tbuckley/cabot-search huggingface dataset:
Clinical Outcomes and Cost-Effectiveness of Collaborative Dementia Care
Authors: Bernhard Michalowsky, Iris Blotenberg, Moritz Platen, Stefan Teipel, Ingo Kilimann, Elena Portacolone, Jens Bohlken, Anika Rädke, Maresa Buchholz, Annelie Scharf, Franka Muehlichen, Feng Xie, Jochen René Thyrian, Wolfgang Hoffmann
Journal: JAMA Network Open (2024)

Long-term evidence for the effectiveness and cost-effectiveness of collaborative dementia care management (CDCM) is lacking.
Preoperative vs Postoperative Opioid Prescriptions and Prolonged Opioid Refills Among US Youths
Authors: Tori N. Sutherland, Jennifer A. Rabbitts, Gregory E. Tasian, Mark D. Neuman, Craig Newcomb, Scott E. Hadland
Journal: JAMA Network Open (2024)

Importance High-risk practices, including dispensing an opioid prescription before surgery when not recommended, remain poorly characterized among US youths and may contribute to new persistent opioid use. Objective To characterize changes in preoperative, postoperative, and refill opioid prescriptions up to 180 days after surgery. Design, Setting, and Participants This retrospective cohort study was performed using national claims data to determine opioid prescribing practices among a cohort of opioid-naive youths aged 11 to 20 years undergoing 22 inpatient and outpatient surgical procedures between 2015 and 2020. Statistical analysis was performed from June 2023 to April 2024. Main Outcomes and Measures The primary outcome was the percentage of initial opioid prescriptions filled up to 14 days prior to vs 7 days after a procedure. Secondary outcomes included the likelihood of a refill up to 180 days after surgery, including refills at 91 to 180 days, as a proxy for new persistent opioid use, and the opioid quantity dispensed in the initial and refill prescriptions in morphine milligram equivalents (MME). Exposures included patient and prescriber characteristics. Multivariable logistic regression models were used to estimate the association between prescription timing and prolonged refills. Results Among 100 026 opioid-naive youths (median [IQR] age, 16.0 [14.0-18.0] years) undergoing a surgical procedure, 46 951 (46.9%) filled an initial prescription, of which 7587 (16.2%) were dispensed 1 to 14 days before surgery. The mean quantity dispensed was 227 (95% CI, 225-229) MME; 6467 youths (13.8%) filled a second prescription (mean MME, 239 [95% CI, 231-246]) up to 30 days after surgery, and 1216 (3.0%) refilled a prescription 91 to 180 days after surgery. Preoperative prescriptions, increasing age, and procedures not typically associated with severe pain were most strongly associated with new persistent opioid use. Conclusions and Relevance In this retrospective study of youths undergoing surgical procedures, of which, many are typically not painful enough to require opioid use, opioid dispensing declined, but approximately 1 in 6 prescriptions were filled before surgery, and 1 in 33 adolescents filled prescriptions 91 to 180 days after surgery, consistent with new persistent opioid use. These findings should be addressed by policymakers and communicated by professional societies to clinicians who prescribe opioids.
Biomarker Testing Disparities in Metastatic Colorectal Cancer
Authors: Saad Sabbagh, María Herrán, Ali Hijazi, Iktej Singh Jabbal, Mohamed Mohanna, Barbara Dominguez, Mira Itani, Kaylee Sarna, Hong Liang, Zeina Nahleh, Steven D. Wexner, Arun Nagarajan
Journal: JAMA Network Open (2024)

Among patients with metastatic colorectal cancer (mCRC), data are limited on disparate biomarker testing and its association with clinical outcomes on a national scale.
Opportunities for Improving System-Level Barriers to Biomarker Testing for Metastatic Colorectal Cancer
Authors: Ayooluwatomiwa Deborah Adekunle, Shannon Coombs, Cassandra D. L. Fritz
Journal: JAMA Network Open (2024)

