tbuckley/cabot-search huggingface dataset:
HIGH-QUALITY COLON CLEANSING IMPROVES REAL-WORLD IDENTIFICATION OF HIGH-RISK PATIENTS: POST HOC ANALYSIS OF RANDOMISED CLINICAL TRIALS USING TWO VALIDATED CLEANSING SCALES
Authors: J Manning, B Amlani, C Hassan, T Ponchon
Journal: Endoscopy (2019)

Clinical guidelines classify colonoscopy patients with three or more detected adenomas as being at high risk for advanced neoplasia. These patients have a recommended follow-up after 3 years. Our post hoc analysis of three phase 3 randomised clinical trials assessed whether increased colon cleansing quality could improve the real-world identification of high-risk patients.
PERCUTANEOUS ENDOSCOPIC GASTROSTOMY IN HEAD AND NECK CANCER PATIENTS: PREDICTORS OF 30-DAY COMPLICATIONS AND MORTALITY
Authors: F Taveira, M Areia, M João, L Elvas, S Alves, D Brito, S Saraiva, AT Cadime
Journal: Endoscopy (2019)

Chemoradiotherapy is essential in the management of head and neck cancer (HNC) patients. Malnutrition during treatment is a major concern and maintaining an enteral feeding route is critical with percutaneous endoscopic gastrostomy (PEG) placement being an option. We intended to elucidate predictors of 30-day complications and mortality during follow-up of HNC patients undergoing PEG.
US opioid industry beset by legal actions
Authors: Owen Dyer
Journal: BMJ (2019)

Makers and distributors of opioids have been hit by a series of legal, financial, and public relations setbacks in recent days, suggesting that a public reckoning for North America’s opioid crisis is gathering momentum.

On 14 May Pennsylvania filed a lawsuit against Purdue Pharma, alleging that the company deliberately misled doctors and patients. “Purdue created the opioid epidemic that is killing Pennsylvanians,” alleges the legal complaint, which documents 531 000 visits by Purdue sales staff to doctors’ offices, a “barrage” of marketing surpassed only in California.1

“While Pennsylvania paid the price, Purdue made more than $35bn [£27bn; €31bn] in revenue,” said Pennsylvania attorney general Josh Shapiro, announcing the suit. Opioid related fatalities cost the state more than $142bn between 2012 and 2016, he said, and in Pennsylvania an average of 15 people a day died from overdose in 2017.

That annual overdose death rate, 42 per 100 000, compares …
Stiffness Softening: Thermoresponsive Stiffness Softening of Hierarchically Porous Nanohybrid Membranes Promotes Niches for Mesenchymal Stem Cell Differentiation (Adv. Healthcare Mater. 10/2019)
Authors: Linxiao Wu, Adrián Magaz, Arnold Darbyshire, Ashley Howkins, Alan Reynolds, Ian W. Boyd, Hang Song, Jin‐Hua Song, Marilena Loizidou, Mark Emberton, Martin Birchall, Wenhui Song
Journal: Advanced Healthcare Materials (2019)

In article number 1801556 by Wenhui Song and co-workers, a group of porous elastomer nanohybrid scaffolds with thermoresponsive stiffness softening through reversed self-assembly, are reported to promote niches for stem cell differentiation, promising dynamic cell culture platforms, smart scaffolds, implants and coatings for tissue repair and regeneration.
USE OF HIGH-DEFINITION EQUIPMENT IMPROVES POLYP DETECTION RATE: OBSERVATIONS FROM THE EUROPEAN COLONOSCOPY QUALITY INVESTIGATION (ECQI) QUESTIONNAIRE
Authors: A Ono, A Agrawal, P Amaro, L Brink, W Fischbach, M Hünger, R Jover, U Kinnunen, A Koulaouzidis, Á Patai, S Pecere, L Petruzziello, E Toth, JF Riemann, B Amlani, C Spada
Journal: Endoscopy (2019)

