tbuckley/cabot-search huggingface dataset:
OP0080 CXCL13 and CCL11 Serum Levels are Associated With Lymphoma Occurrence and Disease Activity in Primary Sjögren Syndrome: Data from the French Prospective Cohort Assessment
Authors: G. Nocturne, R. Seror, O. Fogel, P. Dieudé, J.J. Dubost, A.L. Fauchais, V. Goëb, E. Hachulla, C. Larroche, V. Le Guern, J. Morel, A. Perdriger, X. Puechal, S. Rist, V. Devauchelle-Pensec, A. Saraux, D. Sene, O. Vittecoq, C. Miceli, J.-E. Gottenberg, X. Mariette
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Development of non-Hodgkin lymphoma (NHL) is one of the most severe complications associated with primary Sjogren9s syndrome (pSS). Presence of ectopic germinal center (GC) in salivary glands biopsy is a predictor of NHL occurrence in pSS patients [1]. <h3>Objectives</h3> Given the association between CCL11 and CXCL13 and ectopic GC, we decided to assess the link between these chemokines and B cell lymphoma in pSS patients. <h3>Methods</h3> CCL11 and CXCL13 serum levels at inclusion were evaluated in 385 patients from the ASSESS cohort by multiplex assay. The association between serum chemokine levels, B cell biomarkers and subsets of patients was assessed using Spearman9s test for continuous data and nonparametric Wilcoxon test for categorical data. Multivariate analyses were performed to identify parameters associated with lymphoma and disease activity. <h3>Results</h3> 22 patients of the ASSESS cohort had a NHL (history of NHL [n=17] or future [n=5]). The median [IQR] serum levels of CCL11 and CXCL13 were 106.48 [69.33 - 149.85] pg/ml and 108.31 [58.88 – 200.13] pg/ml, respectively. Patients with lymphoma presented higher levels of CXCL13 compared to patients without lymphoma (p=0.006; trend for an association for CCL11 (p=0.056)). If we focus on the 5 patients who developed lymphoma subsequently after the dosage, serum CXCL13 levels was even higher: 584.76 [262.99 – 756.19] pg/ml and statistically different from patients without any lymphoma (108.31 [59.95 – 197.25], p=0.0014). Low C4 and BAFF levels were associated with NHL in the multivariate analysis (p=0.01 and p=0.0002 respectively). CCL11 and CXCL13 levels positively correlated with 3 B-cell biomarkers: rheumatoid factor, κ/λ free light chain ratio and β2-microglubulin. CXCL13 level was the only parameter associated with disease activity in the multivariate analysis. <h3>Conclusions</h3> This study demonstrates a link between serum levels of CXCL13 and CCL11 and disease activity and lymphoma. This highlights the continuum between chronic B-cell activation, disease activity and lymphomagenesis in pSS patients. <h3>References</h3> Theander et al, ARD, 2011 <h3>Disclosure of Interest</h3> None declared
PTU-232 Can the alvarado score be used to reduce negative appendicectomies in female subjects?
Authors: E Kalakouti, M AlAni, A Moinie, Q Iqbal, A Prabhudesai
Journal: Gut (2015)

<h3>Introduction</h3> The Alvarado scale has been used as a scoring tool to predict the likelihood of acute appendicitis, but has not been validated in the female population. Female gender confers an independent risk for higher negative appendicectomy due to diagnostic confusion with gynaecological pathology. <h3>Method</h3> We performed a prospective study of surgical referrals of female subjects of reproductive age triaged as “suspected appendicitis”. We calculated the Alvarado score for each presentation and compared the score with the respective histological findings of those who underwent an appendicectomy. Negative appendicectomy was defined by histological diagnosis only. <h3>Results</h3> One hundred female subjects were investigated for suspected appendicitis, of which 46% (n = 46) underwent a laparoscopic appendicectomy. 60% (n = 27) of those who had an appendicectomy had histologically proven acute appendicitis and 40% (n = 17) had a normal appendix. 88% (n = 15) of the negative appendicectomies had an Alvarado score of ≤5, as compared to 37% (n = 10) of those with acute appendicitis. Likewise, 63% (n = 17) of those with acute appendicitis had a score of ≥6, as compared to 12% (n = 2) of those who did not have acute appendicitis. 54% (n = 54) did not undergo surgery, of which 80% (n = 43) scored ≤5. Overall, in those who had an appendicectomy, a cut off score of ≤5 was suggestive of a normal appendix, whereas a score of ≥6 suggested acute appendicitis. <h3>Conclusion</h3> Scores of ≤5 can be interpreted as a predictive factor to rule out acute appendicitis. When used in conjunction with clinical judgment, the application of the score in the diagnostic workup can contribute towards greater diagnostic accuracy and subsequently reduce the frequency of negative appendicectomy in females. <h3>Disclosure of interest</h3> None Declared.
PWE-062 The outcomes and benefits of moving stable inflammatory bowel disease patients from a paper based self management system to an supported, self help and management programme (ibd-sshamp) with specialist overview
Authors: T Price, K Lithgo, MW Johnson
Journal: Gut (2015)

