tbuckley/cabot-search huggingface dataset:
Unilateral bloodstained nasal discharge
Authors: Zhenxiao Huang, Qian Huang
Journal: BMJ (2020)

A man in his 40s presented with six months of bloodstained nasal discharge from his right nostril. Nasal endoscopy showed purulent bloodstained nasal discharge in the right nasal cavity and a mass with an irregular friable appearance in the right middle meatus of the right nasal cavity; the appearance of the septum and left nasal cavity was normal. He underwent a non-contrast computed tomography scan of his sinuses (fig 1).



Fig 1 
Computed tomography scan of the sinuses shown in the coronal plane



Biopsy showed cytoplasmic keratinisation, intercellular bridges, and keratin pearls.

What is the most likely diagnosis? 

Sinonasal squamous cell …
Burden of eye disease and demand for care in the Bangladesh Rohingya displaced population and host community: A cohort study
Authors: Munir Ahmed, Noelle Whitestone, Jennifer L. Patnaik, Mohammad Awlad Hossain, Lutful Husain, Mohammed Alauddin, Mushfiqur Rahaman, David Hunter Cherwek, Nathan Congdon, Danny Haddad
Journal: PLoS Medicine (2020)

There is a growing awareness that addressing chronic as well as acute health conditions may contribute importantly to the well-being of displaced populations, but eye care service has generally not been prioritized in crisis situations. We describe a replicable model of eye care provision as delivered by Orbis International and local partners to the Rohingya and host population in Cox's Bazar, Bangladesh, and characterize the burden of vision impairment and demand for sight-restoring services in this setting.Orbis International and local secondary facility Cox's Bazar Baitush Sharaf Hospital (CBBSH) provide eye care support to the Rohingya population and the host community of all ages in Cox's Bazar, Bangladesh, with fixed vision screening locations established in Camps 4 and 11 of the Kutupalong refugee settlement. Structured outreach targets these camps and four surrounding local subdistricts, with referrals made as needed for refraction (glasses measurement) and cataract surgery to CBBSH. Between February 2018 and March 2019, 48,105 displaced Rohingya (70.3%, among whom 71.6% were children and 46.5% women) and 20,357 local residents (29.7%, 88.5% children, 54.4% women) underwent vision screening. Displaced Rohingya sought services from a total of 12 surrounding camps, within which coverage was 17.3%, including 43.3% (27,027/62,424) of children aged 5-11 years and 60.0% (5,315/8,857) of adults ≥ 60 years old. The prevalence of blindness (presenting acuity < 3/60) among Rohingya patients exceeded that among local residents by 3- to 6-fold in each 10-year age group between 18 and 59 years (P < 0.001 comparing vision between the two groups in this age range), and the prevalence of cataract requiring surgery was also higher in Rohingya patients (18-29 years: 4.67% versus 1.80%, P = 0.0019; 30-39: 7.61% versus 2.39%, P < 0.001; and 40-49 years: 7.91% versus 3.77%, P = 0.0014). A limitation of the study is lack of data on population prevalence of eye disease.The burden of untreated eye disease is very high among the Rohingya, particularly those in their peak working years who could contribute most to the resiliency of their community. Demand for eye care service is also great among children and adults in this population with many competing healthcare priorities. Research is needed, building on strong evidence of benefit in settled populations, to explore the specific impact of vision care on the well-being of displaced populations.
Abstract 111: Age-Dependent Trends in Survival After Adult In-Hospital Cardiac Arrest
Authors: Sebastian Wiberg, Mathias J Holmberg, Michael Donnino, Jesper Kjaergaard, Christian Hassager, Lise Witten, Katherine BERG, Ari Moskowitz, Lars W Andersen
Journal: Circulation (2019)

