tbuckley/cabot-search huggingface dataset:
P226 Managing suspected pulmonary embolism in an ambulatory setting: the Leicester experience
Authors: R. M. Ladwa, E. Bailie, Y. Vali, R. H. Green, J. A. Bennett, C. M. Free
Journal: Thorax (2011)

<h3>Introduction</h3> Suspected Pulmonary Embolism (PE) is a significant cause of admission to hospital. The objective of this study was to establish the feasibility and safety of managing suspected and proven PE in an out-patient setting. <h3>Methods</h3> Criteria for low risk patients with suspected PE suitable for treatment in an ambulatory setting were established based on modified Pulmonary Embolism Severity Score (PESI) criteria. Patients deemed low risk were referred to a nurse-led clinic. Clinical pre-test probability of PE was recorded for all patients and those with a low/intermediate probability had D-dimer testing. Patients with a high pre-test probability or D-dimer=0.5 μg/ml had radiological investigations. Data were collected prospectively. Missing information was completed from pathology, imaging systems and case-note review. <h3>Results</h3> 362 patients (Median age 46, Female 70%) with suspected PE were referred to the ambulatory clinic in 12 months from June 2010. 269 (74%) patients presented with chest pain. 145 patients (40%) had a negative D-dimer and were discharged. 210 patients (58%) had subsequent imaging in the form of 65 (31%) VQ scan, 138 (66%) CT scan, 7 (3%) both. Median time to imaging was 1 day (range 0–5 days). 34 patients were diagnosed with PE (9%). 11 patients (3%) were admitted, of which 5 (45%) were due to right heart strain. Likelihood of PE correlated strongly to clinical probability (low 2%, intermediate 14%, high 42%). One patient with a negative D-Dimer and intermediate clinical probability was diagnosed with PE. 294 (81%) patients were discharged with no follow-up, 28 (8%) patients were followed-up by consultant care. One patient admitted as they did not meet criteria for ambulatory care (tachycardia) had a cardiorespiratory arrest as an inpatient due to massive PE but was successfully resuscitated. To date three patients have (0.8%) died since attending the clinic, no death was related to PE. Savings to PCTs were estimated at £120 000 over 12 months. <h3>Conclusion</h3> Selected patients with suspected and proven PE may be managed safely in an ambulatory PE clinic setting resulting in significant savings to the healthcare community.
SAT0100 Incidence of Systemic Lupus Erythematosus and Cutaneous Lupus Erythematosuis in A Population Based Cohort from 1993-2005
Authors: V.R. Chowdhary, C.S. Crowson, H. Maradit-Kremers, M.D.P. Davis
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> Systemic Lupus Erythematosus (SLE) is a rare, autoimmune disease with heterogeneous clinical manifestations. Patients with cutaneous lupus erythematosus (CLE) present with skin rashes without underlying systemic involvement. Few studies have compared the incidence and characteristic of systemic and cutaneous lupus in the same population. <h3>Objectives</h3> We estimated and compared the incidence of SLE and CLE from 1993 to 2005, in a population based cohort. <h3>Methods</h3> An incident SLE case was defined as an individual who fulfilled four out of 11, 1982 ACR SLE classification criteria and who had been a resident of Olmsted County, MN, USA for at least 1 year prior to first physician diagnosis of SLE (1). Cases with drug induced lupus and overlap diseases were excluded. Cutaneous cases (without systemic features or SLE diagnosis) were identified from a previous data set from 1965-2005 and included patients with classic discoid LE, lupus panniculitis, bullous LE, and subcutaneous LE (2). Overall incidence rates (expressed as per 100 000 population) and 95% confidence intervals (CI) were calculated and age- and sex adjusted to the 2000 US white population. <h3>Results</h3> The study included 45 patients with incident SLE and 62 patients with incident CLE in 1993-2005. The overall incidence of SLE and CLE were similar (SLE 2.9, 95% CI 2.0, 3.7 and CLE 4.2, 95% CI 3.1, 5.2, p=0.10). Majority of patients with SLE