tbuckley/cabot-search huggingface dataset:
¿ES ÚTIL LA ECO-PAAF EN LAS LESIONES QUÍSTICAS PANCREÁTICAS?
Authors: B Merino Rodríguez, C González Asanza, K Klimova, F Díaz Fontenla, M López Ibánez, C Padilla, G Perez Rial, L Pérez Carazo, D Pérez Valderas, Ó Nogales Rincón, P Menchén Fernández Pacheco
Journal: Endoscopy (2013)

Introducción: La adecuada filiación de las lesiones quística pancreáticas (LQP) es fundamental dado los diferentes potenciales de malignización. Objetivo: Valorar las características demográficas, el rendimiento diagnóstico de la ecoendoscopia (USE), la calidad de la muestra para citología, la concordancia del diagnóstico por USE con el histológico en aquellos pacientes intervenidos, así como las complicaciones relacionadas con la punción. Material y Métodos: Recogida prospectiva y consecutiva de todos los pacientes a los que se les ha realizado una USE para valoración de LQP, en el periodo comprendido entre enero 2008 y enero de 2013. Resultados: Se recogieron un total de 268 pacientes. La edad media fue de 64.65 (rango 28 – 98). 50.37% varones. El diagnóstico fue incidental en el 51.87%. La localización fue en cabeza en 49.25%, en cuerpo 20.15%, en cola 12.68 y en uncinado 17.9%. Complicaciones en 7 pacientes (2.61%): – 1 desaturación (0.37% del total), 2 hemorragias (0.74% del total), 4 dolores post-punción (1.4% del total). Todas leves y resueltas conservadoramente. Citológicamente obtuvimos diagnóstico en 151 pacientes (56.34%): 21 cistoadenomas mucinosos (12.91%), 20 cistoadenomas serosos (13.25%), 29 pseudoquistes (19.21%), TMPI de CPP 35 (23.18%), TMPI de rama 41 (27.15%), TNE 5 (1.99%), 90 punciones fueron inespecíficas (33.58%) y 27 el material remitido fue insuficiente (10.08%). Se intervinieron quirúrgicamente 24 pacientes (8.96%): 2 con diagnóstico de quiste seroso por sintomatología asociada, 4 por TPMI de rama, 13 por TPMI de CPP, 2 TNE quísticos, 3 mucinosos de cola. La concordancia diagnóstico entre la USE y la pieza quirúrgica fue del 92.31%. Conclusiones: La rentabilidad citológica de las muestras obtenidas por USE es del 56,34% por lo que para una adecuada toma de decisiones es necesaria una valoración multidisciplinar.
Effect of a Clinical Practice Guideline for Pediatric Complicated Appendicitis
Authors: Zachary I. Willis, Eileen M. Duggan, Brian T. Bucher, John B. Pietsch, Monica Milovancev, Whitney Wharton, Jessica Gillon, Harold N. Lovvorn, James A. O’Neill, M. Cecilia Di Pentima, Martin L. Blakely
Journal: JAMA Surgery (2016)

Complicated appendicitis is a common condition in children that causes substantial morbidity. Significant variation in practice exists within and between centers. We observed highly variable practices within our hospital and hypothesized that a clinical practice guideline (CPG) would standardize care and be associated with improved patient outcomes.To determine whether a CPG for complicated appendicitis could be associated with improved clinical outcomes.A comprehensive CPG was developed for all children with complicated appendicitis at Monroe Carell Jr Children's Hospital at Vanderbilt, a freestanding children's hospital in Nashville, Tennessee, and was implemented in July 2013. All patients with complicated appendicitis who were treated with early appendectomy during the study period were included in the study. Patients were divided into 2 cohorts, based on whether they were treated before or after CPG implementation. Clinical characteristics and outcomes were recorded for 30 months prior to and 16 months following CPG implementation.Clinical practice guideline developed for all children with complicated appendicitis at Monroe Carell Jr Children's Hospital at Vanderbilt.The primary outcome measure was the occurrence of any adverse event such as readmission or surgical site infection. In addition, resource use, practice variation, and CPG adherence were assessed.Of the 313 patients included in the study, 183 were boys (58.5%) and 234 were white (74.8%). Complete CPG adherence occurred in 78.7% of cases (n = 96). The pre-CPG group included 191 patients with a mean (SD) age of 8.8 (4.0) years, and the post-CPG group included 122 patients with a mean (SD) age of 8.7 (4.1) years. Compared with the pre-CPG group, patients in the post-CPG group were less likely to receive a peripherally inserted central catheter (2.5%, n = 3 vs 30.4%, n = 58; P < .001) or require a postoperative computed tomographic scan (13.1%, n = 16 vs 29.3%, n = 56; P = .001), and length of hospital stay was significantly reduced (4.6 days post-CPG vs 5.1 days pre-CPG, P < .05). Patients in the post-CPG group were less likely to have a surgical site infection (relative risk [RR], 0.41; 95% CI, 0.27-0.74) or require a second operation (RR, 0.35; 95% CI, 0.12-1.00). In the pre-CPG group, 30.9% of patients (n = 59) experienced any adverse event, while 22.1% of post-CPG patients (n = 27) experienced any adverse event (RR, 0.72; 95% CI, 0.48-1.06).Significant practice variation exists among surgeons in the management of pediatric complicated appendicitis. In our institution, a CPG that standardized practice patterns was associated with reduced resource use and improved patient outcomes. Most surgeons had very high compliance with the CPG.
Incidental Detection of Pericardial Effusion on Bone Scan
Authors: Kemal Unal, Mustafa Unlu, Levent Guner
Journal: Clinical Nuclear Medicine (2012)

