tbuckley/cabot-search huggingface dataset:
Efficacy of Artificial Pancreas Use in Patients With Type 2 Diabetes Using Intensive Insulin Therapy: A Randomized Crossover Pilot Trial
Authors: Nadine Taleb, André C. Carpentier, Virginie Messier, Martin Ladouceur, Ahmad Haidar, Rémi Rabasa-Lhoret
Journal: Diabetes Care (2019)

Artificial pancreas (AP) systems have proven efficacy and superiority in glucose control compared with other insulin delivery methods in patients with type 1 diabetes (1,2). Patients with type 2 diabetes (T2D) requiring intensive insulin therapy are difficult to treat and could potentially benefit from AP. Two published reports have addressed AP and T2D in hospitalized patients, with overall results favoring AP (2,3). We aimed to test the applicability of a single-hormone (SH) (insulin only) AP algorithm in patients with T2D who require multiple daily injections (MDI) of insulin.

We conducted an open-label, randomized, crossover study to compare glucose control under SH-AP and MDI in adults with T2D (≥55 years old, BMI >25 kg/m2, on ≥3 insulin injections/day). Exclusion criteria were change in hypoglycemic agents within 6 weeks prior to or during the study, creatinine clearance <30 mL/min, macrovascular event within the past 6 months, infections and hospitalization within the past 2 months, severe hypoglycemia in the past 2 weeks, or morning basal insulin. Participants were recruited at diabetes clinics of three Canadian (Quebec) participating centers. Respective ethics committees approved the study with written informed consent. Dexcom G4 Platinum (Dexcom, San Diego, CA) was inserted 24 h before interventions and calibrated 2–3 times/day. In a crossover design, each participant underwent two 24-h intervention visits using SH-AP and MDI in randomized order (separated by at least 3 days). Schedules were identical between these interventions: arrival at the research center at 6:30 p.m. (dinner and insulin bolus prior to that at home), standardized evening snack, next day’s breakfast at 8:00 a.m., lunch at 12:00 p.m., dinner at 5:00 p.m., 15-min walks at 10:00 a.m. and 3:00 p.m., and …
OUTCOMES OF COLONOSCOPY WITH NON-ANESTHESIOLOGIST ADMINISTERED PROPOFOL (NAAP)
Authors: M Alburquerque, A Smarrelli, J Chevarria, S Ortega, A Zaragoza, A Vargas, C Ledezma, L Vidal, M Figa, F González-Huix
Journal: Endoscopy (2019)

To determine the equivalence of adenoma detection rate (ADR) in colorectal cancer (CRC) screening colonoscopies performed with NAAP and performed with monitored anesthesia care (MAC).
Predictors of mortality in patients with yellow fever: an observational cohort study
Authors: Esper G Kallas, Luiz Gonzaga F A B D'Elia Zanella, Carlos Henrique V Moreira, Renata Buccheri, Gabriela B F Diniz, Anna Carla P Castiñeiras, Priscilla R Costa, Juliana Z C Dias, Mariana P Marmorato, Alice T W Song, Alvino Maestri, Igor C Borges, Daniel Joelsons, Natalia B Cerqueira, Nathália C Santiago e Souza, Ingra Morales Claro, Ester C Sabino, José Eduardo Levi, Vivian I Avelino-Silva, Yeh-Li Ho
Journal: The Lancet Infectious Diseases (2019)
DIAGNOSTIC OF HELICOBACTER PYLORI VIA ENDOSCOPY: THE CLINICAL ISSUE OF SUPPRESSIVE CONDITIONS
Authors: RF Knoop, V Ellenrieder, A Neesse, S Kunsch
Journal: Endoscopy (2019)

Testing for Helicobacter pylori (H. p.) is frequently conducted during esophagogastroduodenoscopy (EGD). Proton-pump inhibitors (PPI), upper gastrointestinal bleedings and recent antibiotic treatment deteriorate H. p. test quality.
Cardiac Devices Enveloped with an Ounce of Prevention
Authors: Federico Perez, Robert A Bonomo
Journal: New England Journal of Medicine (2019)

