tbuckley/cabot-search huggingface dataset:
A LOCAL REVIEW OF THE NCEPOD AUDIT OF PARENTERAL NUTRITION - WHAT CAUSED THE ‘MIXED BAG’?
Authors: E Murray, V Kalansooriya, R Campbell, M Green, T Beattie, G B Turner.
Journal: Gut (2013)

<h3>Introduction</h3> The report, “A Mixed Bag”, published by NCEPOD in 2010 was a review of Parenteral Nutrition (PN) in hospitalised patients. It demonstrated that only 19% of adults received care deemed to represent good clinical practice. Particular attention was drawn to poor documentation of nutritional issues. <h3>Aims/Background</h3> To audit the administration of Parenteral Nutrition within the RVH, Belfast in direct comparison with NCEPOD report and to identify where discrepancies existed. <h3>Method</h3> Consecutive patients started on PN at the time of the NCEPOD report were identified using pharmacy records. Each patient9s medical, dietetic and nutrition nursing notes were independently reviewed using the NCEPOD PN Questionnaire. <h3>Results</h3> 27 patients were identified with patients excluded due to missing casenotes. No treatment goal was documented for 89% of patients. Twelve percent of patients had PN started at a weekend, refeeding risk was not documented for these patients but was for all others. The initial bag was inappropriate for patient needs in 17%, the majority of these started at the weekend. While combining records revealed good clinical monitoring, this was poor in medical notes compared with dietetic/nursing records. Metabolic complications occurred in 39%, similar to NCEPOD. There was a universal lack of documentation regarding central venous catheter insertion. <h3>Conclusion</h3> Our audit reiterates the findings of the NCEPOD report, with particular regard to documentation and complications. Patients started at the weekend appeared to have poorer documentation. The development of a PN proforma or clinical check list may be useful to identify and reduce risks/complications.
Fluorescence in situ hybridization for the detection and monitoring of the Ph-positive clone in chronic myelogenous leukemia: comparison with metaphase banding analysis
Authors: A Cuneo, R Bigoni, B Emmanuel, E Smit, GM Rigolin, MG Roberti, A Bardi, N Piva, G Scapoli, G Castoldi, H Van Den Berghe, A Hagemeijer
Journal: Leukemia (1998)
Abstract 609: Paradoxical actions of a c-Src inhibitor on estradiol-induced apoptosis in long-term estrogen deprivation breast cancer cells
Authors: Ping Fan, Helen R. Kim, V. Craig Jordan
Journal: Cancer Research (2010)

Abstract Resistance to aromatase inhibitors used for the treatment of estrogen receptor (ER) positive breast cancer is an increasing problem clinically. We have demonstrated in the laboratory that long term estrogen-deprived MCF-7 breast cancer cells referred to as MCF-7:5C (Lewis et al, JNCI 2005, 97:1746-1759), respond to physiological estrogen by triggering apoptosis. This scientific observation is now in clinical trial, but only 30% of patients receive clinical benefit (Ellis et al, JAMA 2009, 302:774-780). A goal of translational research is to increase the therapeutic responsiveness of antihormone resistant breast cancer. c-Src inhibitors are currently of interest, as they inhibit survival pathways in breast cancer. We have evaluated the potential of the c-Src inhibitor, PP2, alone (5 µM), and compared results of cell survival with estradiol (1 nM E2) alone, or in combination with PP2. The MCF-7:5C cells have increased levels of phosphorylation c-Src, compared to wild type MCF-7 cells. Long term treatment (at least 2 months) with PP2 initially decreased growth rates of MCF-7:5C cells, but then growth recovered. Long term treatment of MCF-7:5C cells with E2 initially causes massive apoptosis, but a population of surviving cells subsequently regrew, but these ER-positive cells were refractory to estrogen action. In contrast, a combination of PP2 + E2 actually retarded apoptosis and the resulting cell line (MCF-7:PF) is unique, as they grew vigorously in culture with physiological levels of estradiol, but remarkably are also stimulated in vitro by a panel of selective estrogen receptor modulators (SERMs). This is the first description of a Phase I (Jordan, Cancer Cell 2004, 5:207-213) resistant breast cancer cell line in vitro. These data illustrate that caution must be exercised when considering the evaluation of c-Src inhibitors in clinical trial following the development of acquired resistance to aromatase inhibitors. A combination with therapeutic estrogen treatment or indeed endogenous estrogen may impair therapeutic effectiveness of c-Src in breast cancer. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 609.
Traitement endoscopique d'une sténose caustique réfractaire
Authors: P Bulois, V Maunoury, C Mariette, JP Triboulet
Journal: Endoscopy (2009)

