tbuckley/cabot-search huggingface dataset:
AFECTACIÓN PANCREÁTICA TRAS ENTEROSCOPIA DE DOBLE BALÓN: CORRELACIÓN ENTRE UNA SERIE ANIMAL Y HUMANA Y POSIBLES MECANISMOS FISIOPATOLÓGICOS
Authors: P Esteban, R La Torre, F Soria, O López, I Ayala, S Chacón, JL Rodrigo, J Shanabo, F Carballo, E Pérez Cuadrado
Journal: Endoscopy (2011)

Introducción: las complicaciones de la enteroscopia de doble balón (EDB) son similares a la endoscopia convencional salvo la pancreatitis aguda de la que no se conocen los posibles mecanismos fisiopatológicos, entre los que se han propuesto la obstrucción del conducto pancreático principal, reflujo contenido intestinal por presión intraduodenal y lesiones isquémicas producidas por tracción.
INCIDENCE OF PERIOPERATIVE COMPLICATIONS AND ITS IMPACT ON CLINICAL OUTCOME AFTER ENDOVASCULAR THERAPY FOR PATIENTS WITH DIABETIC ISCHEMIC FOOT PRESENTING WITH ISOLATED INFRAPOPLITEAL LESIONS
Authors: Shin Okamoto, Osamu Iida, Mitsuyoshi Takahara, Yasutaka Yamauchi, Keisuke Hirano, Yoshimitsu Soga, Kenji Suzuki, Masashi Fukunaga, Nobuhiro Suematsu, Terutoshi Yamaoka, Junichi Tazaki, Masahiko Fujihara, Makoto Utsunomiya, Yoshiaki Shintani, Yusuke Miyashita, Taketsugu Tsuchiya, Masaaki Uematsu
Journal: Journal of the American College of Cardiology (2015)
AB0478 Systematic safety review of five biologic antirheumatic drugs:
Authors: M.E. Stuart, S.A. Shrite, S.R. Gandra
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Decision-making regarding therapeutic intervention depends on various factors, including knowledge of the risk-benefit profile of each agent. The relative safety of antirheumatic biologic agents is difficult to assess because of the paucity of direct comparative data, relative rarity of adverse events (AEs), and study design and patient population heterogeneity. <h3>Objectives</h3> Review clinical trial and observational study evidence regarding comparative safety of 5 biologics used in the treatment of rheumatoid arthritis (RA), psoriasis, and psoriatic arthritis: adalimumab (ADA), certolizumab pegol (CZP), etanercept (ETN), golimumab (GLM), and infliximab (IFX). <h3>Methods</h3> Search strategy for this systematic safety review utilized: PubMed, Cochrane Databases, Agency for Healthcare Research and Quality (AHRQ), FDA databases and selected studies from bibliographies of retrieved studies. Search terms: DMARD, tumor necrosis factor, the 5 biologics names, FDA-approved conditions, and associated AE types. Studies were evaluated for inclusion based on validity and clinical relevancy. Findings were graded for evidence strength using a modified AHRQ approach: high, moderate, borderline or inconclusive. <h3>Results</h3> In total, 73 publications were included. Numeric differences were observed in the safety profiles of the 5 biologics. Borderline evidence (Table) indicated RA patients treated with ETN compared to those treated with ADA and IFX may have lower risk for serious infections and withdrawal due to AEs. Inconclusive evidence suggested RA patients treated with ADA, ETN, GLM, and IFX may have lower risk for serious infections (SIs) than those receiving CZP. Across studied populations, borderline evidence indicated lower risk with ETN for tuberculosis (TB) than with ADA or IFX, and inconclusive evidence indicated that ETN had a lower risk for opportunistic infections (OIs) and lymphoma than ADA or IFX. <h3>Conclusions</h3> Although the evidence was rated as borderline or inconclusive using a modified AHRQ approach, our systematic review found patterns suggesting differences among ETN, ADA, and IFX in some safety outcomes. These findings add to the existing body of literature to inform managed care formulary decisions. <i>This study was sponsored by Immunex, a wholly owned subsidiary of Amgen Inc. and by Wyeth, which was acquired by Pfizer Inc. in October 2009.</i> <h3>Disclosure of Interest</h3> M. Stuart Consultant for: Amgen Inc, S. Shrite Consultant for: Amgen Inc, S. Gandra Employee of: Amgen Inc
FRI0493 Clinical and Serological Comparative Analysis of Systemic Sclerosis with or without Overlap Syndromes in A Large Brazilian Cohort
Authors: C.M. Silva, V.S. Viana, S.G. Pasoto, L.P. Seguro, D.C.O. Andrade, E. Bonfá, P.D. Sampaio-Barros
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> There are scarce data comparing clinical and serological features in patients with systemic sclerosis (SSc) and SSc overlap syndromes (SSc-OS) due to the rarity of these associations. <h3>Objectives</h3> To analyze clinical and SSc-associated serological profiles including a panel of novel described antinucleolar antibodies (ANoA) in a large cohort of Brazilian patients with SSc and SSc overlap syndromes. <h3>Methods</h3> Three-hundred twenty-eight SSc patients classified according to the ACR/EULAR 2013 SSc criteria, attended at the Scleroderma Outpatient Clinic of a tertiary referral university hospital from 2000 to 2011 were enrolled in the study; 32% had diffuse cutaneous SSc and 68% limited cutaneous SSc. Clinical and demographic data were obtained from an electronic register database. Serum samples were analyzed for the presence of antinuclear antibodies (indirect immunofluorescence on HEp-2 cells), antibodies to Scl-70, PM-Scl, RNA-Pol III, CENP-A/CENP-B, and Ro/SS-A (52 and 60 kDa) (ELISA), and antinucleolar antibodies (ANoA) fibrillarin, Ku, Th/To and NOR90 (line blot immunoassay) using commercial available standardized kits. <h3>Results</h3> Two-hundred sixty eigth patients were classified as SSc and sixty patients as SSc-OS (14 with systemic lupus erythematosus, 11 with polymyositis, 7 with rheumatoid arthritis, and 35 with Sjogren Syndrome, isolated or combined). Both groups (SSc-O and SSc) were similar regarding mean age at onset, female predominance, disease duration and ethnicity (p&gt;0.05). Concerning clinical features, there were no significant differences related to the occurrence of pitting scars, digital amputation, calcinosis, telangiectasia, interstitial lung disease, pulmonary hypertension, cardiovascular disease, renal crisis (p&gt;0.05). Conversely, SSc-OS patients had lower mean modified Rodnan skin score (5.6±4.24 vs. 10±11.7, p&lt;0,001),but higher percentage of joint (33 vs. 21%, p=0.04) and muscle involvement (22 vs. 8%, p=0.003) compared to the SSc group. There was no difference regarding the frequency of all autoantibodies tested in the two groups (p&gt;0.05), except for the negative association among anti-RNA-Pol III with SSc-OS (p=0.011). <h3>Conclusions</h3> This study identified a comparable occurrence of major organ involvement and ischemic lesions in SSc-OS and SSc. This finding is strengthened by the observation of a similar frequency of all scleroderma autoantibodies in both groups and suggests that SSc determines the clinical manifestation in overlap syndromes in spite of a less extensive skin involvement in these patients. <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.5863
HER2/ER subtypes associated with patient and tumor factors and predicted survival among participants in a retrospective breast cancer cohort study in Southern California.
Authors: R Haque, MF Press, JA Polikoff, CC Avila, SM Enger
Journal: Cancer Research (2009)

