tbuckley/cabot-search huggingface dataset:
Tube-in-tube endoscopic vacuum therapy for the closure of upper gastrointestinal fistulas, leaks, and perforations
Authors: Marcelo Simas de Lima, Ricardo Sato Uemura, Carla Cristina Gusmon-Oliveira, Amanda Aquino de Miranda Pombo, Bruno Costa Martins, Luciano Lenz, Fabio Shiguehissa Kawaguti, Gustavo Andrade De Paulo, Elisa Ryoka Baba, Adriana V. Safatle-Ribeiro, Ulysses Ribeiro, Klaus Monkemüller, Fauze Maluf-Filho
Journal: Endoscopy (2022)

Background Although endoscopic vacuum therapy (EVT) has been successfully used to treat postoperative upper gastrointestinal (UGI) wall defects, its use demands special materials and several endoscopic treatment sessions. Herein, we propose a technical modification of EVT using a double tube (tube-in-tube drain) without polyurethane sponges for the drainage element. The tube-in-tube drainage device enables irrigation and application of suction. A flowchart for standardizing the management of postoperative UGI wall defects with this device is presented. Methods An EVT modification was made to achieve frequent fistula cleansing, with 3 % hydrogen peroxide rinsing, and the application of negative pressure. A tube-in-tube drain without polyurethane sponges can be inserted like a nasogastric tube or passed through a previously positioned surgical drain. This was a retrospective two-center observational study, with data collected from 30 consecutive patients. Technical success, clinical success, adverse events, time under therapy, interval time from procedure to fistula diagnosis and treatment start, size of transmural defect, volume of cavity, number of endoscopic treatment sessions, and mortality were reviewed. Results 30 patients with UGI wall defects were treated. The technical and clinical success rates were 100 % and 86.7 %, respectively. Three patients (10 %) had adverse events and three patients (10 %) died. The median time under therapy was of 19 days (range 1–70) and the median number of endoscopic sessions was 3 (range 1–9). Conclusions This standardized approach and EVT modification using a tube-in-tube drain, with frequent fistula cleansing, were successful and safe in a wide variety of UGI wall defects.
Management of Chronic Low Back Pain
Authors: Aaron Conger, Belinda Duszynski, Zachary L. McCormick
Journal: JAMA Internal Medicine (2022)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Internal Medicine HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Internal Medicine journal
20P Risk and management of intracranial progression on amivantamab in epidermal growth factor receptor (EGFR) exon 20 insertion (ex20ins)-mutated non-small cell lung cancer (NSCLC)
Authors: J. Trigo, B.C. Cho, K. Park, N. Girard, S. Viteri, P. Garrido, M.G. Krebs, M. Thayu, R.E. Knoblauch, J. Xie, J.M. Bauml, R.W. Schnepp, A. Londhe, P. Mahadevia, N. Leighl
Journal: Annals of Oncology (2022)
Nudging Behavioral Economics into Nephrology Care Delivery Research
Authors: Adam S. Wilk, Delphine S. Tuot
Journal: Journal of the American Society of Nephrology (2021)

CKD is a global health concern, affecting 7.2%–13.4% of the world's population.[1][1] Although CKD is largely asymptomatic, the economic and health consequences of kidney disease manifested by cardiovascular disease and kidney failure loom large. A recent Kidney Disease Improving Global Outcomes
Rules of Engagement: The Lymphocyte Receptor Ecosystem in Renal Cell Carcinoma
Authors: Chirag Krishna, A. Ari Hakimi
Journal: Cancer Research (2022)

Immune receptor repertoires provide insight into the clonal distribution of tumor-infiltrating lymphocytes, yet the clinical implications of T-cell receptor (TCR) and B-cell receptor (BCR) repertoire diversity in cancer are unclear. In this issue of Cancer Research, Ferral-Fairbanks and colleagues reveal the interplay between repertoire diversity, tumor molecular features, and clinical outcome in renal cell carcinoma (RCC). The authors show that aggressive tumors harbor increasingly diverse TCR and BCR repertoires and that both repertoires are altered by common RCC driver mutations. Moreover, the authors demonstrate that high TCR diversity is associated with improved overall survival. This study highlights the contribution of lymphocyte receptor dynamics to the emerging complexity of RCC antitumor immune responses. See related article by Ferral-Fairbanks et al., p. 929.
An Unusual Case of Bilateral Ureteric Metastasis on PSMA PET-CT Scan in Carcinoma Prostate
Authors: Shreya Dang, Melvika Pereira, Natasha Singh, Divya Shivdasani, Debdip Roy, Jugal Kesariya, Rachita Rungta
Journal: Clinical Nuclear Medicine (2021)

