tbuckley/cabot-search huggingface dataset:
Role of the Carotid Bodies in Breath-Holding
Authors: Joseph T. Davidson, Brian J. Whipp, Karlman Wasserman, Sankar N. Koyal, Robert Lugliani
Journal: New England Journal of Medicine (1974)

Abstract To determine the role of the carotid bodies in the sensation of breathlessness during breath-holding, studies were performed in six normal subjects and in five patients with asymptomatic asthma who had had both carotid bodies resected. Breath-holding followed single inspirations of 100, 50, 21 and 12 per cent oxygen and after breathing of 12 per cent oxygen for one minute. In the normal subjects, breath-holding time and alveolar carbon dioxide tension at the breaking point progressively decreased as alveolar oxygen tension decreased. In contrast, there was no change in alveolar carbon dioxide tension or breath-holding time until alveolar oxygen tension was reduced below 50 mm Hg in this patient group. Breath-holding time was twice that for the normal subjects at 50 mm Hg. These studies indicate that the carotid bodies are active chemoreceptors for oxygen through levels greater than 200 mm Hg, that interaction of carbon dioxide and oxygen on respiratory control occurs at the level of the carotid b...
Creeping Eruption — Cutaneous Larva Migrans
Authors: Dong-Lai Ma, Sergio Vano-Galvan
Journal: New England Journal of Medicine (2016)

A 42-year-old man presented with an intensely pruritic eruption on his foot after a vacation in Nigeria. The eruption was migratory, moving a few millimeters to a few centimeters daily. Examination revealed a serpiginous, erythematous raised tract on his right foot.
SP0009 Long-term outcomes of modern treatment: Mortality
Authors: J. Askling
Journal: Annals of the Rheumatic Diseases (2013)

Rheumatoid arthritis and other rheumatic diseases lead to considerable morbidity, and also impact mortality. Efficacious modern anti-rheumatic therapies and treatment regimens holds the promise of reducing the burden of rheumatic diseases, ultimately also or reducing the otherwise increased mortality. This talk aims at summarizing the available data on mortality in rheumatic diseases (level of increase? reasons? secular trends? predictors?) and the relation between anti-rheumatic therapies and mortality (increase? decrease? shifts in causes of deaths?), and to dissect some of the methodological issues complicating analyses of mortality in relation to specific treatments. Mortality data from observational cohorts, randomized trials, and from drug registers will be reviewed, and put into context. <h3>Disclosure of Interest</h3> None Declared
AB0363 Assymetric Dimethylarginine is Associated with Cumulative Inflammatory Burden in Rheumatoid Arthritis
Authors: T. Dimitroulas, A. Sandoo, J. Hodson, J. Smith, K. Douglas, G. Kitas
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> Rheumatoid arthritis (RA) is associated with premature cardiovascular (CV) morbidity and mortality. Inflammatory processes in the rheumatoid synovium and atherosclerotic plaques are remarkably similar, suggesting that RA disease-related inflammation may potentiate the effect of traditional CV risk factors leading to excess CV risk. However, the relationship between atherosclerosis and systemic inflammation in RA remains controversial. Assymetric dimethylarginine (ADMA) – an endogenous inhibitor of nitric oxide synthase - has emerged as a novel surrogate marker of endothelial dysfunction and CVD risk. ADMA levels are elevated in patients with RA compared to controls in several studies. <h3>Objectives</h3> The aim of the present study was to investigate the associations of cumulative inflammatory burden (assessed by serial measurements of inflammatory markers) and classical CV disease risk factors with ADMA, in a large prospective cohort of patients with established RA. <h3>Methods</h3> 201 RA patients [155 females median age 67 (59 – 73)] were assessed at baseline (2006) for presence of classical CVD risk factors and determination of systemic inflammation by C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). At follow-up (2012) ADMA levels were measured by ELISA. A quarterly measurement of CRP and ESR for each year the patient was in the study was used to average areas under the curve (AAUC) for ESR and CRP. <h3>Results</h3> Regression analysis revealed that baseline ESR in 2006 and the AAUC of ESR and CRP all had significant positive relationships with current ADMA (p=0.004, &lt;0.001, 0.002 respectively). Baseline CRP in 2006 was not a significant predictor of ADMA (p=0.093), although this relationship was in the same direction as the other factors. The analysis remained the same when adjusting for classical CV disease risk factors. <h3>Conclusions</h3> Cumulative inflammatory burden is positively related to ADMA levels, suggesting a potential pathogenic mechanism through which chronic systemic inflammation exerts deleterious effects on nitric oxide metabolism and endothelial homeostasis. This association is independent of classical CV disease risk factors. <h3>References</h3> Dimitriulas T, Sandoo A, Kitas GD. Assymetric dimethylarginine as a surrogate marker of endothelial dysfunction and cardiovascular risk in patients with systemic rheumatic diseases. Int J Mol Sci 2012;13:12315-35 Sandoo A, Dimitroulas T, van Zanten JJ et al. Lack of association between assymartic dimethylarginine and in vivo macrovascular and microvascular endothelial dysfunction in patients with rheumatoid arthritis. Clin Exp Rheumatol 2012;30;388-96. <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.1772
Abstract 3116: NF-κB2/p52 induces expression of inflammatory mediators in prostate cancer <i>in vivo</i>.