To assess the influence of the use of high-definition (HD) equipment on polyp detection rate (PDR) using questionnaire responses from across Europe.
RAPID ON-SITE EVALUATION (ROSE) FOR EUS-GUIDED FINE NEEDLE ASPIRATION (EUS-FNA) OF SOLID PANCREATIC LESIONS: “ON SITE” MULTIDISCIPLINARY TEAM IS THE PIVOT FOR AN ACCURATE DIAGNOSIS
Authors: N Olivari, SM Milluzzo, M Graffeo, M Lovera, D Bianchi, E Padolecchia, C Spada
Journal: Endoscopy (2019)

Compare the adequacy, diagnostic yield and accuracy of EUS-FNA for solid pancreatic lesions before and after introduction of ROSE in a single center study.
Endoscopic ultrasound-guided biliary drainage in high grade biliary hilar obstruction
Authors: Ahmad Hashim, Ali Bessissow, David Valenti, Prosanto Chaudhury, Alan Barkun, Kevin Waschke, Yen-I Chen
Journal: Endoscopy (2019)

Endoscopic ultrasound-guided biliary drainage (EUS-BD) is an effective and evolving modality. Biliary hilar strictures, however, cannot be optimally drained with EUS-BD while both endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous drainage also have their limitations [1] [2] [3]. We describe a novel approach to EUS-BD in collaboration with interventional radiology, where hepaticogastrostomy (HPG) is performed with a bridging hilar stent to achieve optimal drainage in a Bismuth-Corlette type IV (BC-IV) obstruction ([Video 1]).
EUS GUIDED ENTEROENTEROSTOMY FOR AFFERENT LIMB SYNDROME
Authors: H El Bacha, S Leblanc, B Bordacahar, B Brieau, M Barret, S Doat, E Savier, B Dousset, O Soubrane, F Prat
Journal: Endoscopy (2019)

Afferent limb syndrome (ALS) is a rare complication of duodenopancreatectomy resulting from the mechanical obstruction of the afferent limb usually after local malignancy recurrence. Conventional management of ALS (ie surgery and conservative palliative therapy) is often unsatisfactory.
Real‐world effectiveness and safety of dupilumab for the treatment of atopic dermatitis in Japanese patients: a single‐centre retrospective study
Authors: H. Uchida, M. Kamata, I. Mizukawa, A. Watanabe, A. Agematsu, M. Nagata, S. Fukaya, K. Hayashi, A. Fukuyasu, T. Tanaka, T. Ishikawa, T. Ohnishi, Y. Tada
Journal: British Journal of Dermatology (2019)
PERORAL CHOLANGIOPANCREATOSCOPY USING A NEW VIDEOSCOPE (CHF-Y0012)
Authors: Y Igarashi, N Okano, K Itou, Y Kishimoto, K Takuma, S Iwasaki, K Yoshimoto, Y Kimura, Y Yamada, K Watanabe, S Hara
Journal: Endoscopy (2019)

Peroral cholangioscopy (PCS) and pancreatoscopy (PPS) using videoscope (CHF-BP260, CHF-B260, Olympus Co.) was performed since 2002 in our hospital. Endoscopic image is a good, however it is sometime easy to broken. We recently started to use a new videoscope (CHF-Y0012, Olympus Co. Tokyo). In this study, we evaluate with the endoscopic image for diagnosis of the biliary and pancreatic disorder.
Analyse des comptes-rendus de coloscopie établis sur une année dans le cadre du programme de dépistage organisé du cancer colorectal dans un département français
Authors: C Noel, J Jézéquel, F Cholet, F Bommelaere, S Bouzeloc, M Cariou, JB Nousbaum, M Robaszkiewicz
Journal: Endoscopy (2019)

