tbuckley/cabot-search huggingface dataset:
Digital cholangioscopy-guided laser versus mechanical lithotripsy for large bile duct stone removal after failed papillary large-balloon dilation: a randomized study
Authors: Phonthep Angsuwatcharakon, Santi Kulpatcharapong, Wiriyaporn Ridtitid, Chaloemphon Boonmee, Panida Piyachaturawat, Pradermchai Kongkam, Wattana Pareesri, Rungsun Rerknimitr
Journal: Endoscopy (2019)

Abstract Background Endoscopic papillary large-balloon dilation (EPLBD) allows for the complete removal of large common bile duct (CBD) stones without fragmentation; however, a significant proportion of very large stones and stones floating above a tapering CBD require lithotripsy. Mechanical lithotripsy and cholangioscopy-guided laser lithotripsy are both effective for stone fragmentation. This study aimed to directly compare, for the first time, the efficacy of these two techniques in terms of stone clearance rate, procedure duration, patient radiation exposure, and safety. Methods 32 patients with very large CBD stones or with stones floating above a tapering CBD, and in whom extraction after standard sphincterotomy and/or EPLBD had failed, were randomly assigned to mechanical lithotripsy or cholangioscopy-guided laser lithotripsy at two tertiary referral centers. Crossover was allowed as a rescue treatment if the assigned technique failed. Results Patients’ demographic data were not different between the two groups. Mechanical lithotripsy had a significantly lower stone clearance rate in the first session compared with laser lithotripsy (63% vs. 100%; P &lt; 0.01). Laser lithotripsy rescued 60% of patients with failed mechanical lithotripsy by achieving complete stone clearance within the same session. Radiation exposure of patients was significantly higher in the mechanical lithotripsy group than in the laser lithotripsy group (40 745 vs. 20 989 mGycm2; P = 0.04). Adverse events (13% vs. 6%; P = 0.76) and length of hospital stay (1 vs. 1 day; P = 0.27) were not different. Conclusions Although mechanical lithotripsy is the standard of care for a very large CBD stone after failed EPLBD, where available, cholangioscopy-guided laser lithotripsy is considered the better option for the treatment of this entity as it provides a higher success rate and lower radiation exposure.
Cardiovascular Disease-Related Morbidity and Mortality in Women With a History of Pregnancy Complications
Authors: Sonia M. Grandi, Kristian B. Filion, Sarah Yoon, Henok T. Ayele, Carla M. Doyle, Jennifer A. Hutcheon, Graeme N. Smith, Genevieve C. Gore, Joel G. Ray, Kara Nerenberg, Robert W. Platt
Journal: Circulation (2019)

