tbuckley/cabot-search huggingface dataset:
THU0520 The Influence of Overweight/Obesity on the Risk of Total Knee Arthroplasty amongst Patients with Newly Diagnosed Knee Osteoarthritis: A Population-Based Cohort Study
Authors: D. Prieto-Alhambra, K. Leyland, A. Judge, M. K. Javaid, C. Cooper, N. K. Arden
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Total knee arthroplasty (TKA) surgery accounts for a great part of the costs related to knee osteoarthritis (KOA). There is a scarcity of data on the association between overweight/obesity and clinical progression from KOA diagnosis to TKA. <h3>Objectives</h3> We aimed to study the association between overweight/obesity at the time of KOA diagnosis and risk of TKA. <h3>Methods</h3> We conducted a retrospective population-based cohort study. The SIDIAP Database comprises all clinical information as collected in primary care records, and hospital admissions for &gt;5 million people (80% of the population) in Catalonia (Spain). SIDIAP participants with an incident diagnosis of KOA in 2006-2011 were included, and followed until the end of 2011. Participants with a history of inflammatory arthritis were excluded. The body mass index (BMI) measurement registered closest to the date of KOA diagnosis was defined as baseline BMI, and categorized following the WHO classification into: normal (&lt;25 kg/m2), overweight(25 to &lt;30), obese I(30 to &lt;35), obese II(35 to &lt;40), and obese III(&gt;=40 kg/m2). Multivariable Cox regression was used to estimate Hazard Ratios (HR) according to BMI category, after adjustment for: age, gender, smoking, alcohol drinking, Charlson co-morbidity index, hip OA, polyarthritic OA, and socio-economic status. We tested for a priori defined interactions with median age (68 years) and gender. <h3>Results</h3> 105,189 participants were studied for a median (inter-quartile range) 2.6 (1.3-4.2) years, and 7,512(7.1%) underwent TKA in this time. Multivariable adjusted HRs for risk of TKA were: 1.41 [95%CI 1.27-1.57] for overweight, 1.97 [1.78-2.18] for obese I, 2.39 [2.15-2.67] for obese II, and 2.67 [2.34-3.04] compared to normal-weight patients (reference group). The effect of BMI on risk of TKA was stronger (p for interaction&lt;0.0001) amongst younger participants (HR 1.64 [1.34-2.03], 2.71 [2.21-3.32], 3.61 [2.92-4.45], and 4.17 [3.33-5.23] for overweight, obese I, II and III respectively). No interactions were found with gender. <h3>Conclusions</h3> BMI is a strong predictor of clinical progression from KOA diagnosis to TKA: overweight patients are at &gt;40% increased risk of surgery, and the obese have a more than doubled risk compared to KOA patients with normal weight. This excess risk is stronger in younger patients. Weight reduction strategies could have a big impact on the need for surgery in KOA, especially for younger patients. <h3>Disclosure of Interest</h3> D. Prieto-Alhambra Grant/research support from: Unrestricted grant from BIOIBERICA SA, K. Leyland: None Declared, A. Judge: None Declared, M. K. Javaid: None Declared, C. Cooper: None Declared, N. Arden: None Declared
Capturing breast cancer patients' experience beyond disease progression: Implementation of a patient-reported outcome (PRO) substudy in the VIRGO Metastatic Breast Cancer Observational Cohort study.
Authors: P. A. Kaufman, N. A. Dreyer, M. Mayer, J. A. Sloan, C. Chung, A. Sing, Y. Yim, E. Yu, S. D. Mathias, C. S. Cleeland
Journal: Journal of Clinical Oncology (2010)

