tbuckley/cabot-search huggingface dataset:
Assessment of Anti–Factor Xa Levels of Patients Undergoing Colorectal Surgery Given Once-Daily Enoxaparin Prophylaxis
Authors: Christopher J. Pannucci, Kory I. Fleming, Corinne B. Bertolaccini, Ann Marie Prazak, Lyen C. Huang, T. Bartley Pickron
Journal: JAMA Surgery (2019)

Between 4% and 12% of patients undergoing colorectal surgery and receiving enoxaparin, 40 mg per day, have a postoperative venous thromboembolism (VTE) event. An improved understanding of why "breakthrough" VTE events occur despite guideline-compliant prophylaxis is an important patient safety question.To determine the proportion of patients undergoing colorectal surgery who received adequate anticoagulation based on peak anti-factor Xa (aFXa) levels while receiving enoxaparin at 40 mg per day.This prospective, nonrandomized clinical trial was conducted between February 2017 and July 2018 with 90-day follow-up at a quaternary academic medical center in the Intermountain West and included patients undergoing colorectal surgery who had surgery after receiving general anesthesia, were admitted for at least 3 days, and received enoxaparin, 40 mg once daily.All patients had aFXa levels measured after receiving enoxaparin 40 mg per day. Patients whose aFXa level was out of range entered the trial's interventional arm where real-time enoxaparin dose adjustment and repeated aFXa measurement were performed.Primary outcome: in-range peak aFXa levels (goal range, 0.3-0.5 IU/mL) with enoxaparin, 40 mg per day. Secondary outcomes: (1) in-range trough aFXa levels (goal range, 0.1-0.2 IU/mL) and (2) the proportion of patients with in-range peak aFXa levels from enoxaparin, 40 mg once daily, vs the real-time enoxaparin dose adjustment protocol.Over 16 months, 116 patients undergoing colorectal surgery (65 women [56.0%]; 99 white individuals [85.3%], 13 Hispanic or Latino individuals [11.2%], and 4 Pacific Islander individuals [3.5%]; mean [range] age, 52.1 [18-85] years) were enrolled. Among 106 patients (91.4%) whose peak aFXa level was appropriately drawn, 72 (67.9%) received inadequate anticoagulation (aFXa < 0.3 IU/mL) with enoxaparin, 40 mg per day. Weight and peak aFXa levels were inversely correlated (r2 = 0.38). Forty-seven patients (77%) had a trough aFXa level that was not detectable (ie, most patients had no detectable level of anticoagulation for at least 12 hours per day). Real-time enoxaparin dose adjustment was effective. Patients were significantly more likely to achieve an in-range peak aFXa with real-time dose adjustment as opposed to fixed dosing alone (85.4% vs 29.2%, P < .001).This study supports the finding that most patients undergoing colorectal surgery receive inadequate prophylaxis from enoxaparin, 40 mg once daily. These findings may explain the high rate of "breakthrough" VTE observed in many clinical trials.ClinicalTrials.gov identifier: NCT02704052.
Anémie ferriprive: Apport de l'endoscopie digestive haute et de l'anatomopathologie dans l'enquête étiologique
Authors: C Baccouche, D Issaoui, K Chabbouh, H Kchir, H Chaabouni, N Maamouri
Journal: Endoscopy (2019)

L'anémie ferriprive est une pathologie encore fréquente dans le monde et surtout dans les pays à faible niveau socio-économique. Sa fréquence est en rapport avec ses étiologies multiples, variées et parfois associés. Ce travail apour objectif d'étudier l'intérêt de l'endoscopie oeso-gastroduodénale (EOGD) et de l'anatomopathologie dans le diagnostique étiologique des anémies ferriprives.
Adverse Health Outcomes in Relationship to Hypogonadism After Chemotherapy: A Multicenter Study of Testicular Cancer Survivors
Authors: Mohammad Abu Zaid, Paul C. Dinh, Patrick O. Monahan, Chunkit Fung, Omar El-Charif, Darren R. Feldman, Robert J. Hamilton, David J. Vaughn, Clair J. Beard, Ryan Cook, Sandra Althouse, Shirin Ardeshir-Rouhani-Fard, Howard D. Sesso, Robert Huddart, Taisei Mushiroda, Michiaki Kubo, M. Eileen Dolan, Lawrence H. Einhorn, Sophie D. Fossa, Lois B. Travis, _ _
Journal: Journal of the National Comprehensive Cancer Network (2019)

