tbuckley/cabot-search huggingface dataset:
ENDOSCOPIC MINOR PAPILLA SPHINCTEROTOMY (EMPS): TECHNICAL SUCCESS AND LONG-TERM CLINICAL OUTCOMES
Authors: MCC Bellocchi, SF Crinò, L Bernardoni, M Ruffini, L Frulloni, A Gabbrielli
Journal: Endoscopy (2020)

Aims EMPS is technical demanding and few data about safety and outcomes are available. We aimed to assess the technical success and the clinical efficacy in a selected subgroup of patients with recurrent pancreatitis (RP).
IS TELEPHONE RE-EDUCATION PREVIOUS TO BOWEL PREPARATION A REAL ASSET?
Authors: C Arieira, S Xavier, PB Carvalho, C Sousa, FD de Castro, J Magalhães, B Rosa, J Cotter
Journal: Endoscopy (2020)

Aims Despite all the innovations in bowel preparation methods, the quality of bowel preparation in some patients undergoing colonoscopy remains a major limitation. Recently, some studies suggest that telephone re-education(TRE)on the day before colonoscopy is associated with better quality of preparation.
A nine gene expression classifier predicts survival in stage II colon cancer based on microsatellite instability status
Authors: Mogens Kruhoffer, Jens L. Jensen, Päivi Laiho, Lars Dyrskjøt, Reijo Salovaara, Diego Arango, Karin Demtroeder, Flemming B. Sorensen, Line Buhl, Jukka-Pekka Mecklin, Heikki Järvinen, Thomas Thykjaer, Friedrik Wikman, Flemming Bech-Knudsen, Matti Juhola, Nina N. Nupponen, Soren Lauerberg, Lauri A. Aaltonen, Torben Orntoft
Journal: Cancer Research (2005)

3574  There has been little progress in identifying prognostic gene expression signatures in colorectal cancer compared with other solid malignancies. We investigated the possibility of building classifiers for disease progression based on the gene expression profile from 101 crude tumor samples from stage II and III patients. Unsupervised hierarchical clustering separated the tumors into groups with distinct microsatellite instability status that were strongly related to outcome in Stage II patients. Stage II colon cancer patients classified as microsatellite unstable had significantly longer overall survival than microsatellite stable (P=0.0014). Using a maximum likelihood classification method we identified nine genes that could separate the 101 tumor samples into stable and unstable tumors, and which were in 97% concordance with microsatellite analysis. The sensitivity for diagnosis of microsatellite stable tumors exceeded 98% with a specificity exceeding 94%. The positive and negative predictive values exceeded 98% and 91%, respectively. The classifier worked equally well when using real-time PCR analysis as 95.7% of an independent set of 47 tumors were correctly classified. Thus, based on quantification of nine gene transcripts we identified a group of stage II patients with a very good prognosis and a group, which are MSS, that have 50% mortality. In addition, microsatellite unstable tumors could be classified into sporadic and hereditary tumors with an accuracy of 97.2% (36 of 37) using the two genes MLH1 and PIWIL1. The combination of such different classifiers based on gene expression profiles may contribute to the development of microarrays as diagnostic tools for colorectal cancer.
Smoking, ACE-2 and COVID-19: ongoing controversies
Authors: Janice M. Leung, Don D. Sin
Journal: European Respiratory Journal (2020)