Infections involving cardiac implantable electronic devices (CIEDs) are challenging to treat. Primary infections, mostly pocket infections occurring at the time of implantation, usually require removal of the device, thus adding to the cost and morbidity associated with CIEDs. Secondary infections, resulting from bacteremia from a remote source, often lead to endocarditis with additional devastating outcomes. Despite the effectiveness of current standard strategies for prevention of CIED infections (i.e., sterile surgical techniques and the timely administration of preoperative antibiotics), the potential to achieve further reductions in infection rates exists.1 In this issue of the Journal, Tarakji et al. report the results . . .
Contrasting Epidemiology and Clinicopathology of Female Breast Cancer in Asians vs the US Population
Authors: Ching-Hung Lin, Yoon Sim Yap, Kyung-Hun Lee, Seock-Ah Im, Yoichi Naito, Winnie Yeo, Takayuki Ueno, Ava Kwong, Huiping Li, Shu-Min Huang, Roland Leung, Wonshik Han, Benita Tan, Fu-Chang Hu, Chiun-Sheng Huang, Ann-Lii Cheng, Yen-Shen Lu
Journal: JNCI Journal of the National Cancer Institute (2019)

The incidence of breast cancer among younger East Asian women has been increasing rapidly over recent decades. This international collaborative study systemically compared the differences in age-specific incidences and pathological characteristics of breast cancer in East Asian women and women of predominantly European ancestry.We excerpted analytic data from six national cancer registries (979 675 cases) and eight hospitals (18 008 cases) in East Asian countries and/or regions and, for comparisons, from the US Surveillance, Epidemiology, and End Results program database. Linear regression analyses of age-specific incidences of female breast cancer and logistic regression analyses of age-specific pathological characteristics of breast cancer were performed. All statistical tests were two-sided.Unlike female colorectal cancer, the age-specific incidences of breast cancer among East Asian women aged 59 years and younger increased disproportionally over recent decades relative to rates in US contemporaries. For years 2010-2014, the estimated age-specific probability of estrogen receptor positivity increased with age in American patients, whereas that of triple-negative breast cancer (TNBC) declined with age. No similar trends were evident in East Asian patients; their probability of estrogen receptor positivity at age 40-49 years was statistically significantly higher (odd ratio [OR] = 1.50, 95% confidence interval [CI] = 1.36 to 1.67, P < .001) and of TNBC was statistically significantly lower (OR = 0.79, 95% CI = 0.71 to 0.88, P < .001), whereas the probability of ER positivity at age 50-59 years was statistically significantly lower (OR = 0.88, 95% CI = 0.828 to 0.95, P < .001). Subgroup analyses of US Surveillance, Epidemiology, and End Results data showed similarly distinct patterns between East Asian American and white American patients.Contrasting age-specific incidences and pathological characteristics of breast cancer between East Asian and American women, as well as between East Asian Americans and white Americans, suggests racial differences in the biology.
Developing a Quality of Cancer Survivorship Care Framework: Implications for Clinical Care, Research, and Policy
Authors: Larissa Nekhlyudov, Michelle A Mollica, Paul B Jacobsen, Deborah K Mayer, Lawrence N Shulman, Ann M Geiger
Journal: JNCI Journal of the National Cancer Institute (2019)

There are now close to 17 million cancer survivors in the United States, and this number is expected to continue to grow. One decade ago the Institute of Medicine report, From Cancer Patient to Cancer Survivor: Lost in Transition, outlined 10 recommendations aiming to provide coordinated, comprehensive care for cancer survivors. Although there has been noteworthy progress made since the release of the report, gaps remain in research, clinical practice, and policy. Specifically, the recommendation calling for the development of quality measures in cancer survivorship care has yet to be fulfilled. In this commentary, we describe the development of a comprehensive, evidence-based cancer survivorship care quality framework and propose the next steps to systematically apply it in clinical settings, research, and policy.
The Power and Limits of Classification — A 32-Year-Old Man with Abdominal Pain
Authors: Daphna Stroumsa, Elizabeth F.S. Roberts, Hadrian Kinnear, Lisa H. Harris
Journal: New England Journal of Medicine (2019)