Background: This study examined the prevalence of hypogonadism, its clinical and genetic risk factors, and its relationship to adverse health outcomes (AHOs) in North American testicular cancer survivors (TCS) after modern platinum-based chemotherapy. Patients and Methods: Eligible TCS were &lt;55 years of age at diagnosis and treated with first-line platinum-based chemotherapy. Participants underwent physical examinations and completed questionnaires regarding 15 AHOs and health behaviors. Hypogonadism was defined as serum testosterone levels ≤3.0 ng/mL or use of testosterone replacement therapy. We investigated the role of 2 single nucleotide polymorphisms (rs6258 and rs12150660) in the sex hormone–binding globulin (SHBG) locus implicated in increased hypogonadism risk in the general population. Results: Of 491 TCS (median age at assessment, 38.2 years; range, 18.7–68.4 years), 38.5% had hypogonadism. Multivariable binary logistic regression analysis identified hypogonadism risk factors, including age at clinical evaluation (odds ratio [OR], 1.42 per 10-year increase; P = .006) and body mass index of 25 to &lt;30 kg/m 2 (OR, 2.08; P = .011) or ≥30 kg/m 2 (OR, 2.36; P = .005) compared with &lt;25 kg/m 2 . TCS with ≥2 risk alleles for the SHBG SNPs had a marginally significant increased hypogonadism risk (OR, 1.45; P = .09). Vigorous-intensity physical activity appeared protective (OR, 0.66; P = .07). Type of cisplatin-based chemotherapy regimen and socioeconomic factors did not correlate with hypogonadism. Compared with TCS without hypogonadism, those with hypogonadism were more likely to report ≥2 AHOs (65% vs 51%; P = .003), to take medications for hypercholesterolemia (20.1% vs 6.0%; P &lt;.001) or hypertension (18.5% vs 10.6%; P = .013), and to report erectile dysfunction (19.6% vs 11.9%; P = .018) or peripheral neuropathy (30.7% vs 22.5%; P = .041). A marginally significant trend for increased use of prescription medications for either diabetes (5.8% vs 2.6%; P = .07) or anxiety/depression (14.8% vs 9.3%; P = .06) was observed. Conclusions: At a relatively young median age, more than one-third of TCS have hypogonadism, which is significantly associated with increased cardiovascular disease risk factors, and erectile dysfunction. Providers should screen TCS for hypogonadism and treat symptomatic patients.
Abstract 17309: Validation of a Novel Prediction Tool for Circulatory Etiology Death After Cardiac Arrest
Authors: Karen Bascom, John Dziodzio, Samip Vasaiwala, Michael Mooney, Nainesh Patel, John McPherson, Paul McMullan, Barbara Unger, Niklas Nielsen, Hans Friberg, Karl Kern, David Seder
Journal: Circulation (2015)

