tbuckley/cabot-search huggingface dataset:
Relevance of point-of-use sterilisation to improve the quality of endoscope reprocessing
Authors: Y. C. Torres Zamora, C. Cárdenes Betancor, G. Aleman Vega, A. M. Borja Paez
Journal: Endoscopy (2024)

Aims Correct reprocessing of endoscopes is essential to prevent nosocomial infections and to ensure patient safety, and many outbreaks have been described in different studies in relation to poor reprocessing of endoscopes1,2.
Microbiota metabolism of intestinal amino acids impacts host nutrient homeostasis and physiology
Authors: Ting-Ting Li, Xi Chen, Da Huo, Mohammad Arifuzzaman, Shanshan Qiao, Wen-Bing Jin, Huiqing Shi, Xin V. Li, Iliyan D. Iliev, David Artis, Chun-Jun Guo
Journal: Cell Host & Microbe (2024)
Abstract 9386: Marfan Syndrome Mouse Model MgΔ <sup>Lpn</sup> Presents Alterations in Glomerular Architecture and Increased Renal Vascular Resistance. Losartan Treatment Attenuates These Phenotypes
Authors: Rodrigo Barbosa Souza, Dieter P. Reinhardt, Ivan H Koh, Lygia d Pereira
Journal: Circulation (2021)

Introduction: Previously, we have shown that mgΔ lpn murine Marfan syndrome (MFS) model with a fibrillin-1 disruption presents increased Metalloproteinase-9 (MMP-9) expression in the cilliary body in eye. MMP-9 has been related to microfibrils degradation. In this study, we examined the fibrillin-1 and MMP-9 distribution in the kidney and their influence on hemodynamics. Hypothesis: The alteration of fibrillin-1 impacts the glomerular architecture and modify renal hemodynamics. Methods: Female mice at 4 months of age were used: MFS mgΔ lpn mice (n=5); mgΔ lpn treated with losartan for 3 months (n=5); and control wild type mice (n=5). The glomerular structure of the kidney was examined by histology. The distribution and quantification of fibrillin-1 and MMP-9 were analyzed by immunofluorescence assay. Blood flow in the aorta and renal artery was monitored with the probe 2SB-T206 of the Transonic Systems, and the cortical micro-hemodynamic of the kidney was examined by SDF video-microscopy (Sidestream Dark Field Imaging). Results: The mgΔ lpn mice showed reduction of fibrillin-1 deposition and an increase in MMP-9 in the entire kidney tissue, including the glomerular structures. In histologic aspects, the glomerulus showed a reduction of the glomerular area, urinary space, and vascular pole area. The reduced glomerulus dimension possibly squeezes the arteriolar system with a subsequent increase of their vascular resistance. In addition, the cortical microvessels showed a significant reduction in blood flow, and there was an increase in the distribution of microvessels with diameters 6 to 8 μm. Blood flow analysis in the mgΔ lpn showed decreased artery renal flow but did not reveal a difference in aorta blood flow when compared to WT animals. These results indicate vascular resistance in the renal artery. Losartan therapy increased fibrillin-1 and decreased MMP-9 quantifications, improved the glomerulus structures and significantly increased the velocity of the microcirculation blood flow. Conclusions: Alterations in fibrillin-1 modify the glomerular structures and impair kidney hemodynamics. Losartan therapy minimized the renal phenotypes.
Management of recurrent or residual adenoma following resection of large (≥15mm) duodenal laterally spreading lesions
Authors: R. Medas, J. Gauci, F. V. Mandarino, S. Gupta, C. Kerrison, A. Whitfield, H. Wang, M. Sidhu, E.Y. T. Lee, N. Burgess, M. J. Bourke
Journal: Endoscopy (2024)