6138 Background: Patient-reported outcomes (PROs) in clinical trials provide insight into the Pt experience but are often limited to the time the Pt is undergoing therapy, since PRO collection typically stops when Pts progress. In an OCS, Pts are observed in a real world setting and followed longitudinally through the course of their disease. To assess the impact of disease progression (PD) on PROs, we have initiated a PRO substudy in VIRGO, a MBC disease OCS. Methods: A literature review was performed to assess potential PRO instruments for study inclusion. Cognitive debriefings were conducted with 10 MBC Pts to assess acceptability, length, frequency, and preferred mode of administration for these instruments. Results: The following instruments were selected: MD Anderson Symptom Inventory (MDASI), the Activity Level Scale (ALS) from the Rotterdam Symptom Checklist, and the Work Productivity and Activity Impairment Questionnaire (WPAI). Participants in the cognitive debriefing completed these instruments in 10-30 minutes, 100% reported this duration to be appropriate in length, 80% stated that monthly frequency was reasonable, and 70% preferred internet as mode of administration. Based on these findings, PRO substudy data are collected monthly for MDASI and ALS, and quarterly for the WPAI until death, study discontinuation, or 5 years of follow up. PRO data collection via a secure internet-based website or IVRS began on 9/14/2009. As of 1/5/2010, 65 Pts have enrolled in the PRO substudy. 63% of Pts provided data through the internet, and 29% through IVRS; 8% are unknown due to new enrollment. Conclusions: VIRGO is currently the largest prospective OCS in MBC. The implementation of the PRO substudy demonstrates that PRO collection is viable in a large OCS. The PRO substudy will be a valuable longitudinal dataset of patient-reported symptoms, activities of daily living, and work productivity. These data will provide a unique understanding of MBC Pts long-term experience through the course of their disease and the relationship between PROs and disease progression. Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Genentech Genentech Roche Genentech, Outcome Sciences, Inc.
Rh-Incompatible Platelet Transfusions - Risks and Consequences of Sensitizing Immunosuppressed Patients
Authors: Dennis Goldfinger, Mary H. McGinniss
Journal: New England Journal of Medicine (1971)

The transfusion records of 102 Rh-negative patients treated with platelet transfusions from Rh-positive donors showed a 7.8 per cent rate of sensitization to the Rh0 (D) antigen. All but one of the patients had diseases associated with impaired immunologic reactivity and received immunosuppressive drugs. These results contrast with a rate of 60 to 80 per cent sensitization reported for normal volunteers given a similar antigenic stimulus. Immunosuppressed, Rh-negative patients with severe thrombocytopenia can be given platelet transfusions from Rh-positive donors with little risk of isoimmunization.
Defective Regulation of Epstein–Barr Virus Infection in Patients with Acquired Immunodeficiency Syndrome (AIDS) or AIDS-Related Disorders
Authors: Deborah L. Birx, Robert R. Redfield, Giovanna Tosato
Journal: New England Journal of Medicine (1986)

Patients with the acquired immunodeficiency syndrome (AIDS) acquire undifferentiated B-cell lymphomas that are similar to African Burkitt's lymphoma and contain Epstein-Barr virus (EBV). Using an in vitro assay system that measures a complex of cellular responses to EBV-infected lymphocytes, we found that B cells from 7 patients with AIDS and from 10 patients with AIDS-related disorders produced abnormally low numbers of immunoglobulin-secreting cells (P less than 0.001 as compared with normal controls) and that T-cell suppression, which was greater than 80 percent in EBV-seropositive normal controls, was absent. Instead, the patients' T cells markedly increased immunoglobulin production induced by EBV. In further studies, we determined that the mean frequency of circulating EBV-infected B cells capable of spontaneous outgrowth in vitro was 13 per 10(6) B cells in 7 patients with AIDS and 21 per 10(6) B cells in 10 patients with AIDS-related disorders--figures that were significantly higher than the mean in normal controls (P less than 0.001). Thus, patients with AIDS or AIDS-related disorders may be predisposed to the development of EBV-containing lymphomas, because they have a profound defect of T-cell immunity to EBV and abnormally high numbers of EBV-infected B cells in the circulation.
P2-03-06: Endothelin-1/Endothelin A Receptor Signalling in Breast Cancer.
Authors: D Tamkus, C Leece, K Gallo, BV Madhukar, N Dimitrov
Journal: Cancer Research (2011)

