tbuckley/cabot-search huggingface dataset:
ANALYSIS OF THE PERFORMANCE OF THE ENDOSCOPIC TREATMENT OF OBESITY WITH INTRAGASTRIC BALLOON. IS THE SECOND HOUR OF GASTRIC EMPTYING THE CRUCIAL FACTOR?
Authors: S Barrichello, G Cairo Nunes, A Carolina Hoff, J Waisberg, T Ferreira de Souza, E Grecco, A Valente, M Galvão Neto, JR Fernandes Fittipaldi, E Guimaraes Hourneax de Moura
Journal: Endoscopy (2019)

Morbid obese Patients are treated very efficiently by the various Bariatric surgery techniques, while overweight patients have good results with drug interventions and changes in lifestyle. For the patients who are at the intersection of these two strategies, the endoscopic treatment of obesity with the intragastric balloon is a very interesting and widely used alternative.
Response to ‘Decision making value of nuclear dense fine speckled pattern in systemic autoimmune rheumatic disease: trick or treat?’ by Deng<i>et al</i>
Authors: Luis Eduardo Coelho Andrade, Jan Damoiseaux, Edward K Chan
Journal: Annals of the Rheumatic Diseases (2019)

The correspondence of Deng et al 1 raises practical issues regarding the recognition and clinical interpretation of the nuclear dense fine speckled (DFS, AC-2) pattern in a typical clinical immunology laboratory during antinuclear antibody (ANA) screening using indirect immunofluorescence assay on HEp-2 cells (HEp-2 IIFA). Based on the recommendation of the International Consensus on ANA Patterns (ICAP),2 the recognition of a nuclear DFS pattern is not to be taken as the same as the determination of an anti-DFS70 antibody using a follow-up specific immunoassay. In fact, HEp-2 IIFA is a screening test for a vast array of autoantibodies and is not intended for the final determination of autoantibody specificity. Accordingly, the ICAP recommendation is clear that all HEp-2 IIFA patterns as defined by ICAP, with the sole exception of anti-centromere (AC-3), must be followed-up with specific immunoassays.2 With specific …
Challenges of the interface of oral medicine and periodontology: Some lessons for the future?
Authors: Stephen Porter, Newell W. Johnson, Stefano Fedele
Journal: Periodontology 2000 (2019)

Abstract This final chapter provides a commentary of what might be learned from this series of articles in relation to the 2017 Classification of Periodontal and Peri‐implant Diseases and Conditions and argues that future classifications should expand sections on nondental plaque‐induced disease that will further patient care, education and research in periodontology, and allied subjects.
Founder mutations BRCA2 c.156_157insAlu in Portuguese population
Authors: F. Macedo, R. Félix Soares, T. Cunha Pereira, A.R. Monteiro, N. Bonito, S. Broco, T. Carvalho, M. Mariano, G. Sousa
Journal: Annals of Oncology (2019)

