tbuckley/cabot-search huggingface dataset:
EFFICACY OF EMERGENCY ENDOSCOPIC HEMOSTASIS IN PATIENTS WITH ACUTE LOWER GASTROINTESTINAL BLEEDING AND FACTORS ASSOCIATED WITH NECESSITY OF ENDOSCOPIC INTERVENTION
Authors: G Diamantopoulou, C Konstantakis, C Tsolias, M Kalafateli, G Theocharis, G Skroubis, C Triantos, K Papantoniou, K Thomopoulos
Journal: Endoscopy (2019)

The necessity and effectiveness of emergency endoscopic hemostasis in patients with acute lower gastrointestinal bleeding (ALGIB) has not been clearly established. The aim of this study was to define the role and efficacy of endoscopic hemostasis in patients with ALGIB and analyze factors associated with necessity for hemostasis.
Abstract 9919: Incremental Values of Resting and Exercise Cardiac Dysfunction for Prediction of Outcome in Asymptomatic Aortic Regurgitation
Authors: Kenya Kusunose, Thomas H Marwick, Brian P Griffin, Zoran B Popovic
Journal: Circulation (2013)

Background: The role of exercise echocardiography in decision-making regarding surgical timing for aortic regurgitation (AR) remains a matter of debate, because there are limited data on its link with outcome. The aim of this study was to assess the role of echocardiographic measurements at rest and during exercise as predictors of prognosis in asymptomatic aortic regurgitation. Methods and Results: Comprehensive resting and exercise echocardiography was performed in 164 consecutive patients (50±15y; 78% male) with isolated moderate to severe AR and preserved left ventricular (LV) function (LV ejection fraction &gt;50%, LV end-diastolic dimension ≤70mm, LV end-systolic dimension ≤50mm or ≤25mm/m2) in whom initial management was expectant. Echocardiographic measurements were performed at rest and during exercise. LV and right ventricular (RV) longitudinal strain was analyzed at rest using velocity vector imaging. Valve surgery was performed in 38 patients (23%) over 33±12 months. After adjustment for age and gender in a multivariable Cox proportional hazards model, exercise tricuspid annular plane systolic excursion (TAPSE) (HR=0.81, p=0.002) was associated with valve surgery-free survival, independent of resting LV strain (HR=1.16, p=0.043), exercise LV end-diastolic volume (HR=1.01, p=0.134) and resting RV strain (HR=1.17, p=0.009). In sequential Cox models, a model based on clinical data (chi-square, 25.6) was improved by resting LV strain (chi-square, 30.1, p=0.010), resting RV strain (chi-square, 46.0, p=0.001) and further increased by exercise TAPSE (chi-square, 56.7, p=0.001)(Figure). Conclusions: In asymptomatic AR, resting LV strain, resting RV strain and exercise TAPSE were independently associated with the need for earlier aortic surgery.
NOVEL EUS GUIDED TREATMENT OF GASTRIC VARICES WITH A LIQUID NON-ADHESIVE NEUROVASCULAR EMBOLIZATION AGENT
Authors: A Baptista, M Guzman, J Piñerua
Journal: Endoscopy (2019)

Endoscopic Injection of adhesive agents as N-Butyl-2-Cyanoacrylate (NBC) is used for the management of gastric varices. Recently the combination of NBC and coils has been used with endoscopic ultrasound assistance. Adhesive properties can blockage instrumentation material and damage endoscopes. Adverse events include ulcers, vascular necrosis, rebleeding and distal embolism. We describe a novel gastric varices embolization therapy with EUS injection of a composite non-adhesive endosvascular liquid agent: Ethylene-vinyl alcohol (EVOH), Tantalum as contrast media and Dimethylsulfoxide (DMSO) as primer. It has been extensively used in interventional radiology to treat cerebral arteriovenous malformations. Has the advantages of being radiopaque and inmediate polimerization.
Program ACTIVE II: Outcomes From a Randomized, Multistate Community-Based Depression Treatment for Rural and Urban Adults With Type 2 Diabetes
Authors: Mary de Groot, Jay H. Shubrook, W. Guyton Hornsby, Yegan Pillay, Kieren J. Mather, Karen Fitzpatrick, Ziyi Yang, Chandan Saha
Journal: Diabetes Care (2019)

