tbuckley/cabot-search huggingface dataset:
Clinical and demographic characteristics and resource utilization in patients newly diagnosed with neuroendocrine tumors (NET).
Authors: J. M. Quigley, G. P. Hess, C. Chen, J. W. Hill, Z. Liu, J. C. Yao
Journal: Journal of Clinical Oncology (2010)

e16552 Background: NETs are malignant neoplasms capable of systemic hormone production. This retrospective study analyzed patient's baseline clinical and demographic characteristics, as well as resource utilization in the three years' post first NET diagnosis. Methods: Qualifying patients were adults newly diagnosed with NET having greater than or equal to one claim with one or more of the following ICD-9-CM codes: 157.4 (islet cell,), 209.xx (carcinoid), 258.01 (MEN1), or 259.2 (carcinoid syndrome) during 10/1/01-9/30/06, and with ≥ 3 years follow-up in SDI Health'smedical claims. Patient's clinical and demographic characteristics were measured at baseline, and utilization of office visits, hospital, and emergency rooms were captured in the three years post-initial diagnosis. Results: Of the 1,330 newly diagnosed NET patients the median age was sixty, 60% were female, and 43.5% were identified by an oncologist. The most common baseline comorbidities were hypertension (25.3%), abdominal pain (18.9%), lipid disorder (16.3%), diabetes (12.0%) and depression (2.7%). During follow-up 16.2% of patients experienced major cardiovascular events (including CHF, CAD, or MI). On average, patients had ≈ 14 office visits per year for the diagnosis or treatment of NET, CV events and other comorbid or concomitant conditions. These patients averaged 1.8 hospital encounters per year (in-patient or ER). Conclusions: The observed clinical and demographic patient characteristics with this tumor type are relatively common, and nonspecific which may contribute to the diagnostic challenge and delayed diagnosis of these relatively infrequent tumors. Treatments and interventions that can help reduce CV and other major complications can potentially ease the NET burden of illness and benefit patients. Future research on additional demographic characteristics, and other comorbid and concomitant conditions can further advance our understanding of neuroendocrine tumors. Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Novartis Ipsen, Novartis Novartis Ipsen, Novartis Novartis
O5.07 * THE IMPACT OF NEURONAVIGATION AND INTRAOPERATIVE HIGH-FIELD MRI ON SURGERY OF GANGLIOGLIOMAS IN PATIENTS WITH DRUG RESISTANT EPILEPSY
Authors: K. Roessler, B. Sommer, C. Wimmer, H. M. Hamer, I. Blumcke, M. Buchfelder
Journal: Neuro-Oncology (2014)

OBJECTIVE: Gangliogliomas (GG) are among the most common lesions causing medically refractory epilepsy. Incomplete resection or early recurrences are common in patients with eloquent located tumours resulting in persistent epilepsy. Neuronavigation combined with intraoperative high-field MR imaging (iopMRI) may improve complete resection even in eloquent located tumours and contribute to a better surgical and seizure outcome. METHODS: We retrospectively identified fifty-two patients (25 female, 27 male, mean age 31.7 ± 14.8 years) with gangliogliomas and lesional epilepsy operated at our clinic. Forty-one (78.8%) were located in the temporal lobe, 11 (21.2%) extratemporally. Additionally to neuronavigation and intraoperative 1.5-Tesla MR imaging, we implemented DTI tractography (visual-, speech- and pyramidal tracts) in 15 and functional MRI (Wernickes area, motor cortex) in 10 patients. Tailored resections were performed in 12 patients using intraoperative electrocorticography (ECoG). RESULTS: The registration accuracy of neuronavigation was 1.5 ± 0.7 mm. The first MRI scan before closing revealed complete resection of the lesion in only 31 of 52 patients (59.6%). Consequently, remnant tumour was identified in 21 patients. After re-segmentation of the residual tumour and update of neuronavigation, total resection rate was improved by 12 patients to 43/52 (82.7%). The remaining patients had subtotal resections due to the vicinity to eloquent brain areas. Follow-up was available for 37 patients to date, who showed excellent seizure control with 31/37 (83.8%) patients having an Engel Class 1 outcome (Engel 1A in 28/37 or 75.7% of all patients) after a mean time period of 60 ± 44 months. Four out of six patients with a permanent neurological deficit presented with short and long term memory decline (7.7%), two had visual field deficits (3.8%). CONCLUSION: Neuronavigation and intraoperative MR imaging increased complete resections in our series of ganglioglioma patients with medically refractory epilepsy by 20%, leading to an excellent seizure control and a low complication rate.
ESTUDIO PROSPECTIVO DE CALIDAD Y COMPLICACIONES EN ENDOSCOPIA "AVANZADA", COLANGIOPANCREATOGRAFIA RETROGRADA ENDOSCOPICA (CPRE) Y ULTRASONOGRAFIA ENDOSCÓPICA (USE)
Authors: C Marra-López, C Enciso, M Salvador, C Sanchez, C Valero, C Arias, JM López-Barbarin, M Marcaide, K Spicakova, L Urtasun Arlegui, F García Campos
Journal: Endoscopy (2013)

