tbuckley/cabot-search huggingface dataset:
SAT0195 Alexithymia: Unspeakable Suffering, a Prevalence Study in Systemic Sclerosis
Authors: K. Stefanantoni, M. Vasile, I. Sciarra, N. Iannace, V. Riccieri, G. Valesini
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Systemic Sclerosis (SSc) is an autoimmune connective tissue disease characterized by abnormal fibrotic processes that can affect multiple organ systems. Indeed the disease is associated with chronically painful symptoms related to ulcerations, joint contractures, arthritis, gastroesophageal reflux or Raynaud phenomenon. Patients with SSc may be at particular risk for depression due to the high levels of chronic pain, fatigue, dissatisfaction with their appearance, and overall disability: all these features may influence the emotional suffering. The psychological construct of alexithymia, literally meaning "no words for mood", was firstly coined in 1972 to describe people who lack the ability to communicate their feelings and who seem unable to fantasize, often presenting with multiple somatic symptoms (1). In turn alexithymia makes rather difficult to recognize any possible underlying psychiatric disorders. <h3>Objectives</h3> To evaluate the presence of alexithymia in ScS patients, comparing its prevalence with that of a group of healthy subjects. <h3>Methods</h3> We used the Italian validated translation of Toronto Alexithymia Scale (TAS-20) (2) to assess the alexithymic tract. It was administered to 50 ScS patients (F/M = 48/2; mean age = 59 years; diffuse form/limited form = 24/26) and to 37 healthy subjects (F/M = 35/2; mean age = 56 years). We also measured depressive symptoms by administering the Italian validated version of Beck Depression Inventory (BDI) to both groups. <h3>Results</h3> In the SSc patient group a TAS-20 score indicating alexithymia (≥ 61) was present in 15 subjects (30%). The prevalence of alexithymia was significantly higher than in the healthy subject group, where it was found in 4 cases (11%)(P=0,038). The proportion of subjects with moderate to severe depression (BDI≥23) was greater in the SSc patient group (24%) than in healthy subjects (3%) (P= 0,01). Finally the SSc group with alexithymia had a strong association with moderate to severe depression (P= 0,0002). There was no statistically significant difference between the diffuse and the limited forms. <h3>Conclusions</h3> We found that SSc patients are more likely than healthy subjects to have difficulty in identifying and describing feelings, as well as higher alexithymia scores. Besides a moderate to severe depression is more prevalent in the patient group. These results underline the importance of considering emotions in the SSc patients, without underestimating their psychological aspects. <h3>References</h3> Lesser IM: Current concepts in Psychiatry-Alexithymia. N Engl J Med 1985; 312: 690-2. Caretti V, Taylor GJ: Reliability and validity of the Toronto Structured Interview for Alexithymia in a mixed clinical and nonclinical sample from Italy. Psychiatry Res. 2011; 187:432-6. <h3>Disclosure of Interest</h3> None Declared
THU0405 Characterization of the group of patients with IgG4-related systemic disease in russian population
Authors: S. Sedyshev, V. Vasilyev, A. Kovrigina
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Objectives</h3> to describe a group ofpatients with IgG4-related systemic disease (IgG4-RSD), followed up in the Institute of Rheumatology, Moscow, Russia <h3>Methods</h3> Between 2008 and 2011 25 patients were diagnosed with IgG4-RSD. Of these, male - 12, female - 13, mean age - 43.6 years (22 - 71). The diagnosis was based on clinical features, evaluation of serum IgG4 level (&gt;1,35 g/l), histological and immunomorphological examination of affected tissue specimens using IgG, IgG4, CD20, CD138 and κ/λ stainig. <h3>Results</h3> As part of the IgG4-RSD 32% (n=8) of patients were diagnosed with multifocal fibrosclerosis, IgG4-associated sclerosing orbit pseudotumor (sclerosing dacryoadenitis, solitary fibrotic mass, fibroplasia of extraocular muscles and orbit fat)–28% (n=7), retroperitoneal fibrosis (Ormond's disease) with periaortic mass, often compressing ureter–16% (n=4), Miculicz's disease–8% (n=2), Küttner's tumor–4% (n=1), autoimmune pancreatitis (AIP) (type I), mediastinal fibrosclerosis and juvenile xanthogranuloma of the orbit–by 4% (n=1) respectively. Among affected areas were orbit (n=17), salivary (parotid and submandibular) glands (n=8), retroperitoneum (n=5), sinuses (n=3), mediastinum (n=2), pancreas (n=2), lymph nodes (n=1), biliary ducts (n=1). Serum IgG4 was elevated &gt;1,35g/l in 65% of patients (1,5–16,5 g/l). IgG4-staining of plasma cells was diagnostic in 100% of cases with maximum IgG4/IgG ratio – 50%. All cells were polyclonal. Highest levels of IgG4 were detected in cases of Miculicz's disease. Histology showed the absence of fibroplasia, MALT-tissue formation with no lymphoepithelial lesions and the abundance of IgG4-expressing plasma cells. <h3>Conclusions</h3> In Russian IgG4-RSD cohort multifocal forms prevail predominantly with orbital affection. Relatively few patients with AIP were found. <h3>Disclosure of Interest</h3> None Declared
Abstract 4020: Genome-wide analysis of stepwise hepatocarcinogenesis using next generation sequencer.
Authors: Yutaka Midorikawa, Tadatoshi Takayama, Shogo Yamamoto, Hiroo Ueda, Kotaro Sonoda, Kiyoko Takane, Shingo Tsuji, Genta Nagae, Kenji Tatsuno, Margaret Morgan, David Wheeler, Hiroyuki Aburatani
Journal: Cancer Research (2013)

