tbuckley/cabot-search huggingface dataset:
¿MEJORA LA SEDACION CON PROPOFOL CONTROLADA POR ENFERMERIA LOS RESULTADOS DE LA CPRE EN EL CASO DE UN ENDOSCOPISTA EXPERIMENTADO?
Authors: S Maestro Antolin, R Castillo Trujillo, K De Jesus Geneaux, J Barcenilla Laguna, F Igea Arisqueta
Journal: Endoscopy (2011)

Introducción: La cpre es una tecnica explorador-dependiente. Numerosos trabajos han demostrado la existencia de una curva de aprendizaje necesaria hasta alcanzar un nivel de eficacia en la realización de la misma. No obstante a partir de un determinado número de exploraciones no se ha demostrado que exista un factor dependiente del endoscopista que pueda ser introducido para aumentar el nivel de eficacia.
Case 19-2001
Authors: Simon M. Helfgott, Alexander Kratz
Journal: New England Journal of Medicine (2001)

Presentation of CaseA 50-year-old man was admitted to the hospital because of fever and arthralgias.The patient had been in excellent health until six weeks earlier, when a sore throat, rhinorrhea, headaches, and low-grade fever developed. Two weeks later, all the symptoms improved for a few days, followed by a recurrence of fever (peak temperature, 39.4°C), night sweats, and occasional rigors. One week before admission, blood cultures and a tuberculin skin test were negative.Four days before admission, the patient had pain in the right elbow and knees and pain and edema in the hands and feet. On the . . .
OP0255 Clinical Characteristics of Infections in Connective Tissue Diseases (CTD); Association with Glucocorticoids (GC) and Glucose Intolerance
Authors: H. Kuda, M. Ushikubo, H. Ito, K. Izumi, K. Akiya, S. Tamaki, I. Tanaka, H. Oshima
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> Patients with connective tissue diseases (CTD) have an increased risk for infectious disease-related morbidity and mortality. This risk in due in part to the underlying immune cell dysfunction and the immunosuppressive therapies. In the past decade a number of newly developed biologic therapies have delivered clinical benefits to CTD patients. With these therapies, however, CTD patients have now more risks for the serious bacterial and opportunistic infections. <h3>Objectives</h3> To investigate clinical characteristics of infections in CTD, especially co-relation with glucocorticoids or glucose intolerance. <h3>Methods</h3> We retrospectively reviewed the medical records of all patients with CTDs visited at the Department of Connective Tissue Diseases, Tokyo Medical Center, Tokyo, Japan, between April 1, 2006, and March, 31, 2013. <h3>Results</h3> A total of 2893 patients visited the office during 8-years study period. Of these, 1170 patients followed for more than half a year were reviewed. Mean age was 63.9 years. They were followed up for a mean of 830 days. There were 177 patients (13.4%) with infections (respiratory infection in 36.4%, urinary tract infection in 26.5%, skin infection in 17.4%). Serious infection (SIE) were seen in 33%. Prednisolone (PSL) was used in 74% of patients with infections and 54% without infections, Immunosuppressants were used in 29% of patients with infections and 18% without infection, Biologics used in 5% with infection and in 2% without infection (p&lt;0.01-0.05). A frequency of commodities (diabetes mellitus, chronic renal disease (CKD), chronic lung disorders) was higher in patients with infections than without infections (p&lt;0.01-0.05). Multiple regression analysis revealed that risk factors of infections in CTD were PSL use, increased age, CKD, chronic lung disorders (p&lt;0.01-0.05). Total dose of PSL in 6 months was positively correlated with the rate of infections (p&lt;0.01). Age, HbA1c and total dose of PSL in 6 months were significantly higher in patients with SIEs than in non-SIEs (p&lt;0.01). <h3>Conclusions</h3> Patients with CTD had high risk of developing infections. Especially patients with diabetes mellitus, CKD, chronic lung disorders and higher age had increased risk of infectious diseases. <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.2929
HER-2 expression on circulating tumor cells in metastatic breast cancer.
Authors: N Hayashi, H Yagata, T Hamaoka, S Sarumaru, K Tsugawa, A Yoshida, H Tsunoda-Shimizu, K Suzuki, M Shimada, Y Shimoda, S Nakamura
Journal: Cancer Research (2009)