En 2018, sous l'égide du CNP-HGE un groupe de travail piloté par la SFED a défini les critères de qualité de la coloscopie transposables aux pratiques professionnelles françaises. Ces critères, basés sur les recommandations de l'ESGE, sont répartis dans 7 domaines: les critères pré-procédure, le caractère complet de la coloscopie, l'identification des lésions coliques et leur prise en charge, les complications, le vécu du patient et les critères post-procédure (1). Certains éléments doivent obligatoirement figurer dans le compte rendu (CR) de coloscopie afin de permettre une évaluation des pratiques: ce sont la qualité de la préparation colique, les informations relatives à l'anesthésie, le taux d'atteinte cæcale, la description détaillée des lésions et de la technique de résection et la survenue de complications et leur prise en charge. Ces éléments permettent de juger de la qualité d'une coloscopie et d'extraire des indicateurs tels que le taux de détection des adénomes.
Effect of Gemcitabine and nab-Paclitaxel With or Without Hydroxychloroquine on Patients With Advanced Pancreatic Cancer
Authors: Thomas B. Karasic, Mark H. O’Hara, Arturo Loaiza-Bonilla, Kim A. Reiss, Ursina R. Teitelbaum, Erkut Borazanci, Ana De Jesus-Acosta, Colleen Redlinger, Jessica A. Burrell, Daniel A. Laheru, Daniel D. Von Hoff, Ravi K. Amaravadi, Jeffrey A. Drebin, Peter J. O’Dwyer
Journal: JAMA Oncology (2019)

Autophagy is a mechanism of treatment resistance to chemotherapy that has a role in the maintenance of pancreatic cancer. Hydroxychloroquine sulfate (HCQ) is an inhibitor of autophagy that inhibits the fusion of the autophagosome to the lysosome.To determine whether HCQ improves overall survival at 1 year in combination with gemcitabine hydrochloride and nab-paclitaxel (GA) among patients with metastatic pancreatic cancer.Open-label, phase 2 randomized clinical trial conducted between March 18, 2013, and November 16, 2017, at the University of Pennsylvania, HonorHealth, and The Johns Hopkins University among 112 patients with previously untreated metastatic or advanced pancreatic ductal adenocarcinoma, Eastern Cooperative Oncology Group performance status of 0 or 1, and adequate marrow and organ function. All efficacy analyses were performed for the intention-to-treat population.Patients were randomized in a 1:1 ratio to receive GA with or without HCQ. All patients received standard doses of GA, and those randomized to receive HCQ were treated continuously with 600 mg orally twice daily.Overall survival at 1 year.A total of 112 patients (45 women and 67 men; median age, 65 years; range, 43-86 years) were enrolled; 55 were randomized to receive GA plus HCQ, and 57 to receive GA. Overall survival at 12 months was 41% (95% CI, 27%-53%) in the HCQ group and 49% (95% CI, 35%-61%) in the non-HCQ group. Median progression-free survival was 5.7 months (95% CI, 4.0-9.3 months) in the HCQ group and 6.4 months (95% CI, 4.5-7.6 months) in the non-HCQ group. Median overall survival was 11.1 months (95% CI, 9.0-14.2 months) in the HCQ group and 12.1 months (95% CI, 9.3-15.5 months) in the non-HCQ group. Overall response rate was 38.2% (n = 21) in the HCQ group and 21.1% (n = 12) in the non-HCQ group (P = .047). Treatment-related grade 3 or 4 adverse events that differed between the HCQ and non-HCQ groups were neutropenia (23 of 54 [42.6%] vs 12 of 53 [22.6%]), anemia (2 of 54 [3.7%] vs 9 of 53 [17.0%]), fatigue (4 of 54 [7.4%] vs 0), nausea (5 of 54 [9.3%] vs 0), peripheral neuropathy (7 of 54 [13.0%] vs 3 of 53 [5.7%]), visual changes (3 of 54 [5.6%] vs 0), and neuropsychiatric symptoms (3 of 54 [5.6%] vs 0).The addition of HCQ to block autophagy did not improve the primary end point of overall survival at 12 months. These data do not support the routine use of GA plus HCQ for metastatic pancreatic cancer in the absence of a biomarker. However, improvement seen in the overall response rate with HCQ may indicate a role for HCQ in the locally advanced setting, where tumor response may permit resection.ClinicalTrials.gov identifier: NCT01506973.
Initial oral antibiotic therapy was noninferior to IV therapy for treatment failure in orthopedic infection at 1 y
Authors: Matthew D. Harrington
Journal: Annals of Internal Medicine (2019)

