tbuckley/cabot-search huggingface dataset:
Prise en charge échoendoscopique du syndrome de l'anse afférente par entéroentérostomie
Authors: H Elbacha, S Leblanc, B Bordacahar, M Barret, B Brieau, S Doat, E Savier, B Dousset, O Soubrane, F Prat
Journal: Endoscopy (2019)

Le syndrome de l'anse afférente est une des complications de la duodénopancréatectomie céphalique. Il est généralement du à une obstruction de l'anse afférente suite à une progression tumorale locorégionale. La prise en charge chirurgicale est souvent accompagnée d'une importante morbidité. Nous rapportons notre expérience dans la prise en charge du syndrome de l'anse afférente par entéroentérostomie sous échoendoscopie.
Study of pathological complete response rates with neoadjuvant concurrent chemoradiation with paclitaxel in locally advanced breast cancer
Authors: P. Iyer, V. Radhakrishnan, A. Balasubramanian, V. Sridevi, A. Krishnamurthy, S. Ganesharaja
Journal: Annals of Oncology (2019)

Background: Neoadjuvant concurrent chemoradiation (CTRT) is not widely practised in breast cancer. We present our experience with the use of neoadjuvant CTRT in patients with locally advanced breast cancers (LABC) treated at our centre. Methods: The study included all consecutive female patients with inoperable stage III LABC treated at our centre from December 2015 to June 2016. Data were collected retrospectively from the patients' case records. The impact of neoadjuvant CTRT on pathological complete response and survival was analysed. All patients received 2 cycles of Paclitaxel 3 weekly (175 mg/m2/dose) with External beam radiotherapy (EBRT) delivered at 46 Gy in 23 fractions given over 5 weeks. Results: The study included 100 patients with a median age of 49 years among whom 9/100 (9%) had IIIA disease, 73/100 (73%) IIIB and 18/100 (18%) had IIIC disease. Hormone receptor-positive disease was observed in 36/100 (36%) patients, triple negative in 24/100 (24%) and Her2 neu positive disease in 40/100 (40%) patients. All patients were operable after completing the planned neoadjuvant treatments. Ninety-one out of 100 (91%) patients underwent modified radical mastectomy whereas 9/100 (9%) did not consent for surgery. pCR was observed in 12/21 (57.1%) patients with triple-negative disease, 11/34 (32.3%) patients with hormone receptor-positive disease and 16/36 (44.4%) patients with Her2 neu positive disease. Most common morbidity observed was grade 3 skin reactions. No grade 4 skin toxicity was observed. The 2-year event-free survival (EFS) and overall survival (OS) for the entire cohort was 88 % and 73.1 % respectively. Conclusions: Neoadjuvant CTRT is well tolerated and is associated with higher pCR rates than what has been reported with neoadjuvant chemotherapy alone. However, further prospective studies with longer follow-up are required to confirm our findings. Legal entity responsible for the study: Cancer Institute, Chennai, India. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
Genetic variants and cognitive functions in patients with brain tumors
Authors: Denise D Correa, Jaya Satagopan, Axel Martin, Erica Braun, Maria Kryza-Lacombe, Kenneth Cheung, Ajay Sharma, Sofia Dimitriadoy, Kelli O’Connell, Siok Leong, Sasan Karimi, John Lyo, Lisa M DeAngelis, Irene Orlow
Journal: Neuro-Oncology (2019)