Introduction: La sténose œsophagienne est fréquente au décours des brûlures caustiques de l'œsophage. La prise en charge thérapeutique de cette complication repose sur l'endoscopie. La dilatation aux bougies est utilisée en première intention. Par rapport aux autres indications de dilatation œsophagienne pour pathologie bénigne, les sténoses caustiques récidivent plus fréquemment et nécessitent dans plus de 90% des cas des séances itératives. 30 à 50% de ces sténoses demeurent réfractaires aux dilatations répétées. L'endoscopie peut être une alternative à la chirurgie dans ces cas difficiles, avec la mise en place de prothèses extractibles temporaires. La réalisation d'incisions per-endoscopiques peut également être proposée pour les sténoses très courtes.
Abstract 2781: Argatroban Anticoagulation for PCI: The E04 European Multi-Center Study
Authors: Lothar Roessig, Sabine Genth-Zotz, Matthias Rau, Guy R Heyndrickx, Frank M Baer, Dietrich C Gulba, Martin Desaga, Michael Buerke, Andreas M Zeiher
Journal: Circulation (2007)

Background —Argatroban is an attractive drug for cardiology because it has a fast onset and offset of anticoagulation, and is hepatically excreted. Argatroban received approval for PCI in patients (pts) with heparin-induced thrombocytopenia (HIT) in the U.S. in 2002. However, data about argatroban in the current PCI setting is limited. Methods –The E04 trial, an open-label, parallel-group, multiple-dose study, included 140 pts undergoing PCI. Pts were randomly assigned to three argatroban- (250, 300 or 350 ìg/kg as a bolus injection before PCI, followed by 15, 20 or 25 ìg/kg/min infusion until the end of the procedure) and one unfractionated heparin (UFH)-treated groups (70 –100 IU/kg as a bolus injection). Efficacy endpoints were the proportion of pts reaching the minimum target ACT (250 sec.) after the initial bolus injection of each anticoagulant; ACT time-course during PCI; number of additional bolus injections; composite incidence of all-cause death, myocardial infarction (MI) and urgent revascularization until Day 30; and incidence of hemorrhagic events during the hospital stay. Results —Argatroban dose-dependently prolonged ACT. Significantly (p &lt; 0.01) more pts reached the minimum target ACT after the initial bolus injection with 86.1%, 89.5% and 96.8% in the low, middle and high dose argatroban groups, respectively, compared to 45.5% in the UFH group. Time to start of PCI after reaching minimum target ACT was significantly (p &lt; 0.01) shortened in the argatroban groups compared to UFH. Composite incidences of death, MI and urgent revascularization were 2.8%, 0.0%, 3.2% and 3.0% in the low, middle and high dose argatroban groups, and the UFH group, respectively (n.s.). Major bleeding was observed only in the UFH group (3.0%), and minor bleeding occurred in the high dose argatroban (3.2%) and the UFH group (6.1%). Conclusions —Argatroban had an adequate anticoagulant effect. More pts reached the minimum target ACT in the argatroban groups than in the UFH group. This resulted in a reduced time to start PCI. Although the sample size was too small to conclude an effect on clinical outcome, the results suggest that argatroban is a safe and effective anticoagulant for PCI in the current clinical setting.
Abstract 2111A: Molecular genetics of non-alcoholic fatty liver disease
Authors: Ivy Shi, Takuya Sakaguchi
Journal: Cancer Research (2012)

Abstract Non-alcoholic fatty liver disease (NAFLD) is a widespread condition of growing concern. It affects up to 25% of people in the United States, and is caused by the buildup of lipids in the liver. NAFLD may lead to hepatocellular carcinoma, the 5th most common cancer in the world, and the 3rd most common cause of death from cancer. Steatosis is the earliest stage in the progression of NAFLD. It is characterized by the deposition of triglycerides as lipid droplets in the cytoplasm of hepatocytes. Although not usually lethal alone, it may develop into nonalcoholic steatohepatitis, and develop further into cirrhosis and ultimately hepatocellular carcinoma. A mutation in zebrafish is created that completely obstructs the guanine monophosphate synthase. The mutants show a phenotype of steatosis. We hypothesize that genes involved in de novo lipogenesis, lipid oxidation, or lipid transportation are altered in the mutants. To test our hypothesis, we conducted gene expression analysis using qPCR. The data indicates that the genes involved in de novo lipogenesis had no significant change. However, the genes involved in lipid oxidation were all significantly downregulated. This downregulation indicates that inadequate lipid metabolism is responsible for the buildup of lipids and steatosis. The genes involved in lipid transportation showed a downregulation trend. It might be a result of steatosis as the liver takes in less fat. Overall, the data suggests that the mutant cell is unable to metabolize enough lipids through oxidation, causing lipid buildup in the liver. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 2111A. doi:1538-7445.AM2012-2111A
NHS Constitution is "patchy, low key, and inconsistent," says review
Authors: Z. Kmietowicz
Journal: BMJ (2012)