Aims The rate of recurrent or residual adenoma (RRA) after endoscopic resection (ER) of large (≥15mm) duodenal lateral spreading lesions (D-LSLs) is reportedly 2.3-24.4%. Accurate recognition and treatment of RRA in the duodenum is challenging and data regarding its management is lacking. We sought to analyze the outcomes of treatment of RRA after ER of D-LSLs in a prospective cohort.
Abstract 9398: Dantrolene Prevents Doxorubicin-Induced Cardiac Ryanodine Receptor Dyssynchrony
Authors: Arjun K Aggarwal, Mohammed Ali Azam, Praloy Chakraborty, Stéphane Massé, Ahmed Niri, Patrick F Lai, Sheila Riazi, Filio Billia, Keith Dadson, Kumaraswamy Nanthakumar
Journal: Circulation (2021)

Background: Ryanodine receptor 2 (RyR2) is important for cardiac calcium release from the sarcoplasmic reticulum. RyR2 activation triggers a spatio-temporally regulated calcium spark. Synchronous activation of RyR2 clusters creates a steeper slope and shorter systolic rise time in calcium transients. Doxorubicin (Dox) is a commonly used chemotherapy drug that can lead to dyssynchronous RyR2 activation and cardiomyopathy. We therefore sought to investigate the effects of RyR2 stabilizer dantrolene (Dan) on restoring normal RyR2 synchrony of calcium release in a murine model of doxorubicin-induced cardiomyopathy. Hypothesis: We hypothesize that treatment with dantrolene will mitigate RyR2 dyssynchrony induced by doxorubicin. Methods: 22 adult male C57BL/6 mice were randomly divided into four groups: (i) Control, (ii) Dox only (single intraperitoneal injection, 10 mg/kg on day 7), (iii) Dan only (10 mg/kg daily starting on day 0 through day 21), and (iv) Dan + Dox. Two weeks after Dox treatment, the hearts were harvested and perfused in a Langendorff setup. Calcium-sensitive dye Rhod-2AM and mechanical uncoupler Blebbistatin were infused. Each heart was electrically stimulated following a pace-and-pause protocol during optical mapping of the anterior ventricular wall. Dye fluorescence was recorded and analyzed using custom MATLAB codes. Time to rise (TTR), the time duration for Rhod-2AM fluorescence to rise from minimum (10%) to maximum (90%) in each heartbeat, was used as a means of assessing RyR2 synchrony. Results: TTR was prolonged in the Dox group compared to control (11.6±1.3 ms in Dox group vs. 10.1±0.6 ms in control; at 14 Hz). Treatment with Dan prevented this prolongation (11.6±1.3 ms in Dox group vs. 9.8±0.6 ms in Dan+Dox group; at 14 Hz). Conclusions: Our findings suggest that dantrolene is effective in mitigating RyR2 dyssynchrony induced by doxorubicin.
Long-term outcomes of endoscopic submucosal dissection including papilla (ESDIP) for laterally growing duodenal epithelial tumors
Authors: T. Akimoto, M. Kato, E. Iwasaki, M. Sasaki, D. Minezaki, K. Morioka, H. Sakurai, A. Tojo, M. Sato, K. Iwata, K. Miyazaki, M. Mizutani, Y. Kubosawa, T. Masunaga, Y. Takatori, S. Kawasaki, N. Matsumura, A. Nakayama, T. Sujino, K. Takabayashi, N. Yahagi
Journal: Endoscopy (2024)

Aims We have been actively performing endoscopic submucosal dissection (ESD) including papilla (ESDIP) for laterally growing duodenal epithelial tumors (DET) located on major papilla for en bloc resection aiming at R0 resection. We analyzed the mid- to long-term outcomes of ESDIP to identify the characteristics of lesions with higher therapeutic efficacy.
Abstract 9881: Safety of Bariatric Surgery in Obese Patients with Hypertrophic Cardiomyopathy
Authors: Daokun Sun, Hartzell V Schaff, Travis J McKenzie, Rick A Nishimura, Jeffrey B Geske, Joseph A Dearani, Steve R Ommen
Journal: Circulation (2021)

