tbuckley/cabot-search huggingface dataset:
Narrow band imaging does not reliably predict residual intestinal metaplasia after radiofrequency ablation at the neo-squamo columnar junction
Authors: Lorenza Alvarez Herrero, Wouter Curvers, Raf Bisschops, Mohammed Kara, Erik Schoon, Fiebo Kate, Mike Visser, Bas Weusten, Jacques Bergman
Journal: Endoscopy (2014)

<b>Background and study aims: </b>After radiofrequency ablation (RFA) of Barrett’s esophagus, it may be difficult to determine whether complete eradication of intestinal metaplasia at the neosquamocolumnar junction (neo-SCJ) in the cardia has been achieved. It is claimed that narrow band imaging (NBI) may predict the presence of intestinal metaplasia, which would enable immediate treatment. The aim of the current study was to evaluate whether inspection of the neo-SCJ with NBI after RFA results in reliable detection of intestinal metaplasia. <b>Patients and methods:</b> Patients with a normal-appearing neo-SCJ who were scheduled for RFA were included in the study. Two expert endoscopists obtained images from the neo-SCJ in overview (high resolution white light and NBI mode) and from four areas using NBI zoom, followed by corresponding biopsies. Four other blinded expert endoscopists evaluated the images for the presence of intestinal metaplasia and type of mucosal pattern (round, small tubular, large tubular, villous). Endpoints were sensitivity and specificity for identifying patients and areas with intestinal metaplasia. <b>Results:</b> From 21 patients overview images from 21 neo-SCJs and NBI zoom images from 83 neo-SCJ areas were obtained. Intestinal metaplasia was present in five overview images (24 %) and nine zoom images (11 %). Using the overview images, sensitivity and specificity for identifying patients with intestinal metaplasia were 65 % (95 % confidence interval [CI] 38 – 86) and 46 % (95 %CI 33 – 60), respectively. For individual zoom images, sensitivity was 71 % (95 %CI 54 – 85) and specificity was 37 % (95 %CI 32 – 43). <b>Conclusions:</b> After RFA, endoscopic inspection of the neo-SCJ with NBI in overview or zoom does not reliably predict presence or absence of intestinal metaplasia.
Abstract 3301: Guanidinium antisense oligonucleotides for cancer therapy.
Authors: Sufi M. Thomas, Danith Ly
Journal: Cancer Research (2013)

