tbuckley/cabot-search huggingface dataset:
FRI0240 Correlation between objective and patient self-reported clinical improvement after multiple courses of rituximab in rheumatoid arthritis patients with inadequate response to tumour necrosis factor inhibitors: data from repeat study
Authors: I. Ancuta, C. Codreanu, R. Ionescu, D. Nemes, R. Chirieac, C. Paulina, M. Suta, A. Balanescu, E. Mociran, E. Rezus
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Rituximab (RTX) has been evaluated in many clinical trials and self-reporting instruments have been used in conjunction with objective measurements. Little is known about the relationship between objective and self-reported outcomes in RA patients treated with repeated courses of biologics over extended periods of time <h3>Objectives</h3> To investigate and compare the evolution of clinical outcome measures and self-perceived health status in patients with severe active RA treated with multiple courses of RTX in routine clinical practice setting in Romania. <h3>Methods</h3> In this open-label, multicentre, prospective observational study, patients were treated with initial (2x1000 mg IV, at 2 weeks apart) and subsequent RTX courses. Clinical assessments including 28-joint disease activity score (DAS-28) were performed at baseline (before treatment initiation), and after each retreatment course at 6, 12, 18 and 24 months. A visual analogue scale (VAS; 0=best, 100=worst) allowed patients to report health status at each clinical assessment. Delta DAS-28 and delta VAS were calculated as difference between values found at two consecutive evaluations. Linear regression models were estimated at baseline, 6, 12, 18, and 24 months with the DAS-28 as the outcome variable and the VAS as a predictor. Statistical analyses were performed with STATA SE 11.0 software. <h3>Results</h3> A total of 943 adult (&gt;18 years) patients with active RA and inadequate response to at least one TNF inhibitor received initial RTX treatment. In our cohort, 805 (85.37%) patients had only one anti-TNF treatment and 138 (14.63%) had more than one, with a median duration of anti-TNF treatment of 21 and 47 months, respectively. Median DAS-28 and VAS self-reported scores steadily decreased after each retreatment: <h3>Conclusions</h3> We found strong correlation between objective clinical outcomes and self-reported health status, with clinical response maintained or improved after each fixed interval retreatment with Rituximab. Major improvements occurred early in our study, at 6 months, and were appreciated by patients. This synergy is important for doctor-patient relationship, increased patient confidence and treatment compliance, key factors for a successful therapy. <b>Disclosure of Interest</b>: None Declared
FRI0166 The effectiveness of shortening intervals of infliximab and dose escalation of infliximab with rheumatoid arthritis in multi-center clinical practice
Authors: K. Funahashi, T. Kojima, N. Takahashi, D. Kato, H. Matsubara, Y. Hattori, N. Ishiguro
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Although anti-TNF blocker prevents joint destruction and makes a role of being drastic change on rheumatoid arthritis treatment, patients who are poor response against the treatment with anti-TNF blocker also exists. One of major problem of Infliximab (IFX) is loss of efficacy. Doing treatment to maintain its efficacy by dose escalation of IFX (DE group) and shortening intervals of IFX (SI group) were performed. But the superiority of both methods remains unclear. <h3>Objectives</h3> To investigate the continuity and effectiveness of both groups using multi-center registry for the treatment of RA with biologics in Japan (Tsurumai Biologics Communications registry;TBCR). <h3>Methods</h3> 603 cases who are treated with IFX from 2072 registrated cases of TBCR until 2011. 136 (22.6%) cases were treated with shortening intervals of IFX to 7 weeks or less, while 115 cases (19.1%) were treated with dose escalation of IFX to add 100mg or over. Baseline characteristics were summarized in Table 1. Drug survival of both therapies was examined using Kaplan-Meier survival analysis. <h3>Results</h3> In SI group, 33 cases (24.3%) discontinued IFX therapy because of loss of efficacy, 15 cases (11.0%) stopped IFX infusion because of adverse events (AEs). In DE group, 36 cases (31.3%) discontinued IFX therapy because of loss of efficacy, 10 cases (8.7%) stopped IFX infusion because of AEs. The continuation of SI group was significantly higher than that of DE group by the Kaplan-Meier method ((Log-rank test; p=0.042) Fig. 1). Furthermore, we divided timing of escalation of therapy is one year over/less from starting IFX. Patients with shortening intervals after more than 1 year had the highest survival rate of all of groups ((Log-rank test; p=0.010) Fig. 2). Drug survival of both groups was significantly higher compared the all of IFX use group in TBCR (n=603) ((Log-rank test; p&lt;0.001) Fig. 3). <h3>Conclusions</h3> In occurring loss of efficacy of IFX, we should remember the effectiveness of not only dose escalation of IFX but also shortening intervals of IFX, considering the maintenance of drug trough. <h3>Disclosure of Interest</h3> K. Funahashi: None Declared, T. Kojima Speakers Bureau: Abbott Japan, Chugai Pharmaceutical, Daiichi Sankyo Pharmaceutical, Eisai, Mitsubishi Tanabe Pharma, Pfizer Japan, Takeda Pharmaceutical, N. Takahashi: None Declared, D. Kato: None Declared, H. Matsubara: None Declared, Y. Hattori: None Declared, N. Ishiguro Speakers Bureau: Abbott Japan, Chugai Pharmaceutical, Daiichi Sankyo Pharmaceutical, Eisai, Mitsubishi Tanabe Pharma, Pfizer Japan, Takeda Pharmaceutical
Plasma Testosterone and Semen Analysis in Male Homosexuals
Authors: Robert C. Kolodny, William H. Masters, Julie Hendryx, Gelson Toro
Journal: New England Journal of Medicine (1971)