Abstract Background: Endothelin-1 (ET-1) and endothelin A receptor (ETAR) are implicated in breast cancer growth and progression. ET-1 is secreted by both tumor cells and stroma (macrophages, endothelial cells). The purpose of this study is to evaluate ET-1/ETAR role on cell proliferation and its effects on EGFR signaling pathway. Materials and Methods: Two breast cancer cell lines: MCF-7 and MDA-MB-231 were stimulated with ET-1. Proliferation of breast cancer cells was analyzed using MTT assay. Protein expression (EGFR, pEGFR, AKT, pAKT, ERK, pERK) was evaluated by Western blot. siRNA knockdown of endothelin A receptor (ETAR) was performed in MCF-7 and MDA-MB-231. Results: ET-1 stimulated proliferation in both cell lines. Interestingly, at higher ET-1 concentrations cell proliferation was more pronounced in MCF-7 when compared with MDA-MB-231. Stimulation with ET-1 activated EGFR and downstream signaling proteins (pAKT and pERK) in both cell lines. Incubation of breast cancer cells with ET-1 for 48 hours had different effect on total EGFR level: 3 fold increase of total EGFR was seen in MCF-7, while no change was detected in MDA-MB-231. siRNA against ETAR decreased ET-1 induced cell proliferation and reduced total EGFR level in MCF-7. Conclusions: These observations suggest that ET-1/ETAR plays an important role in survival and proliferation of breast cancer cells. However, those effects are diverse in different subtypes of breast cancer. Our results may represent an improved selective targeted treatment strategy, especially for estrogen receptor positive breast cancer. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P2-03-06.
PTU-180 Role Of Body Composition And Metabolic Dysfunction In Barrett’s Oesophagus And Progression To Cancer
Authors: S DiCaro, WH Cheung, M Keane, R Haidry, L Lovat, L Fini, R Batterham, M Banks
Journal: Gut (2014)

<h3>Introduction</h3> Oesophageal adenocarcinoma (OAC) arises within Barrett’s oesophagus (BE). Obesity is associated with metabolic syndrome (MS) and cancer progression. Body composition has a direct impact in obesity-related diseases. Normal weight individuals with increased fat mass are considered metabolically obese. <h3>Methods</h3> To evaluate the prevalence of obesity, altered body composition and metabolic indexes in patients (pts) with and without BE; and association with cancer progression in BE. In sequential pts undergoing gastroscopy, MS, waist/hip ratio (WHR) and body fat% (BF by bioimpedance analysis) were obtained. In BE pts, histological findings were correlated with metabolic data. Pts were classified according to Body Mass Index (BMI), abdominal obesity (AO by WHR) and in females, Normal Weight Obese (NWO). Identified risk factors significantly associated with BE at univariate analysis were subsequently entered into a multivariate logistic regression analysis. <h3>Results</h3> 250 cases and 230 controls (F/M: 193/287) were enrolled. Age (cut off: 57 years) and male gender (M/F 193/57; OR 5.01, p &lt; 0.0001) were identified risk factors for BE. AO (76 <i>vs </i>51%; OR 3.13; p &lt; 0.001), increased BF% (30.7 <i>vs </i>17.6%; p = 0.001), higher BMI (overweight: 39.6 <i>vs</i> 30%; OR 2.09; p = 0.0008; obese: 32 <i>vs</i> 22%; OR 2.3; p = 0.004) and MS (33.2 <i>vs</i> 20%; OR 1.95; p = 0.0017) were significantly associated with BE. A positive trend, possibly related to the small number of female cases, was demonstrated for NWO (28.1 <i>vs </i>19.1%; OR 1.06; p = 0.1). More cases were affected by hypertension (37.4 <i>vs</i> 21.3%; OR 2.4; p &lt; 0.001) and hyperlipidaemia (72.8<i> vs</i> 53.9%; OR 2.28; p &lt; 0001) but not diabetes. When adjusted by gender, age and race into a multivariate analysis, independent risk factors for BE were BF% (OR 1.90; p = 0.01) and AO (OR 1.67; p = 0.03). Metaplasia and dysplasia were present in 57.2 and 42.8%. AO was the only metabolic parameter independently correlated with high grade dysplasia (38 <i>vs </i>21%; OR 2.44; p = 0.001). <h3>Conclusion</h3> Abdominal obesity, and body fat mass are strong risk factors for BE. A positive trend association was demonstrated in NWO. Furthermore, abdominal adiposity plays a role in progression to OAC. BE might therefore be considered in the metabolic syndrome spectrum and as such, in this group screening interventions may be considered. <h3>Disclosure of Interest</h3> None Declared.
Abstract 11586: Pulse-based Arrhythmia Discrimination Using a Novel Smartphone Application
Authors: Craig A Napolitano, Jo Woon Chong, Jane S Saczynski, Nada Esa, Chad E Darling, Edward Boyer, Rochelle K Rosen, Kevin C Floyd, Ki H Chon, David D McManus
Journal: Circulation (2015)