The government must do more to publicise the NHS Constitution among the public as well as NHS staff and give the document “more teeth” by defining more clearly what people in England can do when they do not get their rights, says an independent group of experts.

In a letter to the health secretary dated 31 October, Steve Field, head of the NHS Future Forum, said that the forum working group’s consultation with many NHS organisations, patients, staff groups, and charities led it to conclude that there was “a striking degree of consensus” on the constitution and its objectives.1

But he added, “Despite the importance and potential of the NHS Constitution, its effect so far has been patchy, low key, and inconsistent. It has failed to have the impact required to influence the quality …
Abstract 1525: Nuclear homeoprotein SIX1 is associated with stage and grade of endometrial carcinoma.
Authors: Sara E. Wobker, Wendy N. Jefferson, Carmen J. Williams, Victoria L. Bae-Jump
Journal: Cancer Research (2013)

Abstract Introduction: SIX1 is a member of the homeoprotein gene family encoding transcription factors involved in normal embryogenesis. These proteins function in the cell nucleus to regulate transcription of genes that drive differentiation. SIX1 is also aberrantly expressed in numerous human malignancies, including breast, ovarian and cervical carcinomas. In a mouse model, SIX1 initiates transformation of mammary epithelial cells to diverse histologic types of carcinoma. SIX1 has not yet been studied in endometrial carcinoma, which is the most common gynecologic malignancy in the United States. Thus, our goal was to evaluate SIX1 in clinical samples of endometrial carcinoma and determine if there was an association with stage and grade. Methods: A tissue microarray (TMA) was created using endometrial carcinoma cases (n=55) and benign controls (i.e. proliferative, secretory and atrophic endometrium) (n=12). Endometrioid and serous histologic types were included in the carcinoma cases. The TMA was stained using a rabbit polyclonal anti-SIX1 antibody (Sigma). The TMA was then scored in a blinded manner by a single pathologist, using presence versus absence of nuclear staining for the stromal cells and the epithelial cells. Clinical data was collected on these samples to include height, weight, BMI, grade (FIGO 1, 2 or 3) and stage (1A, 1B-2B, 3A-4B). Results: Few controls had nuclear SIX1 in epithelial cells while all controls had nuclear SIX1 in stromal cells. In endometrial cancer samples, there was significantly increased nuclear SIX1 staining in the epithelial cells compared to controls, while there was less nuclear SIX1 in stromal cells. This finding was more pronounced with increasing grade and stage of tumor (Table 1). Conclusions: Nuclear SIX1 expression is associated with increased grade and stage of endometrial cancer. These findings suggest that SIX1 may play a role in the progression of this common cancer and have utility as a marker of more aggressive disease. Table 1. Percentage of uterine samples with nuclear SIX1 staining in epithelial and stromal cells Grade Stage Epithelial Stromal Epithelial Stromal Control 3/12 (25) 12/12 (100) Control 3/12 (25) 12/12 (100) Grade 1 16/22 (72) 13/22 (59) 1A 5/11 (46) 10/11 (91) Grade 2 15/16 (94) 6/16 (38) 1B-2B 26/31 (84) 13/31 (42) Grade 3 14/17 (82) 7/17 (41) 3A-4B 12/13 (92) 3/13 (23) Citation Format: Sara E. Wobker, Wendy N. Jefferson, Carmen J. Williams, Victoria L. Bae-Jump. Nuclear homeoprotein SIX1 is associated with stage and grade of endometrial carcinoma. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 1525. doi:10.1158/1538-7445.AM2013-1525
Association Between Laboratory Calibration of a Serum Bilirubin Assay, Neonatal Bilirubin Levels, and Phototherapy Use
Authors: Michael W. Kuzniewicz, Dina N. Greene, Eileen M. Walsh, Charles E. McCulloch, Thomas B. Newman
Journal: JAMA Pediatrics (2016)