Abstract Molecular targeted therapies are being tested in several clinical settings to target cancer. Most of the drugs being tested are small molecule inhibitors or antibodies that are specific to target proteins. Several of which have reduced target specificity or the tumor develops resistance to the drugs. This results in poor clinical outcomes. An approach that is highly specific and yet malleable enough to circumvent resistance mechanisms would be highly appealing. We have developed an antisense approach that can specifically bind to the mRNA of target proteins preventing translation and resulting in lower protein levels. In addition, unlike conventional antisense approaches, our antisense oligonucleotide carries a pseudo-peptide backbone with positively charged guanidinium residues rendering these resistant to nucleases and proteases. The oligomer binds nucleic acids with high sequence specificity and the hybridized complex is highly stable. As a proof of principle, we developed a 16 base antisense oligomer targeting the epidermal growth factor receptor (EGFR). EGFR is upregulated in several cancers and correlates with a poor prognosis. We tested the guanidinium-peptide nucleic acid (GPNA) EGFR antisense oligomer in tumors of the head and neck, lung and bladder. We carried out in vitro and in vivo studies including uptake and antitumor efficacy. Our data demonstrate that EGFR levels and cell survival are significantly reduced upon EGFRAS GPNA administration but not a scrambled control. Further, the EGFRAS GPNA effectively reduced levels of a constitutively active mutant EGFR (EGFRvIII). In vivo, EGFRAS GPNA had antitumor effects comparable to EGFR inhibitors that are under clinical testing namely erlotinib and cetuximab. Our data demonstrate that GPNA oligomers are an effective therapeutic approach against several tumor types. Citation Format: Sufi M. Thomas, Danith Ly. Guanidinium antisense oligonucleotides for cancer therapy. [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 3301. doi:10.1158/1538-7445.AM2013-3301
AB1034 Bone disease in primary biliary cirrhosis: About 24 cases
Authors: N. Maamouri, H. Kchir, N. Belkahla, B. Arfaoui, B. Mohsni, N. Naija, S. Chouaib, H. Sahli, S. Sallemi, N. Ben Mami
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Primary biliary cirrhosis (PBC) is a cholestatic liver disease that may be complicated by osteoporosis whose etiology seems to be multifactorial. <h3>Objectives</h3> To determinate the frequency of bone diseases associated to PBC and to identify the independent risk factors correlated with osteoporosis during this hepatopathy. <h3>Methods</h3> A retrospective analysis of 66 patients (58 women and 8 men) was performed including all cases of PBC diagnosed between 1996 and 2010. Only patients who benefit from measurement of bone mineral density (BMD) were included. BMD was measured by DEXA at lomber (L2-L4) and femoral (femur neck) region. Measurement was expressed in two ways, one related to the peak bone mass (the T-score) and the other to the age-matched value (the Z-score). Both scores are expressed as the number of standard deviations by which BMD deviates from the mean value. Osteoporosis and osteopenia were defined as T score below or equal to -2,5 and between -2,5 and -1 respectively. <h3>Results</h3> BMD was performed in 32 patients (29 women and 3 men) aged from 19 to 73 years (mean age 52,5years). Only 8 patients had normal BMD (25%). Five patients had osteopenia. Osteoporosis was found in 19 patients (60%) including 17 women and 2 men meanly aged 59,9 years. Osteoporosis was revealed by a fracture in 3 cases. PBC developed since more than one year in 70% of cases. Among the fifteen postmenopausal women, 13 had osteoporosis, 2 had osteopenia and one had a normal BMD. Biological tests showed a cholestasis in all cases of osteoporosis and in 1 case of osteopenia. Phosphocalcic assessment was normal in all cases. Histological examination revealed an advanced stage (3 or 4) in 9 cases (47%) of osteoporosis and one case of osteopenia (25%). The research of another cause of osteoporosis was negative. In univariate analysis, no factor was significantly associated with the presence of osteoporosis. <h3>Conclusions</h3> Osteoporosis is a common complication of CBP where it appears to be related to the post menopausal state and the severity of liver disease. However, no factor was significantly associated with osteoporosis. <h3>Disclosure of Interest</h3> None Declared
PTU-080 Correlation Of Fdg Pet Scanning With Endoscopic Findings In Patients With Crohn’s Disease: Abstract PTU-080 Table 1
Authors: E Russo, S Khan, AP Brown, N Keat, W Hallett, R Janisch, RN Gunn, EA Rabiner, PM Matthews, TR Orchard
Journal: Gut (2014)

<h3>Introduction</h3> <sup>18</sup>F- Fluoro-deoxy-glucose Positron Emission Tomography (FDG-PET) scanning is gaining popularity in the assessment of several inflammatory disorders including Crohn’s Disease (CD). <h3>Methods</h3> 11 patients with established CD,underwent <sup>18</sup>F- FDG-PET scanning that was compared with recent endoscopic data, provided treatment had been unchanged between the two tests. Patients were fasted for 6 h and received 185 MBq of iv FDG followed by 800 ml of oral 2.5% mannitol. A low dose CT scan of the abdomen was performed, followed by PET, at 60 min post FDG injection. PET data was acquired over a maximum of 3 bed positions (10 min/ bed position). Analysis involved dividing the gut into 6 segments on CT (terminal ileum, ascending, transverse, descending and sigmoid colon and rectum). Segmental maximum standardised uptake value (SUV<sub>MAX</sub>) and SUV intestine-to-liver ratio (SUV<sub>ITL</sub>= SUV<sub>MAX</sub>/Liver SUV<sub>MEAN</sub>) were calculated. A segment is defined as abnormal (PET +ve) when its SUV<sub>MAX </sub> &gt; Liver SUV<sub>MEAN</sub> as per previous literature.<sup>1–3</sup> SUV<sub>MAX</sub> and SUV<sub>ITL</sub> of endoscopically abnormal versus endoscopically normal PET +ve segments were compared using the Mann-Whitney test. <h3>Results</h3> 11 patients (52 gut segments) had PET within a median of 1 month of endoscopy. 21/52 segments were active on endoscopy. Of these 20/21 were also PET +ve. However, 17/31 of endoscopically negative segments were alsoPET+ve suggesting a sensitivity of 95% and a specificity of 45% in our cohort. Raising the SUV<sub>MAX </sub>threshold for defining a PET +ve segment from the existing (&gt;SUV<sub>LIVER</sub>) to &gt; 3.5x SUV<sub>LIVER</sub> reduced sensitivity from 95% to 86%, but improved specificity from 45% to 82% compared to the gold-standard of endoscopy. <h3>Conclusion</h3> FDG-PET appears to be up to 95% sensitive in identifying segments with endoscopically active CD. Several ‘false positive’ segments are also observed conferring a low specificity. A threshold of segmental SUV<sub>MAX</sub> signal &gt; 3.5 x SUV<sub>LIVER </sub>greatly improves sensitivity with a minimar reduction in specificity. Segments which demonstrate FDG signal but are negative on endoscopy may reflect disease undetected by endoscopy, or may be false positives. A comparison with histological activity is required to clarify this. <h3>References</h3> Louis E, <i>JNM</i> 2007 Meisner, <i>IBD</i> 2007 Das CJ, <i>Eur J Nucl Med Mol Imaging</i> 2007 <h3>Disclosure of Interest</h3> None Declared.
P246 Suspicion-prompted testing reveals missed opportunities for diagnosing new HIV cases among patients with community-acquired pneumonia
Authors: S. Safavi, F. J. K. Chua, P. Reilly, G. K. Russell
Journal: Thorax (2010)