ACP Journal Club21 May 2019Initial oral antibiotic therapy was noninferior to IV therapy for treatment failure in orthopedic infection at 1 yMatthew D. Harrington, MDMatthew D. Harrington, MDMount Sinai Beth Israel and Icahn School of Medicine at Mount Sinai, New York, New York, USA (M.D.H.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/ACPJ201905210-058 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationLi HK, Rombach I, Zambellas R, et al; OVIVA Trial Collaborators. Oral versus intravenous antibiotics for bone and joint infection. N Engl J Med. 2019;380:425-36. https://pubmed.ncbi.nlm.nih.gov/30699315Clinical Impact RatingsHospitalists: Infectious Disease: References1 Waldvogel FA, Medoff G, Swartz MN. Osteomyelitis: a review of clinical features, therapeutic considerations and unusual aspects. N Engl J Med. 1970;282:198-206. [PMID: 4902833] Google Scholar2 Conterno LO, Turchi MD. Antibiotics for treating chronic osteomyelitis in adults. Cochrane Database Syst Rev. 2013;(9):CD004439. [PMID: 24014191] Google Scholar Author, Article, and Disclosure InformationAffiliations: Mount Sinai Beth Israel and Icahn School of Medicine at Mount Sinai, New York, New York, USA (M.D.H.)This article was published at Annals.org on 7 May 2019. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 21 May 2019Volume 170, Issue 10Page: JC58KeywordsAntibioticsBoneInfectious diseasesKneesOrthopedicsOsteomyelitisPathogensProsthetic device infectionsResearch assessmentSoft tissue infections ePublished: 21 May 2019 Issue Published: 21 May 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
CD81 is a novel immunotherapeutic target for B cell lymphoma
Authors: Felipe Vences-Catalán, Chiung-Chi Kuo, Ranjani Rajapaksa, Caroline Duault, Noemi Andor, Debra K. Czerwinski, Ronald Levy, Shoshana Levy
Journal: The Journal of Experimental Medicine (2019)

The tetraspanin CD81 was initially discovered by screening mAbs elicited against a human B cell lymphoma for their direct antiproliferative effects. We now show that 5A6, one of the mAbs that target CD81, has therapeutic potential. This antibody inhibits the growth of B cell lymphoma in a xenograft model as effectively as rituximab, which is a standard treatment for B cell lymphoma. Importantly, unlike rituximab, which depletes normal as well as malignant B cells, 5A6 selectively kills human lymphoma cells from fresh biopsy specimens while sparing the normal lymphoid cells in the tumor microenvironment. The 5A6 antibody showed a good safety profile when administered to a mouse transgenic for human CD81. Taken together, these data provide the rationale for the development of the 5A6 mAb and its humanized derivatives as a novel treatment against B cell lymphoma.
ALK-Positive Lung Adenocarcinoma Arising in an Adolescent Treated for Relapsed Neuroblastoma
Authors: Yazeed Alwelaie, Rebecca J. Deyell, Helen R. Nadel, Tracy Tucker, Janessa Laskin, S. Rod Rassekh, Chen Zhou, John C. English, Anna F. Lee
Journal: Journal of Thoracic Oncology (2019)
NV-5138 as a fast-acting antidepressant via direct activation of mTORC1 signaling
Authors: Yuto Hasegawa, Xiaolei Zhu, Atsushi Kamiya
Journal: Journal of Clinical Investigation (2019)

Growing evidence implicates altered mTORC1 signaling cascades in the pathophysiology of depression, suggesting that direct modulation of mTORC1 signaling may offer novel therapeutic potential. In this issue of the JCI, Kato and colleagues reported that administration of NV-5138, a recently developed synthetic leucine analog, has a rapid and sustained antidepressant action in rat models via activation of mTORC1 signaling. The investigators also found that the antidepressant effect of NV-5138 is mediated by upregulation of brain-derived neurotrophic factor (BDNF) signaling and that NV-5138 treatment produces rapid synaptic responses in the medial prefrontal cortex. These findings highlight the direct activation of mTORC1 signaling as a potential pharmacological intervention for the treatment of depression.
A prospective, multicentre, randomized trial comparing vascular access strategies for patients receiving non-trastuzumab containing chemotherapy for early stage breast cancer
Authors: A.A. Awan, B. Basulaiman, A. Robinson, C. Stober, D. Fergusson, A.A. Joy, L. Vandermeer, R. Mallick, D. Saunders, M. Clemons
Journal: Annals of Oncology (2019)

