tbuckley/cabot-search huggingface dataset:
AB0294 Comparison between several prediction scores and the new EULAR/ACR criteria for diagnosis and prognosis of rheumatoid arthritis
Authors: J. Kaufmann, S. Seel, A.-E. Roske
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> New ACR/EULAR classification criteria for RA were developed in response to the criticism of existing 1987 ACR criteria due to insufficient sensitivity in early disease. According the new criteria a score of ≥6 is indicative of the presence of RA. But one limitation of these new criteria is a lack of factors with imaging techniques for a better identification of patients with high-risk to devolope erosive course. <h3>Objectives</h3> There are two other prediction models for development of RA, the Helm-van Mil-Score without imaging techniques and the Visser-Score with detection of early erosions by X-ray. The calculated scores correspond to the probability of persistent or self-limiting and non-erosive or erosive course. The aim was to compare the new ACR/EULAR criteria with two other long existing predictive scores regarding cut-off for erosive course. <h3>Methods</h3> 95 Patients with early arthritis were observed and classified by new ACR/EULAR criteria, Helm-van Mil-Score (HvM) and Visser-Score. The treatment decision was made by subjective assessment of the severity. 35 patients have ACR/EULAR-Score ≥6, 33 patients have HvM-Score ≥8 (positive prediction of persistence 84%) and 27 patients with a prediction of persistence ≥80% measured by Visser-Score. All patients will be monitored in order to differentiate in the course by over-treated and under-treated regarding different prediction scores. <h3>Results</h3> There are differences in prediction values for many patients with undifferentiated Arthritis. The pictures show the different cut-offs for assessing the persistence of arthritis. According to the ACR/EULAR criteria, 35 patients a treatment would be supplied with DMARDs, according to Helm-van Mil 33 and after Visser score only 27. It should be clarified in the course of the investigation which patients benefit from treatment actually. <h3>Conclusions</h3> There is a difference of 8 patients between ACR/EULAR criteria of RA and theultrasound-assistedVisser-Score. The at least one year follow up will show how many patients develop a RA and how many of them need an early anti-inflammatory therapy with DMARDs. The goal is to treat as many patients as early as adequate, while the number of over-treated patients on low to keep. <h3>Disclosure of Interest</h3> None Declared
THU0363 Efficacy and Tolerability of Anti-TNF Therapies in Patients with Non-Radiographic Axial Spondyloarthritis: An Observational Cohort Study from Southern Sweden
Authors: L. Kristensen, M. Kapetanovic, T. Saxne, A. Gulfe, P. Geborek
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Treatment recommendations for patients with axial spondyloarthritis (SpA) [1], including non-radiographic axial SpA (nr-axSpA), presents anti-TNF therapies as an option in patients who fail NSAIDs, however at present clinical data targeting nr-axSpA has been sparse. <h3>Objectives</h3> To evaluate the efficacy and tolerability of anti-TNF therapy in nr-axSpA patients treated in clinical practice. <h3>Methods</h3> 112 patients with nr-axSpA and high disease activity as well as inadequate response or intolerance to NSAIDs receiving their first course of anti-TNF therapy were prospectively included in this cohort study. Patients fulfilling modified New York criteria for ankylosing spondylitis were excluded. 89% (N=99) of the included patients fulfilled ASAS criteria for axial SpA. <h3>Results</h3> At baseline median age was 38 years, 59% were males, 79% of the patients had imaging suggestive of sacroiliitis (primarily inflammation on MRI), 71% were HLA-B27 positive, and the median disease duration was 6 years and 10 months. At 6 months of follow-up the median BASDAI decreased from 5.6 to 3.2 (p=0.002), BASFI decreased from 3.9 to 1.8 (p=0.005), and CRP 4.4 mg/L to 1.7 mg/L (p=0.001). After 1 year of treatment the mean drug survival was 75%, and at 2 years of follow-up this fraction decreased to 64%. Patients with positive MRI findings at baseline had significantly better drug survival (HR=0.33 CI 0.16-0.69; p=0.002). Also male sex was associated with higher drug survival (HR=0.45 CI 0.24-0.85; p=0.011). CRP-level at baseline was not associated with drug survival. <h3>Image/graph</h3> <h3>Conclusions</h3> Anti-TNF treatment of patients with nr-axSpA in clinical practice resulted in effective control of disease activity and good drug survival. Results from this study suggest that male gender and positive MRI findings at baseline are associated with a favourable treatment course. <h3>References</h3> van der Heijde D et al. ASAS recommendations for axSpA. Ann Rheum Dis 2011;70:905–8. <h3>Disclosure of Interest</h3> L. Kristensen Consultant for: Pfizer, Wyeth, Abbott, BMS, MSD, M. Kapetanovic: None Declared, T. Saxne: None Declared, A. Gulfe: None Declared, P. Geborek: None Declared
A10.06 Detecting adalimumab serum level and anti-drug antibodies – future tool in monitoring spondyloarthritis patients?
Authors: C Deaconu, D Opriş, D Mazilu, A Borangiu, L Groșeanu, M Negru, C Constantinescu, I Săulescu, V Bojincă, V Vlad, A Bălănescu, D Predețeanu, R Ionescu
Journal: Annals of the Rheumatic Diseases (2016)