Background: Inherited predisposition to breast cancer (BC) accounts for about 5–10% of all cases. Women carrying germline BRCA2 mutations have a cumulative risk at 70 years of 55% for BC and 17% for ovarian cancer. The c.156_157insAlu BRCA2 mutation has so far only been reported in hereditary breast/ovarian cancer families of Portuguese origin. Methods: The authors collected information about every family with the c.156_157insAlu BRCA2 mutation followed in our center. The objective of this study is to divulge this mutation among European community, since this mutation is not detectable using the commonly used screening methodologies and must be specifically sought out. Results: It was identified 27 patients with the mutation, and 51 healthy mutations carriers. All the subjects are natural from the central Portugal. The patients were mainly women (85%), younger than 50 years old at diagnosis (M = 44; SD = 13). Two patients (7.4%) had ovarian cancer, 4 patients (14.8%) had bilateral BC at diagnosis and 9 patients (33.3%) had second cancers some years later (breast, prostate, colorectal and skin). From every BC diagnosed, 55.2% were luminal B like, 24.1% were luminal A like, 6.9% were luminal B Her 2 and 13.8% were triple negative. None of the patients were a stage IV at diagnosis but 30% had metastization during the surveillance time, 24.1% were stage I, 44.8% stage II, and 31.0% stage III. Neoadjuvant chemotherapy was performed in 40% of the patients, with only 2 patients having complete response and 2 patients with no response at all. Adjuvant chemotherapy was prescribed in 53.3%, and palliative treatment in 30%. From the metastasized patients, 66.7% had more than one organ affected, and 66.7% had more than 1 palliative treatment. Presently, 26.9% of the patients are dead. The five-year survival rate is 92.6%. Only 30% of the patients agreed to perform prophylactic surgeries. No relation was found between the age of diagnosis and the clinical stage, the metastization, the chance of a second tumor, and death (p > 0,05). Conclusions: The authors aimed to sensitize physicians regarding the extension of screening of the c.156_157insAlu mutation to all high-risk breast/ovarian cancer families with Portuguese ancestry since these patients will have a different follow-up due to their chance to have second tumors. Legal entity responsible for the study: Filipa Macedo. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
Abstract #2430: Serum amyloid a (saa): a novel biomarker for uterine serous papillary cancer
Authors: Alessandro Santin, Emiliano Cocco, Karim ElSahwi, Stefania Bellone, Marilisa Cargnelutti, Francesca Casagrande, Natalia Buza, Dan-Arin Silasi, Msoud Azodi, Peter Schwartz, Sergio Pecorelli, Thomas Rutherford
Journal: Cancer Research (2009)

Purpose:Serum Amyloid A (SAA) is an acute phase protein recently reported as a potentially useful biomarker for some human tumors. However, although SAA levels are inversely correlated to patient\#8217;s survival in several human malignancies, SAA is not considered a cancer-specific marker because its elevation in the serum of cancer patients is suggested to be of liver origin rather than a tumor cell product. In this study we investigated the expression of SAA in uterine serous papillary carcinoma (USPC), and evaluated its potential as a serum biomarker in this highly aggressive variant of endometrial cancer. Patients and Methods: SAA gene expression levels were evaluated in 22 snap frozen endometrial biopsies including 19 USPC and 3 normal endometrial control cell tissues (NEC) by real time-PCR. Protein expression and potential secretion of SAA by tumors was evaluated in primary USPC tumors and cell lines by flow cytometry and by a sensitive bead-based immunoassay, respectively. Finally, SAA concentration in 64 serum samples from 20 healthy women, 15 women with benign diseases, and 29 USPC patients were also studied. Results: SAA gene expression levels were significantly higher in USPC when compared to NEC (mean copy number by RT-PCR = 580 vs 2.6, USPC vs NEC: p   Citation Information: In: Proc Am Assoc Cancer Res; 2009 Apr 18-22; Denver, CO. Philadelphia (PA): AACR; 2009. Abstract nr 2430.
Comparison of Opioid Prescribing by Dentists in the United States and England
Authors: Katie J. Suda, Michael J. Durkin, Gregory S. Calip, Walid F. Gellad, Hajwa Kim, Peter B. Lockhart, Susan A. Rowan, Martin H. Thornhill
Journal: JAMA Network Open (2019)