Background: Chemotherapy for patients with early stage breast cancer (EBC) can be administered through either a peripheral vein or a central line (i.e. PICC or PORT) associated with different risks, benefits and costs. As the optimal type of vascular access is unknown, the feasibility of using a novel pragmatic trial model with integrated oral consent model to compare peripheral with central access was performed. Methods: Patients with EBC receiving non-trastuzumab containing chemotherapy were randomised to either peripheral or central line insertion. Our primary feasibility endpoint would be met if > 25% of appropriate patients approached agreed to randomisation and if > 25% of physicians who agreed to participate in the trial approached patients. Other outcomes included rates of line-associated complications. Results: Of 159 patients approached, 150/159 (94.3%) agreed to randomization and 7/31 (22.5%) of physicians approached patients. 77 (51.3%) patients were randomized to peripheral and 73 (48.7%) to central access. For patients in the central access arm, PICCs were used in 72/73 (99%). Rates of complications in the peripheral vs central access groups were; thrombotic events (1 [0.67%] vs 3 [2.0%], p = 0.35), line infections (0 [0%] vs 1 [0.67%], p = 0.1084), phlebitis (1 [0.67%] vs 0 [0%], p = 0.35), and extravasations/infiltrations (4 [2.67%] vs 0 [0%], p = 0.1245). Overall, 4.67% (7/150) and 4.67% (7/150) of patients had a complication in the peripheral and central access arms respectively (p = 1.00). Among patients randomized to peripheral access, 9/77 (11.7%) subsequently required a central line. Conclusions: The study did not meet both its a priori criteria to demonstrate feasibility as physician engagement was <25%. However, this prospectively performed randomised trial demonstrated that while the frequency of access-associated complications was similar, the different nature of events (e.g. thrombosis versus extravasations/infiltrations/phlebitis) means that more studies are needed. Importantly, these future studies will need to overcome the barrier of physician participation. Clinical trial identification: NCT02688998. Legal entity responsible for the study: Mark Clemons. Funding: Rethinking Clinical Trials (REaCT Program). Disclosure: All authors have declared no conflicts of interest.
Abstract 18080: Three-Dimensional Echocardiographic Wall Motion Tracking Assessment of Right Ventricular and Right Atrial Remodeling as Prognostic Predictors in Patients With Pulmonary Hypertension
Authors: Masataka Sugahara, Nobuyuki Kagiyama, Nina E Hasselberg, Simon Marc, John Gorcsan
Journal: Circulation (2017)

Background: Chronic pulmonary hypertension (PH) is associated with variable degrees of right ventricular (RV) remodeling and right atrial (RA) remodeling. Hypothesis: We hypothesized that three-dim...
Abstract 17253: Chest Compression Hemodynamics are Dependent on Chest Compression Rate
Authors: Joshua W Lampe, Tai Yin, George Bratinov, Wes Shoap, Yuxi Lin, Christopher L Kaufman, Lance B Becker
Journal: Circulation (2015)