Abstract Abstract #3099 Background: Molecular marker expression analyses have led to the identification of unique breast cancer subtypes that have clinical and prognostic importance. Using data from a large population-based breast cancer cohort, we report results examining combined HER2/neu and estrogen receptor (ER) subtype distribution in relation to patient and tumor characteristics as well as breast cancer specific survival.&amp;#x2028; Methods: We conducted a retrospective cohort study of 1,645 female members of a large managed care organization newly diagnosed with invasive breast cancer from 1988 to 1995. We collected patient, tumor, treatment, and outcome information from medical records and electronic cancer registry files. We used immunohistochemistry techniques to evaluate gene expression of specific molecular markers including HER2/neu and estrogen receptor (ER). We examined prevalence of markers as well as odds ratios (OR) and 95% confidence intervals (CI) comparing outcomes by marker expression.&amp;#x2028; Results: Women with HER2+/ER- tumors were more likely to have been diagnosed at a younger age (less than age 60) than women with luminal A subtype (HER2-, ER+ and/or PR+) tumors (65.5% versus 47.8%, P&amp;lt;0.0001). A higher proportion of women with HER2+/ER- tumors were other than white race compared with women with luminal A subtype (21.8% versus 11.6%, P=0.007). Women with luminal B (HER2+, ER+ and/or PR+) or basal-like (HER2-, ER-, PR) subtype tumors were similarly more likely to be older at diagnosis and from minority backgrounds than women with luminal A subtype. Family history of breast cancer was not clearly associated with HER2/ER subtype. Women with luminal A tumors were more likely to be diagnosed with stage 1 disease than women with other tumor subtypes (luminal A: 56.3%; luminal B: 38.9%; basal-like: 38.1%; HER2+/ER-: 25.5%; P&amp;lt;0.0001). Residual tumor in surgical margins was not associated with HER2/ER subtype. Compared with women with luminal A tumors, women with HER2+/ER- tumors were much more likely to die of their cancers overall (OR=6.5, CI=3.5-11.9), and by stage (stage 1: OR=11.5, CI=2.6-50.3; stage 2: OR=3.8, CI=1.6-9.2; stage 3/4: OR=9.0, CI=1.1-77.2). Odds of breast cancer death, overall and by stage, was also increased for women with luminal B and basal-like subtype tumors compared with women having luminal A subtype.&amp;#x2028; Conclusions: HER2/ER subtype was clearly associated with patient as well as tumor characteristics in this large cohort of breast cancer patients. Specific tumor subtypes (HER2+/ER-, luminal B, and basal-like) were also associated with increased likelihood of dying of breast cancer. Further work is warranted to define treatment strategies by molecular subtypes. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 3099.
Abstract 1503: Anticancer effects of a nutrient mixture in human melanoma cells A2058: Inhibition of cell proliferation, MMP expression, invasion and apoptosis
Authors: M. Waheed Roomi, Samee Siddiqui, Nusrath Roomi, Aleksandra Niedzwiecki, Matthias Rath
Journal: Cancer Research (2011)

