tbuckley/cabot-search huggingface dataset:
SP0059 What is new: Clinical implications of imaging advances
Authors: M. Østergaard
Journal: Annals of the Rheumatic Diseases (2013)

For decades, imaging in rheumatology has been synonymous with conventional radiography. However, new imaging modalities, incl magnetic resonance imaging and ultrasonography but also even newer techniques, have dramatically increased the amount and scope of information obtainable by imaging. In rheumatology, imaging may be used for multiple reasons that include establishing or confirming the diagnosis, determining extent of disease, monitoring change in disease (e.g activity and damage) in clininical practice, assessing therapeutic efficacy in trials, prognostication, selecting patients for specific therapies (e.g. surgery or injections) and identifying complications of disease or treatment. These entirely different contexts may favor different imaging approaches. This presentation will describe the clinical implications of recent imaging advances, with a focus on the inflammatory joint diseases. <h3>Disclosure of Interest</h3> None Declared
TRATAMIENTO ENDOSCÓPICO PALIATIVO DE LA OBSTRUCCIÓN TUMORAL DEL VACIAMIENTO GÁSTRICO MEDIANTE PRÓTESIS METÁLICAS AUTOEXPANDIBLES
Authors: D Ruiz-Clavijo García, A Ciarruiz Munuce, M Fraile González, H León Brito, I Areste Anduaga, E Albéniz Arbizu, S Oquiñena Legaz, A Pueyo Royo, J Eguaras Ros, C Prieto Martínez, C Jiménez López
Journal: Endoscopy (2013)

Introducción: El tratamiento endoscópico mediante prótesis metálicas autoexpandibles para la obstrucción tumoral del vaciamiento gástrico es un procedimiento poco invasivo, que se utiliza con frecuencia. Objetivo: Evaluar el tratamiento endoscópico paliativo mediante la inserción de prótesis metálicas autoexpandibles en pacientes con obstrucción del vaciamiento gástrico. Material y Método: Se revisaron retrospectivamente las prótesis endoscópicas autoexpandibles colocadas desde enero de 2010 hasta julio de 2013. Se examinaron las siguientes variables: edad media al diagnóstico, distribución por sexos, síntomas principales al diagnóstico, indicación de la prótesis, tipo de tumor, localización de la obstrucción, éxito clínico y técnico del procedimiento, complicaciones tras el procedimiento y la supervivencia. Al comparar variables cualitativas utilizamos el test de Fisher, considerando significativos los valores de p < 0,05. Resultados: En 42 meses que comprende nuestro estudio se realizaron 15 intentos de inserción de prótesis autoexpandibles en 15 pacientes. La edad media fue de 81 años. La media de supervivencia fue de 7 meses. Eran 12 mujeres y 3 varones. El síntoma más frecuente fue los vómitos en 10 pacientes. La obstrucción tumoral se debía a adenocarcinomas gástricos primario en 9 pacientes. El resto 3 colangiocarcinomas, 2 adenocarcinomas de páncreas y 1 ampuloma. La obstrucción en 9 pacientes era antropilórica, en 3 bulbar y en 3 en segunda y tercera porción duodenal. En cuanto al éxito clínico 12 pacientes mejoraron de la clínica obstructiva y toleraron dieta en las 24 horas posteriores. En 13 pacientes se colocó con éxito la prótesis en la estenosis tumoral y 2 presentaron una perforación. Se colocaron 12 prótesis auto-expandibles metálicas no cubiertas tipo Wallflex y 3 prótesis autoexpandibles metálicas cubiertas tipo Niti-S. Conclusiones: En nuestra experiencia, la inserción endoscópica de prótesis metálicas autoexpandibles es un método con pocas complicaciones y eficaz en el tratamiento paliativo de la obstrucción tumoral del vaciamiento gástrico.
Effects of norepinephine, calcium, and rate of discharge on 42K movements in canine cardiac Purkinje fibers.
Authors: E Musso, M Vassalle
Journal: Circulation Research (1978)

