tbuckley/cabot-search huggingface dataset:
Polatuzumab vedotin in combination with immunochemotherapy in patients with previously untreated diffuse large B-cell lymphoma: an open-label, non-randomised, phase 1b–2 study
Authors: Hervé Tilly, Franck Morschhauser, Nancy L Bartlett, Amitkumar Mehta, Gilles Salles, Corinne Haioun, Javier Munoz, Andy I Chen, Kathryn Kolibaba, Dan Lu, Mark Yan, Elicia Penuel, Jamie Hirata, Calvin Lee, Jeff P Sharman
Journal: The Lancet Oncology (2019)
The escalating global burden of serious health-related suffering: projections to 2060 by world regions, age groups, and health conditions
Authors: Katherine E Sleeman, Maja de Brito, Simon Etkind, Kennedy Nkhoma, Ping Guo, Irene J Higginson, Barbara Gomes, Richard Harding
Journal: The Lancet Global Health (2019)

Serious life-threatening and life-limiting illnesses place an enormous burden on society and health systems. Understanding how this burden will evolve in the future is essential to inform policies that alleviate suffering and prevent health system weakening. We aimed to project the global burden of serious health-related suffering requiring palliative care until 2060 by world regions, age groups, and health conditions.We projected the future burden of serious health-related suffering as defined by the Lancet Commission on Palliative Care and Pain Relief, by combining WHO mortality projections (2016-60) with estimates of physical and psychological symptom prevalence in 20 conditions most often associated with symptoms requiring palliative care. Projections were described in terms of absolute numbers and proportional change compared with the 2016 baseline data. Results were stratified by World Bank income regions and WHO geographical regions.By 2060, an estimated 48 million people (47% of all deaths globally) will die with serious health-related suffering, which represents an 87% increase from 26 million people in 2016. 83% of these deaths will occur in low-income and middle-income countries. Serious health-related suffering will increase in all regions, with the largest proportional rise in low-income countries (155% increase between 2016 and 2060). Globally, serious health-related suffering will increase most rapidly among people aged 70 years or older (183% increase between 2016 and 2060). In absolute terms, it will be driven by rises in cancer deaths (16 million people, 109% increase between 2016 and 2060). The condition with the highest proportional increase in serious-related suffering will be dementia (6 million people, 264% increase between 2016 and 2060).The burden of serious health-related suffering will almost double by 2060, with the fastest increases occurring in low-income countries, among older people, and people with dementia. Immediate global action to integrate palliative care into health systems is an ethical and economic imperative.Research Challenge Fund, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London.
THE INDEX EVALUATING INDIVIDUALS' INDEPENDANCY IN ACTIVITIES OF DAILY LIVING DOES NOT SATISFACTORILY PREDICT INADEQUATE BOWEL PREPARATION IN INPATIENTS UNDERGOING COLONOSCOPY
Authors: K Triantafyllou, P Gkolfakis, A Skamnelos, G Diamantopoulou, A Dagas, G Tziatzios, K Thomopoulos, S Potamianos, D Christodoulou
Journal: Endoscopy (2019)

Katz index* assesses independancy of a person in performing activities of daily living (bathing, dressing, toileting, transfering, continence, feeding). We evaluated the use of Katz index for the prediction of inadequate bowel preparation among inpatients undergoing colonoscopy.
MULTICENTER RETROSPECTIVE CASE SERIES ASSESSING ADVERSE EVENTS ASSOCIATED TO THE INDWELL AND STENT RETRIEVAL OF LUMEN APPOSING METAL STENTS
Authors: S Bazaga, A Yaiza Carbajo, F Javier García-Alonso, D Martí, V Sánchiz Soler, B Martinez Moreno, J Ramón Aparicio Tormo, R Pedraza Sanz, R Villanueva Hernández, J Vila Costas, E Vázquez Sequeiros, A Jordán Castro, M Jiménez Palacios, M Pérez-Miranda
Journal: Endoscopy (2019)

The primary aim was to describe all LAMS related adverse events presenting during stent indwell and retrieval. Secondary aims were describing the relationship between indwell time, therapeutic target and adverse events.
PATENCY CAPSULE IN CLINICAL PRACTICE – EXPERIENCE OF A TERTIARY REFERENCE CENTER
Authors: M Silva, A Peixoto, S Gomes, AL Santos, P Moreira, A Corte Real Nunes, S Lopes, G Macedo
Journal: Endoscopy (2019)