Interview with Dr. Daphna Stroumsa on the limitations of classification systems in health care and their potential effects on patients. (10:36)Download A 32-year-old transgender man, presenting with severe lower abdominal pain and hypertension, is classified as a man who hasn’t taken his blood-pressure medications. When examined several hours later, he’s found to be pregnant, but no fetal heartbeat can be detected.
Improved survival of young patients with breast cancer ≤ 40 years of age at diagnosis
Authors: J. El Dick, L.E. Khalil, M. Charafeddine, P. El Tomb, J. Fares, N.S. El Saghir
Journal: Annals of Oncology (2019)

Background: Breast cancer in young women is generally considered to carry a worse prognosis. 50% of our patients (pts) are below the age of 50. We looked at our young patients age <40 years (y) with breast cancer at the American University of Beirut, assessed stages, characteristics and outcome. Methods: Data on breast cancer in young pts seen at our institution between the years 2005 to 2018 was reviewed. Survival was calculated from date of diagnosis till recurrence, death, or last follow up. IRB approval was obtained. Results: Total number of pts ≤ 40 was 345. Over 300 pts had complete survival data. The median age at diagnosis was 36 years, IDC was present in 94.5% of cases, ILC in 1.2% of cases, and DCIS in 4.3%. Grade 1 disease was present in 8.9% of pts, grade 2 in 36.0%, grade 3 in 55.1%. HER2 positive pts in 28.9%, hormone receptor positive (ER &/or PR) in 75.9%, and 14.8% had triple negative breast cancer (TNBC). 58.2% of pts with Early Breast Cancer (EBC) had a partial mastectomy while 41.8% had a total mastectomy. 45.8% of all pts received adjuvant chemotherapy and 26.5% received neoadjuvant therapy (chemotherapy with or without anti-HER2 therapy). All hormone receptor positive pts received adjuvant hormonal therapy. 53.7% had EBC (stage I, IIA, IIB subset T2N1M0) while 26.7% had Locally Advanced (LABC): IIB subset T3N0M0, IIIA & IIIB. 14.0% had metastatic cancer at diagnosis and 11.2% of pts developed recurrent metastatic disease while 23.2% had metastatic de novo or recurrent disease. Overall Survival (OS) of pts with early stage was 97.8% at 5 years (y) and 77.5% at 10y; OS of pts with LABC was 91.3% at 5y and 73.7% at 10y. OS of pts with de novo MBC was 58.3% at 5y and 43.7% at 10y. OS of pts with recurrent metastatic disease was 70.3% at 5y and 35.6% at 10y while 5y survival of metastatic de novo or recurrent metastatic disease combined is 63.5% and 34.5% at 10 yr. Conclusions: Prognosis of breast cancer in young women is improved with modern management that includes neoadjuvant therapy, surgery (that included 60% with partial mastectomy), radiation, targeted and adjuvant therapy according to their tumor characteristics, and stage. Young women with breast cancer can be reassured that their age does not mean they have a bad outcome. Biology and tumor characteristics and modern management determine outcome. Legal entity responsible for the study: American University of Beirut Medical Center. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
Human rights and legal dimensions of self care interventions for sexual and reproductive health
Authors: Laura Ferguson, Susana Fried, Thabo Matsaseng, Sundari Ravindran, Sofia Gruskin
Journal: BMJ (2019)

Understanding the user, the health system, and the environment is key to ensuring that self care interventions for sexual and reproductive health are not only available but safe and empowering for all, say <b>Laura Ferguson and colleagues</b>
Two-Year Follow-Up after Treatment with the Cognitive Behavioral Analysis System of Psychotherapy versus Supportive Psychotherapy for Early-Onset Chronic Depression
Authors: Elisabeth Schramm, Levente Kriston, Moritz Elsaesser, Thomas Fangmeier, Ramona Meister, Paul Bausch, Ingo Zobel, Josef Bailer, Katrin Wambach, Matthias Backenstrass, Jan Philipp Klein, Dieter Schoepf, Knut Schnell, Antje Gumz, Bernd Löwe, Henrik Walter, Markus Wolf, Katharina Domschke, Mathias Berger, Martin Hautzinger, Martin Härter
Journal: Psychotherapy and Psychosomatics (2019)