Patients with brain tumors treated with radiotherapy (RT) and chemotherapy (CT) often experience cognitive dysfunction. We reported that single nucleotide polymorphisms (SNPs) in the APOE, COMT, and BDNF genes may influence cognition in brain tumor patients. In this study, we assessed whether genes associated with late-onset Alzheimer's disease (LOAD), inflammation, cholesterol transport, dopamine and myelin regulation, and DNA repair may influence cognitive outcome in this population.One hundred and fifty brain tumor patients treated with RT ± CT or CT alone completed a neurocognitive assessment and provided a blood sample for genotyping. We genotyped genes/SNPs in these pathways: (i) LOAD risk/inflammation/cholesterol transport, (ii) dopamine regulation, (iii) myelin regulation, (iv) DNA repair, (v) blood-brain barrier disruption, (vi) cell cycle regulation, and (vii) response to oxidative stress. White matter (WM) abnormalities were rated on brain MRIs.Multivariable linear regression analysis with Bayesian shrinkage estimation of SNP effects, adjusting for relevant demographic, disease, and treatment variables, indicated strong associations (posterior association summary [PAS] ≥ 0.95) among tests of attention, executive functions, and memory and 33 SNPs in genes involved in: LOAD/inflammation/cholesterol transport (eg, PDE7A, IL-6), dopamine regulation (eg, DRD1, COMT), myelin repair (eg, TCF4), DNA repair (eg, RAD51), cell cycle regulation (eg, SESN1), and response to oxidative stress (eg, GSTP1). The SNPs were not significantly associated with WM abnormalities.This novel study suggests that polymorphisms in genes involved in aging and inflammation, dopamine, myelin and cell cycle regulation, and DNA repair and response to oxidative stress may be associated with cognitive outcome in patients with brain tumors.
Hyoscyamine for a Slow Ventricular Response During Atrial Fibrillation
Authors: Neelesh Gupta
Journal: Annals of Internal Medicine (2019)

Letters21 May 2019Hyoscyamine for a Slow Ventricular Response During Atrial FibrillationNeelesh Gupta, MDNeelesh Gupta, MDUniversity of South Alabama Health University Hospital, Mobile, Alabama (N.G.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L19-0092 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:I read Helgeson and colleagues' case report (1) with interest. In nonagenarians, a slow ventricular response during atrial fibrillation is usually caused by degenerative conduction system disease. However, that dabigatran could be a culprit needs to be explored. Administration of hyoscyamine 4 times daily also could be problematic.Reference1. Helgeson SA, Mwakyanjala EJ, Parikh PP, Venkatachalam KL. Hyoscyamine for a slow ventricular response during atrial fibrillation. Ann Intern Med. 2018;169:418-9. [PMID: 29799971]. doi:10.7326/L18-0037 LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of South Alabama Health University Hospital, Mobile, Alabama (N.G.)Disclosures: The author has disclosed no conflicts of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L19-0092. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoHyoscyamine for a Slow Ventricular Response During Atrial Fibrillation Scott A. Helgeson , Edson J. Mwakyanjala , Pragnesh P. Parikh , and K.L. Venkatachalam Hyoscyamine for a Slow Ventricular Response During Atrial Fibrillation Scott A. Helgeson , Edson J. Mwakyanjala , Pragnesh P. Parikh , and K.L. Venkatachalam Metrics Cited byStructural insights on the interaction potential of natural leads against major protein targets of SARS-CoV-2: Molecular modelling, docking and dynamic simulation studies 21 May 2019Volume 170, Issue 10Page: 735KeywordsAtrial fibrillationConflicts of interestDisclosureSystemic diseases ePublished: 21 May 2019 Issue Published: 21 May 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
IL23 induces IL23R recycling and amplifies innate receptor-induced signalling and cytokines in human macrophages, and the IBD-protective IL23R R381Q variant modulates these outcomes
Authors: Rui Sun, Matija Hedl, Clara Abraham
Journal: Gut (2019)