Introducción: Las técnicas “avanzadas” Colangiopancreatografía-retrógrada endoscópica (CPRE) y Ultrasonografía endoscópica (USE), son exploraciones que deben cumplir los mejores estándares de calidad. Existen guías de diferentes sociedades científicas con indicadores de calidad para ayudar a reconocer las exploraciones de más alta calidad, pero no se han evaluado de manera prospectiva en España. Objetivo: Evaluación de la calidad de pruebas de endoscopia avanzada (CPRE y USE). Material y Método: Estudio de cohortes prospectivo aprobado por CEIC, incluyendo a todos los pacientes remitidos a nuestro hospital para realizar CPRE y USE. Previamente se obtuvo consentimiento informado y se realizó valoración anestésica. Durante la exploración realizamos monitorización de signos vitales, recogida de datos endoscópicos y anestésicos. Seguimiento con entrevista a las 24h y 30 días. Análisis de indicadores de calidad adaptados*: comunes (proceso y sedación) y específicos para cada técnica (preprocedimiento, intraprocedimiento, postprocedimiento y complicaciones). Resultados: Entre 1/3/2012 y 1/3/2013 se realizaron 302 pruebas (168 USE y 134 CPRE). El 85,76% de los pacientes participó en el seguimiento. Indicaciones revisadas adecuadas en 99,3%. Consentimiento informado previo exploración presente en 91,1% vs. sedación en 95,2%. Asesoramiento del grado de dificultad ASGE (CPRE/USE): 1(= estandar) 78.3%/59.5%, 2(= avanzado) 15.5%/35.6%, 3(= terciario) 6,2%/4,3% de los casos. Profilaxis antibiótica correcta en 100% pacientes. La efectividad global (CPRE+USE), éxito diagnóstico fue del 91,8%. Ver tabla* Complicaciones sedación: Tasa eventos cardiovasculares 18,5% (6,5% requirió tratamiento), Tasa complicaciones respiratorias 22% (7,3% requirió tratamiento).* En conjunto, tasa de complicaciones endoscópicas: hemorragia leve en 5%, moderada en 1,17%, pancreatitis 1,95%, colangitis 3,9% y 3 casos de perforación*. No hubo mortalidad relacionada. Documentación e informe final correctos en 100% de los pacientes.
Pin-Hole Collimator, Parallax, and the Localization of Mediastinal Parathyroid Adenoma
Authors: ROXANA MAVAI, VICENTE J. CARIDE
Journal: Clinical Nuclear Medicine (1996)