&lt;b&gt;&lt;i&gt;Background:&lt;/i&gt;&lt;/b&gt; Evidence on the long-term efficacy of psychotherapeutic approaches for chronic depression is scarce. &lt;b&gt;&lt;i&gt;Objective:&lt;/i&gt;&lt;/b&gt; To evaluate the effects of the Cognitive Behavioral Analysis System of Psychotherapy (CBASP) compared to Supportive Psychotherapy (SP) 1 year and 2 years after treatment termination. &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; In this study, we present 1- and 2-year follow-up assessments of a prospective, multicenter, evaluator-blinded, randomized clinical trial of outpatients with early-onset chronic major depression (&lt;i&gt;n&lt;/i&gt; = 268). The initial treatment included 32 sessions of CBASP or SP over 48 weeks. The primary outcome was the rate of “well weeks” (Longitudinal Interval Follow-Up Evaluation; no/minimal symptoms) after 1 year and 2 years. The secondary outcomes were, among others, clinician- and self-rated depressive symptoms, response/remission rates, and quality of life. &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; Of the 268 randomized patients, 207 (77%) participated in the follow-up. In the intention-to-treat analysis, there was no statistically significant difference between CBASP and SP patients in experiencing well weeks (CBASP: mean [SD] of 48.6 [36.9] weeks; SP: 39.0 [34.8]; rate ratio 1.26, 95% CI 0.99–1.59, &lt;i&gt;p&lt;/i&gt; = 0.057, &lt;i&gt;d&lt;/i&gt; = 0.18) and in remission rates (CBASP: 1 year 40%, 2 years 40.2%; SP: 1 year 28.9%, 2 years 33%) in the 2 years after treatment. Statistically significant effects were found in favor of CBASP 1 year after treatment termination regarding the rate of well weeks, self-rated depressive symptoms, and depression-related quality of life. &lt;b&gt;&lt;i&gt;Conclusions:&lt;/i&gt;&lt;/b&gt; CBASP lost its superiority over SP at some point between the first and the second year. This suggests the necessity of maintenance treatment for early-onset chronically depressed patients remitted with CBASP during the acute therapy phase, as well as the sequential integration of other treatment strategies, including medication for those who did not reach remission.
Enhancing Lung Tumor Visibility Using In-Vivo Analyzer-Based X-Ray Phase Contrast Imaging In Mouse : A Feasibility Study
Authors: L. Fardin, Ludovic Broche, J. L Coll, Anders Larsson, S. Bayat, A. Bravin
Journal: American Journal of Respiratory and Critical Care Medicine (2017)

Enhancing Lung Tumor Visibility Using In-Vivo Analyzer-Based X-Ray Phase Contrast Imaging In Mouse : A Feasibility Study
ENDOSCOPIC REMOVAL OF MIGRATED ADJUSTABLE GASTRIC BANDING
Authors: V Bove, I Boškoski, A Tringali, R Landi, P Familiari, V Perri, G Costamagna
Journal: Endoscopy (2019)

Intragastric band migrations or dysfunctions are common long-term complications of laparoscopic adjustable gastric banding (Lap-Band) that classically require surgical treatment. In this video case we describe the endoscopic removal of partially eroded Lap-Bands.
Midazolam or haloperidol premedication reduced ketamine-induced recovery agitation and increased ED recovery time
Authors: Philip Lee, Heather Murray
Journal: Annals of Internal Medicine (2019)

Source Citation Akhlaghi N, Payandemehr P, Yaseri M, Akhlaghi AA, Abdolrazaghnejad A. Premedication with midazolam or haloperidol to prevent recovery agitation in adults undergoing procedural sedation with ketamine: a randomized double-blind clinical trial. Ann Emerg Med. 2019. [Epub ahead of print]. 30611640
Abstract B74: Prevention of breast cancer by withanolides
Authors: Shivendra V. Singh
Journal: Clinical Cancer Research (2018)