Abstract Early hepatocellular carcinoma (HCC) originates from the hepatocytes of chronic liver disease and develops into classical HCC. To identify sequential genomic changes in multistep hepatocarcinogenesis, we analyzed fusion genes and mutations using next generation sequencer about 40 early and 80 advanced HCCs. First, exome sequence showed that base sequence aberrations were more frequent in advanced HCC than early HCC, and mutations including TP53 (24%), CTNNB1 (24%), and ARID1A (16%) were recurrently observed in both early and advanced HCCs. Consistent with our previous report homozygous deletions near CSMD1 and CDKN2A were also found in 8 and 5 cases, respectively, only in advanced HCC. Next, we detected 4 types of fusion gene, including interchromosomal (translocation), intrachromosomal (deletion), intrachromosomal (translocation), and inversion by RNA sequencing. We also found that every HCC harbored 2 to 5 fusion genes, which were more frequent in advanced than early HCC, although there were no recurrent rearrangements in neither advanced nor early HCCs. Especially chromathripsis, in which 10 to 100 rearrangements were localized in the specific genomic regions and genomic features imply chromosome breaks occur in one-off crisis, was the event observed only in advanced HCC. Taken together, genomic changes were more frequent in advanced HCC, suggesting early HCC originates in the chronic liver disease and progresses into advanced HCC with genomic aberrations. Citation Format: Yutaka Midorikawa, Tadatoshi Takayama, Shogo Yamamoto, Hiroo Ueda, Kotaro Sonoda, Kiyoko Takane, Shingo Tsuji, Genta Nagae, Kenji Tatsuno, Margaret Morgan, David Wheeler, Hiroyuki Aburatani. Genome-wide analysis of stepwise hepatocarcinogenesis using next generation sequencer. [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 4020. doi:10.1158/1538-7445.AM2013-4020
PWE-050 An Evaluation of Patients Referred to Gastroenterology Anaemia Clinic
Authors: L Chinnappan, S Westall, P Hayle, I London
Journal: Gut (2013)