We studied the effect of norepinephrine, calcium concentration, and rate of discharge in the presence of different [Ca2+]0 on radioactive potassium movements in cardiac Purkinje fibers. The following results were obtained: (1) norepinephrine increases potassium uptake in quiescent fibers and in fibers driven at constant rate, but more in the latter; (2) norepinephrine also increases potassium uptake in quiescent fibers depolarized at the plateau; (3) increasing [Ca2+]0 increases potassium uptake in fibers driven at constant rate; (4) increasing [Ca2+]0 may decrease K+ uptake in quiescent fibers; (5) increasing [Ca2+]0 decreases the rate of loss of tissue radioactivity in quiescent fibers and increases it in a driven fiber; (6) increasing the driving rate increases potassium uptake in low and high [Ca2+]0; (7) high [Ca2+]0 increases K+ uptake, especially at low rates; (8) norepinephrine is less effective in increasing K+ uptake in the presence of a high [Ca2+]0. We conclude that: (a) norepinephrine increases potassium uptake by different mechanisms; (b) calcium affects potassium movements when it is allowed to enter the cell, presumably by affecting potassium conductance; (c) the effect of an increased rate of discharge on K+ uptake may involve stimulation of active K+ uptake and may include a calcium-dependent component which is largest at high [Ca2+]0 and a slow rate of drive; (d) simultaneous application of two interventions results in a summation that is smallest when one of the mechanisms is already substantially activated.
PMO-014 An innovative model for improving access to and uptake of testing and treatment for patients with chronic hepatitis C in the substance misuse community
Authors: A Evans, D Linzey, J Booth
Journal: Gut (2012)

<h3>Introduction</h3> There is a poor level of uptake of HCV/HIV testing in the UK particularly in the substance misuse community.<sup>1</sup> This patient group employ a non-health centric paradigm with poor attendance to standard hospital outpatient appointments and engagement in health professional orientated screening programmes. Traditional testing requires venous access which can be difficult psychologically and practically in this group due to previous/ongoing IVDU. In addition the delay of up to 1 week for results has limited the success of improving access to services and subsequent follow-up for this patient group. <h3>Methods</h3> New testing technology employing mouth swab testing with results available within 30 min were developed (OraQuick HIV/HCV testing kits, OraSure Technologies). Key workers from substance misuse agencies were selected and trained in blood-borne virus awareness, consent, harm minimisation and in the use of the point of care testing for HIV/HCV. These “Champions” who have daily contact with the substance misuse community offered screening for HCV/HIV. This model differed from previous attempts to engage this community in that it was not dependent on trained health care professionals for accessing and testing this community. Supervision of all “Champions” was shared between the DAAT manager, BBV nurse consultant and the relevant service managers. <h3>Results</h3> In this pilot study 4 Champions tested 200 service users in comparison to 80 in the previous year using a non-Champion nurse based structure. Of the 200 patients screened, 32 were reactive for HCV infection. Of these 28 were HCV-PCR positive. 7/28 (25%) are currently undergoing a course of standard treatment. 19/28 (67.8%) are engaged in alcohol reduction or drug rehabilitation with a view to future treatment for HCV. 1/28 (3.6%) has moved out of area and only 1/28 (3.6%) was lost to follow-up. <h3>Conclusion</h3> This innovative model has significantly improved access to testing and treatment for patients with HCV in the substance misuse community. Training selected key workers as champions allowed them to facilitate access to services for patients with substance misuse. Local Commissioners have further extended the scope of this project to allow training of six “champions” in the Asian community to improve access to testing and treatment for HCV in this community with a high prevalence of HCV. <h3>Competing interests</h3> None declared. <h3>Reference</h3> 1. <b>Swan D</b>, <i>et al.</i> Barriers to and facilitators of hepatitis C testing, management and treatment among current and former injecting drug users: a qualitative exploration. <i>AIDS Patient Care STDS</i> 2010;<b>24</b>:753–62.
Fatal Cardiovascular and Respiratory Failure Associated with Tracheotomy
Authors: Nicholas M. Greene
Journal: New England Journal of Medicine (1959)