Saad Sabbagh, MD; María Herrán, MD; Ali Hijazi, MD; Iktej Singh Jabbal, MD; Mohamed Mohanna, MD; Barbara Dominguez, MBA; Mira Itani, MD; Kaylee Sarna, MSc; Hong Liang, PhD; Zeina Nahleh, MD; Steven D. Wexner, MD, PhD; Arun Nagarajan, MD
Probiotics and Antibiotic-Induced Microbial Aberrations in Children
Authors: Thomas H. Dierikx, Anna M. Malinowska, Jan Łukasik, Isolde Besseling-van der Vaart, Clara Belzer, Hania Szajewska, Tim G. J. de Meij, Sophie R. D. van der Schoor, Malika Chegary, Catharina (Karen) J.M. Koning, Mark Hanemaaijer
Journal: JAMA Network Open (2024)

Importance Probiotics are often considered in children to prevent antibiotic-associated diarrhea. However, the underlying mechanistic effects and impact of probiotics on antibiotic-induced microbiota changes are not well understood. Objective To investigate the effects of a multispecies probiotic on the gut microbiota composition in children receiving antibiotics. Design, Setting, and Participants This is a secondary analysis of a randomized, quadruple-blind, placebo-controlled clinical trial from February 1, 2018, to May 31, 2021, including 350 children receiving broad-spectrum antibiotics in the inpatient and outpatient settings. Patients were followed up until 1 month after the intervention period. Fecal samples and data were analyzed between September 1, 2022, and February 28, 2023. Eligibility criteria included 3 months to 18 years of age and recruitment within 24 hours following initiation of broad-spectrum systemic antibiotics. In total, 646 eligible patients were approached and 350 participated in the trial. Intervention Participants were randomly assigned to receive daily placebo or a multispecies probiotic formulation consisting of 8 strains from 5 different genera during antibiotic treatment and for 7 days afterward. Main Outcomes and Measures Fecal stool samples were collected at 4 predefined times: (1) inclusion, (2) last day of antibiotic use, (3) last day of the study intervention, and (4) 1 month after intervention. Microbiota analysis was performed by 16S ribosomal RNA gene sequencing. Results A total of 350 children were randomized and collected stool samples from 88 were eligible for the microbiota analysis (54 boys and 34 girls; mean [SD] age, 47.09 [55.64] months). Alpha diversity did not significantly differ between groups at the first 3 times. Shannon diversity (mean [SD], 3.56 [0.75] vs 3.09 [1.00]; P = .02) and inverse Simpson diversity (mean [SD], 3.75 [95% CI, 1.66-5.82] vs −1.31 [95% CI, −3.17 to 0.53]; P = 1 × 10 −4 ) indices were higher in the placebo group compared with the probiotic group 1 month after intervention. Beta diversity was not significantly different at any of the times. Three of 5 supplemented genera had higher relative abundance during probiotic supplementation, but this difference had disappeared after 1 month. Conclusions and Relevance The studied probiotic mixture had minor and transient effects on the microbiota composition during and after antibiotic treatment. Further research is needed to understand their working mechanisms in manipulating the microbiome and preventing antibiotic-associated dysbiosis and adverse effects such as antibiotic-associated diarrhea. Trial Registration ClinicalTrials.gov Identifier: NCT03334604
EX103: A newly designed CD20×CD3 molecule in heavily pre-treated patients with B-cell non-Hodgkin lymphoma from a phase I/II trial.
Authors: Mingyuan Sun, Junyuan Qi, Keshu Zhou, Xingchen Liu, Kai Hu, Chunkang Chang, Dong Wu, Zhenling Li, Ming Gong, WENJUN ZHANG, Daniel Chunxu Yang, JIALI LU
Journal: Journal of Clinical Oncology (2024)

