tbuckley/cabot-search huggingface dataset:
PWE-081 Diagnostic Performance Of Faecal Calprotectin In Primary Care
Authors: N Hunt, R Allcock, A Sharma, M Myers
Journal: Gut (2014)

<h3>Introduction</h3> Faecal calprotectin is recommended by NICE<sup>1</sup> for distinguishing between irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) in patients with lower gastrointestinal (GI) symptoms in primary care. If cancer is suspected in these patients and ‘red-flag’ symptoms such as anaemia or bleeding, they should be referred to Gastroenterology in accordance with the NICE suspected cancer guideline.<sup>2</sup> We use calprotectin in secondary care and will be extending the service to primary care providers. However, a number of GPs have been requesting faecal calprotectin on an ad-hoc basis for 1 year, giving us valuable insight into how the test performs in primary care. <h3>Methods</h3> An audit was carried out of primary care calprotectin data in a 1 year period (Dec 12–Dec 13). This data was compared to an audit of 1 month of secondary care data (Jun 13). Clinical details, such as endoscopy and histology results were extracted from electronic patient records. <h3>Results</h3> In total 198 requests for calprotectin came from primary care in 1 year and 40 were unsuitable for analysis (wrong sample type or delayed arrival in lab). Of the remaining 158 calprotectin requests, 76% were considered appropriate, having clinical details including symptoms described by NICE. Worryingly, 17% of requests had inappropriate clinical details such as bleeding; such patients’ referral to Gastroenterology was potentially delayed by requesting calprotectin. In 7% of requests no reason for request was discernable. Of the primary care requests, 29% results were consistent with intestinal inflammation (&gt;50 µg/g). If GPs use our proposed algorithm which suggests only referring patients with a calprotectin &gt;50 µg/g, and those where strong clinical suspicion remains, there is potential for up to 71% reduction in patients referred to Gastroenterology with ‘IBS/IBD’ symptoms. Diagnostic performance of calprotectin compared with endoscopy and histology diagnosis in secondary care is excellent with a sensitivity of 100% and a specificity of 91%. In primary care the corresponding data gives a sensitivity of 93% and a specificity of 79%. <h3>Conclusion</h3> We received a large number of unsuitable samples. In addition GPs appear to be inappropriately requesting calprotectin in patients with symptoms such as bleeding, therefore it is critical to offer the service in a controlled way as part of a locally agreed care pathway. We are producing a GP information leaflet to advise on appropriate sample collection, result interpretation and the proposed patient pathway. We will re-audit primary care data once this is introduced to investigate whether a targeted approach leads to improved diagnostic performance of calprotectin in primary care. <h3>References</h3> 1 Faecal Calprotectin diagnostic tests for inflammatory diseases of the bowel, NICE DG11 2 Referral for suspected cancer, NICE CG27 <h3>Disclosure of Interest</h3> None Declared.
FRI0307 The association between pain and ultrasonographic features of hand osteoarthritis in finger joints:
Authors: A. Mathiessen, I.K. Haugen, B. Slatkowsky-Christensen, T.K. Kvien, H.B. Hammer
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Hand osteoarthritis (HOA) may cause considerable pain, but the sources of pain are still unclear. Radiographic OA features show only a modest association with symptoms in HOA and association between ultrasonography (US) findings and clinical symptoms/findings have not been sufficiently explored. <h3>Objectives</h3> To investigate whether US-detected structural and inflammatory abnormalities are associated with pain in the same joint in HOA. <h3>Methods</h3> We included 127 HOA patients (116 women, mean (SD) age 68.6 (5.8) years and disease duration 18.3 (7.2) years) with ultrasonographic and clinical examination of both hands. The US examination (Siemens Antares, 5-13MHz) included assessment of osteophytes, grey scale synovitis and power Doppler (PD) in the 1st carpometacarpal (CMC), first interphalangeal, 2nd-5th proximal (PIP) and distal interphalangeal (DIP) joints using a dorsal view from radial to ulnar side bilaterally. The same joints were examined clinically for tenderness upon palpation. We calculated the odds ratio (95% confidence interval) for tenderness in joints in which US pathology was present (with joints without US pathology as reference) by Generalized Estimating Equations in order to adjust for within-subject dependency using an exchangeable covariance matrix. The US features were then included in a multivariate model in order to assess the independent associations for each feature. Finally, we tested the multivariate model in the different joint groups separately. All analyses were adjusted for age and sex. <h3>Results</h3> In the 2510 joints examined, we found high prevalence of osteophytes (n=1840), whereas lower prevalence of synovitis (n=560) and especially PD activity (n=72). There were significantly higher odds of tenderness in joints with all types of US pathology (table). Multivariate analyses provided the same results (table). Osteophytes and synovitis were more strongly associated with tenderness in the 1st CMC joints, while power Doppler signal was more strongly associated with tenderness in the PIP-joints. Higher scores of all US features were dose-dependently associated with tenderness in joints (data not shown). <h3>Conclusions</h3> Osteophytes, synovitis and power Doppler signal detected by US were independently and dose-dependently associated with joint tenderness in individual HOA joints. These findings are relevant for our understanding of the etiology of pain in HOA. <h3>Disclosure of Interest</h3> None Declared
PTU-202 Flexible sigmoidoscopy as a screening tool for bowel cancer- time for standardisation!
Authors: I Ahmed, C Rutter, S Hazeldine, P Marden
Journal: Gut (2012)