Videocapsule endoscopy (VCE) is a non-invasive method for examining the small bowel. VCE retention is the most significant complication of these devices and a patency capsule (PC) may be used to safely perform VCE, in patients with an increased risk of VCE retention.
Clinical phenotypes of acute heart failure based on signs and symptoms of perfusion and congestion at emergency department presentation and their relationship with patient management and outcomes
Authors: Patricia Javaloyes, Òscar Miró, Víctor Gil, Francisco Javier Martín‐Sánchez, Javier Jacob, Pablo Herrero, Koji Takagi, Aitor Alquézar‐Arbé, María Pilar López Díez, Enrique Martín, Carlos Bibiano, Rosa Escoda, Cristina Gil, Marta Fuentes, Guillermo Llopis García, José María Álvarez Pérez, Alba Jerez, Josep Tost, Lluís Llauger, Rodolfo Romero, José Manuel Garrido, Esther Rodríguez‐Adrada, Carolina Sánchez, Xavier Rossello, John Parissis, Alexandre Mebazaa, Ovidiu Chioncel, Pere Llorens
Journal: European Journal of Heart Failure (2019)
Patients’ Views About Skin Self-examination After Treatment for Localized Melanoma
Authors: Mbathio Dieng, Amelia K. Smit, Jolyn Hersch, Rachael L. Morton, Anne E. Cust, Les Irwig, Donald Low, Cynthia Low, Katy J. L. Bell
Journal: JAMA Dermatology (2019)

Skin self-examination (SSE) is a key factor in the early detection of melanoma, and many new and recurrent melanomas are first detected by patients themselves or their family members.To explore the views of patients with melanoma regarding SSE in general, as well as their attitudes toward using novel digital technologies to support their own SSE.Qualitative study with semistructured interviews that were conducted from June 20 to December 12, 2016, with 37 individuals in Sydney, Australia, who were previously treated for a first primary localized melanoma during 2014 and had not had a recurrence or new primary melanoma in the time since treatment.Patients' views and experiences, analyzed thematically.A total of 37 patients (11 women and 26 men; median age, 67 years [interquartile range, 59.5-72 years]) were interviewed. Participants perceived SSE as important for the early identification of local recurrence or new primary melanomas. Despite this belief, participants did not report undertaking full-body SSE on a regular basis. Factors that influenced their low engagement in thorough SSE included lack of self-efficacy, reliance on clinician consultations as the primary means of melanoma detection, and fear of cancer recurrence. Regarding the use of digital technology to assist with SSE, the key motivating factors in favor of such tools were the ability to track changes in lesions over time and the use of automated reminders to undertake SSE. Deterrents included a lack of confidence in undertaking SSE and in using new technology.Patients with melanoma are aware of the importance of thorough skin examinations. However, a lack of confidence in their ability to undertake SSE and reliance on clinicians as the primary means of melanoma detection may inhibit patients from undertaking regular and thorough SSE. Patients may benefit from new digital technologies that assist them in undertaking SSE, provided they have appropriate education and technical support.
ENDOSCOPIC TREATMENT OF BILIARY COMPLICATIONS AFTER LIVER TRANSPLANTATION, SINGLE CENTRE EXPERIENCE
Authors: J Březina, P Macinga, P Drastich, P Štirand, T Hucl, J Špičák
Journal: Endoscopy (2019)

Biliary complications are common in liver transplant recipients with incidence as high as 32%. The most common complications are biliary strictures and biliary leak. ERCP is a primary treatment modality in those patients; clinical success depends on the type of complication.
The Impact of Gram-Negative Bacilli in Bacteremic Skin and Soft Tissue Infections Among Patients With Diabetes
Authors: Eva Benavent, Oscar Murillo, Imma Grau, Julia Laporte-Amargos, Joan Gomez-Junyent, Laura Soldevila, Fe Tubau, Javier Ariza, Roman Pallares
Journal: Diabetes Care (2019)

Skin and soft tissue infections (SSTIs) are common and may be more severe in patients with diabetes. In particular, the development of diabetic foot ulcers facilitates diabetic foot infections (DFIs), which are generally not included in SSTI classifications (1). In these situations, gram-negative bacilli (GNB) may have an impact on the etiology of severe SSTIs.

