tbuckley/cabot-search huggingface dataset:
Association of Ambulatory Hemodynamic Monitoring of Heart Failure With Clinical Outcomes in a Concurrent Matched Cohort Analysis
Authors: Jacob Abraham, Rupinder Bharmi, Orvar Jonsson, Guilherme H. Oliveira, Andre Artis, Ali Valika, Robert Capodilupo, Philip B. Adamson, Gregory Roberts, Nirav Dalal, Akshay S. Desai, Raymond L. Benza
Journal: JAMA Cardiology (2019)

In a randomized clinical trial, heart failure (HF) hospitalizations were lower in patients managed with guidance from an implantable pulmonary artery pressure sensor compared with usual care. It remains unclear if ambulatory monitoring could also improve long-term clinical outcomes in real-world practice.To determine the association between ambulatory hemodynamic monitoring and rates of HF hospitalization at 12 months in clinical practice.This matched cohort study of Medicare beneficiaries used claims data collected between June 1, 2014, and March 31, 2016. Medicare patients who received implants of a pulmonary artery pressure sensor were identified from the 100% Medicare claims database. Each patient who received an implant was matched to a control patient by demographic features, history of HF hospitalization, and number of all-cause hospitalizations. Propensity scoring based on comorbidities (arrhythmia, hypertension, diabetes, pulmonary disease, and renal disease) was used for additional matching. Data analysis was completed from July 2017 through January 2019.Implantable pulmonary artery pressure monitoring system.The rates of HF hospitalization were compared using the Andersen-Gill method. Days lost owing to events were compared using a nonparametric bootstrap method.The study cohort consisted of 1087 patients who received an implantable pulmonary artery pressure sensors and 1087 matched control patients. The treatment and control cohorts were well matched by age (mean [SD], 72.7 [10.2] years vs 72.9 [10.1] years) and sex (381 of 1087 female patients [35.1%] in each group), medical history, comorbidities, and timing of preimplant HF hospitalization. At 12 months postimplant, 616 HF hospitalizations occurred in the treatment cohort compared with 784 HF hospitalizations in the control cohort. The rate of HF hospitalization was lower in the treatment cohort at 12 months postimplant (hazard ratio [HR], 0.76 [95% CI, 0.65-0.89]; P < .001). The percentage of days lost to HF hospitalizations or death were lower in the treatment group (HR, 0.73 [95% CI, 0.64-0.84]; P < .001) and the percentage of days lost owing to all-cause hospitalization or death were also lower (HR, 0.77 [95% CI, 0.68-0.88]; P < .001).Patients with HF who were implanted with a pulmonary artery pressure sensor had lower rates of HF hospitalization than matched controls and spent more time alive out of hospital. Ambulatory hemodynamic monitoring may improve outcomes in patients with chronic HF.
HIGH-QUALITY COLON CLEANSING IMPROVES SEGMENTAL POLYP AND ADENOMA DETECTION RATES: POST HOC ANALYSIS OF RANDOMISED CLINICAL TRIALS USING THE BOSTON BOWEL PREPARATION SCALE
Authors: C Hassan, J Halonen, J Manning
Journal: Endoscopy (2019)

Successful colon cleansing is defined as a segmental score of 2 or higher on the Boston Bowel Preparation Scale (BBPS). The additional clinical value of high-quality cleansing (BBPS 3) is subject for debate. This post hoc analysis of three randomised phase 3 clinical trials assessed the segmental lesion detection rates in the right colon at variable BBPS scores.
The aromatase inactivator exemestane suppresses serum leptin levels significantly in vivo - in contrast to the aromatase inhibitor letrozole
Authors: N. Bahrami, S. Jabeen, T. Sauer, V.N. Kristensen, J.M. Gundersen, J. Geisler
Journal: Annals of Oncology (2019)