Abstract Abstract #5020 Background: HER-2 Overexpression in breast cancer is associated with poor prognosis. The circulating tumor cells (CTCs) in peripheral blood can be identified in patients with breast cancer. They are recognized as a predictor of the effect of systemic therapy, and also as a prognostic marker recently. Cristofanilli et al reported that progression-free Survival (PFS) and overall survival(OS) in metastatic breast cancer patients with &amp;lt;5CTCs per7.5ml are significantly better than those with &amp;gt;5CTCs before initiation of a new line of therapy and at the 1st follow-up visit. However, the detection rate and value of HER-2 Overexpression on CTCs has been not determined well.Materials and Methods:CTCs were obtained prospectively for 22 patients with metastatic breast cancer to start a new line of treatment at single institution. Blood specimens were collected at monthly intervals for a period of up to 12 weeks. CT scans were also performed before start of the treatment and 12 weeks after. HER-2 expression on primary lesions and CTCs were determined by both immunohistochemical methods and fluorescence in situ hybridization (FISH) analysis. Mean age was 54.4 years (range, 32-75 years). 8 patients received first line therapy, one patient received second line therapy, and 13 patients received over third line therapy. Of the 22 primary cancer, 7(31.8%) were HER-2 positive(score,+3 or +2/FISH positive) and 15 (68.2%) were HER-2 negative. CTCs were determined using Cell Search™ System.Results:14(63.6%) patients had clinical benefit (partial response and stable disease) during the course. CTCs were detected in 16 patients (72.7%). OS for patients with &amp;lt;5CTCs were significantly longer than those with 5&amp;lt; at any period. In 15 patients with HER-2 negative primary cancer, 5 patients (33.3%) were with HER-2 positive CTCs. However, in 7 patients with HER-2 positive primary cancer, 6 patients (85.7%) who had been treated with trastuzumab was with HER-2 negative CTCs. But only one patient (14.3%) treated without trastuzumab was with HER-2 positive CTCs. The patient had been treated with trastuzumab and failed in past. And the median OS time for those patients with HER2 Positive CTCs were significantly shorter (130.5 days) than for those patients with HER2 negative CTCs (283.3 days). Surprisingly, 5 (83.3%) of 6 patients with HER-2 positive CTCs were dead within 7 months.Conclusion:The number of CTCs is a prognostic marker for the patients with metastatic breast cancer. Furthermore, HER-2 positive CTCs is much related to poor prognosis. And these results indicated that the possibility of negative conversion of HER2 expression on CTCs for patients with HER-2 positive primary cancer due to trastuzumab. Trastuzumab may be effective for the patients with HER2 negative primary cancer and HER-2 positive CTCs. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 5020.
Combined Action of Penicillin G with Methicillin or Oxacillin against Staphylococcus aureus
Authors: Leon D. Sabath, Bruce W. Steinhauer, Maxwell Finland
Journal: New England Journal of Medicine (1963)

WHEN the results of a gram stain or culture of material in a serious case of staphylococcal infection become known, and before the susceptibility of the organism has been determined, the physician is faced with a dilemma concerning the choice of therapy. Should the patient be treated with penicillin G (or some other penicillinase-susceptible penicillin) or with one of the penicillinase-resistant, semisynthetic penicillins, such as methicillin or oxacillin? If the infection turns out to be due to a penicillinase-producing staphylococcus, the penicillin G (or the other penicillinase-susceptible ones) would be virtually ineffective whereas, if it were due to a nonpenicillinase . . .
P4-05-04: Arachidonic Acid-Induced Elevated Expression of 5-Lipoxygenase Is Linked to Metastatic Migration of Breast Cancer Cells.
Authors: D Roy, Chatterjee A De, R Pal, S Roychowdhury, S Das
Journal: Cancer Research (2011)