A parathyroid adenoma was wrongly localized by pinhole Tc-99m sestamibi scintigraphy to the anterior mediastinum near a lower pole of the thyroid gland. After a failed surgical attempt to resect the adenoma, the patient was re-imaged with a parallel-hole collimator and SPECT. The adenoma was found to be near the heart, anterior to the carina. The pinhole findings were replicated using a phantom and measurements obtained from a CT of the chest. By placing the pinhole collimator at the sternal notch level, the lesion was correctly located deep in the chest. Moving the pinhole collimator cephalad or tilting the collimator toward the feet, maneuvers sometimes needed to clear the chest in large patients, projected the lesion closer to the sternal notch. Scintigraphy with a parallel-hole collimator is recommended and SPECT should be considered when the lesion is located below the sternal notch and when a lesion is not detected, despite the clinical and biochemical diagnosis of hyperparathyroidism.
Endoscopic ultrasonography in diagnosis and therapy of submucosal tumors in upper gastrointestinal tract
Authors: Xin Xu, Bangmao Wang, Yixiang Chang, Qingxiang Yu, Wentian Liu
Journal: Endoscopy (2011)

The tool of first choice for examining SMTs in the upper GI tract is endoscopic ultrasonography (EUS). It is the most accurate procedure for detecting and diagnosing SMTs, due to its high sensitivity and specificity. EUS combined with endoluminal resection techniques is increasingly used to provide a definitive diagnosis of submucosal tumors.
AB0574 Prevalence of hla-drb1 in psoriatic arthritis, psoriasis and rheumatoid arthritis: comparison with healthy controls.
Authors: C. Bejerano, E. A. Blanco, J. Pinto-Tasende, S. Pértega, I. Rego, N. Oreiro, A. Lois, J. De Toro, F. J. Blanco, J. L. Fernández-Sueiro
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Major Histocompatibility Complex (HLA) has shown consistent linkage with Psoriasis, Rheumatoid Arthritis (RA) and psoriatic arthritis (PsA) in multiple studies. The complex patterns of inheritance suggest that multiple alleles of different genes HLA are required for susceptibility to these diseases. <h3>Objectives</h3> To study the frequency of HLA-DRB1 genes (including shared epitope, SE) in psoriasis, PsA and RA compared with healthy controls. <h3>Methods</h3> HLA-DRB1 genotyping was performed by PCR-SSP (Sequence Specific Primer) in DNA samples from 625 Caucasian subjects in Northwest Spain. Frequencies of HLA-DRB1 alleles were determined in patients with psoriasis (n = 115), PsA (n = 163), RA (n = 170) and were compared with those of healthy controls (n = 177). The odds ratio (OR) was performed to analyzed association between alleles and disease. We compared differences between individual carriers and non-carriers of the alleles by using Chi-square and Fisher’s exact tests. Statistical significance was p &lt; 0, 05. <h3>Results</h3> With respect to healthy control there was no significant differences in the prevalence of HLA-DRB1 * 10 and * 14. HLA-DRB1 * 02, * 05 and * 06 were more frequent in controls (p &lt;0.0001). HLA-DRB1 * 03 was less frequent in psoriasis and PsA (Table 1). HLA-DRB1 * 07 was less frequent in RA. HLA-DRB1 * 13 and HLA-DRB1 * 17 were more common in psoriasis and PsA. HLA-DRB1 * 15 was more common in psoriasis and RA. Shared epitope (SE) alleles HLA-DRB1 * 0101 and *0401 were more frequent in RA and * 0102 in RA and Psoriasis. <h3>Conclusions: Conclusions</h3> In our study, Psoriasis and PsA are associated with HLA-DRB1 * 13 and * 17. Presence of HLA-DRB1 * 03 is associated with lower risk of psoriasis and PsA. HLA-DRB1 * 07 isassociated with lower risk of RA. Finally, SE alleles 0101, * 0102 and * 0401 are not significantly associated with psoriatic arthritis. <h3>Acknowledgements</h3> The authors thank José Luis Fernández-Sueiro for him hard work and dedication. Rest in peace. <h3>Disclosure of Interest</h3> None Declared
P127 Does it matter how they breathe?--Perceptions in COPD patients when adopting different routes of breathing
Authors: A. J. Williams, A. Pitcher, P. Thomas, R. Baker
Journal: Thorax (2010)

