tbuckley/cabot-search huggingface dataset:
AB0976 Do Ultrasound Color Histograms Show Better Musculoskeletal Changes?
Authors: J.A. Mendonça, C.V. Vierhout, N. Schincariol, F. Peron, L. Pedri, J.R. Provenza
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> Ultrasonography with high frequency linear array probe, besides allowing a better resolution in the GS scale (grey scale), is able to identify color images standards. This is the case of the RGB color images, which are formed through the information of additive primary colors, such as R - Red, G – Green and B - Blue, orange, indigo, magenta, blue and yellow, generating a histogram. The objective of color models is to allow color specification in a universally accepted standard format<sup>1</sup>. <h3>Objectives</h3> To detect synovitis (SYN) and calcifications (calcifs), through histograms, i.e., color image standards and to correlate the area measurement with the GS. <h3>Methods</h3> Ten patients have been assessed, 2 males and 8 females with average age 40.7 years; a total of 104 SYN and calcifs measurements in cm<sup>2</sup> were performed in the dorsal radiocarpal joint (dRC); triangular fibrocartilage complex (TFCC); dorsal metacarpal phalanx (MCP) and lateral and medial knee suprapatellar recesses. Four patients exhibited chondrocalcinosis, 5 patients osteoarthritis and one patient psoriatic arthritis. For each GS measurement, one measurement was performed for each color image standard, at different times and at random, in order not to see or remember prior measurement data. For the Spearman correlation analysis, the program <i>IBM SPSS Statistics</i> 19 was used. <h3>Results</h3> Average ± SD of the image standards: <i>RGB SYN</i> 16.96±0.25 cm<sup>2</sup>; <i>Indigo SYN</i> 6.43±0.07 cm<sup>2</sup>, <i>RGB calcif</i> 0.03±0.00 cm<sup>2</sup>; <i>Indigo calcif</i> 0.06±0.03 cm<sup>2</sup>; <i>GS SYN</i> 16.13±0.35 cm<sup>2</sup> and <i>GS calcif</i> 0.56±0.01 cm<sup>2</sup>. Correlation of the color images standards: <i>RGB</i> dRC SYN and <i>Indigo</i> dRC SYN: <i>r=1.0; p&lt;0, 001</i>. <i>Indigo</i> dRC SYN and <i>RGB</i> suprapatellar SYN: <i>r=1,0; p&lt;0, 001</i>. <i>RGB</i> MCP SYN and <i>Indigo</i> MCP SYN: <i>r=1,0; p&lt;0, 001</i>. <i>Indigo</i> dRC calcif and <i>RGB</i> TFCC calcif: <i>r=1.0; p&lt;0, 001</i>. The <i>RGB</i> and <i>Indigo</i> measurement standards when correlated with <i>GS</i> for SYN and calcifs were not statistically significant (p=0.333 to 0.667). <h3>Conclusions</h3> The color images standards of the mode-B function, represented by the histogram, assesses SYN and calcifs through the tones RGB, orange, indigo, magenta, blue and yellow. The standards <i>RGB</i> and <i>Indigo</i> seem to better set out these ecotextural damages, detected through the area measurements in cm<sup>2</sup>. However, future studies are required to further ground these ultrasonographic findings. <h3>References</h3> Marques Filho, O; Vieira Neto, H. Processamento Digital de Imagens, Rio de Janeiro: Brasport, 1999. ISBN 8574520098. <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.2977
Electrical Stimulation of the Subthalamic Nucleus in Advanced Parkinson's Disease
Authors: Patricia Limousin, Paul Krack, Pierre Pollak, Abdelhamid Benazzouz, Claire Ardouin, Dominique Hoffmann, Alim-Louis Benabid
Journal: New England Journal of Medicine (1998)