Authors: Nagalakshmi Nadiminty, Ramakumar Tummala, Wei Lou, Christopher P. Evans, Allen C. Gao
Journal: Cancer Research (2013)

Abstract Introduction and objective: Inflammation plays a key role in the etiology of carcinoma of colon, cervix or liver, but PCa, in which inflammation has not been deemed to play a causative role, also display a pro-inflammatory gene profile. NF-κB is central to the induction of inflammation and the classical and alternative NF-κB activation pathways have been shown to modulate expression of inflammatory mediators. Here we explored the induction of markers of tumor-infiltrating inflammatory cells in two in vivo models overexpressing NF-κB2/p52. Methods: LNCaP human PCa cells were infected with adenoviruses encoding empty vector or NF-κB2/p52 and injected s.c. into both flanks of nude mice. Gene expression of markers of inflammatory mediators such as macrophages, lymphocytes and dendritic cells was analyzed in the tumor tissues by qRT-PCR. In addition, whole prostates were collected from transgenic mice expressing NF-κB2/p52 in the prostate and RNA was analyzed for inflammatory markers. Expression of the cell surface markers was validated by immunohistochemistry in sections of whole prostates. Results: The infiltration of host immune cells into the xenograft tissues was detected by expression of surface markers of cells of myeloid and lymphoid lineage. The expression of B220 (B cells), F4/80 (activated macrophages), Cd8A (CTL) was increased in p52-expressing xenografts compared to controls, indicating the presence of host-derived inflammatory cells in the xenografts. Expression levels of chemokines (Cxcl1), chemokine receptors (Ccr1, Ccr3) and pro-inflammatory cytokines (Il-6 and Tnf) were enhanced in the xenografts compared to the controls, indicating that expression of NF-κB2/p52 induces an inflammatory response in xenografts of human PCa cells. Compared to littermate negative controls, expression of B220, F4/80, Cd8A and Cd208 was increased in transgenic mouse prostates expressing p52. Furthermore, expression levels of Cxcl1, Ccr1, Ccr3, Il-6 and Tnf were also enhanced compared to controls, indicating the induction of inflammation in mouse prostates by NF-κB2/p52. Conclusions: Our previous studies have shown that NF-κB2/p52 plays an important role in the development of castration resistance in human PCa cells. In this study we showed that NF-κB2/p52 may induce an inflammatory response in xenografts of human PCa cells or in transgenic mouse prostates, and thereby promote tumor proliferation. Citation Format: Nagalakshmi Nadiminty, Ramakumar Tummala, Wei Lou, Christopher P. Evans, Allen C. Gao. NF-κB2/p52 induces expression of inflammatory mediators in prostate cancer in vivo. [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 3116. doi:10.1158/1538-7445.AM2013-3116
OP0116 Cost-effectiveness and cost-utility analysis of treat-to-target versus usual care in early rheumatoid arthritis: Results of the dream registry
Authors: M. Vermeer, W. Kievit, I. Kuper, A. Braakman-Jansen, H. Bernelot Moens, T. Zijlstra, A. den Broeder, P. van Riel, J. Fransen, M. van de Laar
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Treat-to-target (T2T) has proven to be more effective in achieving remission in early rheumatoid arthritis (RA) patients than usual care [1]. However, T2T has not been fully implemented in daily clinical practice yet. Moreover, it is unknown whether T2T is cost-effective. <h3>Objectives</h3> To analyse the cost-effectiveness and cost-utility of a T2T strategy aiming at remission (Disease Activity Score in 28 joints (DAS28) &lt;2.6) compared to usual care in early RA over the first two years of the disease. <h3>Methods</h3> Two early RA inception cohorts including patients who fulfilled the ACR 1987 criteria were compared. The T2T group (n=261) consisted of patients from the DREAM remission induction cohort and was treated according to a protocolized treatment strategy aiming at DAS28 remission. The usual care group (n=213) consisted of patients from the Nijmegen early RA inception cohort and was treated without DAS28-guided, protocolized treatment decisions. For both groups, direct medical costs were collected and compared with gain in effectiveness (DAS28 remission) and quality adjusted life years (QALYs) (EQ-5D utility estimated from the HAQ) over two years of follow-up. <h3>Results</h3> T2T produced a higher remission percentage (64.4% vs. 34.7%) and a