tbuckley/cabot-search huggingface dataset:
Factors associated with SARS-CoV-2 testing, diagnosis and COVID-19 disease among individuals prescribed opioid-agonist treatment: a nationwide retrospective cohort study
Authors: Megan Glancy, Alan Yeung, Andrew McAuley, Norah Palmateer, Jen Bishop, Bob Taylor, Jaroslaw Lang, Lee Barnsdale, Saket Priyadarshi, Sharon Hutchinson
Journal: Clinical Microbiology and Infection (2024)

ObjectivesAmong people receiving opioid-agonist treatment (OAT), the risk of COVID-19 infection and disease may be higher owing to underlying health problems and vulnerable social circumstances. We aimed to determine whether recent OAT, when compared with past exposure, affected the risk of (i) testing for SARS-CoV-2, (ii) testing positive for SARS-CoV-2, and (iii) being hospitalized or dying with COVID-19 disease.MethodsWe included individuals prescribed OAT in Scotland from 2015 to 2020. We performed record linkage to SARS-CoV-2 PCR testing, vaccination, hospitalization, and mortality data, and followed up from March 2020 to December 2021. We used proportional hazards analysis and multivariate logistic regression to estimate associations between recent OAT prescription (in the previous 2 months), compared with past exposure (off treatment for over a year), and COVID-19 outcomes. Models were adjusted for confounders.ResultsAmong 36 093 individuals prescribed OAT, 19 071 (52.9%) were tested for SARS-CoV-2; 2896 (8.3%) tested positive; and 552 (1.5%) were hospitalized or died with COVID-19. Recent OAT, compared with past exposure, was associated with lower odds of testing positive among those tested (aOR, 0.63; 95% CI, 0.57–0.69). However, among those testing positive, recent OAT was associated with two-fold higher odds of hospitalization or death (aOR, 2.04; 95% CI, 1.60–2.59).DiscussionWe found that recent OAT was associated with lower odds of SARS-CoV-2 infection, but with higher odds of disease once diagnosed. Clinical studies are needed to unravel the role of OAT in these associations. An enhanced effort is warranted to increase vaccine coverage among OAT patients to mitigate the severe consequences of COVID-19.
An easy way to retrieve two specimens with one snare
Authors: Song Su, Zimeng Wang, Yawei Bi, Longsong Li, Nanjun Wang, Enqiang Linghu, Ningli Chai
Journal: Endoscopy (2024)

Endoscopic resection of multiple colonic polyps is very common in clinical practice. Successful retrieval of the specimens enables histopathologic evaluation of polyp tissue, which helps determine complete eradication, subsequent management, and endoscopic surveillance interval [1] [2]. However, some specimens may not be extracted by aspiration. In this situation, repeat colonoscope insertion for retrieval of multiple specimens is not only time consuming, but also carries additional risks and discomfort, especially when retrieving polyps in the ascending or transverse colon. Moreover, the process of searching for specimens can at times be extremely frustrating and further prolong the operation time. Herein, we report an easy way to simultaneously retrieve two specimens with one snare, which can reduce the number of repeat colonoscope insertions.
Yet another advantage of saline-immersion therapeutic endoscopy!
Authors: Kosei Hashimoto, Hisashi Fukuda, Toshihiro Fujinuma, Edward J Despott, Hironori Yamamoto
Journal: Endoscopy (2024)

Since its first description, saline-immersion therapeutic endoscopy (SITE) is being increasingly adopted to facilitate endoscopic submucosal dissection (ESD) [1] [2]. SITE enhances access to submucosal pockets, and through buoyancy, obviates any need for traction. It augments visibility through magnification and elimination of smoke/debris, and its minimal distension of the lumen optimizes endoscopic maneuverability and patient comfort [1] [3]. We report a further advantage of SITE.
Intraprocedural hologram support with mixed-reality technique in endoscopic ultrasound-guided biliary drainage
Authors: Kazumasa Nagai, Maki Sugimoto, Takasyoshi Tsuchiya, Ryosuke Tonozuka, Shuntaro Mukai, Kenjiro Yamamoto, Takao Itoi
Journal: Endoscopy (2024)

