tbuckley/cabot-search huggingface dataset:
Association of Frailty and Postoperative Complications With Unplanned Readmissions After Elective Outpatient Surgery
Authors: Kara A. Rothenberg, Jordan R. Stern, Elizabeth L. George, Amber W. Trickey, Arden M. Morris, Daniel E. Hall, Jason M. Johanning, Mary T. Hawn, Shipra Arya
Journal: JAMA Network Open (2019)

<h3>Importance</h3> Ambulatory surgery in geriatric populations is increasingly prevalent. Prior studies have demonstrated the association between frailty and readmissions in the inpatient setting. However, few data exist regarding the association between frailty and readmissions after outpatient procedures. <h3>Objective</h3> To examine the association between frailty and 30-day unplanned readmissions after elective outpatient surgical procedures as well as the potential mediation of surgical complications. <h3>Design, Setting, and Participants</h3> In this retrospective cohort study of elective outpatient procedures from 2012 and 2013 in the National Surgical Quality Improvement Program (NSQIP) database, 417 840 patients who underwent elective outpatient procedures were stratified into cohorts of individuals with a length of stay (LOS) of 0 days (LOS = 0) and those with a LOS of 1 or more days (LOS ≥ 1). Statistical analysis was performed from June 1, 2018, to March 31, 2019. <h3>Exposure</h3> Frailty, as measured by the Risk Analysis Index. <h3>Main Outcomes and Measures</h3> The main outcome was 30-day unplanned readmission. <h3>Results</h3> Of the 417 840 patients in this study, 59.2% were women and unplanned readmission occurred in 2.3% of the cohort overall (LOS = 0, 2.0%; LOS ≥ 1, 3.4%). Frail patients (mean [SD] age, 64.9 [15.5] years) were more likely than nonfrail patients (mean [SD] age, 35.0 [15.8] years) to have an unplanned readmission in both LOS cohorts (LOS = 0, 8.3% vs 1.9%; LOS ≥ 1, 8.5% vs 3.2%;<i>P</i> &lt; .001). Frail patients were also more likely than nonfrail patients to experience complications in both cohorts (LOS = 0, 6.9% vs 2.5%; LOS ≥ 1, 9.8% vs 4.6%;<i>P</i> &lt; .001). In multivariate analysis, frailty doubled the risk of unplanned readmission (LOS = 0: adjusted relative risk [RR], 2.1; 95% CI, 2.0-2.3; LOS ≥ 1: adjusted RR, 1.8; 95% CI, 1.6-2.1). Complications occurred in 3.1% of the entire cohort, and frailty was associated with increased risk of complications (unadjusted RR, 2.6; 95% CI, 2.4-2.8). Mediation analysis confirmed that complications are a significant mediator in the association between frailty and readmissions; however, it also indicated that the association of frailty with readmission was only partially mediated by complications (LOS = 0, 22.8%; LOS ≥ 1, 29.3%). <h3>Conclusions and Relevance</h3> These findings suggest that frailty is a significant risk factor for unplanned readmission after elective outpatient surgery both independently and when partially mediated through increased complications. Screening for frailty might inform the development of interventions to decrease unplanned readmissions, including those for outpatient procedures.
Oncofetal HLF transactivates c-Jun to promote hepatocellular carcinoma development and sorafenib resistance
Authors: Dai-Min Xiang, Wen Sun, Tengfei Zhou, Cheng Zhang, Zhuo Cheng, Shi-Chao Li, Weiqi Jiang, Ruoyu Wang, Gongbo Fu, Xiuliang Cui, Guojun Hou, Guang-Zhi Jin, Hengyu Li, Caiying Hou, Hui Liu, Hongyang Wang, Jin Ding
Journal: Gut (2019)