Abstract Background: In invasive breast cancers, cancerous cells spread outside the ducts of the breast and metastasize to lung and other tissues. Although the rapid arachidonic acid (AA) metabolism and concomitant increase of eicosanoid molecules are involved in the proliferation and invasion of breast cancer cells, the exact mechanism by which AA metabolites regulate these phenomena are not well understood. Here, we show that leukotriene B4 (LTB4), one of the metabolites of AA, which is produced by the action of 5-lipoxygenase (5-LOX), causes the proliferation and metastatic migration of breast cancer cells. Material and Methods: MDA-MB-231 (invasive breast cancer cells) and MCF7 (non-invasive breast cancer cells) were used in this study. Briefly, cells were treated with AA (100 μM) and nordihydroguaiarectin acid (NDGA, 10 μM), and the secreted eicosanoids were characterized by HPLC. Immunofluorescence microscopy was performed to elucidate the expression and intracellular localization of 5-LOX. The metastatic migration was analyzed by wound-healing assays. Results: Our results suggest that while MDA-MB-231 cells produce high levels of PGE2 and PGD2, MCF7 cells synthesize excess HETE compounds (HETE5 and HETE8). Interestingly, MDA-MB-231 cells, when stimulated with AA, show the increased syntheses of LTB4 (∼3 fold) and decreased PGE2 and PGD2 (∼2 fold). In MCF7, on the contrary, AA treatment reduced the syntheses of all eicosanoids. Furthermore, the expression of 5-LOX in MDA-MB-231 cells was also increased by ∼2 fold. We observed that AA promotes cell migration in MDA-MB-231 cells, which could be blocked by NDGA, a generic inhibitor of LOX enzymes. Because LTB4 production and its binding with BLT receptors are linked to IL-8 secretion, we measured the level of IL-8 synthesized by both MCF7 and MDA-MB-231 cells. The results suggest that MDA-MB-231 cells secrete excess IL-8 (∼2 fold) when stimulated with AA, suggesting that LTB4 and IL-8 interactive pathways are important for cancer metastasis. Discussion: Our results demonstrate that LTB4 synthesis is linked to the metastatic migration of MDA-MB-231 cells, and that it therefore should be considered as a target for developing new drugs for the treatment of invasive breast cancers. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P4-05-04.
Abstract 973: Salinomycin sensitized paclitaxel-resistant human ovarian cancer cells and induced apoptosis.
Authors: Chi-Heum Cho, Hyun-Gyo Lee, Bidur Parajuli, So-Jin Shin, Sang-Hoon Kwon, Soon-Do Cha
Journal: Cancer Research (2013)

Abstract Ovarian cancer has the highest mortality rate among gynecologic malignancies in the world. Drug resistance is the main cause of treatment failure and mortality in cancer patients. The objective of this study was to establish a paclitaxel (PTX)-resistant human ovarian carcinoma cell line (OVCAR3) and to sensitize chemoresistant cells. The drug-resistant tumor cell lines were established in vitro by stepwise sequential exposure to increased concentration of PTX. For sensitization, OVCAR3/PTX cells were treated with different concentration of salinomycin alone or combined with PTX. The cell viability and cell cycle distribution was measured by MTT and flow cytometric analysis. The transcriptional change of mRNA was examined by RT-PCR. The induction of apoptosis was measured by caspase-3 activity test, DNA fragmentation assay and western blot analysis. The cell viability was significantly reduced by combination treatment in a dose dependent manner. The flow cytometry result showed an increase in sub-G1 phase. Combination treatment enhanced the sensitivity of OVCAR3/PTX cells to PTX with down-regulation of P-glycoprotein, XIAP and survivin. Taken together, we demonstrated potential effect of salinomycin in sensitization of PTX resistant ovarian tumor growth. Our results suggest salinomycin in combination with PTX may be a beneficial chemotherapeutic strategy, especially in patients with tumors refractory to PTX alone. Citation Format: Chi-Heum Cho, Hyun-Gyo Lee, Bidur Parajuli, So-Jin Shin, Sang-Hoon Kwon, Soon-Do Cha. Salinomycin sensitized paclitaxel-resistant human ovarian cancer cells and induced apoptosis. [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 973. doi:10.1158/1538-7445.AM2013-973
A Recurrent Problem
Authors: Holenarasipur R. Vikram, Gurpreet Dhaliwal, Sanjay Saint, C. Blake Simpson
Journal: New England Journal of Medicine (2011)

A 50-year-old woman from Texas had nasal stuffiness, postnasal drip, myalgias, cough, and hoarseness in early winter. Six weeks later, her nonproductive cough and hoarseness persisted. She had no fever, chills, night sweats, pain, weight loss, nausea, vomiting, or rash.
Risk Factors for Skeletal-Related Events in Patients with Non-Small Cell Lung Cancer Patients with Bone Metastases
Authors: A. Ulas, A. Bilici, S.T. Tokluoglu, S. Akinci, K. Silay, F. Paksoy Turkoz, A. Durnali, B.O. Oksuzoglu, N. Alkis
Journal: Annals of Oncology (2015)
Effect of concomitant proton pump inhibitor (PPI) on effectiveness of tyrosine kinase inhibitor (TKI) in patients with metastatic renal cell carcinoma (mRCC).
Authors: Trang H. Au, Erin B. Bailey, Shiven B. Patel, Srinivas Kiran Tantravahi, Neeraj Agarwal, David D. Stenehjem
Journal: Journal of Clinical Oncology (2016)