The patient was a 57-year-old man with lung cancer. He was referred to nuclear medicine department for the evaluation of bone metastases. Bone scintigraphy was performed with 99mTc-labeled HDP. An abnormal photopenic area around the heart was seen on blood pool images. Delayed image of the thorax was normal. Chest x-ray study and echocardiography were performed to reveal the abnormality. Asymptomatic pericardial effusion was diagnosed in the corresponding area.
Abstract 4297: Selective enrichment of liver cancer stem cell by DNA methyltransferase inhibition
Authors: Chiara Raggi, Jens U. Marquardt, Jesper B. Andersen, Valentina M. Factor, Snorri S. Thorgeirsson
Journal: Cancer Research (2010)

Abstract Background: Evidence is growing that many solid cancers, including liver cancer, contain small subpopulations of cells with stem cell-like properties known as cancer stem cells (CSCs) that are responsible for maintaining and propagating a tumor. Major obstacles in the research on CSC biology are the paucity and lack of specific markers of CSC. We have recently shown that human liver CSC can be enriched by modulating the epigenome of liver cancer cell lines with zebularine (Zeb), a potent DNA methyltransferase inhibitor. Objective: In this study we exploited the impact of epigenetic modulation of cancer epigenome by Zeb in conjunction with the ability of stem/progenitor cells to grow as non-adherent spheres in serum-free media to provide further enrichment of the CSC fraction. Methods: Huh7 cells were plated in high (HD, 13×103cell/cm2) and low (LD, 2.7×103/cm2) density and treated with 100 µM Zeb for 3days. The sphere forming ability and serial sphere formation were investigated in Matrigel and suspension culture, respectively. CSC and pluripotency markers preferentially expressed in cells grown under sphere conditions were examined by qRT-PCR and surface markers by FACS. Results: Huh7 cells grown under LD failed to form tumorspheres when placed in Matrigel or non-adherent growth conditions. In striking contrast, Zeb-treated low density cells were capable of forming spherical clonal-expanding colonies which showed the stem cell-like properties such as strong induction of the stem cell-related genes NANOG and OCT4 and did not express EpCAM. Cells grown at high density possessed a similar sphere forming ability regardless of Zeb pretreatment. However, morphological characterization revealed a predominance of smaller sized spheres suggesting reduced proliferation potential and/or differences in cell type of origin, with smaller spheres originating from the progenitors, and larger spheres from the stem cells. Consistent with this, HD spheres showed a smaller induction of NANOG and OCT4, expressed high levels of EpCAM and exhibited reduced self-renewal in serial sphere formation assay. The sphere forming ability of LD and HD cells was associated with a presence of a subpopulation of CD133-/cKit+ cells. Conclusion: The described “double selective” approach offers an in vitro model to enrich for cells with cancer stem cell properties. Both cell density and epigenetic modulation were able to affect the sphere-forming potential of Huh7 cells. Further studies are needed to characterize this cell population in more detail, to clarify their tumorigenic potential and the capacity to propagate tumor growth in vivo. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 4297.
Abstract 4517: HDAC inhibitors suppress p53 expression through transcriptional repression: Implication for therapy against metastatic breast cancer
Authors: Lisa Y. Zhao, Qiang Li, Edward Seto, Daiqing Liao
Journal: Cancer Research (2010)