Background: While survival after in-hospital cardiac arrest (IHCA) has improved in recent years, it remains unknown whether this trend primarily applies to younger IHCA victims or extends to older patients as well. The aim of this study was to assess trends in survival to hospital discharge after adult IHCA across age groups from 2000 to 2016. Methods: This is an observational study of IHCA patients included in the Get With The Guidelines®-Resuscitation registry between January 2000 and December 2016. The primary outcome was survival to hospital discharge, while secondary outcomes included rates of return of spontaneous circulation (ROSC) and neurological outcome at discharge. Patients were stratified into five age groups: &lt; 50 years, 50-59 years, 60-69 years, 70-79 years, and ≥80 years. Generalized linear regression was used to obtain absolute survival rates over time. Analyses of interaction were included to assess differences in survival trends between age groups. Results: A total of 234,767 IHCA patients were included for the analyses. The absolute increase in survival per calendar year was 0.8% (95%CI 0.7 - 1.0%, p &lt; 0.001) for patients younger than 50 years, 0.6% (95%CI 0.4 - 0.7%, p &lt; 0.001) for patients between 50 and 59 years, 0.5% (95%CI 0.4 - 0.6%, p &lt; 0.001) for patients between 60 and 69 years, 0.5% (95%CI 0.4 - 0.6%, p &lt; 0.001) for patients between 70 and 79 years, and 0.5% (95%CI 0.4 - 0.6%, p &lt; 0.001) for patients older than 80 years. Further, a significant increase in both rates of ROSC and survival with a good neurological outcome was seen for all age groups. In both unadjusted and adjusted analyses of survival, we observed a significant interaction between calendar year and age group ( p &lt; 0.001), indicating that the rate of improvement in survival over time was significantly different between age groups. Conclusions: For patients with IHCA, survival to discharge, ROSC, and survival to discharge with a good neurological outcome have improved significantly from 2000 to 2016 for all age groups.
Author Correction: Tissue patrol by resident memory CD8+ T cells in human skin
Authors: Feline E. Dijkgraaf, Tiago R. Matos, Mark Hoogenboezem, Mireille Toebes, David W. Vredevoogd, Marjolijn Mertz, Bram van den Broek, Ji-Ying Song, Marcel B. M. Teunissen, Rosalie M. Luiten, Joost B. Beltman, Ton N. Schumacher
Journal: Nature Immunology (2020)
A retrievable implant for the long-term encapsulation and survival of therapeutic xenogeneic cells
Authors: Suman Bose, Lisa R. Volpatti, Devina Thiono, Volkan Yesilyurt, Collin McGladrigan, Yaoyu Tang, Amanda Facklam, Amy Wang, Siddharth Jhunjhunwala, Omid Veiseh, Jennifer Hollister-Lock, Chandrabali Bhattacharya, Gordon C. Weir, Dale L. Greiner, Robert Langer, Daniel G. Anderson
Journal: Nature Biomedical Engineering (2020)
Comprehensive infectious disease screening in a cohort of unaccompanied refugee minors in Germany from 2016 to 2017: A cross-sectional study
Authors: Ales Janda, Kristin Eder, Roland Fressle, Anne Geweniger, Natalie Diffloth, Maximilian Heeg, Nadine Binder, Ana-Gabriela Sitaru, Jan Rohr, Philipp Henneke, Markus Hufnagel, Roland Elling
Journal: PLoS Medicine (2020)