Introduction: Screening for atrial fibrillation (AF) normally involves the use of expensive and cumbersome outpatient monitoring equipment. Currently, smartphone based detection allows for assessment of heart rate alone or requires additional hardware which has limited its widespread use in screening for AF. We describe the use of the first smartphone based monitor that has the ability to discriminate AF from ectopy (including PACs and PVCs) without the need of additional hardware. Methods: We analyzed 219 2-minute pulse recordings from 121 study participants with AF (n=98), PACs (n=15), or PVCs (n=15) using an iPhone 4S. We obtained pulsatile time series recordings in 91 participants after successful cardioversion to sinus rhythm from pre-existing AF. The PULSESMART app conducted pulse analysis using 3 methods [Root Mean Square of Successive RR Differences; Shannon Entropy; Poincare plot]. We examined the sensitivity, specificity, and predictive accuracy of the app for AF, PAC, and PVC discrimination from sinus rhythm using the 12-lead EKG or 3-lead telemetry as the gold standard. We also administered a brief usability questionnaire to a subgroup (n=41) of app users. Results: The smartphone-based app demonstrated excellent sensitivity (0.970), specificity (0.935), and accuracy (0.951) for real-time identification of an irregular pulse during AF. The app also showed good accuracy for PAC (0.955) and PVC discrimination (0.960). The vast majority of surveyed app users (83%) reported that it was “useful” and “not complex” to use. Conclusion: A smartphone app can accurately discriminate pulse recordings during AF from sinus rhythm, PACs, and PVCs without the need of additional hardware.
Abstract 756: Pharmacokinetics of curcumin and curcumin O-glucuronide in healthy volunteers characterized by liquid chromatography-tandem mass spectrometry
Authors: Zhongfa Liu, Wei Chen, Patty Fan-Havard, Lisa D. Yee, Xiao-Kui Mo, Gary D. Stoner, Kenneth K. Chan
Journal: Cancer Research (2012)

Abstract Purpose: To develop and validate a liquid chromatography-tandem mass spectrometric method (LC-MS/MS) for simultaneous quantification of curcumin and curcumin O-glucuronide (COG) in human plasma, and to characterize the pharmacokinetics (PK) of curcumin and COG in healthy volunteers after separate oral administrations of Curcumin C3 Complex (CC3C) and nano-emulsion Curcumin (NEC) using this method. Methods: The study was conducted at The Ohio State University (OSU) with the approval of the OSU Institutional Review Board. CC3C and NEC were administered orally to four healthy volunteers and plasma levels of curcumin and COG were determined by a validated LC-MS/MS method. The pharmacokinetic parameters were calculated using WinNonlin computer software. Clinical safety assessment included vital signs and biochemical measurement on the day of each PK study and three weeks following each PK study to monitor potential toxicity. A mixed effect model was used for comparing the concentration of curcumin or COG at each time point after the oral consumption of CC3C or NEC across each donor using SAS 9.2 software. Results: An LC-MS/MS method for simultaneous quantification of curcumin and COG in human plasma with the lower limit of quantification of 2 ng/mL was established. The within-day and between-day validation parameters were consistent with the Food and Drug Administration's (FDA) criteria for Good Laboratory Practice analytical methods. A cross-over pharmacokinetic study in the four healthy volunteers revealed that 2g NEC delivered much higher plasma concentrations of free curcumin (1.5-8.0 ng/mL vs. non-detectable, p&amp;lt;0.001, paired t-test) and COG (550-3300 ng/mL vs. 3.0-167 ng/mL, p&amp;lt;0.05, paired t-test) when compared to 4g of CC3C. The total drug exposure of curcumin and COG from NEC in human volunteers is 26 to 350-fold higher than that of CC3C. No adverse events were noted following administrations of CC3C and NEC. No abnormalities were noted on the hematologic, clinical chemistry, and metabolic profiles at prescreening, and at 3 weeks following CC3C and NEC administration. Conclusion: NEC represents a novel formulation of curcumin with enhanced oral absorption of curcumin and is worthy of evaluation for future clinical applications. Supported by NIH-NCI-R21 CA135478 [ZL], UL1RR025755 [NCRR] and the BioMedical Mass Spectrometry Laboratory [KC &amp; ZL]. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 756. doi:1538-7445.AM2012-756
Case 33-1996
Authors: Dori F. Zaleznik, Timothy R. Quinn
Journal: New England Journal of Medicine (1996)