Abstract Cancer specific mutations of the p53 tumor suppressor gene are the most prevalent genetic lesions that underpin breast cancer pathogenesis and progression. In most cases, mutations result in a single amino acid substitution in the DNA-binding domain of p53. Such missense mutant forms of p53 accumulate at high levels in tumor cells. Recent advances demonstrated that missense p53 mutants have a critical role in driving cancer metastasis. Thus elimination of mutant p53 can potentially prevent metastatic progression of breast cancer. Inhibitors of histone deacetylases (HDACi) have proven anticancer effects and vorinostat, an FDA approved HDACi, has been in clinical use for treating certain malignancies. HDACi shapes epigenetic landscapes by restoring histone acetylation that is often suppressed in breast and other cancer types. One consequence of the restoration of histone acetylation is reactivation of tumor suppressors and other genes. Other effects of HDACi include modulation of posttranslational acetylation of non-histone proteins, which can influence their biochemical functions, resulting in a net effect of enhanced cell cycle arrest and apoptosis. Interestingly, HDACi profoundly suppresses the expression levels of p53. We found that this suppression occurs irrespectively of the mutational status of p53, but surprisingly only in certain types of cancer cells such as breast cancer. We further showed that the expression of exogenous p53 under a heterologous promoter was not affected by HDACi. These results suggest that HDACi might downregulate p53 through gene repression. To further test this idea, we assessed the effects of HDACi treatment and ectopic expression of classical HDACs (Classes I, II and IV) on luciferase reporter gene under the control of the p53 promoter. Among the 11 classical HDACs, ectopic expression of HDAC7 and HDAC10 seem to upregulate the reporter gene. We are currently investigating how these HDACs interact with the p53 promoter and what transcription factors and corepressors are involved in regulating p53 expression. Additionally, we are studying roles of depleting mutant forms of p53 by HDACi in suppressing migration, invasion and metastasis of breast cancer cells and assessing the efficacy of HDACi in conjunction with p53 gene therapy for treating breast cancer in a mouse model. (This work was supported by Bankhead-Coley Cancer Research Program of the Florida Department of Health, Stop! Children's Cancer, Inc. and the NIH.) Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 4517.
Legal aid to be kept for medical negligence cases
Authors: C. Dyer
Journal: BMJ (1998)

The government last week retreated from plans to withdraw legal aid from all money and damages claims—including medical negligence cases—from this summer. Proposals to abolish aid for other types of personal injury claims and a range of other cases will go ahead as planned, but medical negligence cases will continue to be financed by legal aid for the next two or three years.

For cases in which aid is withdrawn, lawyers are expected to fill the gap with no win, no fee deals—so called conditional fee agreements. From June or July solicitors and barristers will be allowed to offer such deals in any type of case, apart from crime or …
THU0283 Predictive factors of response at 12 weeks in patients with ankylosing spondylitis starting biological therapies - results from the portuguese register - REUMA.PT:
Authors: S. Ramiro, P. Machado, R. Roque, H. Santos, J. Polido-Pereira, D. Peixoto, C. Duarte, F. Pimentel-Santos, C. Silva, J.E. Fonseca, F. Teixeira, A. Marques, F. Araújo, J. Branco, J.A.P. da Silva, J. Costa, J. Pereira da Silva, L. Miranda, J. Canas da Silva, H. Canhão, A. van Tubergen, D. van der Heijde, R. Landewé, M.J. Santos
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Identifying predictors of response to biological therapies in patients with Ankylosing Spondylitis (AS) is of utmost importance, especially in view of the costs and potential side effects of these agents. <h3>Objectives</h3> To determine baseline predictive factors of response to biological therapies at 12 weeks in patients with AS in daily clinical practice. <h3>Methods</h3> Patients with AS under biological therapy and followed in the Rheumatic Diseases Portuguese Register (Reuma.pt) were included in this analysis. Reuma.pt is used as an electronic medical record and assessments are performed by rheumatologists. Patients with information at baseline and 12 weeks of follow-up were included in the analysis (n=197). Univariable logistic regression analysis of baseline predictors of ASDAS (improvement ≥1.1) and BASDAI response (improvement ≥2 units or ≥50%) were performed. Variables with a p-value&lt;0.1 were re-tested in multivariable models. When both ASDAS and CRP (or ASDAS and BASDAI) were significant in the univariable analysis, they were included in separate multivariable models, in order to avoid collinearity-problems. Forward selection was performed until the best-fit model was obtained, taking confounding effects into account. Interactions were tested. <h3>Results</h3> ASDAS response at 12 weeks was predicted by male gender, higher educational level, lower back pain and higher ASDAS (table). When ASDAS was removed from the baseline predictors, both a younger age and higher CRP were significant predictors of ASDAS response. A BASDAI response was independently predicted by age (&lt;40), gender (male), baseline BASDAI (per unit) or ASDAS (per unit) (depending on which was tested in the model). <h3>Conclusions</h3> CRP is as an important predictor of ASDAS response, but not of BASDAI response. A better response can be expected in male- and younger patients. Baseline disease activity predicts a response at 12 weeks. The ASDAS predicts both ASDAS- and BASDAI response and the BASDAI only predicts the BASDAI response. <h3>Disclosure of Interest</h3> None Declared
Reviewing the logic of self-deception
Authors: Ellen Fridland
Journal: Behavioral and Brain Sciences (2011)