In many patients with idiopathic Parkinson's disease, treatment with levodopa is complicated by fluctuations between an "off" period (also referred to as "off medication"), when the medication is not working and the motor symptoms of parkinsonism are present, and an "on" period, when the medication is causing improved mobility (also referred to as "on medication"), often accompanied by debilitating dyskinesias. In animal models of Parkinson's disease, there is overactivity in the subthalamic nucleus, and electrical stimulation of the subthalamic nucleus improves parkinsonism. We therefore sought to determine the efficacy and safety of electrical stimulation of the subthalamic nucleus in patients with Parkinson's disease.
Radial Scar, a Retrospective Study of 202 Cases: Development of a Predictive Score to Assess Breast Carcinoma Association
Authors: S. Rikelman, A.E. Dugue, S. Giacchetti, A. De Roquancourt, F. Joly-Lobbedez, C. Levy, H. Crouet, J. Lebrun
Journal: Annals of Oncology (2014)
Services for patients with long term conditions must be reconfigured, says meeting
Authors: T. Richards
Journal: BMJ (2013)

A third of people in England have one or more chronic diseases, and costly NHS services designed primarily for acute care must be reconfigured to meet their needs, a meeting in London has heard.

Involving patients, families, and communities in the management of long term conditions could not only improve health outcomes but save the NHS over £4.4bn a year, it heard.

The meeting was convened to discuss new models of community based care that were co- developed by health professionals, patients, patients’ organisations, and charitable and voluntary groups and to further …
A memorable patient: The man who had 42 psychiatrists (and rising)
Authors: D. Summerfield
Journal: BMJ (2001)

Moving on to my next post on a psychiatric training rotation some years ago I met Mr L in my first outpatient clinic. He had a huge file and had been in follow up for 20 years. As he came through the door he announced, “That drug therapy the last doctor prescribed isn't working, you know doctor.”Then he sat down and, far from being jaded by the repeated re-telling, launched into a sparkling resume of his chronic symptoms and worries. My first reaction (a little naive) was to …
Vascular Toxicities of Cancer Therapies
Authors: Joerg Herrmann, Eric H. Yang, Cezar A. Iliescu, Mehmet Cilingiroglu, Konstantinos Charitakis, Abdul Hakeem, Konstantinos Toutouzas, Massoud A. Leesar, Cindy L. Grines, Konstantinos Marmagkiolis
Journal: Circulation (2016)