<h3>Introduction</h3> Flexible sigmoidoscopy (FS) has been shown to offer substantial reduction in the incidences of and mortality from distal colorectal cancer and is soon to become the new screening method. Although quality markers for colonoscopy have been widely adopted in the UK, similar practice for FS is variable. In order for this procedure to be used as an effective screening tool it will need standardisation in term of quality assurance. <h3>Methods</h3> It was a retrospective study which was carried out using an endoscopy database to identify patients who had FS performed during 2009–2011 in three district general hospitals serving a population of 600 000. The patient9s age, sex, extent of examination, grade of endoscopist, use of medications, procedure tolerance, bowel visualisation and missed left sided lesions were investigated. A complete examination was defined as a procedure when the scope was passed to the splenic flexure or beyond. Mucosal visualisation and patient tolerance were graded as good, fair and poor. <h3>Results</h3> A total of 2823 procedures were recorded, of which 87.5% were carried out as an out-patient. In 56.7% of cases the scope was passed to the splenic flexure or beyond, while examination was limited to descending colon in 20.2%, sigmoid colon in 18.7% and rectum in 4.6%. Poor bowel preparation accounted for procedure failure in 3.7%, pain for 1.5% and anatomical complexities and pathology encounter in 1%, while in 94.1%, there were no limitations. 94.8% of procedures were performed without sedation. Good mucosal visualisation was achieved in 76.1% and the procedure was well tolerated in 80.7%. 2% of the patients used entonox and 3.3% received midazolam (range 1–5 mg median dose 3 mg). Pathologies were detected in 58.8% of the cases while procedure was reported normal in the remaining 41.2 %. No patient had a subsequent diagnosis of a left sided lesion. <h3>Conclusion</h3> This study identified wide variability in FS practice in local hospitals and highlighted the lack of quality standards particularly in terms of examination extent, use of medication, bowel preparation and mucosal visualisation. It showed that FS is widely practiced and a useful diagnostic tool but to make it more effective screening tool for colorectal cancer, a standardisation process is needed. <h3>Competing interests</h3> None declared. <h3>References</h3> 1. <b>Atkin W</b>, Edwards R, Kralj-Hans I, <i>et al.</i> Once-only flexible sigmoidoscopy screening in prevention of colorectal cancer: a multicentre randomised controlled trial. <i>Lancet</i> 2010;375:1624–33. 2. <b>Hoff G</b>, Grotmol T, Skovlund E, <i>et al.</i> Risk of colorectal cancer seven years after flexible sigmoidoscopy screening: randomised controlled trial. <i>BMJ</i> 2009;<b>338</b>:b1846.
SYNTAX SCORE IS AN INDEPENDENT PREDICTOR OF 4-YEARS MORTALITY IN PATIENTS WITH PERIPHERAL ARTERY DISEASE
Authors: Takuya Tsujimura, Takayuki Ishihara, Osamu Iida, Masashi Fujita, Masaharu Masuda, Shin Okamoto, Kiyonori Nanto, Takashi Kanda, Tatsuya Shiraki, Akihiro Sunaga, Masaaki Uematsu
Journal: Journal of the American College of Cardiology (2015)