were female (91% versus 73%, p=0.017). In females, the incidence of both conditions was similar (SLE 5.1, 95% CI 3.5, 6.6 and CLE 5.8, 95% CI 4.1, 7.5; p=0.67). In males, the age-adjusted incidence of SLE was significantly lower than CLE (SLE 0.8, 95% CI 0, 1.6 and CLE 2.4, 95% CI 1.2, 3.6; p=0.009). The mean ages of patients with SLE and CLE were similar (42 years and 47.6 years respectively, p=0.10). The age-specific incidence rates showed that CLE was more common in individuals ≥60 years (9.0) whereas SLE was rare in this age group (2.3). Conversely, CLE was rare in the 20-29 years age group (2.7) compared to SLE (8.0). <h3>Conclusions</h3> The overall incidence of CLE and SLE in this population-based study was similar. Cutaneous disease was more common than SLE in males and in older adults which may reflect differences in genetic or environmental etiology of CLE. <h3>References</h3> Tan EM, Cohen AS, Fries JF, Masi AT, McShane DJ, Rothfield NF, Schaller JG, Talal N, Winchester RJ. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1982 Nov;25(11):1271-7. Durosaro, O., M. D. Davis, et al. (2009). Incidence of cutaneous lupus erythematosus, 1965-2005: a population-based study. Archives of dermatology 145(3): 249-253. <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.1183
Tc-99m HMPAO Brain Perfusion SPECT Images in a Patient With Todd's Paralysis
Authors: HITOYA OHTA, MIHO NISHIMURA, MASAHIKO NII
Journal: Clinical Nuclear Medicine (1999)

Tc-99m HMPAO brain perfusion SPECT was performed in a 10-month-old patient with postepileptic transient left hemiplegia using a dual-headed gamma camera. Decreased perfusion to the right basal ganglia and thalamus was shown. Diagnostic information could be obtained on such a small patient with Todd's paralysis by conventional brain perfusion SPECT.
A Comparison of Conservative and Aggressive Transfusion Regimens in the Perioperative Management of Sickle Cell Disease
Authors: Elliot P. Vichinsky, Charles M. Haberkern, Lynne Neumayr, Ann Noonan Earles, Dennis Black, Mabel Koshy, Charles Pegelow, Miguel Abboud, Kwaku Ohene-Frempong, Rathi V. Iyer
Journal: New England Journal of Medicine (1995)

Preoperative transfusions are frequently given to prevent perioperative morbidity in patients with sickle cell anemia. There is no consensus, however, on the best regimen of transfusions for this purpose.
Intensive Effort Under Way to Develop Taxol Supplies
Authors: R. Gentry
Journal: JNCI Journal of the National Cancer Institute (1991)

Journal Article Intensive Effort Under Way to Develop Taxol Supplies Get access Randall Gentry Randall Gentry Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 83, Issue 9, 1 May 1991, Pages 603–604, https://doi.org/10.1093/jnci/83.9.603 Published: 01 May 1991
Abstract 303: Host-derived CCL2 plays a critical role in prostate cancer growth and skeletal metastasis
Authors: Jiejun Fu, Jian Zhang, Jianhua Wang, Yi Lu
Journal: Cancer Research (2012)

Abstract We have previously reported that the presence of CC chemokine ligand 2 (CCL2) produced by prostate cancer (PCa) epithelial cells, stroma/osteoblasts, and bone marrow endothelial cells, is pro-tumorigenic for prostate cancer cells. CCL2 increases prostate cancer cell proliferation, migration, and survival and induces osteoclast formation. Moreover, the key role of CCL2 in the tumor growth and metastasis has been linked to its regulatory role in mediating monocyte/macrophage infiltration into the tumor microenvironment. Using a model of human PCa cells implanted in mice, Loberg R. et al. reported that anti-murine CCL2 neutralizing antibodies resulted in greater reduction of overall tumor burden compared to the use of anti-human antibody (anti-tumor cell-derived). This suggests that host-derived CCL2 may play a key role in prostate tumor growth and metastasis. Therefore, in this study, we have employed CCL2 knockouts which were interbred to SCID mice to generate colonies of homozygous SCID/CCL2−/− mice. PCa cells (PC3Luc) were injected into the left ventricle (Intracardiac-injection) of SCID/CCL2−/- and wild-type controls (n=20/group). The effects of deletion