tbuckley/cabot-search huggingface dataset:
“HITCH AND RIDE” TECHNIQUE FOR BLIND PANCREATIC DUCT CANNULATION
Authors: JJ Vila, G González, L Aburruza, J Carvalho, J Costa, J Carrascosa, I Fernández-Urién, E Albéniz, A Pueyo
Journal: Endoscopy (2019)

A 72 year old patient suffered a biliary pancreatitis with wall-off pancreatic necrosis endoscopically drained and solved after two sessions of endoscopic necrosectomy. Biliary sphincterotomy was performed for suspected common bile duct stones. The transmural stent was retrieved and from then on the patient complained of epigastric pain with elevation of acute phase reactants. CT showed two new peripancreatic collections with mild dilation of the pancreatic duct, suggesting pancreatic duct disruption. Pancreatic ERCP was planned but the duodenal folds were edematous with stenosis of the duodenal lumen, precluding identification of the ampulla. The duodenoscope was placed facing the theoretical location of the ampulla under fluoroscopic control. Injecting contrast we could see a depression in the wall corresponding to the ampulla with the sphincterotomy which was blindly cannulated. Since we could see the biliary guidewire exiting the duodenoscope, a cannula with a preloaded guidewire and a slit on the tip was snapped onto the biliary guidewire and advanced over it (“hitch and ride” technique) until the theoretical location of the ampulla with fluoroscopic control. Once there, the preloaded guidewire was advanced exiting the cannula tip more caudally because of the slit, in a more convenient orientation for pancreatic duct cannulation. After a couple of attempts and blind adjustments of the cannula position we could easily cannulate the pancreatic duct with the second guidewire only under fluoroscopic control. Pancreatic ductography confirmed pancreatic duct disruption and a pancreatic stent was placed into the fistulous tract. The patient clinical status improved and was discharged asymptomatic (Video).
Adverse effects of immune-checkpoint inhibitors: epidemiology, management and surveillance
Authors: Filipe Martins, Latifyan Sofiya, Gerasimos P. Sykiotis, Faiza Lamine, Michel Maillard, Montserrat Fraga, Keyvan Shabafrouz, Camillo Ribi, Anne Cairoli, Yan Guex-Crosier, Thierry Kuntzer, Olivier Michielin, Solange Peters, Georges Coukos, Francois Spertini, John A. Thompson, Michel Obeid
Journal: Nature Reviews Clinical Oncology (2019)
The Ariane-IPF ERS Clinical Research Collaboration: seeking collaboration through launch of a federation of European registries on idiopathic pulmonary fibrosis
Authors: Vincent Cottin, Isabella Annesi-Maesano, Andreas Günther, Liam Galvin, Michael Kreuter, Pippa Powell, Antje Prasse, George Reynolds, Luca Richeldi, Paolo Spagnolo, Claudia Valenzuela, Marlies Wijsenbeek, Wim A. Wuyts, Bruno Crestani
Journal: European Respiratory Journal (2019)

Idiopathic pulmonary fibrosis (IPF) is the most prevalent of rare pulmonary diseases [1], and the most severe of the chronic forms of idiopathic interstitial pneumonias, with rising incidence and prevalence [2–4]. The prognosis for people diagnosed with IPF is a median survival of 3–3.5 years [1]. Ariane-IPF is a project aimed at creating a federation of European registries for idiopathic pulmonary fibrosis, supported by an ERS Clinical Research Collaboration <http://bit.ly/2J325tb> We thank Celine Genton and Elise Heuvelin from the European Respiratory Society (Lausanne, Switzerland) for their help and support and for managing the survey.
INITIAL EXPERIENCES WITH TRANSPANCREATIC SPHINCTEROTOMY IN HUNGARIAN CENTERS BASED ON PROSPECTIVELY COLLECTED REGISTRY DATA
Authors: S Gódi, D Pécsi, P Hegyi, L Czakó, T Gyökeres, F Pakodi, Á Patai, Z Szepes, Á Vincze
Journal: Endoscopy (2019)