THU0252 Immunoproteasome subunits are up-regulated in inflammatory myopathies
Authors: K.M. Ghannam, L. Martinez Gamboa, L. Naumann, S. Krause, M. Fettke, G.R. Burmester, E. Feist
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> The inflammatory myopathies are a group of diseases characterized by muscle inflammation which can be differentiated into three major diagnoses: dermatomyositis (DM), polymyositis (PM) and inclusion body myositis (IBM). Previous studies showed an up-regulation of certain proteasomal genes in PBMCs of PM patients suggesting an involvement of the proteasome system in the pathogenesis of myositis. <h3>Objectives</h3> To identify differences in the activation of the proteasome in inflammatory and non-inflammatory myopathies, we investigated the gene expression profile of catalytic constitutive and immunoproteasomal subunits. <h3>Methods</h3> Relative quantification of mRNA transcripts of catalytic proteasomal subunits was performed in peripheral blood CD4+, CD8+, CD19+ lymphocytes, CD14+ monocytes, dendritic cells and muscle biopsies in patients with autoimmune inflammatory myopathies (polymyositis n=5, dermatomyositis n=5, overlap-syndromes with myositis n=7) and non-inflammatory myopathies (n=7) in comparison to healthy controls (n=11) by real time PCR. The expression levels of the constitutive subunits (beta1, beta2, beta5), and the corresponding inducible ones (beta1i, beta2i, beta5i) were measured relative to the house keeping gene beta actin. For statistical analysis, the non-parametric Mann-Whitney-U test was applied. <h3>Results</h3> Analyses of the peripheral cellular subsets revealed significantly increased expression levels of the immunosubunit beta2i in CD8+, CD19+ lymphocytes, CD14+ monocytes and dendritic cells only in polymyositis patients compared to non-inflammatory myopathies or to healthy controls. Comparison of levels of constitutive proteasomal subunits in muscle tissues and peripheral cells showed a higher mRNA-expression in muscle biopsies regardless of the inflammatory status. In contrast, the expression of the corresponding immunosubunits in muscle compared to blood cells was increased only in biopsies of inflammatory myopathies (IM) compared to samples without detectable inflammation (non-IM) [beta1i IM to non-IM =5.5 fold, beta2i IM to non-IM =1.8 fold and beta 5i IM to non-IM =4.3 fold]. <h3>Conclusions</h3> The increase in gene expression of catalytic subunits of the immunoproteasome in the affected muscles as well as in blood cell subsets of patients with inflammatory myopathies compared to non-inflammatory myopathies indicates a strong activation of the proteasome system in these diseases. Since the proteasome system plays a central role for antigen presentation and regulation of the inflammatory response, induction of immunosubunits can contribute to the pathogenesis of inflammatory myopathies. <h3>Disclosure of Interest</h3> None Declared
99mTc-MDP Uptake in Implantation Metastasis of Gastric Cancer
Authors: Haimin Zhao, Jiankui Han, Fengli Lv, Changming Zhang
Journal: Clinical Nuclear Medicine (2013)