OBJECTIVE Depression (major depressive disorder [MDD]) in adults with type 2 diabetes mellitus (T2DM) is associated with worsened diabetes complications, increased health care costs, and early mortality. Program ACTIVE II was a randomized, controlled, multicenter treatment trial designed to test the comparative effectiveness of cognitive behavioral therapy (CBT) and/or community-based exercise (EXER) on diabetes and depression outcomes compared with usual care (UC). RESEARCH DESIGN AND METHODS Using a 2 × 2 factorial randomized controlled trial design, adults with T2DM for ≥1 year who met DSM-IV-TR criteria for MDD were randomized to CBT (10 sessions occurring over 12 weeks; N = 36), EXER (12 weeks of community-based exercise including six sessions with a personal trainer; N = 34), CBT+EXER (concurrent over a 12-week period; N = 34), and UC (N = 36). Primary outcomes were depression remission rate (assessed by psychiatric interviewers blind to assignment) and change in glycemic control (HbA1c). RESULTS The mean age was 56.0 years (SD 10.7). Participants were female (77%), white (71%), and married (52%). After controlling for education and antidepressant use, odds of achieving full MDD remission in the intervention groups were 5.0–6.8 times greater than UC (P &amp;lt; 0.0167). The CBT+EXER group demonstrated improved HbA1c compared with UC. For participants with a baseline HbA1c ≥7.0%, exploratory post hoc subgroup analysis showed that the CBT+EXER group had a 1.1% improvement in HbA1c (P &amp;lt; 0.0001) after controlling for covariates. CONCLUSIONS The Program ACTIVE behavioral treatment interventions demonstrated clinically meaningful improvements in depression outcomes in adults with T2DM and MDD. These community-based interventions are complementary to medical care and extend access to those in rural and urban areas.
THE DOUBLE TUNNEL TECHNIQUE FOR SUCCESSFUL TRANSESOPHAGEAL REMOVAL OF A MOSTLY MEDIASTINALLY LOCATED CALCIFIED LYOMYOMA ORIGINATING FROM THE CIRCUMFERENTIAL ESOPHAGEAL MUSCULAR LAYER
Authors: J Hochberger
Journal: Endoscopy (2019)

A 52 year old patient was admitted for discussion of the resection of an oligosymptomatic 3.5 × 2,5 cm tumor of the esophagus located mostly at the level of the aortic arch (24 – 27 cm aborally. Leiomyoma was postulated. As the lesion was partially calcified a GIST tumor could not be excluded. Observation versus FNA versus surgical resection versus submucosal endoscopic tunnel enucleation (SET, SETE) of the tumor was discussed. Due to the size of the tumor and increasing operative risk with age the patient decided to have the tumor resected.
ENDOSCOPIC FULL THICKNESS RESECTION OF COLORECTAL LESIONS WITH THE FULL THICKNESS RESECTION DEVICE: CLINICAL EXPERIENCE FROM TWO REFERRAL CENTERS IN GREECE
Authors: M Velegraki, A Trikola, K Vasiliadis, M Fragaki, A Mpitouli, I Dimas, E Giannikaki, A Kapranou, A Kordelas, G Stefanidis, GA Paspatis
Journal: Endoscopy (2019)

Endoscopic full thickness resection (EFTR) is a novel invasive treatment for colorectal lesions not resectable by conventional endoscopic techniques. This study is the first report of clinical experience with the Full Thickness Resection Device (FTRD) among referral centers in Greece, assessing EFTR efficacy and safety.
In Vivo Assembly and Disassembly of Probes to Improve Near‐Infrared Optical Bioimaging
Authors: Mengyao Zhao, Benhao Li, Yong Fan, Fan Zhang
Journal: Advanced Healthcare Materials (2019)