Background: The aromatase inhibitor letrozole (Femarâ/ Femaraâ) and the aromatase inactivator exemestane (Aromasinâ) are currently widely used to treat estrogen receptor positive breast cancer in postmenopausal patients. Interestingly, exemestane may cause clinical disease stabilization following progression on non-steroidal AIs in patients with metastatic breast cancer indicating that additional effects, not necessarily related to estrogen-suppression, may be involved in the well-known "lack of cross-resistance". The adipocytokine leptin has been shown to enhance the expression of aromatase via promoter II and I.3 using an AP-1 motif. In this study, we evaluated the serum levels of 12 adipokines relative to given treatment with aromatase inhibitors aiming for a direct head-to-head comparison between letrozole and exemestane in vivo. Methods: The NEO-LET-EXE-trial is a neoadjuvant, randomized, open-label, intra-patient cross-over trial. Postmenopausal women with ER+, HER-2 negative, locally advanced breast cancer were enrolled. Blood specimens obtained at baseline, after 2 months and 4 months of treatment were available from 39 patients. All patients were randomized to sequential treatment starting with either letrozole (2.5 mg o.d.) or exemestane (25 mg o.d.) for 2 months followed by another 2 months on the alternative aromatase inhibitor. The serum levels of twelve adipokines were assessed using the Luminex xMAP technology (multiple ELISA). Results: Serum levels of leptin were significantly decreased during treatment with exemestane compared to treatment with letrozole (P < 0.001), regardless whether exemestane was given as first or second therapy. Furthermore, we observed a strong trend towards a reduction of serum levels of adiponectin during treatment with exemestane (P = 0.059). No significant changes in serum levels of the other adipocytokines were registered during treatment with aromatase inhibitors. Conclusions: Our results suggest distinct influences of exemestane on serum leptin but also adiponectin levels that may contribute to the clinical well-document positive effects of exemestane following progression on non-steroidal AIs like letrozole. Legal entity responsible for the study: Akershus University Hospital. Funding: The South-Eastern Norway Regional Health Authority. Disclosure: All authors have declared no conflicts of interest.
Characterising unmet HIV prevention and treatment needs among young female sex workers and young men who have sex with men in Cameroon: a cross-sectional analysis
Authors: Anna L Bowring, Sosthenes Ketende, Amrita Rao, Iliassou Mfochive Njindam, Michele R Decker, Carrie Lyons, Daniel Levitt, Oluwasolape Olawore, Gnilane Turpin, Guy H Fako, Ghislaine Fouda, Ubald Tamoufe, Serge C Billong, Oudou Njoya, Anne-Cecile Zoung-Kanyi Bissek, Stefan Baral
Journal: The Lancet Child & Adolescent Health (2019)
Management of Chronic Pain in Adults Living With Sickle Cell Disease in the Era of the Opioid Epidemic
Authors: Cynthia B. Sinha, Nitya Bakshi, Diana Ross, Lakshmanan Krishnamurti
Journal: JAMA Network Open (2019)

<h3>Importance</h3> The hallmark of sickle cell disease (SCD) is vaso-occlusive pain that may be acute and episodic or may progress to chronic, persistent pain with unpredictable and disabling exacerbations. Patients with SCD rely on opioids almost exclusively for acute and chronic pain management. <h3>Objective</h3> To understand how the current opioid epidemic and subsequent guidelines from the Centers for Disease Control and Prevention are associated with the management of acute and chronic pain for patients with SCD. <h3>Design, Setting, and Participants</h3> Qualitative study using semistructured interview guides. Interviews 1 hour or longer were conducted over the telephone. Participants were adults (aged ≥18 years) diagnosed with SCD who experienced pain on 3 or more days per week recruited from national SCD conferences, symposiums, and 2 sickle cell clinics. Open coding analysis facilitated thematic analysis of interview transcripts. Data collection took place from May 2017 to June 2018. <h3>Main Outcomes and Measures</h3> Participant perspective of any changes to their pain management associated with the 2016 guidelines from the Centers for Disease Control and Prevention. <h3>Results</h3> The 15 adults interviewed had a median (range) age of 32 (21-52) years; 13 (87%) were female; and all were of African American race/ethnicity. Participants reported that recently their opioid prescriptions had become more restrictive, were more closely monitored, and were increasingly difficult to fill in pharmacies. Participants also described increased stigmatization about opioid use and that their medical care was being affected by the physician's exclusive focus on reducing pain medication use. There was an emerging interest among adult patients in the consideration of the use of alternative therapies, including marijuana, to manage pain. <h3>Conclusions and Relevance</h3> These findings suggest that from the perspective of adults living with SCD, the opioid epidemic may have negatively affected patients' care by increasing barriers to opioids. Patients reported decreased opioid dosing, increased stigmatization regarding opioid use, physician preoccupation with opioid dosage interfering with comprehensive care, and lack of access to alternative therapies.
Trends in Levels of Lipids and Apolipoprotein B in US Youths Aged 6 to 19 Years, 1999-2016
Authors: Amanda M. Perak, Hongyan Ning, Brian K. Kit, Sarah D. de Ferranti, Linda V. Van Horn, John T. Wilkins, Donald M. Lloyd-Jones
Journal: JAMA (2019)