Introduction: The mechanisms through which chest compressions (CC) generate blood flow remain controversial. The thoracic pump model is CC rate insensitive in the range 60 - 150 compressions per minute (cpm) but is sensitive to change in CC duty cycle with the prediction that increasing duty cycle would result in a modest, but linear, decrease in minute blood flow at a constant rate. Thus, the recently reported relationship between CC rate and outcomes may be due to changes in duty cycle instead of changes in rate. Methods: CPR was performed on nine domestic swine (∼30 Kg) using standard physiological monitoring. Flow was measured in the abdominal aorta, the inferior vena cava (IVC), the right renal artery and vein, the right common carotid and external jugular. Ventricular fibrillation (VF) was electrically induced. Mechanical CC were started after ten minutes of VF. CC were delivered at a rate of 50, 75, 100, 125, or 150 cpm and at a depth of 2” for a total of 54 min. CC rates were changed every 2 min and were randomized. The compression time was held constant at 350 ms. Results: CC generated blood flow showed a significant rate/duty cycle dependence and time dependence in all measured blood vessels. Early in the resuscitation, blood flows were optimized by rates above 100 cpm. As CC continued both the net blood flow and the optimal CC rate decreased as shown in Figure 1. Using previously collected data at 100 cpm and varying duty cycles, we found that minute blood flow did not decrease linearly with duty cycle, as predicted by the thoracic pump model. Conclusions: The optimal CC rate during CPR changes as a function of time suggesting that a fixed CC rate is not optimal. However, the data support the choice of ∼100 cpm as the “best” choice for a fixed CC rate. While some aspects of the observed rate effect may be explained by changes in CC duty cycle, these data do not support the idea that CC generated blood flow is independent of rate in the range 60-150 cpm.
Frank Ivor Tovey
Authors: Rosemary Dove
Journal: BMJ (2019)

Frank Ivor Tovey was born to a prominent family in Bath on 1 September 1921 and died in Southampton General Hospital from bronchopneumonia on 29 April 2019.

After secondary education at Kingswood School, he attended Bristol University Medical School where he graduated MB ChB Hons (gold medallist) in 1944. As was possible at that time, he passed primary FRCS (Eng) at the same time as he took the 2nd MB examination. After hospital training posts in surgical specialties, Frank became a fellow of the Royal College of Surgeons (Eng) in November 1947.

In 1945 he had applied to and been accepted by the Methodist Missionary Society (MMS) for service overseas, and in 1948, as a qualified surgeon, he and his new wife, Winnie, travelled to Chaotung in the mountains …
ENDOSCOPIC DRAINAGE OF A GIANT NON-RESECTABLE IPMN AFTER PANCREATOSCOPY-GUIDED DIAGNOSTIC
Authors: A Lupu, C Mallard, J Rivory, F Rostain, M Adham, T Walter, M Pioche
Journal: Endoscopy (2019)

A 73 years-old male presented with a giant cystic lesion developed in the pancreatic lodge. The MRI confirmed a 180/70 mm collection, with T2 enhancement, developed from the main pancreatic duct. Patient had always been asymptomatic and we suspected a giant mucinous tumour or a large walled off necrosis after a misdiagnosed acute pancreatitis.
Palbociclib plus fulvestrant as second- or later-line therapy for patients with locally advanced, inoperable or metastatic HR+/HER2- breast cancer in Germany: Interim results of the INGE-B phase II study
Authors: D. Lüftner, M.K. Welslau, R. Liersch, M. Deryal, C. Brucker, J. Rauh, A. Welt, M. Zaiss, J. Sahlmann, L. Houet, C. Vannier, K. Potthoff, N.W. Marschner
Journal: Annals of Oncology (2019)
IMPACT OF TRAINEE INVOLVEMENT ON TECHNICAL OUTCOME OF ERCP PROCEDURES AND PATIENT SAFETY: RESULTS OF A PROSPECTIVE MULTICENTER TRIAL
Authors: T Voiosu, A Ladic, A Bengus, I Boskoski, B Busuioc, I Klarin, A Voiosu, V Bove, I Jovanovic, M Rimbas, R Bogdan Mateescu, N Rustemovic, G Costamagna
Journal: Endoscopy (2019)

Quality standards for the practice of ERCP have been recently updated; however there is limited data regarding the impact of trainee involvement on procedure-related outcomes and patient safety. We aimed to evaluate whether trainee involvement increases the risk of procedure failure or adverse events.
Long-Term Effectiveness of Cognitive Therapy for Refractory Social Anxiety Disorder: One-Year Follow-Up of a Randomized Controlled Trial
Authors: Naoki Yoshinaga, Kazumi Kubota, Kensuke Yoshimura, Rieko Takanashi, Yasushi Ishida, Masaomi Iyo, Takashi Fukuda, Eiji Shimizu
Journal: Psychotherapy and Psychosomatics (2019)