We aimed to analyze the GNB etiology, epidemiologic trends, and risk factors for mortality among a large cohort of adult patients with diabetes attended in our hospital (1996–2016) with bloodstream infections from an SSTI source (1). Cases with nosocomial acquisition or due to a sacral decubitus ulcer were excluded.

Out of 30,363 episodes of bacteremia, 7,202 (23.7%) occurred in patients with diabetes; this proportion increased over time from 17.7% in 1996–2000 to 28.3% in 2011–2016 ( P < 0.001). Among bacteremic episodes in patients with diabetes, 247 (3.4%) were secondary to SSTIs, of which 223 were analyzed (Table 1). The most common clinical form was cellulitis ( n = 184, 82.5%). DFIs represented 25% of cases (with abscesses in 23%), of which 41.8% required surgery (amputation, 43.5%).

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Table 1 
Clinical characteristics of the studied cohort and differences between patients with an infection due to GNB, GPC, or mixed …
CAPNOGRAPHY MONITORING IS BENEFICIAL BY ESTIMATING ETCO2 INSTABILITY DURING ENDOSCOPIC SUBMUCOSAL DISSECTION (ESD)
Authors: SH Kim, B Keum, HJ Jeon, SH Jang, JH Kim, SJ Choi, SH Kim, JM Lee, HS Choi, ES Kim, YT Jeen, HS Lee, HJ Chun, CD Kim
Journal: Endoscopy (2019)

Endoscopic submucosal dissection (ESD) requires deeper sedation than mucosal resection. This may lead to adverse ventilation problems. Capnography measures end-tidal CO2 (EtCO2) levels and it is known to detect depressed respiratory activity prior to the incidence of hypoxic events. However, its usefulness during endoscopy has been disputed. Considering that absolute EtCO2 value monitoring would not be as effective as that of general anesthesia due to belching or body movements during endoscopy, we herein introduced a concept of 'EtCO2 instability', and studied whether it is correlated with higher chance of hypoxia.
Les polypes minuscules recto-coliques: Faut-il une analyse histologique systématique?
Authors: H Jlassi, D Trad, M Sabbah, N Bibani, A Ouakaa Kchaou, H Elloumi, D Gargouri
Journal: Endoscopy (2019)

Les petits polypes constituent la grande majorité des polypes recto-coliques. Parmi ceux-ci, la prévalence des adénomes avancés est faible. La stratégie „Detect-and-leave” se discute pour les très petits polypes (≤5 mm), compte tenu des coûts induits et de la forte proportion de lésions non significatives (hyperplasiques).
Comparison of Machine Learning Optimal Classification Trees With the Pediatric Emergency Care Applied Research Network Head Trauma Decision Rules
Authors: Dimitris Bertsimas, Jack Dunn, Dale W. Steele, Thomas A. Trikalinos, Yuchen Wang
Journal: JAMA Pediatrics (2019)