608 Background: PPIs may reduce TKI bioavailability resulting in reduced efficacy, shortened time on TKI treatment, and disease progression. Axitinib, sorafenib, and pazopanib exhibit pH-dependent solubility. Esomeprazole reduced the AUC and Cmax of pazopanib by 40%, but there was no significant interaction for sorafenib with omeprazole or axitinib with rabeprazole. In real world practice, the effect of PPIs as a class on the efficacy of TKIs as a class in mRCC has not been reported. Methods: This observational cohort study evaluated adult patients treated with a TKI for mRCC. Time on TKI treatment was defined as TKI initiation date to date of discontinuation, change in therapy, lost to follow-up, or death. We performed a treatment line analysis. Time on TKI treatment was compared between patients with and without concurrent PPI (Kaplan-Meier, log-rank). Results: Analysis included 128 treatment lines, including 49 TKI with PPI and 79 TKI with no PPI treatment lines. TKIs included sunitinib, pazopanib, sorafenib, and axitinib. PPIs included omeprazole, lansoprazole, esomeprazole, pantoprazole, and rabeprazole. The three most common TKI/PPI combinations involved omeprazole with sunitinib (26), pazopanib (13), and axitinib (3). No difference in time on TKI treatment with PPI (median 8.7 months) and with no PPI (median 7.0 months, p = 0.41) was observed. In pazopanib treatment lines, no difference in time on treatment was observed in those treated with omeprazole or esomeprazole (n = 14, median 4.8 months) compared to those without PPI (n = 18, median 1.7 months, p = 0.22). Conclusions: Among the TKI/PPI combinations evaluated, there was no difference in time to TKI discontinuation with or without concurrent PPI. This suggests that concurrent PPI does not affect time to discontinuation of TKI. Study limitations include the small sample size, limited number of TKI/PPI combinations, and retrospective study design. A larger study is needed to validate these findings.
Targeting ultrasound remission in early rheumatoid arthritis: the results of the TaSER study, a randomised clinical trial
Authors: James Dale, Anne Stirling, Ruiqi Zhang, David Purves, Jonathan Foley, Martin Sambrook, Philip G Conaghan, Désirée van der Heijde, Alex McConnachie, Iain B McInnes, Duncan Porter
Journal: Annals of the Rheumatic Diseases (2016)

Objective To investigate whether an intensive early rheumatoid arthritis (RA) treat-to-target (T2T) strategy could be improved through the use of musculoskeletal ultrasound (MSUS) assessment of disease activity. Methods 111 newly diagnosed patients with RA or undifferentiated arthritis (symptom duration &lt;1 year) were randomised to strategies that aimed to attain either DAS28-erythrocyte sedimentation rate (ESR)&lt;3.2 (control) or a total power Doppler joint count≤1 during a combined DAS28-ESR/MSUS assessment (intervention). MSUS examination was indicated if: DAS28-ESR&lt;3.2 or DAS28-ESR≥3.2 with two swollen joints. Step-up disease-modifying antirheumatic drug (DMARD) escalation was standardised: methotrexate monotherapy, triple therapy and then etanercept/triple therapy. American College of Rheumatology (ACR) core-set variables were assessed 3 monthly by a metrologist blinded to group allocation. MRI of dominant hand and wrist, and plain radiographs of hands and feet were undertaken at baseline and 18 months for grading by two readers using the Outcome Measures in Rheumatology (OMERACT) Rheumatoid Arthritis MRI Scoring System (RAMRIS) and van der Heijde/Sharp Score, respectively. The coprimary outcomes were mean change from baseline of DAS44 and RAMRIS erosion score. Results Groups were matched for baseline clinical, demographic and radiographic features. The intervention group received more intensive DMARD therapy. Both groups demonstrated significant improvements in DAS44 (mean change: control −2.58, intervention −2.69; 95% CI difference between groups −0.70 to 0.48; p=0.72). There were no significant between-group differences for any ACR core-set variables, except DAS44 remission after 18 months (control 43%, intervention 66%; p=0.03). There was minimal progression of MRI and radiographic erosions and no difference in imaging outcomes or serious adverse event rates. Conclusions In early RA, a MSUS-driven T2T strategy led to more intensive treatment, but was not associated with significantly better clinical or imaging outcomes than a DAS28-driven strategy. Trial registration number NCT00920478.
Communicating Risk of Hereditary Breast/Ovarian Cancer among Underserved Women: Interim Findings from the CREdIT Study.
Authors: D. Braithwaite, M. Metrikin, R. Lee, M. Beattie, J. Luce
Journal: Cancer Research (2009)