Objective The interleukin (IL)23 pathway contributes to IBD pathogenesis and is being actively studied as a therapeutic target in patients with IBD. Unexpected outcomes in these therapeutic trials have highlighted the importance of understanding the cell types and mechanisms through which IL23 regulates immune outcomes. How IL23 regulates macrophage outcomes and the consequences of the IL23R R381Q IBD-protective variant on macrophages are not well defined; macrophages are key players in IBD pathogenesis and inflammation. Design We analysed protein and RNA expression, signalling and localisation in human monocyte-derived macrophages (MDMs) through western blot, ELISA, real-time PCR, flow cytometry, immunoprecipitation and microscopy. Results IL23R was critical for optimal levels of pattern-recognition receptor (PRR)-induced signalling and cytokines in human MDMs. In contrast to the coreceptor IL12Rβ1, IL23 induced dynamic IL23R cell surface regulation and this required clathrin and dynamin-mediated endocytosis and endocytic recycling-dependent pathways; these pathways were essential for IL23R-mediated outcomes. The IBD-protective IL23R R381Q variant showed distinct outcomes. Relative to IL23R R381, HeLa cells expressing IL23R Q381 showed decreased IL23R recycling and reduced assembly of IL23R Q381 with Janus kinase/signal transducer and activator of transcription pathway members. In MDMs from IL23R Q381 carriers, IL23R accumulated in late endosomes and lysosomes on IL23 treatment and cells demonstrated decreased IL23R- and PRR-induced signalling and cytokines relative to IL23R R381 MDMs. Conclusion Macrophage-mediated inflammatory pathways are key contributors to IBD pathogenesis, and we identify an autocrine/paracrine IL23 requirement in PRR-initiated human macrophage outcomes and in human intestinal myeloid cells, establish that IL23R undergoes ligand-induced recycling, define mechanisms regulating IL23R-induced signalling and determine how the IBD-protective IL23R R381Q variant modulates these processes.
UNDERWATER ENDOSCOPIC RESECTION FOR COLONIC LESIONS IN DIFFICULT AND CHALLENGING SITUATIONS. MULTICENTER – PRELIMINARY RESULTS
Authors: H Uchima, J Rodriguez-Sanchez, JC Marin, L Torrealba, M Sánchez-Alonso, D Busquets, R Turro, M Albert, A Mata Bilbao, JC Espinos
Journal: Endoscopy (2019)

Underwater endoscopic resection (uEMR) avoids the need for submucosal injection, and it may be helpful in challenging situations such as non-lifting lesions, or difficult locations.
COLONOSCOPY WITH THE SINGLE USE ENDOSCOPE INVENDOSCOPE SC210 IN ROUTINE CLINICAL PRACTICE
Authors: F Straulino, A Genthner, K Ralf, A Eickhoff
Journal: Endoscopy (2019)

Healthcare-associated infections linked to re-useable endoscopes was a matter of controversy in the past. In 2008 Invendo Medical presented the first single use endoscope for colonoscopy. With the Invendoscope SC210 there is now a further development with high definition available. Instead of the classic „wheel and wire“ mechanism this 170 cm colonoscope works with an electro-hydraulic controlled deflecting tip which allows a 180 ° bending in all directions. A joystick-like handheld control plate is used to navigate the tip. Standard endoscopic devices for interventions can be used over the 3.1 mm working channel. This multicenter study assessed the safety and efficacy of this new endoscope in routine clinical practice.
Pneumonitis resulting from radiation and immune checkpoint blockade illustrates characteristic clinical, radiologic and circulating biomarker features
Authors: Jonathan D. Schoenfeld, Mizuki Nishino, Mariano Severgnini, Michael Manos, Raymond H. Mak, F. Stephen Hodi
Journal: Journal for ImmunoTherapy of Cancer (2019)