<h3>Introduction</h3> National UK policy for HIV testing1 recommends offering an HIV test to all patients with HIV indicator diseases such as tuberculosis (TB), Pneumocystis pneumonia, <i>aspergillosis</i> and bacterial pneumonia. Universal testing is advocated for all adults registering with a GP and all general medical hospital admissions in regions where HIV prevalence is &gt;2/1000 population. Although ‘opt out’ HIV testing is a standard practice for patients with TB, testing falls far short in other clinical settings. <h3>Method</h3> A large number of community-acquired pneumonia (CAP) cases across three south London boroughs where HIV prevalence exceeds 2/10002 are managed at our institution. All cases of CAP in 2008 (with one or more of: radiographic consolidation, CAP clinical case definition fulfilment, positive microbiology or pneumococcal urinary antigenaemia) were included in the present analysis. Demographic, HIV sampling and outcome data were collected. <h3>Results</h3> 618 patients (325 or 53% male, 293 female) with a diagnosis of CAP were identified. The majority (500, 81%) were aged &gt;50. Of the total, only 23 (3.7%) patients underwent HIV testing, of whom 1 in 4 (26%) tested positive. Half represented new diagnoses while the remainder had prior documentation of HIV positivity. Overall, 9/60 (15%) of ethnically black (African-Caribbean) patients were tested, compared to only 6/429 (1.4%) of White British patients. The rate of testing varied between age groups: 16% (19/118) of those aged 15–50 were tested, in contrast to only 0.8% (4/500) of patients aged over 50. Information regarding patients were declined testing was not available. <h3>Discussion</h3> Of individuals diagnosed with CAP who were HIV-tested, the proportion of ‘incident’ positive testing (13%) is approximately 5 times higher than expected if a policy of universal testing was practised. HIV testing was more often performed on younger or black patients. Despite serving a high prevalence population, HIV testing at this and likely many other institutions is under-utilised by medical teams even for patients with an HIV indicator pathology. Management of CAP in secondary care represents an opportunity to prevent a delayed diagnosis of HIV. Barriers to HIV testing need to be identified to reduce HIV mortality associated with late diagnosis.
FRI0039 VISFATIN/PBEF in bone remodelling of rheumatoid arthritis
Authors: G. Krumbholz, S. Junker, A. Lehr, M. Rickert, G. Schett, S. Rehart, U. Müller-Ladner, E. Neumann
Journal: Annals of the Rheumatic Diseases (2012)