Abstract Purpose: With the support of the Avon Foundation, genetic counseling is available to underserved populations at the San Francisco General Hospital. One of the major challenges in providing genetic counseling for hereditary breast and ovarian cancer among these women is the lack of culturally appropriate educational tools.The purpose of this study is to evaluate the use of a Cancer Risk Educational Intervention (CREdIT), a novel audio-visual PowerPoint-based tool as an adjunct to genetic counseling. Methods: CREdIT took on average 15 minutes to view and was available in English and Spanish. It employed non-scientific images and language specifically designed for use by our target population. Participant questionnaires evaluating patient satisfaction, risk perception, knowledge of cancer genetics, and anxiety were administered before and after the intervention and at 1 year follow-up. For each of the continuous outcomes, differences from pre- to post-intervention were assessed with analyses of variance, while chi-squared tests were used to examine the differences among categorical variables. Results: A total of 52 women of diverse backgrounds who were on average 47 years old (range 27-69) took part in the study. Of these, 15% reported previous history of cancer, 58% were non-white and 59% had a below college education. Twenty-one percent viewed the presentation in Spanish. Following the presentation of CREdIT, we found an increase in the knowledge of BRCA inheritance and associated risk of malignancy, and options for risk reduction (all p &amp;lt; .05). However, participants' perceived risk perception did not change from baseline to post-CREdIT (p=.73). Virtually all participants (98%) reported that CREdIT helped them learn more about cancer risk. Although patient anxiety decreased post-CREdIT (p=.02), 29% patients reported that CREdIT made them worry more about cancer. Among 32 participants who were interviewed at the long-term follow-up, we found that, compared to post-CREdIT, knowledge changed for only two of the seven questions (p&amp;lt; .05). There were also no changes in anxiety or cancer worry compared to baseline (both p&amp;lt; .05). Conclusions: These interim findings suggest that our intervention was successful at increasing knowledge regarding breast cancer genetics without increasing anxiety or cancer worry. Our long-term goal is to perform a large-scale evaluation among underserved women at risk of hereditary cancer across the Avon Foundation-supported clinics nationwide. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 4074.
OC-130 Emergency cholecystectomy; an economic evaluation of practice at a regional hepatobiliary centre
Authors: N Misra, V Kaliyaperumal, N Grimes, E McChesney, R Jones, D Dunne, G Poston, S Fenwick, H Malik
Journal: Gut (2012)

<h3>Introduction</h3> The debate as to how to best manage patients presenting acutely with complications of gallstones continues—whether to consider early emergency surgery or not. Perceptions of increased risk and greatly increased cost still persist about the early approach. We report on our experience from a regional hepatobiliary centre. <h3>Methods</h3> A retrospective clinical study was conducted of all patients admitted with acute biliary symptoms, and who underwent cholecystectomy between January 2008 and August 2011. Costing data were calculated for each patient on an individual basis, including all theatre consumables, drugs and calculated cost for length of stay. A decision tree analysis economic model was created, using input data derived from the clinical study as well as the individual patient level costs, and uncertainty in this model tested with probabilistic sensitivity analyses. Categorical data were analysed using the χ<sup>2</sup> test. <h3>Results</h3> Of the 1888 patients who had a cholecystectomy during this period, 89 had an emergency or early laparoscopic cholecysytectomy (eLC) and 310 patients presented acutely with biliary disease and then went on to have a delayed cholecystectomy (dLC). Overall median length of stay (LoS) for the eLC group was 6 days, and for the delayed group was 7 days (p=NS), including the primary admission for medical treatment. The emergency readmission rate for all patients on the waiting list was 13% with a median stay of 4.5 days. Post-operative readmission rates were equivalent for both eLC (8%) and dLC (9%)—p=NS. Mean operating time was longer in the eLC group than the dLC group—120 min vs 60 min (p&lt;0.05). Post operative ERCP rates were 3% for the eLC group and 0% for the dLC group (p=NS), post operative fluid collections requiring intervention were 6% for the eLC group as opposed to 0% for the dLC group (p=NS). The baseline cost difference between the eLC and dLC groups was around £150 more expensive for the eLC group. After complications and readmission costs were calculated and inputted into the decision tree analysis, this difference decreased to a cost of £52—more expensive for the eLC pathway. <h3>Conclusion</h3> Early cholecystectomy on the index admission appears to be safe, with overall hospital stay slightly shorter. The difference in costs between the early and delayed pathway was essentially cost equivalent. But with NHS tariff (around £3650 for eLC and £2900 for dLC), the difference in net monetary benefit was around £700 per patient in favour eLC pathway. In a hospital conducting around 200 cholecystectomies per year on patients for acute biliary disease in the NHS, this could translate to a cost saving of over £140 000 per year. <h3>Competing interests</h3> None declared.