tbuckley/cabot-search huggingface dataset:
SAT0402 Evaluation of weight-bearing joint damage in patients with rheumatoid arthritis using a new radiographic scoring method (ARASHI)
Authors: I. Matsushita, H. Motomura, E. Seki, T. Kimura
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> The radiographic joint damage in rheumatoid arthritis (RA) is commonly evaluated by van der Heijde total Sharp score, however only small joints of hands and feet are assessed in this method. We developed and demonstrated a new radiographic scoring method for Large joint of rheumatoid arthritis (Assessment of Rheumatoid Arthritis by Scoring of Large Joint Destruction and Healing in Radiographic Imaging: ARASHI) in EULAR 2011<sup>1)</sup>. <h3>Objectives</h3> The purpose of this study is to evaluate the radiographic damage of hip and knee joints in rheumatoid arthritis (RA) during TNF-blocking therapies by this new radiographic scoring method, and to clarify the pattern of the progression of hip and knee joints during 2 years of TNF-blocking therapies. <h3>Methods</h3> “ARASHI status score” consists of 4 categories; joint space narrowing (0∼3 points), erosion (0∼3 points), joint surface (0∼6 points), and stability (0∼4 points), (total 0-16 points). “ARASHI change score” consists of 5 categories; porosis (-1∼1 point), joint space narrowing (-1∼2 points), erosion (-2∼2 points), joint surface (-6∼6 points), and stability (-1∼1 point), (total -11∼12 points). Increase in more than 1 point of change score was considered as progression of joint damage. hirty seven consecutive patients (4 male, 33 women, mean age of 58.7 years old) were enrolled in this study. All patients fulfilled the ACR 1987 revised criteria. The joints with history of surgical intervention were excluded from this analysis, and the radiographic findings of 65 hip joints and 53 knee joints were evaluated at baseline using the ARASHI status score, and at 1 and 2 years after TNF-blocking therapies (infliximab or etanercept) using the ARASHI change score. <h3>Results</h3> There were 2 hip and 8 knee joints with 3 and more points of the status score at baseline. All of these joints showed significant increase in the change score at 1 or 2 years after TNF-blocking therapies. On the other hand, in hip and knee joints with pre-existing status score of 0-2 points, only 5.6% of the joints showed progression of joint damage during follow-up. <h3>Conclusions</h3> ARASHI scoring method was useful for radiographic assessment of the status and progression of the large weight-bearing joints. In this study, we demonstrated that hip and knee joints with pre-existing damage greater than 2 points of status score were highly predisposed to progressive destruction even under TNF-blocking therapies. Therefore, it is essential that there is less status score in hip and knee joints at the start of TNF-blocking therapies. <h3>References</h3> Nasu Y, Nishida K, Hashizume K et al. The verification of a new radiographic scoring method for large joint damage of rheumatoid arthritis (ARASHI status score) relevant to clinical and radiographic parameters. Ann Rheum Dis 2011;70(Suppl3):727 <h3>Disclosure of Interest</h3> None Declared
Extended application of the Olympus linear echobronchovideoscope (BF-UC160F-OL8) in the upper gastrointestinal tract - Study on visualization of the celiac axis and EUS-FNA of lymph nodes beyond the stenosis in esophageal cancers
Authors: S Omar, S Seewald, U Seitz, S Groth, Y Zhong, F Thonke, N Soehendra
Journal: Endoscopy (2006)