THE performance of a tracheotomy is an established and valuable adjunct in the management of patients with inadequate pulmonary ventilation. Tracheotomies performed either prophylactically or therapeutically have repeatedly proved life saving in the correction of respiratory-tract obstructions due either to tracheal secretions or to soft-tissue obstructions of the upper airway. They have also proved of value as a means of decreasing ventilatory dead space in patients with inadequate tidal volumes. Despite these advantages of tracheotomy, the procedure carries a certain, although relatively slight, risk owing to complications that may be associated with the surgical procedure itself. The most frequently mentioned . . .
Resources for emergency laparotomy vary widely across England and Wales
Authors: J. Wise
Journal: BMJ (2014)

A fifth of hospitals in England and Wales do not have a fully staffed operating theatre in which emergency abdominal surgery can be performed at all times, the first National Emergency Laparotomy Audit has shown.1

The Healthcare Quality Improvement Partnership commissioned the clinical audit, which investigated the structures and processes in place for emergency abdominal surgery at 190 hospitals in England and Wales. Patient level data are due to …
Incidental diagnosis of mesh plug migration
Authors: A. Garioud, X. Amiot
Journal: Endoscopy (2013)

A 59-year old patient was referred in April 2012 for a routine colonoscopy 3 years after undergoing polyp ablation. His past medical history was significant for periumbilical mesh herniorrhaphy in 2010. The patient was asymptomatic at admission. The physical examination and laboratory findings were normal. During colonoscopy, a mass-like compression of the cecum with a mesh pattern of colonic mucosa was observed ([Fig. 1]). Incomplete migration of surgical mesh embedded in the colonic mucosa was diagnosed. There was no ulceration of mucosa, no protrusion of mesh into the colonic lumen, and no inflammation. Because the patient was asymptomatic, conservative management was decided. The patient was informed of the possible outcomes of complete migration and bowel perforation.
FRI0525 Poly(ADP-RIBOSE) Polymerase-1 (PARP-1) Suppresses the Profibrotic Effects of Transforming Growth Factor-β in Systemic Sclerosis
Authors: Y. Zhang, K. Palumbo-Zerr, C. Beyer, P. Zerr, R. Liang, C. Dees, O. Distler, G. Schett, J.H.W. Distler
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> The enzyme poly(ADP-ribose) polymerase-1 (PARP-1) transfers negatively charged ADP-ribose units from the donor β-NAD onto various substrate proteins either as mono- or oligomeric moieties or as linear or branched poly(ADP-ribose) (PAR) chains. Those modifications can have pronounced regulatory effects on the half-life or the enzymatic activity of target proteins. Recent studies demonstrated that PARP-1 can poly(ADP-ribosyl)ates (PARylates) members of the Smad family of transcription factors. However, the role of PARP1 in the pathogenesis of SSc has not been investigated. <h3>Objectives</h3> The aim of the study was to characterize the effects of PARP1 on TGFβ signaling and to evaluate its role in the pathologic activation of fibroblasts in SSc. <h3>Methods</h3> The expression of PARP1 in human skin and in experimental fibrosis was determined by qPCR and immunohistochemistry. TGFβ signalling was analysed by Smad reporter assays and target gene analysis after 1mM selective PARP1 inhibitor 3-Aminobenzamide (3AB). Bleomycin-induced skin fibrosis and Tsk-1 mice were used to evaluate the effect of PARP inhibition (10mg/kg/d 3AB) <i>in vivo</i>. <h3>Results</h3> Decreased expression of PARP1 was detected by immunohistochemistry in skin sections of SSc patients, particularly in fibroblasts. Inhibition of PARylation by 3AB augmented the stimulatory effects of TGFβ on fibroblasts <i>in vitro</i>. PARP1 inhibition increased Smad dependent transcription in reporter assays and promoted the transcription of TGFβ/Smad target genes. Treatment with 3AB also stimulated the collagen release and fostered the expression of contractile proteins with increased expression of α-smooth muscle actin (α-SMA) and enhanced formation of stress fiber formation compared to fibroblasts stimulated with TGFβ alone. Inhibition of PARylation also exacerbated experimental fibrosis <i>in vivo</i>. Treatment with 3AB induced a more severe fibrotic response to bleomycin with increased dermal thickening by up to 103% (p&lt;0.0001), hydroxyproline contents and myofibroblast counts compared to control mice (p&lt;0.0001 and p=0.0059). Inhibition of PARylation also strongly exacerbated fibrosis in Tsk-1 mice. Meanwhile, after bleomycin-injection, dermal thickening, hydroxyproline contents and myofibroblast counts of PARP1 knockout mice are increased by 85% (p=0.0046), 67% (p=0.0098) and 56% (p=0.0043) compared to wild-type mice. <h3>Conclusions</h3> We demonstrate that PARP1 negative regulates canonical TGFβ signalling. The down-regulation of PARP1 in SSc fibroblasts may thus directly contribute to hyperactive TGFβ signalling and to persistent fibroblast activation in SSc. <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.2771
A Case of Postictal Cortical Blindness Detected by Brain Perfusion SPECT
Authors: HITOYA OHTA, HIDEHIKO YAMAMOTO, NORIYUKI KOJIMA, GIRO TODO, MASAHIKO NII
Journal: Clinical Nuclear Medicine (2001)

