tbuckley/cabot-search huggingface dataset:
Cabozantinib monotherapy for advanced adrenocortical carcinoma: a single-arm, phase 2 trial
Authors: Matthew T Campbell, Vania Balderrama-Brondani, Camilo Jimenez, Gina Tamsen, Leonardo P Marcal, Jeena Varghese, Amishi Y Shah, James P Long, Miao Zhang, Joshua Ochieng, Cara Haymaker, Mouhammed Amir Habra
Journal: The Lancet Oncology (2024)
A rare case of delayed duodenal perforation due to an over-the-scope clip
Authors: Yujiro Kawakami, Shinji Yoshii, Masahiro Taniguchi, Yoshiharu Masaki, Taro Sugawara, Yasutoshi Kimura, Hiroshi Nakase
Journal: Endoscopy (2024)

A 53-year-old man was referred to our department because of jaundice. We performed endoscopic retrograde cholangiopancreatography, which revealed an ampullary carcinoma. Endoscopic biliary and pancreatic stenting were performed ([Fig. 1]); however, 3 days later, the patient developed a fever and abdominal pain. Computed tomography (CT) revealed a duodenal perforation due to stent deviation ([Fig. 2]). Esophagogastroduodenoscopy confirmed the duodenal perforation opposite the papilla that had been caused by a pancreatic stent. We deployed an over-the-scope (OTS) clip (Ovesco Endoscopy AG, Tübingen, Germany) for closure of the perforated site ([Fig. 3]; [Video 1]). Subsequently, we performed percutaneous drainage for a retroperitoneal abscess that formed, extending from the site of the perforation to the pelvis. The retroperitoneal abscess did not improve, even after 3 weeks of drainage. Contrast imaging of the percutaneous drainage tube revealed leakage from the side of the OTS clip deployment site ([Fig. 4]). We diagnosed the patient as having a delayed perforation due to the OTS clip and performed pancreaticoduodenectomy. Histopathological findings showed perforation of all layers in the area of the OTS clip ([Fig. 5]).
A radiation-free novel approach for intestinal stent placement: the “scope-in-scope” technique
Authors: Jiaqing Hu, Jinhui Zheng, Changshun Yang, Xiang Gao, Xianbin Guo, Xiaoling Zheng
Journal: Endoscopy (2024)

An elderly woman with persistent abdominal pain and bloating was diagnosed with obstructive sigmoid colon cancer on computed tomography (CT) ([Fig. 1]). Because of a low oxygen saturation value caused by secondary aspiration pneumonia she was admitted to the intensive care unit; therefore transfer to a fluoroscopy-equipped operating room was inappropriate.
Endoscopic ultrasound-guided vascular intervention for pancreaticojejunal variceal bleeding
Authors: Nozomi Okuno, Kazuo Hara, Shin Haba, Takamichi Kuwahara, Minako Urata, Takashi Kondo, Yoshitaro Yamamoto
Journal: Endoscopy (2024)

Ectopic variceal bleeding is rare, only accounting for up to 5% of all variceal bleeding [1]; however, a previous study reported a higher risk of bleeding and mortality for ectopic varices than for esophageal varices [2]. Endoscopic treatment can be difficult because of difficulty in identifying the location of the bleeding [3]. Endoscopic ultrasound (EUS)-guided vascular intervention has recently been reported to be particularly useful in situations where traditional approaches may be challenging or ineffective [4].
Detective flow imaging endoscopic ultrasound for localizing pancreatic insulinomas that are undetectable with other imaging modalities
Authors: Shinichi Nihei, Yusuke Kurita, Sho Hasegawa, Kunihiro Hosono, Noritoshi Kobayashi, Kensuke Kubota, Atsushi Nakajima
Journal: Endoscopy (2024)

Among pancreatic neuroendocrine tumors (PNETs), pancreatic insulinomas are often particularly difficult to detect by imaging studies, making localization diagnosis difficult [1] [2]. Recently, the new technique of detective flow imaging endoscopic ultrasound (DFI-EUS), which is capable of displaying minute blood flow in the entire pancreas without contrast medium, has been introduced. We report a pancreatic insulinoma that was difficult to detect with other imaging tests, and for which DFI-EUS was useful for tumor detection.
Ileus tube-assisted endoscopic detorsion as a useful initial management for cecal volvulus in a patient with septic shock
Authors: Hideaki Kazumori, Takashi Sato
Journal: Endoscopy (2024)