Background and aims The unique expression pattern makes oncofetal proteins ideal diagnostic biomarkers and therapeutic targets in cancer. However, few oncofetal proteins have been identified and entered clinical practice. Methods Fetal liver, adult liver and hepatocellular carcinoma (HCC) tissues were employed to assess the expression of hepatic leukaemia factor (HLF). The impact of HLF on HCC onset and progression was investigated both in vivo and in vitro. The association between HLF and patient prognosis was determined in patient cohorts. The correlation between HLF expression and sorafenib benefits in HCC was further evaluated in patient cohorts and patient-derived xenografts (PDXs). Results HLF is a novel oncofetal protein which is reactivated in HCC by SOX2 and OCT4. Functional studies revealed that HLF transactivates c-Jun to promote tumour initiating cell (TIC) generation and enhances TIC-like properties of hepatoma cells, thus driving HCC initiation and progression. Consistently, our clinical investigations elucidated the association between HLF and patient prognosis and unravelled the close correlation between HLF levels and c-Jun expression in patient HCCs. Importantly, HLF/c-Jun axis determines the responses of hepatoma cells to sorafenib treatment, and interference of HLF abrogated c-Jun activation and enhanced sorafenib response. Analysis of patient cohorts and PDXs further suggests that HLF/c-Jun axis might serve as a biomarker for sorafenib benefits in HCC patients. Conclusions Our findings uncovered HLF as a novel oncofetal protein and revealed the crucial role of the HLF/c-Jun axis in HCC development and sorafenib response, rendering HLF as an optimal target for the prevention and intervention of HCC.
Alveolar Septa Muscle: Subclinical Pulmonary Hypertension-Related Change or Malformation?
Authors: Adriana Handra-Luca
Journal: Journal of Thoracic Oncology (2019)

I have read with great interest the article by Casagrande and Pederiva1Casagrande A. Pederiva F. Association between congenital lung malformations and lung tumors in children and adults: a systematic review.J Thorac Oncol. 2016; 11: 1837-1845Abstract Full Text Full Text PDF PubMed Scopus (57) Google Scholar on the association of congenital lung malformations and tumors in adults. I would like to report incidental microscopic lesions observed on a lung lobectomy specimen resected for adenocarcinoma (pT2N2Mx) diagnosed after accidental thoracic traumatism. The lesions consisted of alveolar microfoci of muscle cells occupying the alveolar septa or located at the alveolar tip (Fig. 1). There was no inflammation or fibrosis at contact. CD31 staining did not show vascular lumina. The precise nature of these incidental microscopy lesions is difficult to precise. The hypothesis of pulmonary hypertension-related vessel wall muscle hypertrophia occurring in the context of vascular obstructions by tumor emboli would be to favor as regards that of malformative lesions as part of an asymptomatic congenital adenomatoid malformation. However, both lesion types may coexist, the evolutive potential of similar lesions in the nonresected lung and the clinical relevance remaining to be further investigated.
EUS-GUIDED RECANALIZATION OF ACOMPLETE STENOSIS OF THE BILIARY ANASTOMOSIS IN A PATIENT WITH WHIPPLE RESECTION
Authors: B Martinez Moreno, M Roger Ibañez, G Acevedo Piedra
Journal: Endoscopy (2019)

The biliary-enteric anastomosis can be achieved by echoendoscopy (EUS) to assess the etiology of the stenosis and, if it is not possible to perform an ERCP due to complete stenosis, create the repermeabilization of the anastomosis.
Abstract 17078: Methadone Use in Children: Assessment of Cardiotoxicity
Authors: Dustin Nash, Sylvia Okrzesik, Sarah Scarpace Lucas, Akash Patel
Journal: Circulation (2017)

Introduction: Methadone exposure carries the risk of QT prolongation with associated torsade-de-pointes (TdP) and sudden death (SCD) in adults. Recent guidelines regarding screening ECGs exist desp...
MORE DETECTED POLYPS PER PATIENT WITH 1L NER1006 VERSUS STANDARD BOWEL PREPARATIONS: META-ANALYSIS OF 1749 PATIENTS IN THREE RANDOMISED PHASE 3 CLINICAL TRIALS
Authors: C Hassan, MA Alvarez-Gonzalez, J Halonen, J Manning
Journal: Endoscopy (2019)

