tbuckley/cabot-search huggingface dataset:
S46 Outcome after pulmonary endarterectomy (PEA): Long term follow-up of the UK national cohort: Abstract S47 Table 1.
Authors: J Cannon, K Page, M Roots, A Ponnaberanam, C Tracy, D Taboada Buasso, K Sheares, C Ng, J Dunning, S Tsui, J Pepke-Zaba, D Jenkins
Journal: Thorax (2013)

<h3>Introduction</h3> Chronic thromboembolic pulmonary hypertension (CTEPH) is a life threatening condition that historically has a poor outcome with supportive medical treatment. Pulmonary endarterectomy (PEA) is the treatment of choice and offers the only chance of cure. Data on the long term survival after PEA are limited. <h3>Method</h3> All patients who have undergone a PEA for CTEPH at Papworth hospital were included between January 1997 and November 2012. Patients who had a re-do operation were excluded. Pre- and post-operative data on haemodynamics, exercise capacity, functional class and targeted PAH therapies taken were obtained from our PH database and from other UK PH centres. The long-term survival of patients who returned for follow-up at 3 months post PEA was determined using the NHS spine summary care record tracking system. Overseas patients were censored when last seen. <h3>Results</h3> 880 patients underwent PEA over the 15 year period. The mean age was 57 (range 15–84) and 53% were male. The majority (89%) were in WHO functional class 3 or 4 prior to surgery with an average mean pulmonary artery pressure (mPAP) of 47 mmHg and PVR of 795 dynes. 65% of patients were taking at least 1 targeted therapy as a "bridge to surgery". Post surgery the majority of patients (86%) were in WHO functional class 1 or 2 at the 12 month follow-up with only 17% taking targeted therapy. There was a reduction in the average mPAP to 27 mmHg and PVR to 308 dynes by 12 months. The 10 year conditional survival post PEA of the first 314 patients from the cohort (Freed <i>et al</i>. J Thorac Cardiovasc Surg, 2011;141:383–7) was 74%. <h3>Conclusion</h3> The conditional survival of a subset of the cohort at 10 years was 74%. There was a significant functional and haemodynamic improvement in the majority of patients at 12 months post surgery. Only 17% of patients at 12 months post surgery were being treated with targeted therapy. <h3>Acknowledgements</h3> The authors would like to acknowledge the pulmonary hypertension centres in the UK. “<i>This research was supported by the National Institute for Health Research (NIHR) Cambridge Biomedical Research Centre</i>”.
SAT0069 Regulation of syndecan-1 expression in monocytes/macrophages in chronic inflammatory arthritis
Authors: M.M. Alam, J.H. Kang, J.A. Jang, K.H. Sa, E.J. Nam, Y.M. Kang
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> The syndecans (SDCs) are integral cell surface heparan sulfate proteoglycans (HSPGs) that are expressed in a cell, tissue and development specific manner. To date, the regulation of SDC-1 expression in synovial tissues (ST) of rheumatoid arthritis (RA) has not been uncovered. <h3>Objectives</h3> The aims of this study were to delineate the expression of SDC-1 on subsets of inflammatory cells in RA-ST and to investigate regulatory pathways involved in its expression. <h3>Methods</h3> ST was obtained during patients with RA and OA during joint replacement surgery. Expression of SDC-1 and other cell markers in ST was evaluated with immunohistochemical (IHC) and immunofluorescence (IF) staining. Synthesis of SDC-1 was determined by semi-quantitative RT-PCR, western blot, and flow cytometry. A murine collagen-induced arthritis (CIA) model was used for evaluation of SDC-1 expression at different stages of arthritis. <h3>Results</h3> The expression of SDC-1 was upregulated in subsets of cells in RA-ST compared with those in OA-ST. SDC-1 was expressed on the surface of CD68+ and CD11c+ cells as well as CD38+ cells. CD68+SDC-1+cells were mainly localized at the periphery of follicular structure where critical cell-cell interactions take place and a subset of lining cells. SDC-1 was highly upregulated in monocytes from RA synovial fluid compared with those from peripheral blood of RA and normal controls. The upregulated expression of SDC-1 on classically activated macrophages compared to CD14+ monocytes was inhibited by either JNK- or NF-kB inhibitors, but not by ERK and p38 MAPKinase inhibitors. To confirm if SDC-1 is differentially expressed at different stages of arthritis development, CIA mice were used. SDC-1 expression was increased from the early stages of arthritis and was most remarkable at cartilage-pannus junctions in advanced arthritis. Treatment with methotrexate clearly reduced the SDC-1 expression in CIA mice. <h3>Conclusions</h3> The expression of SDC-1, which is upregulated in ST of inflammatory arthritis according to disease progression, was increased in monocytes/macrophages in a JNK- and NF-kB-dependent manner. These results underscore the existence of pathways by which SDC-1 expression was regulated in the inflammatory context of RA. <h3>Disclosure of Interest</h3> None Declared
Mammographic density and breast cancer risk factors in Chinese women.
Authors: J Gao, W Zhao, R Lian, X Liang
Journal: Cancer Research (2009)