Introduction: Obesity is an independent risk factor for heart failure in patients with hypertrophic cardiomyopathy (HCM). Bariatric surgery is associated with improved cardiac function in obese patients with heart failure, but the safety of this procedure has not been evaluated in HCM patients. In this study, we examined national trends and early outcomes in bariatric surgery for patients with HCM. Methods: Using the weighted discharge data from the National Inpatient Sample, we identified adult patients with HCM who underwent elective bariatric surgery for obesity between 2011 and 2017. Patients with a history of bariatric surgery or having malignant neoplasms in the esophagus, stomach, small intestine, or pancreas were excluded. Results: A total of 443 obese patients with HCM were identified, and 41.8% (n=185) had obstructive HCM. The annual number of patients increased from 18 in 2011 to 130 in 2017, and nearly half of the patients (48%) had bariatric surgery in 2016 and 2017. Overall, the median (IQR) age was 50 (43-57) years, and 85 (19%) patients were 60 years or older. Approximately 20% (n=90) of the patients had heart failure at the time of operation. Atrial fibrillation was present in 83 (19%) patients, and 22% (n=95) of the cohort had a pacemaker or automatic cardiac defibrillator implanted prior to the operation. Laparoscopic sleeve gastrectomy (72%, n=318) and laparoscopic Roux-en-Y gastric bypass (25%, n=110) were the most commonly performed bariatric procedures. Overall, patients stayed in hospital for a median (IQR) of 2 (1-2) days. During the hospital stay, 1% (n=5) of the patients had acute worsening of chronic heart failure, but there were no deaths, cardiac arrests, or cerebrovascular accidents post procedure. Conclusions: Bariatric surgery in patients with HCM is performed more frequently in recent years and is safe and associated with few perioperative complications. Given the impact of obesity on long-term survival, clinicians should strongly consider bariatric surgery for HCM patients who do not respond to conservative weight loss measures.
Successful endoscopic management of a duodenal-cutaneous fistula using a cardiac septal occluder device
Authors: M. Lajin, N. Khan
Journal: Endoscopy (2024)

Abstract Text 47-year-old male with a history of alcoholic pancreatitis, pancreatic divisum, pancreatic-cutaneous fistula managed by stenting the dorsal duct, and walled-off necrosis managed by cystoduodenostomy/necrosectomy. Five months later, he had a retroperitoneal abscess extending to the groin, treated with I & D, and percutaneous drain.
Endoscopic ultrasound-guided gastroenterostomy with lumen-apposing metal stents: a large retrospective multicentric study of tertiary Italian centers
Authors: G.E. M. Rizzo, E. Forti, A. Fugazza, C. Binda, G. Vanella, F. M. Di Matteo, S. F. Crinò, A. Lisotti, M. Maida, G. Aragona, A. Repici, A. Anderloni, C. Fabbri, I. Tarantino
Journal: Endoscopy (2024)

Aims Endoscopic ultrasonography (EUS) combined with the development of specifically designed stents has significantly increased the indications for EUS guided interventional procedure as in case of patients needing the positioning of a lumen apposing metal stent (LAMS) to create an anastomosis between the stomach and the jejunum (EUS-GE). Moreover, in patients with altered anatomy due to previous surgery, such as Roux-en-Y reconstructions and bariatric surgery, further type of EUS-guided anastomosis permit to perform endoscopic retrograde cholagiopancreatography (ERCP) or to treat afferent limb syndrome, such as gastrogastrostomy (EUS-GG) or jejunojejunostomy (EUS-JJ). The aim of this study is to evaluate performances and safety of EUS-guided anastomosis (EUS-GE, EUS-GG and EUS-JJ) for any indication in a large multicenter study.
Transition to a sustainable endoscopy unit
Authors: C. Lavín Expósito, A. Bouhmidi Assakali, V. Rodriguez Romero, P. Vozmediano Sánchez, M. Velasco Del Burgo, M. Alañon Barba, F. Cebrián Moraleda, M. L. Hidalgo Juárez, J. Pinilla Sánchez, C. Merino Bonillo, A. Sanchez Pardo, M. Sanchez Alonso, E. Barreto, I. Salueña Salueña
Journal: Endoscopy (2024)