Introduction: Post-resuscitation cardiac arrest (CA) triage to urgent angiography, percutaneous intervention, and mechanical circulatory support is hampered by inconclusive risk stratification, especially among patients without ST elevation myocardial infarction (STEMI). We analyzed registry data to develop a prediction tool to determine the risk of circulatory-etiology (CV) death in patients without STEMI, and validated it in a separate cohort. Methods: Using the International Cardiac Arrest Registry (INTCAR)-Cardiology data set and stepwise linear regression with an inclusion rule of P≤0.1, we determined demographic and clinical factors independently associated with CV death, and created a weighted prediction model for patients presenting after CA without STEMI. The model was then validated in a separate, larger cohort from INTCAR. This project was approved by the Maine Medical Center IRB. Results: Of 468 patients in the derivation cohort, 90 met criteria for the endpoint. In the multivariable model, age greater than 65 (OR=2.4, p=0.0001), preexisting coronary disease (OR=1.9, P=0.0065), diabetes (OR=1.8, P=0.01), in-hospital arrest (OR=1.5, P=0.1), time from collapse to return of circulation (TTROSC) greater than 25 minutes (OR=1.7, p=0.02), shock at presentation (OR=3.9, P&lt;0.0001), and EF&lt;30% on first echo (OR=1.6, P=0.05) were independently associated with CV death. Using weighted predictors (age&gt;65 =1, prior CAD =1, diabetes =1, in-hospital arrest =1, TTROSC&gt;25 =1, admission LVEF&lt;30% =1, shock =2,), an additive score of 0-2 predicted CV death in 8.5% and ≥3 in 34% in the derivation cohort. In the validation cohort, which comprised 1197 patients, of whom 263 met criteria for CV death, a score of 0-2 was associated with 13.1% and ≥3 with 35.1% CV death, respectively. Conclusions: A simple bedside prediction tool can predict high (34-35.1%) vs. low (8.5-13.1%) risk of circulatory-etiology death in cardiac arrest survivors without STEMI. This model could be used to risk-stratify cardiac arrest survivors, and aid in the triage of patients to appropriate and cost-effective post-resuscitation treatments.
Résultats et complications de la CPRE: sujets âgés Vs sujets jeunes
Authors: M Kadiri, S Lajouad, M Acharki, I Serraj, M Salihoun, N Kabbaj
Journal: Endoscopy (2019)

La cholangiopancréatografie rétrograde endoscopique (CPRE) est un moyen efficace pour le traitement des maladies pancréatobiliaires. Le but de notre étude est d'évaluer les caractéristiques des patients âgés ayant subi une CPRE et de les comparer avec les patients les plus jeunes.
Correction: Unique CDR3 epitope targeting by CAR-T cells is a viable approach for treating T-cell malignancies
Authors: Jinqi Huang, Stepanov Alexey, Jian Li, Terri Jones, Geramie Grande, Lacey Douthit, Jun Xie, Danna Chen, Xiaolei Wu, Maschan Michael, Changchun Xiao, Jiangning Zhao, Xuehua Xie, Jia Xie, Xiao Lei Chen, Guo Fu, Gabibov Alexander, Chi-Meng Tzeng
Journal: Leukemia (2019)
Etude de l'impact d'une formation sur la détection de la métaplasie intestinale gastrique en NBI
Authors: V Grymonpré, A Prost, J Hazebroucq, E Assenat, P Blanc, P Pouderoux
Journal: Endoscopy (2019)

L'atrophie gastrique et la métaplasie intestinale sont des lésions pré-cancéreuses identifiées depuis longtemps. La chromo-endoscopie électronique telle que le Narrow-Band Imaging (NBI) est simple d'utilisation et a montré une supériorité de détection de ces lésions par rapport à la lumière blanche. Cependant cette technique n'est pas utilisée en routine en Europe même s'il existe des recommandations de l'ESGE sur la détection endoscopique de la métaplasie intestinale dans l'estomac. Il est probable que cela soit dû au manque de formation des gastroentérologues pour la détection de ces lésions. L' objectif de cette étude étaient d'évaluer la performance d'un programme d'enseignement en ligne pour la détection de la métaplasie intestinale gastrique dans les conditions d'endoscopie standard en France chez des gastro-entérologues avec différents niveaux de formation.
HIGH REBLEEDING RATE IN PATIENTS EVALUATED FOR OBSCURE GASTROINTESTINAL BLEEDING AFTER A FALSE-NEGATIVE DEEP ENTEROSCOPY
Authors: AC Gomes, R Pinho, A Rodrigues, A Ponte, J Rodrigues, M Sousa, JC Silva, V Pavão-Borges, J Carvalho
Journal: Endoscopy (2019)