of CCL2 in the host on prostate cancer cell homing, growth in bone and bone destruction were evaluated for 4 weeks. In a parallel experiment, PC3Luc cells were subcutaneously implanted and tumor size was monitored weekly for 4 weeks. This parallel study addressed bone-specific vs. generalized influences of host-derived CCL2 on prostate cancer growth. We found that skeletal metastases occurred in 4/20 SCID/CCL2−/− mice vs 14/20 WT mice. In addition, X-ray photographs showed significantly fewer bone resorptive lesions in SCID/CCL2−/− mice vs. WT mice. Histology examinations confirmed x-ray findings. In the parallel experiment, PC3Luc tumor grew slower in SCID/CCL2−/- mice vs. WT mice. These results indicate that host-derived CCL2 production defines a permissive microenvironment for prostate cancer growth and skeletal metastasis. These findings may significantly impact the therapeutic field through targeting “the host” instead of “the tumor cells” in prostate cancer. Supported by U.S. Department of Defense PC061231 (J. Zhang), National Natural Sciences Foundation Key Project (81130046, J. Zhang) and National Natural Science Foundation Project (81171993, Y. Lu). Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 303. doi:1538-7445.AM2012-303
PTU-174 Cost Saving Implications Of New Surveillance Guidelines For Barrett’s Oesophagus: Abstract PTU-174 Table 1
Authors: R Hewett, D Chan, A Poullis, J-Y Kang
Journal: Gut (2014)

<h3>Introduction</h3> The BSG have recently risk stratified Barrett’s Oesophagus (BO) according to length of the BO segment and the presence of intestinal metaplasia (IM). Previously the recommendation was for a surveillance gastroscopy every two years. The surveillance interval recommended by the new guidelines<sup>1</sup> now reflects the risk of developing adenocarcinoma. We aimed to quantify the potential cost saving of the implementation of the new BO surveillance guidelines. <h3>Methods</h3> Patients with an endoscopic diagnosis BO were identified from endoscopy database records at our unit between 2009 and 2012. BO segment length was available and the presence of IM in the biopsy samples was retrievable from histology records. We allocated our patients into three groups: The 1st was those with a BO segment &lt;3 cm and no IM (not needing further surveillance), the 2nd was those with a BO segment &lt;3 cm with IM (now needing surveillance every 5 years) and the 3rd were those with a BO segment of 3cm or greater (needing surveillance every 3 years). The cost of a surveillance gastroscopy is estimated to be £520<sup>2</sup> and our histopathology department advised that the cost of four quadrant biopsies was £65 (surveillance cost therefore being greater for those with longer BO segments). We first calculated the projected cost of surveillance over the next 10 years under the old guidelines. From this we subtracted the projected cost of surveillance for this period under the new guidelines. <h3>Results</h3> 463 patients were identified who had an endoscopic diagnosis of BO. Sixty patients were excluded due to lack of data on BO length/IM. The ten year projected cost saving for our trust by implementing the new BO surveillance guidelines was £754,260 (£75,426 per annum). There are over 150 hospital trusts in the UK that have endoscopy units, therefore even a conservative estimate is that the new BO guidelines will save the NHS in excess of £100 million in the next 10 years. <h3>Conclusion</h3> New guidelines on BO surveillance will mean fewer surveillance gastroscopies need to be performed in the future. As well as giving the patients a better experience, these guidelines will result in a significant cost saving to our hospital and the NHS in general. <h3>References</h3> Fitzgerald R, di Pietro M, Ragunath K, <i>et al</i>. British society of gastroenterology guidelines on the management of Barrett’s oesophagus.<i> Gut </i>published online October 28:2013 Broe M, Barry M, Patchett S, Hill AD. Evaluating the clinical efficacy and cost effectiveness of direct access endoscopy.<i> Surgeon</i> 2013 Dec;11(6):304–8 <h3>Disclosure of Interest</h3> None Declared.