Thirty male homosexual students between the ages of 18 and 24 were interviewed and classified according to degree of homosexuality. Physical examination, plasma testosterone determinations, semen analyses and buccal smears were performed. Physical examinations and buccal smears gave normal results. Plasma testosterone levels (compared to a control group of 50 heterosexual males 17 to 24 years old) were significantly below the control of 689 ± 26 (mean ± S.E.M.) ng per 100 ml for groups of homosexuals either exclusively or almost exclusively homosexual: 372 ± 22 (mean ± S.E.M.) and 264 ± 15 (mean ± S.E.M.) ng per 100 ml for the two groups, respectively (p less than 0.01). Analysis of variance showed a significant difference in sperm counts according to degree of homosexuality (p less than 0.01). The correlation of sperm counts and plasma testosterone concentrations showed r = 0.713, p less than 0.001. These findings suggest that further investigation of endocrine variants in homosexuals may be of major value in relation to primary pathogenesis or to secondary hypothalamic response to human homosexual orientation.
The Inverse Relation between Fish Consumption and 20-Year Mortality from Coronary Heart Disease
Authors: Daan Kromhout, Edward B. Bosschieter, Cor de Lezenne Coulander
Journal: New England Journal of Medicine (1985)

The low death rate from coronary heart disease among the Greenland Eskimos has been ascribed to their high fish consumption. We therefore decided to investigate the relation between fish consumption and coronary heart disease in a group of men in the town of Zutphen, the Netherlands. Information about the fish consumption of 852 middle-aged men without coronary heart disease was collected in 1960 by a careful dietary history obtained from the participants and their wives. During 20 years of follow-up 78 men died from coronary heart disease. An inverse dose–response relation was observed between fish consumption in 1960 and death from coronary heart disease during 20 years of follow-up. This relation persisted after multiple logistic-regression analyses. Mortality from coronary heart disease was more than 50 per cent lower among those who consumed at least 30 g of fish per day than among those who did not eat fish. We conclude that the consumption of as little as one or two fish dishes per week may be of preventive value in relation to coronary heart disease. (N Engl J Med 1985; 312:1205–9.)
Abstract 2093: Next-gen deep sequencing improves FGFR3 mutation detection in the urine of bladder cancer patients
Authors: John M. Millholland, Shuqiang Li, Cecilia A. Fernandez, Anthony P. Shuber
Journal: Cancer Research (2012)