Favorable trends occurred in the lipid levels of US youths through 2010, but these trends may be altered by ongoing changes in the food supply, obesity prevalence, and other factors.
TWO CASES OF DELAYED REMOVAL OF MIGRATED PANCREATIC STENT SOLVED WITH THE SAME TECHNIQUE – FOREIGN-BODY FORCEPS
Authors: G Mendes Simões, M Kumar Goenka
Journal: Endoscopy (2019)

Pancreatic stenting has been increasingly used for a variety of pancreatic conditions during therapeutic endoscopic retrograde cholangiopancreatography (ERCP). Proximal migration of pancreatic stents is an infrequent complication of pancreatic stenting and its management is difficult to tackle despite the several different methods described.
Dual targeting of RANKL/RANK pathway and HER-2 as a novel treatment strategy in HER-2 positive (+) breast carcinomas (BC)
Authors: I. Zoi, E. Xingi, D. Thomaidou, A.G. Papavassiliou, M.V. Karamouzis
Journal: Annals of Oncology (2019)

Background: HER-2 is overexpressed in 20–30% of BC, indicating poor prognosis. RANKL/RANK pathway is implicated in HER-2(+) BC. The molecular mechanism and the potential dual targeting have been evaluated and showed promising results. Methods: We used SKBR3, BT474, MCF7, MDA-MB-453 human BC cell lines. We examined the expression of RANK and RANKL using RT-PCR, Western-Blot and immunofluorescence. The interaction between RANK and HER-2 was detected using Proximity Ligation Assay (PLA) which enables the visualization of interacting proteins. NF-κB pathway activation was studied using Western-Blot. We used inhibitors of both pathways [trastuzumab (T), pertuzumab (P), denosumab (D)]. Cell viability and cell migration was evaluated using XTT and scratch assay, respectively. Results: Cell lines differentially express RANK and RANKL. RANK receptor dimerizes with HER-2. RANK/HER-2 dimer number depends on HER-2 expression (SKBR3: 5.4, BT474: 8.2, MCF7: 0.7, MDA-MB-453: 0.3). RANK/HER-2 dimers are decreased in the presence of the inhibitors D, T and P, while they are increased after RANKL (R) treatment in SKBR3 (m:5.4, D:1.2, T:1.9, DT:0.6, TP:1, DTP:0.4, R:11.8,) and BT474 (m:8.2, D:3.1, T:4.3, DT:0.7, TP:3.4, DTP:3.2, R:11.6). MCF7 and MDA-MB-453 do not correspond to inhibitors. The combination treatment of SKBR3 with the inhibitors further decreased NF-κB pathway activation compared to single targeting. SKBR3, after inhibitors treatment, also exhibit reduced cell proliferation (m:100%, D:84.7%, T:51.57%, DT:48.61%, R:111%) and lower metastatic potential (m:26.02%, D:33.56%, T:16.54%, DT:13.75%, R:32.36%) compared to mock cells (m) and increased values in RANKL presence. The combination treatment of SKBR3 with D and T has an advantage in functional proliferation assays compared to single targeting. Conclusions: The results indicate a novel association between HER-2 and RANKL/RANK pathway that affects HER-2(+) BC growth. We also present data suggesting that the combination of HER-2 targeting and RANKL inhibition has therapeutic benefit and should be further tested for certain BC patients. Legal entity responsible for the study: Michalis V. Karamouzis. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
CORRELATION OF OBSTRUCTIVE SYMPTOMS AND RADIOLOGICAL FINDINGS WITH THE PRESENCE OF DUODENAL STENOSIS ON SIDE VIEWING ENDOSCOPY IN PATIENTS WITH MALIGNANT OBSTRUCTIVE JAUNDICE
Authors: M Dodmani, P Patil, A Kale, S Mehta
Journal: Endoscopy (2019)