Abstract The near‐infrared range (NIR, 700−1700 nm) has been used as a superior optical window for non‐invasive bioimaging. Increasing signal‐to‐noise ratio (SNR) is the most fundamental method to improve NIR bioimaging. However, the low delivery efficiency of fluorescent contrast agents leads to weak signal at lesions. Moreover, non‐specific accumulation and “always on” signals will cause “false positive” signals and high background noise, all of which result in low SNR and potential long‐term biotoxicity. Thus, to reach precise detection of lesions, strong bioimaging signals and low background interference are the two important pre‐requisites. This review provides an overview of in vivo assembly and disassembly strategies to improve tumor‐specific accumulation, “turn‐on” the silent signals, and reduce the background noise in NIR bioimaging windows. In vivo assembly and disassembly occurring spontaneously, responding to disease micro‐environment or external stimuli, including pH, enzymes, reactive oxygen species, redox, light, and specific recognition is summarized, which may provide ideas and approaches to further enhance bioimaging and reduce long‐term biotoxicity concerns.
A FEARED COMPLICATION OF AN INTRAGASTRIC BALLOON HYPERINSUFFLATION
Authors: M Silva, M Dos Passos Galvão Neto, E Grecco, T Ferreira de Souza, AL Santos, S Gomes, G Macedo, LG de Quadros
Journal: Endoscopy (2019)

Bariatric endoscopy is rapidly emerging as an effective and less invasive alternative to bariatric surgery. IGB placement is one of the most common procedures performed for the treatment of obesity. The authors report a rare, but potentially serious, complication of IGB placement.
Effects of Allopurinol Dose Escalation on Bone Erosion and Urate Volume in Gout: A Dual‐Energy Computed Tomography Imaging Study Within a Randomized, Controlled Trial
Authors: Nicola Dalbeth, Karen Billington, Anthony Doyle, Christopher Frampton, Paul Tan, Opetaia Aati, Jordyn Allan, Jill Drake, Anne Horne, Lisa K. Stamp
Journal: Arthritis & Rheumatology (2019)

Objective To examine whether allopurinol dose escalation to achieve serum urate ( SU ) target can influence bone erosion or monosodium urate ( MSU ) crystal deposition, as measured by dual‐energy computed tomography ( DECT ) in patients with gout. Methods We conducted an imaging study of a 2‐year randomized clinical trial that compared immediate allopurinol dose escalation to SU target with conventional dosing for 1 year followed by dose escalation to target, in gout patients who were receiving allopurinol and who had an SU level of ≥0.36 mmoles/liter. DECT scans of feet and radiographs of hands and feet were obtained at baseline, year 1, and year 2 visits. DECT scans were scored for bone erosion and urate volume. Results Paired imaging data were available for 87 patients (42 in the dose‐escalation group and 45 in the control group). At year 2, the progression in the CT erosion score was higher in the control group than in the dose‐escalation group (+7.8% versus +1.4%; P = 0.015). Changes in plain radiography erosion or narrowing scores did not differ between groups. Reductions in DECT urate volume were observed in both groups. At year 2, patients in the control group who had an SU level of &lt;0.36 mmoles/liter and patients in the dose‐escalation group had reduced DECT urate volume (−27.6 to −28.3%), whereas reduction in DECT urate volume was not observed in control group patients with an SU level of ≥0.36 mmoles/liter (+1.5%) ( P = 0.023). Conclusion These findings provide evidence that long‐term urate‐lowering therapy using a treat‐to‐SU‐target strategy can influence structural damage and reduce urate crystal deposition in gout.
Endoscopic removal of a migrated intrauterine contraceptive device in the rectum assisted by Overstitch defect closure
Authors: Lei Peng, Shuchun Wei, Xuan Li, Duochen Jin, Huaiming Sang, Huihua Dai, Guoxin Zhang
Journal: Endoscopy (2019)