<h3>Importance</h3> The United States consumes most of the opioids worldwide despite representing a small portion of the world’s population. Dentists are one of the most frequent US prescribers of opioids despite data suggesting that nonopioid analgesics are similarly effective for oral pain. While oral health and dentist use are generally similar between the United States and England, it is unclear how opioid prescribing by dentists varies between the 2 countries. <h3>Objective</h3> To compare opioid prescribing by dentists in the United States and England. <h3>Design, Setting, and Participants</h3> Cross-sectional study of prescriptions for opioids dispensed from outpatient pharmacies and health care settings between January 1 and December 31, 2016, by dentists in the United States and England. Data were analyzed from October 2018 to January 2019. <h3>Exposures</h3> Opioids prescribed by dentists. <h3>Main Outcomes and Measures</h3> Proportion and prescribing rates of opioid prescriptions. <h3>Results</h3> In 2016, the proportion of prescriptions written by US dentists that were for opioids was 37 times greater than the proportion written by English dentists. In all, 22.3% of US dental prescriptions were opioids (11.4 million prescriptions) compared with 0.6% of English dental prescriptions (28 082 prescriptions) (difference, 21.7%; 95% CI, 13.8%-32.1%;<i>P</i> &lt; .001). Dentists in the United States also had a higher number of opioid prescriptions per 1000 population (35.4 per 1000 US population [95% CI, 25.2-48.7 per 1000 population] vs 0.5 per 1000 England population [95% CI, 0.03-3.7 per 1000 population]) and number of opioid prescriptions per dentist (58.2 prescriptions per dentist [95% CI, 44.9-75.0 prescriptions per dentist] vs 1.2 prescriptions per dentist [95% CI, 0.2-5.6 prescriptions per dentist]). While the codeine derivative dihydrocodeine was the sole opioid prescribed by English dentists, US dentists prescribed a range of opioids containing hydrocodone (62.3%), codeine (23.2%), oxycodone (9.1%), and tramadol (4.8%). Dentists in the United States also prescribed long-acting opioids (0.06% of opioids prescribed by US dentists [6425 prescriptions]). Long-acting opioids were not prescribed by English dentists. <h3>Conclusions and Relevance</h3> This study found that in 2016, dentists in the United States prescribed opioids with significantly greater frequency than their English counterparts. Opioids with a high potential for abuse, such as oxycodone, were frequently prescribed by US dentists but not prescribed in England. These results illustrate how 1 source of opioids differs substantially in the United States vs England. To reduce dental opioid prescribing in the United States, dentists could adopt measures similar to those used in England, including national guidelines for treating dental pain that emphasize prescribing opioids conservatively.
Early- vs late-start levodopa relieved symptoms but did not affect disease progression in Parkinson disease
Authors: Joseph H. Friedman
Journal: Annals of Internal Medicine (2019)

ACP Journal Club21 May 2019Early- vs late-start levodopa relieved symptoms but did not affect disease progression in Parkinson diseaseJoseph H. Friedman, MDJoseph H. Friedman, MDButler Hospital/Alpert Medical School of Brown University, Providence, Rhode Island, USA. (J.H.F.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/ACPJ201905210-056 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationVerschuur CVM, Suwijn SR, Boel JA, et al; LEAP Study Group. Randomized delayed-start trial of levodopa in Parkinson's disease. N Engl J Med. 2019;380:315-24. https://pubmed.ncbi.nlm.nih.gov/30673543Clinical Impact RatingsGIM/FP/GP: Neurology: References1 Fahn S, Oakes D, Shoulson I, et al; Parkinson Study Group. Levodopa and the progression of Parkinson's disease. N Engl J Med. 2004;351:2498-508. [PMID: 15590952] Google Scholar2 Espay AJ, Morgante F, Merola A, et al. Levodopa-induced dyskinesia in Parkinson disease: current and evolving concepts. Ann Neurol. 2018;84:797-811. [PMID: 30357892] Google Scholar Author, Article, and Disclosure InformationAffiliations: Butler Hospital/Alpert Medical School of Brown University, Providence, Rhode Island, USA. (J.H.F.)This article was published at Annals.org on 7 May 2019. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byDrp1-mediated mitochondrial fission contributes to mitophagy in paraquat-induced neuronal cell damage 21 May 2019Volume 170, Issue 10Page: JC56KeywordsDisabilitiesDopamineDrugsIntent to treat analysisLevodopaLife expectancyNeurologyOxidative stressParkinson disease ePublished: 21 May 2019 Issue Published: 21 May 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
“CLIP-BAND CLOSURE” TECHNIQUE FOR COLORECTAL PERFORATION AND LARGE MUCOSAL DEFECTS AFTER COLORECTAL ENDOSCOPIC SUBMUCOSAL DISSECTION
Authors: B Agudo, D De Frutos, J Santiago, I González, M González-Haba, A Garrido, P Matallanos, M Bote, E Blazquez, M Sol Delgado, P Garcia, A Herreros de Tejada
Journal: Endoscopy (2019)