7022 Background: T-cell-engaging bispecific antibody (TCB) had emerged as a promising therapy for blood malignancies, including relapsed/refractory (R/R) B-NHL. However, severe cytokine release syndrome (CRS) remains to be a significant challenge in TCB treatment. To overcome this setback, we re-designed a new CD20xCD3 bispecific antibody (EX103) with a lower affinity to CD3. Clinical data from an ongoing first-in-human phase I/II study demonstrates that EX103 has an encouraging safety and promising single-agent antitumor activity in heavily pretreated R/R B-NHL patients. We present updated safety and efficacy data from the ongoing trial (CTR20212096). Methods: Eligible patients received EX103 with 3 step-up doses followed by target doses in 28-day cycles (iv, QW: cycle 1-2; Q2W thereafter) until disease progression or unacceptable toxicity. At data cut off (Dec 24, 2023), a total of 23 patients were evaluated, including 18 patients in dose-escalation part and 5 patients in dose-expansion part. Results: Among 23 evaluable patients (median age: 51 years [range 42-70]; median prior lines of treatment: 4 [range 2-10]), 13 patients had diffuse large B-cell lymphoma (DLBCL), 4 had FL 1-3a, 2 had FL grade 3B, 1 had marginal zone lymphoma, 1 had mantle cell lymphoma, and 2 had chronic lymphocytic leukemia. Median time since last therapy was 2.5 (range 0.3-39.2) months. No DLT and treatment-related death were observed. CRS was the most common treatment related adverse event. All CRS events were grade (Gr) 1-2 (Gr 1: 78.3%, Gr 2: 13.0%), no Gr 3 or higher events. Most CRS events occurred in the first or second treatment cycle, and all CRS-related clinical symptoms were resolved within 48 hours. No cases of immune effector cell-associated neurotoxicity syndrome or other clinically significant neurologic AEs were observed. For dose ≥ 6 mg cohorts, the overall response rate (ORR) for aggressive B-NHL is 78.6% and the complete response (CR) rate is 50.0% (14 patients). Meanwhile, the ORR for indolent B-NHL is 100%, and CR rate is 25.0% (4 patients). The overall DCR is 89.5%. Currently, treatment is ongoing for 18 patients. The longest duration of response is 14 months. Patients who were refractory to previous therapies achieved impressive responses to EX103 treatment. 3 patients who failed CAR-T therapy achieved either CR or partial response (PR) (2 CR and 1 PR), 2 patients who failed CD19×CD3 bispecific antibody treatment both achieved PR, and 4 patients who failed ASCT achieved either CR or PR (2 CR and 2 PR). Conclusions: EX103 can induce deep and durable responses in heavily pretreated patients with R/R B-NHL, such as those patients who failed CAR-T treatment (3 cases), CD19xCD3 bispecific antibody treatment (2 cases) and ASCT (4 cases). Clinical trial information: CTR20212096.
Author Correction: The Cyclophilin A–CD147 complex promotes the proliferation and homing of multiple myeloma cells
Authors: Di Zhu, Zhongqiu Wang, Jian-Jun Zhao, Teresa Calimeri, Jiang Meng, Teru Hideshima, Mariateresa Fulciniti, Yue Kang, Scott B Ficarro, Yu-Tzu Tai, Zachary Hunter, Douglas McMilin, Haoxuan Tong, Constantine S Mitsiades, Catherine J Wu, Steven P Treon, David M Dorfman, Geraldine Pinkus, Nikhil C Munshi, Pierfrancesco Tassone, Jarrod A Marto, Kenneth C Anderson, Ruben D Carrasco
Journal: Nature Medicine (2024)
The Uniform Determination of Death Act is Not Changing. Will Physicians Continue to Misdiagnose Brain Death?
Authors: Michael Nair-Collins
Journal: The American Journal of Bioethics (2024)

Efforts to revise the Uniform Determination of Death Act in order to align law with medical practice have failed. Medical practice must now align with the law. People who are not dead under the law that defines death should not be declared dead. There is no compelling reason to continue the practice of declaring legally living persons to be dead.
TNF compromises intestinal bile-acid tolerance dictating colitis progression and limited infliximab response
Authors: Mengqi Zheng, Yunjiao Zhai, Yanbo Yu, Jing Shen, Shuzheng Chu, Enrico Focaccia, Wenyu Tian, Sui Wang, Xuesong Liu, Xi Yuan, Yue Wang, Lixiang Li, Bingcheng Feng, Zhen Li, Xiaohuan Guo, Ju Qiu, Cuijuan Zhang, Jiajie Hou, Yiyuan Sun, Xiaoyun Yang, Xiuli Zuo, Mathias Heikenwalder, Yanqing Li, Detian Yuan, Shiyang Li
Journal: Cell Metabolism (2024)
Application of AI on Fractional Flow Reserve (FFR) Determining the Requirement of Angioplasty and Stenting
Authors: N John Camm
Journal: Clinical Cardiology and Cardiovascular Interventions (2023)