The most common locations for metastasis in adenocarcinoma of the prostate gland are lymph nodes, bone, lung, and liver. The involvement of the ureter as a site of metastasis in prostate carcinoma is quite rare in literature. Here we present a case involving bilateral ureters along with bilateral vesicoureteric junctions in a known case of prostate adenocarcinoma.
Prenatal Exposure to Per- and Polyfluoroalkyl Substances and Facial Features at 5 Years of Age: A Study from the Danish National Birth Cohort
Authors: Jiajun Luo, Cecilia Høst Ramlau-Hansen, Ulrik Schiøler Kesmodel, Jingyuan Xiao, Vasilis Vasiliou, Nicole C. Deziel, Yawei Zhang, Jørn Olsen, Zeyan Liew
Journal: Environmental Health Perspectives (2022)

Background: Per- and polyfluoroalkyl substances (PFAS) are widespread persistent pollutants. Evidence regarding neurodevelopmental effects of PFAS have been mixed. The relation between PFAS exposure and anatomical markers that have been suggested to correlate with fetal brain development have not been studied. Objectives: We investigated the association between prenatal PFAS exposures and three craniofacial features in children measured at 5 years of age. Methods: Measures of palpebral fissure length (PFL), philtrum groove, and upper-lip thickness were generated from standardized digital facial photographs from 656 children in the Danish National Birth Cohort. PFL was classified into two groups (shorter; normal), and the philtrum (grooved; smooth; normal) and upper-lip (thick; thin; normal) measures into three groups each. Six PFAS were measured in maternal plasma (median=8 gestational wk). Multinomial logistic regression was used to estimate the odds ratio (OR) and 95% confidence interval (CI) for each facial feature using the normal group as the reference according to log2-PFAS concentration (in nanograms per milliliter) or PFAS tertiles, adjusting for potential confounders, including maternal alcohol intake and smoking. Stratified analyses by maternal alcohol intake or child's sex were performed. Results: Prenatal exposure to each PFAS was associated with elevated odds for a shorter PFL, with the strongest association observed for perfluorodecanoic acid (PFDA; per doubling OR=2.02; 95% CI: 1.11, 3.70). Some nonlinear associations were found for philtrum measures: the second tertile of PFDA and perfluorononanoic acid were associated with grooved philtrum, whereas the second tertile of perfluoroheptane sulfonate with smooth philtrum. The associations between PFAS exposure and a shorter PFL were stronger among mothers who consumed alcohol in the first trimester, some sex-specific associations were noted for philtrum and upper-lip measures. Discussion: Prenatal PFAS exposures might influence fetal craniofacial development. A larger study is needed to replicate the potential modifying effects observed for alcohol exposure and to clarify whether associations of craniofacial markers observed reflect specific neurologic deficits. https://doi.org/10.1289/EHP9478
Abstract EP36: Socioeconomic Status And Spontaneous Coronary Artery Dissection Outcomes
Authors: Pyi Phyo Aung, Kyeeun Park, Htoo Myat Nge
Journal: Circulation (2022)