Background Information regarding the prevalence of infectious diseases (IDs) in child and adolescent refugees in Europe is scarce. Here, we evaluate a standardized ID screening protocol in a cohort of unaccompanied refugee minors (URMs) in a municipal region of southwest Germany. Methods and findings From January 2016 to December 2017, we employed a structured questionnaire to screen a cohort of 890 URMs. Collecting sociodemographic information and medical history, we also performed a standardized diagnostics panel, including complete blood count, urine status, microbial stool testing, tuberculosis (TB) screening, and serologies for hepatitis B virus (HBV) and human immunodeficiency virus (HIV). The mean age was 16.2 years; 94.0% were male, and 93.6% originated from an African country. The most common health complaints were dental problems (66.0%). The single most frequent ID was scabies (14.2%). Of the 776 URMs originating from high-prevalence countries, 7.7% and 0.4% tested positive for HBV and HIV, respectively. Nineteen pathogens were detected in a total of 119 stool samples (16.0% positivity), with intestinal schistosomiasis being the most frequent pathogen (6.7%). Blood eosinophilia proved to be a nonspecific criterion for the detection of parasitic infections. Active pulmonary TB was identified in 1.7% of URMs screened. Of note, clinical warning symptoms (fever, cough >2 weeks, and weight loss) were insensitive parameters for the identification of patients with active TB. Study limitations include the possibility of an incomplete eosinophilia workup (as no parasite serologies or malaria diagnostics were performed), as well as the inherent selection bias in our cohort because refugee populations differ across Europe. Conclusions Our study found that standardized ID screening in a URM cohort was practicable and helped collection of relevant patient data in a thorough and time-effective manner. However, screening practices need to be ameliorated, especially in relation to testing for parasitic infections. Most importantly, we found that only a minority of infections were able to be detected clinically. This underscores the importance of active surveillance of IDs among refugees.
Randomized, Phase II Study of Trastuzumab Beyond Progression in Patients With HER2-Positive Advanced Gastric or Gastroesophageal Junction Cancer: WJOG7112G (T-ACT Study)
Authors: Akitaka Makiyama, Yasutaka Sukawa, Tomomi Kashiwada, Junji Kawada, Ayumu Hosokawa, Yoshiki Horie, Akihito Tsuji, Toshikazu Moriwaki, Hiroaki Tanioka, Katsunori Shinozaki, Keita Uchino, Hirofumi Yasui, Hiroshi Tsukuda, Kazuhiro Nishikawa, Hiroyasu Ishida, Takeharu Yamanaka, Kentaro Yamazaki, Shuichi Hironaka, Taito Esaki, Narikazu Boku, Ichinosuke Hyodo, Kei Muro
Journal: Journal of Clinical Oncology (2020)

This study evaluated the continuous use of trastuzumab beyond progression (TBP) in human epidermal growth factor receptor 2 (HER2)-positive advanced gastric or gastroesophageal junction (G/GEJ) cancer.Patients with HER2-positive advanced G/GEJ cancer refractory to first-line chemotherapy with trastuzumab in combination with fluoropyrimidine and platinum were eligible. Patients were randomly assigned to the paclitaxel (80 mg/m2, days 1, 8, and 15, every 4 weeks) or paclitaxel with trastuzumab (PT; initially 8 mg/kg followed by 6 mg/kg, every 3 weeks) arms. The primary endpoint was progression-free survival (PFS). Secondary endpoints included overall survival (OS), response rate, and safety. Biomarkers such as HER2 expression status in tumor tissue after first-line treatment, HER2 amplification evaluated in serum cell-free DNA, and soluble HER2 levels were analyzed.Overall, 91 patients were allocated to the paclitaxel (n = 46) and PT (n = 45) arms. The median PFS in the paclitaxel and PT arms was 3.2 and 3.7 months, respectively (hazard ratio [HR], 0.91; 80% CI, 0.67 to 1.22; P = .33), and the median OS in both arms was 10 months (HR, 1.2; 95% CI, 0.75 to 2.0; P = .20). The overall response rates in the paclitaxel and PT arms were 32% and 33%, respectively (P = 1.00), and safety was comparable between the 2 arms. On exploratory analyses, HER2 positivity of tumor tissues was lost after first-line chemotherapy in 11 (69%) of 16 patients whose tumor tissues were available, and circulating HER2 DNA amplification was detected in 41 (60%) of 68 patients. However, no biomarkers associated with efficacy of TBP were found.The TBP strategy failed to improve PFS in patients with HER2-positive advanced G/GEJ cancer, and no beneficial biomarkers were found.
Evolving epidemiology and transmission dynamics of coronavirus disease 2019 outside Hubei province, China: a descriptive and modelling study
Authors: Juanjuan Zhang, Maria Litvinova, Wei Wang, Yan Wang, Xiaowei Deng, Xinghui Chen, Mei Li, Wen Zheng, Lan Yi, Xinhua Chen, Qianhui Wu, Yuxia Liang, Xiling Wang, Juan Yang, Kaiyuan Sun, Ira M Longini, M Elizabeth Halloran, Peng Wu, Benjamin J Cowling, Stefano Merler, Cecile Viboud, Alessandro Vespignani, Marco Ajelli, Hongjie Yu
Journal: The Lancet Infectious Diseases (2020)
UTILITY OF CAC VOLUME FOR PREDICTION OF 10-YEAR CVD MORTALITY WITH A MODEL-AGNOSTIC INTERPRETATION OF MACHINE LEARNING: THE CAC CONSORTIUM
Authors: Fay Lin, Gabriel Maliakal, Lohendran Baskaran, Gurpreet Singh, Subhi Al’Aref, Zhuoran Xu, Jeong Choi, A. Maxim Bax, Umberto Gianni, Emma J. Hollenberg, Inge J. van den Hoogen, Alexander van Rosendael, Sara Tantawy, Piotr J. Slomka, Damini Dey, Alan Rozanski, Daniel S. Berman, Matthew J. Budoff, Michael D. Miedema, Khurram Nasir, John A. Rumberger, Seamus P. Whelton, James Min, Michael Blaha, Leslee J. Shaw
Journal: Journal of the American College of Cardiology (2020)
Clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19 in Wuhan, China: a retrospective, single-centre, descriptive study
Authors: Nan Yu, Wei Li, Qingling Kang, Zhi Xiong, Shaoshuai Wang, Xingguang Lin, Yanyan Liu, Juan Xiao, Haiyi Liu, Dongrui Deng, Suhua Chen, Wanjiang Zeng, Ling Feng, Jianli Wu
Journal: The Lancet Infectious Diseases (2020)