Women with a history of certain pregnancy complications are at higher risk for cardiovascular (CVD) disease. However, most clinical guidelines only recommend postpartum follow-up of those with a history of preeclampsia, gestational diabetes mellitus, or preterm birth. This systematic review was undertaken to determine if there is an association between a broader array of pregnancy complications and the future risk of CVD.We systematically searched PubMed, MEDLINE and EMBASE (via Ovid), CINAHL, and the Cochrane Library from inception to September 22, 2017, for observational studies of the association between the hypertensive disorders of pregnancy, placental abruption, preterm birth, gestational diabetes mellitus, low birth weight, small-for-gestational-age birth, stillbirth, and miscarriage and subsequent CVD. Likelihood ratio meta-analyses were performed to generate pooled odds ratios (OR) and 95% intrinsic confidence intervals (ICI).Our systematic review included 84 studies (28 993 438 patients). Sample sizes varied from 250 to 2 000 000, with a median follow-up of 7.5 years postpartum. The risk of CVD was highest in women with gestational hypertension (OR 1.7; 95% ICI, 1.3-2.2), preeclampsia (OR 2.7; 95% ICI, 2.5-3.0), placental abruption (OR 1.8; 95% ICI, 1.4-2.3), preterm birth (OR 1.6; 95% ICI, 1.4-1.9), gestational diabetes mellitus (OR 1.7; 95% ICI, 1.1-2.5), and stillbirth (OR 1.5; 95% ICI, 1.1-2.1). A consistent trend was seen for low birth weight and small-for-gestational-age birth weight but not for miscarriage.Women with a broader array of pregnancy complications, including placental abruption and stillbirth, are at increased risk of future CVD. The findings support the need for assessment and risk factor management beyond the postpartum period.
TCT-262 Differential Prognostic Effect of Revascularization Between Chronic Total Occlusion with Left Ventricular Systolic Dysfunction and without that
Authors: Cheol Woong Yu, Duck Hyun Jang, Je Sang Kim, Seung Hun Lee, Jae Hyoung Park, Rak Kyeong Choi, Young Jin Choi, Jin Sik Park, Hyung Joon Joo, Jeong Hoon Yang, Joo Yong Hahn, Seung Hyuk Choiu, Hyeon Cheol Gwon, Do Sun Lim
Journal: Journal of the American College of Cardiology (2017)
Metformin for Gestational Diabetes Mellitus: Progeny, Perspective, and a Personalized Approach
Authors: Linda A. Barbour, Denice S. Feig
Journal: Diabetes Care (2019)

Given the rapidly growing population of women diagnosed with gestational diabetes mellitus (GDM), approximating 1 in 7 pregnancies globally (1), in conjunction with the rising cost of insulins and lack of affordability (2), the popularity of using an oral agent such as metformin is expanding enormously. In fact, a number of organizations have supported its use as an alternative to insulin (3–6). However, recent long-term studies on offspring have provided conflicting results, with two of three studies recently published on the 4- to 9-year-old children of mothers with GDM or polycystic ovarian syndrome (PCOS) suggesting some long-term metabolic programming effects on the offspring (7–9). This has given some clinical investigators and organizations (10,11) pause in embracing metformin as equivalent to insulin (12–17).

In the short term, there is an abundance of evidence that metformin has a safe track record and may have some benefits compared with insulin or glyburide when used for the treatment of GDM (18). Metformin is not teratogenic, with reassuring data for use in the first trimester (19–21), and in several meta-analyses, women with GDM randomized to metformin (often used with insulin) had less gestational weight gain, less gestational hypertension, and fewer infants who were large-for-gestational age (LGA) or with macrosomia (birth weight >4,000 g), and their infants had less neonatal hypoglycemia, than those randomized to insulin or glibenclamide (glyburide) therapy (22–24). However, metformin has a high failure rate, and 46% of women randomized to metformin needed to add insulin in the Metformin in Gestational Diabetes (MiG) randomized controlled trial (RCT) (25). In comparison, in a large multisite RCT in which insulin was compared with glyburide for GDM, the failure rate of glyburide was 18% (26). Important in interpreting RCT data is that glyburide …
Clonotypic Diversity of the T-cell Receptor Corroborates the Immature Precursor Origin of Cutaneous T-cell Lymphoma
Authors: Abdelbasset Hamrouni, Hanne Fogh, Zoulika Zak, Niels Ødum, Robert Gniadecki
Journal: Clinical Cancer Research (2019)