<h3>Objectives</h3> Rheumatoid arthritis (RA) is associated with increased production of adipocytokines, which are cytokine-like mediators. Increased levels of the adipokine visfatin were found in synovial fluid and tissue of RA patients. Moreover, visfatin promotes the synthesis of pro-inflammatory and matrix-degrading effector molecules in RA synovial fibroblasts. However, the role of visfatin in bone remodelling of RA is unclear. In this study, we focussed on visfatin and its influence on RA osteoblast activity and differentiation as well as on its immunomodulatory properties on RA osteoblasts. <h3>Methods</h3> For expression analysis of visfatin, bone tissue obtained from RA patients during joint replacement surgery, was analyzed. Serial sections of decalcified and deparaffinised bone tissue were used to identify the expression sites of visfatin in articular remodelling. (Immuno)histochemistry was performed by using anti-visfatin and anti human ALP (alkaline phosphatase) antibodies in addition to Masson- and TRAP-staining. Human osteoblasts isolated from bone tissue of RA patients were stimulated with visfatin. Visfatin-mediated effects on human osteoblasts were analyzed on the transcriptional and translational level using quantitative realtime polymerase chain reaction (qRT-PCR) and immunoassays. Furthermore, the cells were stimulated with the pro-inflammatory cytokine IL-1β and gene expression of visfatin was examined by qRT-PCR. <h3>Results</h3> Immunohistochemical staining of RA bone tissue showed a co-localization of visfatin with key cells of bone remodelling (osteoblasts, osteoclasts). Stimulation with visfatin induced the secretion of pro-inflammatory cytokines (e.g. IL-6: 5-fold increase; IL-8: up to 100-fold) in RA osteoblasts. Additionally, quantitative realtime PCR showed several genes being differentially expressed in osteoblasts after stimulation with Visfatin (<i>e.g</i>. alkaline phosphatase, osteocalcin, OPG). Furthermore, the stimulation with IL-1β led to a 5-fold increase of Visfatin gene expression in RA osteoblasts. <h3>Conclusions</h3> The results of the present study indicate that visfatin influences the activity as well as the differentiaton of human osteoblasts in RA by modulating the expression of genes being involved in matrix production and osteoblast phenotype development. These results, together with the finding of increased visfatin expression in osteoblasts after IL-1β treatment, support the idea of visfatin affecting bone metabolism in RA. Acknowledgement: Funded by the German Research Society (SPP1468, IMMUNOBONE, NE1174/6-1). <h3>Disclosure of Interest</h3> None Declared
CLINICAL OUTCOMES OF ATRIAL FIBRILLATION PATIENTS RECEIVING DIGOXIN IN THE RE-LY ® TRIAL
Authors: Rangadham Nagarakanti, Stuart Connolly, Mandy Fraessdorf, Martina Brueckmann, Joerg Kreuzer, Paul Reilly, Jonas Oldgren, Salim Yusuf, Lars Wallentin, Michael Ezekowitz
Journal: Journal of the American College of Cardiology (2016)
Chronic Idiopathic Hypoparathyroidism Simulating Cardiac Asthma
Authors: Ralph M. Sussman, Alfred Edinburgh
Journal: New England Journal of Medicine (1957)

CHRONIC idiopathic hypoparathyroidism is a rare disease that may be identified if the clinical features of chronic tetany are recognized and confirmed by appropriate chemical and electrocardiographic investigations. Diagnosis may be obscure in elderly and middle-aged persons, when coexistent disease deflects the observer's attention from the primary metabolic fault. The case reported below represents arteriosclerotic heart disease culminating in an attack of acute myocardial infarction, leading to right-bundle-branch block. As a result of this background, attacks of "asthma" and "fainting" were mistakenly attributed to conditions other than hypoparathyroidism for a two-year period. Because the electrocardiogram indicated the fixed abnormality due . . .
Abstract 1549: Diet-induced obesity increases tumor levels of MCP-1, macrophage infiltration and microvessel density in a murine model of breast cancer.
Authors: Emily Ngan, Alessandra Pacilli, Eva Marshall, Kirstie Cutlip, James Coad, Amanda Ammer, Linda Vona-Davis
Journal: Cancer Research (2013)