Artificial Intelligence (AI) has the potential to greatly improve the field of cardiovascular medicine, particularly in the determination of the need for angioplasty and stenting in patients with coronary artery disease. Fractional Flow Reserve (FFR), a commonly used method for assessing the severity of stenosis in the coronary arteries, is often subjective and subject to inter-observer variability. AI algorithms can be integrated with medical imaging to provide a more objective and quantitative analysis of FFR, reducing the variability in FFR determination and improving diagnostic accuracy. The benefits of using AI in FFR analysis include improved patient outcomes, better patient care, and reduced healthcare costs. AI algorithms can provide more accurate and consistent assessments of stenosis severity, leading to improved diagnoses and treatments for coronary artery disease. In addition, AI can improve the efficiency of the healthcare system by reducing the need for repeated tests or procedures due to inconsistent results. The future outlook for AI in FFR analysis is extremely promising. With further advancements in AI technology, it is likely that AI algorithms will become an increasingly important tool in the diagnosis and treatment of coronary artery disease. AI algorithms may also be integrated with other medical imaging modalities, such as CT scans or MRIs, to provide a more comprehensive assessment of a patient's cardiovascular health.AI has the potential to greatly improve the accuracy and efficiency of FFR analysis in determining the need for angioplasty and stenting in patients with coronary artery disease. The benefits of AI in this field include improved patient outcomes, better patient care, and reduced healthcare costs. The future outlook for AI in FFR analysis is extremely promising, and further advancements in AI technology are likely to drive continued progress in this field.
Undescended Testis Torsion. Clinical Observations
Authors: М. V. Topolnik, Е. В. Olkhova, V. О. Soboleva
Journal: Radiology - Practice (2024)

Objective. Demonstration of the possibilities of ultrasound diagnosis of Undescended testis torsion (UTT) in children.Materials and Methods. The publication presents clinical observations of UTT in small children, illustrated with echographic scans and intraoperative images.Results. UTT is a rare urgent urological disease, accounting, according to our own data, for only 2,8% of all cases of postnatal testicular torsion. Acute ischemia is extremely dangerous for the testicle, but the clinical symptoms of the pathology are nonspecific, and surgical care may be delayed. This determines the probability of an unfavorable outcome of the disease (necrosis, testicular sclerosis), which determines not only the medical, but also the social significance of the problem. At present the only fast method of radiological imaging for UTT is ultrasonography, according to the results of which an urgent revision of the testicle is performed. At the same time, the echographic image of UTT is difficult to interpret due to the predominance of young patients, when severe soft tissue edema, structural changes in the twisted gonad and behavioral characteristics of the patient sharply complicate the examination.Conclusion. The clinical presentation of UTT in the form of painful swelling in the inguinal region requires an emergency differential diagnosis. Clinically and echographically UTT is similar to the manifestations of a pinched inguinal hernia and destructive lymphadenitis of the inguinal region, which in some cases requires an expansion of the examination area: it is necessary to scan the abdominal cavity to assess the presence/absence of echographic symptoms of intestinal obstruction.
Non-Hodgkin's Lymphomas in Patients with HIV Infection
Authors: N. V. Klimova, A. O. Ramzina, A. A. Gaus, I. V. Bazhukhina
Journal: Radiology - Practice (2024)

Aim . To study the main predictor factors of the development of non-Hodgkin's lymphomas, such as diffuse B-large cell lymphoma, Burkitt's lymphoma, plasmoblastic lymphoma, in HIVpositive patients. Materials and Methods. Within the framework of this study, the data obtained by radiation research methods in 90 HIV-positive patients who were treated in the period from 2016 to 2023 at the hematology department of the Surgut District Clinical Hospital were studied and analyzed.All patients with suspected lymphoproliferative disease underwent computed tomography with intravenous bolus contrast. Results . As a result of the study, when a patient at stage 4B-4B is diagnosed with HIV infection under the age of 50, has a history of oncogenic viruses (EBV infection, hepatitis C virus), an HIV viral load above 500 thousand copies /ml, accompanied by the development of generalized lymphadenopathy syndrome, first of all, it is necessary to exclude the presence of lymphomas. Conclusion . Сomputed tomography with contrast enhancement is a highly informative and non-invasive method that allows, quite accurately, to suspect the presence of lymphoproliferative disease in the early stages, to give a complete spatial visualization of the lesion volume and additional information about the attachment of a secondary infection. In our study, we developed a general algorithm for the primary radiation diagnosis of non-Hodgkin's lymphomas, based on the identified predictor factors.
Maternal-Infant Triad of Cardiovascular Health: Pregnancy, Breastfeeding and Public Policies
Authors: Leany Blandón-Renteria
Journal: Clinical Cardiology and Cardiovascular Interventions (2023)