Since the late 1990s, there has been a steady decline in cancer-related mortality, in part related to the introduction of so-called targeted therapies. Intended to interfere with a specific molecular pathway, these therapies have, paradoxically, led to a number of effects off their intended cancer tissue or molecular targets. The latest examples are tyrosine kinase inhibitors targeting the Philadelphia Chromosome mutation product, which have been associated with progressive atherosclerosis and acute vascular events. In addition, agents designed to interfere with the vascular growth factor signaling pathway have vascular side effects ranging from hypertension to arterial events and cardiomyocyte toxicity. Interestingly, the risk of cardiotoxicity with drugs such as trastuzumab is predicted by preexisting cardiovascular risk factors and disease, posing the question of a vascular component to the pathophysiology. The effect on the coronary circulation has been the leading explanation for the cardiotoxicity of 5-fluorouracil and may be the underlying the mechanism of presentation of apical ballooning syndrome with various chemotherapeutic agents. Classical chemotherapeutic agents such as cisplatin, often used in combination with bleomycin and vinca alkaloids, can lead to vascular events including acute coronary thrombosis and may be associated with an increased long-term cardiovascular risk. This review is intended to provide an update on the evolving spectrum of vascular toxicities with cancer therapeutics, particularly as they pertain to clinical practice, and to the conceptualization of cardiovascular diseases, as well. Vascular toxicity with cancer therapy: the old and the new, an evolving avenue.
SAT0559 Reuma.Pt/LES: the Experience of Two Central Hospitals in Lisbon
Authors: S. I. Sousa, M. J. Gonçalves, R. Roque, F. Vinagre, A. Cordeiro, F. Godinho, M. J. Saavedra, F. Ramos, C. Macieira, H. Canhão, J. E. Fonseca, C. da Silva, J. A. Pereira da Silva, M. J. Santos
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Reuma.pt, the Rheumatic Diseases Register from the Portuguese Society of Rheumatology has recently expanded its coverage to Systemic Lupus Erythematous (SLE) patients, the Reuma.pt/LES. Reuma.pt/LES is a web-based platform launched in September 2012 that simultaneously serves as a nationwide registry and as an electronic medical record. Its aim is to register all patients with SLE and follow them up in a standard manner in order to improve the monitoring and clinical care for patients with SLE while simultaneously increase the knowledge of this disease. <h3>Methods</h3> The authors present the structure and the functioning of this national project, giving as an example the subpopulation of patients with SLE from two centres in Lisbon (Hospital Santa Maria and Hospital Garcia de Orta) included in Reuma.pt/LES. <h3>Results</h3> 878 patients from all the country with the clinical diagnosis of SLE were registered in the database Reuma.pt/LES until January 2013. Recorded information includes demographics, work status, life-styles, ACR and SLICC 2012 classification criteria, thrombotic and obstetric manifestations, SLE disease activity at each visit, fatigue scale, health related quality of life measures (SF-36 and EQD5), irreversible damage, comorbid conditions, medication and adverse events. Hospital Santa Maria (Lisbon) and the Hospital Garcia de Orta (Almada) contributed to Reuma.pt/LES with 305 patients, 95,1% females, 80% Caucasians with a mean age of 45.5 ±14.9y. The mean age at diagnosis was 35.9 ±14.9y and the mean disease duration was 10.3 ± 7.3y. SLE Disease Activity Index (SLEDAI) at the first evaluation was 3,4 ± 3,8 and current accrual damage assessed by the Systemic Lupus International Collaborating Clinics (SLICC) was 0,7 ± 1,1. Hypertension was reported in 24% of the patients, diabetes in 8.8% and cardiovascular diseases in 11%. The vast majority of patients was treated with hydroxychloroquine (93.9%) and corticosteroids (prednisolone 44.6%, prednisone 12.4%, deflazacort 18.%). Immunosuppressive drugs were used in about half of the cases (azathioprine in 27%, methotrexate in 15.5%, cyclophosphamide in 7.4%, micophenolate in 5%) and to a lesser extent biological therapies (rituximab in 5.9% and belimumab in 0.98% of the patients). <h3>Conclusions</h3> Reuma.pt, is a very useful tool, that allows a more efficient patient follow-up, and standardized data collection, storage and analysis, with the ultimate objective of improving patient care and simultaneously scientific research in the field of SLE. <h3>Disclosure of Interest</h3> None Declared
Management of Heparin Therapy
Authors: Edwin W. Salzman, Daniel Deykin, Ruth Mayer Shapiro, Robert Rosenberg
Journal: New England Journal of Medicine (1975)

Among 100 consecutive patients receiving heparin in therapeutic dosage, major bleeding occurred in 21, and minor bleeding in 16. Two patients died from bleeding, and two had recurrent pulmonary embolism. Major bleeding occurred in 21% when therapy was regulated with whole-blood clotting time and in 20% when heparin was given without clotting tests. In a subsequent prospective trial patients received heparin by intermittent intravenous injection with or without laboratory control according to the partial thromboplastin time or continuously by intravenous infusion. Recurrent thromboembolism occurred once in each group. Major bleeding was seven times more frequent with intermittent injection than with continuous infusion. Control with the partial thromboplastin time did not prevent major bleeding in patients receiving intermittent injections. With continuous infusion, one-fourth less heparin was required than with intermittent injections. Administration of heparin by continuous infusion appears safer than intermittent injection with or without laboratory control and is no less effective for prevention of thromboembolism. (N Engl J Med 292:1046–1050,1975)
Abstract 2206: SOCS1 and SOCS3 attenuate Lck-mediated cellular transformation through distinct mechanisms
Authors: Srividya Venkitachalam, Fu-Yu Chueh, Chao-Lan Yu
Journal: Cancer Research (2011)