<h3>Introduction</h3> Self management in inflammatory bowel disease (IBD) has proven itself to be a safe and cost effective method of managing the more stable IBD patients. It is however not without its issues. In February 2012 we introduced our IBD-Supported, Self Help and Management Programme (IBD-SSHAMP) with specialist nursing and consultant support to try an avoid some of the issues inherent on relying on self management alone. We now have 3 years experience in running IBD-SSHAMP with regular virtual telephone clinics and personalised web-site supported management. Some of the outcomes seen in transferring patients from self management to a supported self management system are presented here. <h3>Method</h3> In total 425 of our more stable IBD patients are now managed in the community on IBD-SSHAMP. Using hospital coding data, Evolve (the hospital–s electronic record system), the National IBD Registry and HICSS (the endoscopy reporting software) we reviewed the following aspects;- number of flares, steroid courses, emergency outpatient clinics, and hospital admissions. By continuing to keep them under a close monitoring system we were interested to know if improvements would be seen in their compliance with prophylactic medication and their uptake on surveillance colonoscopy. <h3>Results</h3> In 3 years just 43 flares were experienced in this cohort, and most of these were successfully treated using mesalazines alone. Steroids were however required in 16 of these patients, most of which was directed by telephone consultation. In that 3 year period only 8 required urgent outpatient appointments (OPAs) were required and no patients needed hospital admission. Many patients on pure self management had been lost to follow up and had avoided surveillance colonoscopy. Unfortunately after bringing these patients back into a monitored and supported management system we have subsequently found 3 colorectal cancers (ascending, sigmoid and ano-rectal) within this group. Most of these patients were overdue their surveillance colonoscopy, but despite the known risks 114 still declined surveillance. Other cancers were also found amongst this cohort, including; 2 breast cancers, one prostrate cancer and one skin cancer. Most were happy with the new IBD- SSHAMP, but 3 patients chose to attend standard hospital based OPAs. <h3>Conclusion</h3> IBD-SSHAMP has been shown to be a highly efficient and cost effective method of keeping community based IBD patients under close specialist review. Reductions in flares, emergency OPAs and admissions have been seen. It has been well received by the patients who prefer to be supported rather than discharged and left alone to self manage. <h3>Disclosure of interest</h3> None Declared.
Leading Major Congenital Malformations Among Minority Groups in the United States, 1981-1986
Authors: G F Chávez, J F Cordero, J E Becerra
Journal: JAMA (1989)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Lipocalin-2 mediates non-alcoholic steatohepatitis by promoting neutrophil-macrophage crosstalk via the induction of CXCR2
Authors: Dewei Ye, Kangmin Yang, Shufei Zang, Zhuofeng Lin, Hau-Tak Chau, Yudong Wang, Jialiang Zhang, Junping Shi, Aimin Xu, Shaoqiang Lin, Yu Wang
Journal: Journal of Hepatology (2016)
Stepped care targeting psychological distress in head and neck cancer and lung cancer patients: a randomized, controlled trial
Authors: A.M.H. Krebber, F. Jansen, B.I. Witte, P. Cuijpers, R. de Bree, A. Becker-Commissaris, E.F. Smit, A. van Straten, A.M. Eeckhout, A.T.F. Beekman, C.R. Leemans, I.M. Verdonck-de Leeuw
Journal: Annals of Oncology (2016)
The Adolescent Kidney Donor: The Right To Give
Authors: Dorothy M. Bernstein, Roberta G. Simmons
Journal: American Journal of Psychiatry (1974)