A 70-year-old man with abdominal pain and vomiting came to our emergency department, and was found to be in a serious condition. Arterial blood gas analysis showed a pH of 7.24, with bicarbonate 12.9 mmol/L, lactate 6.51 mmol/L, and anion gap 26.7 mmol/L, and therefore lactic acidosis was considered. Laboratory results found elevated aspartate aminotransferase at 463 U/L, alanine aminotransferase at 371 U/L, creatine kinase at 1566 U/L, and lactate dehydrogenase at 779 U/L. Computed tomography findings indicated that his cecum was grossly dilated and inverted, and mesenteric whirl signs were also noted ([Fig. 1]). A diagnosis of cecal volvulus with intestinal necrosis was made.
An unusual complication following endoscopic ultrasound-directed transgastric ERCP in a patient with a history of bariatric surgery
Authors: Daniele Balducci, Clément Archimbaud, Jean-Philippe Ratone, Yanis Dahel, Solene Hoibian, Fabrice Caillol, Marc Giovannini
Journal: Endoscopy (2024)

We present the case of a 56-year-old woman with a history of sleeve gastrectomy and gastric bypass who developed an atypical complication following gastro–gastric anastomosis during an endoscopic ultrasound (EUS)-directed transgastric endoscopic retrograde cholangiopancreatography (ERCP) procedure (EDGE) to access the biliary tract. The patient had undergone sleeve gastrectomy followed by gastric bypass 7 years previously for severe gastroesophageal reflux disease. She was referred to our center for management of symptomatic biliary tract stones. EUS confirmed the presence of biliary lithiasis and EDGE was planned for biliary access.
Endoscopic hemostasis with bipolar forceps coagulation for post-endoscopic sphincterotomy bleeding
Authors: Haruo Miwa, Kazuya Sugimori, Kazuki Endo, Ritsuko Oishi, Hiromi Tsuchiya, Takashi Kaneko, Shin Maeda
Journal: Endoscopy (2024)

Post-endoscopic sphincterotomy (EST) bleeding is a well-known complication; however, an optimal procedure for endoscopic hemostasis has not been determined [1]. Electrocoagulation using bipolar forceps (Hemostat Y; Pentax, Tokyo, Japan) has been documented as effective for gastrointestinal bleeding while minimizing the risk of excessive tissue injury [2] [3] [4] ([Fig. 1]). The bipolar forceps are available in both open and closed forms, and their soft and thin nature makes them compatible with the elevator system of a duodenoscope ([Fig. 2]).
Lotus sign: The lumen-apposing metal stent that failed to bloom
Authors: Gabriel Liu Yuan Cher, Yu-Ting Kuo, Chen-Ling Peng, Hsiu-Po Wang
Journal: Endoscopy (2024)

Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) with the use of a lumen-apposing metal stent (LAMS) has emerged as a promising modality for the treatment of a malignant gastric outlet obstruction (MGOO) [1]. The design of single-step delivery systems of LAMSs can significantly reduce the risk of adverse events. However, the process of stent deployment is the crucial step in determining the success of EUS-GE. This report describes the case of a patient who underwent EUS-GE with the deployment of the proximal flange of the LAMS failing to open.
Finding the needle in a haystack: single-balloon enteroscopy to diagnose diffuse large B-cell lymphoma
Authors: Reid D. Wasserman, William F. Abel, David Lebel, Klaus Mönkemüller, Paul Yeaton, Vivek Kesar, Varun Kesar
Journal: Endoscopy (2024)