<h3>Background</h3> Pneumonitis is a potential consequence of both lung-directed radiation and immune checkpoint blockade (ICB), particularly treatment with PD-1/PD-L1 inhibitors. Significant morbidity and mortality can result, and severe pneumonitis attributed to ICB precludes continued therapy. Thus, discriminating between radiation- and ICB- related pneumonitis is of importance for the increasing number of patients receiving both treatments. Furthermore, data are limited regarding the interplay between radiation- and ICB-induced lung injury, and which biomarkers might be associated with toxicity. <h3>Case presentation</h3> We report longitudinal clinical&nbsp;and radiologic&nbsp;data, and circulating biomarkers in a melanoma patient treated with axillary radiation followed by ICB who developed consolidation and ground glass opacities (GGO) within the radiation field suggestive of radiation-pneumonitis followed by consolidation outside of the radiation field suggestive of ICB-related pneumonitis. Of note, symptomatic radiation-pneumonitis developed despite a low radiation dose to the lung (V20 &lt; 8%), and ICB-related pneumonitis was limited to the ipsilateral lung, suggesting additive effect of radiation and ICB in the development of lung injury. Circulating biomarker analyses demonstrated increases in CXCR2, IL1ra and IL2ra that coincided with the development of symptomatic pneumonitis. <h3>Conclusions</h3> These data highlight the imaging findings associated with radiation and ICB-related lung toxicity, and anecdotally describe a clinical course with circulating biomarker correlates. This information can help guide clinical evaluation and future research investigations into the toxicity of combined radiation immunotherapy approaches.
Alabama law makes almost any abortion a crime
Authors: Owen Dyer
Journal: BMJ (2019)

Doctors who perform abortions in the US state of Alabama would face from 10 to 99 years in prison under a new law that bans the procedure at all stages of pregnancy, including in cases of rape or incest. Exceptions will only be allowed if the mother faces a “serious health risk” from continuing the pregnancy or the “unborn child has a lethal anomaly.”

The bill passed the Republican dominated state senate by 25 votes to six. All of those voting for it were male Republicans. Only four of Alabama’s 35 state senators are women, and all of them are Democrats.

Alabama’s Republican governor Kay Ivey is expected to …
CONVERSION COEFFICIENT FOR THE ESTIMATION OF THE ADENOMA DETECTION RATE FROM THE POLYP DETECTION RATE: VALIDATION IN A REAL COLONOSCOPY SCREENING PRACTICE SETTING IN GREECE
Authors: V Papastergiou, N Mathou, A Giannakopoulos, A Evgenidi, E Schoretsanitis, M Lenas, D Apessou, K Paraskeva
Journal: Endoscopy (2019)

Adenoma detection rate (ADR) is a fundamental metric in colonoscopy quality; however, it is cumbersome to obtain as it requires the linkage of endoscopy and pathology reports. The adenoma-to-polyp-detection-rate-quotient (APDRQ) has been proposed as an easy multiplier for the estimation of the individual endoscopist's ADR from polyp detection rate (PDR), although it lacks validation in different populations and practice settings. We aimed to validate the use of the APDRQ in a real colonoscopy practice setting in Greece.
1L NER1006 IMPROVES HIGH-QUALITY COLON CLEANSING VERSUS STANDARD BOWEL PREPARATIONS: POST HOC ANALYSIS OF PHASE 3 CLINICAL TRIALS USING REAL-WORLD CLEANSING ASSESSMENT BY SITE ENDOSCOPISTS
Authors: J Gschossmann, C Noble, B Amlani, A Repici
Journal: Endoscopy (2019)

Colonoscopy requires bowel cleansing; high-quality cleansing facilitates lesion detection. NER1006 is a 1L polyethylene glycol (PEG) bowel preparation. This post hoc analysis of three randomised trials investigated cleansing efficacy assessed, as in clinical practice, by site endoscopists.
La dilatation endoscopique des sténoses peptiques oesophagiennes: facteurs prédictifs de recours à la chirurgie (à propos de 34 cas)
Authors: M Ben Abdelwahed, HL Mohamed, R Baklouti, F Aissaoui, M Zakhama, A Guediche, W Bouhlel, W Ben Mansour, BC Nabil, L Safer
Journal: Endoscopy (2019)