In December, 2019, coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, China. The number of affected pregnant women is increasing, but scarce information is available about the clinical features of COVID-19 in pregnancy. This study aimed to clarify the clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19.In this retrospective, single-centre study, we included all pregnant women with COVID-19 who were admitted to Tongji Hospital in Wuhan, China. Clinical features, treatments, and maternal and fetal outcomes were assessed.Seven patients, admitted to Tongji Hospital from Jan 1, to Feb 8, 2020, were included in our study. The mean age of the patients was 32 years (range 29-34 years) and the mean gestational age was 39 weeks plus 1 day (range 37 weeks to 41 weeks plus 2 days). Clinical manifestations were fever (six [86%] patients), cough (one [14%] patient), shortness of breath (one [14%] patient), and diarrhoea (one [14%] patient). All the patients had caesarean section within 3 days of clinical presentation with an average gestational age of 39 weeks plus 2 days. The final date of follow-up was Feb 12, 2020. The outcomes of the pregnant women and neonates were good. Three neonates were tested for SARS-CoV-2 and one neonate was infected with SARS-CoV-2 36 h after birth.The maternal, fetal, and neonatal outcomes of patients who were infected in late pregnancy appeared very good, and these outcomes were achieved with intensive, active management that might be the best practice in the absence of more robust data. The clinical characteristics of these patients with COVID-19 during pregnancy were similar to those of non-pregnant adults with COVID-19 that have been reported in the literature.National Natural Science Foundation of China, Hubei Provincial Natural Science Foundation of China.
Repeat hepatectomy for early and late recurrence of hepatocellular carcinoma: A multicenter study with propensity score matching analysis
Authors: Lei Liang, Hao Xing, Zhi-yu Chen, Ya-hao Zhou, Hong Wang, Ting-hao Chen, Timothy M. Pawlik, Wan Yee Lau, Feng Shen, Tian Yang
Journal: International Journal of Surgery (2020)
Reply to Arvanitakis et al.
Authors: Theodor Voiosu, Ivo Boskoski, Andrei M. Voiosu, Andreea Bengus, Agata Ladic, Ivo Klarin, Vincenzo Bove, Bogdan Busuioc, Mihai Rimbas, Nadan Rustemovic, Bogdan Mateescu, Ivan Jovanovic, Guido Costamagna
Journal: Endoscopy (2020)