Abstract 847: Foretinib, a multi-kinase inhibitor of cMET and PDGFRα, in the treatment of disseminated medulloblastoma
Authors: Claudia C. Faria, Brian J. Golbourn, Christian A. Smith, James T. Rutka
Journal: Cancer Research (2012)

Abstract Medulloblastoma (MB) is the most common malignant brain tumor in childhood accounting for around 10% of all pediatric cancer deaths. Dissemination occurs in 30% of the patients at the time of diagnosis and essentially defines children with incurable disease given that metastatic disease is refractory to current treatments. Therefore, there is an urgent need for new therapies to treat metastatic MB. The hepatocyte growth factor (HGF)/cMET signaling pathway has been recently implicated in the pathogenesis of MB. Overexpression of cMET and HGF is associated with group C tumors which have high incidence of metastasis and poor outcome. Moreover, overexpression of the platelet-derived growth factor receptor (PDGFR) was also identified in metastatic MB. Using foretinib, a multi-kinase inhibitor of cMET and PDGFRα, we aimed to target two important pathways involved in MB dissemination. Using three MB cell lines (Daoy, ONS - 76 and D425) that express different amounts of the receptors (cMET and PDGF), we performed dose-response experiments with foretinib, measuring downstream targets of cMET and PDGFRα activation. We showed that foretinib inhibits proliferation, migration, invasion and anchorage independent growth of MB cell lines in a dose-dependent manner. By immunofluorecence, we observed that foretinib induces polyploidy and using flow cytometry analysis we found that it also induces apoptosis and cell cycle arrest in G2-M phase. To test the efficacy of foretinib in vivo we have created a disseminated mouse model of MB injecting MB cells in the fourth ventricle of nude mice, mimicking the process of dissemination in children. The cells were previously transfected with a luciferase expressing vector allowing weekly monitoring of tumor growth and dissemination by bioluminescence imaging. Foretinib was able to reduce tumor growth and metastasis in xenografts, increasing survival when compared to controls. Altogether these results suggest that small molecule inhibitors of cMET and PDGFR may represent a new therapeutic strategy in the treatment of disseminated MB. Given that foretinib is already being tested in clinical trials for other forms of cancer, the findings from our experiments may lead to the design of identical trials in children with metastatic medulloblastoma. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 847. doi:1538-7445.AM2012-847
AB0192 Altered T cell compartment could contribute to radiographic changes in AS
Authors: Y.-N. Cho, S.-J. Lee, H.-M. Jin, M.-J. Kim, T.-J. Kim, Y.W. Park
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> In terms of the presence of chronic inflammation in AS, direct and indirect evidence suggests that T cells play a role in its pathogenesis. Although the proportions of peripheral blood immune cells have been evaluated in AS, much less has been known about the relations between immune cells and bony changes in AS. <h3>Objectives</h3> The aims of this study were to examine immune cell proportions in peripheral blood of patients with ankylosing spondylitis (AS) and to investigate relationships between immune cells, bone formation related molecules, and radiographic changes. <h3>Methods</h3> Forty-nine AS patients and 53 age- and sex- matched healthy controls were enrolled in this study. Clinical parameters were extensively evaluated in the study subjects. CD4+ T cells, CD8+ T cells, CD56+ T cells, natural killer cells, and natural killer T (NKT) cells in peripheral blood were measured by flow cytometry. Serum levels of Dickkopf-1and bone morphogenic proteins were determined using enzyme linked immunosorbent assays. Modified Stokes AS Spinal Scores were used to assess radiographic changes. <h3>Results</h3> Patients were found to have a significantly greater percentage of CD56+T cells than healthy controls (median 1.31% <i>vs.</i> 0.53%, <i>p</i>&lt;0.001), whereas peripheral blood NKT cell percentages were lower in patients than in controls (median 0.07% <i>vs.