Transpancreatic sphincterotomy (TPS) might be an alternative in cases of inadvertent pancreatic duct (PD) cannulation. We evaluated the efficacy and safety of TPS in comparison to needle-knife precut (NKP) techniques from a prospective database with the analysis of post-ERCP pancreatitis (PEP) prophylaxis measures.
WATER-AIDED PEDIATRIC COLONOSCOPY: A PILOT FEASIBILITY AND SAFETY STUDY
Authors: A Granata, G Curcio, D Ligresti, L Barresi, I Tarantino, M Traina
Journal: Endoscopy (2019)

Water-aided methods for adult colonoscopy have received renewed attention in the literature in recent years. Published studies evaluating water exchange (WE) colonoscopy have shown a reduction in procedural pain and postprocedural discomfort, with a higher completion rate. This pilot study aimed to evaluate feasibility and safety of water-aided methods for adult colonoscopy performed in pediatric patients.
Characteristics of circulating tumor DNA (ctDNA) in patients with ER-positive (ER+), HER2-negative (HER2-) metastatic breast cancer (MBC) on different lines of endocrine treatment
Authors: M.K. Bos, D.T. Kruger, M.P.H.M. Jansen, J.W.M. Martens, E. Boven, S. Sleijfer
Journal: Annals of Oncology (2019)

Background: ctDNA is emerging as a non-invasive disease-monitoring biomarker alternative to a tissue biopsy. In this study, we characterized ctDNA from patients with ER+, HER2- MBC 1) starting first-line non-steroidal aromatase inhibitors (NSAIs) and 2) refractory to treatment with NSAI. Methods: Patients starting treatment with NSAIs (cohort 1, n = 100) and patients refractory to NSAIs, starting treatment with everolimus/exemestane (cohort 2, n = 164) were included in this analysis. Longitudinal plasma samples and whole genome sequencing (WGS) data from paired metastatic tissues, collected at baseline, were available from 23 patients in cohort 1. Cell-free DNA (cfDNA) (10ng) was characterized by targeted next generation sequencing (NGS) for hotspot mutations in 10 genes. Numbers of specific mutations and mutant molecules/mL and numbers were compared for both cohorts and related to PFS for cohort 1. Results: Patients in cohort 2 more often had detectable ctDNA (76% vs 53%, p < 0.001) and ≥3 specific mutations (18% vs 3%, p = 0.001) when compared to patients in cohort 1. Mutations in ESR1 (40% vs 9%, p < 0.001) and PIK3CA (46% vs 29%, p = 0.009) were enriched in patients in cohort 2, of whom ESR1 mutations were more often polyclonal (11% vs 1%, p = 0.009). The most frequently identified ESR1 variants were p.E380Q in cohort 1 (n = 4) and p.D538G and p.Y537S in cohort 2 (n = 38, n = 27). Mutations in KRAS and ERBB3 were only detected in cohort 2 (p = 0.331, p = 0.232). The median number of mutant molecules/mL in ctDNA-positive patients did not significantly differ between cohort 1 and cohort 2 for all mutations (48 vs 54, p = 0.87). In cohort 1, mutant molecules/mL and numbers of mutations were not significantly associated with PFS (p = 0.393, p = 0.384). Analysis of 23 patients with longitudinal plasma samples and WGS data from metastatic tissue is ongoing and will be presented at the meeting. Conclusions: Patients refractory to endocrine therapy develop more heterogeneous disease demonstrated by higher number of mutations detected in ctDNA. Legal entity responsible for the study: Erasmus Medical Center. Funding: Novartis Merck KGaA. Disclosure: All authors have declared no conflicts of interest.
Systematic Review of the Role of Stereotactic Radiotherapy for Bone Metastases
Authors: Katie L Spencer, Joanne M van der Velden, Erin Wong, Enrica Seravalli, Arjun Sahgal, Edward Chow, Jorrit-Jan Verlaan, Helena M Verkooijen, Yvette M van der Linden
Journal: JNCI Journal of the National Cancer Institute (2019)