Adolescents are rapidly acquiring new medical and legal rights. One of the issues being raised in the field of organ transplantation is the ability of the adolescent to decide to give one of his body organs to another person. Can he make a valid and lasting decision? The authors found that adolescent donors were more likely than adult donors to experience a boost in self-esteem and feel rewarded by rather than regretful of their decision a year later.
PTU-097 The experience of methadone users in community pharmacy: a qualitative study to define the important attributes when designing a hepatitis C virus testing and treatment pathway
Authors: A Radley, K Melville, P Easton, J Dillon
Journal: Gut (2015)

<h3>Introduction</h3> Opioid replacement therapy (ORT) provided through community pharmacies is a public health service with major benefits. ORT patients have the highest rates of hepatitis C infection (HCV) and are the easiest to reach (i.e. they fetch their methadone every day from the pharmacy). However, these patients seem to have little interest in testing. Hence, a program that increases uptake of testing and treatment should have a major impact on patient health, reduce the spread of HCV, and be highly cost-effective. Service user perspectives are an important factor in enhancing value and utilisation. This study explored the experiences and perceptions of service users of community pharmacies, around provision of supervised self-administration of ORT and how they would obtain testing and treatment for HCV. <h3>Method</h3> A focus group methodology was chosen to identify the range of experiences and perceptions of service users. A topic guide was developed from evidence syntheses and refined through the study. Individuals were eligible for inclusion if they received ORT from a community pharmacy or were a carer. The study used a purposive sampling strategy to ensure a diversity of views were identified. Recruitment focussed on: Place of Residence –large urban/other urban/accessible small town Service Users Subject to Detention by the Criminal Justice System Perspectives of female service users Focus groups were digitally recorded and anonymised at transcription. Analysis drew on the constant comparison method in a general thematic approach. AR and KM developed a coding framework on the basis of the topic guide and initial analysis of transcripts. <h3>Results</h3> A pilot focus group and further 5 focus groups were undertaken, with 37 participants drawing on perspectives of service users and a small number of carers. Recurrent themes were identified of the experiences of service users: Issue of long waiting times; experiences of stigma; experiences of discrimination; issue of compromised confidentiality; experiences of good quality care provision; service users’ explanations for their experiences. Service Users’ understanding of HCV infection was based around: Perception of the disease; perception of the burden of treatment; preferences for obtaining treatment. <h3>Conclusion</h3> The eradication of HCV infection with new highly effective oral agents requires that much greater numbers of patients access testing and treatment. Community pharmacies offer the prospect of a hosting highly accessible testing and treatment in a local facility. In designing such a pathway it will be important to address the patients’ perceived obstacles to entering treatment <h3>Disclosure of interest</h3> None Declared.
PWE-009 Evaluation of out-of-hours emergency endoscopy outcomes at a large liver and gastrointestinal centre
Authors: J Hawken, V Audimoolam, B Hayee, P Dubois, G Chung-Faye, I Bjarnason, J Devlin, P Harrison, M Heneghan, K Agarwal, A Suddle
Journal: Gut (2015)