Abstract FGFR3 mutations have been identified in ∼60-70% of low-stage, non-invasive tumors. Our group and others have developed assays to detect FGFR3 mutations in the urine of bladder cancer patients. However, urine-based assays have been limited by the technical ability to detect rare events in a dilute medium where there is a high background of normal DNA. In these assays, FGFR3 mutations are generally found in ∼30% of the urine samples, which is &amp;lt; 50% concordance with the expected detection in tissue. We have now developed an ultra-deep amplicon sequencing technique that increases FGFR3 mutation detection in urine to ∼67%, near the expected detection if every mutation found in tissue could be detected in urine. Amplicons were designed against FGFR3 exons 7, 10, and 15 using PCR primers containing the adapter sequences for unidirectional sequencing. Taqman probes were used to determine if sufficient DNA was present in each sample. Primary amplification was performed from DNA isolated from 4 ml of urine. The resulting PCR products were used as template for emulsion PCR and these were then sequenced using the Roche 454 GS Junior. Samples were analyzed for total DNA reads per sample and number of mutant sequencing reads to determine percent mutation. Urine samples from 29 patients with stage Ta bladder cancer were analyzed by both our previously described qPCR method and the new ultra-deep sequencing approach. Of the 29 samples, 2 did not have sufficient DNA for analysis by sequencing. Using ultra-deep amplicon sequencing, 18 out of 27 (66.7%) were positive for FGFR3 mutations, while only 3 out of 27 (11.1%) were positive for mutations by qPCR. The urine samples from the 15 newly identified mutations using deep sequencing contained FGFR3 mutations as low as 0.05%. Using matched tissue and urine samples, we demonstrate that the sensitivity in urine approximates the FGFR3 mutations observed in tissue. We have developed a highly sensitive non-invasive urine based assay that can detect FGFR3 mutant DNA when present at &amp;lt; 1% of the sample and that achieves &amp;gt; 90% concordance with tumor tissues. To our knowledge, this is the first practical application of next generation sequencing technology for diagnostic use. 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 2093. doi:1538-7445.AM2012-2093
CLINICAL UTILITY OF THE J-CTO SCORE IN CORONARY CHRONIC TOTAL OCCLUSION INTERVENTIONS: RESULTS FROM A MULTICENTER REGISTRY
Authors: Georgios Christopoulos, R. Michael Wyman, Khaldoon Alaswad, Dimitri Karmpaliotis, William Lombardi, James A. Grantham, Robert Yeh, Farouc Jaffer, Bavana Rangan, Georgios Christakopoulos, Megan A. Kypreos, Nicholas Lembo, David Kandzari, Santiago Garcia, Craig A. Thompson, Subhash Banerjee, Emmanouil Brilakis
Journal: Journal of the American College of Cardiology (2015)
Abstract 526: Tetraspanin CD81/TAPA-1 up-regulates MT1-MMP involved in melanoma cell motility through Akt-dependent Sp1 activation signaling pathways
Authors: In-Kee Hong, Sun-Ju Wang, Moon-Sung Lee, Iha Park, Young-Myeong Kim, Hansoo Lee
Journal: Cancer Research (2010)

Abstract Tetraspanin CD81 is a member of transmembrane 4 superfamily proteins that have four putative membrane-spanning domains, short C- and N-terminal cytoplasmic domains, two extracellular loops and small intracellular loop. Tetraspanin CD81 is involved in cell adhesion, cell proliferation, motility and metastasis. In this study, to reveal the role of CD81 in tumor invasion, we examined the effect of CD81 overexpression on invasive phenotype in human melanoma cells. We also investigated the intracellular signaling pathways mediated by CD81 involved in these invasive phenotypes. For this study, we generated MelJuSo human melanoma cell lines stably expressing CD81. Cell invasion and motility of the CD81-transfected cells was enhanced significantly as compared to control transfectant cells lacking CD81 expression. In addition, MT1-MMP expression is up-regulated in CD81 transfectant cells as compared to control transfectant cells. MT1-MMP knockdown in CD81 transfectant cells abolished the increase of cell motility by CD81 expression, suggesting the role of MT1-MMP in CD81-induced cell motility. Through the studies using chemical inhibitors and siRNAs for gene knockdown, we found that Akt/PI3K signaling pathway is involved in CD81-mediated MT1-MMP expression. The enhancement of cell motility by CD81 expression was abolished by knockdown of Akt. Finally, we found the involvement of Sp1 transcription factor in the induction of MT1-MMP expression mediated by CD81. Sp1 binding site in MT1-MMP gene promoter was indispensable for the induction of MT1-MMP expression by CD81. Electrophoretic mobility shift assay confirmed the involvement of Sp1 in MT1-MMP expression by CD81. Taken together, these results suggest that tetraspanin CD81 stimulates melanoma cell invasion and motility by up-regulating MT1-MMP expression through the activation of AKT signaling pathways and Sp1 transcription factor. 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 526.
Parasitism in Medical Education
Authors: Dieter Koch-Weser
Journal: New England Journal of Medicine (1972)