Abstract Abstract #4082 Background: Past studies have indicated that mammographic density is associated with not only breast cancer risk but also breast cancer risk factors in women living in western nations. However, to data, no such association has been shown among native Chinese women. The aim of this cross-sectional study was to investigate the effects of age, body mass index (BMI), age at menarche, parity, and menopausal status on mammographic patterns in women from a province of Northern China.&amp;#x2028; Methods: Seven hundred and two women's mammograms and information of the breast cancer risk factors were obtained from Shanxi province cancer hospital in Northern China. Mammograms were assessed according to the Wolfe classification.&amp;#x2028; Results: Age, BMI, parity, and menopause were inversely and independently related to high-risk mammographic parenchymal patterns. However, there was no statistically significant association between age at menarche and high mammographic density. Relative to subjects aged less than or equal to 35 years, subjects aged greater than 55 years had reduced 62% (OR = 0.38, 95% CI: 0.14 – 1.00) odds of having a high-risk pattern. In comparison to women whose BMI was less than or equal to 25, there was a 51% and 72% reduction in the odds of having high-risk mammographic patterns for those with BMI 25 to 30 and larger than or equal to 30 respectively (OR = 0.49, 95% CI: 0.32 - 0.74; OR = 0.28, 95% CI: 0.12 - 0.68 respectively). Women with more than three children had decreased 68% risk to have high mammographic density compared to those who were nulliparous (OR = 0.32, 95% CI: 0.1 – 1.0). Premenopausal women were more than four times likely to have a high-risk pattern than postmenopausal women (OR = 4.12, 95% CI: 2.17 – 7.87).&amp;#x2028; Conclusion: Our findings demonstrated that mammographic parenchymal patterns are also associated with some risk factors of breast cancer in native Chinese women. This is consistent with most studies carried out in Western countries. Further studies are needed to determine the relationship between quantitative percentage density and breast cancer risk factors. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 4082.
Imperforate Hymen with Hematocolpometra
Authors: Ludger Wilhelm Poll, Peter Flake
Journal: New England Journal of Medicine (2011)

A 15-year-old premenarchal girl presented with a 4-day history of increasing abdominal pain. Her medical history was unremarkable. Physical examination revealed a palpable, nontender, nonpulsatile midline mass extending from the pelvis to the umbilicus.
Infections Due to Coxsackie Virus Group A, Type 9, in Boston, 1959, with Special Reference to Exanthems and Pneumonia
Authors: A. Martin Lerner, Jerome O. Klein, Howard S. Levin, Maxwell Finland, Priscilla Bills, Ann Ewalt
Journal: New England Journal of Medicine (1960)

FROM early July through mid-October, 1959, illnesses apparently caused by viruses were regularly seen at the Boston City Hospital. During this period, virologic studies, focused particularly on the enterovirus group,1 were carried out in patients with aseptic meningitis, various skin eruptions and pneumonia. These studies indicated that infections with Coxsackie virus Group A, Type 9, occurred throughout this period and accounted for some of the cases in each of these clinical categories. Moreover, although the studies included adults and children, the infections occurred predominantly among the latter.∥ Previous reports have associated this virus mostly with aseptic meningitis,2 sometimes accompanied by . . .
A Missed Connection
Authors: Prashant D. Bhave, Elyse Foster, Gurpreet Dhaliwal
Journal: New England Journal of Medicine (2012)