We describe for the first time the clip-band closure (CBC) technique for successful management of extra-large mucosal defects and perforations associated with colorectal endoscopic submucosal dissection (CR-ESD).
THE COMPARISON OF THE EFFICIENCY OF COLON CAPSULE ENDOSCOPY AND OPTICAL COLONOSCOPY IN PATIENTS WITH POSITIVE IMMUNOCHEMICAL FECAL OCCULT BLOOD TEST: MULTICENTER, PROSPECTIVE STUDY
Authors: M Voska, T Grega, O Ngo, B Buckova, O Majek, G Vojtechova, I Tacheci, M Benes, J Bures, J Spicak, M Zavoral, S Suchanek
Journal: Endoscopy (2019)

The main aim of the study was a negative predictive value (NPV) of the second generation of colon capsule endoscopy (CCE2) for large polyps (≥10 mm). The secondary aims were: accuracy of detection of polyps ≥6 mm and ≥10 mm, complications and target population acceptance of CCE2 and optical colonoscopy (OC).
Anémie par carence en vitamine B 12: apport de l'endoscopie digestive haute avec étude anatomopathologique dans le diagnostic étiologique
Authors: D Issaoui, K Chabbouh, C Baccouche, H Kchir, H Chaabouni, N Maamouri
Journal: Endoscopy (2019)

Une anémie par carence en vitamine B12 est relativement fréquente chez l'adulte et plus particulièrement chez le sujet âgé. Le diagnostic étiologique chez l'adulte est dominé par la malabsorption secondaire à des anomalies iléales suivie par l'anémie de Biermer due à un déficit en facteur intrinsèque gastrique. La fibroscopie oeso-gastro-duodénale constitue un examen primordial dans l'enquête étiologique d'une anémie par carence en vitamine B12.
POOR QUALITY OF CAPSULE ENDOSCOPY IMAGES HAS A SIGNIFICANT NEGATIVE EFFECT ON THE DIAGNOSIS OF SMALL BOWEL MALIGNANCY
Authors: DE Yung, JN Plevris, A Koulaouzidis
Journal: Endoscopy (2019)

Capsule endoscopy (CE) diagnosis relies on image quality, commonly affected by poor preparation. Currently, there is no widely-accepted method for quantifying visualisation quality. We examined the contribution of image parameters to visualisation quality and their effect on diagnostic certainty of small bowel (SB) lesions.
Determinants of anxiety in elite athletes: a systematic review and meta-analysis
Authors: Simon M Rice, Kate Gwyther, Olga Santesteban-Echarri, David Baron, Paul Gorczynski, Vincent Gouttebarge, Claudia L Reardon, Mary E Hitchcock, Brian Hainline, Rosemary Purcell
Journal: British Journal of Sports Medicine (2019)

To identify and quantify determinants of anxiety symptoms and disorders experienced by elite athletes.Systematic review and meta-analysis.Five online databases (PubMed, SportDiscus, PsycINFO, Scopus and Cochrane) were searched up to November 2018 to identify eligible citations.Articles were included if they were published in English, were quantitative studies and measured a symptom-level anxiety outcome in competing or retired athletes at the professional (including professional youth), Olympic or collegiate/university levels.We screened 1163 articles; 61 studies were included in the systematic review and 27 of them were suitable for meta-analysis. Overall risk of bias for included studies was low. Athletes and non-athletes had no differences in anxiety profiles (d=-0.11, p=0.28). Pooled effect sizes, demonstrating moderate effects, were identified for (1) career dissatisfaction (d=0.45; higher anxiety in dissatisfied athletes), (2) gender (d=0.38; higher anxiety in female athletes), (3) age (d=-0.34; higher anxiety for younger athletes) and (4) musculoskeletal injury (d=0.31; higher anxiety for injured athletes). A small pooled effect was found for recent adverse life events (d=0.26)-higher anxiety in athletes who had experienced one or more recent adverse life events.Determinants of anxiety in elite populations broadly reflect those experienced by the general population. Clinicians should be aware of these general and athlete-specific determinants of anxiety among elite athletes.
Big tobacco, the new politics, and the threat to public health
Authors: Jonathan Gornall
Journal: BMJ (2019)