Data on the long-term outcomes after a false-negative enteroscopy in obscure gastrointestinal bleeding (OGIB), following capsule endoscopy (CE) with positive findings is scarce.
Abstract 18195: 20 Year Experience of Aortic Arch Surgery in 1004 Case: Single Centre Study
Authors: Sergey Leontyev, Mikhail Semenov, Piroze Davierwala, Christian Etz, David M Holzhey, Jörg Seeburger, Anne K Funkat, Farhad Bakhtiary, Martin Misfeld, Friedrich W Mohr
Journal: Circulation (2015)

Objective: Treatment of patients with extensive thoracic aortic disease (TAD) is performed using the different surgical techniques and is associated with higher operative mortality and morbidity as compared to other heart operations. We retrospectively evaluated our 20-years experience in treatment of TAD by analysing the early and late outcomes and identifying the clinical and surgical factors influencing them. Methods: Between July 1995 and February 2015, 1004 patients (mean age 61±11 years) underwent elective and urgent aortic arch surgery. Chronic Type A and B aortic dissection were indications for surgery in 61 (6.1%) patients whereas degenerative or atherosclerotic aneurysms accounted for the remaining 943 (93.9%) patients. Circulatory arrest was used in all patients. Antegrade selective cerebral protection (ASCP) was used in 686 (68.3%) patients. Results: The overall in-hospital mortality was 5.5 % and was significantly lower in patients who received ASCP (4.4%) compared those who did not (7.9%). Stroke and paraplegia occurred in 8.3% and 1.4% of patients, respectively. Logistic regression analysis revealed age &gt;70 years (OR2.5,p=0.004), coronary artery disease (CAD) (OR 2.4, p=0.002), left ventricle ejection fraction (LVEF) &lt;30% (OR , p=0.05), prior cardiac surgery (OR 2.4, p=0.008), and total arch replacement (OR 3.2, p&lt;0.001) as independent predictors of in-hospital mortality. Use of bilateral ASCP was protective for early survival (OR 0.4, p=0.01). One, five and ten-year survival was 88%, 80% and 61%, respectively. Cox regression analysis revealed that long-term survival was negatively influenced by age, NYHA III-IV, CAD, previously stroke, prior cardiac surgery and total arch replacement and positively influenced by good LVEF and bilateral ASCP. Five and ten-year freedom from aorta-related surgical and endovascular re-intervention was 91% and 86%, respectively. Conclusions: Elective aortic arch surgery was associated with low early and late mortality and aorta-related reoperation rate, but increased rate of neurological complications. Use of bilateral ASCP positively influenced survival after surgery. Total aortic arch replacement was associated with worse outcomes compared to partial arch replacement.
Drainage endoscopique des faux kystes du pancréas. Expérience marocaine
Authors: Z Bouhnoun, H Horma, H Abid, N Lahmidani, M Elyoussfi, N Aqodad, M Elabkari, A Ibrahimi, DA Benajah
Journal: Endoscopy (2019)

Le faux kyste du pancréas (FKP) est une complication des pancréatites aiguës ou chroniques dont la régression spontanée est fréquente. Le drainage est réservé aux formes symptomatiques ou compliquées. Le traitement endoscopique est le traitement de référence vu son caractère moins invasif par rapport à la chirurgie, avec moins de recours au drainage radiologique externe et des résultats satisfaisants à long terme. Nous rapportons 26 observations de drainage endoscopique FKP.
Prognostic risk score for patients with relapsed or refractory chronic lymphocytic leukaemia treated with targeted therapies or chemoimmunotherapy: a retrospective, pooled cohort study with external validations
Authors: Jacob D Soumerai, Ai Ni, Mohamed Darif, Anil Londhe, Guan Xing, Yong Mun, Neil E Kay, Tait D Shanafelt, Kari G Rabe, John C Byrd, Asher A Chanan-Khan, Richard R Furman, Peter Hillmen, Jeffrey Jones, John F Seymour, Jeffrey P Sharman, Lucille Ferrante, Mehrdad Mobasher, Thomas Stark, Vijay Reddy, Lyndah K Dreiling, Pankaj Bhargava, Angela Howes, Danelle F James, Andrew D Zelenetz
Journal: The Lancet Haematology (2019)
EFFICACY OF ENDOSCOPIC TREATMENT OF POST-SLEEVE GASTRECTOMY FISTULAS ACCORDING TO THE RADIOLOGICAL TYPE
Authors: A Sportes, G Airinei, R Kamel, JJ Raynaud, JM Sabate, G Donatelli, R Benamouzig
Journal: Endoscopy (2019)