The intrauterine device (IUD) is one of the most commonly used reversible contraception products in the word. Perforation and migration are serious complications associated with IUD insertion. The migrated IUDs can be removed by colonoscopy when a part of the IUD is visible intraluminally; however, they should be retrieved by laparoscopy and open surgery in difficult cases [1] [2] [3].
Abstract 16759: Seasonal Variations in Cardiovascular-related Mortality But Not Hospitalization Are Modulated by Temperature and Not Climate Type: a Systematic Review and Meta-analysis of 4.5 Million Events in 26 Countries
Authors: Simon Stewart, Yasmin Ahamed, Joshua F Wiley, Cressida J McDermott, Jocasta Ball, Ashley K Keates, Maja-Lisa Løchen, Melinda J Carrington
Journal: Circulation (2016)

Introduction: We undertook a systematic review and meta-analysis of seasonal variations in cardiovascular-related events across a range of climatic conditions. Methods: A systematic review of bibli...
E-cigarette makers under fire for marketing to young people
Authors: Owen Dyer
Journal: BMJ (2019)

Philip Morris International, the world’s biggest cigarette company which is seeking to diversify into non-combustible tobacco products, has suspended a global social media marketing campaign following a Reuters investigation into the company’s use of young online “influencers” to sell its new IQOS “heated tobacco” device.

The company’s own marketing code of conduct rules out promotions involving youth oriented celebrities or “models who are or appear to be under the age of 25.” But Reuters found that paid “IQOS ambassadors” in several countries were “rail thin young women who revel in the high life.”

The suspension of Philip Morris’ campaign came as another e-cigarette company, JUUL, was targeted in a lawsuit by the US state of North Carolina over marketing and products that the state claims …
Effect of bardoxolone methyl on the urine albumin-to-creatinine ratio in patients with type 2 diabetes and stage 4 chronic kidney disease
Authors: Peter Rossing, Geoffrey A. Block, Melanie P. Chin, Angie Goldsberry, Hiddo J.L. Heerspink, Peter A. McCullough, Colin J. Meyer, David Packham, Pablo E. Pergola, Bruce Spinowitz, Stuart M. Sprague, David G. Warnock, Glenn M. Chertow
Journal: Kidney International (2019)
GP who was secretly filmed taking pills from stock cupboard is suspended for a year
Authors: Clare Dyer
Journal: BMJ (2019)

A locum GP who was filmed by a hidden camera removing pills from the medication stock cupboard of an out-of-hours service has been suspended from the UK medical register for 12 months.

Sandra Jackson told a colleague that she was “going to get some Clexane” (enoxaparin sodium) but instead removed a box of codeine from the cupboard at the BrisDoc out-of-hours unit at Cossham Hospital in Bristol in September 2015.

After advice from the police, a hidden camera had been installed after drug audits had identified shortfalls of the sleeping pill zopiclone. Some of these shortfalls had occurred when Jackson was not working there.

On two days, a …
Confounding of Race/Ethnicity and Age in the Survival among Veterans Obtaining Dialysis in VA and Non-VA Settings
Authors: Guofen Yan
Journal: Journal of the American Society of Nephrology (2019)