OHTA, HITOYA M.D.; YAMAMOTO, HIDEHIKO M.D.; KOJIMA, NORIYUKI M.D.; TODO, GIRO M.D.; NII, MASAHIKO M.D. Author Information
1222 IN VITRO RESISTANCE TO ALS-2200, A POTENT NUCLEOTIDE POLYMERASE INHIBITOR FOR THE TREATMENT OF CHRONIC HEPATITIS C
Authors: H. Tan, A. Jekle, H. Kang, C. Moy, J. Deval, A. Tigges, E. Zhang, M. Jiang, A. Andzinski, N. Dyatkina, G. Wang, R. Rijnbrand, T.L. Kieffer, L.M. Blatt, L. Beigelman, D.B. Smith, J.A. Symons
Journal: Journal of Hepatology (2013)
AB0075 The endogenous angiostatic mediators endostatin and thrombospondin-1 are increased in psoriatic arthritis
Authors: A. Delle Sedie, I. Puxeddu, M. Tronchetti, P. Migliorini, S. Bombardieri, L. Riente
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Psoriatic arthritis (PsA) is an inflammatory joint disease associated with psoriasis, classified within the familyof spondyloarthropathies. The events underlying the pathogenesis of PsA have not yet been fully elucidated. It is known that angiogenesis is an early event in the joint inflammation during PsA, resulting in cartilage degradation and bone destruction. Previous studies have demonstrated an increase of circulating pro-angiogenic mediators, including vascular endothelial growth factor (VEGF) in PsA. The role of endogenous inhibitors of angiogenesis in PsA is unknown. <h3>Objectives</h3> The aim of our study is to investigate the potential involvement of Endostatin (ES) and Thrombospondin-1 (TSP-1), extracellular matrix (ECM) fragments with anti-angiogenic activity, in patients with PsA. <h3>Methods</h3> Fifty four adult patients with PsA were studied. The diagnosis of PsA was established according to the CASPAR criteria. Endostatin (ES) and Thrombospondin-1 (TSP-1) were measured, by enzyme immunoassays, in the sera of these patients and of 52 patients with Rheumatoid Arthritis (RA), diagnosed according to the 2010 ACR-EULAR classification criteria, and of 39 healthy subjects. <h3>Results</h3> The serum level of ES resulted significantly higher in the PsA group than in the control subjects (P&lt;0.0001), similarly to that detected in RA. Parallel to ES, TSP-1 levels were significantly higher in PsA (P&lt;0.0001) compared to the controls and significantly higher than RA (P=0.0003). <h3>Conclusions</h3> The observed increase of ECM fragments with anti-angiogenic properties suggests a reduction of pro-angiogenic activity in PsA. It is possible that this reduction is due to underlying treatments. <h3>Disclosure of Interest</h3> None Declared
Simultaneous Whole-Body Time-of-Flight 18F-FDG PET/MRI
Authors: Andrei Iagaru, Erik Mittra, Ryogo Minamimoto, Mehran Jamali, Craig Levin, Andrew Quon, Garry Gold, Robert Herfkens, Shreyas Vasanawala, Sanjiv Sam Gambhir, Greg Zaharchuk
Journal: Clinical Nuclear Medicine (2014)