Abstract The suppressor of cytokine signaling (SOCS) proteins are negative feedback inhibitors of Janus kinase (JAK) – signal transducer and activator of transcription (STAT) signaling in response to cytokine stimulation. Among eight SOCS family members, SOCS1, SOCS2, SOCS3 and CIS (cytokine-inducible SH2-containing protein) are best characterized both structurally and functionally. We showed previously that CIS, SOCS1 and SOCS3 were not expressed in Lck-transformed cells (Cell Signal 18:851; Int J Oncol 36:1201). It suggests that defective negative feedback control may contribute to constitutive JAK-STAT5 activation in Lck-mediated oncogenesis (J Immunol 159:5206; Mol Cancer Res 4:39). These findings also raise the possibility that SOCS proteins may function as tumor suppressors. Indeed, by enforced SOCS1 and SOCS3 expression, we were able to reduce Lck-induced cellular transformation (Int J Oncol 36:1201). In this report, we further examine the molecular mechanisms underlying SOCS tumor-suppressing activity. Through comparative studies of SOCS1, SOCS2, SOCS3 and CIS, we demonstrate here two distinct properties of SOCS1 and SOCS3 toward oncogenic Lck kinase. First, SOCS1 has the highest affinity in binding to oncogenic Lck kinase. We identified the positive regulatory phospho-tyrosine 394 residue (Y394) in the kinase domain as the key interacting determinant in Lck. Additionally, the Lck kinase domain alone is sufficient to bind SOCS1. While the SH2 domain in SOCS1 is important in its association with the oncogenic Lck kinase, other functional domains may also contribute to overall binding affinity. These data suggest that SOCS1 may inhibit Lck kinase activity in a manner similar to JAK kinases. Second, only SOCS3 becomes phosphorylated in the presence of oncogenic Lck kinase. We identified the phosphorylation sites as Y204 and Y221 located in the C-terminal SOCS box of SOCS3. We further analyzed the contribution of SOCS3 tyrosine phosphorylation on its tumor suppressor activity. Preliminary studies suggested that SOCS3 phosphorylation on Y204 and Y221 might play an important role in blocking cell proliferation and cell cycle progression of Lck-transformed cells. SOCS3 tyrosine phosphorylation can lead to altered protein stability and crosstalk with other signal transduction pathways, such as MAPK signaling. Experiments are in progress to further define the molecular details of SOCS3 phosphorylation involved in tumor suppression. All together, these results provide important mechanistic insights into the distinct roles of SOCS proteins as tumor suppressors in cells transformed by oncogenic protein tyrosine kinases. This work is supported in part by NIH grant CA107210. 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 2206. doi:10.1158/1538-7445.AM2011-2206
LIPOPROTEIN(A) IS ASSOCIATED WITH INCIDENT HEART FAILURE HOSPITALIZATION: ARIC STUDY
Authors: Anandita Agarwala, Yashashwi Pokharel, Salim Virani, Wensheng Sun, Chiadi Ndumele, Eyal Shahar, Gerardo Heiss, Eric Boerwinkle, Suma Konety, Ron Hoogeveen, Christie Ballantyne
Journal: Journal of the American College of Cardiology (2016)
Chest Wall Sarcoma
Authors: Tyson Chadaz, Susan K. Hobbs, Hongju Son
Journal: Clinical Nuclear Medicine (2013)