Wang et al.1 recently examined the 2-year survival rates among veterans receiving dialysis in Veterans Affairs (VA) and non-VA settings. This line of research is highly important because findings can inform institutional decisions about dialysis care models for veterans with ESKD. The study found that the crude 2-year cumulative incidence of death differed substantially across VA and non-VA settings, with especially greater incidence in veterans undergoing dialysis in Medicare-certified facilities (42%) than VA facilities (25%). After adjustment for covariates through multivariable regression, the adjusted mortality rate of Medicare facilities remained significantly greater than that of VA facilities. It is unclear whether the adjusted mortality differences across VA and non-VA settings reflect the true differences or may have still been confounded by race/ethnicity and age, because analyses stratifying by race/ethnicity and age were not performed to verify the regression-adjusted results. Race/ethnicity and age are two highly significant predictors of dialysis mortality. In the United States, white patients receiving dialysis have significantly greater mortality than their black and Hispanic counterparts.2 Also, elderly patients receiving dialysis are at a substantially greater risk of death. As shown in Table 1 of Wang et al.,1 race/ethnicity and age distributions differed markedly across VA and non-VA dialysis settings. For example, in Table 1, among veterans receiving dialysis in the Medicare facilities with greater mortality, 75% were white and 80% were aged >65 years. By contrast, among veterans in VA facilities with lower mortality, only 37% were white and only 41% were aged >65 years. It appears that the strong confounding effects of race/ethnicity and age have not been adequately accounted for by the multivariable-regression method used. Furthermore, prior research has demonstrated the presence of interactions between race/ethnicity and age, i.e., the relationship of race/ethnicity and dialysis mortality is age-dependent,3,4 which was not factored into their multivariable regression. To ensure the robustness of the results regarding the survival among veterans undergoing dialysis in VA and non-VA facilities, which have already been shown to be inconsistent in the literature (as reviewed by Wang et al.1), different covariate adjustment methods may be needed to verify the regression-adjusted mortality. Stratified analyses by race/ethnicity and age would be very useful to verify whether the observed/adjusted mortality differences in the overall sample would still be similar or be greatly attenuated, eliminated, or even reversed within each of the important race and age groups. Disclosures None.
Coevolution of Genome Architecture and Social Behavior
Authors: Dustin R. Rubenstein, J. Arvid Ågren, Lucia Carbone, Nels C. Elde, Hopi E. Hoekstra, Karen M. Kapheim, Laurent Keller, Corrie S. Moreau, Amy L. Toth, Sam Yeaman, Hans A. Hofmann
Journal: Trends in Ecology & Evolution (2019)
Platelet function tests predict bleeding in patients with acute myeloid leukemia and thrombocytopenia
Authors: Pernille Just Vinholt, Gustav Højrup Knudsen, Signe Sperling, Henrik Frederiksen, Christian Nielsen
Journal: American Journal of Hematology (2019)

Bleeding is frequent among patients with thrombocytopenia. We studied whether in vitro platelet function predicts future bleeding in patients with acute myeloid leukemia (AML), and thrombocytopenia. Adult AML patients with platelet count <5.0 × 1010 /L were included. Detailed bleeding history and blood samples were collected at inclusion and every 7 days. We analyzed hematology and coagulation parameters. With flow cytometry we evaluated platelet activation (activated GPIIb/IIIa, P-selectin, and CD63 expression), and platelet aggregation. Agonists were thrombin-receptor activating peptide (TRAP) and collagen-related peptide (CRP-XL). During 18 months, sixty participants were enrolled and followed for a total of 114 weeks. Bleeding occurred in 52 weeks, and was not associated with clinical, hematology or coagulation parameters. Predictors of bleeding were assessed using multivariate logistic regression, adjusted for platelet count, sex, and age. Bleeding history and receiver operating curves were compared using c-index. Reduced TRAP-induced platelet aggregation had Odds ratio 3.00 (95% confidence interval [CI] 1.38-6.60). Reduced CRP-XL-induced platelet aggregation had Odds ratio 4.00 (95%-CI 1.70-9.20) for bleeding. Overall, C-index was 0.71 for the models including platelet aggregation results, 0.72 for activated GPIIb/IIIa-positive platelets after stimulation with TRAP, 0.68 for percent P-selectin positive platelets with TRAP and 0.63 for the platelet count. Among patients receiving no platelet transfusion, C-index was 0.83-0.91 for bleeding; highest for models using platelet aggregation. Change in platelet aggregation did not correlate with the number of platelet concentrates administered. In conclusion, platelet aggregation and platelet activation results predict bleeding better than platelet count alone, among AML patients with thrombocytopenia.
BODY COMPOSITION ALTERATIONS WITH THE ENDOSCOPIC TREATMENT OF OBESITY WITH INTRAGASTRIC BALLOON (IGB). IS IT THE BEST FOLLOW UP STRATEGY?
Authors: S Barrichello, AC Hoff, JR Fernandes Fittipaldi, M Galvão Neto, T Ferreira de Souza, A Zamarian Veinert, C Teixeira, AF Teixeira, E Nobuki Usuy, E Guimaraes Hourneax de Moura
Journal: Endoscopy (2019)