Abstract Malignancy of the breast is a leading cause of cancer-related deaths among women globally. Feasibility of breast cancer prevention is illustrated by clinical success with SERMs and aromatase inhibitors for ER+ breast cancers. However, a clinically viable preventive intervention targeting ER-negative breast cancers is still lacking. Constituents of Ayurvedic medicine, which has been practiced in India for thousands of years, continue to draw attention for identification of novel small molecules potentially useful for prevention of chronic diseases including cancer. This presentation summarizes efficacy data, molecular targets, and biomarkers of mammary cancer prevention by a small-molecule steroidal lactone (withaferin A) derived from an Ayurvedic medicinal plant (Withania somnifera). This work was supported by the grant US PHS grant RO1 CA142694-05 from the National Cancer Institute. Citation Format: Shivendra V. Singh. Prevention of breast cancer by withanolides [abstract]. In: Proceedings of the AACR International Conference held in cooperation with the Latin American Cooperative Oncology Group (LACOG) on Translational Cancer Medicine; May 4-6, 2017; São Paulo, Brazil. Philadelphia (PA): AACR; Clin Cancer Res 2018;24(1_Suppl):Abstract nr B74.
ENDOSCOPIC TREATMENT OF BOERHAAVE'S SYNDROME IN A PATIENT WITH PREVIOUS HELLER'S MIOTOMY AND GASTRIC BYPASS: “CHIKEN SOUP IS NOT GOOD FOR THE HEART”
Authors: A Baptista, M Guzman, A Salinas
Journal: Endoscopy (2019)

Boerhaave's Syndrome or spontaneous rupture of the esophagus is a critical event with high mortality if untreated in the first 24 hours. Endoscopic management has been described.
RISK OF INFECTION FOLLOWED BY COLONOSCOPIC POLYPECTOMY IN PATIENTS WITH LIVER CIRRHOSIS: A KASID MULTICENTER STUDY
Authors: HW Kang, HG Kim, Y Jung, DB Kim, SJ Koh, HS Lee, K Nam, J Park, J Chum, CH Yang
Journal: Endoscopy (2019)

Liver cirrhosis is an immunocompromised state. However, there have been no study about infection rates and related risk factors in the patients with liver cirrhosis followed by colonoscopic polypectomy including endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD). We aimed to evaluate the incidence of infectious complication followed by polypectomy and investigate risk factors of infectious complication in these patients.
REPEATED ENDOSCOPIC ULTRASUND (EUS)-GUIDED FINE NEEDLE ASPIRATION (EUS-FNA) AFTER NON-DIAGNOSTIC OR INCONCLUSIVE RESULTS – A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: A Lisotti, P Fusaroli
Journal: Endoscopy (2019)

EUS-guided fine needle aspiration (EUS-FNA) is the gold standard technique for the pathological diagnosis of solid pancreatic lesions. Several studies have been conducted to assess the role of repeat EUS-FNA after an inconclusive index study, reporting different outcomes. The aim of this study was to evaluate the pooled diagnostic accuracy of repeated EUS-FNA after previous non-diagnostic or inconclusive results on first attempt.
A Comparison of Payments to a For-profit Dialysis Firm From Government and Commercial Insurers
Authors: Christopher P. Childers, Jill Q. Dworsky, Gerald Kominski, Melinda Maggard-Gibbons
Journal: JAMA Internal Medicine (2019)

This study assesses differences in payments from government and commercial insurers to dialysis clinics using data from a single for-profit organization.
CHOLANGIOSCOPY AND PANCREATOSCOPY ARE SAFE AND ARE ASSOCIATED WITH HIGH CLINICAL IMPACT
Authors: D Wengrower, D Livovsky, J Patz, E Goldin
Journal: Endoscopy (2019)

Diagnosis and effective management of complex biliary and pancreatic duct abnormalities is challenging. We evaluate the utility of peroral cholangioscopy and pancretoscopy with targeted biopsy in these patients.
Abstract 20095: Arrhythmogenic Right Ventricular Cardiomyopathy or Athlete’S Heart? - Special Derived Cardiac Magnetic Resonance Parameters Help the Differential Diagnosis
Authors: Ibolya Csécs, Csilla Czimbalmos, Nóra Sydó, Ferenc I Suhai, Zsófia Dohy, Orsolya Kiss, Attila Tóth, Béla Merkely, Hajnalka Vágó
Journal: Circulation (2017)