Abstract I argue that framing the issue of motivated belief formation and its subsequent social gains in the language of self-deception raises logical difficulties. Two such difficulties are that (1) in trying to provide an evolutionary motive for viewing self-deception as a mechanism to facilitate other-deception, the ease and ubiquity of self-deception are undermined, and (2) because after one has successfully deceived oneself, what one communicates to others, though untrue, is not deceptive, we cannot say that self-deception evolved in order to facilitate the deception of others.
Abstract 2429: Increased incidence of brain metastases in BRCA1 related ovarian cancers
Authors: Masayuki Sekine, Kenichi Tanaka
Journal: Cancer Research (2011)

Abstract Objective: Brain metastasis to ovarian cancer is a very rare phenomenon. BRCA1 related ovarian cancers show specific pathobiological profiles, an advanced stage, and sensitivity to chemotherapeutic agents. However, no clear relationship to any known metastatic behavior has yet been found, so we examined the BRCA1 mutation and expression profiles in ovarian cancer cases with brain metastases. Methods: We examined our clinical records of 320 ovarian cancer cases from 1983 to 2008 in order to ascertain cases with brain metastases. In the molecular genetic analyses, we performed loss of heterozygosity (LOH), direct sequence, and immunohistochemical staining analysis of BRCA1. For LOH analysis, 4 markers spanning the region of BRCA1 were selected for use. The entire exons, 23 exons in BRCA1 and 26 exons in BRCA2, and the intronic boundary regions were sequenced in both forward and reverse directions for detecting germline mutations. The immunohistochemical studies were performed with the BRCA1 C-terminal mouse monoclonal antibody (Ab-3, Calbiochem,×500) Results: We ascertained 7 cases with brain metastases in 320 ovarian cancer cases (7/320=2.2%). Among the 7 cases, 3 cases had ovarian and/or breast cancer patients in third-degree relatives. We detected 4 LOH-positive cases and a germline mutation of BRCA1 in 2 of the 4 cases, Q934X and L63X respectively. Furthermore, the remaining 2 cases showed an absent staining of the BRCA1 protein. Therefore, 4 out of 7 cases with brain metastases were considered BRCA1-related ovarian cancers (4/7=57.1%). All 4 of the cases were serous adenocarcinoma of ovary. Conclusions: This is the first report of a hospital population-based study in relation to brain metastasis and BRCA1-related ovarian cancers. Our results suggest that the loss of BRCA1 function may be involved in the phenomenon of brain metastasis to ovarian cancer. Further molecular biologic analyses will be required for a better understanding of this rare phenomenon. 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 2429. doi:10.1158/1538-7445.AM2011-2429
Abstract LB-352: B-CLL phenotype in Eµ-miR-29 transgenic mice
Authors: Urmila Santanam, Nicola Zanesi, Alexey Efanov, Alexey Palamarchuk, Stefan Costinean, John Hagan, Carlo Croce, Yuri Pekarsky
Journal: Cancer Research (2010)