La sténose peptique (SP) constitue une des complications graves du reflux gastro-oesophagien (RGO). Elle reste une pathologie fréquente dans les pays en voie de développement.
SAFETY AND EFFICACY OF ENDOSCOPIC ULTRASOUND-GUIDED RADIOFREQUENCY ABLATION (EUS-RFA) OF PANCREATIC CYSTIC NEOPLASMS (PCNS) AND PANCREATIC NEUROENDOCRINE TUMORS (PNETS): PRELIMINARY REPORT OF A PROSPECTIVE COHORT
Authors: F Younis, O Shibolet, A Philips, E Santo, E Scapa
Journal: Endoscopy (2019)

To assess the safety and efficacy of EUS guided RFA for the treatment of pancreatic lesions, initial experience of a prospective cohort.
IMPACT OF THE IMPLEMENTATION OF UPPER GASTROINTESTINAL BLEEDING-CODE IN PATIENTS AT EMERGENCY ROOM WITH UPPER GASTROINTESTINAL NON-VARICEAL BLEEDING
Authors: I Marquez, L Ruiz, X Andujar, JC Espinos, V Mayor, F Fernandez-Bañares, M Esteve, C Loras
Journal: Endoscopy (2019)

Upper gastrointestinal bleeding (UGIB) is a common condition in the emergency room (ER), with high morbimortality. Nevertheless, there is no evidence about the impact of the implementation of an urgent intervention protocol (UGIB-CODE) for its management.
PERCUTANEOUS TRANSHEPATIC CHOLANGIOSCOPIC RESECTION OF AN DISTAL BILE DUCT ADENOMA IN ESD TECHNIQUE
Authors: J Hochberger
Journal: Endoscopy (2019)

An 80 year old patient was referred for acute cholangitis. A 2 × 1,5 cm lesion suspect of a distal bile duct stone was detected in US and ERCP. However, the lesion was fixed to the bile duct wall. EUS and biopsy revealed a distal biliary adenoma. The patient refused surgery but agreed to an experimental approach. A percutaneous stabile fistula tract was created and dilated over 2 weeks until 20". A sterilized therapeutic bronchoscope was used and the tumor located at the level of the distal common bile duct. Successful keedle knife excision and transpapillary expulsion of the tumor was achieved after prior EPT. A percutaneous transhepatic drainage was temporarily placed. There was fortunately no acute bleeding or perforation but the tumor specimen was lost to the small intestine. The patient recovered completely but died three years later due to a local recurrence.
CAN WE APPLY THE "DETECT-AND-LEAVE" STRATEGY FOR DIMINUTIVE POLYPS OF THE RECTO-SIGMOID?
Authors: A Nakhli, R Ennaifer, N Hemdani, B Bouchabou, H Ben Romdhane, H Ben Nejma
Journal: Endoscopy (2019)

The prevalence of advanced histological signs (villous contingent, or high grade dysplasia, or cancer) in small polyps is relatively low. ESGE recommends a "detect-and-leave" strategy for very small (≤5 mm) polyps of the recto-sigmoid and whose appearance is suggestive of a hyperplastic polyp.
Nutrient Sensing in CD11c Cells Alters the Gut Microbiota to Regulate Food Intake and Body Mass
Authors: D. Nyasha Chagwedera, Qi Yan Ang, Jordan E. Bisanz, Yew Ann Leong, Kirthana Ganeshan, Jingwei Cai, Andrew D. Patterson, Peter J. Turnbaugh, Ajay Chawla
Journal: Cell Metabolism (2019)
Dual Sinus Nodes With Donor Sinus Node Dysfunction in Biatrial Heart Transplantation
Authors: Everett Lai, Ranjan Ray, Richard Hongo
Journal: JAMA Internal Medicine (2019)

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ACUTE UPPER GASTROINTESTINAL BLEEDING: ADHERENT CLOTS, ADHERENCE TO GUIDELINES
Authors: RN Patel, S Ikidde, CN Oza, Z Tariq
Journal: Endoscopy (2019)