A 74-year-old woman who was on warfarin for a past medical history of atrial fibrillation and a mechanical mitral valve was admitted with symptomatic anemia. The patient reported fatigue, shortness of breath, and epigastric abdominal pain, with associated black stools for a week. Her physical examination was unremarkable. Laboratory investigations were notable for a normocytic anemia (hemoglobin 6.2 g/dL), with an international normalized ratio (INR) of 1.6 and a prothrombin time of 19.5 seconds. The patient underwent esophagogastroduodenoscopy and colonoscopy, with there being no evidence of active bleeding. She continued to have persistent drops in her hemoglobin requiring several transfusions during her admission. Subsequent video capsule endoscopy revealed blood intermittently in the mid-to-distal small bowel ([Video 1]). Computed tomography with enterography of the abdomen and pelvis revealed no acute intra-abdominal process. Push enteroscopy was subsequently performed, with examination of the jejunum being normal ([Fig. 1]). Further evaluation with single-balloon push enteroscopy revealed an ulcerated lesion of 1 cm, with no active bleeding in the jejunum ([Fig. 2]). The lesion was biopsied, and the rest of the examination was unremarkable. Biopsies showed an infiltrate of large atypical lymphocytes within the lamina propria of the small bowel with architectural destruction and lymphoepithelial lesions ([Fig. 3] a). PAX-5 immunohistochemical staining identified these atypical lymphocytes to be B cells ([Fig. 3] b). The histology and remaining immunohistochemical stains (not shown) were diagnostic of a diffuse large B-cell lymphoma (DLBCL), activated B-cell subtype.
The case of infected intra-abdominal hematoma complicating endoscopic ultrasound-guided tissue acquisition
Authors: Daiki Agarie, Susumu Hijioka, Yoshikuni Nagashio, Yuta Maruki, Mark Chatto, Yutaka Saito, Takuji Okusaka
Journal: Endoscopy (2024)

Endoscopic ultrasound-guided tissue acquisition (EUS-TA) rarely causes complications. Severe bleeding requiring blood transfusion or hemostasis has occurred only in 0.05–0.2% of cases [1] [2] [3]. Herein we report, to the best of our knowledge, the first case of EUS-TA complicated by an infected intra-abdominal hematoma ([Video 1]).
A novel endoscopic electrocoagulation hemostasis technique for uncontrolled intraprocedural bleeding: series connection of foreign body forceps and hemostatic forceps
Authors: Ruide Liu, Xianglei Yuan, Jia Liu, Shuang Liu, Jia Xie, Bing Hu
Journal: Endoscopy (2024)

Intraprocedural bleeding is unavoidable during endoscopic procedures [1] [2]. Minor bleeding from small vessels can typically be managed with an electric knife, while significant bleeding from larger vessels requires the use of hemostatic forceps [3] [4]. In cases of uncontrollable severe bleeding, clips can be used as rescue treatment, but their use may impede subsequent procedures. Here, we introduce a method using foreign body forceps and hemostatic forceps to achieve hemostasis for emergency massive bleeding during endoscopic full-thickness resection (EFTR).
Asparagine Synthetase Marks a Distinct Dependency Threshold for Cardiomyocyte Dedifferentiation
Authors: Yike Zhu, Matthew Ackers-Johnson, Muthu K. Shanmugam, Leroy Sivappiragasam Pakkiri, Chester Lee Drum, Yanpu Chen, Johnny Kim, Wyatt G. Paltzer, Ahmed I. Mahmoud, Wilson Lek Wen Tan, Mick Chang Jie Lee, Jianming Jiang, Danh Anh Tuan Luu, Shi Ling Ng, Peter Yi Qing Li, Anhui Wang, Rong Qi, Gabriel Jing Xiang Ong, Timothy Yu Ng, Jody J. Haigh, Zenia Tiang, A. Mark Richards, Roger S.Y. Foo
Journal: Circulation (2024)

Adult mammalian cardiomyocytes have limited proliferative capacity, but in specifically induced contexts they traverse through cell-cycle reentry, offering the potential for heart regeneration. Endogenous cardiomyocyte proliferation is preceded by cardiomyocyte dedifferentiation (CMDD), wherein adult cardiomyocytes revert to a less matured state that is distinct from the classical myocardial fetal stress gene response associated with heart failure. However, very little is known about CMDD as a defined cardiomyocyte cell state in transition.
Xpert MTB/RIF Ultra versus mycobacterial growth indicator tube liquid culture for detection of Mycobacterium tuberculosis in symptomatic adults: a diagnostic accuracy study
Authors: Yingda L Xie, Christie Eichberg, Nchimunya Hapeela, Elizabeth Nakabugo, Irene Anyango, Kiranjot Arora, Jeffrey E Korte, Ronald Odero, Judi van Heerden, Widaad Zemanay, Samuel Kennedy, Pamela Nabeta, Mahmud Hanif, Camilla Rodrigues, Alena Skrahina, Wendy Stevens, Reynaldo Dietze, Xin Liu, Jerrold J Ellner, David Alland, Moses L Joloba, Samuel G Schumacher, Kimberly D McCarthy, Lydia Nakiyingi, Susan E Dorman
Journal: The Lancet Microbe (2024)