A 63-year-old woman presented with edema and erythema of the skin of her legs and with orthopnea and paroxysmal nocturnal dyspnea. The edema had first appeared almost 2 years earlier but had worsened markedly in the previous week.
AB1137 Association between vitamin d deficiency and disease activity in juvenile idiopathic arthritis
Authors: E. Comak, M. Koyun, S. Özdem, C.S. Dogan, A. Uslu Gokceoglu, S. Akman
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Beyond its traditional metabolic effects, vitamin D also have immunomodulatory and anti-inflammatory properties. Serum levels of vitamin D have been found to be low in several autoimmune or immune-mediated diseases. <h3>Objectives</h3> The aims of this study were to evaluate the vitamin D status in patients with juvenile idiopathic arthritis (JIA), and also to examine whether there is an association between serum levels of 25-hydroxyvitamin D (vitamin D) and disease activity in JIA. <h3>Methods</h3> The children withJIA who had an outpatient visit between March and April 2011 were evaluated retrospectively. Demographic data, disease duration, treatment modalities, physical examination findings, disease activity, sedimentation, and vitamin D levels were evaluated. Disease activitywas calculatedwithJADAS-27. Serum vitamin D levels were measured by high-performance liquid chromatography (HPLC) method. <h3>Results</h3> A total of 47 patients, 29 (61.7%) girls with a mean age of 9.3±3.9 years and median follow-up period of 28 months, were included in the study. 12 patients(25.5%) wereusing vitamin D supplement at the time of the study. The mean serum vitamin D level of all patients was 17.74 ng/ml ±11.66. Vitamin D insufficiency (serum vitamin D: 15-20 ng/ml) and deficiency (serum vitamin D level &lt;15 ng/ml) were found in 9 (19.1%) and 25 patients (53.2%), respectively. Only 13 patients (27.7%) have adequate vitamin D levels (&gt;20 ng/ml). There is a significant negative correlation between Vitamin D levels and disease activity (p=0.01, r=-0,37). <h3>Conclusions</h3> Vitamin D deficiency is common in children with JIA. There is a relationship between vitamin D levels and disease activity. Clinicians should be aware of vitamin D deficiency in patients with JIA. <h3>Disclosure of Interest</h3> None Declared
P64 Central nervous system involvement in patients with chronic hepatitis C virus infection and minimal liver disease
Authors: E. Williams, M. Heeren, C. D. Jackson, H. Pflugrad, J. Krause, L. M. Weber, K. Wiessenborn, M. Y. Morgan
Journal: Gut (2011)

<h3>Introduction</h3> Individuals with chronic HCV infection are frequently fatigued and have difficulties with tasks of complex attention, visual scanning and psychomotor speed, even in the absence of significant liver injury. However, the objectivity of these findings has been questioned. Observed alterations in neurometabolite concentrations on cerebral <sup>1</sup>H-MRS further supports evidence of CNS involvement. These changes in cognition and <sup>1</sup>H-MRS seem to persist despite successful anti-viral therapy but this has not been studied systematically. No information is currently available on possible EEG changes in this population which, if present, might provide an easily available objective marker of CNS involvement. <h3>Aim</h3> The aim of this study was to characterise the EEG in HCV-infected patients with minimal liver injury in relation to treatment status and treatment responses. <h3>Method</h3> The study population comprised 114 HCV-infected individuals (75 women: 39 men) of mean (range) age 52.0 (25–75) years with little or no liver disease; the majority of patients had been infected by contaminated blood or blood products; none was misusing alcohol nor on treatment with interferon or psychoactive medication at the time of the study. All patients underwent formal assessment of fatigue, depression and anxiety and extensive psychometric testing. EEGs were recorded on the same day as the neuropsychometric assessment; reference data were obtained from 137 age/gender-matched healthy controls. The EEG was defined as <i>‘fast’</i> if the relative β power was &gt;30% on the P3-P4 derivation. <h3>Results</h3> The prevalence of fast EEG activity was significantly greater in the patients than controls 43% vs 15% (p&lt;0.0001). Significant correlations were observed between the presence of fast EEG activity and impairments in specific psychometric tests but not with fatigue, depression or anxiety. These abnormalities were observed independently of HCV-RNA levels and treatment status (Abstract P64 table 1): <h3>Conclusion</h3> Patients with HCV infection with little or no evidence of liver injury show impaired cognitive function and an excess of fast EEG activity independent of fatigue, depression and anxiety. These findings hold true even if the patients have cleared the virus, either spontaneously or following anti-viral treatment. These results could be indicative of an effect of cerebral HCV-quasispecies similar to that suggested in HIV-associated dementia.
Charitable Incentives for Blood Donation Are Promising, But Require Careful Consideration
Authors: Dominique Martin
Journal: The American Journal of Bioethics (2013)