Abstract Purpose: Mycosis fungoides is one of the most common types of extranodal T-cell lymphomas, considered to be caused by malignant transformation of the mature T cells residing in the skin. However, some clinical observations such as the multifocal distribution of mycosis fungoides lesions or patterns of relapse after radiotherapy are not readily explainable by the mature T-cell origin theory. Experimental Design: We have performed a detailed analysis of T-cell receptor (TCR) rearrangements in single malignant cells and in biopsies from mycosis fungoides tumors composed of &amp;gt;80% of malignant cells using next-generation sequencing (NGS) to pinpoint the relationship between neoplastic cells in mycosis fungoides. We have also aimed to detect malignant, circulating T-cell by whole blood TCR sequencing. Results: We found a substantial clonal heterogeneity in the mycosis fungoides samples with regards to TCR, and we demonstrated that lymphoma cells harboring identical TCRγ sequences may harbor different TCRα and β sequences. Lack of absolute TCRα, -β, -γ monoclonality was further confirmed by TCR amplification and sequencing from microdissected lymphoma cells. We have also found the TCR rearrangements characteristic for lymphoma cells in patients' peripheral blood despite the lack of leukemic blood involvement; however, the circulating TCRγ clonotype did not always represent the dominant cutaneous clonotype. Conclusions: These findings can be explained by a model where malignant transformation takes place during early T-cell development giving rise to circulating premalignant clones, which home to the skin producing clinically apparent lesions of cutaneous lymphoma. Therapeutic strategies in T-cell lymphoma should therefore target those early lymphoma precursor cells.
P152 The National Lung Cancer Audit: year 6 completeness and outcomes
Authors: P. Beckett, I. Woolhouse, R. Stanley, A. Yelland, M. D. Peake
Journal: Thorax (2011)

<h3>Introduction</h3> The National Lung Cancer Audit is run jointly by the Royal College of Physicians and The Information Centre for health and social care, and is commissioned by the Healthcare Quality Improvement Partnership (HQIP). Its development was driven by the realisation that lung cancer outcomes vary widely across the UK and are poor compared to other western countries. The aim of the audit is to facilitate service improvement by recording elements of process and outcomes in lung cancer on a large scale and, using case-mix adjustment, to explain the wide variations noted and improve standards of care. Although several other countries also submit data to the audit, this abstract presents provisional results for England only. <h3>Results</h3> In Year 6, participation has again increased and all trusts have now contributed data at some time. Completeness of data on individual cases remains high although it is noteworthy that 18% of cases are submitted without a disease stage and 16% without performance status. This year the results show that the histological confirmation rate has risen substantially to nearly 77%, and 96% of patients have been discussed in an MDT, although the surgical resection and anti-cancer treatment rates have not increased further. <h3>Conclusions</h3> Participation remains high and the audit continues to collect data on close to 100% of cases of lung cancer and mesothelioma that present to secondary care. Overall treatment rates seem to have stopped improving, although it is acknowledged that some of the earlier annual improvements reflected improvements in data quality. The rise in HCR is likely to reflect a real change in practice, possibly due to the new found importance of tissue (choice of chemotherapy, use of EGFR antagonists) and possibly due to the focus given to HCR by the audit itself. It is of concern that a significant minority of patients appear to be managed without information on disease stage and PS—key variables needed for appropriate management of patients.
Ovarian Cancer Surgery — Heed This LION’s Roar
Authors: Eric L. Eisenhauer, Dennis S. Chi
Journal: New England Journal of Medicine (2019)