Endoscopic ultrasound-guided biliary drainage (EUS-BD) is being used increasingly frequently in patients with benign biliary diseases [1] [2]. However, puncturing and exploring the intrahepatic bile duct, which runs in a complicated tortuous fashion, can be challenging using two-dimensional (2D) images of EUS and fluoroscopy. Successful EUS-BD is necessary to understand the biliary anatomy, identify the appropriate puncture point, and advance the guidewire smoothly. Thus, it would be ideal to have a device that could confirm the bile duct route with a three-dimensional (3D) device during the procedure. Holograms, which are computer-generated graphics models, have recently been used with mixed reality techniques as a surgical navigation tool [3] [4]. Herein we report the first case of EUS-BD using a 3D hologram of the bile duct.
Combined endoscopic and laparoscopic anastomosis with lumen-apposing metal stent for treatment of obstructed gastrojejunal anastomotic malignancy
Authors: Chaiti Gandhi, Radhika Chavan, Maitrey Patel, Rushil Solanki, Milind Prajapati, Dushyant Bhatt, Sanjay Rajput
Journal: Endoscopy (2024)

A 75-year-old man with diabetes mellitus, hypertension, ischemic heart disease, and a past history of gastrojejunostomy (40 years back) presented with vomiting and weight loss of 25 kg in 6 months. Gastroscopy showed a proliferative lesion at the anastomotic site with obstructive angulation blocking entry into the efferent loop. Even a guidewire for nasojejunal feeding could not be passed beyond the angulation. Biopsy confirmed moderately differentiated adenocarcinoma. Laboratory evaluation showed moderate anemia (Hb 8.5 g/dL) and hypoproteinemia (total protein 4.6 g/dL, albumin 2.3 g/dL), likely from nutritional deficiency. In view of the patient's poor nutritional status, our inability to place a catheter for EUS-guided gastrojejunostomy, and the high risk of surgery together with the anticipated duration of recovery, a multidisciplinary team opted for combined endoscopy and laparoscopy-guided gastrojejunostomy with a lumen-apposing metal stent (LAMS). During laparoscopy, the jejunal loop was closely approximated to the stomach with a single suture. Simultaneously, a therapeutic endoscope (GIF-ITQ160; Olympus, Tokyo, Japan) was advanced into the stomach. Gastric wall illumination from the laparoscope was visualized with the gastroscope and gastric wall puncture was guided to a point near the suture site ([Fig. 1]). The gastric wall was punctured with an electrocautery-enhanced LAMS (20 × 10 mm Hot Axios; Boston Scientific Corp., Massachusetts, USA). Following puncture of the gastric wall, the delivery system was guided with the laparoscope and passed into the jejunal lumen with the cautery tip ([Video 1], [Fig. 2]). Following deployment of the distal flange, the proximal flange was deployed (after visualization of the black marker) under direct endoscopic view ([Fig. 3]). With deployment of the LAMS, distension of the collapsed jejunum was immediately noted on laparoscopy. For additional safety, another suture was placed between the gastric and the jejunal wall next to the LAMS ([Fig. 4]). Accurate placement of the LAMS was also confirmed fluoroscopically by injection of contrast through the LAMS ([Fig. 5]). The patient was commenced on a liquid diet the following day and was discharged within 24 hours.
Successful closure of large mucosal defect with novel anchor-pronged clip after gastric endoscopic submucosal dissection
Authors: Kenichiro Okimoto, Tomoaki Matsumura, Keisuke Matsusaka, Yuki Ohta, Takashi Taida, Jun Kato, Naoya Kato
Journal: Endoscopy (2024)