See also: Trainee involvement in ERCP: safe under close surveillanceEndoscopy 2020; 52(04): 318-318DOI: 10.1055/a-1089-9163
Endoscopic ultrasound-guided intervention for gastric varices: sticky stuff might not (yet) be enough
Authors: Wim Laleman
Journal: Endoscopy (2020)

Bleeding gastroesophageal varices remain a devastating and life-threatening clinical condition that requires immediate and urgent intervention, with the ultimate goal being hemostasis. While esophageal varices (80 % – 85 %) form the bulk of all variceal bleedings in patients with cirrhotic portal hypertension (PHT), gastric varices should not be ignored as a trivial remainder. The second, albeit less frequent, scenario in which gastric varices are found relates to prehepatic conditions (so-called left-sided PHT), such as noncirrhotic thrombosis of the portal/splenic vein [1].
Abstract P1-21-06: Deregulated immune pathway associated with palbociclib resistance in breast cancer preclinical models: Integrative analysis of genomics and transcriptomics
Authors: Yong Wha Moon, Eunbyeol Lee, Sohyun Hwang, Kamal Pandey, Nahee Park, Jin Hur, Young Bin Cho, Seung Ki Kim, Seung Ah Lee, Hee-Jung An, Joohyuk Sohn
Journal: Cancer Research (2020)

Abstract Background: Recently CDK4/6 inhibitors are being widely used to treat advanced HR-positive breast cancer. Despite promising clinical outcomes, almost all patients eventually acquire resistance to CDK4/6 inhibitors. Hence, understanding the mechanisms of acquired resistance to CDK4/6 inhibitors is crucial to develop alternate treatment strategy. Therefore, we screened genes associated with palbociclib resistance through genomics and transcriptomics in breast cancer preclinical models. Methods: We generated palbociclib-resistant cell lines, MCF7-PR and T47D-PR by exposing MCF7 and T47D cells to palbociclib for over 9 months. After confirming the acquired resistance through in vitro assays, we performed whole exome sequencing (WES) and mRNA microarray to compare genomic and transcriptomic landscape between palbociclib-sensitive and resistant cells. Real-time PCR was performed to confirm differentially expressed genes. Results: Microrray analysis revealed 651 differentially expressed genes (DEGs) (fold change ≥2) by comparing MCF7 vs. MCF7-PR cells. WES also revealed 107 mutated genes by comparing T47D vs. T47D-PR cells. Further, GO annotation of both the DEGs and mutated genes found deregulation of immune pathway commonly in MCF7-PR and T47D-PR (FDR&amp;lt;0.25). Representatively, activated type I interferon pathway was notable in MCF7-PR cells with annotation of the DEGs. By real-time PCR, IRF9 and SP100 were commonly increased in the resistant cells (MCF7-PR, T47D-PR) compared to each sensitive counterpart. Besides, STAT1, IFI27, IFIT2, IFIT3, and XAF1 were increased in the MCF7-PR compared to MCF7, STAT2 was also increased in the T47D-PR compared to T47D. Regarding mutations found in resistant cells, MUC4 (in MCF7-PR) and MUC16 (in T47D-PR) mutations were annotated as immune pathway including immune response activating cell surface receptor signaling or O-glycan processing, et al. Besides, RB1 mutation was detected in T47D-PR cells. Conclusions: Deregulated immune pathway was found to be associated with palbociclib resistance in preclinical breast cancer models. Further studies are warranted to evaluate whether immune pathway may be a therapeutic target to overcome CDK4/6 inhibitor resistance. Citation Format: Yong Wha Moon, Eunbyeol Lee, Sohyun Hwang, Kamal Pandey, Nahee Park, Jin Hur, Young Bin Cho, Seung Ki Kim, Seung Ah Lee, Hee-Jung An, Joohyuk Sohn. Deregulated immune pathway associated with palbociclib resistance in breast cancer preclinical models: Integrative analysis of genomics and transcriptomics [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P1-21-06.
Adenocarcinoma Ex goblet cell: A retrospective experience.
Authors: Satya Das, Jordan Berlin, Liping Du, Chanjuan Shi
Journal: Journal of Clinical Oncology (2018)