The American Academy of Pediatrics treatment recommendations for neonatal jaundice are based on age-specific total serum bilirubin (TSB) levels. In May 2012, Ortho Clinical Diagnostics adjusted the calibrator values for Vitros Chemistry Products BuBc Slides (Ortho Clinical Diagnostics), a widely used method to quantify TSB, after concerns of positively biased results.To investigate the association between recalibration of a reflectance spectrophotometry serum bilirubin assay and TSB levels and phototherapy use among newborns.Descriptive study comparing TSB levels and phototherapy use before and after recalibration at Kaiser Permanente Northern California, a large, integrated health care delivery system. The study evaluated live births at or after 35 weeks' gestation at 12 facilities that used universal serum bilirubin screening before (January 1, 2010, through April 30, 2012; n = 61 677) and after (July 1, 2012, through December 31, 2013; n = 42 571) recalibration. The analysis took place in December 2015.Recalibration of bilirubin testing instruments.Proportions of newborns with (1) at least 1 TSB value at or above 15 mg/dL; (2) at least 1 TSB level exceeding the American Academy of Pediatrics phototherapy threshold; (3) phototherapy during the birth hospitalization; and (4) at least 1 readmission for phototherapy.In 104 420 infants (61 677 in the prerecalibration period and 42 511 in the postrecalibration period), a TSB was obtained in 99.2% of infants during birth and in 99.5% of infants within the first 30 days after birth. The postrecalibration period was associated with a 1.25 mg/dL (95% CI, 1.19-1.31; P < .001) decrease in mean maximum TSB, which led to a 39% relative reduction (from 20.4% to 12.4%) in infants with a TSB level of 15 mg/dL or more and a 51% relative reduction (from 9.3% to 4.5%) in infants with a TSB level that was at or above the American Academy of Pediatrics phototherapy threshold. Phototherapy during birth hospitalizations was reduced by 59% (absolute risk reduction, 5.5%; 95% CI, 4.7%-6.1%) and readmissions for phototherapy by 53% (absolute risk reduction, 1.8%; 95% CI, 1.4%-2.3%).Modest recalibration-induced reductions in mean TSB concentrations was associated with a significant reduction in the percentage of infants with clinically significant hyperbilirubinemia. Current laboratory accuracy standards are insufficient to detect biases that can have significant clinical effect. These data underline the need for increased integration of laboratory expertise into clinical guidelines and to support international initiatives to standardize laboratory measurements.
SAT0494 Evaluation of Conventional Assessment of Tocilizumab Therapy in Patients with Rheumatoid Arthritis using FDG-PET/CT
Authors: K. Okamura, Y. Yonemoto, T. Kaneko, C. Okura, T. Kobayashi, K. Takagishi
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> In recent years, the treatments of rheumatoid arthritis (RA) patients were rapidly developed and many biological drugs, such as tumor necrosis factor (TNF) inhibitors, were newly administered. A humanized anti-interleukin-6 receptor (anti-IL-6R) antibody, Tocilizumab (TCZ) is one of these drugs. In the early stage of the TCZ therapies, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) have the immediate decrease after the initiation of this drug. Therefore, some previous report demonstrated that Disease Activity Score in 28 Joints (DAS28) was inappropriate marker for the assessments of the patients with RA. <h3>Objectives</h3> To evaluate whether TCZ suppress the synovitis of RA patients after 3 months of TCZ therapies and whether we can recognize the conventional assessment by DAS28-CRP and SDAI for patients with TCZ treatments at that time. <h3>Methods</h3> Fifteen RA patients treated with TCZ were assessed. Positron emission tomography (PET) with 2-[18F]-fluoro-2-deoxy-D-glucose (<sup>18</sup>F-FDG) were performed at baseline, 3 months and 6 months after the initiation of the therapies. The maximal SUV (SUVmax) of the bilateral shoulder, elbow, wrist, hip, knee, and ankle joints were summed up (total SUV) and used for the assessment of the FDG uptake as a representative value. Wilcoxon rank-sum test was applied to compare the clinical evaluations between baseline and each observation period. Spearman's rank correlation test was used to assess the correlation between the Δ SUV and the difference of the clinical parameters. <h3>Results</h3> The total SUV were significantly decreased 3 and 6 months after the initiation of TCZ (p&lt;0.001). The ΔSUV, the difference in the SUVmax of the affected 12 joints before and after treatment, was positively correlated with the ΔDAS28-CRP (r=0.639, p=0.01) and ΔSDAI (r=0.618, p=0.014) (3 months), and ΔDAS28-CRP (r=0.811, p&lt;0.001) and ΔSDAI (r=0.707, p=0.003) (6 months). <h3>Conclusions</h3> The TCZ might suppress the synovitis of the RA joint 3 months after the initiation of the therapies. The conventional assessment of RA for the TCZ therapies could reflect the true disease activity. <h3>Disclosure of Interest</h3> None Declared