<h3>Introduction</h3> Acute Upper GI bleeding is a common medical emergency and is associated with high mortality. Pre-existing co-morbidities along with in-hospital and portal hypertensive bleeds have been linked with increased mortality. With the emphasis and implementation of 24/7 endoscopy cover for gastrointestinal bleeding across the country, we conducted a study into emergency out-of-hours endoscopies to describe patient characteristics, diagnoses and mortality. <h3>Method</h3> Retrospective data was collected from all out-of-hours emergency endoscopies at king–s College Hospital, a tertiary referral centre, between 6/10/13 and 2/11/14. The majority of procedures were carried out under general anaesthesia by the on-call endoscopy team in theatre or one of the intensive therapy units (ITU). Referral to endoscopy time, re-bleed rate, completed Rockall score, consequent surgical or radiological intervention and mortality at 72 h and 28 days were collected. <h3>Results</h3> 131 endoscopies (mean age 56.2 yrs, 44% &gt;theatre and 53% &gt;ITU), 45% new admissions and 55% in- patients were undertaken. 53% had liver disease as their primary source of morbidity. Variceal bleed was the most common finding (40%), followed by peptic ulcers (24.6%). The mean referral to scope time was 7.7 h (range 2–24) and the 72-hour re-bleed rate was 7.4%. Banding alone or as a combination with histoacryl glue injection was the most frequently used therapy (30%). Mortality with a completed Rockall score of ≤3 was 0%, rising to 39% with a score of ≥7. 72 h and 28 days mortality was 5.8% and 26.7%. Overall 28-day mortality for an out of hospital bleed was 22% and 39% for in hospital bleed. Mortality for variceal bleeding and ulcer bleeding was comparable at 33% and 34%. 2.7% underwent surgery following initial endoscopy and 0.9% interventional radiology. <h3>Conclusion</h3> In-hospital bleeds carry high rates of mortality due to extensive comorbidities, especially in the case of liver disease. The study findings of a similarly high mortality for bleeding ulcers as for variceal bleeding in an intensive therapy setting reflects the severity of their critical illness. The high percentage of liver disease patients and those with concurrent critical illness, as well as the fact that the endoscopies were performed out of hours reflecting the clinical urgency, contributes to the higher mortality rate than the 10–14% previously described. <h3>Disclosure of interest</h3> None Declared. <h3>References</h3> Hearnshaw SA, <i><i>et al</i></i>. Acute upper GI bleeding in the UK: patient characteristics, diagnoses and outcomes in the 2007 UK audit. <i>Gut</i>. 2011. doi:10.1136/gut.2010.228437 Rockall TA, <i><i>et al</i>.</i>Risk assessment after acute upper gastrointestinal haemorrhage. <i>Gut</i>. 1996;<b>38</b>:316–321
Frontiers in Cardiovascular Biology: a forum for exploratory basic science and translational research from the ESC Council for Basic Cardiovascular Sciences
Authors: Elisabetta Cerbai, Karin R. Sipido, Lina Badimon
Journal: Cardiovascular Research (2016)

The year 2004 saw the creation of the Council for Basic Cardiovascular Sciences (CBCS), within the European Society of Cardiology (ESC). The Council brought together ESC working groups focused on different aspects of cardiovascular biology and pathology, and societies and groups outside ESC who shared similar scientific interests (https://www.escardio.org/The-ESC/Communities/Councils/Council-on-Basic-Cardiovascular-Science/About). The CBCS aims to advance basic science and its relation to clinical practice and to provide …
Adaptive and Acquired Resistance to EGFR Inhibitors Converge on the MAPK Pathway
Authors: Pengfei Ma, Yujie Fu, Minjiang Chen, Ying Jing, Jie Wu, Ke Li, Ying Shen, Jian-Xin Gao, Mengzhao Wang, Xiaojing Zhao, Guanglei Zhuang
Journal: Theranostics (2016)

Both adaptive and acquired resistance significantly limits the efficacy of the epidermal growth factor receptor (EGFR) kinase inhibitors.However, the distinct or common mechanisms of adaptive and acquired resistance have not been fully characterized.Here, through systematic modeling of erlotinib resistance in lung cancer, we found that feedback reactivation of MAPK signaling following erlotinib treatment, which was dependent on the MET receptor, contributed to the adaptive resistance of EGFR inhibitors.Interestingly, acquired resistance to erlotinib was also associated with the MAPK pathway activation as a result of CRAF or NRAS amplification.Consequently, combined inhibition of EGFR and MAPK impeded the development of both adaptive and acquired resistance.These observations demonstrate that adaptive and acquired resistance to EGFR inhibitors can converge on the same pathway and credential cotargeting EGFR and MAPK as a promising therapeutic approach in EGFR mutant tumors.
Soundings: What not to do
Authors: George Dunea
Journal: BMJ (2000)

In 1968 Dr Richard Armour wrote an essay in JAMA in which he pretended to have found an old book, “being a study of certain curious categories of physicians.” There were four types. Firstly, the Ebullient, outgoing, exuding optimism and good cheer, backslapping, always encouraging and minimising his patients' illnesses. Next, the Lugubrious, entering the sickroom with a pained look like an undertaker coming to remove a body, speaking in a low sepulchral tone and always guarded about the outlook. Then the Fussbudget, meticulous to the extreme, even checking his stethoscope before using it, ordering every possible test and keeping elaborate notes on every detail, his files overflowing, his waiting patients growing weak while he completes his first physical examination of the day. Finally, Dr Speedy, always looking at his watch, notes in shorthand, counting the pulse while looking at the tongue, never sitting down, always on the move.