Presentation of CaseA 55-year-old man with obstructive sleep apnea, which had been managed by a long-term tracheostomy, was admitted to the hospital because acid-fast bacilli were found in stomal granulations.Eighteen and a half years earlier, obstructive sleep apnea, with an arterial oxygen saturation of 44 percent, was diagnosed. Examination revealed a mandibular deformity and a large, hypermotile tongue with abundant lymphoid tissue at its base. Four years later, a tracheostomy was performed at the Massachusetts Eye and Ear Infirmary, with the placement of a silicone cannula. The cannula was changed every two to three years. At approximately semiannual . . .
IMPACTO DEL ENTRENAMIENTO EN UN CENTRO ESPECIALIZADO EN EL ÍNDICE DIAGNÓSTICO DE CÁNCER GÁSTRICO PRECOZ Y LESIONES PRECANCEROSAS GÁSTRICAS EN NUESTRO MEDIO
Authors: JJ Vila, T Uraoka, M Gómez Alonso, M Basterra, H Ishii, FJ Jiménez, JM Zozaya, N Yahagi
Journal: Endoscopy (2012)

Introducción: El entrenamiento intensivo diagnóstico de cáncer gástrico precoz (CGP) mejora su detección1. Objetivo: Evaluar el impacto diagnóstico del entrenamiento realizado en centro especializado en detección y tratamiento de CGP. Método: En abril 2012 un Endoscopista de Nuestra Unidad (ENU) realizó una estancia en centro referente de CGP en Tokio con entrenamiento intensivo diagnóstico y terapéutico en disección submucosa endoscópica (DSE). Las gastroscopias realizadas posteriormente por ENU fueron registradas prospectivamente (Grupo I). La detección de lesiones gástricas (clasificación Paris) del Grupo I fue comparado con grupo control (Grupo II) constituido por las gastroscopias diagnósticas realizadas por ENU entre enero2011-marzo2012. Utilizamos anestésico tópico o sedación. Especialmente en Grupo I prestamos especial atención a áreas elevadas/deprimidas y cambios coloración. Excluimos gastroscopias urgentes y terapéuticas. Las lesiones mucosas no CGP fueron consideradas potencialmente malignas siguiendo guías ASGE2 y ESGE3. Resultados: Se comparó Grupo I (n=76) con Grupo II (n=178) sin diferencias referentes a edad, sedación ni tolerancia (p>0,05). El diagnóstico de lesiones gástricas en Grupo I fue significativamente superior [24 (31,6%) vs. 21 (11,8%), p=0,0001)]. En Grupo I clasificamos 14 como Paris II por 5 del Grupo II (73,7% vs. 26,3%; p=0,01). Encontramos 4 adenocarcinomas avanzados en cada grupo (p>0,05). Si tomamos en conjunto CGP y lesiones precancerosas tampoco encontramos diferencias: 3 en Grupo I (1 hiperplásico>3cm, 2 CGP) y 4 en Grupo II (4 adenomas) (p>0,05); pero hubo significativamente más CGP en Grupo I [2 (2,2%) vs. 0 (0%); p=0,03]. Un CGP fue tratado quirúrgicamente y el otro mediante DSE. El resto de lesiones: inflamación, pólipos hiperplásicos pequeños y displasias leves. Conclusiones: Una estancia en centro especializado en CGP mejora significativamente el diagnóstico de estas lesiones en nuestro medio a expensas de diagnosticar lesiones sutiles Paris tipo II, permitiendo tratamiento endoscópico curativo. Referencias: 1.- Yamazato T et al. Intern Med. 2012;51:1461–5. 2.- Hirota WK et al. Gastrointest Endosc. 2006;63:570–80. 3.- Dinis-Ribeiro M et al. Endoscopy. 2012;44:74–94.
<i>Campylobacter jejuni</i>Infection and Guillain–Barré Syndrome
Authors: Jeremy H. Rees, Sara E. Soudain, Norman A. Gregson, Richard A.C. Hughes
Journal: New England Journal of Medicine (1995)

Although infection with Campylobacter jejuni is recognized as a common antecedent of the Guillain–Barré syndrome, the clinical and epidemiologic features of this association are not well understood.
A drinkable foreign body: acrylated resin
Authors: J. Knuth, B. Krakamp, M. Heiss, D. Bulian
Journal: Endoscopy (2012)

A 65-year-old schizophrenic patient had ongoing epigastric pain. Gastroscopy revealed a large foreign body ([Fig. 1]). Endoscopic fragmentation and retrieval were impossible ([Fig. 2]). The patient denied having ingested the object, which, considering its size, was plausible.