Computed tomographic (CT) scanning is the standard for the rapid diagnosis of intracranial injury, but it is costly and exposes patients to ionizing radiation. The Pediatric Emergency Care Applied Research Network (PECARN) rules for identifying children with minor head trauma who are at very low risk of clinically important traumatic brain injury (ciTBI) are widely used to triage CT imaging. To examine whether optimal classification trees (OCTs), which are novel machine-learning classifiers, improve on PECARN rules' predictive accuracy. A secondary analysis of prospective, publicly available data on emergency department visits for head trauma used by the PECARN group to develop their tool was conducted to derive OCT-based prediction rules for ciTBI in a development cohort and compare their predictive performance vs the PECARN rules in a validation cohort among children who were younger than 2 years and 2 years or older. Data on 42 412 children with head trauma and without severely altered mental status who were examined between June 1, 2004, and September 30, 2006, were gathered from 25 emergency departments in North America participating in PECARN. Data analysis was conducted from September 15, 2016, to December 18, 2018. The outcome was ciTBI, with predictive performance measured by estimating the sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio for the OCT and the PECARN rules. The OCT and PECARN rules' performance was compared by estimating ratios for each measure. Of the 42 412 children (15 996 [37.7%] girls) included in the analysis, 10 718 were younger than 2 years (25.3%; mean [SD] age, 11.6 [0.6] months) and 31 694 were 2 years or older (74.7%; age, 9.1 [4.9] years). Compared with PECARN rules, OCTs misclassified 0 vs 1 child with ciTBI in the younger and 10 vs 9 children with ciTBI in the older cohort, and correctly identified more children with very low risk of ciTBI in the younger (7605 vs 5701) and older (20 594 vs 18 134) cohorts. In the validation cohorts, compared with the PECARN rules, the OCTs had statistically significantly better specificity (in the younger cohort: 69.3%; 95% CI, 67.4%-71.2% vs 52.8%; 95% CI, 50.8%-54.9%; in the older cohort: 65.6%; 95% CI, 64.5%-66.8% vs 57.6%; 95% CI, 56.4%-58.8%), positive predictive value (odds ratios, 1.54; 95% CI, 1.36-1.74 and 1.23; 95% CI, 1.17-1.30, in younger and older children, respectively), and positive likelihood ratio (risk ratios, 1.54; 95% CI, 1.36-1.74 and 1.23; 95% CI, 1.17-1.30, in younger and older children, respectively). There were no statistically significant differences in the sensitivity, negative predictive value, and negative likelihood ratio between the 2 sets of rules. If implemented, OCTs may help reduce the number of unnecessary CT scans, without missing more patients with ciTBI than the PECARN rules.
Association between pregnancy loss and ambient PM2·5 using survey data in Africa: a longitudinal case-control study, 1998–2016
Authors: Tao Xue, Tong Zhu, Guannan Geng, Qiang Zhang
Journal: The Lancet Planetary Health (2019)

BackgroundIncreasing evidence from epidemiological studies suggests that maternal exposure to ambient PM2·5 can increase the risk of pregnancy loss. However, no studies have been done in low-income countries such as those in Africa, which have the highest incidences of pregnancy loss. In this study, we aimed to analyse the association between PM2·5 and pregnancy loss, including miscarriage and stillbirth.MethodsThis self-compared case control study collected data on mothers who reported at least two births (at least one case of pregnancy loss plus at least one normal delivery) in the African Demographic and Health Surveys. Gestational exposure to PM2·5 was assessed using a state-of-the-art estimator based on satellite measurements and chemical transport model outputs. Each case of pregnancy loss was compared with the successful control deliveries in the same mother. We estimated the association between gestational exposure to PM2·5 and pregnancy loss using a conditional logistical model with multiple adjustments, and assessed it using the odds ratio (OR) derived from the regression.FindingsBetween Jan 1, 1998, and Dec 31, 2016, 67 566 cases of pregnancy loss were reported across Africa in the DHS. After removal of mothers who did not report at least one successful delivery and those with missing spatial information, 42 952 were included in the study. Of these, 30 418 were categorised as miscarriages and 12 534 were stillbirths. Each increment of 10 μg/m3 PM2·5 was associated with an adjusted OR of 1·122 (95% CI 1·107–1·137) for pregnancy loss, including miscarriage (1·125; 1·109–1·142) and stillbirth (1·094; 1·051–1·138).InterpretationOur findings from African DHS data showing that PM2·5 exposure is significantly associated with increased risk of pregnancy loss add to the existing epidemiological evidence from middle-income and high-income countries on the health impacts of poor air quality. Our results support public health interventions for reducing ambient particulate matter to improve maternal health in Africa.FundingChina National Natural Science Foundation and China Ministry of Science and Technology.
Abstract 15423: Importance of Coronary Artery Plaques in Patients With Coronary Artery Ectasia
Authors: Nasim Sheidaee, Dong Li, Rine Nakanishi, Sirous Darabian, Negin Nezarat, Sina Rahmani, Juhwan Lee, Hamid Far, Michel Kim, Eranthi Jayawardena, Nicoli Hthiramani, Nicholas Kim, Wendy Post, Matthew Budoff
Journal: Circulation (2017)

Introduction: Coronary artery ectasia (CAE) is a manifestation of cardiovascular disease with prevalence of 0.3-12%. It increases the risk of thrombosis and myocardial infarction. Hypothesis: The g...
Ethnoracial and social trends in breast cancer staging at diagnosis in Brazil, 2001–14: a case only analysis
Authors: Isabel dos-Santos-Silva, Bianca L De Stavola, Nelson L Renna, Mário C Nogueira, Estela M L Aquino, Maria Teresa Bustamante-Teixeira, Gulnar Azevedo e Silva
Journal: The Lancet Global Health (2019)