larger gain in QALYs (median (IQR) 1.45 (1.24-1.55) vs. 1.39 (1.18-1.53), p=0.037) than usual care. The total mean (SD) costs per patient were €4.807 (7.434) in the T2T group and €3.806 (5.761) in the usual care group. The incremental cost-effectiveness ratio was €3.340 per patient in remission. The incremental cost-utility ratio was €18.259 per QALY. The figure presents the cost planes which show the relation between A) the differences in effectiveness and costs and B) the differences in utility and costs of T2T versus usual care. Anti-TNF therapy was given to more T2T patients (21.5% vs. 15.0%) and was prescribed earlier in the disease process, compared to usual care. <h3>Conclusions</h3> This quasi-experiment showed that over the first two years of treatment, T2T is associated with higher costs but also with substantial higher effectiveness. We conclude that T2T is cost-effective in daily clinical practice. <h3>References</h3> [1]Schipper et al, Ann Rheum Dis. 2011 (In press). <h3>Disclosure of Interest</h3> None Declared
ASSOCIATION OF SERUM TOTAL BILIRUBIN LEVEL WITH SEVERITY OF CORONARY ATHEROSCLEROSIS IS LINKED TO SYSTEMIC INFLAMMATION: PROMISING RESULTS FROM A LARGE SCALE COHORT STUDY
Authors: Mehmet Kadri Akboga, Ugur Canpolat, Asife Sahinarslan, Yakup Alsancak, Serdar Nurkoc, Dursun Aras, Sinan Aydogdu, Adnan Abaci
Journal: Journal of the American College of Cardiology (2015)
Abstract 596: Low-dose 1,25-dihydroxyvitamin D3 combined with arsenic trioxide synergistically inhibits proliferation of acute myeloid leukemia cells by promoting apoptosis.
Authors: Bae Ji-Yeon, Ji-Won Kim, Inho Kim
Journal: Cancer Research (2013)

Abstract Arsenic trioxide (As2O3) has shown substantial efficacy in the treatment of patients with acute promyelocytic leukemia (APL). However, since not all patients can achieve remission after treatment, it is necessary to investigate a novel method to overcome the problem. We investigated the anti-leukemic effect of low-dose 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) in combination with As2O3 on HL-60 and K562 cells. The cell viability was in reverse proportion to As2O3 or 1,25(OH)2D3 concentration. In both HL-60 and K562 cells, after the combination treatment with As2O3 and 1,25(OH)2D3 at a 10:1 ratio, the combination index values were less than 1 in all treatment groups. In the RT-PCR and Western blot analysis, the combination treatment decreased Bcl-2 expression and increased Bax and Caspase-3 expressions more prominently than the single treatment. In the flow cytometric analysis performed in HL-60 cells, the proportion of late apoptosis was 4.9% in control, 30.0% in 1.0 μM As2O3, 8.1% in 100nM 1,25(OH)2D3, and 64.3% in 1.0 μM As2O3 plus 100 nM 1,25(OH)2D3. In conclusion, low-dose 1,25(OH)2D3 combined with As2O3 synergistically inhibited proliferation of HL-60 and K562 cells. In addition, this combination activated the apoptosis pathway more prominently than the single-drug treatment. Citation Format: Bae Ji-Yeon, Ji-Won Kim, Inho Kim. Low-dose 1,25-dihydroxyvitamin D3 combined with arsenic trioxide synergistically inhibits proliferation of acute myeloid leukemia cells by promoting apoptosis. [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 596. doi:10.1158/1538-7445.AM2013-596
THU0336 Impact of Disease on Family Size and Family Planning Decisions in Korean Women with Systemic Lupus Erythematosus
Authors: J. Lee, C.-H. Suh, H.-A. Kim, Y.-W. Park, S.-C. Bae, H.-S. Lee, S.-Y. Bang, Y.-M. Kang, W.-K. Lee, H. Park
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Systemiclupus erythematosus(SLE)often affects women in their reproductive years. SLE has impact on their family size and planning, in addition to physical health. <h3>Objectives</h3> To determine factors affecting family size and family planning decisions among Korean women with systemic lupus erythematosus. <h3>Methods</h3> A case-control study comparing childbearing history and decisions of 112 SLE patients and 135 controls was performed. Data was collected through a survey with an existing cohort of women with SLE between ages of 18-45, who are/were married or living with a partner and matching controls. We assessed impact of SLE on pregnancy and family size, and factors influencing childbearing decisions. <h3>Results</h3> More women with SLE reported at least one pregnancy (85.7% vs 71.9%, p=0.009) or at least one live birth (85.7% vs 71. 