Effective colonoscopy requires adequate bowel cleansing to detect polyps of 5 mm or more in size. The 1L polyethylene glycol (PEG) NER1006 recently demonstrated superior high-quality colon cleansing efficacy over standard bowel preparations with, between them, comparable cleansing efficacies on validated cleansing scales. To explore the clinical value of improved high-quality cleansing, this meta-analysis of three randomised clinical trials assessed the mean lesion detection rates per patient for NER1006 versus standard treatments.
ENDOSCOPIC TREATMENT OF ZENKER'S DIVERTICULUM WITH LIGASURE: SIMPLE, SAFE AND EFFECTIVE
Authors: P Diez Redondo, H Núñez Rodriguez, M de Benito Sanz, R Torres Yuste, M Pérez-Miranda
Journal: Endoscopy (2019)

Zenker's diverticulum may cause disabling symptoms, especially in the elderly. Treatment has changed in recent decades from open surgery to management with flexible endoscopy, resulting in lower morbidity and mortality.
TRANSORAL OUTLET REDUCTION FOR WEIGHT REGAIN AFTER GASTRIC BYPASS: ONE YEAR FOLLOW-UP
Authors: V Bove, I Boškoski, R Landi, G Gibiino, L Laterza, F Mangiola, F D'Aversa, P Familiari, A Tringali, F Attili, V Perri, G Costamagna
Journal: Endoscopy (2019)

Enlargement of gastrojejunal anastomosis is associated with weight regain in patients with Roux-en-Y gastric bypass (RYGB). Endoscopic transoral outlet reduction (TORe) has proven safe and effective for treatment of weight regain. The objective of this study was to evaluate the safety and the efficacy in weight loss and quality of life after TORe.
Mindfulness-Based Training Improves Technical Skills and Emotional Regulation for Surgical Residents
Authors: Brooke Gurland
Journal: JAMA Network Open (2019)

Carter C. Lebares, MD; Ekaterina V. Guvva, BS; Maria Olaru, BS; Leo P. Sugrue, MD, PhD; Adam M. Staffaroni, PhD; Kevin L. Delucchi, PhD; Joel H. Kramer, PsyD; Nancy L. Ascher, MD, PhD; Hobart W. Harris, MD, MPH
All hands on DEK
Authors: David M. Bodine
Journal: Journal of Clinical Investigation (2019)

In this issue of the JCI, Capitano et al. demonstrate that the secreted form of the DNA-binding chromatin factor DEK regulates hematopoiesis. It is known that DEK can be secreted by macrophages and other cells, but no function has been attached to secreted DEK. Capitano et al. showed that extracellular DEK activates signaling through the CXCL2 receptor, which in turn enhances the proliferation of hematopoietic stem cells and decreases hematopoietic progenitor cell numbers both in vivo and in vitro. These results offer the opportunity to expand transplantable stem cells to improve outcomes in patients undergoing bone marrow transplant.
TB at Record Low in US
Authors: Bridget Kuehn
Journal: JAMA (2019)

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Fatty acid metabolism in the host and commensal bacteria for the control of intestinal immune responses and diseases
Authors: Koji Hosomi, Hiroshi Kiyono, Jun Kunisawa
Journal: Gut Microbes (2019)

Intestinal tissue has a specialized immune system that exhibits an exquisite balance between active and suppressive responses important for the maintenance of health. Intestinal immunity is functionally affected by both diet and gut commensal bacteria. Here, we review the effects of fatty acids on the regulation of intestinal immunity and immunological diseases, revealing that dietary fatty acids and their metabolites play an important role in the regulation of allergy, inflammation, and immunosurveillance in the intestine. Several lines of evidence have revealed that some dietary fatty acids are converted to biologically active metabolites by enzymes not only in the host but also in the commensal bacteria. Thus, biological interaction between diet and commensal bacteria could form the basis of a new era in the control of host immunity and its associated diseases.
A treatment protocol for botulinum toxin injections in the treatment of pachyonychia congenita‐associated keratoderma
Authors: A. Koren, E. Sprecher, E. Reider, O. Artzi
Journal: British Journal of Dermatology (2019)