Delayed bleeding after gastric endoscopic submucosal dissection (ESD) is a major complication [1] that sometimes leads to shock, and mucosal defect closure to prevent delayed bleeding was reported [2]. However, the thickness of the gastric mucosa and proper muscle layer makes suturing difficult [3]. A recent study reported the closure of an intermediate-size mucosal defect post-gastric ESD with a novel anchor-pronged clip (MANTIS Clip; Boston Scientific, Marlborough, Massachusetts, USA) ([Fig. 1]) [4]. Here, we present the successful closure of large mucosal defect with a MANTIS Clip after gastric ESD ([Video 1]).
Severe bleeding associated with lumen-apposing metal stent placement for walled-off necrosis: bloody memory in WONderland
Authors: Shuichi Tange, Tomotaka Saito, Yousuke Nakai, Tsuyoshi Hamada, Yusuke Watanabe, Naminatsu Takahara, Mitsuhiro Fujishiro
Journal: Endoscopy (2024)

Lumen-apposing metal stents (LAMSs) may facilitate endoscopic ultrasound (EUS)-guided treatment of walled-off necrosis (WON) as a transluminal port for necrosectomy [1] [2]. However, this modality has a risk of potentially lethal bleeding [3] [4]. In this case, we experienced dreadful bleeding when conducting EUS-guided LAMS placement with balloon dilation for direct endoscopic necrosectomy (DEN) ([Video 1]).
Endoscopic submucosal dissection for a rare cause of esophageal mass: Von Recklinghausen's neurofibromatosis
Authors: Huige Wang, Jiyu Zhang, Miao Shi, Bingrong Liu, Dan Liu
Journal: Endoscopy (2024)

A 72-year-old woman was admitted to our hospital with a 20-year history of intermittent subxiphoid pain, which intensified in the past 2 months. Physical examination revealed dermal manifestations suggestive of neurofibromatosis ([Fig. 1]a). Enhanced computed tomography identified thickening of the distal esophageal wall. During upper endoscopy, a mass was observed stretching from the lower esophagus to the gastric cardia, leading to partial esophageal obstruction ([Fig. 1]b). Endoscopic ultrasound depicted a hypoechoic submucosal mass, distinguished by several anechoic lesions extending into the esophageal lumen ([Fig. 1]c). With informed consent from the patient, the mass was successfully excised using endoscopic submucosal dissection ([Fig. 1]d, [Video 1]). The extracted specimen measured 3.0 × 5.0 × 5.0 cm ([Fig. 1]e). Histopathological evaluation confirmed neurofibromatosis, identified by neurofibromatous cells encircling the specimen ([Fig. 1]f). The patient experienced no symptoms and showed no signs of recurrence or residual mass on follow-up endoscopic evaluations over 1 year.
A new T-type electrosurgical knife with waterjet function used in probe mode: a safe technical variant for colorectal endoscopic submucosal dissection
Authors: Felipe Ramos-Zabala, Francisco J. Gallego Rojo, Julio Guilarte López-Mañas, Francisco Gallardo Sánchez, Sara Reina Serrado, Marian García-Mayor, Alejandra Alzina-Pérez
Journal: Endoscopy (2024)

The water-jet hydrodissection technique is an effective method for colorectal endoscopic submucosal dissection (ESD) [1], even during the technique learning curve [2]. The use of the T-type HybridKnife in "probe mode" can facilitate ESD [3], even in complex situations [4] [5]. The design of the new HybridKnife Flex ([Fig. 1]) may improve the precision and safety of the technique.
Rectal cavernous hemangioma: is endoscopic submucosal dissection the new standard of care?
Authors: Francesco Cocomazzi, Marco Gentile, Lucia Dimitri, Antonio Capogreco, Roberta Maselli, Alessandro Repici, Francesco Perri
Journal: Endoscopy (2024)