Introduction: Spontaneous coronary artery dissection (SCAD) is an emerging cause of myocardial infarction. The epidemiology of SCAD is elucidated with recent investigations and analyses. However, the association between socioeconomic status (SES) and SCAD remains to be studied. We performed this study to identify the effects of SES on SCAD. Methods: We conducted a retrospective analysis of the 2016 to 2018 National Inpatient Sample database and the 2018 to 2019 Nationwide Readmission Database (NRD). Study populations were selected using ICD-10 diagnosis code and ICD-10 procedure code for MCS. Socioeconomic status was evaluated using median household income of patient’s ZIP code and dived into quarter. Discharge-level weight analysis was used to produce a national estimate. We conducted univariate and multivariable hierarchical regression analysis to calculate odds ratio (OR) with STATA 17. Results: During the study period, total 106,970,745 patients were hospitalized of which 30.17% were from 1 st (lowest), 26.26% from 2 nd , 23.76% from 3 rd and 19.82 from 4 th (highest) quartile. 0.02 % (24,560 of 106,970,745) patients were diagnosed with spontaneous coronary artery dissection. When lowest SES was compared to the highest SES quartile, the patients from the lowest SES tended to be diabetic (34.17 % v 18.39%) and younger (48.39 ± 0.01 v 50.16 ± 0.01) and less prevalence of hyperlipidemia (2.79% v 3.86%). The prevalence of hypertension (29.78% v 28.31%) and proportion of male (43.59% v 43.33%) were similar. After adjusting for age, sex and comorbid burden, the lowest SES quartile was associated with lower risk of SCAD when it was compared to highest quartile (OR 0.70; 95% CI 0.65-0.76; p&lt;0.0001). However, the lowest SES quartile was associated with higher in-hospital mortality (OR 1.51; 95%CI 1.07-2.15; p=0.02) and 30-day readmission rate (OR 1.56; 95%CI 1.39 -1.88; p&lt;0.0001) with SCAD when it compared to the highest quartile. Discussion: In this study, the lowest SES was associated with lower risk of SCAD. Individuals with low SES carry substantial burden of cardiovascular diseases. It is possible that SCAD is underdiagnosed in low SES population due to the presence of traditional cardiovascular risk factors. The unfavorable effects of low SES on SCAD can be identified with in-hospital mortality and rate of 30-day readmission. Further research is required to better understand the impact of SES on the outcomes of SCAD.
The contribution of evolutionarily volatile promoters to molecular phenotypes and human trait variation
Authors: Robert S. Young, Lana Talmane, Sophie Marion de Procé, Martin S. Taylor
Journal: Genome biology (2022)

Abstract Background Promoters are sites of transcription initiation that harbour a high concentration of phenotype-associated genetic variation. The evolutionary gain and loss of promoters between species (collectively, termed turnover) is pervasive across mammalian genomes and may play a prominent role in driving human phenotypic diversity. Results We classified human promoters by their evolutionary history during the divergence of mouse and human lineages from a common ancestor. This defined conserved, human-inserted and mouse-deleted promoters, and a class of functional-turnover promoters that align between species but are only active in humans. We show that promoters of all evolutionary categories are hotspots for substitution and often, insertion mutations. Loci with a history of insertion and deletion continue that mode of evolution within contemporary humans. The presence of an evolutionary volatile promoter within a gene is associated with increased expression variance between individuals, but only in the case of human-inserted and mouse-deleted promoters does that correspond to an enrichment of promoter-proximal genetic effects. Despite the enrichment of these molecular quantitative trait loci (QTL) at evolutionarily volatile promoters, this does not translate into a corresponding enrichment of phenotypic traits mapping to these loci. Conclusions Promoter turnover is pervasive in the human genome, and these promoters are rich in molecularly quantifiable but phenotypically inconsequential variation in gene expression. However, since evolutionarily volatile promoters show evidence of selection, coupled with high mutation rates and enrichment of QTLs, this implicates them as a source of evolutionary innovation and phenotypic variation, albeit with a high background of selectively neutral expression variation.
Distinct immune cell dynamics correlate with the immunogenicity and reactogenicity of SARS-CoV-2 mRNA vaccine
Authors: Tomohiro Takano, Miwa Morikawa, Yu Adachi, Kiyomi Kabasawa, Nicolas Sax, Saya Moriyama, Lin Sun, Masanori Isogawa, Ayae Nishiyama, Taishi Onodera, Kazutaka Terahara, Keisuke Tonouchi, Masashi Nishimura, Kentaro Tomii, Kazuo Yamashita, Takayuki Matsumura, Masaharu Shinkai, Yoshimasa Takahashi
Journal: Cell Reports Medicine (2022)

