients with coarse AF had increased percentage of low left atrial voltage (bipolar voltage ≤ 0.5 mV) (24± 8 % vs 8 ± 4 %; p = 0.01). Long term arrhythmia free survival was inferior in patients with coarse AF post ablation when compared to fine AF (Hazard ratio 1.83; p = 0.04).   Conclusions:  The surface electrocardiographic appearance of coarse versus fine AF may represent distinct left atrial low voltage electrophysiology. Further evaluation is necessary to determine if this distinction can provide clinical insights that would alter patient care.
TCT-263 Quality of Life Outcomes in Transcatheter Aortic Valve Replacement Patients Requiring Pacemaker Implantation
Authors: Aishwarya Bhardwaj, Tharmathai Ramanan, Abhishek Sawant, Michael Pham, Everett Sinibaldi, Rosemary Hansen, Shannon Baldo, Gerald Colern, Hiroko Beck, Vijay Iyer
Journal: Journal of the American College of Cardiology (2017)
TCT-752 Risk assessment of premature discontinuation of dual antiplatelet therapy in patients undergoing vascular surgery after second generation DES implantation
Authors: Aleksander Zurakowski, Mateusz Kachel, Dariusz Szykowski, Przemek Nowakowski, Krzysztof Milewski, Piotr Buszman
Journal: Journal of the American College of Cardiology (2017)
Acupuncture does not reduce C section rate but may improve cervical maturity, review finds
Authors: Jacqui Wise
Journal: BMJ (2017)

Acupuncture and acupressure do not seem to reduce the need for a caesarean section, a Cochrane review has concluded, although acupuncture may help the cervix get ready for labour.1

Medical induction methods such as prostaglandins can have significant side effects, so many women choose complementary methods to bring on labour. Many midwives practise these along with usual care, and the limited observational studies to date show that acupuncture may be effective. Acupuncture involves inserting fine needles …
TCT-69 Comparison of Quantitative Flow Ratio and Fractional Flow Reserve to Identify Myocardial Ischemia: Validation With Myocardial Perfusion Scintigraphy and Cardiovascular Magnetic Resonance
Authors: Jelmer Westra, Simon Winther, Shengxian Tu, Louise Nissen, Lars Gormsen, Steffen Petersen, June Ejlersen, Christin Isaksen, Morten Bottcher, Evald Christiansen, Niels Holm
Journal: Journal of the American College of Cardiology (2017)
Drug-eluting stents in elderly patients with coronary artery disease (SENIOR): a randomised single-blind trial
Authors: Olivier Varenne, Stéphane Cook, Georgios Sideris, Sasko Kedev, Thomas Cuisset, Didier Carrié, Thomas Hovasse, Philippe Garot, Rami El Mahmoud, Christian Spaulding, Gérard Helft, José F Diaz Fernandez, Salvatore Brugaletta, Eduardo Pinar-Bermudez, Josepa Mauri Ferre, Philippe Commeau, Emmanuel Teiger, Kris Bogaerts, Manel Sabate, Marie-Claude Morice, Peter R Sinnaeve
Journal: The Lancet (2017)