Policies for early detection of breast cancer, including clinical breast examinations and mammographic screening, were introduced in Brazil in 2004, but their effect on disease stage at diagnosis is unclear. We aimed to assess whether these policies have led to a decrease in the prevalence of late-stage breast cancer at diagnosis.
Chronic use of tramadol after acute pain episode: cohort study
Authors: Cornelius A Thiels, Elizabeth B Habermann, W Michael Hooten, Molly M Jeffery
Journal: BMJ (2019)

Abstract Objective To determine the risk of prolonged opioid use in patients receiving tramadol compared with other short acting opioids. Design Observational study of administrative claims data. Setting United States commercial and Medicare Advantage insurance claims (OptumLabs Data Warehouse) January 1, 2009 through June 30, 2018. Participants Opioid-naive patients undergoing elective surgery. Main outcome measure Risk of persistent opioid use after discharge for patients treated with tramadol alone compared with other short acting opioids, using three commonly used definitions of prolonged opioid use from the literature: additional opioid use (defined as at least one opioid fill 90-180 days after surgery); persistent opioid use (any span of opioid use starting in the 180 days after surgery and lasting ≥90 days); and CONSORT definition (an opioid use episode starting in the 180 days after surgery that spans ≥90 days and includes either ≥10 opioid fills or ≥120 days’ supply of opioids). Results Of 444 764 patients who met the inclusion criteria, 357 884 filled a discharge prescription for one or more opioids associated with one of 20 included operations. The most commonly prescribed post-surgery opioid was hydrocodone (53.0% of those filling a single opioid), followed by short acting oxycodone (37.5%) and tramadol (4.0%). The unadjusted risk of prolonged opioid use after surgery was 7.1% (n=31 431) with additional opioid use, 1.0% (n=4457) with persistent opioid use, and 0.5% (n=2027) meeting the CONSORT definition. Receipt of tramadol alone was associated with a 6% increase in the risk of additional opioid use relative to people receiving other short acting opioids (incidence rate ratio 95% confidence interval 1.00 to 1.13; risk difference 0.5 percentage points; P=0.049), 47% increase in the adjusted risk of persistent opioid use (1.25 to 1.69; 0.5 percentage points; P&lt;0.001), and 41% increase in the adjusted risk of a CONSORT chronic opioid use episode (1.08 to 1.75; 0.2 percentage points; P=0.013). Conclusions People receiving tramadol alone after surgery had similar to somewhat higher risks of prolonged opioid use compared with those receiving other short acting opioids. Federal governing bodies should consider reclassifying tramadol, and providers should use as much caution when prescribing tramadol in the setting of acute pain as for other short acting opioids.
Traitement endoscopique des fistules oesophagiennes par injection de vésicules extracellulaires contenues dans un gel thermosensible dans un modèle porcin
Authors: G Rahmi, A Brun, S Perretta, G Perrod, L Pidial, V Lindner, C Wilhelm, F Gazeau, M Barthet, C Cellier, O Clement
Journal: Endoscopy (2019)

Les fistules digestives post chirurgicales sont une complication redoutée car associées à une morbi-mortalité élevée chez des patients fragiles. Le risque est particulièrement élevé pour une chirurgie oeso gastrique compte tenu de la complexité technique du geste. Nous avons développé un modèle endoscopico-chirurgical de fistule oeso-cutanée chez le porc (1). L'objectif de notre étude était d'évaluer l'efficacité de l'injection endoscopique de vésicules extracellulaires (VE) issues de cellules souches mésenchymateuses (CSM) et contenues dans un gel thermosensible, le Pluronic F127, pour la fermeture des fistules dans ce modèle porcin.
Confrontation des aspects endoscopiques aux résultats des biopsies coliques systématiques au cours de l'exploration des diarrhées chroniques
Authors: H Kchir, A hassine, R Tlili, D Issaoui, H Chaabouni, N Maamouri
Journal: Endoscopy (2019)

Le diagnostic étiologique des diarrhées chroniques repose sur les explorations endoscopiques digestives haute et basse. Au cours de la coloscopie, les aspects endoscopiques sont polymorphes mais l'étude histologique peut faire défaut au cours des coloscopies normales.