847 Background: Adenocarcinoma ex goblet cell tumors (AGCC) represent rare appendiceal neoplasms with neuroendocrine and adenocarcinoma features. They represent the most aggressive subset of goblet cell carcinoids (Group B and C) and are often categorized as chemotherapy unresponsive [Am J SurgPathol.2008;32(10):1429-43]. Despite this, most patients with AGCC are treated with colon cancer chemotherapy regimens. We explored outcomes in patients treated at our institution with these regimens. Methods: We performed a single center retrospective analysis of 22 biopsy-proven AGCC patients (13 men, 9 women, median age at diagnosis 54.5) at Vanderbilt who had undergone treatment for local or metastatic disease. PFS and OS were determined for each patient and stratified by features listed on Table 1. Patients who were lost to follow up were censored based on their last recorded clinic date. Results: 16 patients received chemotherapy in the metastatic setting and all 16 had peritoneal involvement; of these patients 4 underwent HIPEC. Median PFS and OS in HIPEC treated patients was 17 months and 33 months respectively. 8 patients received adjuvant chemotherapy with FOLFOX; 6 in the local setting and 2 in the metastatic setting. Patients with metastatic AGCC had a median PFS of 21.5 months and a median OS of 32.9 months. Patients with local disease had a median PFS of 32.8 months and an OS that was not reached (median duration of follow up 12.4 months). Conclusions: AGCC have a predilection for peritoneal spread. Patients who received either adjuvant FOLFOX post definitive surgery or FOLFOX/FOLFIRI in the metastatic setting post optimal cytoreduction had prolonged periods of PFS and OS. [Table: see text]
Machine learning prediction of incidence of Alzheimer’s disease using large-scale administrative health data
Authors: Ji Hwan Park, Han Eol Cho, Jong Hun Kim, Melanie M. Wall, Yaakov Stern, Hyunsun Lim, Shinjae Yoo, Hyoung Seop Kim, Jiook Cha
Journal: npj Digital Medicine (2020)

Abstract Nationwide population-based cohort provides a new opportunity to build an automated risk prediction model based on individuals’ history of health and healthcare beyond existing risk prediction models. We tested the possibility of machine learning models to predict future incidence of Alzheimer’s disease (AD) using large-scale administrative health data. From the Korean National Health Insurance Service database between 2002 and 2010, we obtained de-identified health data in elders above 65 years ( N = 40,736) containing 4,894 unique clinical features including ICD-10 codes, medication codes, laboratory values, history of personal and family illness and socio-demographics. To define incident AD we considered two operational definitions: “definite AD” with diagnostic codes and dementia medication ( n = 614) and “probable AD” with only diagnosis ( n = 2026). We trained and validated random forest, support vector machine and logistic regression to predict incident AD in 1, 2, 3, and 4 subsequent years. For predicting future incidence of AD in balanced samples (bootstrapping), the machine learning models showed reasonable performance in 1-year prediction with AUC of 0.775 and 0.759, based on “definite AD” and “probable AD” outcomes, respectively; in 2-year, 0.730 and 0.693; in 3-year, 0.677 and 0.644; in 4-year, 0.725 and 0.683. The results were similar when the entire (unbalanced) samples were used. Important clinical features selected in logistic regression included hemoglobin level, age and urine protein level. This study may shed a light on the utility of the data-driven machine learning model based on large-scale administrative health data in AD risk prediction, which may enable better selection of individuals at risk for AD in clinical trials or early detection in clinical settings.