</i> 0.10%, <i>p</i>=0.010). Moreover, mean CD 56+T to NKT cell ratio was markedly higher in patients. Although no significant correlations were observed between the immune cell percentages and bone formation-related molecule levels, interestingly, during 3 years of radiographic follow up, patients with a higher CD56+T to NKT cell ratio at baseline were found to develop greater radiographic changes (<i>r</i> =0.79, <i>p</i>=0.007, age and disease duration adjusted). <h3>Conclusions</h3> An altered T cell compartment, particularly with respect to CD56+ T and NKT cells, was observed in AS patients, and could contribute to radiographic changes in AS. <h3>References</h3> Zhang L, Jarvis LB, Baek HJ and Gaston JS. Regulatory IL4+CD8+ T cells in patients with ankylosing spondylitis and healthy controls. Ann Rheum Dis 2009;68(8):1345-51. Atagunduz P, Appel H, Kuon W, et al. HLA-B27-restricted CD8+ T cell response to cartilage-derived self peptides in ankylosing spondylitis. Arthritis Rheum 2005;52(3):892-901. Azuz-Lieberman N, Markel G, Mizrahi S, et al. The involvement of NK cells in ankylosing spondylitis. Int Immunol 2005;17(7):837-45. Hammond KJ and Godfrey DI. NKT cells: potential targets for autoimmune disease therapy? Tissue Antigens 2002;59(5):353-63. Hu M, Bassett JH, Danks L, et al. Activated invariant NKT cells regulate osteoclast development and function. J Immunol 2011;186(5):2910-7. <h3>Disclosure of Interest</h3> None Declared
The Effects of Ibuprofen on the Physiology and Survival of Patients with Sepsis
Authors: Gordon R. Bernard, Arthur P. Wheeler, James A. Russell, Roland Schein, Warren R. Summer, Kenneth P. Steinberg, William J. Fulkerson, Patrick E. Wright, Brian W. Christman, William D. Dupont, Stanley B. Higgins, Bridget B. Swindell
Journal: New England Journal of Medicine (1997)

In patients with sepsis the production of arachidonic acid metabolites by cyclooxygenase increases, but the pathophysiologic role of these prostaglandins is unclear. In animal models, inhibition of cyclooxygenase by treatment with ibuprofen before the onset of sepsis reduces physiologic abnormalities and improves survival. In pilot studies of patients with sepsis, treatment with ibuprofen led to improvements in gas exchange and airway mechanics.
THU0093 Relation between Lumbar and Cervical Affectation Grade in Patients with Ankylosing Spondylitis According to Mobility and Structural Damage: Table 1
Authors: J.L. Garrido-Castro, J. Gil-Cabezas, J. Calvo, C. Gonzalez-Navas, P. Font-Ugalde, E. Collantes
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> Ankylosing spondylitis produces a progressive decrease in spinal mobility with the evolution of the disease. This decrease is due to inflammation and structural damage at radiological level that occurs in neck and spine. Several indices have been validated to quantify this grade of affectation. The most used index to assess structural damage is the mSASSS. This index is evaluated between 0 to 72 points and it measures equally the affectation grade of the neck and lower back. Recently a new index based on motion analysis has been defined wich produces accurate and objective information about mobility, the UCOASMI [1] index. For calculating this index, two cervical mobility and three lumbar mobility measures are used, so cervical UCOASMI and lumbar UCOASMI can be defined. With the evolution of the disease UCOASMI and mSASSS indexes increases with more structural damage and loss of mobility, but what is the relation between lumbar and cervical damage with the evolution of AS? <h3>Objectives</h3> To analyze the evolution of AS in terms of radiological damage and mobility at the cervical and lumbar area. <h3>Methods</h3> 76 patients diagnosed with AS (75% male, age 44.1±11.5 years, duration 13.6±9.4 years) were analyzed. A radiologist assessed radiographs for calculating mSASSS. At the Motion Analysis Laboratory of the Reina Sofia University Hospital, UCOTrack system was used to calculate UCOASMI index. For both indices, coefficient cervical/lumbar ratio was calculated to identify which part was more affected. <h3>Results</h3> Table shows affectation grade in mobility (UCOASMI) and radiographic damage (mSASSS) in total sample and grouped by gender, duration, and affectation grade in mobility. Differences between groups are also showed indicating whether these are statistically significant. <h3>Conclusions</h3> The relation between affectation of cervical and lumbar part seems to be balanced around 50% according to both structural damage and mobility. Mobility differences in genre were not appreciated. While there are differences in the structural damage between male and female, this difference appears similarly in both areas. According to our results, only at initial stages of the disease, lower back is most affected, especially as far as mobility is concerned. <h3>References</h3> Garrido-Castro JL, Escudero A, Medina-Carnicer R, Galisteo AM, Gonzalez-Navas C, Carmona L, Collantes-Estevez E. Validation of a new objective index to measure spinal mobility: the University of Cordoba Ankylosing Spondylitis Metrology Index (UCOASMI). Rheumatol Int. 2013 Dec 20. [Epub ahead of print] <h3>Disclosure of Interest</h3> : None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.3280