Introduction: Malignant lymph nodes (LN) in esophageal cancer (EC) necessitate neoadjuvant chemo- and/or radiotherapy for curative surgery. However, cytological diagnosis is often impossible due to inability to perform LN EUS-FNA beyond non-traversable stenosis with linear echoendoscopes (ø 11.8mm). Aim: To study the ability of the linear echobronchovideoscope (CEBUS) to visualize the celiac axis (CA) and passage through stenotic EC for CEBUS-guided FNA of LN. Method: Consecutive patients with no surgical history who underwent EUS for non-EC indications were recruited for the CA study (Group A); patients with stenotic EC for the EUS-FNA study (Group B). (1) CEBUS (ø 6.2mm) was inserted transorally up to 50cm to visualize CA. (2) For patients with stenotic EC, a pediatric gastroscope was first used to place a 0.035“ guidewire. A 5F Teflon catheter was inserted through the working channel of CEBUS to enable retrograde insertion of guidewire through CEBUS. After the guidewire appeared, CEBUS was then carefully advanced over the guidewire through the stenosis. (3) EUS-FNA was performed on LN beyond the stenosis using TBNA needle. Results: 17 patients were recruited for the CA study (12M:5F; median age 62.7 years, range 43.6–86.6) (A). Two patients had EC, both with non-traversable stenosis (B). In Group A, CA was visualized in 15/17 (88.2%) patients. No difficulty in intubation was encountered. The median length of the scope was 48cm (range 41–50) upon CA visualization. In Group B, CEBUS was passed through the stenosis with EUS-FNA of LN successfully performed in the 2 patients. There was no complication. Conclusion: CEBUS was able to visualize CA in the majority of patients. CEBUS and CEBUS-guided FNA were feasible in patients with stenotic EC without the need for predilation. Despite the floppy shaft of CEBUS, narrow viewing angle and less echo-penetration, FNA of LN was feasible.
AB0312 Effect of tocilizumab on anti-cyclic citrullinated peptide antibodies and rheumatoid factor in patients with rheumatoid arthritis
Authors: M. Sato, M. Takemura, K. Shimizu
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by synovial inflammation that eventually results in joint destruction and functional damages. Rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibodies (anti-CCP) are useful diagnostic tools for subclinical and early RA. RF titers decrease with successful drug therapy. Some reports have shown that tumor necrosis factor (TNF)-alpha blockers reduce anti-CCP. <h3>Objectives</h3> To analyze the effect of tocilizumab (TCZ) therapy on anti-CCP and IgM RF in patients with RA. <h3>Methods</h3> Forty-six patients (38 women and 8 men; mean age 58.3 years, range 25 – 76 years) treated with TCZ were enrolled. All patients met the American College of Rheumatology classification criteria for RA. Patients received 8 mg/kg TCZ intravenously every 4 weeks. Serum samples were collected at baseline, 12 weeks, and 52 weeks. Sera were stored at -80 degree until they were assayed. Anti-CCP was measured by enzyme-linked immunosorbent assay (ELISA), and RF was detected by immune nephelometry. Anti-CCP was considered positive when the titer was greater than 5 U/mL. RF was considered positive when the titer was greater than 15 IU/mL. <h3>Results</h3> At baseline, 37 patients were positive for anti-CCP (80%) and 35 were positive for RF (76%). Thirty-two patients (70%) were positive for both anti-CCP and RF. There was a weak correlation between anti-CCP and RF at baseline (r =0.186). No differences were noted in disease activity relative to the patient's anti-CCP and RF positivity. Three patients who were positive for anti-CCP at baseline became anti-CCP negative after TCZ therapy, with titers below 10 U/mL. RF titers in 8 patients changed from positive to negative during the course of treatment. These RF titers ranged from 22 to 102 IU/mL. Anti-CCP levels decreased at 12 weeks (p=0.06), and then increased at 52 weeks (p&lt;0.005). The concentrations of anti-CCP at baseline, 12 weeks, and 52 weeks were 201±40, 188±39, and 248±52 U/mL, respectively. These changes in anti-CCP levels were greater than in biologics- naïve patient group. RF titers decreased in association with the improvement in RA disease activity (p&lt;0.0001). RF titers at baseline, 12 weeks, and 52 weeks were 157±37, 107±26, and 98±26 IU/mL, respectively. <h3>Conclusions</h3> RF titers may be useful for RA treatment not only as a diagnostic tool but also for monitoring the efficacy of TCZ therapy. However, although TCZ treatment directly influenced anti-CCP titers, these changes were not associated with clinical response to TCZ therapy. These results suggested that TCZ treatment had different effects on anti-CCP and RF production in RA patient sera. We conclude that anti-CCP and RF might be independent antibodies in the immune network of RA. <h3>Disclosure of Interest</h3> None Declared
Tax-Exempt Institutes Taking Private Monies and Public Flack
Authors: K. Nagy
Journal: JNCI Journal of the National Cancer Institute (1993)

Journal Article Tax-Exempt Institutes Taking Private Monies and Public Flack Get access Kate Nagy Kate Nagy Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 85, Issue 14, 21 July 1993, Pages 1109–1110, https://doi.org/10.1093/jnci/85.14.1109 Published: 21 July 1993
The First Months of the Prescription-Drug Benefit — A CMS Update
Authors: Peter B. Bach, Mark B. McClellan
Journal: New England Journal of Medicine (2006)