Abstract Introduction: Melanoma, an extremely aggressive cancer, causes the majority of skin cancer-related deaths, secondary to metastasis to other organs of the body, such as lymph nodes, lungs, liver, brain or bone. Currently, there are no viable treatments for melanoma. We investigated the effect of a specific mixture (PB) of quercetin, cruciferex, curcumin, green tea extract and resveratrol on human melanoma cell line A2058 for viability, MMP expression, invasion, apoptosis and cell morphology. Materials and Methods: Melanoma cells A2058 (ATCC), were maintained in DMEM culture, supplemented with 10% FBS and antibiotics in 24-well tissue plates. At near confluence, cells were treated with PB at 0, 10, 25, 50, 75 and 100 mcg/mL concentration in triplicate at each dose. Cells were also treated with PMA (100 ng/mL) for MMP-9 induction. Cell proliferation was assessed by MTT assay, MMPs by zymography, invasion through Matrigel, apoptosis using green caspase detection, and morphology by H&amp;E staining. Results: PB inhibited proliferation of melanoma cells A2058 by 45% at 10 mcg/mL and 80% at 25-100 mcg/mL concentration, and inhibited the secretion of both MMP-2 and MMP-9 in a dose dependent manner with total inhibition at 50 mcg/mL concentration. Invasion through Matrigel was inhibited by 65% at 10 mcg/mL and 100% at 25 mcg/mL, respectively. PB also induced apoptosis in a dose-dependent fashion. H&amp;E staining showed slight morphological changes at higher concentrations. Conclusions: In conclusion, PB significantly inhibited melanoma cell growth, invasion through Matrigel, MMP-2 and -9 expression and apoptosis, important parameters for cancer prevention, suggesting PB as a potential effective treatment of melanoma. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 1503. doi:10.1158/1538-7445.AM2011-1503
A memorable study day: Rehumanise yourself
Authors: J. Milton
Journal: BMJ (2002)

“You can never go back,” I was always being told by colleagues who had regretted not gathering more training experience before taking up their consultant posts. This was therefore my motto as I attempted to accumulate diverse training experiences.

I had been working on a research oriented forensic unit treating people with personality disorder, a new venture in uncertain times for these services in Britain. Most patients were offenders with severe problems, and I spent my time categorising and classifying their problems, formulating any possible link between their offending and their disorders, and thus directing the treatment approaches and interventions. Assessment had become my forte, and I breathed diagnostic systems and psychological ratings. With an eye on outcome, we probably overmeasured, with little evidence available to identify which variables might be the most important in the future. Patients' ratings had become as important to me as their stories and how they came to be.