A 47-year-old woman with a history of subtotal gastrectomy due to gastric cancer underwent bone scintigraphy to evaluate possible recurrent disease. The whole-body images revealed a single focus of elevated 99mTc-MDP activity in the right pubic region, which was located in the intrapelvic soft tissue on subsequent SPECT/CT images. Pathological examination after needle biopsy demonstrated that the soft tissue was an implantation metastasis from gastric cancer.
Abstract 1432: Tnfα ablation demonstrates no suppressive effect on inflammation-related mouse colon tumorigenesis
Authors: Hiroyasu Sakai, Yasuhiro Yamada, Masahito Shimizu, Hisataka Moriwaki, Akira Hara
Journal: Cancer Research (2010)

Abstract Colorectal cancer (CRC) is one of the most serious complications of inflammatory bowel disease. Tumor necrosis factor-α (Tnfα) is a major mediator of inflammation and there is increasing evidence that Tnfα/Tnf-receptor-1 (Tnfr1) signaling may act as an endogenous tumor promoter for colon carcinogenesis. In fact, a previous study revealed that mice lacking Tnfr1 develop significantly fewer colonic tumors in the inflammation-related CRC model. Apc Min/+;Tnfα -/- mice were treated with 2% dextran sodium sulfate (DSS) and the tumor development was compared with Apc Min/+;Tnfα +/+ control mice in order to investigate the role of Tnfα by itself in the inflammation-related CRC. Surprisingly, there were no significant differences in either the severity of colonic inflammation or the expression of DSS-induced chemokines and cytokines (Ccl2, Cxcl1, Tnfβ, Il1β, Il6, and Cox-2) that relate to the colonic inflammation and tumorigenesis between these two groups. Furthermore, the genetic ablation of Tnfα did not suppress the colon tumorigenesis in comparison to the wild-type mice. These observations suggest that redundant inflammatory responses other than the Tnfα-mediated inflammation promote tumorigenesis in the colon. These results also suggest that Tnfα alone may not be an efficient target for the prevention/ treatment of inflammation-related colon tumorigenesis. 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 1432.
Rhabdoid Papillary Meningioma Treated With 177Lu DOTATATE PRRT
Authors: William Makis, Karey McCann, Alexander J.B. McEwan
Journal: Clinical Nuclear Medicine (2015)

An 18-year-old girl presented with a 3-year history of a recurrent skull base mass confirmed to be a rhabdoid papillary meningioma. The tumor was octreotide avid and metastatic to the lungs, thoracic lymph nodes, and bones, and she was referred for PRRT (peptide receptor radionuclide therapy) with 177Lu DOTATATE. After 3 induction treatment cycles of 177Lu DOTATATE, she experienced significant improvements in her symptoms; however, just before the fourth treatment, she developed cervical spinal cord compression and passed away shortly thereafter. The use of 177Lu DOTATATE therapy in the management of rhabdoid papillary meningioma warrants further research.
ABSENCE OF A DIFFERENTIAL EFFECT OF TICAGRELOR VERSUS PRASUGREL MAINTENANCE DOSE ON ENDOTHELIAL FUNCTION OF PERIPHERAL VESSELS IN PATIENTS WITH STABLE CORONARY ARTERY DISEASE
Authors: Ioanna Xanthopoulou, Chrysoula Vogiatzi, Theodora Bampouri, Athina Chasapi, Periklis Davlouros, George Hahalis, Dimitrios Alexopoulos
Journal: Journal of the American College of Cardiology (2015)
Time distributions and prognosis factors of breast cancer recurrence in different sites after operation.
Authors: L Zhou, W Yin, J Lu, G Di, J Wu, K Shen, Z Shen, Z Shao
Journal: Cancer Research (2009)