BackgroundXpert MTB/RIF Ultra (Ultra) is an automated molecular test for the detection of Mycobacterium tuberculosis in sputum. We compared the sensitivity of Ultra to that of mycobacterial growth indicator tube (MGIT) liquid culture, considered the most sensitive assay in routine clinical use.MethodsIn this prospective, multicentre, cross-sectional diagnostic accuracy study, we used a non-inferiority design to assess whether the sensitivity of a single Ultra test was non-inferior to that of a single liquid culture for detection of M tuberculosis in sputum. We enrolled adults (age ≥18 years) with pulmonary tuberculosis symptoms in 11 countries and each adult provided three sputum specimens with a minimum volume of 2 mL over 2 days. Ultra was done directly on sputum 1, and Ultra and MGIT liquid culture were done on resuspended pellet from sputum 2. Results of MGIT and solid media cultures done on sputum 3 were considered the reference standard. The pre-defined non-inferiority margin was 5·0%.FindingsBetween Feb 18, 2016, and Dec 4, 2019, we enrolled 2906 participants. 2600 (89%) participants were analysed, including 639 (25%) of 2600 who were positive for tuberculosis by the reference standard. Of the 2357 included in the non-inferiority analysis, 877 (37%) were HIV-positive and 984 (42%) were female. Sensitivity of Ultra performed directly on sputum 1 was non-inferior to that of sputum 2 MGIT culture (MGIT 91·1% vs Ultra 91·9%; difference –0·8 percentage points; 95% CI –2·8 to 1·1). Sensitivity of Ultra performed on sputum 2 pellet was also non-inferior to that of sputum 2 MGIT (MGIT 91·1% vs Ultra 91·9%; difference –0·8 percentage points; –2·7 to 1·0).InterpretationFor the detection of M tuberculosis in sputum from adults with respiratory symptoms, there was no difference in sensitivity of a single Ultra test to that of a single MGIT culture. Highly sensitive, rapid molecular approaches for M tuberculosis detection, combined with advances in genotypic methods for drug resistance detection, have potential to replace culture.FundingUS National Institute of Allergy and Infectious Diseases.
Acetaminophen Use During Pregnancy and Children’s Risk of Autism, ADHD, and Intellectual Disability
Authors: Viktor H. Ahlqvist, Hugo Sjöqvist, Christina Dalman, Håkan Karlsson, Olof Stephansson, Stefan Johansson, Cecilia Magnusson, Renee M. Gardner, Brian K. Lee
Journal: JAMA (2024)