I decided to take a study day and was accepted as a visitor to a therapeutic community, a psychotherapeutically oriented NHS residential group of men and women also with personality disorder. After my early coffee and staff introductions, I waited with interest to see how the psychological assessments contrasted with those in my own unit. To my surprise I was shepherded through the residents' door while the staff disappeared upstairs to do their evaluations on new referrals. Somewhat disorientated, I sat through the first residents' group where the weekend's problems were discussed. People introduced themselves, but I felt a bit disarmed. What were the diagnoses? How long had they had their problems? How bad were things? Next followed the chores, and, luckily, I'm not bad at cleaning. I could guess from the healed (and not so healed) lacerations peeping out from sleeves as to some of the residents' psychopathology, but gradually my usual frames of reference were replaced by my interest in their coping with adversity as much as any possible disorder. As we ate lunch, I detected tensions among the group, but, as the outsider with no role, I felt focused on the people rather than the causes or their management.

I felt both sad and elated as the day ended, with the sense that, for once, I had actually learnt something on a study day in psychiatry. I've always been a bit cynical about experiential training, but being unprepared and having no preconceptions had somehow liberated my ability to empathise. Maybe I had re-experienced the process of active rather than critical listening.

Now, some time on, I still look for the diagnosis, for ratings of severity and suchlike, but I try to suspend my judgment just that little bit longer to get a sense of the person behind the scores. As Patrick McGoohan famously said in The Prisoner, “I am not [just] a number.”
S39 The Role Of Soluble Guanylate Cyclase Stimulator Bay 41-2272 On Remodelling Processes Relevant To The Pathogenesis Of Pulmonary Arterial Hypertension
Authors: D. Shao, S. Wort
Journal: Thorax (2014)

<h3>Introduction and objectives</h3> Pulmonary arterial hypertension (PAH) is characterised by remodelling of small, muscular pre-capillary blood vessels. The subsequent rise in pulmonary vascular resistance leads to right ventricular failure and death. The aetiology of the remodelling process is largely unknown although defects in the bone morphogenetic protein receptor II (BMPR II) pathway are likely to be involved. Most of the therapies used thus far are aimed at pulmonary vasodilation. However it is unclear how much of the benefit seen with these medications is related to reverse remodelling. Riociguat is a “first in class” drug that stimulates soluble guanylate cyclase, with a consequent increase in cyclic GMP (and vasodilation). Riociguat has recently been shown to improve haemodynamics and exercise capacity in patients with idiopathic PAH and chronic thromboembolic PH (PATENT and CHEST). Here we sought to determine the effects of Bay 41–2272, the tool compound for riociguat, on remodelling processes in pulmonary vascular cells. <h3>Methods</h3> We used primary human endothelial (HPAECs) and smooth muscle cells (HPASMCs) as our target cells. Proliferation was measured using the CyQUANT proliferation kit after cells were treated with various concentration of Bay 41–2272 (kind gifted by Bayer Pharmaceuticals Ltd) for 72 h in the presence of 15% serum. Apoptosis was measured using Cell death ELISA kit and DAPI staining after cells were treated with various concentration of Bay 41–2272 for 24 and 48 h in the absence of serum. <h3>Results</h3> Bay41–2272 treatment increased HPASMC apoptosis after 24 and 48 h (Figure 1) by Cell death ELISA; this was further confirmed by DNA condensation assay (DAPI staining). Bay 41–2272 treatment also increased HPAEC apoptosis at 24 h. It was not clear at 48 h treatment whether HPAEC cell death was significant in the absence of serum. Bay 41–2272 treatment reduced HPASMC proliferation (Figure 2), but had no effect on HPAECs. <h3>Conclusions</h3> Our preliminary indicate that Bay 41–2272 increases apoptosis and inhibits proliferation, at least in HPASMCs, <i>in vitro</i>. Further studies are needed to fully characterise these effects on remodelling processes and to compare sGC stimulators, such as Bay 41–2272 to Type V phosphodiesterases.
Safety and efficacy of Scrambler therapy for cancer pain.
Authors: M. Ricci, S. Pirotti, M. Burgio, E. Scarpi, E. Sansoni, R. Ridolfi, D. Amadori, M. Maltoni
Journal: Journal of Clinical Oncology (2010)