BackgroundSeverely debilitating plantar keratoderma pain is the most distressing clinical feature of pachyonychia congenita (PC). Several earlier publications have reported therapeutic success with plantar injections of botulinum toxin (Btx).
OUTCOMES OF ESOPHAGECTOMY FOR PATIENTS AFTER NON-CURATIVE ENDOSCOPIC RESECTION OF EARLY ESOPHAGEAL CANCER
Authors: M Barret, S Dermine, M Leconte, S Leblanc, A Berger, G Rahmi, M Pioche, JM Canard, V Lepilliez, O Plomteux, F Prat, S Chaussade
Journal: Endoscopy (2019)

To analyze the oncological outcomes and the safety of esophagectomy after non curative endoscopic resection of a superficial esophageal cancer.
AN NOVEL DEVICE FOR ENDOSCOPIC RECORDING GASTROINTESTINAL SLOW WAVE
Authors: SH Kim, HJ Chun, S Kim, JH Kim, HJ Jeon, S Jang, SJ Choi, JM Lee, HS Choi, ES Kim, B Keum, YT Jeen, HS Lee, CD Kim
Journal: Endoscopy (2019)

Gastric slow waves regulate peristalsis, and gastric dysrhythmias have been implicated in functional motility disorders. To accurately define slow wave patterns, it is currently necessary to collect recordings during open surgery, which is invasive and limit their application. We therefore developed a novel gastric slow wave mapping device for use during endoscopic procedures. We aimed to assess feasibility of the new device for acquisition of gastrointestinal slow wave.
Risk of Gastrointestinal Bleeding Increases With Combinations of Antithrombotic Agents and Patient Age
Authors: Neena S. Abraham, Peter A. Noseworthy, Jonathan Inselman, Jeph Herrin, Xiaoxi Yao, Lindsey R. Sangaralingham, Gabriella Cornish, Che Ngufor, Nilay D. Shah
Journal: Clinical Gastroenterology and Hepatology (2019)
Abstract 14248: Infarct Size Reduction by Remote Ischemic Perconditioning in Pigs Requires Activation of Stat3 but Not Akt and Erk
Authors: Petra Kleinbongard, Sabine Gent, Andreas Skyschally, Gerd Heusch
Journal: Circulation (2016)

Brief episodes of ischemia/reperfusion (I/R) in a tissue or organ remote from the heart reduce infarct size after sustained severe myocardial I/R in all species tested so far, including humans. Remote ischemic conditioning can be induced before (pre) or during (per) myocardial ischemia. In pigs, cardioprotection by remote ischemic preconditioning requires the activation of the signal transducer and activator of transcription 3 (STAT3), whereas the activation protein kinase B (Akt) and extracellular regulated kinases (ERK) is not causal for cardioprotection (Circ Res 2015;117:279-88). We now identified the myocardial signal transduction of remote ischemic perconditioning (RPERC). Anesthetized open-chest pigs were subjected to 60 min occlusion of the left anterior descending coronary artery (LAD) and 180 min reperfusion (PLA; n=10). RPERC (n=10) was induced by 4х5/5 min hindlimb I/R during the last 40 min of LAD occlusion. Infarct size (TTC) was calculated as % of area at risk (AAR). Myocardial biopsies wer...
Les tumeurs de Klatskin: Efficacité du drainage endoscopique?
Authors: I Akoch, H Abid, M Lahlali, A Lamine, N Lahmidani, M Elyoussfi, DA Benajah, M Elabkari, SA Ibrahimi
Journal: Endoscopy (2019)