Dublin's paper in this issue of the Journal focuses on the alarming increase in the number of foreign medical graduates remaining permanently in this country. It also points out the problem of U.S. nationals, who study medicine abroad with the intent of returning and practicing medicine here. Few will argue with the author's statement that "there is an opportunity for a new form of international co-operation in meeting the challenges of the mass migration of physicians from one country to another." This lofty (and unfortunately distant) prospect does not, however, free the United States – by far the largest recipient . . .
Risk factors for complications of pancreatic extracorporeal shock wave lithotripsy
Authors: Bai-Rong Li, Zhuan Liao, Ting-Ting Du, Bo Ye, Wen-Bin Zou, Hui Chen, Jun-Tao Ji, Zhao-Hong Zheng, Jun-Feng Hao, Ying-Yi Jiang, Liang-Hao Hu, Zhao-Shen Li
Journal: Endoscopy (2014)

<b>Background and study aims:</b> Extracorporeal shock wave lithotripsy is recommended as treatment for stones in chronic pancreatitis. The aim of this study was to investigate the risk factors for complications of pancreatic extracorporeal shock wave lithotripsy (P-ESWL). <b>Patients and methods:</b> Patients with painful chronic pancreatitis and pancreatic stones (> 5 mm diameter) who were treated with P-ESWL between March 2011 and June 2013 were prospectively included. Adverse events after P-ESWL were classified as complications and transient adverse events, depending on severity. The major complications of P-ESWL included post-ESWL pancreatitis, bleeding, infection, steinstrasse, and perforation. Multivariate analyses based on univariate analysis were performed to detect risk factors of overall and moderate-to-severe complications. <b>Results:</b> A total of 634 patients underwent 1470 P-ESWL procedures. The overall complication rate was 6.7 % of all procedures. Complications occurred in 62 patients (9.8 %) after the first ESWL procedure. The risk factors for complications were pancreas divisum (odds ratio [OR] 1.28) and the interval between diagnosis of chronic pancreatitis and P-ESWL (OR 1.28). Protective factors were male sex (OR 0.50), diabetes (OR 0.45), and steatorrhea (OR 0.43). Male sex, the only identified predictor for moderate-to-severe complications, was a protective factor (OR 0.19). For the second P-ESWL procedure, complications occurred in 22/409 patients (5.4 %). Complication and asymptomatic hyperamylasemia after the first ESWL session were significantly associated with higher risk for complications after the second ESWL session (<i>P</i> < 0.05). <b>Conclusions: </b>Patient-related factors were important in determining a high risk of P-ESWL complications when no procedure-related factors were identified. Patients suffering from complications after the first ESWL session were also likely to experience complications in subsequent P-ESWL sessions.
“Cold” and “Hot” Osteomyelitis on Bone Scintigraphy
Authors: Nir Hod, Tifha Horne
Journal: Clinical Nuclear Medicine (2003)

Bone scanning is frequently used for the assessment of a child with pain around the hip joint. The authors present a child with septic hip arthritis in which a striking abnormality of complete absence of tracer uptake in an extensive region of the proximal femur was demonstrated on bone scintigraphy. Later during the course of his disease, markedly increased tracer uptake was seen along most of the femoral diaphysis with the exception of the avascular proximal bone. These scintigraphic findings represent extensive osteomyelitis of the femur with avascular necrosis of its proximal part.
P3-13-07: The TARGIT-A Trial Update Confirms No Increase in Local Recurrence.
Authors: JS Vaidya, M Baum, F Wenz, M Bulsara, J Tobias, M Alvarodo, C Saunders, N Williams, D Joseph
Journal: Cancer Research (2011)