Cavernous hemangioma is a benign vascular tumor whose incidence is very low in the gastrointestinal (GI) tract. Usually, it arises from the submucosal vascular plexus. Rectosigmoid is the most frequent location. Anemia, pain, and rectal bleeding are the main symptoms. Endoscopic diagnosis is far from easy: a bluish polypoid lesion, sometimes pedunculated, with superficial vascular congestion is typical. On endoscopic ultrasound (EUS) it appears heterogeneous with hypoechoic and hyperechoic areas, the latter attributable to calcifications. Biopsies should be avoided, as they can cause massive hemorrhage. Sclerotherapy, embolization, and surgery have been the most considered treatment over the years [1]. Endoscopic mucosal resection and endoscopic full-thickness resection have been described, but the best technique should be endoscopic submucosal dissection (ESD) [2] [3].
Management of recurrence after peroral endoscopic myotomy and submucosal tunneling endoscopic septum division
Authors: Ke-Yang Fan, Meng-Jiang He, Li Wang, Jia-Qi Xu, Quan-Lin Li, Ping-Hong Zhou
Journal: Endoscopy (2024)

Achalasia sometimes coexists with esophageal diverticulum [1], and the combination of peroral endoscopic myotomy (POEM) and submucosal tunneling endoscopic septum division (STESD) is efficient and safe for relieving the symptom [2] [3]. However, the management of symptom recurrence after this combination of procedures is more challenging due to fibrosis of the submucosa. We present a case of short-term recurrence in a teenager after POEM and STESD, in which achalasia and epiphrenic diverticulum were treated through a repeat POEM procedure.
A novel long-balloon dilator for endoscopic ultrasound-guided hepaticogastrostomy and bridging stenting with partial stent-in-stent method
Authors: Fumitaka Niiya, Naoki Tamai, Jun Noda, Tetsushi Azami, Yuichi Takano, Fumiya Nishimoto, Masatsugu Nagahama
Journal: Endoscopy (2024)

Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) is useful for the drainage of malignant hilar biliary obstructions [1] [2]. The partial stent-in-stent (pSIS) method using the HGS route is helpful for draining the separated right intrahepatic bile duct; however, it is challenging because of long, tight bile duct strictures and difficulty in passing delivery systems through the stent mesh [3]. A novel balloon dilator ([Fig. 1]) with a tapered tip and long dilation portion has recently become available in Japan. This report describes successful implementation of the pSIS method for hilar stenting of the right anterior bile duct (RAD) and right posterior bile duct (RPD) via the HGS route using such a novel long-type balloon dilator ([Video 1]).
Hold-and-drag suturing using a new closure device
Authors: Hiroki Kato, Makoto Kobayashi, Hitoshi Sugiyama
Journal: Endoscopy (2024)

Various suturing techniques have been used to close mucosal defects after endoscopic resection [1] [2] [3]. Hold-and-drag suturing, in which one side of the mucosa is grasped with a graspable endoscopic clip and pulled to the contralateral mucosa for suturing, is highly convenient because it does not require other assistive devices. However, if the tip of the clip does not catch well, it will come off when the hook is opened.
Marking can improve defect closure in endoscopic suturing systems
Authors: Yoen-Young Chuah, Chung-Ying Lee, Ding-Ek Toh, Hsin-Yu Chen, Kun-Feng Tsai, Kuang-I Fu, Chu-Kuang Chou
Journal: Endoscopy (2024)

The emergence of endoscopic suturing systems (ESS) provides a nonsurgical approach to rescuing perforations during endoscopic resection of gastric gastrointestinal tumors [1] [2] [3]. OverStitch Sx (Boston Scientific, Marlborough, Massachusetts, USA) can be applied to most single-channel endoscopes at the cost of hindering maneuverability. Furthermore, achieving complete full-thickness poses a challenge owing to the anatomic complexities and the obscured visibility of the muscle defect beneath the flap. Endoscopic techniques of ESS remain unfamiliar to most endoscopists. The marking technique is occasionally employed in endoscopic sleeve gastroplasty but has seldom been mentioned in the context of defect closure.
Environmentally responsive hydrogel promotes vascular normalization to enhance STING anti-tumor immunity
Authors: Duo Wang, Xiujiao Deng, Jinghao Wang, Shuang Che, Xiaocong Ma, Siqi Zhang, Qiu Dong, Cuiqing Huang, Jifeng Chen, Changzheng Shi, Ming-Rong Zhang, Kuan Hu, Liangping Luo, Zeyu Xiao
Journal: Journal of Controlled Release (2024)
Correction: Endoscopic vacuum therapy for anastomotic leakage after upper gastrointestinal surgery
Authors: Lisanne M. D. Pattynama, Roos E. Pouw, Mark I. van Berge Henegouwen, Freek Daams, Suzanne S. Gisbertz, Jacques J. G. H. M. Bergman, Wietse J. Eshuis
Journal: Endoscopy (2023)
Endoscopic ultrasound-guided mediastinal mass biopsy in an undiagnosed pediatric liver transplant recipient
Authors: Giacomo Emanuele Maria Rizzo, Mario Traina, Dario Ligresti, Lucio Carrozza, Gabriele Rancatore, Giusy Ranucci, Ilaria Tarantino
Journal: Endoscopy (2024)