<h3>Introduction</h3> Iron-deficiency anaemia in adults is a common cause of referral to gastroenterologists (4–13% of referrals). NICE guidelines, UK provides clear recommendations regarding upper and lower gastrointestinal investigations for such patients including coeliac and urine screening. The aim of this audit is to conduct a snapshot review of anaemic patients seen in gastroenterology anaemia clinic conducted by specialist nurses with consultant gastroenterologists input in a DGH to assess adherence to the NICE guidelines and to highlight changes in clinical practise that may be required, with implications for service development. <h3>Methods</h3> Retrospective study involving 90 new patients referred predominantly from primary health care (92%) between July to September 2012.Of the 90 patients referred, 84 patients in the age range of 30–90 attended the clinic of which 53% were females. <h3>Results</h3> The mean HB was 10.8 &amp; 80% of the patients had ferritin level of less than 45. Of them 14 patients (16%), all referred from primary care were normocytic with no evidence of iron deficiency and did not require GI investigations. All iron deficient patients underwent coeliac screening (100%) but only 62% had evidence of urine screening for blood loss. 82% of the patients finished their investigations within 12 weeks from their first clinic appointment.62 patients (88%) underwent upper GI endoscopy and the rest were either unfit or declined endoscopies. Lower gastrointestinal tract was investigated in 75% of patients endoscopically or by CT colon (25%) and 22% underwent CT abdomen. An upper GI cause for anaemia was found in 30 patients (42%) and 20% had lower GI cause with gastric and colonic cancer diagnosed in one patient each. 5 patients (22%) with resistant anaemia are awaiting small bowel investigations whilst the rest (21%) are being monitored on iron therapy. Interestingly one patient each with lung, renal and bone malignancy were diagnosed and one with carcinoid after undergoing investigations in this clinic. <h3>Conclusion</h3> Development of a referral pro-forma to anaemia clinic with clear criteria to establish iron deficiency has been recommended to ensure appropriate referrals and to enable effective use of resources. The importance of regular urine screening and its inclusion in the referral pro-forma to assess renal causes for anaemia is being highlighted. Though the detection rate of gastrointestinal malignancy in anaemia clinic during the audit period was low, this rate can be periodically variable. The audit found that majority of patients with iron deficiency anaemia underwent upper and lower GI investigations in compliance with NICE guidelines within a satisfactory time scale and investigations not only led to early detection of GI cancers but also other malignancies. <h3>Disclosure of Interest</h3> None Declared. <h3>Reference</h3> NICE Guidelines UK for Iron deficiency anaemia.
P3-18-06: AEZS-131 – A Highly Selective ERK-Inhibitor: Characterization and Preclinical Testing in Triple Negative Breast Cancer (TNBC).
Authors: JB Engel, I Seipelt, A Hönig, JC Hahne, M Teifel
Journal: Cancer Research (2011)

Abstract Introduction: Overexpression of MAPK has been detected in 34 % of TNBC and has been found to be associated with anthracycline resistance (1). AEZS-131 is a highly selective orally active ERK1/2-inhibitor, which has shown in vivo activity (first in class) in colon cancer. The following study explores mode of action and efficacy in models of TNBC. Study design: AEZS-131 was tested in a kinase panel of 36 STK, 26 TK and 7 PIK to check for selectivity. Inhbition of Rsk-phosphorylation (cellular substrate of ERK) was evaluated by western blot analysis. Mode of action was explored by cell cycle FACS-analysis. Cleavage of PARP was explored by Western blot. Cytotoxic efficacy was evaluated in 5 TNBC, of which 2 had mutations in the MAPK signal transduction pathway lines, by MTT assay. Additionally it was explored if inhibition of classical apoptosis could abrogate the effect of AEZS-131. Results: AEZS-131 selectively inhibited ERK with an IC50&amp;lt;4nM. Phosphorylation of Rsk-1 the cellular substrate of ERK was inhibited with an IC 50 of 158 nM. AEZS-131 induced cell cycle arrest in G1 dose-dependently and cleavage of PARP. EC 50 was 0,739 μM for MDA-MB-231 (Ras-mutated), 0,137 μM for MDA-MB-435s (B-RAF mutated), 17,5 μM for MDA-MB-468 (PTEN loss), 25 μM for HCC 1806. HCC 1937 were not inhibited by the compound. Of note, inhibition of classical apoptosis did not alter the cytotoxic effect of the compound in MDA-MB-468 and HCC-1806 cells. Conclusions: AZS-131 was shown to selectively inhibit ERK at low nM concentrations and to induce G1-arrest. Accordingly, the cytotoxic effect most pronounced in TNBC cell lines with mutations in the MAPK pathway. If classical apoptosis is inhibited, cytotoxic effects remain unchanged, suggesting that AEZS-131 can also induce nonclassical forms of programmed cell death. AEZS-131 should be further explored in TNBCs with overexpression of MAPK or mutations in the MAPK-pathway. *Æterna Zentaris GmbH, Frankfurt/M, Germany. (1): MAPK overexpression is associated with anthracycline resistance and increased risk for recurrence in patients with triple-negative breast cancer. Eralp Y, Derin D, Ozluk Y, Yavuz E, Guney N, Saip P, Muslumanoglu M, Igci A, Kücücük S, Dincer M, Aydiner A, Topuz E. Ann Oncol. 2008 Apr;19(4):669–74. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P3-18-06.
FRI0230 Stable incidence rates of anca-associated vasculitides and giant cell arteritis in northern germany (schleswig-holstein) from 1998 to 2010
Authors: K. Herlyn, W.L. Gross, E. Reinhold-Keller
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Little data is available regarding the epidemiology of systemic vasculitides (SV), particularly on their incidence. Available data is heterogenous and often derived from referral centers or small populations. <h3>Objectives</h3> To assess the incidence of systemic vasculitides in a stable population by registering all newly diagnosed patients in a large region in North Germany. To investigate the epidemiology and pattern of SV and particularly ANCA-associated vasculitis (AAV) over twelve years in a prospective study. <h3>Methods</h3> Since 1/1/98 all newly diagnosed cases of SV as defined by the Chapel Hill Consensus Conference 1992 were identified in a large mixed rural/urban northern German region consisting of 2,83 million habitants in a population-based prospective study. The following sources were used: (a) departments of all hospitals, including their outpatient clinics; (b) all departments of pathology, and (c) the reference immunological laboratories serving the catchment area. All cases were re-evaluated by the authors. <h3>Results</h3> Within the observation period of twelve years 1614 patients were identified as having a new diagnosis of SV in the catchment area, 473 patients with giant cell arteritis (GCA) and 434 with ANCA-associated vasculitis (granulomatosis with polyangitis (GPA), microscopic polyangitis (MPA), Churg-Strauss-Syndrome (CSS)) were observed, incidence rates were 14 (range 9-17)/million/year (95% CI 7;21) and 13 (range 8-16)/million/year (95% CI 6;20), respectively. The incidence rates for all SV were between 40 and 54 cases per one million/year with a mean incidence rate of 48/million/year. Incidence rates of GPA were two to three times higher than MPA and CSS. The incidence rates were stable between 1998 and 2010, our observations did not reveal significant differences. People 50 years and older were at a three to five-fold higher risk to <i>get</i> SV compared to those younger than 50 years. <h3>Conclusions</h3> Results of our population based vasculitis register over twelve years assessing the incidence of PSV in a region of 2.83 million habitants in north Germany demonstrate stable incidence rates for all SV. Variances between years have been observed, but no pattern or periodicity. Compared to other studies investigating small regions or referral centers the incidence rates for AAV were comparable to the incidence rates observed in Norway, Sweden and the United States, lower than those in United Kingdom, but higher than in Spain and Vilnius. The incidence rates of MPA are significantly higher in Japan, whereas GPA and CSS have not been diagnosed. AAV and giant cell arteritis present with similar incidence rates. <h3>Disclosure of Interest</h3> None Declared
Letter from South Africa: Tree bug
Authors: C. V. Williams
Journal: BMJ (1998)