RIGHT VENTRICULAR (RV) LINEAR DIMENSIONS ON ECHOCARDIOGRAPHY (ECHO) ARE RELIABLE INDICES OF CARDIAC MAGNETIC RESONANCE (CMR) QUANTIFIED CHAMBER REMODELING: A MULTIMODALITY VALIDATION STUDY
Authors: Jiwon Kim, Aparna Srinivasan, Tracy Paul, Alexi Geevarghese, David M. McQueen, Charles S. Peskin, Meenakshi Rozenstrauch, Anna Wysocka, Noel C.F. Codella, Richard Devereux, Jonathan Weinsaft
Journal: Journal of the American College of Cardiology (2016)
THU0458 Assessment of dietary calcium intake among rheumatology patients
Authors: X. Grapton, D. Leclere, P. Lemesle, L. Poulain, P. Renard
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Objectives</h3> Our patients are influenced by all medical information, and even rumours. The aim of this study is to analyse their habits and reactions concerning dairy products and calcium. <h3>Methods</h3> 305 patients completed a questionnaire in the waiting room of non-hospital-based rheumatologists. 90% were women, while the average age was 62 years and 97% were from the île-de-France region. 33.6% took osteoporosis medication or a vitamin and calcium supplement. 66% underwent a bone densitometry test (17.4% for osteopenia, 13% for osteoporosis). 24% had a history of non-traumatic fracture and 13% had another osteoporosis risk factor. 32% practised a weight-bearing sport, while 12.5% had lost more than 8kg through diet. <h3>Results</h3> 80% of those questioned did not know the body's calcium or nutritional requirements apart from dairy products in content, but believe they have a sufficient intake. Nutritional calcium intake is mainly via yoghurts (37%). 56.4% have a nutritional calcium intake of &lt;900 mg/day. 22% of patients drink calcium-enriched water. 25% of those questioned think that soya milk has the same benefits as cow's milk and use it instead of cow's milk half the time. Those with a BMI of less than 19 have the lowest nutritional calcium intake (740 mg/day on average). 40-60-year-old patients are the most responsive to rumours and lectures on milk. They are the ones who change their nutritional habits with regard to dairy products. Before the age of 40 years, patients are less responsive to medical advice and are influenced by the cost of dairy products and advertising. Less than 10% of those questioned have no dairy intake because of taste, fat content, high cholesterol concerns and intolerances. In 25% of cases, lectures and rumours created a mistrust of dairy products due to contradictory advice. Two thirds consider them useful while one third fear them. Calcium is not dangerous (63%) but can lead to disorders if taken in excess. The dairy products-calcium-osteoporosis relationship is well-understood, yet the onset of a fracture does not change people's habits concerning calcium (71%). Bone density measurement results and medical advice have a strong impact (91%). The effects of tobacco, alcohol and salt on bones is not well-known. 52% are ignorant of the role of vitamin D for the bones, but do relate it to calcium. <h3>Conclusions</h3> While campaigns for the consumption of dairy products have helped promote their relevance in bone health, they have not dispelled any concerns over gaining weight or worsening cholesterol levels. Calcium is widely approved &lt;73%&gt;89%&gt; whatever the age to maintain bone quality (41%) and fight osteoporosis (28%). Osteoporosis and the risk of fracture are well-understood, which presupposes that there is a determination to fight both. <h3>Disclosure of Interest</h3> None Declared
MYOCARDIAL EDEMA ASSESSED WITH T2-WEIGHTED CMR IMAGING AND SUDDEN CARDIAC DEATH RISK IN PATIENTS WITH HYPERTROPHIC CARDIOMYOPATHY
Authors: Frank Gommans, Etienne Cramer, Jeannette Bakker, Michelle Michels, Hendrik-Jan Dieker, Michael Fouraux, Carlo Marcelis, Janneke Timmermans, Freek Verheugt, Marc Brouwer, Marcel Kofflard
Journal: Journal of the American College of Cardiology (2016)