Two doses of Pfizer/BioNTech BNT162b2 mRNA vaccine elicit robust severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-neutralizing antibodies with frequent adverse events. Here, by applying a high-dimensional immune profiling on 92 vaccinees, we identify six vaccine-induced immune dynamics that correlate with the amounts of neutralizing antibodies, the severity of adverse events, or both. The early dynamics of natural killer (NK)/monocyte subsets (CD16+ NK cells, CD56high NK cells, and non-classical monocytes), dendritic cell (DC) subsets (DC3s and CD11c- Axl+ Siglec-6+ [AS]-DCs), and NKT-like cells are revealed as the distinct cell correlates for neutralizing-antibody titers, severity of adverse events, and both, respectively. The cell correlates for neutralizing antibodies or adverse events are consistently associated with elevation of interferon gamma (IFN-γ)-inducible chemokines, but the chemokine receptors CCR2 and CXCR3 are expressed in distinct manners between the two correlates: vaccine-induced expression on the neutralizing-antibody correlate and constitutive expression on the adverse-event correlate. The finding may guide vaccine strategies that balance immunogenicity and reactogenicity.
Combined Inhibition of G9a and EZH2 Suppresses Tumor Growth via Synergistic Induction of IL24-Mediated Apoptosis
Authors: Francesco Casciello, Gregory M. Kelly, Priya Ramarao-Milne, Nabilah Kamal, Teneale A. Stewart, Pamela Mukhopadhyay, Stephen H. Kazakoff, Mariska Miranda, Dorim Kim, Felicity M. Davis, Nicholas K. Hayward, Paula M. Vertino, Nicola Waddell, Frank Gannon, Jason S. Lee
Journal: Cancer Research (2022)

Abstract G9a and EZH2 are two histone methyltransferases commonly upregulated in several cancer types, yet the precise roles that these enzymes play cooperatively in cancer is unclear. We demonstrate here that frequent concurrent upregulation of both G9a and EZH2 occurs in several human tumors. These methyltransferases cooperatively repressed molecular pathways responsible for tumor cell death. In genetically distinct tumor subtypes, concomitant inhibition of G9a and EZH2 potently induced tumor cell death, highlighting the existence of tumor cell survival dependency at the epigenetic level. G9a and EZH2 synergistically repressed expression of genes involved in the induction of endoplasmic reticulum (ER) stress and the production of reactive oxygen species. IL24 was essential for the induction of tumor cell death and was identified as a common target of G9a and EZH2. Loss of function of G9a and EZH2 activated the IL24-ER stress axis and increased apoptosis in cancer cells while not affecting normal cells. These results indicate that G9a and EZH2 promotes the evasion of ER stress–mediated apoptosis by repressing IL24 transcription, therefore suggesting that their inhibition may represent a potential therapeutic strategy for solid cancers. Significance: These findings demonstrate a novel role for G9a and EZH2 histone methyltransferases in suppressing apoptosis, which can be targeted with small molecule inhibitors as a potential approach to improve solid cancer treatment.
SARS-CoV-2 Vaccination in Kidney Transplant Recipients: Should We Consider Intradermal Vaccination?
Authors: Veerle Wijtvliet, Karl Martin Wissing, Daniel Abramowicz, Kristien J. Ledeganck
Journal: Journal of the American Society of Nephrology (2022)