ERCP may not be feasible due to duodenal stenosis (DS) in some patients with malignant obstructive jaundice (OJ). Predicting likelihood of DS can help anticipate and prepare for an alternative biliary drainage method like EUS-BD at the same sitting. We correlated the symptoms and radiological findings suggestive of gastric outlet obstruction (GOO) in these patients with DS on side viewing endoscopy (SVE).
New environmental reservoir of CPE in hospitals
Authors: Annick Smismans, Erwin Ho, Davy Daniels, Sara Ombelet, Bea Mellaerts, Dagmar Obbels, Hanne Valgaeren, Anja Goovaerts, Eline Huybrechts, Ilke Montag, Johan Frans
Journal: The Lancet Infectious Diseases (2019)
Racial and Ethnic Differences in Atopic Dermatitis–Related School Absences Among US Children
Authors: Joy Wan, David J. Margolis, Nandita Mitra, Ole J Hoffstad, Junko Takeshita
Journal: JAMA Dermatology (2019)

This cross-sectional study examines data from the Pediatric Eczema Elective Registry to assess associations of race/ethnicity with school absences attributed to atopic dermatitis in US school-aged children (6 to 17 years).
ESOPHAGEAL CLEANSING BEFORE POEM – A SIMPLE AND EFFECTIVE TECHNIQUE
Authors: P Desai, M Kabrawala, P Kalra, R Mehta, C Patel, S Nandwani, R Prajapati, N Patel
Journal: Endoscopy (2019)

We have devised a scoring system depending on the esophageal mucosa, presence of fluid/froth and severity of candidial infection on the initial endoscopy.
Abstract 1564: A YY1-containing Complex Drives Cardiac Cushion Mesenchyme and Schwann Cell-Specific Periostin Expression
Authors: Andrew Lindsley, Paige Snyder, Rhonda Rogers, Anthony B Firulli, Simon J Conway
Journal: Circulation (2006)

Periostin is a fasciclin-containing adhesive glycoprotein that facilitates the migration and differentiation of cells undergoing epithelial-mesenchymal-transformation (EMT) in the embryonic heart and peripheral nervous system. Despite the importance of EMT as a general developmental mechanism, little is known about how periostin’s embryonic expression patterns are controlled. To help resolve this deficiency, periostin’s 3.9 kb proximal promoter was isolated and using a transgenic approach found to drive embryonic, tissue-specific expression in schwann cells and in a sub-population of periostin-expressing cells in the cardiac out-flow tract mesenchyme. In order to identify the factor(s) responsible for this expression pattern, in vitro promoter dissection was undertaken utilizing dual-luciferase luminometry. Serially and internally truncated fragments of the proximal promoter were used to drive expression of firefly luciferase following transfection into RT4-D6P2T rat schwannoma cells. A 304 bp enhancer el...
Evaluation à 1 an de l'efficacité de la pylorotomie endoscopique (G-POEM) dans la gastroparésie réfractaire: étude multicentrique française
Authors: O Ragi, J Jacques, J Branche, S Leblanc, G Vanbiervliet, R Legros, M Pioche, J Rivory, S Chaussade, V Vitton, M Barthet, JM Gonzalez
Journal: Endoscopy (2019)