Aims Climate change and the destruction of ecosystems by human activities are among the greatest challenges of the 21st century and require urgent action. Healthcare activities contribute significantly to greenhouse gas emissions and waste production, with gastrointestinal endoscopy being one of the largest contributors due to its resource-intensive activity with a significant environmental impact. The Endoscopy Scientific Societies recommend taking immediate action to reduce this environmental impact. The main objetives are:
Abstract 9124: The Role of Mitochondrial Pyruvate Carrier on Myocardial Salvage Following Acute Myocardial Infarction
Authors: Joseph R Visker, JING LING, Hyoin Kwak, Thirupura S S Shankar, Jesse Velasco, Apasia S Thodou, Sutip Navankasattusas, Gregory Ducker, Jared P Rutter, Stavros G Drakos
Journal: Circulation (2021)

Acute myocardial infarction (AMI) may progress to heart failure (HF). Ischemic-reperfusion injury (I/R) accounts for ~50% of the damage post-AMI. Currently, there are minimal interventions to mitigate I/R and prevent HF. Mitochondrial Pyruvate Carrier (MPC) is considered cardio-protective, and deletion causes HF. The purpose of this investigation was to determine if cardiac MPC deletion (MPC -/- ) in mice limits myocardial salvage following I/R. We hypothesized MPC -/- mice would have more necrosis and less myocardial salvage compared to wild type (WT) littermates.MPC1 was targeted in C57Bl/6 mice by placing loxP sites in the introns flanking the exon 3-5 of MPC1. A cardiac-specific deletion was used by intraperitoneal injections of tamoxifen at 8 weeks old. Four weeks post injection, prior to development of HF, mice were intubated, ventilated, and the left anterior descending artery was occluded for 30 minutes then reperfused for 2 hours. Next, Evans-Blue was injected into the heart to define the ischemic area. Hearts of paired littermates between WT (n=6) and MPC -/- (n=6) were excised and cut into 1-mm transverse slices. Slices were stained with triphenyltetrazolium-chloride (TTC) to define myocardial salvage. Next, slices were imaged and quantified by independent researchers using planimetry. Paired t-tests with an α-level of 0.05 were used to compare groups. Litters not subjected to I/R showed significant (p&lt;0.001) MPC1 deletion (WT: 0.28±0.11 au vs. MPC -/- : 0.06±0.02 au). The area at risk (AAR) was comparable (p=0.12) between groups (WT: 46.7±5.9% vs. MPC -/- : 54.3±13.3), indicating equivalent coronary ligation-induced ischemia. Within the AAR, MPC -/- mice showed significantly (p=0.04) more necrosis (MPC -/- : 52.8±10.4% vs. WT: 42.7±17.4%) with less myocardial salvage (MPC -/- : 47.2±10.4% vs. WT: 57.3±10.6%). MPC -/- mice also had significantly (p=0.002) more absolute necrosis (28.4±7.8%) compared to WT mice (19.8±7.8%). There were no significant differences (p&gt;0.05) in percent viable or salvageable tissue in relation to total area. In conclusion, following I/R, MPC -/- mice showed more absolute and standardized necrosis with less myocardial salvage, suggesting when cardiac MPC is reduced it causes more myocardial damage leading to HF.
Cold snare endoscopic resection for large colon polyps – a randomized trial
Authors: H. Pohl, D. K. Rex, J. Barber, M. Moyer, J. Elmunzer, A. Rastogi, S. Gordon, E. Zolotarevsky, J. M. Levenick, H. Aslanian, M. El Atrache, D. Von Renteln, B. Bhaumik, R. Keswani, N. Kumta, D. K. Pleskow, Z. Smith, M. K. Abu Ghanimeh, O. Sanaei, L. L. Jensen, T. Mackenzie, C. Piraka
Journal: Endoscopy (2024)

Aims Despite improvements in technique, severe adverse events (SAE), including post-procedure bleeding, remain a major concern following endoscopic resection of large colorectal polyps. We examined whether cold resection without the use of electrocautery reduces the risk of SAE and affords completeness of resection.
Abstract 9392: Cardiovascular, Metabolic and Safety Outcomes With Semaglutide by Age: A <i>Post Hoc</i> Analysis of SUSTAIN 6 and PIONEER 6
Authors: Mark Petrie, Stephen Bain, Soren Tetens Hoff, Nicklas Johansen, Søren Rasmussen, Tina Vilsboell, Mansoor Husain
Journal: Circulation (2021)