Abstract Background Stereotactic radiotherapy (SBRT) might improve pain and local control in patients with bone metastases compared to conventional radiotherapy, although an overall estimate of these outcomes is currently unknown. Methods A systematic review was carried out following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Pubmed, Embase, and Cochrane databases were systematically searched to identify studies reporting pain response and local control among patients with bone metastases from solid-organ tumors who underwent SBRT in 1–6 fractions. All studies prior to April 15, 2017, were included. Study quality was assessed by predefined criteria, and pain response and local control rates were extracted. Results A total of 2619 studies were screened; 57 were included (reporting outcomes for 3995 patients) of which 38 reported pain response and 45 local control rates. Local control rates were high with pain response rates above those previously reported for conventional radiotherapy. Marked heterogeneity in study populations and delivered treatments were identified such that quantitative synthesis was not appropriate. Reported toxicity was limited. Of the pain response studies, 73.7% used a retrospective cohort design and only 10.5% used the international consensus endpoint definitions of pain response. The median survival within the included studies ranged from 8 to 30.4 months, suggesting a high risk of selection bias in the included observational studies. Conclusions This review demonstrates the potential benefit of SBRT over conventional palliative radiotherapy in improving pain due to bone metastases. Given the methodological limitations of the published literature, however, large randomized trials are now urgently required to better quantify this benefit.
Apport diagnostique de la vidéocapsule endoscopique: Expérience d'un centre hospitalier général
Authors: T Gharbi, H Laarabi, Y Thiyfa, L Kabbage, I Dadamessi
Journal: Endoscopy (2019)

La vidéocapsule endoscopique (VCE) a amélioré l'exploration de l'intestin grêle jusque-là inaccessible aux explorations endoscopiques usuelles.
Safety and clinical activity of PD-L1 blockade in patients with aggressive recurrent respiratory papillomatosis
Authors: Clint T. Allen, Sunmin Lee, Scott M. Norberg, Damian Kovalovsky, Hong Ye, Paul E. Clavijo, Siwen Hu-Lieskovan, Richard Schlegel, Jeffrey Schlom, Julius Strauss, James L. Gulley, Jane Trepel, Christian S. Hinrichs
Journal: Journal for ImmunoTherapy of Cancer (2019)

Recurrent respiratory papillomatosis (RRP) is a human papillomavirus (HPV)-driven disorder that causes substantial morbidity and can lead to fatal distal airway obstruction and post-obstructive pneumonias. Patients require frequent surgical debridement of disease, and no approved systemic adjuvant therapies exist.A phase II study was conducted to investigate the clinical activity and safety of programmed death-ligand 1 (PD-L1) blockade with avelumab in patients with RRP.Twelve patients were treated. All patients with laryngeal RRP displayed improvement in disease burden, and 5 of 9 (56%) displayed partial responses. None of 4 patients with pulmonary RRP displayed a response. Using each patient's surgical history as their own control, patients required fewer surgical interventions after avelumab treatment (p = 0.008). A subset of partial responders developed HPV-specific reactivity in papilloma-infiltrating T-cells that correlated with reduced HPV viral load and an increased Tissue Inflammation Signature.Avelumab demonstrated safety and clinical activity in patients with laryngeal RRP. Further study of immune checkpoint blockade for RRP, possibly with longer treatment duration or in combination with other immunotherapies aimed at activating antiviral immunity, is warranted.NCT, number NCT02859454 , registered August 9, 2016.
Association of Early-Life Exposure to Income Inequality With Bullying in Adolescence in 40 Countries
Authors: Frank J. Elgar, Genevieve Gariepy, Melanie Dirks, Sophie D. Walsh, Michal Molcho, Alina Cosma, Marta Malinowska-Cieslik, Peter D. Donnelly, Wendy Craig
Journal: JAMA Pediatrics (2019)