There are two common conditions that affect doctors who work at Mosvold Hospital. One is tick bite fever. Almost every new doctor is confidently diagnosed as a sufferer sooner or later. We do not have the serology for confirmation. It is, however, of note how often it is diagnosed among medical staff and how rarely in patients. Most patients have to make do with less distinguished illnesses such as flu and perhaps an infected insect bite. There are a lot of ticks around. There are also a lot of mosquitoes; not to mention the 80 000 described insect species and 3000 species of spider and the thousands of undescribed bugs of various kinds, many of …
Case 24-2005
Authors: Paula D. Ryan, Daniel B. Kopans, Dennis C. Sgroi
Journal: New England Journal of Medicine (2005)

A 58-year-old woman with cancer detected on mammography chose to undergo breast-conserving therapy. The tumor expressed estrogen and progesterone receptors and lacked HER2/neu amplification. The authors discuss management options for early-stage breast cancer, and new techniques that may help clinicians select optimal therapy.
Abstract 1782: Detection of T790M gefitinib resistance mutation in EGFR using the BEAMing method
Authors: Kazuya Taniguchi, Kimiyoshi Nishitani, Jiro Okami, Ken Kodama, Masahiko Higashiyama, Kikuya Kato
Journal: Cancer Research (2010)

Abstract Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs), such as gefitinib or erlotinib, are effective therapies for non-small cell lung cancer (NSCLC) patients with primary EGFR mutations. However, most patients who initially respond to treatment with these drugs will develop resistance to EGFR TKIs. The secondary EGFR T790M mutation is reported to correlate with acquired resistance. We examined the T790M mutation in primary tumors with BEAMing (beads, emulsion, amplification, magnetic), which is the most sensitive technique to detect minor mutated alleles. Currently, we can detect point mutation at the level of 1/10,000 using an improved version of the BEAMing. We detected T790M mutant alleles in NSCLCs in 19 out of 270 NSCLCs with primary EGFR mutations. The detection of small fraction of T790M mutant alleles may be useful for predicting resistance of NSCLCs to TKIs. 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 1782.
Abstract P1-01-08: <b>A Nomogram for predicting two or less axillary lymph node involvement for breast cancer</b>
Authors: SK Ahn, JS Kim, Mk Kim, JW Lee, T Kim, JY Kim, HG Moon, W Han, D-Y Noh
Journal: Cancer Research (2012)