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a major cause of life-threatening arrhythmias in young athletes. However in highly trained athletes the diagnosis is challenging because of...
IFN-γ-independent immune markers of Mycobacterium tuberculosis exposure
Authors: Lenette L. Lu, Malisa T. Smith, Krystle K. Q. Yu, Corinne Luedemann, Todd J. Suscovich, Patricia S. Grace, Adam Cain, Wen Han Yu, Tanya R. McKitrick, Douglas Lauffenburger, Richard D. Cummings, Harriet Mayanja-Kizza, Thomas R. Hawn, W. Henry Boom, Catherine M. Stein, Sarah M. Fortune, Chetan Seshadri, Galit Alter
Journal: Nature Medicine (2019)

Exposure to Mycobacterium tuberculosis (Mtb) results in heterogeneous clinical outcomes including primary progressive tuberculosis and latent Mtb infection (LTBI). Mtb infection is identified using the tuberculin skin test and interferon-γ (IFN-γ) release assay IGRA, and a positive result may prompt chemoprophylaxis to prevent progression to tuberculosis. In the present study, we report on a cohort of Ugandan individuals who were household contacts of patients with TB. These individuals were highly exposed to Mtb but tested negative by IFN-γ release assay and tuberculin skin test, ‘resisting’ development of classic LTBI. We show that ‘resisters’ possess IgM, class-switched IgG antibody responses and non-IFN-γ T cell responses to the Mtb-specific proteins ESAT6 and CFP10, immunologic evidence of exposure to Mtb. Compared to subjects with classic LTBI, ‘resisters’ display enhanced antibody avidity and distinct Mtb-specific IgG Fc profiles. These data reveal a distinctive adaptive immune profile among Mtb-exposed subjects, supporting an expanded definition of the host response to Mtb exposure, with implications for public health and the design of clinical trials. New immune biomarkers of exposure to tuberculosis may require a rethink of evidence of Mycobacterium tuberculosis infection and control.
Endoscopic ischemic polypectomy for small-bowel polyps in patients with Peutz–Jeghers syndrome
Authors: Tsevelnorov Khurelbaatar, Hirotsugu Sakamoto, Tomonori Yano, Yuichi Sagara, Ulzii Dashnyam, Satoshi Shinozaki, Keijiro Sunada, Alan Kawarai Lefor, Hironori Yamamoto
Journal: Endoscopy (2020)

To decrease the risk of bleeding or perforation, ischemic polypectomy is performed using a detachable snare or endoclip with double-balloon endoscopy (DBE) for small-bowel polyps in patients with Peutz - Jeghers syndrome. The aim of this study was to determine the effectiveness and feasibility of ischemic polypectomy.We retrospectively reviewed patients who underwent two or more sessions of ischemic polypectomy using DBE from July 2004 to August 2017.67 therapeutic DBEs were performed in nine patients during the study period and 352 polyps were treated. The median observation period was 34 months (range 12 - 66). There was a declining trend over time in the median number of polyps > 15 mm treated per patient first DBE session 6, second 2, third 1.5, fourth 0.5, fifth 0.5; P = 0.11, Friedman test). No patient required laparotomy due to intussusception during the study period. One patient developed mild acute pancreatitis after the procedure.Ischemic polypectomy was feasible for the control of small-bowel polyps in patients with Peutz - Jeghers syndrome.
Endoscopic ultrasound-guided injection of N-butyl-2-cyanoacrylate into portal venous collateral vessels that were feeding bleeding duodenal varices
Authors: Ingo Wallstabe, Marlen Zurek, Christian Geyer
Journal: Endoscopy (2019)

Endoscopic injection of sclerosants (N-butyl-2-cyanoacrylate, fibrin glue) is a well-established treatment for bleeding gastroesophageal and ectopic varices, with injection into the varices usually performed under direct endoscopic view [1]. Alternatively, injection can be performed under endoscopic ultrasound (EUS) guidance [2] [3] [4]. We describe a case of duodenal varices with recurrent bleeding that were not accessible to direct endoscopic injection because of postoperatively altered anatomy ([Fig. 1] and [Fig. 2]).