While the association between income inequality and interpersonal violence has been attributed to the psychosocial effects of inequality (eg, increased class anxiety, reduced social capital), longitudinal evidence for this pathway is limited by a reliance on small ecological studies and cross-sectional data. The developmental consequences of early-life inequality for subsequent involvement in violence have not been investigated.To examine the association between income inequality during infancy and early childhood and adolescents' involvement in bullying others, experiences of being bullied, or both.The Health Behavior in School-aged Children survey study was conducted in European and North American schools. This analysis used individual data on bullying (being bullied, bullying others, or both) from 6 consecutive school-based surveys of 11-year-old to 15-year-old students carried out in 40 countries between February 1994 to March 2014. Data analysis occurred from March 2018 to January 2019.National Gini indices of income inequality for every year of life spanning a 35-year period (1979 to 2014).Being bullied, bullying others, and both outcomes were measured using a common definition and questions adapted from the Bully-Victim Questionnaire and translated to many languages.The sample included 425 938 male students and 448 265 female students from 162 country-survey year groups in 29 196 schools. Linear regression coefficients indicated that early-life income inequality from birth to 4 years was positively associated with being bullied (male students: linear regression coefficient, 18.26 [95% CI, 11.04-25.47]; P < .001; female students: linear regression coefficient, 15.67 [95% CI, 10.02-21.33]; P < .001), and dual involvement in being bullied and bullying others (male students: linear regression coefficient, 5.55 [95% CI, 2.67-8.44]; P < .001; female students: linear regression coefficient, 2.45 [95% CI, 0.93-3.97]; P < .001), after differences in lifetime mean income inequality (from birth to when bullying was measured), national per capita income, family socioeconomic position, age, and cohort were controlled. No such association was found with bullying others after differences in being bullied were controlled.Being bullied is associated with early-life exposure to income inequality. Although further research on the underlying pathways is needed to guide intervention, these results suggest temporality in the association between inequality and violence and suggest that growing up in areas of high income inequality is associated with victimization in adolescence.
HER-Seq: A blood-based genomic screening study to identify HER2 mutation-positive patients for enrollment into clinical trials with the pan-HER inhibitor neratinib
Authors: Z. Tomasevic, L.M. Smyth, C. Saura, V. Boni, J.Á. Garcia-Sáenz, A. Prat, L. Eli, S.J. Garza, A.S. Lalani, J.P. Crown
Journal: Annals of Oncology (2019)

Background: Somatic mutations in HER2 (ERBB2), in the absence of HER2 amplification, are oncogenic and occur in ∼3% to 5% of solid tumors. HER-Seq (PUMA-NER-9501; ClinicalTrials.gov NCT03786107) is an international genomic screening study for the identification of patients with HER2-mutant breast or cervical cancer, who may be eligible for neratinib clinical trials. Neratinib, an irreversible pan-HER tyrosine kinase inhibitor, has reported clinical activity in HER2-mutant cancers, with the greatest efficacy observed in breast and cervical cancer. The ongoing Phase II SUMMIT trial for HER2-mutant cancers examines the safety and efficacy of neratinib as monotherapy or in combination (ClinicalTrials.gov NCT01953926; EudraCT 2013-002872-42). Identification of somatic HER2 mutations using a rapid and minimally-invasive test offers a novel therapeutic opportunity for this rare molecular cancer subtype. Trial design: Patients with histologically-confirmed metastatic breast cancer (MBC) or metastatic cervical cancer (MCC) on active treatment or in follow-up, may be enrolled. Blood samples are collected for circulating tumor DNA (ctDNA) analysis at 3–6-month intervals (coincident with scheduled patient visits). Samples are sequenced centrally for the detection of somatic HER2 mutations, using a custom targeted next-generation sequencing (NGS) assay. Patients found to have a mutation in HER2 are then eligible to screen for therapeutic studies with neratinib. Eligible patients are ≥18 years of age with histologically-confirmed MBC or MCC, an ECOG status of 0–2, and are able to provide blood samples. Excluded are patients with known HER2-positive/HER2-amplified MBC, or those who have previously received neratinib. Editorial acknowledgement: Lee Miller (Miller Medical Communications Ltd). Clinical trial identification: NCT03786107. Legal entity responsible for the study: Puma Biotechnology Inc. Funding: Puma Biotechnology Inc. Disclosure: L.M. Smyth: Consulting or advisory role: Roche Genentech, AstraZenaca; Research funding (Inst): Puma Biotechnology, AstraZeneca, Roche Genentech; Travel, accommodations, expenses: Pfizer; Honoraria: Pfizer, AstraZeneca. C. Saura: Consulting fees: Puma Biotechnology Inc. V. Boni: Consulting/advisory board: Loxo therapeutics, Ideya. L. Eli, S.J. Garza: Employee: Puma Biotechnology Inc. A.S. Lalani: Employee, shareholder: Puma Biotechnology Inc. All other authors have declared no conflicts of interest.
Identifying the Transcriptome Signatures of Calcium Channel Blockers in Human Induced Pluripotent Stem Cell–Derived Cardiomyocytes
Authors: Chi Keung Lam, Lei Tian, Nadjet Belbachir, Alexa Wnorowski, Rajani Shrestha, Ning Ma, Tomoya Kitani, June-Wha Rhee, Joseph C. Wu
Journal: Circulation Research (2019)