Introduction: For older patients with type 2 diabetes, treatments that minimize the risk of hypoglycemia and provide benefits in terms of comorbidities, while optimizing glycemic control, are particularly important. Semaglutide, a glucagon-like peptide-1 receptor agonist available as a once-weekly (OW) subcutaneous and once-daily oral formulation, reduces HbA 1c and body weight with a low risk of hypoglycemia. In addition, major adverse cardiovascular events (MACE) were reduced in SUSTAIN 6 (OW semaglutide; significant) and PIONEER 6 (oral semaglutide; not significant) vs placebo. The aim of this post hoc analysis was to evaluate cardiovascular (CV), metabolic and safety outcomes with semaglutide according to age. Methods: Subgroup analyses for semaglutide vs placebo by age as quartiles (≤60 years; &gt;60 years to ≤65; &gt;65 years to ≤70 years; &gt;70 years) were performed for pooled SUSTAIN 6 and PIONEER 6 data in relation to: CV (3-point and individual MACE components), metabolic (change in HbA 1c , body weight) and safety (severe hypoglycemia, serious adverse events [SAEs]) outcomes. Results: In patients treated with semaglutide (n=3,239) vs placebo (n=3,241), the reduction in MACE and individual components of MACE was consistent across age subgroups (p interaction &gt;0.05 for all; Table ). Minor heterogeneity for change in HbA 1c from baseline was observed with semaglutide vs placebo across the four age subgroups (p interaction =0.01). Weight reduction with semaglutide vs placebo did not differ across age subgroups. Semaglutide (vs placebo) did not result in an increase in severe hypoglycemia or SAEs in any of the age subgroups ( Table ). Conclusions: This post hoc combined analysis of SUSTAIN 6 and PIONEER 6 indicates that the CV and metabolic benefits and the safety profile of semaglutide (vs placebo) align with the drug class and were consistent across age subgroups.
Abstract 9810: Acute Exposure to Vaping E-Liquid Induces Multiple Cardiotoxic Effects on Fetal-Like Human Induced Pluripotent Stem Cell-Derived Cardiomyocytes and Epicardial Cells
Authors: Miriel Ho, Mirabelle Ho, Clifford Librach
Journal: Circulation (2021)

Introduction: Cardiomyocytes (CM) and epicardial (EPI) cells are key to orchestrating proper heart development. Vaping during pregnancy is rising, however, its implications on the prenatal heart are not fully understood. We exploited the immature phenotype of human induced pluripotent stem (iPS)-derived CM (iCM) and EPI (iEPI) cells to investigate the acute effect of e-cigarette liquid (e-liquid) on early cardiogenesis. Hypothesis: E-liquid exposure triggers dysfunction in fetal-like cardiac cells via distinct mechanisms. Methods: Human iCM and iEPI cultures were exposed to heated e-liquid for 20 minutes, twice daily, for 3 weeks; controls were performed in parallel. Video microscopy monitored morphological alterations and contractions. Immunostaining/flow cytometry of cell markers, Annexin V, EdU incorporation quantified protein expression, cell viability and proliferation, respectively. Mean fluorescence intensity measured reactive oxygen species (ROS). Wound healing assays assessed cell migration. Data reported as mean±SD (n=4/study). Results: Human iPSCs were differentiated into cTnT + iCM and Wt1 + iEPI cells with ≥83% purity. Addition of e-liquid progressively pruned the iCM syncytium, and slowed contractions in small regions from day 12. E-liquid treatment dysregulated HIF1α/p53 signaling in iCM relative to control. This enhanced apoptosis (49±5% vs. 21±6%) and disrupted G 1 /S cell cycle progression (5±1% vs. 15±3% in S-phase). Sustained elevation of ROS production by 35±7% led to ~20% decline in NKX2.5 + progenitors (p&lt;0.05 for all). E-liquid treatment also impaired iEPI motility (77±5% vs. 30±7% of open wound area), and reduced the proportion of iEPI-derived PFGFRβ + pericytes and αSMA + smooth muscle cells by ≥31% (p&lt;0.05 for all). This was attributed to N-cadherin repression and E-cadherin upregulation, which promoted defective epicardial epithelial-to-mesenchymal transition that affected vascular mural cell differentiation. Conclusions: Acute e-liquid exposure is detrimental to iCM and iEPI cell survival, behavior and fate trajectories. Our study suggests that long-term maternal vaping may compromise fetal cardiovascular integrity and maturation, heightening the risk of developing congenital heart disease.
Abstract 9364: Caregiver Anxiety Significantly Reduced from Baseline to 24 Months After Surgery: Findings from the Sustaining Quality of Life of the Aged: Heart Transplant or Mechanical Circulatory Support ( <i>Sustain-it)</i> Study
Authors: Michael Petty, Tingqing Wu, Adin-cristian Andrei, Abigail S Baldridge, Anna Warzecha, Andrew Kao, John Spertus, Eileen M Hsich, Mary Amanda Dew, Duc Thinh Pham, Justin Hartupee, William Cotts, Salpy Pamboukian, Francis D Pagani, Brent Lampert, Maryl R Johnson, Margaret A Murray, Koji Takeda, melana yuzefpolskaya, Scott Silvestry, James K Kirklin, Clyde Yancy, Kathleen L Grady
Journal: Circulation (2021)