Schrezenmeier and colleagues report a poor effect of a third dose of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination in kidney transplant recipients (KTR) who had no response to the two previous doses (December 2021 issue).1 At 27 days after the third dose, seroconversion was observed in only nine of the 25 (36%) KTR without a previous seroconversion. This low efficacy of booster doses in KTR emphasizes the need for alternative multidose vaccination strategies for transplant recipients and, more broadly, patients who are immunocompromised. Moreover, coronavirus disease 2019 vaccines are still scarce worldwide and a vast majority of the world's population is still awaiting their first jab. The World Health Organization advises prioritizing global vaccination coverage, and preserving booster doses for the populations in greatest need.2 To address these two issues, we feel that intradermal administration should be considered in patients who are immunocompromised.3(preprint) Indeed, a recent report on 38 healthy adults provides preliminary evidence that intradermal injection of SARS-CoV-2 mRNA vaccines is as effective as intramuscular injection.3(preprint) Intradermal SARS-CoV-2 mRNA vaccination (n=24) resulted in equal antibody responses compared with intramuscular vaccination (n=14), using only one fifth to one tenth of the intramuscular dose. The efficacy of the intradermal dose is in line with previous studies on influenza vaccine responses in patients who are nonresponding after kidney transplant, showing significantly greater seroconversion rates and significantly higher peak antibody titers after intradermal booster vaccination compared with intramuscular administration.4 Therefore, intradermal SARS-CoV-2 vaccination has the potential to solve both the scarcity of vaccines at a global level, and to improve efficacy. Studies investigating the clinical efficacy of dose-sparing intradermal SARS-CoV-2 booster vaccines are urgently needed. Disclosures K. Wissing reports having an advisory or leadership role with Astellas and AstraZeneca. All remaining authors have nothing to disclose. Funding None.
MIBG Uptake in Pancreas as a Normal Variant
Authors: Yu Wang, Xu Yang, Wei Wang, Jigang Yang
Journal: Clinical Nuclear Medicine (2021)

Abstract A 5-year-old girl with high-risk neuroblastoma underwent 123 I-MIBG scintigraphy for disease restaging. The whole-body images showed a faint MIBG uptake in the midabdomen. Abdominal SPECT/CT demonstrated the focus locating in the pancreatic head. However, this activity disappeared on delayed acquisition at 6-hour later. Follow-up MIBG scan after 6 months did not show the abnormal MIBG uptake in the pancreatic head. Delayed scan could be helpful for differential diagnosis.
Abstract 017: Clinical Utility Of Genetic Testing For Familial Hypercholesterolemia In A Pediatric Dyslipidemia Clinic
Authors: Adam Ware, Nadaa Kemmou, Briana Sawyer, Layne Wells, Zhining Ou, Mark Yandell, Richard V Williams, Martin Tristani-firouzi
Journal: Circulation (2022)

Background: Familial hypercholesterolemia (FH) in children is diagnosed by identification of a known FH pathogenic variant or clinical criteria. We sought to determine the number of pediatric probands undergoing genetic testing for FH that met clinical criteria, and to evaluate differences between genotype positive and negative probands. Methods: All children ≤18 years old undergoing genetic testing for suspected FH were included. Clinical FH was defined as LDL ≥160 mg/dL and family history of premature CAD in 1 st /2 nd degree relatives. Screening of 1 st /appropriate 2 nd degree family members was recommended at all visits (lipid panel or genetic test) and was complete if obtained within 1 year of proband testing. Probands were stratified based on the presence or absence of known FH pathogenic variants. Wilcoxon rank sum or chi-squared tests compared lipid panel, LP(a), BMI percentile, number of screening tests performed, and family members diagnosed with FH. Results: Of 76 probands (age 12.5±2.9 years, 57% males) with suspected FH and genetic testing; 41 (54%) were genotype positive. Genotype positive probands were more likely to meet clinical criteria (44% vs. 17%, p=0.01), but only 19/41 (46%) had a positive family history. Genotype positive probands had higher total cholesterol (mg/dL) [median (IQR): 260 (242-297) vs. 226 (215-245), p&lt;0.01] and LDL [199 mg/dL (174-229) vs. 153 mg/dL (144-171), p&lt;0.01]. Sex, BMI percentile, family history, HDL, triglycerides, and LP(a) were similar between groups. Genotype positive probands (adopted probands excluded) had more screening tests performed [median (IQR): 4 (2-6) vs. 2 (1-3), p&lt;0.01] and more new family members identified [3 (1-4) vs. 0 (0-1), p&lt;0.01]. Conclusion: Clinical criteria alone underdiagnosed FH in children and a negative family history occurred in over half of pediatric FH patients. A positive genetic diagnosis increased the number of screening tests performed and improved identification of at-risk family members. Therefore, genetic testing should be performed in all suspected pediatric FH patients.