<h3>Background and objectives</h3> Anti-TNF agents have highly proved their efficacy in spondylarthritis (SpA) patients, with a good rate of response of approximately 70%. However a third of patients lose response to treatment. Measuring the drug serum level and anti-drug antibodies might lead to identifying the cause of non-response, followed by adjusting the therapeutic scheme. The aim was to determine the utility of determining drug serum adalimumab (ADL) and anti-ADL antibodies in assessing disease activity in SpA patients. <h3>Methods</h3> Over a period of 11 months we included 54 SpA patients on ADL, with further exclusion of those who had delayed drug administration or suffered a concomitant infection. Demographic, clinical (disease activity scores) and laboratory (ESR, CRP) data were collected. We measured the determination of interest using Promonitor kits, using the ELISA technique and the statistical analysis was performed with SPSS 20.0. <h3>Results</h3> Out of the total 35 patients, 74% were males, the mean age was 40 years old with a mean disease duration of 102 months. HLA B27 was positive in 91% of patients and 28% required sacroiliac joint MRI at diagnosis, being a non-radiographic form. 28% of patients tested positive for Quantiferon and underwent chemoprophylaxis. 22% had history of uveitis before diagnosis and 9% had recurrences while on ADL. 82% of patients had detectable ADL levels. The BASDAI score was significantly higher in patients with undetectable ADL (P &lt; 0.001), with a mean value of 6.3 indicating an inadequate disease control. Furthermore, both ASDAS-ESR and ASDAS-CRP were higher in these patients (P &lt; 0.001). 25% had positive anti-ADL antibodies. Patients with no identified antibodies had lower disease activity scores (BASDAI, ASDAS-VSH and ASDAS-CRP, P &lt; 0.001). Acute phase reactants (ESR, CRP) had a higher value in patients with positive anti-ADL antibodies (P = 0.015 and P &lt; 0.001, respectively). Serum level ADL negatively correlated to the presence of anti-ADL antibodies (r&nbsp;= -0.360, P = 0.034) and to disease activity scores. <h3>Conclusions</h3> Undetectable serum drug level together with the presence of anti-drug antibodies and the increase of SpA activity scores indicate the impact of immunogenicity throughout secondary non-responder patients. Prompt identification of these patients might lead to a better adapted therapeutic scheme.
Natural-orifice transluminal endoscopic surgery: low-pressure pneumoperitoneum is sufficient and is associated with an improved cardiopulmonary response (PressurePig Study)
Authors: S. von Delius, A. Schorn, M. Grimm, A. Schneider, D. Wilhelm, T. Schuster, M. Stangassinger, H. Feussner, R. Schmid, A. Meining
Journal: Endoscopy (2011)

Background and aims: The aim of this randomized trial in the acute porcine model was to compare the quality of transgastric peritoneoscopy with the use of low-pressure versus standard-pressure pneumoperitoneum and to evaluate the respective associated cardiopulmonary changes.
5-Fluorouracil, folinic acid, epidoxorubicin and cisplatin (FLEP) combination chemotherapy in advanced measurable gastric cancer. A phase II trial of the Spanish Cooperative Group for Gastrointestinal Tumor Therapy
Authors: A Cervantes, A Villar-Grimalt, A Abad, A Antón-Torres, J Belón, J Dorta, A Tres, C Camps, E Fonseca, B Massutí
Journal: Annals of Oncology (1993)
Immunotherapy with a HER2-Targeting <i>Listeria</i> Induces HER2-Specific Immunity and Demonstrates Potential Therapeutic Effects in a Phase I Trial in Canine Osteosarcoma
Authors: Nicola J. Mason, Josephine S. Gnanandarajah, Julie B. Engiles, Falon Gray, Danielle Laughlin, Anita Gaurnier-Hausser, Anu Wallecha, Margie Huebner, Yvonne Paterson
Journal: Clinical Cancer Research (2016)