Calcium channel blockers (CCBs) are an important class of drugs in managing cardiovascular diseases. Patients usually rely on these medications for the remainder of their lives after diagnosis. Although the acute pharmacological actions of CCBs in the hearts are well-defined, little is known about the drug-specific effects on human cardiomyocyte transcriptomes and physiological alterations after long-term exposure.This study aimed to simulate chronic CCB treatment and to examine both the functional and transcriptomic changes in human cardiomyocytes.We differentiated cardiomyocytes and generated engineered heart tissues from 3 human induced pluripotent stem cell lines and exposed them to 4 different CCBs-nifedipine, amlodipine, diltiazem, and verapamil-at their physiological serum concentrations for 2 weeks. Without inducing cell death and damage to myofilament structure, CCBs elicited line-specific inhibition on calcium kinetics and contractility. While all 4 CCBs exerted similar inhibition on calcium kinetics, verapamil applied the strongest inhibition on cardiomyocyte contractile function. By profiling cardiomyocyte transcriptome after CCB treatment, we identified little overlap in their transcriptome signatures. Verapamil is the only inhibitor that reduced the expression of contraction-related genes, such as MYH (myosin heavy chain) and troponin I, consistent with its depressive effects on contractile function. The reduction of these contraction-related genes may also explain the responsiveness of patients with hypertrophic cardiomyopathy to verapamil in managing left ventricular outflow tract obstruction.This is the first study to identify the transcriptome signatures of different CCBs in human cardiomyocytes. The distinct gene expression patterns suggest that although the 4 inhibitors act on the same target, they may have distinct effects on normal cardiac cell physiology.
Turkish doctors protest as 11 of their leaders are imprisoned
Authors: Owen Dyer
Journal: BMJ (2019)

Members of the Turkish Medical Association (TTB) gathered at the Ministry of Justice in Ankara on 14 May to petition against prison sentences imposed on their leadership for criticising a Turkish army operation in Syria.

All 11 members of the group’s central council were arrested in raids across the country in January 2018, after the group put out a statement saying “war is a public health problem,” in response to a Turkish army incursion into the Kurdish controlled Syrian district of Afrin.

On 5 May, 10 of the 11 were sentenced to 20 months’ imprisonment for “provoking people into animosity and hatred.”