The originality of this study relies on the evaluation of the effectiveness of the endoscopic internal drainage (EID) according to the type of fistula.
PTH-116 The impact of remaining oesophageal motility on the pathology of reflux
Authors: I Miah, G Sui, T Wong, J Jafari
Journal: Gut (2017)

Introduction  Remaining peristaltic activity of the oesophagus with multiple rapid swallows and solid swallows has been found in patients with absent contractility diagnosis. It is unknown whether the remaining motility impacts on the reflux pathology.  Aim  Characterising the degree of pathological reflux in patients with absolute absent contractility and with remaining motility  Method  Patients underwent high-resolution manometry (HRM) testing using Sierra Scientific Instrument (36 channel solid-state catheter and manoscan 360) between September 2014 and December 2016. 47 patients (M:F=19:28, aged 18–75 years) were diagnosed with absent contractility (according to Chicago classification [1]) and 17 of the patients showed evidence of remaining peristaltic motility (group I) during multiple rapid swallows with water and/or eating sandwich meal (normal motility with solid bolus [2]) while 30 patients maintained absolute absent contractility (group II). The lower oesophageal sphincter (LOS) tone was also assessed between 30–60s of the resting phase and size of the hiatus hernia (HH) (if present). Patients underwent reflux monitoring using Sandhill Scientific with pH-impedance catheters (ZAN-BG-44), data captured by ZepHrTM recording device and data was analysed using Biovew Analysis. Reflux was detected when retrograde impedance flow with oesophageal pH sensor recorded pH   χ2 testing was employed to compare the prevalence of abnormal LOS tone and the diagnosis of GORD found in groups I and II. Student t-test was used to compare the following in groups I and II: size of HH, total acid exposure time (in minutes)(AET), total acid exposure percentage (AEP), the period of longest reflux episodes (LRE). Patients completed Reflux Disease Questionnaire (RDQ) and Hospital Odynophagia Dysphagia Questionnaire (HODQ) and their scores where compared between the groups.  Results  HRM revealed 66.7% patients in group II having hypotensive LOS and 65% of patients in group I having normotensive LOS (p=0.0209). HH sizes were significantly larger in group II compared to group I (p=0.0058).  The pH data revealed patients in group II, compared to group I, have significantly higher AET (p=0.0024), AEP (p=0.0007), LPR (p=0.0024) owing to poor acid clearance (p=0.039) and RDQ scores (p=0.0285). GORD from acid exposure was found in 85% of the patients in group II while 46.7% patients in group I did not have GORD diagnosis (p=0.020). No statistical differences were found the HODQ scores (p=0.244) and age of the oesophagus (p=0.2024) between patients in both groups.  Conclusion  Patients with absolute oesophageal absent contractility have shown significant association with greater degree of pathological reflux and in severity in reflux symptoms.  References  . Kahrilas PJ, et al. Neurogastroenterol Motil 2015;27(2):160–174.  . Sweis R, et al. Neurogastroenterol Motil. 2011;23(6):509-516.  Disclosure of Interest  None Declared
Comparison of Outcomes By Age of Patients with Limited Stage Hodgkin Lymphoma Treated with ABVD Alone; A Secondary Analysis of the Canadian Cancer Trial Group HD.6 Trial
Authors: Laura N Rodriguez-Romo, Ralph Meyer, Joseph L Pater, Jonathan Sussman, Siwei Zhang, Lui Hongbo, Jane N. Winter, Te Vuong, Walter Blahey, Liam Mulroy, Lois E. Shepherd, Marina S Djurfeldt, Bingshu E. Chen, Annette E Hay
Journal: Blood (2017)
Early prediction of non-pCR using ultrasound-guided serial core needle biopsy in HER2-positive breast cancer patients
Authors: Y. Zhang, J. Shen, Y. Zhou, Z.-M. Shao, G. Liu
Journal: Annals of Oncology (2019)