Importance Several studies suggest that acetaminophen (paracetamol) use during pregnancy may increase risk of neurodevelopmental disorders in children. If true, this would have substantial implications for management of pain and fever during pregnancy. Objective To examine the associations of acetaminophen use during pregnancy with children’s risk of autism, attention-deficit/hyperactivity disorder (ADHD), and intellectual disability. Design, Setting, and Participants This nationwide cohort study with sibling control analysis included a population-based sample of 2 480 797 children born in 1995 to 2019 in Sweden, with follow-up through December 31, 2021. Exposure Use of acetaminophen during pregnancy prospectively recorded from antenatal and prescription records. Main Outcomes and Measures Autism, ADHD, and intellectual disability based on International Classification of Diseases, Ninth Revision and International Classification of Diseases, Tenth Revision codes in health registers. Results In total, 185 909 children (7.49%) were exposed to acetaminophen during pregnancy. Crude absolute risks at 10 years of age for those not exposed vs those exposed to acetaminophen were 1.33% vs 1.53% for autism, 2.46% vs 2.87% for ADHD, and 0.70% vs 0.82% for intellectual disability. In models without sibling control, ever-use vs no use of acetaminophen during pregnancy was associated with marginally increased risk of autism (hazard ratio [HR], 1.05 [95% CI, 1.02-1.08]; risk difference [RD] at 10 years of age, 0.09% [95% CI, −0.01% to 0.20%]), ADHD (HR, 1.07 [95% CI, 1.05-1.10]; RD, 0.21% [95% CI, 0.08%-0.34%]), and intellectual disability (HR, 1.05 [95% CI, 1.00-1.10]; RD, 0.04% [95% CI, −0.04% to 0.12%]). To address unobserved confounding, matched full sibling pairs were also analyzed. Sibling control analyses found no evidence that acetaminophen use during pregnancy was associated with autism (HR, 0.98 [95% CI, 0.93-1.04]; RD, 0.02% [95% CI, −0.14% to 0.18%]), ADHD (HR, 0.98 [95% CI, 0.94-1.02]; RD, −0.02% [95% CI, −0.21% to 0.15%]), or intellectual disability (HR, 1.01 [95% CI, 0.92-1.10]; RD, 0% [95% CI, −0.10% to 0.13%]). Similarly, there was no evidence of a dose-response pattern in sibling control analyses. For example, for autism, compared with no use of acetaminophen, persons with low (&amp;amp;lt;25th percentile), medium (25th-75th percentile), and high (&amp;amp;gt;75th percentile) mean daily acetaminophen use had HRs of 0.85, 0.96, and 0.88, respectively. Conclusions and Relevance Acetaminophen use during pregnancy was not associated with children’s risk of autism, ADHD, or intellectual disability in sibling control analysis. This suggests that associations observed in other models may have been attributable to familial confounding.
The influence of transcatheter aortic valve replacement on left atrial mechanics: a systematic review and meta-analysis
Authors: Thomas Meredith, Lauren Brown, Farhan Mohammed, Amy Pomeroy, David Roy, David W M Muller, Christopher Hayward, Michael Feneley, Mayooran Namasivayam
Journal:  (2024)

Abstract Aims The morphology and function of the left atrium (LA) are intimately tied to left ventricular loading conditions. Data pertaining to the effect of transcatheter aortic valve replacement (TAVR) on LA function and geometry are scarce. The aim of the study was to quantify associations between TAVR and LA remodelling by pooling available data from published observational studies. Methods and results A systematic review and meta-analysis were performed. Studies reporting serial LA speckle-tracking echocardiographic (STE) data, before and after TAVR, were included. Other outcome data included LA area and indexed volume (LAVi) and standard chamber measurements. Outcomes were stratified by timing of follow-up echocardiography: early (&amp;lt;6 months) or late (≥6 months). Twelve studies were included, comprising 1066 patients. The mean reduction in LAVi was 2.72 mL/m2 [95% confidence interval (CI) 1.37–4.06, P &amp;lt; 0.01]. LA reservoir function improved overall by a mean difference (MD) of 3.71% (95% CI 1.82–5.6, P &amp;lt; 0.01), although there was significant heterogeneity within the pooled studies (I2 = 87.3%). Significant improvement in reservoir strain was seen in both early follow-up (MD 3.1%, P &amp;lt; 0.01) and late follow-up studies (MD 4.48%, P = 0.03), but heterogeneity remained high (I2 = 65.23 and 94.4%, respectively). Six studies reported a change in LA contractile function, which recovered in the early follow-up studies (MD 2.26, P &amp;lt; 0.01), but not in the late group (MD 1.41, P = 0.05). Pooled improvement in LA booster function was 1.96% (95% CI 1.11–2.8, P &amp;lt; 0.01). Conclusion TAVR is associated with significant negative LA remodelling, and an improvement in LA mechanics, quantified by STE. The prognostic implications of these findings require further study.
Paediatric-onset lymphomatoid papulosis: results of a multicentre retrospective cohort study on behalf of the EORTC Cutaneous Lymphoma Tumours Group (CLTG)
Authors: Maël Blanchard, Marie-Anne Morren, Anne-Marie Busschots, Esther Hauben, Silvia Alberti-Violetti, Emilio Berti, Gianluca Avallone, Gianluca Tavoletti, Michele Panzone, Pietro Quaglino, Cristiana Colonna, Rutger C Melchers, Maarten H Vermeer, Robert Gniadecki, Christina Mitteldorf, Janika Gosmann, Rudolf Stadler, Constanze Jonak, Meital Oren-Shabtai, Emmilia Hodak, Rivka Friedland, Emily Gordon, Larisa J Geskin, Julia J Scarisbrick, Fatima Mayo Martínez, Lucero Noguera Morel, Kevin Pehr, Boyko Amarov, Mohamed Faouzi, Jan P Nicolay, Werner Kempf, Gabriela Blanchard, Emmanuella Guenova
Journal: British Journal of Dermatology (2024)