January 1, 2006, marked the beginning of prescription-drug coverage under Medicare.1 The new benefit is provided by competing “stand-alone” private drug plans that work with the traditional fee-for-service Medicare benefit and by plans that are part of private Medicare Advantage programs. After the initial start-up challenges, the drug benefit is being widely used.Because the average beneficiary had many options, choosing a plan was often daunting, but enrollment assistance has been available through Medicare and other organizations. Of the 42 million beneficiaries eligible for drug coverage, more than 31 million were enrolled in a plan by early May 2006, including . . .
Tofacitinib attenuates pathologic immune pathways in patients with psoriasis: A randomized phase 2 study
Authors: James Krueger, James D. Clark, Mayte Suárez-Fariñas, Judilyn Fuentes-Duculan, Inna Cueto, Claire Q. Wang, Huaming Tan, Robert Wolk, Scott T. Rottinghaus, Maryann Z. Whitley, Hernan Valdez, David von Schack, Shawn P. O'Neil, Padmalatha S. Reddy, Svitlana Tatulych
Journal: Journal of Allergy and Clinical Immunology (2016)

<h3>Background</h3> Tofacitinib is an oral Janus kinase inhibitor being investigated for psoriasis. <h3>Objective</h3> We sought to elucidate the molecular mechanisms underlying the clinical efficacy of tofacitinib in patients with psoriasis. <h3>Methods</h3> Twelve patients with plaque psoriasis were randomized (3:1) to receive 10 mg of tofacitinib or placebo twice daily for 12 weeks. Biopsy specimens were taken from nonlesional (baseline) and lesional (baseline, days 1 and 3, and weeks 1, 2, 4, and 12) skin. Biopsy specimens were examined for psoriatic epidermal features (thickness, Ki67<sup>+</sup> keratinocytes and keratin 16 [KRT16] mRNA expression, and phosphorylated signal transducer and activator of transcription [pSTAT]<sup>+</sup> nuclei) and T-cell and dendritic cell (DC) subsets by using immunohistochemistry, and mRNA transcripts were quantified by using a microarray. <h3>Results</h3> In lesional skin keratinocyte pSTAT1 and pSTAT3 staining was increased at baseline but reduced after 1 day of tofacitinib (baseline, median of 1290 pSTAT1<sup>+</sup> cells/μm<sup>2</sup>; day 1, median of 332 pSTAT1<sup>+</sup> cells/μm<sup>2</sup>; and nonlesional, median of 155 pSTAT1<sup>+</sup> cells/μm<sup>2</sup>). Epidermal thickness and KRT16 mRNA expression were significantly and progressively reduced after days 1 and 3 of tofacitinib administration, respectively (eg, KRT16 decreased 2.74-fold, day 3 vs baseline, <i>P</i> = .016). Decreases in DC and T-cell numbers were observed after weeks 1 and 2, respectively. At week 4, significant decreases in IL-23/T<sub>H</sub>17 pathways were observed that persisted through week 12. Improvements in clinical and histologic features were strongly associated with changes in expression of psoriasis-related genes and reduction in IL-17 gene expression. <h3>Conclusions</h3> Tofacitinib has a multitiered response in patients with psoriasis: (1) rapid attenuation of keratinocyte Janus kinase/STAT signaling; (2) removal of keratinocyte-induced cytokine signaling, leading to reductions in pathologic DC and T-cell numbers to nonlesional levels; and (3) inhibition of the IL-23/T<sub>H</sub>17 pathway.
Abstract 2406: Molecular characterization of ciclooxigenase-2 in canine proliferative inflammatory atrophy of the prostate
Authors: Renee L. Amorim, Marcela Rodrigues, Luciana Rosa, Sandra Drigo, Priscila Cirilo, Silvia Rogatto
Journal: Cancer Research (2011)

Abstract Due to the importance and incidence of prostatic carcinoma in man, some animals are being used as a model in the investigation of the pathogenesis and development of this lesion. Similarly to men, the dog presents a spontaneous development of prostate cancer, which is locally invasive and can develop bone metastasis. Proliferative inflammatory atrophy (PIA) is considered a pre-neoplastic lesion in men. Overexpression of COX-2 has been associated with PIA, PIN and prostatic carcinoma playing a role in angiogenesis, apoptosis inhibition, increasing of invasive capacity, metastasis and inflammation in different prostatic affections. The aim of this study was to assess the protein and gene expression of COX-2 in laser capture microdissected stroma and epithelial cells of PIA foci in canine prostate by immunohistochemistry (IHC) and qRT-PCR. For IHC, 38 PIA lesions arranged in a tissue microarray were evaluated. Frozen fragments from 17 PIA and 3 normal prostatic tissues were used for COX2 gene expression. Our results showed increased COX2 gene expression in stromal cells compared to epithelial cells. High level of COX-2 protein expression was observed in 87% of PIA lesions, despite epithelial or stromal compartment. The In the present study, the stroma presented an important role, since the COX-2 gene expression in canine PIA lesions was increased in this cell compartment. To the best of our knowledge, this is the first report of COX2 gene expression in canine PIA. Since high levels of COX-2 have been associated to the risk of developing of prostate cancer in man, dog can be used as a natural model for this disease. The stroma can act as paracrine way in the epithelial cells, stimulating epithelial proliferation, reducing the apoptosis of this compartment and promoting angiogenesis in the microenvironment, factor that contribute to prostatic carcinogenesis and that the protein expression is increased in this lesion. Sponcer: Fapesp (Fundação de Apoio a Pesqusia do Estado de São Paulo) Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 2406. doi:10.1158/1538-7445.AM2011-2406
Implication of Lymph Node Metastasis Detected on 18F-FDG PET/CT for Surgical Planning in Patients With Peripheral Intrahepatic Cholangiocarcinoma
Authors: Tae Gyu Park, Young-Dong Yu, Beom Jin Park, Gi Jeong Cheon, Sun Young Oh, Dong-Sik Kim, Jae-Gol Choe
Journal: Clinical Nuclear Medicine (2013)