Recombinant Listeria vaccines induce tumor-specific T-cell responses that eliminate established tumors and prevent metastatic disease in murine cancer models. We used dogs with HER2/neu(+) appendicular osteosarcoma, a well-recognized spontaneous model for pediatric osteosarcoma, to determine whether a highly attenuated, recombinant Listeria monocytogenes expressing a chimeric human HER2/neu fusion protein (ADXS31-164) could safely induce HER2/neu-specific immunity and prevent metastatic disease.Eighteen dogs that underwent limb amputation or salvage surgery and adjuvant chemotherapy were enrolled in a phase I dose escalation clinical trial and received either 2 × 10(8), 5 × 10(8), 1 × 10(9), or 3.3 × 10(9) CFU of ADXS31-164 intravenously every 3 weeks for 3 administrations.Only low-grade, transient toxicities were observed. ADXS31-164 broke peripheral tolerance and induced antigen-specific IFNγ responses against the intracellular domain of HER2/neu in 15 of 18 dogs within 6 months of treatment. Furthermore, ADXS31-164 reduced the incidence of metastatic disease and significantly increased duration of survival time and 1-, 2-, and 3-year survival rates when compared with a historical control group with HER2/neu(+) appendicular osteosarcoma treated with amputation and chemotherapy alone.These findings demonstrate that ADXS31-164 administered in the setting of minimal residual disease can induce HER2/neu-specific immunity and may reduce the incidence of metastatic disease and prolong overall survival in a clinically relevant, spontaneous, large animal model of cancer. These findings, therefore, have important translational relevance for children with osteosarcoma and adults with other HER2/neu(+) cancers. Clin Cancer Res; 22(17); 4380-90. ©2016 AACR.
P138 Efficacy of inhaled pan-selectin antagonist Bimosiamose on ozone-induced airway inflammation in healthy subjects
Authors: A. Kirsten, H. Watz, G. Kretschmar, F. Pedersen, W. Meyer-Sabellek, D. Bock, H. Magnussen
Journal: Thorax (2010)

Selectins, a family of adhesion molecules, play a key role in the activation and extravasation of leukocytes in inflammatory diseases, like COPD. We investigated the effect of repeated inhalations of the pan-selectin antagonist Bimosiamose on ozone-induced airway inflammation in healthy volunteers. In a double-blind, placebo-controlled, randomised, cross-over study the effect of a 4-days treatment with 10 mg of Bimosiamose bid inhaled by a breath actuated nebuliser (AKITA2 APIXNEB®) on cellular and non-cellular composition of induced sputum after inhalation of ozone (250 ppb) for three hours was evaluated. 18 subjects were randomised and completed the study. All treatments were safe and well tolerated. Bimosiamose, compared to placebo treatment, reduced numbers of sputum neutrophils by 40% (p=0.068) and lymphocytes by 65% (p=0.004). Sputum concentration of interleukin-8 and MMP-9 was diminished by 35% (p=0,004) and 46% (p=0,022), respectively. Inhalation of Bimosiamose showed a broad and favourable significant effect on ozone-induced airway inflammation in healthy subjects. Further studies have to proof and translate this anti-inflammatory effect of Bimosiamose into a clinical benefit in patients with COPD.
Keeping Cells in Their Place: The Role of Tumor Suppressor Genes
Authors: E. Blume
Journal: JNCI Journal of the National Cancer Institute (1989)

Journal Article Keeping Cells in Their Place: The Role of Tumor Suppressor Genes Get access Elaine Blume Elaine Blume Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 81, Issue 19, 4 October 1989, Pages 1440–1441, https://doi.org/10.1093/jnci/81.19.1440 Published: 04 October 1989
Azathioprine for Long-Term Maintenance of Remission in Autoimmune Hepatitis
Authors: Philip J. Johnson, Ian G. McFarlane, Roger Williams
Journal: New England Journal of Medicine (1995)

In most patients with autoimmune hepatitis, remission can be maintained with prednisolone, usually in combination with azathioprine, but the majority of patients have a relapse when treatment is stopped and therefore require long-term therapy. Because prolonged corticosteroid therapy may have serious toxic effects, in 1984 we undertook a controlled trial of maintenance therapy with azathioprine alone. None of the 25 patients in that trial had relapses during the follow-up period of one year. We have now followed these 25 patients for 10 years and have treated an additional 47 patients in a similar manner.
Scalp Necrosis Associated with Giant-Cell Arteritis
Authors: Qasim Akram, Hector Chinoy
Journal: New England Journal of Medicine (2016)