e19591 Background: Chronic cancer pain (CCP) is present in 50% of cancer patients at any stage of disease and in 70% of those in an advanced setting. Preliminary results have shown the effectiveness of Scrambler therapy, which uses electroanalgesia to neuromodulate cancer-related neuropathic pain. The Scrambler machine is supported by a multiprocessor computer capable of simulating 5 artificial neurons that send out signals identified by the central nervous system as “no pain.” In this way the Scrambler information can be conveyed through electrodes to nerve fibres involved in the production or transmission of the pain signal. Methods: Two consecutive weeks of treatment (one treatment per day lasting 30 minutes, 5 days a week) (T1, T2) are normally given followed by weekly follow-up for a further 2 weeks (T3, T4). Patients are asked to describe their current level of pain in a VAS questionnaire immediately before starting treatment and after each 30-minute session. At follow up appointments, the efficacy and duration of the Scrambler's effects are evaluated. Forty-seven patients with CCP were treated with Scrambler therapy from July 2008 to November 2009. Results: Preliminary analysis of pain intensity showed a decrease from an average of 4.7 (SD 2.9) baseline to 2.5 (SD 2.3) at the end of the second week of treatment (T2) and 2.6 (SD 2.6) at the end of the second week of follow-up (T4). Patients with a T0 pain intensity ≥ 5 showed a decrease from 6.5 at baseline to 3.5. 88% of patients reported that pain did not increase during treatment and 97% of these said that they would repeat it. Therapy was considered satisfactory by 63% of patients at T2 and very satisfactory by 12% at T4. No changes were made in analgesic treatment in 42 patients at T3 and in 43 patients at T4. No adverse events were reported. Conclusions: Our preliminary results indicate the potential effectiveness of Scrambler therapy for pain control in patients with advanced cancer. It is now planned to extend the study to compare Scrambler therapy with placebo treatment. No significant financial relationships to disclose.
A NEW CLINICAL GUIDELINE (2007) AND NATIONAL AWARENESS CAMPAIGN (2011) ACCELERATED BRAIN TUMOUR DIAGNOSIS IN UK CHILDREN (HEADSMART - BE BRAIN TUMOUR AWARE)
Authors: D. A. Walker, T. Chu, A. Shah, S. WIlne, M. Coleman
Journal: Neuro-Oncology (2014)

BACKGROUND: Public and professional concern about delays in diagnosis of childhood brain tumours has led to new referral guidelines and a public health campaign to raise awareness of the early features of brain tumours and the need for timely imaging. We believe this is a “world first attempt” to accelerate childhood cancer diagnosis at the primary-secondary care interface. METHODS: We investigated the referral pathways of children with a brain tumour 1989-2013 using (a) cancer registrations linked to routine records from primary care (Clinical Practice Research Datalink) and secondary care (Hospital Episode Statistics), (b) referral practice data from a multi-centre audit, and (c) data on total diagnostic interval (TDI) from a national service evaluation of HeadSmart. RESULTS: In a cohort of 181 patients (England, 1989-2006), primary care consultation rates rose 40-fold, from 3.1 per 100 person-months (pm) one year before diagnosis to 148.9 at diagnosis. In a cohort of 3,959 patients (England, 1997-2006), hospital admission rates rose 100-fold, from 1.3 per 100pm at one year before diagnosis to 134.0 at diagnosis. Emergency admissions rose from 35% to 55%. Long delays, repeated presentations in primary care and many ineffective referrals, especially in patients with low-grade brain tumours, were also identified in a multi-centre audit (2006). Headaches or convulsions were the commonest first symptoms at age 4+ years. Ophthalmic signs were more prominent in younger children, and changed most between onset (23% of patients) and diagnosis (46%). Raised intracranial pressure was the most common hospital presentation (40% of patients). During the period 2006-11, the median TDI fell by 53%, from 13.4 to 6.3 weeks. The greatest impact of HeadSmart is a 65% reduction in median interval between first clinical contact and diagnosis (P < 0.01; 730 children in 19 UK specialist centres, 2011-13). CONCLUSIONS: Longer total diagnostic intervals (TDI) were associated with slower-growing tumours, repeated presentations to primary care, ineffective referrals to hospitals and increasing likelihood of urgent admission. The referral guidance and awareness campaign shortened the interval from first contact to scanning, suggesting that professional awareness was enhanced. The campaign is ongoing, and it will be disseminated to primary care in 2013-14. TDI data are now collected routinely as part of UK cancer registration. SECONDARY CATEGORY: Pediatrics.