8%, p=0.003) compared with controls; however, mean number of live birth was significantly lower in women with SLE (1.2±0.8 vs 1.6±0.8, p &lt;0.001). Women diagnosed with SLE before the first child was born had the fewest children (p&lt;0.001). Problems of decreased sexual interest (p=0.035) and menstrual irregularity (p&lt;0.0001) were more common among SLE patients. Significantly more women with SLE made decision not to have children compared with controls (54.5% vs 40.7%, p=0.031), and SLE itself was the major cause of the decision. Socio-behavioral factors commonly influencing the childbearing decisions in controls such as woman's and husband's family size, drinking, decreased sexual interest, and amenorrhea did not have any influence on childbearing decisions in women with SLE. <h3>Conclusions</h3> The disease had significant impact on family size and family planning decisions among Korean women with SLE. <h3>Acknowledgements</h3> The study was supported by a grant of the Korean Healthcare R&amp;D project (A080588) <h3>Disclosure of Interest</h3> None Declared
S-1 + Oxaliplatin as an Adjuvant Chemotherapy for Patients with Curative Resection of Double Cancer of Stomach and Rectum
Authors: K. Kobayashi, M. Kosuge, N. Mitsumori, E. Ken, F. Bungo, T. Harada, M. Uematsu, Y. Arakawa, E. Nagasaki, K. Aiba
Journal: Annals of Oncology (2013)
AB0850 Tuberculosis of Bilateral Sacroiliac Joints: an Unusual Presentation
Authors: A. Atal, D.S. Bhakuni, K. Shanmuganandan, K. Sivasami, A. Hegde
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> Bilateral sacroiliitis at presentation usually prompts a search for an inflammatory disease with the usual suspect being the spondyloarthritides. Infectious diseases and neoplasias, as a rule, affect this joint unilaterally. A worldwide resurgence in tuberculosis and resultant improvement in diagnostic modalities has contributed to unmasking this great masquerader at unusual sites.We present one case. <h3>Results</h3> A 42 year old female, presented with low back and buttock pain of 3 months duration, along with significant morning stiffness. There was no evidence of other articular or extra-articular manifestations. On the basis of clinical presentation, raised acute phase reactants (APRs) and radiographic bilateral sacroiliitis,she was diagnosed as a case of spondyloarthritis and initiated on daily non steroidal anti-inflammatory drugs (NSAIDs). She reported to our referral center with persistent symptoms despite four weeks of NSAIDs. On examination, she was afebrile, with bilateral sacroiliac joint tenderness and painful spinal movements. Investigations revealed normocytic anaemia with elevated APRs, positive Tuberculin test (18mm) and negative Human Leucocyte Antigen B27. Chest radiograph and abdominal ultrasound was normal. Magnetic resonance imaging of the sacroiliac (SI) joints revealed bilateral effusion with multiple abscesses in gluteal muscles. Polymerase chain reaction for Mycobacterium tuberculosis was positive on computed tomography guided needle aspirate of the SI joint. Patient showed clinical improvement and complete radiographic resolution of abscesses after two months of conventional four drug anti tubercular therapy. <h3>Conclusions</h3> Tuberculosis of bilateral sacroiliac joints is uncommon with only isolated case reports. There is usually a lesion in the lumbar spine from where a psoas abscess spreads to involve both sacroiliac joints, however no such vertebral lesions were discernable in our case. Diagnosis is usually delayed because of deep pelvic location and absence of clinically discernable joint inflammation. Lack of awareness of the possibility of bilateral SI joint involvement in this infection often leads to diagnostic delay, prolonged management as spondyloarthritis and consequent increased morbidity. <h3>References</h3> Seddon HJ, Strange FG. Sacroiliac tuberculosis. Br J Surg 1940; 28:193–221 <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.5329
Pledging to Eliminate Low-Volume Surgery
Authors: David R Urbach
Journal: New England Journal of Medicine (2015)

Interview with Dr. David Urbach on a plan to concentrate certain surgical procedures among the physicians and hospitals that perform the most of them. (09:55)Download Though we've long known that higher surgical volume results in lower postoperative mortality, surgeons are balking at a new “Volume Pledge” campaign. But the biggest problem is that such a pledge can't improve the quality of care at low-volume hospitals.