Li-Fraumeni syndrome is an autosomal dominant inherited disorder also known as the SBLA cancer syndrome (sarcoma, breast, leukemia, and adrenal). A 39-year-old female patient with a history of bilateral breast cancer treated with bilateral mastectomies and radiation treatment 4 years ago and left chest wall pleomorphic sarcoma 1 year ago presented with a small hypermetabolic right chest wall mass on 18F-FDG PET/CT. This mass was found to be a spindle cell sarcoma. FDG PET/CT plays an important role in following up oncology patients, particularly in group of high-risk malignancy, for detecting small hypermetabolic lesions.
FRACTIONAL MYOCARDIAL MASS: A NEW INDEX FOR DIAGNOSIS AND TREATMENT OF CORONARY ARTERY DISEASE
Authors: Hyung Yoon Kim, Eun kyoung Kim, Sung Mok Kim, Young Bin Song, Joo-Yong Hahn, Seung-Hyuk Choi, Hyeon-Cheol Gwon, Sang Hoon Lee, Yeon Hyeon Choe, Jae K. Oh, Jin-Ho Choi
Journal: Journal of the American College of Cardiology (2015)
Permanent Iatrogenic Vocal Cord Paralysis After I-131 Therapy
Authors: LEONARD R. COOVER
Journal: Clinical Nuclear Medicine (2000)

A patient who underwent I-131 therapy for a solitary toxic thyroid nodule subsequently experienced vocal cord paralysis, a rare complication. The patient was examined because of hoarseness 1 week after treatment. Indirect laryngoscopy at the time confirmed right vocal cord paralysis. When the examination was repeated in 6 months, no improvement was noted; vocal cord paralysis was then declared permanent. Surprisingly, 11 months after the onset of symptoms, the patient observed improvement in her voice. At 14 months, she experienced complete vocal recovery. However, a computed tomography performed after this showed that her right vocal cord paralysis was unresolved. The apparent complete recovery of her voice is believed to be a result of adaptive compensatory mechanisms. Patients who recover from hoarseness after injury to the recurrent laryngeal nerve should have cord function documented by indirect laryngoscopy or other means before the physician performs a procedure that could harm the contralateral nerve, because damage to this nerve could result in devastating consequences.
PMO-154 Plasma HBSAG levels decline was similar during subsequent pegylated interferon and nucleos(T)IDE analogues treatment in chronic hepatitis B patients
Authors: M J Bruce, M Horner, S Hughes, S Knighton, D Joshi, P M Harrison, K Agarwal, I Carey
Journal: Gut (2012)

<h3>Introduction</h3> Pegylated interferon (Peg-IFN) therapy responses in chronic hepatitis B (CH-B) are associated with decline of HBsAg plasma levels (qHBsAg) (&gt;10% in HBeAg− and &gt;0.5 log<sub>10</sub>IU/ml in HBeAg+) and HBV DNA decrease &gt;2 log<sub>10</sub>IU/ml during the first 6 months of therapy. In contrast, qHBsAg decline is less pronounced, but with sharper HBV DNA decline on therapy with nucleos(t)ide analogues (NA). The previous studies comparing qHBsAg and HBV DNA kinetics between Peg-IFN and NA treatments were performed on variable cohorts, but not on a monocentric single cohort of patients undergoing consecutively variable courses of therapy. <h3>Aims</h3> To compare the kinetics of qHBsAg and HBV DNA levels before and during therapy; initially with Peg-IFN and then after at least a 6-month break (median 15 months) with subsequent NA therapy in the same cohort of CH-B patients. <h3>Methods</h3> qHBsAg levels by Abbott ARCHITECT® assay and HBV DNA by real-time TaqMan PCR [both log<sub>10</sub> IU/ml] were quantified in serial samples at baseline, treatment week 12 (TW12), TW24, TW48. HBeAg loss/anti-HBe seroconversion were evaluated at the same time-points. All results are presented as medians. <h3>Results</h3> Four Peg-IFN patients (20%) achieved anti-HBe seroconversion, in contrast to only 1 NA patient (5%). At baseline, qHBsAg and HBV DNA levels were similar between Peg-IFN and NA (3.92 vs 3.72 and 6.21 vs 5.91). At TW12 and TW24, qHBsAg did not change in Peg-IFN and NA treatment (3.86 vs 3.68 and 3.57 vs 3.49 respectively), but HBV DNA dropped significantly during NA therapy only (4.55 vs 2.29 and 4.53 vs 1.23, both p&lt;0.01). At TW48, qHBsAg remained unchanged in both treatments (3.48 vs 3.46), but HBV DNA was undetectable in NA patients (0 vs 4.68, p&lt;0.01). Only NA therapy achieved complete virological response (HBV DNA&lt;20 IU/ml) in six patients (30%) at TW12, 8 patients (40%) at TW24 and 15 patients (75%) at TW48 (all p&lt;0.05). Only patients with qHBsAg decline by &gt;0.5 log<sub>10</sub>IU/ml by TW24 achieved anti-HBe seroconversion in both treatments. <h3>Conclusion</h3> HBsAg decline &gt;0.5 log<sub>10</sub>IU/ml by TW24 was predictive of anti-HBe seroconversion irrespective of therapeutic approach. Although plasma HBsAg kinetics was similar during Peg-IFN or NA therapy in Peg-IFN non-responders, HBV DNA viral load declined significantly only during NA therapy from TW12 in the same cohort of CH-B patients. <h3>Competing interests</h3> M Bruce: None declared, M Horner: None declared, S Hughes: None declared, S Knighton: None declared, D Joshi: None declared, P Harrison: None declared, K Agarwal: None declared, I Carey grant/research support from: BMS, Gilea.
FDG Positron Emission Tomography in the Surveillance of Hepatic Tumors Treated with Radiofrequency Ablation
Authors: GREGORY S. ANDERSON, FRANK BRINKMANN, MICHAEL C. SOULEN, ABASS ALAVI, HONGMING ZHUANG
Journal: Clinical Nuclear Medicine (2003)