A 6-year-old girl with biliary atresia underwent a left-sided partial liver transplantation at the age of 1 year, starting immunosuppressive therapy thereafter. She developed portal cavernoma after liver transplantation, which was not treated by shunt meso-rex or interventional radiology. At the age of 5 years, she developed mediastinal lymphadenopathy and pleural effusion due to thoracic duct leak (chylothorax), necessitating bilateral pleurodesis, which resolved the decompensation. After a few months without symptoms, she developed respiratory insufficiency, fever, and cough, requiring oxygen therapy.
The 2023 Annual Report of DataDerm: The database of the American Academy of Dermatology
Authors: Marta J Van Beek, Robert A Swerlick, Steven Daveluy, Toni Kaye, Arik Aninos, Alyssa Burns, Stephanie Bruno, Anh Tran, Matthew Fitzgerald, Caryn D Etkin, Jeffrey P Jacobs
Journal: Journal of the American Academy of Dermatology (2024)
Breaking down barriers between liver, addiction, and mental health services for people with alcohol-related liver disease
Authors: Ashwin D Dhanda, Victoria Allgar, Neeraj Bhala, Lynne Callaghan, Joana Castro, Shilpa Chokshi, Amanda Clements, Colin Drummond, Ewan H Forrest, Lesle Manning, Richard Parker, Debbie L Shawcross, Jennifer Towey
Journal: The Lancet. Gastroenterology & hepatology (2024)
Molecular diagnosis of primary CNS lymphoma in 2024 using MYD88Leu265Pro and IL-10
Authors: Teresa Calimeri, Nicoletta Anzalone, Maria Giulia Cangi, Paolo Fiore, Filippo Gagliardi, Elisabetta Miserocchi, Maurilio Ponzoni, Andrés J M Ferreri
Journal: The Lancet Haematology (2024)
Granulocyte-macrophage colony-stimulating factor neutralisation in patients with axial spondyloarthritis in the UK (NAMASTE): a randomised, double-blind, placebo-controlled, phase 2 trial
Authors: Claudia Worth, M Hussein Al-Mossawi, Joanne Macdonald, Benjamin A Fisher, Antoni Chan, Raj Sengupta, Jonathan Packham, Karl Gaffney, Nicola Gullick, Jonathan A Cook, Tim H Corn, James Teh, Pedro M Machado, Peter C Taylor, Paul Bowness
Journal: The Lancet Rheumatology (2024)