<h3>Introduction</h3> We have reported that normal subjects prefer nasal breathing (NB) and that the adoption of mouth breathing (MB) is associated with uncomfortable sensations including breathlessness.1 MB may predispose to the perception of breathlessness by dynamically changing chest wall mechanics (CWM), and thus proprioceptive input. This study has been extended to COPD patients in whom airways resistance and dynamic hyperinflation is likely to alter CWM. <h3>Method</h3> 20 COPD patients, mean age 71 years (range 47–89), FEV<sub>1</sub> mean 0.8 l (range 0.4–2.02 l), whilst at rest (tidal breathing), undertook a 2×2 min cross over exercise during which subjects were requested to note their perceptual experiences when randomly allocated to either NB or, after a break, MB. The results have been compared to the individuals preferred route of breathing normally and 20 normal subjects (controls).1 <h3>Results</h3> 10/20 (50%) of COPD patients during NB found the exercise to be uncomfortable compared to only 3/20 (15%) controls (p=0.04). 9/20 (45%) witnessed discomfort with breathing/breathlessness, 0/20 dry mouth and 2/20 (5%) a desire to cough. 13/20 (65%) of COPD patients during MB found the exercise to be uncomfortable compared to 10/20 (50%) controls (p=0.52). 8/20 (40%) COPD patients witnessed discomfort with breathing/breathlessness, and dry mouth 6/20 (30%). 6/20 (30%) COPD patients preferred NB, 7/20 (35%) had no preference and 7/20 (35%) preferred MB during normal breathing in usual life. This compares to 13/20 (65%), 4/20 (20%) and 3/20 (15%) respectively for controls. 9/20 (45%) COPD patients had a positive Nijmegen score (&gt;23) (compared to 0/20 controls) and Hospital Anxiety Depression (HAD) scores were greater in COPD (p&lt;0.001). Depression in COPD patients was strongly associated with a preference for MB normally (r=0.6, p=0.007). <h3>Conclusions</h3> This study has shown that COPD patients, in contrast to controls, have adopted a shift in breathing preferences to favour MB. High scores for Nijmegen and HAD in COPD suggest ventilatory dysfunction with depression closely linked to MB. We hypothesise that MB in COPD patients is intricately linked to high levels of ventilatory dysfunction and depression.
1227 INHIBITION OF VASCULAR ENDOTHELIAL GROWTH FACTOR RECEPTOR 2 (VEGFR2) ATTENUATES STEATOSIS AND INFLAMMATION IN A DIET-INDUCED MOUSE MODEL FOR NON-ALCOHOLIC STEATOHEPATITIS (NASH)
Authors: S. Coulon, F. Heindryckx, I. Colle, C. Van Steenkiste, L. Libbrecht, B. Jonckx, J.-M. Stassen, N. Lanthier, I. Leclercq, H. Van Vlierberghe, A. Geerts
Journal: Journal of Hepatology (2012)
Colovesical Fistula Demonstrated on Renal Cortical Scintigraphy
Authors: Maria Stathaki, Lampros Vamvakas, Emmanouela Papadaki, Elisavet Papadimitraki, Angeliki Tsaroucha, Nikolaos Karkavitsas
Journal: Clinical Nuclear Medicine (2012)

A 70-year-old man with a history of weight loss, changes in bowel habits, and hematochezia had rectal adenocarcinoma. He was palliated with diverting colostomy, followed by radiochemotherapy. Bilateral hydronephrosis was found incidentally on lower abdominal CT scan. He underwent 99mTc dimercaptosuccinic acid scan prior to percutaneous nephrostomy tube placement. Apart from the renal cortex, scintigraphy showed activity in the ascending colon continuous to the activity of the bladder. This indicated urine extravasation on account of a colovesical fistula, complicating postoperative radiation treatment. Here we highlight the contribution of renal cortical scintigraphy in the detection of colovesical fistulas.
Gynecomastia Induced by Prostate-Cancer Treatment
Authors: Nikolaos V Michalopoulos, Mohammed R Keshtgar
Journal: New England Journal of Medicine (2012)

A 60-year-old man presented to the breast clinic with gynecomastia. A high-grade, advanced prostate cancer had been diagnosed 4 years earlier, and the patient was treated with radiotherapy and adjuvant hormonal therapy.
Abstract 3812: Target identification in rhabdomyosarcomas induced in mouse skeletal muscle.
Authors: Simone Hettmer, Anna Schinzel, William C. Hahn, Amy Wagers
Journal: Cancer Research (2013)