Introduction: We previously reported higher health-related quality of life (HRQOL), lower depression scores, and decreased anxiety in caregivers (CGs) of older (60-80 years) heart failure (HF) patients (PTs) treated with destination therapy mechanical circulatory support (DT MCS) or heart transplantation (HT) from baseline (before surgery) to 12 months post-surgery. We expand the analysis of CGs’ HRQOL and symptoms of depression and anxiety through 24-months post-surgery. Methods: From 10/1/15-12/31/18, 13 U.S. centers enrolled 301 CGs of HF PTs: 193 awaiting HT (92 with MCS, 101 without MCS) and 108 DT MCS. At baseline and 24-months post-surgery, CGs completed the following instruments: EQ-5D-3L (Visual Analog Scale [VAS]: 0 [worst]-100 [best] imaginable health state); PHQ-8 (range=0-24; score &gt; 10=current depressive symptoms); and STAI-State (range=20-80, higher score=more anxiety). Analyses included paired t-tests and baseline-adjusted linear regression. Results: CGs average age was 60.9±10 years, 85% were Caucasian, 85% female, and 83% spouses. No significant differences in HRQOL and depressive symptoms were found between groups at baseline, nor were significant changes observed between baseline and 24-months within any group. At baseline, anxiety was higher for CGs of DT MCS PTs compared to CGs of HT MCS (p=0.026) and HT non-MCS PTs (p&lt;0.001; Figure). Between baseline and 24-months, STAI-State total scores were reduced among DT MCS and HT Non-MCS CGs (p=0.019 and p=0.001, respectively), but not among HT MCS CGs (p=0.86). At 24 months, significant between-group differences were observed in all scales: HRQOL was highest in HT non-MCS, depressive symptoms and anxiety highest in HT MCS CGs. Conclusions: Recognizing the impact of HT and DT MCS on CGs of older HF PTs may allow clinicians to provide targeted support to CGs, especially related to anxiety. These findings also may inform PT and CG decision making when considering surgical treatments for HF.
Nurses’ workflow challenges in GI endoscopy services
Authors: C. N. Borja Bruges, I. Martos Pereira, U. Beilenhoff
Journal: Endoscopy (2024)

Aims Nurses can face different challenges in their endoscopy service. In-depth understanding of the pains and challenges in their daily routine is crucial for the improvement of efficiency and overall endoscopy practice, adding value to the hospital workflow, nurses, and patients. This global study investigated gastrointestinal (GI) endoscopy nurses' challenges regarding their service workflow in different hospital settings.