BackgroundGranulocyte-macrophage colony-stimulating factor (GM-CSF) is a proinflammatory cytokine overproduced in several inflammatory and autoimmune diseases, including axial spondyloarthritis. Namilumab is a human IgG1 monoclonal anti-GM-CSF antibody that potently neutralises human GM-CSF. We aimed to assess the efficacy of namilumab in participants with moderate-to-severe active axial spondyloarthritis.MethodsThis proof-of-concept, randomised, double-blind, placebo-controlled, phase 2, Bayesian (NAMASTE) trial was done at nine hospitals in the UK. Participants aged 18–75 years with axial spondyloarthritis, meeting the Assessment in SpondyloArthritis international Society (ASAS) criteria and the ASAS-defined MRI criteria, with active disease as defined by a Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), were eligible. Those who had inadequately responded or had intolerance to previous treatment with an anti-TNF agent were included. Participants were randomly assigned (6:1) to receive subcutaneous namilumab 150 mg or placebo at weeks 0, 2, 6, and 10. Participants, site staff (except pharmacy staff), and central study staff were masked to treatment assignment. The primary endpoint was the proportion of participants who had an ASAS ≥20% improvement (ASAS20) clinical response at week 12 in the full analysis set (all randomly assigned participants). This trial is registered with ClinicalTrials.gov (NCT03622658).FindingsFrom Sept 6, 2018, to July 25, 2019, 60 patients with moderate-to-severe active axial spondyloarthritis were assessed for eligibility and 42 were randomly assigned to receive namilumab (n=36) or placebo (n=six). The mean age of participants was 39·5 years (SD 13·3), 17 were women, 25 were men, 39 were White, and seven had previously received anti-TNF therapy. The primary endpoint was not met. At week 12, the proportion of patients who had an ASAS20 clinical response was lower in the namilumab group (14 of 36) than in the placebo group (three of six; estimated between-group difference 6·8%). The Bayesian posterior probability η was 0·72 (>0·927 suggests high clinical significance). The rates of any treatment-emergent adverse events in the namilumab group were similar to those in the placebo group (31 vs five).InterpretationNamilumab did not show efficacy compared with placebo in patients with active axial spondyloarthritis, but the treatment was generally well tolerated.FundingIzana Bioscience, NIHR Oxford Biomedical Research Centre (BRC), NIHR Birmingham BRC, and Clinical Research Facility.
National, regional, and global trends in insufficient physical activity among adults from 2000 to 2022: a pooled analysis of 507 population-based surveys with 5·7 million participants
Authors: Tessa Strain, Seth Flaxman, Regina Guthold, Elizaveta Semenova, Melanie Cowan, Leanne M Riley, Fiona C Bull, Gretchen A Stevens
Journal: The Lancet Global Health (2024)

BackgroundInsufficient physical activity increases the risk of non-communicable diseases, poor physical and cognitive function, weight gain, and mental ill-health. Global prevalence of adult insufficient physical activity was last published for 2016, with limited trend data. We aimed to estimate the prevalence of insufficient physical activity for 197 countries and territories, from 2000 to 2022.MethodsWe collated physical activity reported by adults (aged ≥18 years) in population-based surveys. Insufficient physical activity was defined as not doing 150 minutes of moderate-intensity activity, 75 minutes of vigorous-intensity activity, or an equivalent combination per week. We used a Bayesian hierarchical model to compute estimates of insufficient physical activity by country or territory, year, age, and sex. We assessed whether countries or territories, regions, and the world would meet the global target of a 15% relative reduction of the prevalence of insufficient physical activity by 2030 if 2010–22 trends continue.FindingsWe included 507 surveys across 163 countries and territories. The global age-standardised prevalence of insufficient physical activity was 31·3% (95% uncertainty interval 28·6–34·0) in 2022, an increase from 23·4% (21·1–26·0) in 2000 and 26·4% (24·8–27·9) in 2010. Prevalence was increasing in 103 (52%) of 197 countries and territories and six (67%) of nine regions, and was declining in the remainder. Prevalence was 5 percentage points higher among female (33·8% [29·9–37·7]) than male (28·7% [25·0–32·6]) individuals. Insufficient physical activity increased in people aged 60 years and older in all regions and both sexes, but age patterns differed for those younger than 60 years. If 2010–22 trends continue, the global target of a 15% relative reduction between 2010 and 2030 will not be met (posterior probability <0·01); however, two regions, Oceania and sub-Saharan Africa, were on track with considerable uncertainty (posterior probabilities 0·70–0·74).InterpretationConcerted multi-sectoral efforts to reduce insufficient physical activity levels are needed to meet the 2030 target. Physical activity promotion should not exacerbate sex, age, or geographical inequalities.FundingMinistry of Public Health, Qatar, and World Health Organization.TranslationsFor the Spanish and Portuguese translations of the abstract see Supplementary Materials section.