Most women with ovarian cancer will have metastatic disease at diagnosis, and their symptoms and survival will depend on whether their abdominal tumor can be controlled. Death from ovarian cancer most often occurs from progression of abdominal disease, as a result of either bowel obstruction or the consequences of malnutrition. Removal of all visible disease is the goal of primary cytoreduction and is consistently associated with improved survival in randomized trials.1 The nonvisible, microscopic tumor that remains is targeted with subsequent chemotherapy. Pelvic and aortic lymph nodes that appear normal frequently harbor microscopic metastases. For several decades, considerable debate has . . .
Peginterferon alfa-2a plus tenofovir disoproxil fumarate for hepatitis D (HIDIT-II): a randomised, placebo controlled, phase 2 trial
Authors: Heiner Wedemeyer, Cihan Yurdaydin, Svenja Hardtke, Florin Alexandru Caruntu, Manuela G Curescu, Kendal Yalcin, Ulus S Akarca, Selim Gürel, Stefan Zeuzem, Andreas Erhardt, Stefan Lüth, George V Papatheodoridis, Onur Keskin, Kerstin Port, Monica Radu, Mustafa K Celen, Ramazan Idilman, Kristina Weber, Judith Stift, Ulrike Wittkop, Benjamin Heidrich, Ingmar Mederacke, Heiko von der Leyen, Hans Peter Dienes, Markus Cornberg, Armin Koch, Michael P Manns
Journal: The Lancet Infectious Diseases (2019)
Sex-Specific Epidemiology of Heart Failure Risk and Mortality in Europe
Authors: Christina Magnussen, Teemu J. Niiranen, Francisco M. Ojeda, Francesco Gianfagna, Stefan Blankenberg, Erkki Vartiainen, Susana Sans, Gerard Pasterkamp, Maria Hughes, Simona Costanzo, Maria Benedetta Donati, Pekka Jousilahti, Allan Linneberg, Tarja Palosaari, Giovanni de Gaetano, Martin Bobak, Hester M. den Ruijter, Torben Jørgensen, Stefan Söderberg, Kari Kuulasmaa, Tanja Zeller, Licia Iacoviello, Veikko Salomaa, Renate B. Schnabel
Journal: JACC Heart Failure (2019)
A to Z of nutritional supplements: dietary supplements, sports nutrition foods and ergogenic aids for health and performance--Part 21
Authors: C Goodman, P Peeling, M K Ranchordas, L M Burke, S J Stear, L M Castell
Journal: British Journal of Sports Medicine (2011)

Part 21 deals with the major topic of iron supplementation. Iron deficiency is a well-known problem in the general population and athletes in particular. Symptoms in the latter group include decreased endurance ability, chronic fatigue and recurring illnesses such as minor infections and symptoms, which are also often prevalent in unexplained underperformance syndrome (overtraining). The review of iron, which our experts have provided, is comprehensive. In addition, two lesser topics (α-ketoglutarate (AKG) and α-ketoisocaproate (KIC)) are addressed in separate articles.

### C Goodman and P Peeling

Iron deficiency is the most prevalent nutritional disorder in the world and is particularly pertinent in athletes. An altered iron status may range in severity from iron depletion (serum ferritin (SF)  115 g/l, transferrin saturation >16%) to iron deficiency anaemia (SF <12 µg/l, Hb <11.5 g/l, transferrin saturation <16%).1

It is recognised that optimal physical performance is dependent on the efficient delivery and utilisation of oxygen by the exercising muscle. Iron is a fundamental element to both of these processes due to its role as the functional component of haemoglobin and myoglobin, as well as being a critical constituent of mitochondrial enzymes and cytochromes that promote oxidative phosphorylation. Insufficient iron stores may thus lead to feelings of lethargy and decrements in athletic performance.

There are several reasons why athletes may present with low iron levels, including plasma volume expansion, low dietary iron intake, low iron bioavailability and excessive iron excretion/loss. Furthermore, female athletes are at greater risk of iron deficiency, due to menstrual blood loss and suboptimal dietary intake. During exercise, iron losses can occur from several avenues such as red blood cell haemolysis, haematuria and sweating. Such iron loss mechanisms are dependent on the exercise mode, intensity and duration (for review see ref 2). Additionally, recent research has demonstrated that the hormone hepcidin may …
Adjuvant denosumab in postmenopausal patients with hormone receptor-positive breast cancer (ABCSG-18): disease-free survival results from a randomised, double-blind, placebo-controlled, phase 3 trial
Authors: Michael Gnant, Georg Pfeiler, Günther G Steger, Daniel Egle, Richard Greil, Florian Fitzal, Viktor Wette, Marija Balic, Ferdinand Haslbauer, Elisabeth Melbinger-Zeinitzer, Vesna Bjelic-Radisic, Raimund Jakesz, Christian Marth, Paul Sevelda, Brigitte Mlineritsch, Ruth Exner, Christian Fesl, Sophie Frantal, Christian F Singer
Journal: The Lancet Oncology (2019)
Analysis of exotic squirrel trade and detection of human infections with variegated squirrel bornavirus 1, Germany, 2005 to 2018
Authors: Dennis Tappe, Christina Frank, Timo Homeier-Bachmann, Hendrik Wilking, Valerie Allendorf, Kore Schlottau, César Muñoz-Fontela, Monika Rottstegge, Julia R Port, Jürgen Rissland, Philip Eisermann, Martin Beer, Jonas Schmidt-Chanasit
Journal: Eurosurveillance (2019)