A 74-year-old man presented with headache, jaw claudication, and worsening scalp ulceration. Examination revealed areas of scalp necrosis. He received a diagnosis of scalp necrosis as a complication of giant-cell arteritis.
Intravenous Immunoglobulin for the Prevention of Infection in Chronic Lymphocytic Leukemia
Journal: New England Journal of Medicine (1988)

In a double-blind study, we randomly assigned 84 patients with chronic lymphocytic leukemia who were judged to be at increased risk of bacterial infection to receive intravenous immunoglobulin G (400 mg per kilogram of body weight) or a placebo every three weeks for one year. Eligible patients had hypogammaglobulinemia, a history of infection, or both. The patients receiving immunoglobulin had significantly fewer bacterial infections during the study period than those receiving placebo (23 vs. 42; P = 0.01). This reduction was most striking in the patients who completed a full year of treatment (14 vs. 36; P = 0.001). The period from study entry to the first serious bacterial infection was significantly longer in the patients receiving immunoglobulin (P = 0.026). There was no significant difference between the two groups in the incidence of nonbacterial infection. Immunoglobulin therapy was tolerated well; there were no serious adverse reactions, and the incidence of minor reactions was low. We conclude that selected patients with chronic lymphocytic leukemia who are at risk of bacterial infection can be substantially protected from this complication by the regular intravenous administration of immunoglobulin. (N Engl J Med 1988; 319:902–7.)
OP0029 The Risk of Serious Infections in Patients Receiving Rituximab for Rheumatoid Arthritis: Table 1
Authors: L. Silva-Fernandez, M. Lunt, A.S. Low, K.D. Watson, D.P. Symmons, K.L. Hyrich
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> In the Europe, rituximab (RTX), an anti-CD20 monoclonal antibody, is reserved for patients with rheumatoid arthritis (RA) who have failed initial anti-TNF therapy. There is a concern over whether B-cell depletion and potential resultant hypogammaglobulinaemia may result in an increased risk of serious infections (SI). <h3>Objectives</h3> The aim of this study was to determine if RTX influences the risk of SI when used in routine clinical practice. <h3>Methods</h3> The British Society for Rheumatology Biologics Register-RA is an ongoing national prospective cohort study of subjects with RA recently started on biologic therapy. Patients who had failed a 1st anti-TNF and were switched to either a 2nd anti-TNF or RTX between 2001-2012 were identified from the study cohort. All patients were followed by physician and patient questionnaires every 6 months for the first 3 years and annual physician questionnaires thereafter, in which data on drug therapy and serious adverse events were reported. Deaths were identified by flagging with UK National Health Service Information Centre. SIs were defined as those requiring intravenous antibiotics and/or hospitalization, or those resulting in death. Subjects were followed until 01/31/2013, the end of the 1st year after the switch, 1st SI, death or treatment discontinuation allowing for a lag window (90 days after 1st missed dose of anti-TNF and 9 months following each course of RTX), whichever came first. The rates of SI in both cohorts were compared using Cox proportional hazards model adjusted by propensity score using inverse probability of treatment weighting (IPTW) (see variables in table). <h3>Results</h3> In total, 205 subjects experienced at least one SI in the 1st year of follow-up after the switch of treatment (158 in 3237 anti-TNF treated subjects (2688 person-years (pyrs) and 47 in 1018 RTX treated subjects (866 pyrs)) (Table 1). After adjustment, the risk of SI in patients receiving RTX did not differ from that in patients receiving a 2nd anti-TNF: hazard ratio (HR) for RTX 0.74 (95% CI 0.37, 1.50). <h3>Conclusions</h3> Patients receiving RTX after one anti-TNF failure do not appear to have an increased risk of SI during the 1st year of treatment compared to patients receiving a 2nd anti-TNF. <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.1112
Temporary Remissions in Acute Leukemia in Children Produced by Folic Acid Antagonist, 4-Aminopteroyl-Glutamic Acid (Aminopterin)
Authors: Sidney Farber, Louis K. Diamond, Robert D. Mercer, Robert F. Sylvester, James A. Wolff
Journal: New England Journal of Medicine (1948)