Abstract Abstract #2080 Objective Our study aims to analyze the breast caner patients with different sites of recurrence, and to have knowledge of the regular patterns and influence factors of metastastic breast cancer.&amp;#x2028; Methods We performed a retrospective study of 210 female breast cancer patients who were continuously followed up in our hospital from January 2005 to May 2007 and had complete data of metastasis. The clinical and biological characteristics were compared between the patients with organ metastases (lung, liver, brain) and non-viscera metastases (lymph node, bone).&amp;#x2028; Results Cox regression analysis-hazard function showed that patients with elder age (RR=0.927 95%CI 0.877∼0.981, P=0.008) and HER-2 negative(RR=0.253 95%CI 0.076∼0.836, P=0.024)tended to develop non-viscera metastases, while patients with larger tumors (RR=3.832 95%CI 1.073∼13.687, P=0.039) tended to develop organ metastasesp.&amp;#x2028; &amp;#x2028; When stratified by the prognostic factors, the annual risk hazard curve of the patients with high risk of recurrence had double peaks at the second year and the ninth years after mastectomy respectively, and it was significantly higher than those of the patients with middle and low risk.[figure1]Annual risk hazard curves of both local relapse and metastasis also showed a double-peaked pattern. The curves for lymph node, bone, lung and liver metastasis showed a similar pattern, but all the peaks of curve emerged later than that of the local relapse.&amp;#x2028; &amp;#x2028; Conclusion Patients with different clinical and biological characteristics may develop recurrence in different sites. There are certain regular patterns of time distribution for different metastasis sites after mastectomy. The local recurrence may be the foreboding for the metastasis and we should pay attention to the local relapse signs especially in the patients with high risk. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 2080.
Secreted Phosphoprotein 1 and Sex-Specific Differences in Silica-Induced Pulmonary Fibrosis in Mice
Authors: Joseph D. Latoche, Alexander Chukwuma Ufelle, Fabrizio Fazzi, Koustav Ganguly, George D. Leikauf, Cheryl L. Fattman
Journal: Environmental Health Perspectives (2016)

Fibrotic lung diseases occur predominantly in males, and reports describe better survival in affected females. Male mice are more sensitive to silica-induced lung fibrosis than silica-treated female mice. Secreted phosphoprotein 1 (SPP1, also known as osteopontin) increases in pulmonary fibrosis, and Spp1 transcription may be regulated by estrogen or estrogen receptor-related receptors.
Combined stents for the treatment of large gastric fistulas or stenosis after sleeve gastrectomy
Authors: Lionel Rebibo, Mathurin Fumery, Samy Hakim, Franck Brazier, Abdennaceur Dhahri, Jean-Marc Regimbeau
Journal: Endoscopy (2015)

Gastric fistulas after sleeve gastrectomy may require placement of a prosthesis such as a covered stent [1] [2] [3] or double-pigtail stent (DPS) [4]. In our experience, use of a DPS is associated with a shorter period of hospitalization, lower pain levels, and shorter treatment duration than when a covered stent is used [4]. We present the results for combined covered stent and DPS placement as treatment for large-diameter gastric fistula or gastric stenosis associated with a gastric fistula in four patients. The patients had a > 2-cm large-diameter gastric fistula (n = 2) or gastric stenosis associated with a gastric fistula (n = 2) after sleeve gastrectomy.
Abstract 53: Krebs cycle substrate-level phosphorylation drives metastatic cancer cells
Authors: Laura M. Shelton, Cheryl L. Strelko, Mary F. Roberts, Thomas N. Seyfried
Journal: Cancer Research (2010)

Abstract Many metastatic cancers are derived from compromised respiration in tissue cells of myeloid origin (e.g., macrophages), which use glutamine as a major energy substrate. Although impaired respiration can render tumor cells dependent on glycolysis for energy in the presence of oxygen (Warburg effect), it has not been determined if glutamine alone could provide enough energy (ATP) through substrate level phosphorylation in the TCA (Krebs) cycle to maintain tumor cell viability. Using a bioluminescent-based ATP assay, we determined the viability of metastatic mouse VM-M3 tumor cells grown in serum free medium in the presence of glucose alone (25 mM), glutamine alone (4 mM), or in glucose + glutamine. The VM-M3 cells could not survive on glucose alone, but could survive in glutamine alone indicating an absolute requirement for glutamine in these metastatic tumor cells. Glucose + glutamine acted synergistically in providing growth and viability. Lactic acid production was 10-fold lower in the cells grown in glutamine alone than in glucose alone. Glutamine could also maintain viability in the absence of glucose and in the presence of the F1 ATPase inhibitor oligomycin. Glutamine could not maintain viability in the presence of the TCA cycle enzyme inhibitor, 3-Nitropropionic acid. NMR analysis indicated that glutamine metabolism via the TCA cycle was active resulting in accumulation of both succinate and aspartate. The data indicate that glutamine can provide ATP for viability in the metastatic VM-M3 cells through Krebs cycle phosphorylation in the absence of energy from either glycolysis or oxidative phosphorylation. 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 53.