Following the discovery in 2015 of the variegated squirrel bornavirus 1 (VSBV-1) in fatal encephalitis cases among exotic squirrel breeders and a zoo animal caretaker in Germany, a case definition was developed. It was employed during trace-back animal trade investigations and sero-epidemiological studies among breeders and zoo animal caretakers of holdings with VSBV-1 infected squirrels. During the investigation, two possible human cases who had died of encephalitis were identified retrospectively among the squirrel breeders. Moreover, one probable human case was detected among the breeders who had a positive memory T-cell response to VSBV-1 antigen and antibodies against VSBV-1. The low rate of seropositivity found among living persons in risk groups that handle exotic squirrels privately or at zoos may reflect rareness of exposure to VSBV-1 during animal contact, a high lethality of infection or a combination of these factors. As a precaution against human exposure, testing of exotic squirrels for VSBV-1 infection and/or avoiding direct contact with exotic squirrels in zoos and private holdings is strongly advised.
Review of US Medical School Finances, 1998-1999
Authors: J Y Krakower, T Y Coble, D J Williams, R F Jones
Journal: JAMA (2000)

Based on data from the Annual Medical School Questionnaire of the Liaison Committee on Medical Education, to which 100% of the 125 accredited allopathic US medical schools responded, we found that revenue supporting programs and activities of the 125 accredited medical schools in the United States totaled $39,761 million in 1998-1999. Three sources accounted for 79.3% of total revenues: practice plans ($13,724 million; 34.5%), grants and contracts ($11, 982 million; 30.1%), and hospital support ($5814 million; 14.6%). In the aggregate, total revenues increased by 7.4% between 1997-1998 and 1998-1999, a consequence at least in part due to a 2.9% increase in the number of full-time faculty. The largest increase in dollar amount came from grants and contracts ($1101 million; 10.2% increase). Revenue increases were not evenly distributed across the schools. Increases of 10% or more in key revenue sources-practice plans and hospital support-were reported by approximately one fourth of all schools. Another one fourth reported decreases in these same sources. JAMA. 2000;284:1127-1129
Clinical and laboratory features of autoimmune hemolytic anemia associated with immune checkpoint inhibitors
Authors: Rebecca Karp Leaf, Christopher Ferreri, Deepa Rangachari, James Mier, Wesley Witteles, George Ansstas, Theodora Anagnostou, Leyre Zubiri, Zofia Piotrowska, Thein H. Oo, David Iberri, Mark Yarchoan, April K. S. Salama, Douglas B. Johnson, Andrew D. Leavitt, Osama E. Rahma, Kerry L. Reynolds, David E. Leaf
Journal: American Journal of Hematology (2019)