Body mass index (BMI) is the most widespread method used worldwide to classify the degree of obesity. Since BMI is an imprecise method for analyzing body composition, there is an urgent need to adopt more objective methods for patient follow-up and the treatment of obesity, helping in the adoption of strategies for maintaining weight after withdrawal of the accessary.
GP who flouted infection control standards is suspended for three months
Authors: Clare Dyer
Journal: BMJ (2019)

A general practitioner who reused single use implements despite nurses’ complaints and who told a practice nurse to lie to a patient about a vaccine “cold chain” incident has been suspended from the UK medical register for three months.

Sikandir Arshad rinsed the equipment that he had used to extract a patient’s contraceptive coil and then used it to remove a coil from another patient. When challenged by a nurse, he told her that that part of the body was not sterile anyway, so there was no need for sterile instruments.

On another occasion Arshad said to a nurse that he could use forceps from a drawer rather than a sterile pack to extract a patient’s coil. He also reused single …
Maximizing the Benefit of Life-Saving Treatments for Pompe Disease, Spinal Muscular Atrophy, and Duchenne Muscular Dystrophy Through Newborn Screening
Authors: Mei Baker, Robert Griggs, Barry Byrne, Anne M. Connolly, Richard Finkel, Lucja Grajkowska, Amanda Haidet-Phillips, Laura Hagerty, Robert Ostrander, Lianna Orlando, Kathryn Swoboda, Michael Watson, R. Rodney Howell
Journal: JAMA Neurology (2019)

<h3>Importance</h3> Newborn screening (NBS) identifies infants with specific congenital disorders for which earlier intervention cannot only prevent a lifetime of chronic disability but also, most importantly, save lives. In this article, we discuss complexities associated with NBS processes in the United States, with a focus on challenges in neuromuscular disorders. <h3>Observations</h3> As new interventions for neuromuscular disorders become available, the clinical community must prepare to overcome the challenges of adding new diseases to screening panels and understand the rigorous evidence review at the federal level and the complex process of state-level implementation. In this regard, NBS programs for Pompe disease and spinal muscular atrophy can guide the path of Duchenne muscular dystrophy and other neuromuscular disorders as future candidates for NBS. <h3>Conclusions and Relevance</h3> The availability of advanced screening methods, the emergence of effective treatment, and the support of professional organizations may facilitate the expansion of NBS, such that an increasing number of infants can be identified in the newborn period who will benefit from life-saving interventions.
Abstract 15707: The Glucagon-Like Peptide-1 Receptor Agonists Liraglutide and Semaglutide Improve Cardiovascular and Renal Outcomes Across Baseline Blood Pressure Categories: Analysis of LEADER and SUSTAIN 6
Authors: Lawrence A Leiter, Stephen Bain, Deepak L Bhatt, John Buse, C David Mazer, Richard Pratley, Søren Lindberg, Søren Rasmussen, Hrvoje Vrazic, Subodh Verma
Journal: Circulation (2018)

Objective: High blood pressure (BP) is prevalent in patients with type 2 diabetes (T2D). This post hoc analysis evaluated major adverse cardiovascular (CV) events (MACE) and renal events in patient...