The recent introduction of hybrid PET/MRI scanners in clinical practice has shown promising initial results for several clinical scenarios. However, the first generation of combined PET/MRI lacks time-of-flight (TOF) technology. Here we report the results of the first patients to be scanned on a completely novel fully integrated PET/MRI scanner with TOF.We analyzed data from patients who underwent a clinically indicated F FDG PET/CT, followed by PET/MRI. Maximum standardized uptake values (SUVmax) were measured from F FDG PET/MRI and F FDG PET/CT for lesions, cerebellum, salivary glands, lungs, aortic arch, liver, spleen, skeletal muscle, and fat. Two experienced radiologists independently reviewed the MR data for image quality.Thirty-six patients (19 men, 17 women, mean [±standard deviation] age of 61 ± 14 years [range: 27-86 years]) with a total of 69 discrete lesions met the inclusion criteria. PET/CT images were acquired at a mean (±standard deviation) of 74 ± 14 minutes (range: 49-100 minutes) after injection of 10 ± 1 mCi (range: 8-12 mCi) of F FDG. PET/MRI scans started at 161 ± 29 minutes (range: 117 - 286 minutes) after the F FDG injection. All lesions identified on PET from PET/CT were also seen on PET from PET/MRI. The mean SUVmax values were higher from PET/MRI than PET/CT for all lesions. No degradation of MR image quality was observed.The data obtained so far using this investigational PET/MR system have shown that the TOF PET system is capable of excellent performance during simultaneous PET/MR with routine pulse sequences. MR imaging was not compromised. Comparison of the PET images from PET/CT and PET/MRI show no loss of image quality for the latter. These results support further investigation of this novel fully integrated TOF PET/MRI instrument.
Abstract LB-316: Association of Bcl2 family gene polymorphisms with response to and toxicity of platinum-based chemotherapy in non-small-cell lung cancer patients in a Chinese population
Authors: Ji Qian, Qi Han Wu, Da Ru Lu, Qing Yi Wei
Journal: Cancer Research (2011)