With several Tory leadership contenders sympathetic to its ideology, the Institute of Economic Affairs is closer to power than it has been for decades. In an exclusive investigation, <b>Jonathan Gornall</b> reveals how the organisation is funded by British American Tobacco and has links with senior conservative ministers. After orchestrating a series of attacks on public health initiatives, the IEA may now hold the key to No 10
Multicenter Phase I Study of Erdafitinib (JNJ-42756493), Oral Pan-Fibroblast Growth Factor Receptor Inhibitor, in Patients with Advanced or Refractory Solid Tumors
Authors: Rastislav Bahleda, Antoine Italiano, Cinta Hierro, Alain Mita, Andres Cervantes, Nancy Chan, Mark Awad, Emiliano Calvo, Victor Moreno, Ramaswamy Govindan, Alexander Spira, Martha Gonzalez, Bob Zhong, Ademi Santiago-Walker, Italo Poggesi, Trilok Parekh, Hong Xie, Jeffrey Infante, Josep Tabernero
Journal: Clinical Cancer Research (2019)

Abstract Purpose: Here, we report results of the first phase I study of erdafitinib, a potent, oral pan-FGFR inhibitor. Patients and Methods: Patients age ≥18 years with advanced solid tumors for which standard antineoplastic therapy was no longer effective were enrolled (NCT01703481). Parts 2 to 4 employed molecular screening for activating FGFR genomic alterations. In patients with such alterations, two selected doses/schedules identified during part 1 dose-escalation [9 mg once daily and 10 mg intermittently (7 days on/7 days off), as previously published (Tabernero JCO 2015;33:3401-8)] were tested. Results: The study included 187 patients. The most common treatment-related adverse events were hyperphosphatemia (64%), dry mouth (42%), and asthenia (28%), generally grade 1/2 severity. All cases of hyperphosphatemia were grade 1/2 except for 1 grade 3 event. Skin, nail, and eye changes were observed in 43%, 33%, and 28% of patients, respectively (mostly grade 1/2 and reversible after temporary dosing interruption). Urothelial carcinoma and cholangiocarcinoma were most responsive to erdafitinib, with objective response rates (ORR) of 46.2% (12/26) and 27.3% (3/11), respectively, in response-evaluable patients with FGFR mutations or fusions. All patients with urothelial carcinoma and cholangiocarcinoma who responded to erdafitinib carried FGFR mutations or fusions. Median response duration was 5.6 months for urothelial carcinoma and 11.4 months for cholangiocarcinoma. ORRs in other tumor types were &amp;lt;10%. Conclusions: Erdafitinib shows tolerability and preliminary clinical activity in advanced solid tumors with genomic changes in the FGFR pathway, at two different dosing schedules and with particularly encouraging responses in urothelial carcinoma and cholangiocarcinoma.
David Oliver: Vaccination sceptics are immune to debate
Authors: David Oliver
Journal: BMJ (2019)

In 2018 we learnt that rates of vaccination against measles, mumps, and rubella (MMR) in under 10s fell in the UK for the sixth consecutive year.1 From 2010 to 2017 an estimated half a million children missed their MMR vaccination.2

The UK’s MMR coverage is now well below the 95% recommended by the World Health Organization to ensure effective herd immunity. Unicef reported that over 21 million children a year worldwide miss their measles vaccination. The picture is similar for several vaccine preventable conditions.3

WHO announced that, from 2017 to 2018, reported measles cases in Europe tripled.4 The United Nations reported that cases had quadrupled worldwide.5 Experts such as Helen Bedford, writing for the BBC, set out links between declining uptake of vaccination and the rise in outbreaks.6