Background: Pathological complete remission (pCR) distinguishes the prognosis of breast cancer patients undergoing neoadjuvant chemotherapy (NAC). On the contrary, non-pCR patients have poorer prognosis and may benefit from escalation or alteration of systemic therapy. Early and accurate identification of non-pCR remains a focused issue. Methods: From December 2013 to January 2017, 805 patients undergoing NAC and serial breast core needle biopsy (CNB) were recruited at our center. Serial CNB was performed under ultrasound guidance after 2-4 cycles of NAC. The results of contrast enhanced-magnetic resonance imaging (CE-MRI) performed by the time of serial CNB and were evaluated per the RECIST1.1 criteria. An objective response was defined as complete or partial remission. Diagnostic values of serial CNB pathology and simultaneous CE-MRI were compared for predicting non-pCR. Results: A total of 653 patients were eligible for analysis and underwent a median of 6 (IQR: 4-7) cycles of chemotherapy. Serial CNB was performed after 2 (IQR: 2-3) cycles. Serial CNB pathology predicted non-pCR more accurately than simultaneous CE-MRI (0.793 vs 0.516, p < 0.001) with higher sensitivity (0.851 vs 0.365, p < 0.001). Multivariate analysis revealed the estrogen receptor, human epidermal receptor (HER2) status and serial CNB pathology as independent factors of non-pCR. Superior non-pCR prediction was evident in the HER2+ subgroup population. Conclusions: Serial CNB pathology predicted non-pCR more accurately, early before the completion of NAC. HER2+ patients who received 2-3 cycles of NAC plus trastuzumab and still had residual malignancy on serial CNB might be suitable candidates for early treatment escalation or alteration. Legal entity responsible for the study: Fudan University Shanghai Cancer Center. Funding: Grants from the National Natural Science Foundation of China (81874113 and 81572583), the Municipal Project for Developing Emerging and Frontier Technology in Shanghai Hospitals (SHDC12010116), the Cooperation Project of Conquering Major Diseases in Shanghai Municipality Health System (2013ZYJB0302), the Innovation Team of Ministry of Education (IRT1223), and the Shanghai Key Laboratory of Breast Cancer (12DZ2260100). Disclosure: All authors have declared no conflicts of interest.
Inhibition of the ERK1/2-mTORC1 axis ameliorates proteinuria and the fibrogenic action of transforming growth factor-β in Adriamycin-induced glomerulosclerosis
Authors: Ranjan Das, Soo-Jin Kim, Nhung Thi Nguyen, Hyeong Ju Kwon, Seung-Kuy Cha, Kyu-Sang Park
Journal: Kidney International (2019)
La classification de Paris est-elle fiable pour évaluer les lésions dégénérées sur endobrachyoesophage? Résultats d'une étude du GRAPHE incluant 29 endoscopistes chevronnés
Authors: N Chapelle, J Branche, E Chabrun, D Karsenti, U Chaput, F Caillol, S Koch, G Vanbiervliet, M Dahan, L Quénéhervé, N Musquer, M Robaszkiewicz, E Coron
Journal: Endoscopy (2019)

La reconnaissance et l'interprétation en temps réel de critères bien définis de lésions détectées en endoscopie est censée guider leur prise en charge. La classification de Paris est l'une des plus simples et doit être utilisée pour décrire chaque lésion. Cependant, des publications récentes ont mis en évidence un corrélation inter-observateur moyenne pour les lésions coliques. L'objectif de cette étude était d'évaluer la performance d'un groupe d'endoscopistes français pour décrire une lésion oesophagienne au sein d'un endobrachyoesophage (EBO) selon la classification de Paris.