The three letters from D. Lutchman, K.D. McAlinden and co-workers, and K. Farsalinos and co-workers together capture the divergence in opinion on the impact of smoking on coronavirus disease 2019 (COVID-19) and whether the angiotensin-converting enzyme 2 (ACE-2) receptor mediates this relationship. At the heart of this controversy is whether smoking reduces or increases the risk of contracting COVID-19. K. Farsalinos and co-workers, through analysis of the pooled prevalence of current smoking across 11 case series determined that current smoking status was significantly lower than expected gender- and age-adjusted prevalence in COVID-19 patients. That smoking could potentially be protective against COVID-19 has not gone unnoticed by the public. Since late April, multiple media outlets have reported on this possibility, prompting the World Health Organization (WHO) to release a warning on 4 May, 2020, on tobacco use during this pandemic [1]. While we do not dispute that the prevalence of smoking in COVID-19 cases has been surprisingly low across the world, we would echo WHO's advice, based on emerging evidence that outcomes in COVID-19 are worse in patients who do smoke. An analysis conducted by Killerby et al. [2], of 220 hospitalised and 311 nonhospitalised patients with COVID-19 patients across six acute care hospitals and associated outpatient clinics in metropolitan Atlanta, Georgia, for instance, demonstrated that smoking was an independent risk factor for COVID-19 hospitalisation, carrying an odds ratio of 2.3 (95% CI 1.2–4.5). A recent meta-analysis has also shown that smokers have a relative risk of 1.34 (95% CI 1.07–1.67) of having more severe disease or experiencing refractory or progressive disease [3]. While smoking may not necessarily increase one's risk for contracting COVID-19, the biological and inflammatory cascade that occurs upon severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may be particularly devastating for a smoker. Smoking increases severity of COVID-19 <https://bit.ly/2yWp3jb>
OVER-THE-SCOPE CLIP FOR THE TREATMENT OF A BILIARY STENT-INDUCED DUODENAL PERFORATION
Authors: P Gkolfakis, A Lemmers, D Blero, J Devière, G Verset, M Arvanitakis
Journal: Endoscopy (2020)

Duodenal perforation due to distal migration of plastic biliary stents is a rare ERCP complication. Endoscopic treatment options include through-the-scope and over-the-scope clips (OTSC). Surgery may be recommended, especially in cases of late (> 12 h) diagnosis or when there is contrast extravasation or intra-abdominal fluid collection. However, successful perforation closure using clips has been reported even in cases of late diagnosis. Herein, we demonstrate the successful application of a 12-mm OTSC (OVESCO, Tubingen, Germany) to treat a duodenal perforation. OTSC was applied late (> 12 h) and despite its technical success, patient’s medical condition necessitated further surgical management (laparoscopy and peritoneal lavage).
PERCUTANEOUS TRANSHEPATIC CHOLANGIO DRAINAGE (PTCD) FOR MALIGNANT BILIARY STENOSES – THE ONCOLOGIC OUTCOME IN A GERMAN TERTIARY CENTER
Authors: CF M Jung, JD Claas, H Schwörer, S Kunsch, V Ellenrieder, E Wedi
Journal: Endoscopy (2020)

Aims For more than 50 years, PTCD remains a palliative treatment option for patients with malignant biliary stenoses where ERCP fails. With this retrospective analysis, a closer look on the oncologic outcome of patients after PTCD drainage was taken. A primary endpoint was the ability to receive or return to a point where chemotherapy was possible again.
EFFECT OF DIMINUTIVE POLYPS WITH HGD ON SURVEILLANCE COLONOSCOPY
Authors: JH Park, HS Moon, SH Kang, JS Kim, JK Sung, HY Jeong
Journal: Endoscopy (2020)

Aims The colonoscopy surveillance guideline AGA 2012 and ESGE 2013, set the surveillance schedule based on the characteristics of polyp. Polyp with high grade dysplasia (HGD) requires three years of follow-up regardless of size. It is unclear whether diminutive polyps (less than 5 mm) with HGD have more risk than the low risk group. Therefore, in this study, the effect of diminutive with HGD on the occurrence of Advanced adenoma was analyzed.
THE ROLE OF ENDOSCOPIC ULTRASOUND-GUIDED THROUGH-THE-NEEDLE MICROFORCEPS BIOPSY IN THE DIAGNOSIS OF PANCREATIC CYSTIC LESIONS
Authors: S Stigliano, D Biasutto, F Covotta, FM Di Matteo
Journal: Endoscopy (2020)