AB1369 What is the evidence-based for future policy decisions regarding biologics in sle? A structured review of the literature
Authors: N. Bansback, J. Chiu, A. Avina-Zubieta
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> The introduction of biologics in Rheumatoid Arthritis (RA) had a dramatic impact on pharmaceutical budgets. Policy-makers initially struggled to make informed resource allocation decisions on use of biologics due to a poor evidence base. With emerging biologics for Systemic Lupus Erythematosus (SLE), we examine the state of the evidence and consider whether lessons from RA have been learnt. <h3>Objectives</h3> To conduct a structured review of the literature to determine the evidence base for supporting policy-making regarding biologics for SLE. <h3>Methods</h3> The review comprised of three parts. First, a scoping phase was conducted which reviewed documents from European and North American reimbursement authorities regarding policies towards biologics in RA. In particular, we sought historical documents where evidence gaps were highlighted in the early decision making. Second, we reviewed current documents to identify sources for informing these evidence gaps. Third, we comprehensively searched and reviewed the SLE literature to (i) identify information possible source of evidence, and (ii) critically appraise this evidence. <h3>Results</h3> Our scoping phase highlighted 7 evidence gaps mentioned by policy makers pertaining to decisions regarding decisions in RA. In general, we found that evidence for SLE was lacking. In particular, the lack of a suitable surrogate outcome for costs and values will hamper the development of decision models. <h3>Conclusions</h3> After reviewing the current evidence base, we believe that policy-makers are ill equipped to be making informed decisions regarding allocation of resources for biologics for SLE. With many biologics beginning to emerge, there exists a small window of opportunity to generate evidence to address this important topic. <h3>Disclosure of Interest</h3> None Declared
FDG Positron Emission Tomography in Isolated Limb Perfusion Therapy in Patients with Locally Advanced Melanoma
Authors: G A Mercier, A Alavi, D L Fraker
Journal: Clinical Nuclear Medicine (2001)

Purpose Isolated limb perfusion (ILP) with high-dose chemotherapy and tumor necrosis factor is being tested in clinical trials as a treatment for locally advanced extremity melanoma. The authors investigated the ability of F-18 fluorodeoxyglucose positron emission tomography (FDG PET) to determine the true extent of disease in patients with this condition, whose distribution of lesions differs from that seen in previous studies. Methods Nine patients with locally advanced melanoma were selected for imaging of the entire body and extremities using FDG PET from a group of participants in a clinical trial of ILP with melphalan ± tumor necrosis factor. Scans were obtained without attenuation correction. Post-treatment scans were obtained in three patients 1 month after ILP. The findings in the FDG-PET scans were compared with those of a standard protocol (SP) that included anatomic images and physical examinations. Results Eighty lesions (74 malignant, 6 benign) were detected with FDG PET and the SP combined. Only malignant lesions were detected by both methods in the perfused limbs. Of the malignant lesions, FDG PET detected 65 lesions (sensitivity rate, 88%). In contrast, 48 lesions were detected with the SP (sensitivity rate, 65%). Twenty-six malignant lesions were seen only with FDG PET (35%), whereas nine malignant lesions were seen only with SP (12%). The six benign lesions included three false-positive mediastinal lymph nodes in one patient. The accuracy rates of FDG PET and the SP were 83% and 65%, respectively. These results are comparable to those seen in previous studies with patients who had disease confined primarily to the torso. All post-therapy FDG-PET scans showed a reduction in the number of visualized limb lesions, and diffuse uptake throughout the perfused limbs. The diffuse uptake correlated with post-therapy limb inflammation. Conclusions Non–attenuation-corrected FDG PET is more sensitive than the SP in detecting the extent of disease in candidates for ILP. The FDG uptake associated with post-therapy inflammation may reduce the contrast resolution of this technique and must be evaluated further.