Intrahepatic cholangiocarcinoma (ICC) is the second most common primary hepatic malignancy after hepatocellular carcinoma. ICC can be divided into 2 types according to their location: peripheral and hilar types. Intense F-FDG uptake on PET was reported in peripheral ICC. However, the usefulness of PET/CT in detecting tumors and predicting prognosis in peripheral ICC has not been fully evaluated. In this study, we evaluated the clinical role of F-FDG PET/CT to predict the recurrence after the curative resection in patients with surgically indicated peripheral ICC.Eighteen patients with ICC underwent preoperative CT and F-FDG PET/CT scans. SUVmax of tumor, tumor to normal liver SUV ratio (TNR), lymph node status evaluated by F-FDG PET/CT, tumor and lymph node size measured by CT, vascular invasion confirmed by pathology, and satellite nodules found on CT were compared between 1-year recurrence group and recurrence-free group by chi-square test.Of total 23 measurable lymph nodes, 4 nodes were positive and other 19 nodes were negative or equivocal on CT. Among those 23 nodes, 9 nodes were positive and other 14 nodes were negative on F-FDG PET/CT. The sensitivity and specificity of CT were 20.0% and 86.4%, and those of F-FDG PET/CT were 80.0% and 92.3%. In the comparison between 1-year recurrent and nonrecurrent groups, lymph node metastasis detected on F-FDG PET/CT had statistically positive correlation with the 1-year recurrence after surgical resection (P = 0.02). Other factors showed no statistically significant difference between the groups.We found that lymph node metastasis detected on F-FDG PET/CT correlated positively with 1-year recurrence after surgical resection in patients with peripheral ICC.
METABOLOMIC PROFILING IDENTIFIES BIOMARKERS PREDICTING ADVERSE OUTCOMES IN PATIENTS WITH HEART FAILURE WITH PRESERVED EJECTION FRACTION
Authors: Jacob P. Kelly, Wynn Hunter, Damian Craig, Carol Haynes, Robert McGarrah, Eric Velazquez, Michael Felker, Adrian Hernandez, Olga Ilkayeva, Robert D. Stevens, James Bain, Michael Muehlbauer, Christopher Newgard, William Kraus, Svati Shah
Journal: Journal of the American College of Cardiology (2015)
Bundled Payment Models for Actinic Keratosis Management
Authors: Joslyn S. Kirby, Amber Delikat, Douglas Leslie, Jeffrey J. Miller
Journal: JAMA Dermatology (2016)