Acute upper gastrointestinal haemorrhage secondary to peptic ulcer disease carries a significant mortality risk. The management of peptic ulcers with adherent clots (Forrest IIB) remains uncertain. ESGE recommends consideration of endoscopic clot removal. We aim to describe the demographics and outcomes of patients with adherent clots at a district general hospital.
Abstract 11133: Prevalence and Types of Long QT Syndrome among Children with Hearing Loss
Authors: Ruey-Kang Chang, Yueh-Tze Lan, Michael Silka, Hallie Morrow, Janna Smith Lang, Robert Wallerstein, Henry J Lin
Journal: Circulation (2012)

Introduction. Long QT syndrome (LQTS) associated with sensorineural hearing loss (SNHL) is known as the Jervell and Lang Nielsen syndrome (JLNS), an autosomal recessive disorder. Autosomal dominant...
Monotherapy for toenail onychomycosis: a systematic review and network meta‐analysis
Authors: A.K. Gupta, K.A. Foley, R.R. Mays, N.H. Shear, V. Piguet
Journal: British Journal of Dermatology (2019)

Background Onychomycosis is a fungal infection of the nail caused by dermatophytes, yeasts and nondermatophyte moulds that accounts for approximately 50% of all nail-related disease. Objectives This study aims to assess the effectiveness and safety of monotherapy and combination treatments for toenail onychomycosis using a network meta-analysis (NMA). Methods Quality of evidence was assessed using Cochrane-compliant rules and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Efficacy and safety outcomes were compared using a random-effects NMA to estimate pooled odds ratios (ORs) of direct and indirect comparisons among oral and topical treatments (PROSPERO 2015: CRD42018086912). There were not enough eligible combination and device-based therapy trials to include in the NMA. Results Of 77 randomized controlled trials, 26 were included in the ORs (8136 patients). There were no significant inconsistencies between the direct and indirect evidence. Relative effects show that the odds of mycological cure with continuous terbinafine 250 mg or continuous itraconazole 200 mg are significantly greater than topical treatments. Fluconazole, pulse regimens of terbinafine and itraconazole, and topical treatments did not differ significantly in the odds of achieving mycological cure. The ORs of adverse events occurring with oral or topical treatments were not significantly different from each other. For mycological cure, evidence was of moderate or high quality while evidence ranged from very low to high quality for adverse events. Conclusions Our review suggests that oral and topical treatments for toenail onychomycosis are safe and effective in producing mycological cure. What's already known about this topic? Topical treatments traditionally have lower success rates than oral treatments. Oral treatments have the advantage of shorter treatment durations, but also present challenges in cases of drug–drug interactions or immunosuppression. A network meta-analysis (NMA) gathers data from indirect evidence to gain confidence about all treatment comparisons and allows for estimation of comparative effects that have not been investigated in head-to-head randomized clinical trials (RCTs). What does this study add? This NMA of efficacy and safety includes all RCTs of oral, topical, combination and device-based treatments for toenail onychomycosis, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement for NMA. The odds of achieving mycological cure with continuous terbinafine 250 mg or continuous itraconazole 200 mg were significantly greater than topical treatments. Fluconazole, pulse regimens of terbinafine and itraconazole, and topical treatments did not differ significantly in the odds of achieving mycological cure.
ENDOSCOPIC SUTURING IS FEASIBLE FOR TREATMENT OF LOW COLORECTAL ANASTOMOTIC LEAK – EXPERIMENTAL STUDY
Authors: J Martínek, T Hucl, O Ryska, J Kalvach, J Hadac, J Pazin, O Foltan, H Kristianova, J Ptacnik, J Juhasova, S Juhas
Journal: Endoscopy (2019)

The aim of our study was to assess the feasibility of endoscopic repair of anastomotic leak on animal model. Secondary aim was to evaluate whether this technique prevents intraabdominal sepsis.