Abstract PURPOSE: The Bcl2 family members have dual functions in apoptosis. Platinum agents cause genetic lesions and cell death that may be modulated by the normal pathway of apoptosis regulated by the Bcl2 family genes. We hypothesized that genetic polymorphisms of these genes have an impact on the outcome of platinum-based chemotherapy. The aim of our research was to assess whether single nucleotide polymorphism (SNPs) of BAD, BAX, PUMA, BID, and BCL2 in a pathway of regulating apoptosis affect the response to and toxicity in patients with NSCLC treated with platinum-based chemotherapy. METHODS AND METERIALS: We genotyped 64 SNPS of 5 genes by Illumina Custom Designed Chip in 1004 patients with advanced NSCLC treated with platinum-based chemotherapy. We investigated the response and the toxicity of patients after platinum-based chemotherapy. The genotyping data were analyzed by the Sofeware of SPSS12.0, PHASE2.1 and Haploview. RESULTES: A SNP of BID (rs5746474) was significantly associated with the hematological toxicity. Compared with the wild-type GG genotype, the variant AA genotype was associated with significantly increased risk to hematological toxicity (adjusted OR: 2.4344, 95%CI=1.4084–4.2077, p=0.0014) in a recessive model (adjusted OR: 2.5241, 95% CI = 1.4839–4.2933, P=0.0006). In the allelic analysis, a SNP of BCL2 (rs8099575) showed an effect on gastrointestinal toxicity (adjusted OR: 0.3041, 95% CI=0.1524–0.6.68, P=0.0007). Several haplotypes of these genes were associated with the response and toxicity; however, after Bonfernoni correction, no association between haplotypes and clinical outcome remained. CONCLUSION: Genetic polymorphisms in the BID and BCL2 genes may have an impact on the response to and toxicity of platinum-based chemotherapy in patients with NSCLC, which may be prognostic biomarkers of chemotherapy in NSCLC patients, if validated in larger studies. 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 LB-316. doi:10.1158/1538-7445.AM2011-LB-316
1011 ACUTE KIDNEY INJURY REQUIRING RENAL REPLACEMENT THERAPY IN PATIENTS WITH ACUTE LIVER FAILURE – IMPACT ON MORTALITY
Authors: K. Staufer, A. Zubkova, K. Roedl, A. Drolz, T. Horvatits, C. Zauner, M. Oppert, M. Trauner, V. Fuhrmann
Journal: Journal of Hepatology (2013)
Substance Use Disorders
Authors: Christine A. Pace, Jeffrey H. Samet
Journal: Annals of Internal Medicine (2016)

This issue provides a clinical overview of substance use disorders, focusing on epidemiology, prevention, diagnosis, complications, and management. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of additional science writers and physician writers.
THU0013 Interaction between two common HLA antigens defines a subset of individuals at a very high risk for ankylosing spondylitis
Authors: F. van Gaalen, W. Verduyn, D. Roelen, S. Böhringer, T. Huizinga, D. van der Heijde, R. Toes
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Susceptibility to spondyloarthritis (SpA) is largely genetically determined. To understand increasingly complex genetic associations, one can look for interaction between genetic risk factors. <h3>Objectives</h3> In this study, we investigated interaction between common HLA class I risk antigens in ankylosing spondylitis (AS) the most typical form of SpA. <h3>Methods</h3> In 155 patients with AS and 5584 controls, common HLA class I antigens were analyzed for association with AS. Biologic interaction was analyzed by investigating whether the effects of the risk factors combined departed from additivity. <h3>Results</h3> Apart from an association with HLA-B27, we found an association between HLA-B60 and AS (OR 2,0; 95%CI 1.3-2.9; p&lt;0.001). This was confirmed in meta-analysis of published studies (OR 2.3; CI 1.8 – 2.8). While 21.3% of AS patients had both HLA-B27 and HLA-B60, this combination was found in only 0.4% of controls. With HLA-B27-/HLA-B60- AS patients as the reference, the relative risk (RR) for HLA-B27-/HLA-B60+ patients was 2.3 (CI 0.9-5.8). For HLA-B27+/HLA-B60- the RR was 66 (CI 40-111) but increased to 342 (CI 167- 703) in HLA-B27+/HLA-B60+ patients. For the interaction, the relative excess risk (RERI) was 310 (95% CI 130-490), the attributable proportion (AP) was 0.8 (CI 0.7-0.9), and the synergy index (S) 5.7 (CI 3.8 -8.5). The interaction was confirmed in an independent cohort. <h3>Conclusions</h3> We report a strong interaction between HLA-B60 and HLA-B27 in AS susceptibility. As a result, individuals with the HLA-B27+/HLA-B60+ genotype are at a very high risk of developing AS. <h3>Disclosure of Interest</h3> None Declared