In outlining his proposal for a charitable incentive schemefor blood donors, Sass (2013) highlights the ongoing challengeof translating widespread public support for blooddonation into actual donors. Sass rightly points out that a reliableand effective blood supply depends on regular donations,rather than sporadic surges in response to exceptionalevents like September 11. He argues that prospective donorsmight be more effectively motivated to donate if each donationis rewarded or recognized with a financial contributionto public health care services or medical research. Sass anticipatessuch “health-related charitable incentives” wouldencourage prosocial behavior by enhancing the beneficialimpact of blood donation. The increased consequentialistvalue of each blood donation would strengthen preexistingprosocial motivations, and would augment the signalingvalue of donation as an altruistic activity. Unfortunately,Sass’s account of the donor–societal relationship is incomplete,due to his reliance on the traditional conception ofdonation as an act of unilateral altruism. He neglects to considerthe potential influence of reciprocity and solidarity inmotivating prosocial behavior and donation in particular(Sykora 2009), and the implications of these elements for ´his proposal. In this commentary, I outline a stronger argumentfor his charitable incentive proposal and discuss someof the potential concerns the proposal may raise.
PTH-024 Self Provided Guided Medical History Is Fast, Complete And Accurate
Authors: C Van Someren, N van Someren, A Millar, G Edwards
Journal: Gut (2014)

<h3>Introduction</h3> The medical history is the fundamental basis of diagnosis. Every medical student learns how to take a full history, but in clinical practice the history is often truncated due to pressures of various kinds. Many clinicians use pre-consultation forms to collect relevant history, but these are rigid and cannot include the complete medical history. <h3>Methods</h3> We have developed a large database of questions that could be asked during history taking. A computerised algorithm selects the next relevant question depending on the previous answer. A designer interface allows questionnaires to be developed and adjusted readily. The questions are phrased in plain English, but the program translates the answers into medical terminology. The history is then available in PDF format for presentation to the clinician. Patients self completed their history using a touch screen, and checked the results before printing. Comments about the process were recorded from patients and clinical staff. The system was trialled in a hepatitis assessment clinic. Patients are fully informed about this voluntary and secure system prior to use. <h3>Results</h3> 443 patients used the touch screen. 12 did not complete their history because of language problems (8) or indifference (3). The average time to complete was 14.7 min (range 7–21 min). 7 patients were identified who were at high risk of hepatitis infection, and a monospot test was offered and accepted in all of these and further serological tests undertaken. 180 patients with known positive serology completed their history. <h3>Conclusion</h3> Patients found the touch screen easy to use, and were able to complete their history in the waiting area prior to consultation. They were universally happy to keep a printout of their history. The clinicians were able to spend more time discussing risks and treatment options, and were able to ask supplementary questions rather than repeatedly obtaining basic data. Printouts of the PDF were retained in the notes as part of the medical record. This technology has shown great potential in allowing more new patients to be seen, increasing efficiency in carrying out regular reviews, gathering better clinical information and reducing patient distress when asking sensitive questions. Perceived benefits are – more rapid and thorough clinical assessment; semi-automated follow up; health screening; and patient surveys. There are applications for this technology in many fields of medical practice. <h3>Disclosure of Interest</h3> None Declared.
IMPACT OF ATRIAL FIBRILLATION ABLATION ON THE CARDIAC SYMPATHETIC NERVOUS SYSTEM IN PATIENTS WITH AND WITHOUT HEART FAILURE: INVESTIGATION USING CARDIAC IODINE-123-METAIODOBENZYLGUANIDINE SCINTIGRAPHY
Authors: Masaharu Masuda, Hiroya Mizuno, Hitoshi Minamiguchi, Shozo Konishi, Tomohito Ohtani, Yuji Okuyama, Masaaki Uematsu, Yasushi Sakata
Journal: Journal of the American College of Cardiology (2015)
PWE-089 Long Term Outcomes From Leucocytapheresis In Ulcerative Colitis: A Retrospective Case Series
Authors: P Harrow, H Kwok, G Parkes, P Premchand
Journal: Gut (2014)