Purpose Radiofrequency thermal ablation (RFA) is an emerging technique in the treatment of focal hepatic tumors. Magnetic resonance imaging (MRI) and computed tomography (CT) are currently used to monitor hepatic tumors after RFA for residual disease and recurrence. Fluorodeoxyglucose (FDG) positron emission tomography (PET) is an excellent imaging method for the detection of liver metastases, but it has not been thoroughly evaluated as an alternative to anatomic imaging in the surveillance of liver tumors treated with RFA. The purpose of this investigation was to determine the role of FDG-PET imaging in the surveillance of liver tumors treated with RFA. Methods Thirteen patients with histories of malignant tumors of the liver treated with RFA and who had received post-treatment FDG-PET scans were assessed retrospectively. One patient had two post-RFA FDG-PET scans, eight patients had concurrent MRI scans, and six patients had concurrent CT scans. Imaging findings were compared with the results of clinical follow-up. Results There were either recurrent tumors at the ablation site (8 patients) or new metastases (3 patients) in 11 patients. FDG-PET identified all 11 cases and did not misidentify any cases. Of the seven patients with positive PET findings who received an MRI scan, three were also positive on MRI (42.9%); the other four cases were either negative or equivocal. Of the four patients with positive PET findings who received a CT scan, only two had positive CT scan findings (50%). All recurrences diagnosed by PET were confirmed on clinical follow-up. Conclusion In this preliminary study, FDG-PET was superior to anatomic imaging in the surveillance of patients treated with RFA for malignant hepatic tumors.
Financial Implications of Implementing Standards of Care for Diabetic Eye Disease
Authors: Lawrence I Rand
Journal: Diabetes Care (1992)

This article reviews practical financial issues surrounding the implementation of published standards of care for diabetic patients concerning examination for detection of retinopathy. Issues such as the financial basis of referral patterns and the fear of patient loss are raised. The role of the primary physician in coordinating care is discussed. The strategies of ophthalmic screening at the site of primary care are presented as alternatives to published standards. There is a need for development of low-cost screening for low-risk patient groups. All effective means of detecting retinopathy and implementing sight-saving therapy in a timely manner is cost-effective compared with the cost saved of disability payment alone.