L'intérêt scientifique autour du G-POEM comme traitement de la gastroparésie réfractaire est grandissant vu la faible disponibilité et efficacité des alternatives thérapeutiques dans cette situation clinique difficile. Peu de facteurs de risque d'efficacité ou d'échec ont été individualisés concernant cette nouvelle procédure, les études restant monocentriques et de faible effectif pour la plupart. Nous rapportons ici les résultats de la plus large série multicentrique rétrospective de patients traités par G-POEM pour gastroparésie réfractaire, avec un suivi d'un an.
Allergy…No more fear of needles!
Authors: Giovanni Traina, Alberto G. Martelli, Alessandro Giovanni Fiocchi, Valentina Franco, Barbara Ronchi, Federica Betti
Journal: Allergy (2019)

Abstract Needleless injection systems are nowadays widespread and are mainly used to overcome the common problems of needle injection systems, such as pain, hematoma, scar tissue formation, infection or abscess, possibility of accidentally injecting into a venous vessel, and transmission of infectious diseases. All these problems are independent of the type of drug injected and are exclusively related to the needle devices. Current needleless injection systems are a valuable tool, which is especially available for the administration of vaccines to large numbers of patients. Our experience focused in particular on the so‐called "jet injectors," of which one of the most valid representatives is Injex®. Our patent essentially concerns a medical needleless device, suitable to inject a subcutaneous AIT (allergy immunotherapy). The mechanism at the base of our device works with compressed air by means of a spring: It is very simple and similar to that of compressed air guns. Once the syringe has been filled, it is placed perpendicular to the skin, and then, the device is activated. The pressure vaporizes the drug, without changing or altering its chemical structure; it makes it pass through the epidermis, until it quickly reaches the subcutaneous layer, at a depth between 3.2 and 9.1 mm, without the patient feeling any pain. The entrance hole made by the needleless device in the epidermis is 0.17 mm rather than 0.39 mm of a normal needle. This type of administration also allows a uniform and spray diffusion of the drug, without causing localized inflammation, as it sometimes happens with normal syringe.
EVALUATION OF THE RELATIONSHIP BETWEEN HELICOBACTER PYLORI AND THE SMALL WHITE SPOT LESIONS OF THE DUODENUM
Authors: B Çavuş, T Çavuş, B Akyüz Erdoğan, E Kumcu
Journal: Endoscopy (2019)

Most of the time we are unable to pinpoint the clear cause or clinical equivalent of the small white spot lesions of the duodenum which we often encounter during routine endoscopic evaluation and identify as duodenal lymphangiectasia (DL). We aimed to evaluate the frequency of these small white spot lesions in the duodenum and their relationship with Helicobacter pylori (H. pylori).
3D POLYPECTOMY: RANDOMISED COMPARISON TO 2D POLYPECTOMY IN AN EX-VIVO MODEL
Authors: S Gmeiner, S Delius, M Abdelhafez, N Kohn, S Reiser, J Wießner, H Feußner, D Wilhelm
Journal: Endoscopy (2019)

Three-dimensional (3D) visualisation has been established for laparoscopy, but not for endoluminal flexible endoscopy. In the actual study we investigated the effects of 3D imaging on endoluminal endoscopic procedures.
Real-time analysis of the behaviour of groups of mice via a depth-sensing camera and machine learning
Authors: Fabrice de Chaumont, Elodie Ey, Nicolas Torquet, Thibault Lagache, Stéphane Dallongeville, Albane Imbert, Thierry Legou, Anne-Marie Le Sourd, Philippe Faure, Thomas Bourgeron, Jean-Christophe Olivo-Marin
Journal: Nature Biomedical Engineering (2019)
Is it still relevant to consider polysomnography as essential for noninvasive ventilation titration?
Authors: Jean-Christian Borel, Jesus Gonzalez-Bermejo
Journal: European Respiratory Journal (2019)

<b>Titration of noninvasive ventilation by polysomnography reduces patient–ventilator asynchrony and may be useful to improve treatment tolerance in patients who are struggling with NIV</b>http://bit.ly/2v1RDty
Robust clinical and laboratory response to hydroxyurea using pharmacokinetically guided dosing for young children with sickle cell anemia
Authors: Patrick T. McGann, Omar Niss, Min Dong, Anu Marahatta, Thad A. Howard, Tomoyuki Mizuno, Adam Lane, Theodosia A. Kalfa, Punam Malik, Charles T. Quinn, Russell E. Ware, Alexander A. Vinks
Journal: American Journal of Hematology (2019)