Abstract Background Lymphomatoid papulosis (LyP) is a rare cutaneous T-cell lymphoproliferative disorder. Comprehensive data on LyP in the paediatric population are scarce. Objectives To characterize the epidemiological, clinical, histopathological and prognostic features of paediatric LyP. Methods This was a retrospective multicentre international cohort study that included 87 children and adolescents with LyP diagnosed between 1998 and 2022. Patients aged ≤ 18 years at disease onset were included. LyP diagnosis was made in each centre, based on clinicopathological correlation. Results Eighty-seven patients from 12 centres were included. Mean age at disease onset was 7.0 years (range 3 months–18 years) with a male to female ratio of 2 : 1. Mean time between the onset of the first cutaneous lesions and diagnosis was 1.3 years (range 0–14). Initial misdiagnosis concerned 26% of patients. LyP was most often misdiagnosed as pityriasis lichenoides et varioliformis acuta, insect bites or mollusca contagiosa. Erythematous papules or papulonodules were the most frequent clinical presentation. Pruritus was specifically mentioned in 21% of patients. The main histological subtype was type A in 55% of cases. When analysed, monoclonal T-cell receptor rearrangement was found in 77% of skin biopsies. The overall survival rate was 100%, with follow-up at 5 years available for 33 patients and at 15 years for 8 patients. Associated haematological malignancy (HM) occurred in 10% of cases (n = 7/73), including four patients with mycosis fungoides, one with primary cutaneous anaplastic large cell lymphoma (ALCL), one with systemic ALCL and one with acute myeloid leukaemia. If we compared incidence rates of cancer with the world population aged 0–19 years from 2001 to 2010, we estimated a significantly higher risk of associated malignancy in general, occurring before the age of 19 years (incidence rate ratio 87.49, 95% confidence interval 86.01–88.99). Conclusions We report epidemiological data from a large international cohort of children and adolescents with LyP. Overall, the disease prognosis is good, with excellent survival rates for all patients. Owing to an increased risk of associated HM, long-term follow-up should be recommended for patients with LyP.
Incidence of liver cancer in young adults according to the Global Burden of Disease database 2019
Authors: Pojsakorn Danpanichkul, Majd B. Aboona, Banthoon Sukphutanan, Siwanart Kongarin, Kwanjit Duangsonk, Cheng Han Ng, Mark D. Muthiah, Daniel Q. Huang, Yuya Seko, Luis Antonio Díaz, Juan Pablo Arab, Ju Dong Yang, Vincent L. Chen, Donghee Kim, Mazen Noureddin, Suthat Liangpunsakul, Karn Wijarnpreecha
Journal: Hepatology (2024)

The worldwide burden of cancer is increasing in younger populations. However, the epidemiology of primary liver cancer remains understudied in young adults compared to other cancer forms.
Combination p53 activation and BCL-xL/BCL-2 inhibition as a therapeutic strategy in high-risk and relapsed acute lymphoblastic leukemia
Authors: Hayden L. Bell, Helen J. Blair, Samantha J. Jepson Gosling, Martin Galler, Daniel Astley, Anthony V. Moorman, Olaf Heidenreich, Gareth J. Veal, Frederik W. van Delft, John Lunec, Julie A. E. Irving
Journal: Leukemia (2024)

Due to the rarity of TP53 mutations in acute lymphoblastic leukemia (ALL), p53 re-activation by antagonism of the p53-MDM2 interaction represents a potential therapeutic strategy for the majority of ALL. Here, we demonstrate the potent antileukemic activity of the MDM2 antagonist idasanutlin in high-risk and relapsed ex vivo coculture models of TP53 wildtype ALL (n = 40). Insufficient clinical responses to monotherapy MDM2 inhibitors in other cancers prompted us to explore optimal drugs for combination therapy. Utilizing high-throughput combination screening of 1971 FDA-approved and clinically advanced compounds, we identified BCL-x