Academic and journalistic analyses of vaccine hesitancy and falling uptake have highlighted the role of social media activism and pseudoscience in citing vaccination as …
PANCREATIC CANCER ANGIOGENESIS ASSESSMENT BY CONFOCAL LASER ENDOMICROSCOPY AND ANTI-CD105 ANTIBODY IN PANCREATIC CANCER – A PILOT STUDY
Authors: BS Ungureanu, D Pirici, S Dima, I Popescu, V Surlin, IM Cazacu, A Saftoiu
Journal: Endoscopy (2019)

Pancreatic ductal adenocacinoma (PDAC) remains one of the most aggresive types of cancer with a limited number of therapeutic options. Confocal laser endomicroscopy (CLE), with various miniprobes available is accessible tool for different lesions providing a live diagnosis. To assess neoangiogenesis PDAC diagnosed patients by two fluorescently labeled antibodies on fresh biopsy samples imaged with CLE.
Association of Unrecognized Obstructive Sleep Apnea With Postoperative Cardiovascular Events in Patients Undergoing Major Noncardiac Surgery
Authors: Matthew T. V. Chan, Chew Yin Wang, Edwin Seet, Stanley Tam, Hou Yee Lai, Eleanor F. F. Chew, William K. K. Wu, Benny C. P. Cheng, Carmen K. M. Lam, Timothy G. Short, David S. C. Hui, Frances Chung
Journal: JAMA (2019)

Unrecognized obstructive sleep apnea increases cardiovascular risks in the general population, but whether obstructive sleep apnea poses a similar risk in the perioperative period remains uncertain.To determine the association between obstructive sleep apnea and 30-day risk of cardiovascular complications after major noncardiac surgery.Prospective cohort study involving adult at-risk patients without prior diagnosis of sleep apnea and undergoing major noncardiac surgery from 8 hospitals in 5 countries between January 2012 and July 2017, with follow-up until August 2017. Postoperative monitoring included nocturnal pulse oximetry and measurement of cardiac troponin concentrations.Obstructive sleep apnea was classified as mild (respiratory event index [REI] 5-14.9 events/h), moderate (REI 15-30), and severe (REI >30), based on preoperative portable sleep monitoring.The primary outcome was a composite of myocardial injury, cardiac death, heart failure, thromboembolism, atrial fibrillation, and stroke within 30 days of surgery. Proportional-hazards analysis was used to determine the association between obstructive sleep apnea and postoperative cardiovascular complications.Among a total of 1364 patients recruited for the study, 1218 patients (mean age, 67 [SD, 9] years; 40.2% women) were included in the analyses. At 30 days after surgery, rates of the primary outcome were 30.1% (41/136) for patients with severe OSA, 22.1% (52/235) for patients with moderate OSA, 19.0% (86/452) for patients with mild OSA, and 14.2% (56/395) for patients with no OSA. OSA was associated with higher risk for the primary outcome (adjusted hazard ratio [HR], 1.49 [95% CI, 1.19-2.01]; P = .01); however, the association was significant only among patients with severe OSA (adjusted HR, 2.23 [95% CI, 1.49-3.34]; P = .001) and not among those with moderate OSA (adjusted HR, 1.47 [95% CI, 0.98-2.09]; P = .07) or mild OSA (adjusted HR, 1.36 [95% CI, 0.97-1.91]; P = .08) (P = .01 for interaction). The mean cumulative duration of oxyhemoglobin desaturation less than 80% during the first 3 postoperative nights in patients with cardiovascular complications (23.1 [95% CI, 15.5-27.7] minutes) was longer than in those without (10.2 [95% CI, 7.8-10.9] minutes) (P < .001). No significant interaction effects on perioperative outcomes were observed with type of anesthesia, use of postoperative opioids, and supplemental oxygen therapy.Among at-risk adults undergoing major noncardiac surgery, unrecognized severe obstructive sleep apnea was significantly associated with increased risk of 30-day postoperative cardiovascular complications. Further research would be needed to assess whether interventions can modify this risk.