Abstract B-cell chronic lymphocytic leukemia (B-CLL) is the most common leukemia in the western world. Human B-CLL occurs in two forms: aggressive (showing high ZAP-70 expression and unmutated IgH VH) and indolent (showing low ZAP-70 expression and mutated IgH VH). We found that miR-29a is upregulated in indolent human B-CLL compared to aggressive B-CLL and normal CD19+ B-cells. To study the role of miR-29 in B-CLL, we generated Eµ-miR-29 transgenic mice overexpressing miR-29 in mouse B-cells. Flow cytometric analysis revealed a markedly expanded CD5+ population in the spleen of these mice starting at 2 months of age. Over 80% of miR-29 transgenic mice exhibited an expanded population of CD5+ B-cells, a characteristic of the B-CLL phenotype. An average of 56% of the B-cell population in these transgenics were CD5 positive. At the age of 2 years these mice showed significantly enlarged spleens and an increase in CD5+ B-cell population of up to 100% of B-cells. Over 8% (3/36) of Eµ-miR-29 transgenic mice developed frank leukemia and prematurely died from the disease at the age of 24-26 months. The expanded CD5+ B-cell population was found to be proliferative, with an increased number of cells in the S-phase of the cell cycle, compared to wild type CD19+ B-cells. These results suggest that deregulation of miR-29 can cause, or at least significantly contribute to the pathogenesis of indolent B-CLL. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr LB-352.
OP0177 Randomized Comparison of Triple Dmard Therapy with Methotrexate Mono-Therapy
Authors: P. H. P. De Jong, J. M. Hazes, J. J. Luime, A. E. Weel
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> EULAR/ACR guidelines recommend Methotrexate (MTX) with or without glucocorticoids (GCs) for DMARD naïve patients. Triple DMARD therapy however is not recommended in these guidelines, because well proven evidence of superior efficacy is lacking. However, we recently published a superior effect after 3 months in favor of triple DMARD therapy independent of GCs. Longer follow-up was needed. <h3>Objectives</h3> To compare the clinical efficacy of: (1) triple DMARD therapy vs. MTX mono-therapy and (2) oral GCs bridging therapy vs. 1 dose of intramuscular (im) GCs in patients with early RA. <h3>Methods</h3> The one-year data of the ongoing single-blinded randomized clinical trial in patients with recent-onset arthritis (tREACH) were used. All patients, who had a high probability (&gt;70%) of progressing to persistent arthritis, based on the prediction model of Visser, were included. At baseline 267 (95%) of patients fulfilled the 2010 criteria for RA. Patients were randomized into 3 induction therapy strategies: (A) triple DMARD therapy (MTX 25 mg + Sulphasalazine 2 gr. + Hydroxychloroquine 400 mg) with im GCs (Depomedrol 120mg), (B) triple DMARD therapy with an oral GCs tapering scheme (starting 15 mg) and (C) MTX 25 mg with oral GCs similar to B. Treatment strategies were ‘tightly controlled’, with patients being examined every 3 months. Treatment decisions were based upon the original DAS threshold for low disease activity. We investigated DAS and HAQ response over time, using a linear mixed model (LMM). <h3>Results</h3> A total of 281 patients were included and randomly assigned to A (n=91), B (n=93) or C (n=97). Patients were mostly females (68%) with an average symptom duration of 166 days (95% CI: 156 – 177). At baseline 216 (77%) patients were ACPA positive and 48 (16%) patients had erosions. Despite randomization, symptom duration, occurrence of erosions and proportion of patients fulfilling 1987 criteria for RA differed significantly between treatment arms. figure 1 shows the HAQ and DAS per treatment arm over time. At three months a statistical superior effect was seen favouring triple DMARD therapy. In our LMM there is no significant difference in DAS and HAQ between triple DMARD therapy and MTX mono-therapy after 12 months (β=-0.15, p=0.056 and β=-0.052, p=0.28 respectively). However after correction for baseline differences, DAS differed significantly after 12 months of therapy in favour of the triple DMARD therapy (β=-0.16, p=0.044). There were no differences in HAQ and DAS after 12 months between both GCs bridging therapies. <h3>Image/graph</h3> <h3>Conclusions</h3> In patients with early RA triple DMARD therapy stays superior to MTX mono-therapy even after 12 months of therapy. Furthermore both intramuscular and oral GCs can be used as bridging therapy. <h3>Disclosure of Interest</h3> None Declared
The detection of contaminating clonal cells in apheresis products is related to response and outcome in multiple myeloma undergoing autologous peripheral blood stem cell transplantation
Authors: R López-Pérez, R García-Sanz, D González, A Balanzategui, MC Chillón, I Alaejos, MV Mateos, MD Caballero, G Mateo, MJ Nieto, M González, JF San Miguel
Journal: Leukemia (2000)