IT IS the purpose of this paper to record the results of clinical and hematologic studies on 5 children with acute leukemia treated by the intramuscular injection of a synthetic compound, 4-aminopteroylglutamic acid (aminopterin). This substance is an antagonist to folic acid regarding the growth of Streptococcus faecalis R. The occurrence of what he interpreted as an "acceleration phenomenon" in the leukemic process as seen in the marrow and viscera of children with acute leukemia treated by the injection of folic acid conjugates1 — pteroyltriglutamic acid (teropterin) and pteroyldiglutamic acid (diopterin) — and an experience gained from studies on folic . . .
PMO-070 FREKA® pexact placement in patients with head and neck cancer—the city hospital experience
Authors: B R Disney, M Nizamuddin, A Tanajura, M Anderson, M Lewis
Journal: Gut (2012)

<h3>Introduction</h3> Patients with head and neck cancer are at risk of malnutrition as a direct result of the tumour or as a result of treatment, that is, chemo-radiotherapy. Oral intake may not be enough to maintain nutrition, therefore many patients receive enteral feeding via a percutaneous endoscopic gastrostomy (PEG). A standard pull-through PEG may expose patients to the risk of tumour seeding within the tract in patients with oro-pharyngeal and oesophageal cancers. Current British Society of Gastroenterology guidelines recommend consideration for a direct gastric puncture technique and gastropexy for percutaneous feeding tube placement, with the technique being considered mandatory in those patients being treated with curative intent. The Freka<sup>®</sup> Pexact (Fresenius Kabi, Germany) set was used in our setting. We aimed to review our practice of this technique with particular attention to safety and complication rates with this method of PEG insertion. <h3>Methods</h3> Patients having a Freka<sup>®</sup> Pexact placement for nutritional support at City Hospital, Birmingham, UK from 2009 to 2011 were identified using the ADAM<sup>®</sup> medical documentation system (Fujinon Europe GmbH, Willich, Germany) and the Nutrition team logs. Complications, peristomal infection and 30-day mortality were documented after review of case notes and liaison with Community Nutrition Nurses. <h3>Results</h3> A total of 30 patients having Freka<sup>®</sup> Pexact placement were identified. The insertion was carried out as a day case procedure in 93.3% (n=28) of cases. Of these 76.7% were male (n=23). The mean age of patients was 58 years (range 35–81). All Freka<sup>®</sup> Pexact (n=30) were inserted for nutritional support in patients with head and neck cancer. Prophylactic antibiotics were received by 83.3% (n=25). Success of Freka<sup>®</sup> Pexact placement was 100% (n=30) with no immediate complications or procedure related mortality. Two patients (6.7%) were admitted for PEG related problems within 30 days. Peristomal infections occurred in 36.7% (n=11) of cases. The most common problem, other than infection, post-procedure was sutures becoming untied or falling out, this occurred in 16.6% (n=5) of patients, with consequence. There were no deaths at 30 days. <h3>Conclusion</h3> Pexact insertion is safe and can be performed as a day case procedure. There are minimal complications. Our results compare favourably with those in the literature. This technique should be used in all patients having a PEG inserted for nutritional support in head and neck cancer. <h3>Competing interests</h3> None declared.
Case report of conversion symptom associated with major depressive disorder in a child
Authors: E B Weller, R A Weller
Journal: American Journal of Psychiatry (1983)

A 10-year-old boy had a prominent conversion symptom that obscured a major depressive episode as defined by DSM-III. After the conversion symptom was removed with amobarbital, his depressive symptoms became more obvious and subsequently improved with imipramine treatment.
Case 8-2011
Authors: Katherine B. Sims, Andrew J. Cole, Janet C. Sherman, Paul A. Caruso, Matija Snuderl
Journal: New England Journal of Medicine (2011)

A 32-year-old woman had seizures since childhood, myoclonus, and recent cognitive decline. Family members had an autosomal-dominant pattern of neurologic disease. Diagnostic testing was performed. Cognitive decline continued; the patient died 2 years later. An autopsy was performed.
Thymoma With Pure Red Cell Aplasia Demonstrated by Tc-99m Tetrofosmin SPECT
Authors: CHETAN PATEL, ATUL MAINI, GOPAL PUNJABI, BHARATHI DASAN, CHANDRA SEKHAR BAL
Journal: Clinical Nuclear Medicine (2000)

Thymoma may be present in as many as one third of cases of pure red cell aplasia. Presented is a case of pure red cell aplasia with a mediastinal mass seen on a plain chest radiograph. A computed tomographic scan showed an anterior mediastinal mass. A Tc-99m tetrofosmin whole-bodyscan and SPECT revealed avid concentration corresponding to the mass. The diagnosis of thymoma was made based on the result of an excisional biopsy.