Abstract Soft-tissue sarcomas are a group of cancers arising in non-hematopoietic, mesodermal tissues. Rhabdomyosarcoma (RMS), the most common soft-tissue sarcoma in children and adolescents, represents a biologically heterogeneous category of mesodermal, non-hematopoietic malignancies, which exhibit evidence of skeletal muscle differentiation. This study builds on the premise that ex-vivo induction of sarcomas by cell-specific activation of sarcoma-relevant pathways can be used to model biologically distinct sarcoma categories in mice and identify novel downstream targets. Up to 35% of human RMS tumors carry Ras mutations, and we have demonstrated Ras/ Raf/ Mek/ Erk pathway activation in approximately 50% of human RMS tumors surveyed. We showed that Kras-expressing; p16p19null muscle satellite cells gave rise to mouse pleomorphic RMS, whereas Kras-expressing; p16p19null non-myogenic progenitors typically induced pleomorphic non-myogenic sarcomas (NMS). Transcriptional profiling demonstrated that myogenic and non-myogenic Kras; p16p19null sarcomas recapitulate gene expression signatures of human RMS and share a cluster of concordantly upregulated genes (many associated with Ras pathway activation) with human RMS. We used a customized RT² Profiler™ PCR Array (SA Biosciences) to confirm that 105 out of these 141 candidate genes were indeed upregulated in Kras;16p19null sarcomas compared to mouse skeletal muscle. The functional contributions of individual candidate genes to sarcoma proliferation were evaluated using a customized shRNA-based proliferation screen in cell lines established from Kras; p16p19null sarcoma explants. These comprehensive experiments identified a small group of high-priority candidates that contributed significantly to the growth of Kras; p16p19null NMS (n=11 genes) and RMS (n=10 genes) (q&amp;lt;0.05). The effects of shRNA mediated silencing of selected candidate genes in human sarcoma cells were verified using human sarcoma cell lines. We conclude that these genes have potential broad importance in sarcoma biology and anti-sarcoma therapy. Future studies will help to illuminate their roles in promoting RMS growth and may suggest new approaches for therapeutic intervention. Citation Format: Simone Hettmer, Anna Schinzel, William C. Hahn, Amy Wagers. Target identification in rhabdomyosarcomas induced in mouse skeletal muscle. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 3812. doi:10.1158/1538-7445.AM2013-3812
Radiographic Zebra Lines from Cyclical Pamidronate Therapy
Authors: Khaled M Sarraf
Journal: New England Journal of Medicine (2011)

A 6-year-old boy with type IV osteogenesis imperfecta presented to the ER with pain in the right leg after a fall. Plain radiographs revealed an undisplaced, transverse fracture of the right tibia. The images also revealed the presence of radiographic zebra lines.
Preoperative evaluation of ampullary neoplasm with endoscopic ultrasonography (EUS) and intraductal ultrasonography (IDUS) -A prospective study
Authors: K Ito, N Fujita, Y Noda, G Kobayashi, J Horaguchi, O Takasawa
Journal: Endoscopy (2006)