Since I decided to work in cardiovascular health, I see with concern that cardiovascular disease continues to be the number one killer in the world and that its prevalence and incidence are increasing every day. Analyzing the literature, health services, and government education programs, I observe that we are making a mistake: we only focus on diagnosis and disease and not on effective prevention. And when prevention activities are carried out, they are focused on action and separating the importance of collective health, the social sphere and local reality. As Rose said, "Case-focused epidemiology identifies individual susceptibility, but may be unable to identify underlying causes of incidence."
Ultrasound Diagnosis of a Strangulated Diaphragmatic Hernia in a Child. Сlinical Observation
Authors: E. B. Olkhova, D. V. Khaspekov, A. S. Sar, M. M. Fedoseeva
Journal: Radiology - Practice (2024)

Diaphragmatic hernia occurs in newborns in the vast majority of cases and is diagnosed while still in utero. Cases of it delayed diagnosis are extremely rare and involve significant diagnostic difficulties, especially when there are ischemic damages to the organs that make up the hernial contents. The clinical manifestations of a strangulated diaphragmatic hernia are nonspecific, especially in young children, when adequate verbal contact is impossible.Objective. We demonstrate the possibilities and limitations of various radial methods of examination of a child with a strangulated diaphragmatic hernia.Materials and Methods. We present an observation of an 8-month-old child with a leftsided strangulated false diaphragmatic hernia. The child was subjected to ultrasound, radiologic examination (image in supine position in direct posterior projection), CT scan (native scan without breath-holding). Radiologic findings were compared with the intraoperative picture. Results. The history of the disease was unclear, the clinical picture was nonspecific, respiratory failure prevailed. Radiologic diagnosis was difficult because of the combined disease: pneumonia, left-sided pleuritis. The diagnosis was made at ultrasound when hollow organ fragments were visualized in the left hemithorax and confirmed by CT scanning. The child was successfully operated.Conclusion. Congenital diaphragmatic hernia in rare cases may exist asymptomatic for a long period of time and present with extremely nonspecific clinical manifestations. It is necessary to remember the possibility of the presence of previously undiagnosed diseases and developmental anomalies when performing chest ultrasound in children, because they fundamentally affect the management of the patient.
Safety, Efficacy, Feasibility of Trans Radial Approach compared with Transfemoral Approach in Patients Undergoing Coronary Catheterization
Authors: Aubin Sandio
Journal: Clinical Cardiology and Cardiovascular Interventions (2023)

Background: Percutaneous Coronary Intervention has been done traditionally through Transfemoral route. Trans Radial route is coming up in the practice. We compared Trans Radial with Transfemoral accesses for ease of operability, time of procedure, complications, and failure rates through a cross sectional study. Objectives: To evaluate the safety, efficacy, feasibility and procedural variables in Trans radial approach compared with the Transfemoral Approach in patients undergoing coronary catheterization. Methods: A total of 180 patients with both chronic and acute coronary syndromes were enrolled in this study , 140cases with Radial , 28 of whom were crossed to Femoral access(hence 112 Radials with 108 Right Radial and 4 Left Radial)and 68 cases with Femoral access. Results: Procedural time between Trans Radial and Transfemoral accesses were similar (17.39±10.33 vs 19.68±16.62 minutes p 0.36) respectively while among Femoral crossover group was higher (33.50±20.30 minutes p0.01). Fluoroscopy time was (5.51±4.70 in Trans Radial Vs. 7.18 ±7.65 minutes in Transfemoralp 0.07) were similar in both groups. Post procedure access site complications seen in (9% in Trans Radial compared to 7.35% in Transfemoral P 0.048), Access site Hematoma being the most common one (6.25% in Trans Radial vs 4.4% in Transfemoral), Non-flow limiting dissections occurred in (0.89% in Trans Radial VS 1.4% Transfemoral), Radial artery perforation occurred in 1.78%,1.4% of patients in Femoral group had Femoral artery perforation and had major bleeding. Conclusion: The overall local complications were lower in Transfemoral access, except for major bleeding which is still a big concern. both vascular Access techniques should not be considered opposite or mutually exclusive, but rather provide the Interventionist a wide spectrum of the therapeutic options.