During my medical school days I also had an old book. It was a real one, bought on an impulse, written in French by no doubt a distinguished member of the academy. I never read much of it, but after graduation I took it on a Pacific cruise and in an expansive mood after an all-night party threw it overboard. It rests at the bottom of the ocean somewhere between Suva and Noumea, where generations of Francophone fish have come to appreciate the interesting approach of starting each chapter with brief introductory vignettes on “what to do” and on “what not to do.”

In former days the warnings of “what not to do” were against such things as administering creosote to consumptives or arsenic for gonorrhea. Now they might be against giving intravenous calcium to patients being given digitalis, morphine to patients with asthma, pethidine to patients receiving dialysis, or amiloride to patients with renal insufficiency.

More on the domestic side, you might add a warning against not heating water in a microwave unless you put in the cup something non-metallic such as a wooden stir stick or a tea bag. Otherwise there could be a build-up of energy, such as happened recently to a young man who sustained severe facial burns and was blinded in one eye as hot water blew up in his face. The doctors at the hospital said that they had seen several such cases, and accordingly emphasised this important “what not to do” warning.
513P Using Quality Improvement Methods and Time-Driven Activity Based Costing to Improve Value-Based Cancer Care Delivery at a Cancer Genetics Clinic
Authors: R. Tan, M. Met-Domestici, K. Zhou, A. Guzman, S.T. Lim, K.C. Soo, T. Feeley, J. Ngeow
Journal: Annals of Oncology (2015)
PTH-331 Non-operative management of low rectal cancer with complete response to standard neoadjuvant chemoradiotherapy
Authors: RA Dickson-Lowe, P Hanek, S Kalaskar, J Taylor
Journal: Gut (2015)

<h3>Introduction</h3> 20% of low rectal cancers respond extremely well to standard long course radiotherapy and on clinical examination apparently disappear from the rectal lumen after chemoradiotherapy; an apparent complete response. There are two dilemmas which follow this: Can we be sure about the complete response and that there is no viable residual tumour tissue? If we believe there is no tumour tissue left, how do we then manage these patients? Our Trust started to suggest non-operative management to ‘complete responders’ in January 2007, and the results were remarkable. <h3>Method</h3> Ongoing study looking at 14 complete responders. Surveillance has been MRI/EUS/EUA under GA during years 0–2 every three months. MRI/EUS/EUA under GA during years 3–5 every six months. MRI/EUS/EUA under GA after 5 years every year. A CT scan and colonoscopy were performed at the two and five year marks. These are the Trust’s local guidelines. <h3>Results</h3> 14 patients in total. Seven are still disease-free and still under surveillance. Three had recurrence; two underwent APR and one underwent ultra low anterior resection; all had R0 resections and are still disease-free. Four were suspected to have recurrence but were not fit for major resections therefore had transanal procedures; all had tumour-free specimens and are still disease-free and under surveillance. <h3>Conclusion</h3> There are an important cohort of patients who have low rectal cancer who may not need an operation. We are still unsure exactly how to manage these patients and it is therefore important for each unit to follow them up and share experiences. As a Trust, we will continue to manage these patients with the diagnosis of low rectal cancer, who are ‘disease-free’ following long course chemoradiotherapy, non-operatively. <h3>Disclosure of interest</h3> None Declared. <h3>References</h3> Smith JD, <i>et al</i>. Non-operative management of rectal cancer with complete response to neoadjvant therapy. Ann Surg. 2012;256:965–972 Habr-Gama A, <i>et al</i>. Non-operative management of distal rectal cancer after chemoradiation: experience with the “watch and wait” policy. Dis. Colon Rectum. 2010;52:1137–1143 Habr-Gama A, <i>et al</i>. Operative versus non-operative treatment for stage 0 distal rectal cancer following chemoradiation therapy. Ann Surg. 2004;240(4):711–718 Tennyson MD, <i>et al</i>. Transanal excision with radiation therapy for rectal cancer. Clin Med Res. 2012;10(4):224–229 Schmoll HJ, <i>et al</i>. ESMO concensus guideline for management of patients with colon and rectal cancer: a personalised approach to clinical decision making. Ann Oncol. 2012;23:2479–2516 Deferral of Surgery (Watch And Wait) Study. Royal Marsden Hospital, Pelican Cancer Foundation, Phase II Multicentre Single-Arm Study, Cancer Research Trial Number CRUK/10/006