Aims Pancreatic cystic neoplasms (PCN) are estimated to be present in 2-45% of the general population. Their biological behaviour ranges from benign to malignant disease. Correct management may prevent progression to pancreatic cancer while minimising the need for lifelong screening. Unfortunately, accurate diagnosis and classification of PCN remains a challenge.
Addition of Androgen-Deprivation Therapy or Brachytherapy Boost to External Beam Radiotherapy for Localized Prostate Cancer: A Network Meta-Analysis of Randomized Trials
Authors: William C. Jackson, Holly E. Hartman, Robert T. Dess, Sam R. Birer, Payal D. Soni, Jason W.D. Hearn, Zachary R. Reichert, Amar U. Kishan, Brandon A. Mahal, Zachary S. Zumsteg, Jason A. Efstathiou, Samuel Kaffenberger, Todd M. Morgan, Rohit Mehra, Timothy N. Showalter, Daniel A. Krauss, Paul L. Nguyen, Matthew J. Schipper, Felix Y. Feng, Howard M. Sandler, Peter J. Hoskin, Mack Roach, Daniel E. Spratt
Journal: Journal of Clinical Oncology (2020)

In men with localized prostate cancer, the addition of androgen-deprivation therapy (ADT) or a brachytherapy boost (BT) to external beam radiotherapy (EBRT) have been shown to improve various oncologic end points. Practice patterns indicate that those who receive BT are significantly less likely to receive ADT, and thus we sought to perform a network meta-analysis to compare the predicted outcomes of a randomized trial of EBRT plus ADT versus EBRT plus BT.A systematic review identified published randomized trials comparing EBRT with or without ADT, or EBRT (with or without ADT) with or without BT, that reported on overall survival (OS). Standard fixed-effects meta-analyses were performed for each comparison, and a meta-regression was conducted to adjust for use and duration of ADT. Network meta-analyses were performed to compare EBRT plus ADT versus EBRT plus BT. Bayesian analyses were also performed, and a rank was assigned to each treatment after Markov Chain Monte Carlo analyses to create a surface under the cumulative ranking curve.Six trials compared EBRT with or without ADT (n = 4,663), and 3 compared EBRT with or without BT (n = 718). The addition of ADT to EBRT improved OS (hazard ratio [HR], 0.71 [95% CI, 0.62 to 0.81]), whereas the addition of BT did not significantly improve OS (HR, 1.03 [95% CI, 0.78 to 1.36]). In a network meta-analysis, EBRT plus ADT had improved OS compared with EBRT plus BT (HR, 0.68 [95% CI, 0.52 to 0.89]). Bayesian modeling demonstrated an 88% probability that EBRT plus ADT resulted in superior OS compared with EBRT plus BT.Our findings suggest that current practice patterns of omitting ADT with EBRT plus BT may result in inferior OS compared with EBRT plus ADT in men with intermediate- and high-risk prostate cancer. ADT for these men should remain a critical component of treatment regardless of radiotherapy delivery method until randomized evidence demonstrates otherwise.
Medications for opioid use disorder among pregnant women referred by criminal justice agencies before and after Medicaid expansion: A retrospective study of admissions to treatment centers in the United States
Authors: Tyler N. A. Winkelman, Becky R. Ford, Rebecca J. Shlafer, Anna McWilliams, Lindsay K. Admon, Stephen W. Patrick
Journal: PLoS Medicine (2020)