La tumeur de Klatskin est la plus fréquente des cholangiocarcinomes (CCK). Elle s'agit d'une entité rare, habituellement diagnostiquée à un stade avancé inopérable, et son pronostic est extrêmement mauvais. Le drainage biliaire est proposé en situation palliative, avec comme objectif d'assurer un confort de survie optimale et la possibilité de bénéficier d'une chimiothérapie, rarement la chirurgie. Le but de notre travail est de rapporter les résultats de drainage biliaire endoscopique ainsi que les facteurs prédictifs de son échec.
A case of successful full-thickness resection using endoscopic submucosal dissection and transanal suturing of rectal cancer
Authors: Satoshi Ono, Ryosuke Kobayashi, Shun Ito, Shosuke Hosaka, Shin-ichiro Sato, Kiyotaka Umeki, Satoshi Wakasugi
Journal: Endoscopy (2019)

Endoscopic resection techniques have been applied to full-thickness resection of gastrointestinal neoplasms as combination procedures with surgical resection [1] [2]. However, the applications of these procedures are mainly limited to the upper gastrointestinal tract owing to severe leakage complications in the lower gastrointestinal tract. Here we present a case of a successful full-thickness resection using endoscopic submucosal dissection (ESD) techniques to treat rectal adenocarcinoma [3] [4].
BLUE RUBBER BLEB NEVUS SYNDROME IN A 7-YEAR-OLD CHILD TREATED WITH LOOP LIGATION FACILITATED BY DOUBLE-BALLOON ENTEROSCOPY
Authors: N Lazaridis, A Murino, D Costa, A Telese, R Raymond, N Koukias, D Crespi, M Furman, EJ Despott
Journal: Endoscopy (2019)

Blue rubber bleb nevus syndrome (BRBNS) is an extremely rare systemic vascular disorder characterised by multiple cutaneous and gastrointestinal venous malformations. Patients present with fatigue, iron deficiency anaemia (IDA) and occult or overt gastrointestinal (GI) bleeding. Patients are usually treated with conservative management including iron supplementation and blood transfusions. However, endoscopic (argon plasma coagulation, sclerotherapy, polypectomy, band ligation etc), radiological and surgical approaches are preferred for severe cases.
EVALUATION OF A LOW VOLUME BOWEL CLEANSING PREPARATION (ORAL SULPHATE SOLUTION) VERSUS MACROGOL: A PHASE III, MULTICENTRE, RANDOMISED COMPARATIVE CLINICAL TRIAL
Authors: E Fedorov, S Kashin, V Veselov, E Tikhomirova, D Zavialov, A Veselov, A Kornowski, T Gorskaya, M Volteau, T Ponchon
Journal: Endoscopy (2019)

This study aimed to demonstrate the non-inferiority of low-volume oral sulphate solution (OSS) to macrogol 4000+electrolytes for bowel preparation, and assess the efficacy, safety and acceptability of OSS.
Association Between Thyroid Disorders and Colorectal Cancer Risk in Adult Patients in Taiwan
Authors: Abby L’Heureux, Daniel R. Wieland, Chien-Huan Weng, Yi-Huei Chen, Ching-Heng Lin, Tseng-Hsi Lin, Chien-Hsiang Weng
Journal: JAMA Network Open (2019)