<h3>Introduction</h3> Leucocytapheresis, the extracorporeal removal of leucocytes from patient’s blood, has conflicting evidence of benefit in ulcerative colitis (UC). Numerous studies have recorded short term clinical remission rates while few have examined the long term end-points of colectomy, death and steroid free remission. Queen’s Hospital, Romford is one of the largest centres performing leucoytapheresis in the UK. Here we present a retrospective case series of patients treated with the Adacolumn® leucocytapheresis filter column for UC between 2008 and 2012, designed to assess these long term end-points with follow-up to June 2013. <h3>Methods</h3> Case notes of all patients who underwent leucocytapheresis for refractory UC were reviewed retrospectively to assess the primary end-points of colectomy and death, and the secondary end-points of clinical remission and steroid-free remission. <h3>Results</h3> 34 patients met the entry criteria and relevant outcome data was available in 31/34. Prior to leucocytapheresis 94% of patients were steroid dependent and 91% had previously failed treatment with a thiopurine. The mean number of leucocytapheresis columns given was 7.7 +/- 0.3. Following treatment 23% underwent colectomy a median 7 months after the start of this treatment with a mean overall follow-up of 500 days. 1 patient died during the study period (from a sub-arachnoid haemorrhage). 52% experienced an initial clinical response and 32% remained in steroid-free remission at 1 year after treatment. <h3>Conclusion</h3> The rate of colectomy after leucocytapheresis compares favourably with other rescue therapies<sup>.1,2</sup> The rate of steroid-free remission with leucocytapheresis is comparable to the response rates seen in randomised controlled trials of anti-TNF therapy<sup>.3</sup>Given that the patients in this study were steroid dependent and had been refractory or intolerant to thiopurines, these results are similar to sub-group analysis of an earlier sham-controlled trial in which those patients with severe UC were more likely to respond to leucocytapheresis than sham<sup>.4</sup> Leucocytapheresis appears to be a safe and useful option for patients with refractory UC. <h3>References</h3> 1 Landy J, <i>et al</i>. Oral tacrolimus as maintenance therapy for refractory ulcerative colitis-an analysis of outcomes in two London tertiary centres. 2013 2 Aratari A, <i>et al</i>. Colectomy rate in acute severe ulcerative colitis in the infliximab era. 2008 3 Rutgeerts, <i>et al</i>. Infliximab for induction and maintenance therapy for ulcerative colitis. 2006 4 Sands, <i>et al</i>. A randomized, double-blind, sham-controlled study of granulocyte/monocyte apheresis for active ulcerative colitis. 2008 <h3>Disclosure of Interest</h3> None Declared.
ED-06 * BRAINSTEM GLIOMAS IN ADULTS: DO ADULT DIFFUSE INTRINSIC PONTINE GLIOMAS EXIST?
Authors: N. Garren, S. Harris, E. Baker, T. Kreisl, K. Warren
Journal: Neuro-Oncology (2014)

BACKGROUND: The majority of brainstem tumors in children are diffuse intrinsic pontine gliomas (DIPG), and are diagnosed in middle childhood. Recent data suggests DIPG is a disease of development. Relatively little information is available for adult brainstem gliomas (BSG). We reviewed clinical and radiographic information from adults with BSG referred to our institution. METHODS: Patients were enrolled on IRB-approved protocols. Clinical data was obtained from patient charts and electronic records. Radiographic data was reviewed on a Picture Archiving and Communications System (PACS) and assessed for primary tumor location, enhancement, intensity on T1, invasion of surrounding anatomical structures, and presence of CNS disease outside of the brainstem. RESULTS: 18 patients diagnosed with BSG were identified; diagnostic MRI was available for review on 15. M:F was 16:2; median age 29.5 (range 16-71) years at diagnosis. Presenting symptoms included long tract signs (61%), diplopia (50%), other visual changes (22%), imbalance (44%), headache (33%) and nausea/vomiting (33%). Primary tumor location varied: 27% were located in the pons only, 33% in pons with extension to medulla, 13% in pons with extension to midbrain, and 20% in pons with extension to midbrain and medulla. 80% showed contrast enhancement, with the majority (58%) of these enhanced diffusely. Other radiographic findings included encasement of the basilar artery (20%) and evidence of CNS disease outside of the brainstem (20%) at diagnosis (cerebellum and parietal lobe). The majority (88%) received radiation treatment; 56% received concurrent chemotherapy and 44% received adjuvant chemotherapy. Median time to first progression (defined radiographically and clinically) was 22 months (range 3-192 months). CONCLUSIONS: Although adults with brainstem tumors involving the pons have similar presentation as children with DIPG, imaging findings and clinical outcome differ significantly. Investigation into the biology of the adult lesions, including H3.3 mutations, may help define these as more distinct entities.