Recent legislation encourages alternative payment models, such as bundled payments. There are no clear recommendations on bundled payment design, and research on bundled payments for dermatologic care is limited.To investigate several methods to develop bundled payment models for actinic keratosis (AK) management and the likely effect on the cost of AK management.Cohort cost identification study using claims from Highmark Insurance and the MarketScan Commercial Claims and Encounters databases. Patients with claims for AK during the study period, January 2010 to December 2012, were included (N = 118 129). Utilization measures, such as visits and procedures, and direct costs were calculated and 8 bundled payment models were developed. Indirect costs were not included.The actual health care costs and theoretical cost differences for the bundled payments. Costs are reported in 2012 US dollars and were adjusted for inflation. The proportion of patients and clinicians with annual AK claim costs less than or equal to the bundled payments were calculated.Eight bundled payment models were developed and 2, based on the 75th percentile payment, did not result in theoretical savings for any of the patient samples (increased annual spending of $1.04 million to $6.88 million). The median-based payment without adjustments resulted in the largest theoretical savings (decreased spending of $2.22 million to $6.43 million). In contrast, the mean-based payment with adjustments resulted in the smallest theoretical savings. The median-based with indirect payment (65.2% for patients and 62.0% for clinicians) and mean-based adjusted payments, with (68.9% and 66.2%) and without (68.1% and 65.6%) discount, were equal to or greater than the actual health care costs for similar proportions of patients and clinicians, respectively. In addition, both resulted in a decrease in overall health care costs for the patient cohort.It is important to consider alternative payment models, such as bundled payments, in preparation for payment reform. The dermatology profession needs to understand disease management in dollar terms to advocate on behalf of clinicians and patients for fair and reasonable reimbursement, regardless of payment type.
Four and 24-Hour Imaging of Mesoblastic Nephroma With Tc-99m DMSA
Authors: LAURA A. DRUBACH, LEONARD P. CONNOLLY, TAYLOR CHUNG, S. TED TREVES
Journal: Clinical Nuclear Medicine (1997)

Mesoblastic nephroma is the most common renal tumor of infancy. It is a benign tumor, but the growth pattern is one of local invasion and extension through the capsule. The treatment of choice is total nephrectomy with wide local excision. A case in which Tc-99m DMSA localization in a mesoblastic nephroma was markedly more prominent at 4 hours than at 24 hours after tracer administration is presented. This can be explained by localization of Tc-99m DMSA in a highly vascularized tumor.
Determination of histological differentiation of pancreatic cancer by radial-scanned EUS
Authors: VG Neoustroev, EA Iljicheva, RI Rasoulov, VA Khmelnickaya, AA Vladimirova
Journal: Endoscopy (2006)

Background: Postoperative survival and treatment program for the patients with pancreatic adenocarcinoma is determined by histological differentiation and stage of tumor. The accuracy of preoperative morphological diagnosis depends on peculiarities of pancreas anatomic position. This fact induces to find new non-invasive criteria of diagnosis.
Primary Rosai-Dorfman Disease of the Bone in a Patient With History of Breast Cancer
Authors: Lorenzo Mannelli, Serena Monti, Jason E. Love, Steven J. Kussick, Anna McLuen, Fatemeh Behnia
Journal: Clinical Nuclear Medicine (2014)

A 49-year-old woman with history of breast cancer presented with pain at the level of the left anterior proximal tibia. An x-ray of the tibia demonstrated a lytic cortical lesion that prompted a whole-body 99mTc-MDP bone scan. The bone scan revealed intense bone remodeling at the level of the tibial lytic lesion and in the cervical spine. CT demonstrated an expansile lesion eroding the vertebral bodies of C6 and C7 with a large soft tissue component. A biopsy of the cervical spine mass demonstrated features diagnostic of Rosai-Dorfman disease without evidence of neoplastic cells.
Effects of Walnuts on Serum Lipid Levels and Blood Pressure in Normal Men
Authors: Joan Sabate, Gary E. Fraser, Kenneth Burke, Synnove F. Knutsen, Hannelore Bennett, Kristian D. Lindsted
Journal: New England Journal of Medicine (1993)

In a recent six-year follow-up study, we found that frequent consumption of nuts was associated with a reduced risk of ischemic heart disease. To explore possible explanations for this finding, we studied the effects of nut consumption on serum lipids and blood pressure.
Renal Disease in Systemic Lupus Erythematosus
Authors: Naomi F. Rothfield, Robert T. McCluskey, David S. Baldwin
Journal: New England Journal of Medicine (1963)

THE ability of adrenal corticosteroid therapy to prolong life in patients with systemic lupus erythematosus has been recognized by most observers.1 2 3 It is generally stated, however, that the renal lesion usually progresses despite suppression of activity of the disease in other systems.1 2 3 Recently, Pollak et al.4 have suggested that "lupus glomerulonephritis" can be treated successfully by prolonged administration of corticosteroids if they are given in excess of the dosage required to control other manifestations of the disease.We have observed a relatively low incidence of progressive renal disease in patients with systemic lupus erythematosus although steroids have been administered at . . .
IMPACT OF SIMPLE THREE RISK FACTORS (AGE, BODY WEIGHT, AND HISTORY OF STROKE) ON IN-HOSTPIAL BLEEDINGS IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION
Authors: Se Yong Jang, Nam Kyun Kim, Chang-Yeon Kim, Myung Hwan Bae, Jang Hoon Lee, Dong Heon Yang, Hun Sik Park, Yongkeun Cho, Shung Chull Chae
Journal: Journal of the American College of Cardiology (2016)