They are Mehmet Rasit Tukel, Ayfer Horasan, Bulent Nazim Yilmaz, Dursun Yasar Ulutas, Funda Barlik Obuz, Mehmet Sezai Berber, Mustafa Tamer Goren, Selma …
EUS-GUIDED DOUBLE BILIARY DRAINAGE FOR COMPLEX MALIGNANT HILAR BILIARY OBSTRUCTION
Authors: P Kongkam, S Safa, R Reknimitr, W Ridtitid, C Boonmee
Journal: Endoscopy (2019)

Endoscopic ultrasound guided biliary drainage (EUS BD) is a novel technique to rescue patients who had failed ERCP biliary drainage due to significant stricture or because of surgically altered anatomy.
PROSPECTIVE EVALUATION OF CONECCT CLASSIFICATION WITH 237 COLORECTAL ESD
Authors: J Albouys, M Pioche, M Fabritius, R Legros, J Rivory, D Sautereauau, T Ponchon, J Jacques
Journal: Endoscopy (2019)

Several classifications has been developed to predict the risk of submucosal invasion in case of superficial colorectal lesion. We developed the CONECCT classification that merged all existing classification (Paris, SANO, KUDO, WASP, LST, NICE) in one table to simplify endoscopic characterization.
MAGNIFICATION ENDOSCOPY WITH OPTICAL CHROMOENDOSCOPY FOR THE IN VIVO ASSESSMENT OF HISTOLOGIC INFLAMMATION IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE
Authors: E Klenske, R Atreya, A Hartmann, S Fischer, S Hirschmann, S Zundler, M Iacucci, M Neurath, T Rath
Journal: Endoscopy (2019)

Apart from mucosal healing as an established treatment goal in inflammatory bowel diseases (IBD), recent evidence suggests that histologic healing is another key prognostic parameter in IBD patients. Herein we aimed to evaluate whether magnification endoscopy in combination with optical chromoendoscopy can accurately assess histologic inflammation in IBD patients.
Association of Sugary Beverage Consumption With Mortality Risk in US Adults
Authors: Lindsay J. Collin, Suzanne Judd, Monika Safford, Viola Vaccarino, Jean A. Welsh
Journal: JAMA Network Open (2019)

Research has linked sugar-sweetened beverage (SSB) consumption to coronary heart disease (CHD) risk, but the role of nutritionally similar fruit juice and the association of these beverages with mortality risk is unknown.
Breast cancer risk in transgender people receiving hormone treatment: nationwide cohort study in the Netherlands
Authors: Christel J M de Blok, Chantal M Wiepjes, Nienke M Nota, Klaartje van Engelen, Muriel A Adank, Koen M A Dreijerink, Ellis Barbé, Inge R H M Konings, Martin den Heijer
Journal: BMJ (2019)

Abstract Objective To investigate the incidence and characteristics of breast cancer in transgender people in the Netherlands compared with the general Dutch population. Design Retrospective, nationwide cohort study. Setting Specialised tertiary gender clinic in Amsterdam, the Netherlands. Participants 2260 adult trans women (male sex assigned at birth, female gender identity) and 1229 adult trans men (female sex assigned at birth, male gender identity) who received gender affirming hormone treatment. Main outcome measures Incidence and characteristics (eg, histology, hormone receptor status) of breast cancer in transgender people. Results The total person time in this cohort was 33 991 years for trans women and 14 883 years for trans men. In the 2260 trans women in the cohort, 15 cases of invasive breast cancer were identified (median duration of hormone treatment 18 years, range 7-37 years). This was 46-fold higher than in cisgender men (standardised incidence ratio 46.7, 95% confidence interval 27.2 to 75.4) but lower than in cisgender women (0.3, 0.2 to 0.4). Most tumours were of ductal origin and oestrogen and progesterone receptor positive, and 8.3% were human epidermal growth factor 2 (HER2) positive. In 1229 trans men, four cases of invasive breast cancer were identified (median duration of hormone treatment 15 years, range 2-17 years). This was lower than expected compared with cisgender women (standardised incidence ratio 0.2, 95% confidence interval 0.1 to 0.5). Conclusions This study showed an increased risk of breast cancer in trans women compared with cisgender men, and a lower risk in trans men compared with cisgender women. In trans women, the risk of breast cancer increased during a relatively short duration of hormone treatment and the characteristics of the breast cancer resembled a more female pattern. These results suggest that breast cancer screening guidelines for cisgender people are sufficient for transgender people using hormone treatment.