Immune checkpoint inhibitors (ICPis) are a novel class of immunotherapeutic agents that have revolutionized the treatment of cancer; however, these drugs can also cause a unique spectrum of autoimmune toxicity. Autoimmune hemolytic anemia (AIHA) is a rare, but often severe, complication of ICPis. We identified 14 patients from nine institutions across the United States who developed ICPi-AIHA. The median interval from ICPi initiation to development of AIHA was 55 days (interquartile range [IQR], 22-110 days). Results from the direct antiglobulin test (DAT) were available for 13 of 14 patients: 8 patients (62%) had a positive DAT and 5 (38%) had a negative DAT. The median pretreatment and nadir hemoglobin concentrations were 11.8 g/dL (IQR, 10.2-12.9 g/dL) and 6.3 g/dL (IQR, 6.1-8.0 g/dL), respectively. Four patients (29%) had a preexisting lymphoproliferative disorder, and two (14%) had a positive DAT prior to initiation of ICPi therapy. All patients were treated with glucocorticoids, with three requiring additional immunosuppressive therapy. Complete and partial recoveries of hemoglobin were achieved in 12 (86%) and 2 (14%) patients, respectively. Seven patients (50%) were rechallenged with ICPis, and one (14%) developed recurrent AIHA. Clinical and laboratory features of ICPi-AIHA were similar in DAT positive and negative patients. ICPi-AIHA shares many clinical features with primary AIHA; however, a unique aspect of ICPi-AIHA is a high incidence of DAT negativity. Glucocorticoids are an effective first-line treatment in the majority of patients with ICPi-AIHA, and most patients who are rechallenged with an ICPi do not appear to develop recurrence of AIHA.
Molecular profiling and targeted therapy in pediatric gliomas: review and consensus recommendations
Authors: Zachary Miklja, Amy Pasternak, Stefanie Stallard, Theodore Nicolaides, Cassie Kline-Nunnally, Bonnie Cole, Rameen Beroukhim, Pratiti Bandopadhayay, Susan Chi, Shakti H Ramkissoon, Brendan Mullan, Amy K Bruzek, Angela Gauthier, Taylor Garcia, Christie Atchison, Bernard Marini, Maryam Fouladi, D William Parsons, Sarah Leary, Sabine Mueller, Keith L Ligon, Carl Koschmann
Journal: Neuro-Oncology (2019)

Abstract As the field of neuro-oncology makes headway in uncovering the key oncogenic drivers in pediatric glioma, the role of precision diagnostics and therapies continues to rapidly evolve with important implications for the standard of care for clinical management of these patients. Four studies at major academic centers were published in the last year outlining the clinically integrated molecular profiling and targeting of pediatric brain tumors; all 4 demonstrated the feasibility and utility of incorporating sequencing into the care of children with brain tumors, in particular for children and young adults with glioma. Based on synthesis of the data from these studies and others, we provide consensus recommendations for the integration of precision diagnostics and therapeutics into the practice of pediatric neuro-oncology. Our primary consensus recommendation is that next-generation sequencing should be routinely included in the workup of most pediatric gliomas.
<i>Circulation Research</i> Editors’ Annual Report for 2004
Authors: Eduardo Marbán, Roberto Bolli, Gerda Breitwieser, Rudi Busse, Hal Dietz, Masao Endoh, Toren Finkel, Kathy Griendling, David Kass, Charles Lowenstein, Gordon Tomaselli, Kara Hansell Keehan
Journal: Circulation Research (2005)
Considering Bariatric Surgery in Patients With Nonalcoholic Steatohepatitis—Worth the Risk
Authors: Seth A. Waits, Kyle H. Sheetz, Amir A. Ghaferi
Journal: JAMA Network Open (2019)

Matthew J. Klebanoff, BA; Kathleen E. Corey, MD, MPH, MMSc; Sumeyye Samur, PhD; Jin G. Choi, BS; Lee M. Kaplan, MD, PhD; Jagpreet Chhatwal, PhD; Chin Hur, MD, MPH
Longitudinal changes of right ventricular deformation mechanics during trastuzumab therapy in breast cancer patients
Authors: Kalliopi Keramida, Dimitrios Farmakis, Jose Bingcang, Samir Sulemane, Stephanie Sutherland, Roma A. Bingcang, Kanchana Ramachandran, Chara Tzavara, Georgios Charalampopoulos, Dimitrios Filippiadis, Nikolaos Kouris, Petros Nihoyannopoulos
Journal: European Journal of Heart Failure (2019)