Abstract Hydroxyurea is FDA‐approved and now increasingly used for children with sickle cell anemia (SCA), but dosing strategies, pharmacokinetic (PK) profiles, and treatment responses for individual patients are highly variable. Typical weight‐based dosing with step‐wise escalation to maximum tolerated dose (MTD) leads to predictable laboratory and clinical benefits, but often takes 6 to 12 months to achieve. The Therapeutic Response Evaluation and Adherence Trial (TREAT, NCT02286154) was a single‐center study designed to prospectively validate a novel personalized PK‐guided hydroxyurea dosing strategy with a primary endpoint of time to MTD. Enrolled participants received a single oral 20 mg/kg dose of hydroxyurea, followed by a sparse PK sampling approach with three samples collected over three hours. Analysis of individual PK data into a population PK model generated a starting dose that targets the MTD. The TREAT cohort (n = 50) was young, starting hydroxyurea at a median age of 11 months (IQR 9‐26 months), and PK‐guided starting doses were high (27.7 ± 4.9 mg/kg/d). Time to MTD was 4.8 months (IQR 3.3‐9.3), significantly shorter than comparison studies (p &lt; 0.0001), thus meeting the primary endpoint. More remarkably, the laboratory response for participants starting with a PK‐guided dose was quite robust, achieving higher hemoglobin (10.1 ± 1.3 g/dL) and HbF (33.3 ± 9.1%) levels than traditional dosing. Though higher than traditional dosing, PK‐guided doses were safe without excess hematologic toxicities. Our data suggest early initiation of hydroxyurea, using a personalized dosing strategy for children with SCA, provides laboratory and clinical response beyond what has been seen historically, with traditional weight‐based dosing.
Abstract 10551: Physical Activity is Associated With Physical Fitness in HIV+ Women but Not HIV+ Men
Authors: Allison R Webel, Liana Davis, Joseph Perazzo, Vitor Hugo Fernando de Oliveira, J. Craig Phillips, Carol Dawson-Rose, Mary Jane Hamilton, Elizabeth Sefcik, Rebecca Schnall, Rita Musanti, Penelope Orton, Kimberly Adams Tufts, Puangtip Chaiphibalsarisdi
Journal: Circulation (2018)

Background: People living with HIV (PLHIV) are at increased risk for developing cardiovascular disease (CVD). Cardiorespiratory fitness is the best indicator of CVD-related morbidity and mortality ...
ENDOSCOPIC AND HISTOLOGICAL ASPECTS OF HELICOBACTER PYLORI GASTRITIS
Authors: S Mrabet, K Chabbouh, I Akkari, E Ben Jazia
Journal: Endoscopy (2019)

The responsibility for Helicobacter pylori (HP) in the genesis of peptic ulcer is well established. Its role in gastric carcinogenesis has also been demonstrated. The purpose of our work was to determine the endoscopic and histological aspects of HP gastritis.
Préparation colique fractionnée au polyéthylèneglycol versus schéma unique classique; laquelle améliore la qualité de la coloscopie?
Authors: E Bel Hadj Mabrouk, Y Zaimi, M Ayari, S Ayadi, K El Jeri, Y Said, L Mouelhi, R Debbeche
Journal: Endoscopy (2019)

Une bonne coloscopie, en tant qu'outil de dépistage et de traitement, dépend largement de la qualité de la préparation intestinale. Il n'existe pas de standard quant au schéma de préparation. Cela dépend largement de la référence du prescripteur. On se propose de comparer les schémas fractionné et unique en utilisant le PEG comme soluté de préparation.
Abstract 18194: Site Variation and Trends for Antithrombotic Therapy in Patients With Atrial Fibrillation After Percutaneous Coronary Intervention in the VA System: Findings From the TREAT-AF Study
Authors: Christoph B Olivier, Alexander C Perino, Jun Fan, Mariam Askari, George C Leef, Kenneth W Mahaffey, Mintu P Turakhia
Journal: Circulation (2017)

Background: Most patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI) require multiple antithrombotic therapies. Recent trials support the safety of an oral an...