Criminal justice involvement is common among pregnant women with opioid use disorder (OUD). Medications for OUD improve pregnancy-related outcomes, but trends in treatment data among justice-involved pregnant women are limited. We sought to examine trends in medications for OUD among pregnant women referred to treatment by criminal justice agencies and other sources before and after the Affordable Care Act's Medicaid expansion.We conducted a serial, cross-sectional analysis using 1992-2017 data from pregnant women admitted to treatment facilities for OUD using a national survey of substance use treatment facilities in the United States (N = 131,838). We used multiple logistic regression and difference-in-differences methods to assess trends in medications for OUD by referral source. Women in the sample were predominantly aged 18-29 (63.3%), white non-Hispanic, high school graduates, and not employed. Over the study period, 26.3% (95% CI 25.7-27.0) of pregnant women referred by criminal justice agencies received medications for OUD, which was significantly less than those with individual referrals (adjusted rate ratio [ARR] 0.45, 95% CI 0.43-0.46; P < 0.001) or those referred from other sources (ARR 0.51, 95% CI 0.50-0.53; P < 0.001). Among pregnant women referred by criminal justice agencies, receipt of medications for OUD increased significantly more in states that expanded Medicaid (n = 32) compared with nonexpansion states (n = 18) (adjusted difference-in-differences: 12.0 percentage points, 95% CI 1.0-23.0; P = 0.03). Limitations of this study include encounters that are at treatment centers only and that do not encompass buprenorphine prescribed in ambulatory care settings, prisons, or jails.Pregnant women with OUD referred by criminal justice agencies received evidence-based treatment at lower rates than women referred through other sources. Improving access to medications for OUD for pregnant women referred by criminal justice agencies could provide public health benefits to mothers, infants, and communities. Medicaid expansion is a potential mechanism for expanding access to evidence-based treatment for pregnant women in the US.
GEL IMMERSION ENDOSCOPY (GIE) FACILITATES HAEMOSTASIS FOR THE MANAGEMENT OF BLEEDING POST WIDE-FIELD CAECAL ENDOSCOPIC MUCOSAL RESECTION (EMR)
Authors: N Lazaridis, EJ Despott, A Podesta, E Athanasiadou, F Solonos, R Raymond, N Koukias, T Yano, A Murino
Journal: Endoscopy (2020)

Post-procedural-bleeding(PPB) is an adverse event that may lead to hospitalisation, transfusion and additional endotherapy after wide-field-EMR(WF-EMR). Gel-immersion-endoscopy(GIE) has been recently described to improve targeted views and facilitate endotherapy.
Abstract 13208: A Novel Risk Prediction Model of Atrial Fibrillation: The Multi-Ethnic Study of Atherosclerosis (MESA)
Authors: Joshua D Bundy, Susan R Heckbert, Lin Y Chen, Donald M Lloyd-Jones, Philip Greenland
Journal: Circulation (2018)

Introduction: Atrial fibrillation (AF) is the most common clinically-significant cardiac arrhythmia and is strongly associated with increased risk of stroke and other cardiovascular diseases. Valid...
Assessment of rapid shallow breathing index as a predictor for weaning in respiratory care unit
Authors: Abbas Fadaii, Hamid Sohrabpour, Saber Sadat Amini, Bahador Bagheri, Bahar Taherkahnchi
Journal: European Respiratory Journal (2011)

Introduction:  Weaning is gradual removal of mechanical ventilator support. Different predictors are used for weaning initiation. This study is designed to investigate the rapid shallow breathing index (RBSI) as a predictor for successful weaning.   Materials and methods:  We did this cross-sectional study on 70 patients who had mechanical ventilation for more than 48 hours in respiratory care unit (RCU) in Tehran Labbafi Nejad hospital. We measured RBSI, and then evaluate the value of RBSI for successful extubation.   Results:  63 (90%) Patients had RBSI ≤105 (Breath/min/L), among them 49 (77%) patients had successful weaning and did not need re-intubation but the rest had unsuccessful weaning (P=0.001). Weaning index mean for patients with successful extubation was 66±57.2 and for patients with unsuccessful extubaion was 76.9±28.1. We could not find a significant difference between means (P=0.433).   Conclusion:  Our findings exhibited that RBSI has high sensitivity with low specifity. RBSI ≤80 is more reliable than RBSI≤105 as a predictor for weaning.
TAKING BIOPSIES IN MACROSCOPICALLY NORMAL ENDOSCOPIES - IS THERE INTER-OPERATOR VARIABILITY AND NEED FOR STRINGENT GUIDELINES AND TRAINING?
Authors: N Cianci, B Varghese, M Diossy, A Agarwal, A Radzi, A Mandal, A Khanna
Journal: Endoscopy (2020)

Aims Numerous studies have questioned the value of taking biopsies in macroscopically-normal mucosa. Inappropriate biopsies increase financial and time pressures on the increasingly-strained endoscopy, pathology and NHS services. We hypothesized that non-physician endoscopists have greater uptake on performing biopsies in macroscopically normal endoscopies.
THE USE OF A SPECIALIZED BLEEDING-MANAGEMENT TEAM HAD NO IMPACT ON MORTALITY FOR ACUTE UPPER GASTROINTESTINAL BLEEDING (AUGIB): AN ITALIAN PROSPECTIVE MULTICENTER COHORT STUDY
Authors: R Marmo, M Soncini, C Marmo
Journal: Endoscopy (2020)