Abstract Epidemiological studies indicate that obesity is associated with poor outcomes in breast cancer. In our previous work, we demonstrated that a chronic consumption of a high fat diet increases solid tumor growth and metastasis in a spontaneous mammary cancer mouse model. In addition to higher tumor burdens and rates of metastases, mice fed a high fat diet showed elevated levels of adipocyte derived monocyte chemoattractant protein-1 (MCP-1) in the blood. We hypothesized that diet-induced obesity promotes mammary carcinogenesis by inducing an inflammatory and tumor-supportive microenvironment. We further compared chow fed lean MMTV(PyMT) mice with those fed 45.0% (w/w) high fat (HF) to investigate the impact of body adiposity and dietary nutrient overload on levels of MCP-1 in tissue, tumor associated macrophages (TAMs) and for the degree of microvessel density. We analyzed early and late carcinoma stage tumors together with adipose tissue from mice fed HF and control diets in order to identify possible sources of MCP-1 production. MCP-1 levels in tumors of mice differed significantly by cancer stage and diet, with late stage tumors showing more MCP-1 (P&amp;lt;0.05). Moreover, MCP-1 production was elevated in adipose tissue of obese mice compared to lean mice. Tumors and adjacent adipose were stained with CD68 and the numbers of TAMs were quantified. Significantly more TAMs (P&amp;lt;0.05) were found within tumor beds and more crown-like structures were evident in adipose tissue from obese mice at both early and late stage carcinoma. Tumor beds also showed increased microvessel density when stained with CD31. In summary, diet-induced obesity increased levels of MCP-1 in tumors and adipose with more macrophage infiltration and greater vascular density evident in mammary tumor beds. Taken together, these findings suggest that high body adiposity caused by diet-induced changes promote an inflammatory and tumor-supportive microenvironment in breast cancer. NIH P20 RR016440, P30 R032138/GM103488, and P20 RR016477 Citation Format: Emily Ngan, Alessandra Pacilli, Eva Marshall, Kirstie Cutlip, James Coad, Amanda Ammer, Linda Vona-Davis. Diet-induced obesity increases tumor levels of MCP-1, macrophage infiltration and microvessel density in a murine model of breast cancer. [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 1549. doi:10.1158/1538-7445.AM2013-1549
Lasers in minimally invasive periodontal and peri‐implant therapy
Authors: Koji Mizutani, Akira Aoki, Donald Coluzzi, Raymond Yukna, Chen‐Ying Wang, Verica Pavlic, Yuichi Izumi
Journal: Periodontology 2000 (2016)

Abstract Laser therapy has the potential to be an effective, minimally invasive procedure in periodontal therapy. The aim of the present review was to survey the relevant literature on the clinical application of lasers as a minimally invasive treatment for periodontitis and peri‐implant disease. Currently, there are a large number of published clinical studies and case reports that evaluate the adjunctive use of diode, carbon dioxide, neodymium‐doped yttrium aluminium garnet (Nd: YAG ), erbium‐doped yttrium aluminium garnet (Er: YAG ) and erbium, chromium‐doped: yttrium, scandium, gallium, garnet (Er,Cr: YSGG ) lasers or antimicrobial photodynamic therapy for nonsurgical and minimally invasive surgical treatment of periodontal pockets. These procedures are expected not only to control inflammation but also to provide biostimulation effects with photonic energy. Recent meta‐analyses did not show statistically significant differences in pocket reduction and clinical attachment gain compared with mechanical debridement alone, although limited positive effects of adjunctive laser therapy were reported. At present, systematic literature approaches suggest that more evidence‐based studies need to be performed to support the integration of various laser therapies into the treatment of periodontal and peri‐implant diseases. The disparity between previous statistical analyses and individual successful clinical outcomes of laser applications might reveal the necessity of developing optimal laser‐treatment modalities of different wavelengths and better‐defined indications for each protocol.
Epidemiology of<i>Clostridium perfringens</i>Food Poisoning
Authors: Matthew S. Loewenstein
Journal: New England Journal of Medicine (1972)

During 1970 Clostridium perfringens was responsible for 54 (22.4 per cent) food-borne outbreaks and 6942 (37.8 per cent) cases of food poisoning reported to the Center for Disease Control. The median number of persons affected in an outbreak involving this organism during 1970 was 35. This figure is larger than that for the other common causes of food poisoning, such as staphylococcus, shigella and salmonella. In 41 of the 49 outbreaks in 1970 in which the specific food vehicle was known, it was a meat or poultry product. Other vehicles included dairy products, fruit and vegetables and Chinese food. Outbreaks of C. perfringens food poisoning almost invariably involve a product that was cooked and then inadequately refrigerated and reheated before serving. The extremely ubiquitous nature of C. perfringens requires great diligence in food handling, with special attention to maintaining proper holding temperatures to prevent disease from this agent.