Thyroid hormones have been shown to affect several important pathways in cancer development, including colorectal cancer (CRC). Clinical studies examining the association between thyroid disorders and colorectal cancer have conflicting results and have predominantly involved white populations. To determine if a diagnosis of hyperthyroidism or hypothyroidism is associated with the risk of developing colorectal cancer in an East Asian population. This nationwide population-based case-control study was conducted from April 27, 2018, to November 8, 2018, using the Taiwanese National Health Insurance Research Database. Participants were adults (n = 139 426) either with a new diagnosis (between 2008 and 2013) of primary colorectal cancer without a history of cancer, or without cancer. Cases and controls were matched 1:1 by age, sex, and index date. Diagnosis of hyperthyroidism or hypothyroidism prior to the diagnosis of colorectal cancer (or the same index date in controls) was then determined. Risk differences in developing colorectal cancer among patients with a medical history of hyperthyroidism or hypothyroidism. A total of 139 426 patients were included in the study, and 69 713 individuals made up each case and control group, which were both predominantly male (39 872 [57.2%]). The mean (SD) age for those with CRC was 65.8 (13.7) years and for those without CRC was 66.0 (13.6) years. Both hyperthyroidism (adjusted odds ratio [aOR], 0.77; 95% CI, 0.69-0.86; P < .001) and hypothyroidism (aOR, 0.78; 95% CI, 0.65-0.94; P = .008) were associated with a decreased risk of being diagnosed with colorectal cancer. An inverse association of rectal cancer was found among patients aged 50 years or older with a history of hypothyroidism despite treatment (aOR, 0.54; 95% CI, 0.39-0.74; P < .001). A history of hyperthyroidism in all age groups was associated with a lower risk of colon cancer (aOR, 0.74; 95% CI, 0.64-0.85; P < .001), with a stronger association seen among those younger than 50 years (aOR, 0.55; 95% CI, 0.36-0.85; P = .007). In this study, hypothyroidism appeared to be associated with a lower risk of rectal cancer, whereas hyperthyroidism appeared to be associated with a lower risk of colon cancer. Because of this, biochemical in vivo research and epidemiologic studies appear to be needed to further clarify the nature of these associations.
UP TO WHAT AGE PROPOSE MASS SCREENING FOR COLORECTAL CANCER BY FAECAL OCCULT BLOOD TEST? ANALYSIS OF A COHORT IN A WELL-DEFINED POPULATION
Authors: E Tardieu, S Manfredi, V Cottet, J Faivre
Journal: Endoscopy (2019)

The question of continuing screening beyond 75 years is often asked. Our cohort is the only one concerned with a population screened after 75 years, allowing the determination of participation rate, the rate of positivity of the test and the effect of screening on CRC mortality and incidence.
Insulin Resistance and Atherosclerosis: Implications for Insulin-Sensitizing Agents
Authors: Antonino Di Pino, Ralph A DeFronzo
Journal: Endocrine Reviews (2019)

Patients with type 2 diabetes mellitus (T2DM) are at high risk for macrovascular complications, which represent the major cause of mortality. Despite effective treatment of established cardiovascular (CV) risk factors (dyslipidemia, hypertension, procoagulant state), there remains a significant amount of unexplained CV risk. Insulin resistance is associated with a cluster of cardiometabolic risk factors known collectively as the insulin resistance (metabolic) syndrome (IRS). Considerable evidence, reviewed herein, suggests that insulin resistance and the IRS contribute to this unexplained CV risk in patients with T2DM. Accordingly, CV outcome trials with pioglitazone have demonstrated that this insulin-sensitizing thiazolidinedione reduces CV events in high-risk patients with T2DM. In this review the roles of insulin resistance and the IRS in the development of atherosclerotic CV disease and the impact of the insulin-sensitizing agents and of other antihyperglycemic medications on CV outcomes are discussed.
Prevalence of Reverse Triggering Assessed by Electrical Activity of the Diaphragm in the First 48 Hours of Mechanical Ventilation
Authors: F. Damiani, D. Junhasavasdikul, M. Dres, T. Piraino, R. Mellado Artigas, L. Chen, I. Soliman, M. Rauseo, N. Rittayamai, D. Grieco, T. Pham, I. G. Telias, L. Melo, J. O. Friedrich, H. Every, P. Greco, O. M. Smith, G. Sandhu, J. Gu, C. A. Sinderby, L. M. Heunks, L. J. Brochard
Journal: American Journal of Respiratory and Critical Care Medicine (2018)
Abstract 16032: Absence of Immune Response to Syngeneic or Allogeneic Mitochondria Transplantation
Authors: Giovanna Ramirez-Barbieri, Kamila Moskowitzova, Ben Illigens, Borami Shin, Ingeborg Friehs, Pedro Del Nido, James D McCully
Journal: Circulation (2017)

Introduction: Autologous mitochondrial transplantation has been shown to be efficacious in cardiac ischemia/reperfusion injury. We now provide evidence that single or multiple injections of autogen...