Aims Aim of the study was to verifiy if patients with AUGIB, treated by a BT had better survival in comparison with patients not treated by a BT.
Variable uptake of face masks could reinforce health inequalities
Authors: Michael R Robling
Journal: BMJ (2020)

Greenhalgh and colleagues present a pragmatic argument for face mask use by the public in response to covid-19.1 Their precautionary principle model in the absence of clear evidence invokes the parachute approach to evidence based medicine.2 To extend that analogy, although trialling parachutes seems redundant, considerations such as quality control, “user” training, and ultimately reach remain relevant. Before implementing guidance from the US Centers for Disease Control …
Characteristics associated with hospitalisation for COVID-19 in people with rheumatic disease: data from the COVID-19 Global Rheumatology Alliance physician-reported registry
Authors: Milena Gianfrancesco, Kimme L Hyrich, Sarah Al-Adely, Loreto Carmona, Maria I Danila, Laure Gossec, Zara Izadi, Lindsay Jacobsohn, Patricia Katz, Saskia Lawson-Tovey, Elsa F Mateus, Stephanie Rush, Gabriela Schmajuk, Julia Simard, Anja Strangfeld, Laura Trupin, Katherine D Wysham, Suleman Bhana, Wendy Costello, Rebecca Grainger, Jonathan S Hausmann, Jean W Liew, Emily Sirotich, Paul Sufka, Zachary S Wallace, Jinoos Yazdany, Pedro M Machado, Philip C Robinson
Journal: Annals of the Rheumatic Diseases (2020)

COVID-19 outcomes in people with rheumatic diseases remain poorly understood. The aim was to examine demographic and clinical factors associated with COVID-19 hospitalisation status in people with rheumatic disease.Case series of individuals with rheumatic disease and COVID-19 from the COVID-19 Global Rheumatology Alliance registry: 24 March 2020 to 20 April 2020. Multivariable logistic regression was used to estimate ORs and 95% CIs of hospitalisation. Age, sex, smoking status, rheumatic disease diagnosis, comorbidities and rheumatic disease medications taken immediately prior to infection were analysed.A total of 600 cases from 40 countries were included. Nearly half of the cases were hospitalised (277, 46%) and 55 (9%) died. In multivariable-adjusted models, prednisone dose ≥10 mg/day was associated with higher odds of hospitalisation (OR 2.05, 95% CI 1.06 to 3.96). Use of conventional disease-modifying antirheumatic drug (DMARD) alone or in combination with biologics/Janus Kinase inhibitors was not associated with hospitalisation (OR 1.23, 95% CI 0.70 to 2.17 and OR 0.74, 95% CI 0.37 to 1.46, respectively). Non-steroidal anti-inflammatory drug (NSAID) use was not associated with hospitalisation status (OR 0.64, 95% CI 0.39 to 1.06). Tumour necrosis factor inhibitor (anti-TNF) use was associated with a reduced odds of hospitalisation (OR 0.40, 95% CI 0.19 to 0.81), while no association with antimalarial use (OR 0.94, 95% CI 0.57 to 1.57) was observed.We found that glucocorticoid exposure of ≥10 mg/day is associated with a higher odds of hospitalisation and anti-TNF with a decreased odds of hospitalisation in patients with rheumatic disease. Neither exposure to DMARDs nor NSAIDs were associated with increased odds of hospitalisation.
The Diagnosis and Management of Gestational Diabetes Mellitus in the Context of the COVID-19 Pandemic
Authors: H. David McIntyre, Robert G. Moses
Journal: Diabetes Care (2020)

The oral glucose tolerance test (OGTT) has, to date, been considered the cornerstone of the diagnosis of gestational diabetes mellitus (GDM). This is despite ongoing national and international disagreement regarding which women require testing, whether “one step” or “two step” testing is optimal, and which glucose thresholds should be used.