Background: Endoscopic papillectomy has been performed in selected patients with ampullary neoplasm, and accurate preoperative tumor staging for making management decisions is indispensable for its application. Patients and methods: Endoscopic ultrasonography (EUS) and transpapillary intraductal ultrasonography (IDUS) were performed in 34 patients with ampullary neoplasm before surgery (n=25) or endoscopic papillectomy (n=9). Ductal infiltration by the tumor into the bile duct (BD) or the pancreatic duct (PD) was also evaluated. Indication for endoscopic papillectomy was determined by findings obtained by EUS and IDUS. These findings were compared with histological features of the resected specimens. Twenty-eight patients had adenocarcinoma (pT1, 14; pT2, 7; pT3–4, 7) and six had adenoma. Results: Depiction of tumor by EUS and IDUS was achieved in 94% and 100% of the patients, respectively. The diagnostic accuracy of EUS and IDUS in T staging was 60% and 85% in adenoma and pT1, 29% and 57% in pT2, and 86% and 86% in pT3–4, respectively. Overall accuracy in T staging by EUS and IDUS was 69% and 79%, respectively. In nine patients who underwent endoscopic papillectomy, the accuracy of IDUS in T staging was superior to that of EUS (100% vs. 78%). Ductal infiltration into the BD and the PD was correctly assessed in 79% and 85% by EUS and in 88% and 91% by IDUS, respectively. Ductal infiltration was correctly diagnosed by IDUS in all papillectomy patients, while in 89% of the patients by EUS. Conclusions: IDUS was superior to EUS in terms of tumor staging and assessment of ductal infiltration in patients with ampullary neoplasm. Although estimation of duodenal involvement remains challenging, IDUS can provide useful information for making therapeutic decisions, especially in cases appropriate for endoscopic papillectomy.
SC-08 * TRANSCRIPTIONAL AND POST-TRANSLATIONAL REGULATIONS OF c-Myc IN GLIOBLASTOMA STEM CELLS
Authors: X. Fang, W. Zhou, Z. Huang, Q. Wu, J. Yu, J. Rich, S. Bao
Journal: Neuro-Oncology (2014)

Glioblastomas are highly lethal brain tumors containing glioma stem cells (GSCs) that display stem cell-like properties. The molecular link between stemness and malignancy in GSCs is not fully understood. c-Myc appears to be the dominant driver linking self-renewal to neoplasia, but how c-Myc is regulated in GSCs is not defined. We previously demonstrated that the zinc finger and X-linked transcription factor (ZFX) controls c-Myc expression to maintain GSC self-renewal and tumorigenic potential. Down-regulation of ZFX by shRNA reduced c-Myc expression and potently inhibited GSC self-renewal and tumor growth in vivo. Ectopic expression of c-Myc to its endogenous level rescued the phenotype caused by ZFX disruption, demonstrating that ZFX controls c-Myc expression to maintain GSC properties. Here we show a post-translational regulation of c-Myc by deubiquitylation in GSCs. Deubiquitylation of c-Myc in GSCs stabilizes c-Myc protein to promote the maintenance of the GSC phenotype. Blocking c-Myc deubiquitylation disrupted GSC self-renewal and tumorigenic potential. These data indicated that c-Myc is regulated at both transcriptional and post-translational levels in GSCs and c-Myc is a dominant driver linking self-renewal to malignancy.
Bone Scintigraphy in Recurrent Osteoid Osteoma of the Talus
Authors: DAVID GROSHAR, MICHAEL ALPERSON, AHARON LIBERSON
Journal: Clinical Nuclear Medicine (1996)

A 16-year-old boy with recurrent osteoid osteoma of the talus underwent a Tc-99m MDP bone scintigraphy to localize and monitor ablation of the lesion.
EVALUACIÓN DE LA EFICACIA TERAPÉUTICA ENDOSCÓPICA EN HEMORRAGIA DIGESTIVA SECUNDARIA A ANGIODISPLASIAS
Authors: J Arribas, C Zaera, RM Martin, JA González, JL Cuño, L Téllez, S López, A Cañete, D Boixeda, A Albillos
Journal: Endoscopy (2014)

Introducción: Las angiodisplasias gastrointestinales se definen como dilataciones vasculares que comunican capilares y venas en las paredes del tracto digestivo. La presentación clínica de estas lesiones varía desde sangrado oculto crónico a hemorragia gastrointestinal grave.
Up in the Air — Suspending Ethical Medical Practice
Authors: D Malcolm Shaner
Journal: New England Journal of Medicine (2010)

First I will define what I conceive medicine to be. In general terms, it is to do away with the sufferings of the sick, to lessen the violence of their diseases, and to refuse to treat those who are overmastered by their disease, realizing that in such cases medicine is powerless. — The Hippocratic CorpusOur plane was flying from the East Coast to the West carrying 167 passengers, including my wife, a hospitalist and internist, and me, a neurologist and clinical ethicist. About midflight, a woman in the row behind us reached frantically for the baggage bin over our . . .