Abstract BACKGROUND: Completion axillary lymph node dissection (ALND) is currently the standard of care in the event of a positive sentinel lymph node biopsy (SLNB). However, result from Z0011 indicate that women with a one or two involved axillary nodes and clinical T1-T2 tumors undergoing lumpectomy with radiation therapy followed by systemic therapy do not benefit from completion of ALND in terms of survival. As a result, the use of intraoperative frozen section during SLNB will be declined. OBJECTIVE: To define possible predictors of having two or less involved axillary node using preoperative image study to provide information for surgeons making decision about sparing intraoperative frozen section analysis of sentinel lymph node. METHODS: We reviewed the records of 1214 patients with clinical T1-T2 and clinical node negative invasive breast cancer. None of these patients were in situ cancer on initial gun biopsy nor received neoadjuvant chemotherapy. Factors associated with having three or more involved axillary nodes were evaluated by univariate and multivariate logistic regression analysis. RESULTS: Among 1214 patients, 203 patients (16.7%) had three or more positive nodes. On a multivariate analysis, having three or more positive nodes was associated with primary tumor size by breast US, axillary LN grade according to cortical thickness by US and presence of axillary LN enlargement on chest CT. The area under ROC curve corresponding to the multivariate logistic regression model applied to dataset of 1214 patients was 0.827 (95% CI: 0.793–0.860). When applied to a validation dataset of 378 patients, it was 0.899 (95% CI: 0.841–0.957). A nomogram to predict the probability of having two or less axillary nodes involvement based on patients' age and preoperative image findings was developed from the multivariate logistic regression model. CONCLUSION: Patients with a low probability of having three or more positive nodes can be identified from preoperative image finding. The nomogram developed will be helpful to surgeons making decision about sparing intraoperative frozen section analysis of sentinel lymph. Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P1-01-08.
Occlusive Arterial Disease in the Hand Due to Occupational Trauma
Authors: Irwin J. Schatz
Journal: New England Journal of Medicine (1963)

REPEATED trauma to the hand may result in severe ischemia of the digits. In 1944 Barker and Hines1 first described arterial occlusion in the fingers associated with repeated occupational injury, and since then occasional case reports of traumatic thrombosis of hand arteries have appeared in the medical literature.2 , 3 It has been a clinical impression, however, that this syndrome is a rare disorder.In a heavily industrialized area of the United States, 8 cases were encountered personally in a ten-month period, and a review of the records of the Henry Ford Hospital revealed 2 other patients with this disease. Consequently, it . . .
Meaningful Placebos — Controlling the Uncontrollable
Authors: Daniel E. Moerman
Journal: New England Journal of Medicine (2011)

In this issue of the Journal, Wechsler et al.1 report data from a study that compared four interventions involving patients with asthma (ClinicalTrials.gov number, NCT01143688). They found that three of the interventions — active albuterol, sham albuterol, and sham acupuncture — were all equally effective in controlling asthma symptoms, as judged by patient-reported improvement. In contrast, lung function was improved only in those given active albuterol, as measured by an increase in the forced expiratory volume in 1 second (FEV1). The fourth intervention was "no treatment," in which patients were told to wait for several hours and then . . .
Results of a phase II trial of a combination of oral cytarabine ocfosfate (YNK01) and interferon α-2b for the treatment of chronic myelogenous leukemia patients in chronic phase
Authors: F Maloisel, A Guerci, D Guyotat, N Ifrah, M Michallet, J Reiffers, G Tertain, M Blanc, F Bauduer, J Brière, JF Abgrall, B Pegourie-Bandelier, E Solary, N Cambier, D Coso, JP Vilque, M Delain, JL Harousseau, P Rousselot, K Belhadj, P Morice, J Attal, M Chabin, C Chastang, J Guilhot, F Guilhot
Journal: Leukemia (2002)
Unilateral Lung Hypoperfusion With Normal Ventilation on Pulmonary Scintigraphy Caused by Pulmonary Artery Sling
Authors: PERRY J. PICKHARDT
Journal: Clinical Nuclear Medicine (1997)

Anomalous origin of the left pulmonary artery, arising from the right pulmonary artery and coursing between the trachea and the esophagus to reach the left hilum, represents a rare vascular abnormality. It has been termed pulmonary artery sling because of its effect on the airway; it generally manifests itself in infancy and is accompanied by severe respiratory symptoms. A young adult patient had an asymptomatic pulmonary artery sling found subsequent to ventilation-perfusion scintigraphy, which showed uniformly decreased perfusion to the left lung with normal ventilation.