However, in the context of the current coronavirus disease 2019 (COVID-19) pandemic, widespread anecdotal evidence suggests that both clinicians and pregnant women are increasingly unwilling to recommend or undergo the OGTT. This is based on valid concerns regarding travel, the possible need for two visits, and the time (up to 3 h) spent in the potentially infectious environment of specimen collection centers. Further, a GDM diagnosis generally involves additional health service visits for diabetes education, glucose monitoring review, and fetal ultrasonography, all of which carry exposure risks during a pandemic.

In response to these concerns, professional societies from the U.K. (1), Canada (2), and Australia (3) have released urgent statements of advice/guidance for modification of GDM diagnostic pathways during the COVID-19 pandemic. Current GDM guidelines differ in each of these jurisdictions, as do the revised recommendations. All seek to reduce the need for OGTTs, both during pregnancy and in postpartum follow-up. All guidelines support use of an early pregnancy HbA1c ≥41 mmol/mol (5.9%) to identify GDM, though some offer other options.

The revised recommendations for standard (24- to 28-week) GDM testing are more divergent. The U.K. currently advocates risk factor–based testing for GDM, and …
ANNUAL ENDOSCOPY IS ENOUGH FOR GASTRIC CANCER SURVEILLANCE SCHEDULE AFTER THE ENDOSCOPIC RESECTION
Authors: S Kim, D Kang, HW Kim, S Park, JW Lee
Journal: Endoscopy (2020)

Aims Patients who received endoscopic resection for early gastric cancer (EGC) or high grade dysplasia (HGD) are at high risk of subsequent development of metachronous gastric cancer. The aim of this study is to compare the prognosis of patients between biannual and annual endoscopic surveillance in patients after endoscopic resection of EGC or HGD.
Efficacy and Safety of PF‐06651600 (Ritlecitinib), a Novel JAK3/TEC Inhibitor, in Patients With Moderate‐to‐Severe Rheumatoid Arthritis and an Inadequate Response to Methotrexate
Authors: Michael F. Robinson, Nemanja Damjanov, Bojana Stamenkovic, Goran Radunovic, Alan Kivitz, Lori Cox, Zorayr Manukyan, Christopher Banfield, Michael Saunders, Deepa Chandra, Michael S. Vincent, Jessica Mancuso, Elena Peeva, Jean S. Beebe
Journal: Arthritis & Rheumatology (2020)

Objective To evaluate the efficacy and safety of PF‐06651600 (ritlecitinib), an irreversible inhibitor of JAK3 and the tyrosine kinase expressed in hepatocellular carcinoma (TEC) kinase family, in comparison with placebo in patients with rheumatoid arthritis (RA). Methods An 8‐week, phase II, double‐blind, parallel‐group study was conducted. Seventy patients who were seropositive for anti–citrullinated protein antibodies and/or rheumatoid factor were randomized 3:2 to receive oral PF‐06651600 (200 mg once daily) or placebo for 8 weeks. Eligible patients had an inadequate response to methotrexate, and the study design allowed up to 50% of patients to have previously received 1 tumor necrosis factor inhibitor that was inadequately effective and/or not tolerated. The primary end point was change from baseline in the Simplified Disease Activity Index (SDAI) score at week 8, assessed by Bayesian analysis using an informative prior distribution for placebo response. Results Mean change from baseline in the SDAI score at week 8 was greater in the PF‐06651600 group (−26.1 [95% credible interval −29.7, −22.4]) than in the placebo group (−16.8 [95% credible interval −20.9, −12.7]; P &lt; 0.001). Most adverse events (AEs) were mild in severity, and no treatment‐related serious AEs, severe AEs, or deaths were reported. The most common classes of AE were infections and infestations as well as skin and subcutaneous tissue disorders; there was 1 mild case of herpes simplex in the PF‐06651600 group that was considered to be treatment related, which resolved within 3 days without study treatment discontinuation or antiviral therapy. Conclusion Treatment with the oral JAK3/TEC inhibitor PF‐06651600 (200 mg once daily) was associated with significant improvements in RA disease activity and was generally well‐tolerated in this small 8‐week study.