Abstract Introduction: In June 2010, we published the results of the TARGIT-A trial (1) that compared “one-size fits” all radiotherapy (whole breast radiotherapy-EBRT group) with risk -adjusted radiotherapy (TARGIT- group: single dose TARGeted Intraoperative radioTherapy with additional whole breast radiotherapy if adverse prognostic factors were found). These results showed that the risk of local recurrence in the TARGIT group was non-inferior to that of the EBRT group (the difference between the two arms was 0.25% at 4 years). We now report the results analyzed after further follow up of the total trial cohort without unblinding. Method: As often repeated, unplanned analysis comparing two groups in a randomized trial can result in an increased alpha-spent as well as carry the risk of a false positive result, we have remained blinded to the further recurrences in the trial according to allocated treatment, since the original publication in the Lancet. Instead we proposed and performed a blinded analysis of the local recurrence rate for the whole cohort. We plotted the Kaplan Meier plots and compared the estimated 4-year recurrences. Results: Amongst the 2232 patients randomized, there were 13 recurrences at the time of Lancet publication and since then, we have had 8 additional recurrences. The number of patients who have completed at least 4 years of follow up has increased from 420 to 717. We found that the 4-year Kaplan Meier estimate of local recurrence was 1.08% (95% CI 0.59 −1.96) at the time of the Lancet publication and it is 1.09% (95% CI 0.65 - 1.85) now. Conclusion: We found that the overall 4-year recurrence rates of the TARGIT-A trial have remained stable with a longer follow up and therefore; it is statistically implausible, that one particular arm has a significantly higher local recurrence. References 1. Vaidya JS, Joseph DJ, Tobias JS, Bulsara M, Wenz F, Saunders C, Alvarado M, Flyger HL, Massarut S, Eiermann W, Keshtgar M, Dewar J, Kraus-Tiefenbacher U, Sutterlin M, Esserman L, Holtveg HM, Roncadin M, Pigorsch S, Metaxas M, Falzon M, Matthews A, Corica T, Williams NR, Baum M. Targeted intraoperative radiotherapy versus whole breast radiotherapy for breast cancer (TARGIT-A trial): an international, prospective, randomised, non-inferiority phase 3 trial. Lancet 2010;376(9735):91–102. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P3-13-07.
Evaluation the diagnostic value of endoscopic ultrasound guided fine needle aspiration for the lesions with suspicious lymph nodes metastasis around the upper digestive tract and pancreas
Authors: Sun Yun-wei, Gong Ting-ting, Zhang Shu-xian, Zhu Qi
Journal: Endoscopy (2011)

Objective: To evaluate the clinical application of endoscopic ultrasound guided fine needle aspiration (EUS-FNA) in upper digestive tract and pancreatic diseases accompanied with peripheral suspicious lymph nodes as metastasis on differenzial diagnosis between benign and malignant lesions.
Are MR Compatible hemoclips safe after control of hemostasis?
Authors: Mevlut Kurt, Emrah Posul, Vildan Tekelioglu, Bulent Yilmaz, Ugur Korkmaz, Betul Kizildag
Journal: Endoscopy (2014)

An 82-year-old man with a medical history of hypertension and cerebrovascular disease was referred to our clinic with hematemesis. Laboratory findings were: hemoglobin 8.5 g/dL (normal range 14 – 18 g/dL), white blood cells 16.1 × 109/L (normal range 4 – 10 × 109/L), and platelets 74 × 109/L (normal range 150 – 400 × 109/L). He was given a transfusion of two units of packed red blood cells.
GW25-e4145 Anti-peroxynitrite Treatment Ameliorated Vasorelaxation of Resistance Arteries in Aging Rats: Involvement with NO-sGC-cGKs Pathway
Authors: Ma Lu, Wang Ke, Shang Jianyu, Cao Chengzhang, Zhen Panpan, Liu Xin, Wang Wen, Zhang Hui, Du Yunhui, Liu Huirong
Journal: Journal of the American College of Cardiology (2014)
A Double-Blind Comparison of Clomipramine and Desipramine in the Treatment of Trichotillomania (Hair Pulling)
Authors: Susan E. Swedo, Henrietta L. Leonard, Judith L. Rapoport, Marge C. Lenane, Erica L. Goldberger, Deborah L. Cheslow
Journal: New England Journal of Medicine (1989)

Trichotillomania, an irresistible impulse to pull out one's own hair, is a chronic psychiatric illness that causes severe discomfort, interferes with daily activities, and leads to social isolation. Treatment is usually unsatisfactory. Thirteen women with severe trichotillomania completed a 10-week double-blind, crossover trial of clomipramine, a new tricyclic antidepressant agent with selective antiobsessional effects, and desipramine, a standard tricyclic antidepressant. Treatment with clomipramine resulted in significantly greater improvement in symptoms than desipramine, as indicated by physicians' ratings of the women's clinical progress on a scale in which lower scores indicate improvement (mean [±SD] scores: at base line, 10.0; after desipramine treatment, 8.7±2.4; after clomipramine treatment, 4.7±3.1; P = 0.006) and by scores on a trichotillomania-impairment scale, in which higher scores indicate greater impairment (at base line, 6.8±1.7; after desipramine treatment, 6.2±1.7; after clomipramine treatment, 4.2±2.7; P = 0.03). The severity of symptoms (mean base-line score, 15.9±3.8) was reduced more by clomipramine (10.6±6.4) than by desipramine (14.4±3.9). The patients reported that the compulsion decreased in intensity and that they were more able to resist the urge to pull out their hair during treatment with clomipramine. We conclude that clomipramine appears to be effective in the short-term treatment of trichotillomania. (N Engl J Med 1989; 321:497–501.)