tbuckley/cabot-search huggingface dataset:
PWE-127 The Extended Effect of An Alcohol Liaison Nurse Service on Attendance at A County’s Emergency Departments: A 3 Year Retrospective Cohort Study
Authors: E Davies, M Vardy, B Deans, J France, D Aldulaimi
Journal: Gut (2016)

<h3>Introduction</h3> Worcestershire Acute Hospitals NHS Trust has an Alcohol Liaison Nurse Service (ALNS) across two hospital sites, with two full-time ALNs providing screening, case management support, brief interventions (BI) and referrals into community treatment services. We performed a retrospective cohort study to assess the impact of the ALNS on emergency departement (ED) re-attendance over a 3 year period and estimated the cost saving using the 2012/3 reference costs. <h3>Methods</h3> All patients who had attended the ED, surgical or medical assessment units and received a BI delivered by the ALNS over a 3 month period, between January to March 2012, was identified via hospital records (Patient First ED computer system and OASIS). Patient attendances to ED for the preceding 12 month period were compared with the 12 month periods after the BI over the following 3 years. Patients were excluded if they lived outside the trust catchment area or were imprisoned or died during the study period. Costs of attendances to ED over the period were estimated as £114 per visit. Statistical analysis was by paired t-test. <h3>Results</h3> 192 patients (123 males &amp; 69 females) identified as having a BI were included in the cohort. 36 were excluded due to death within the study period and 4 due to incarceration. The median age of the cohort was 44 years (range 17–87 years). The most common reason for presentation related to mental health issues including deliberate self harm and overdose. During the 12 month period before ALNS intervention there were 464 qualifying ED attendances with an average of 2.42 attendances per patient. In the first 12 months following BI, the ED attendance rate fell to 327 (1.7 attendances/patient), and then to 255 in the second 12 months (1.33 attendances/patient), and finally 225 in the third 12 months following BI (1.17 attendances/patient). The reduction in attendance was statistically significant 12 months after intervention compared with the preceding year (p &lt; 0.005) and was sustained at 36 months post intervention (p &lt; 0.005). Attendance for the third 12 month period post-intervention was statistically significantly lower compared with the first (<i>p</i> = 0.0181). For this 3 month cohort of 192 patients, the cost of ED attendance in the year before BI was estimated at £52, 896. By the end of the study period this had been reduced by 51.5% (twelve monthly cost estimates £37,278, £29,070 and £25,650). <h3>Conclusion</h3> This pragmatic study suggests that an ALNS may have a sustained effect upon the number and cost of ED attendances. <h3>Reference</h3> 1 https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/261154/nhs_reference_costs_2012-13_acc.pdf <h3>Disclosure of Interest</h3> None Declared
AB0111 The Underlying Pathogenic Effect of Impared Dnase I Activity on Rheumatoid Arthritis
Authors: X. Xu, H. Shen
Journal: Annals of the Rheumatic Diseases (2016)

<h3>Background</h3> Aberrant formation of neutrophil extracellular traps (NETs) play important role in the pathogenesis of rheumatoid arthritis (RA) and Deoxyribonuclease I (DNase I) can remove NETs in vivo. <h3>Objectives</h3> We aimed to investigate the underlying pathogenic effect of DNase I on RA. <h3>Methods</h3> Serum DNase I activity was measured by radial enzyme diffusion method in 83 RA patients and 60 healthy volunteers, synovial fluid (SF) from 27 RA patients and 38 other inflammatory arthritis patients was measured by the same way. The SF cfDNA level was measured by Pico Green Kit. Correlation analysis were performed between DNase I activity, cfDNA level and clinical parameters of RA patients. <h3>Results</h3> Serum DNase I activity was significantly lower in RA group than in healthy control group [0.2913 (0.2029, 0.4064)U/ml vs 0.3980 (0.2864, 0.5484)U/ml, P&lt;0.001] and negatively correlated with ESR (r=-0.2862, P=0.0122), CRP (r=-0.2790, P=0.0184) and neutrophil cell counts (r=-0.287, P=0.011). SF DNase I activity in RA group, ankylosing spondylitis (AS) group and gouty arthritis (GA) group were almost negative. SF cfDNA level in RA group was significantly higher than that in OA group [40.00 (12.47, 163.22) ug/ml vs 9.27 (4.62, 17.58) ug/ml, P=0.002], but there were no significant difference when compared to AS group [36.80 (4.84, 84.82) ug/ml, P=0.428] and GA group [156.72 (89.81, 257.11) ug/ml,P=0.132]. In inflammatory arthritis patients, SF cfDNA level was positively correlated to ESR (r=0.4106, P=0.0116)and CRP (r=0.5747, P=0.0002). <h3>Conclusions</h3> Impairment of DNase I activity may be responsible for the enhanced NETs generation and involve in the pathogenesis of RA. <h3>References</h3> Holers VM. Autoimmunity to citrullinated proteins and the initiation of rheumatoid arthritis[J]. Curr Opin Immunol, 2013, 25(6):728–35. Khandpur R, CarmonaRivera C, VivekanandanGiri A, et al. NETs are a source of citrullinated autoantigens and stimulate inflammatory responses in rheumatoid arthritis [J]. Sci Transl Med, 2013, 5(178): 178ra40. Pratesi F, Dioni I, Tommasi C, et al. Antibodies from patients with rheumatoid arthritis target citrullinated histone4 contained in neutrophils extracellular traps[J]. Ann Rheum Dis 2014, 73(7):1414–22. Sur Chowdhury C, Giaglis S, Walker UA,et al. Enhanced neutrophil extracellular trap generation in rheumatoid arthritis: analysis of underlying signal transduction pathways and potential diagnostic utility[J].Arthritis Res Ther, 2014;16(3):R122 Gupta AK, Hasler P, Holzgreve W, et al. Induction of neutrophil extracellular DNA lattices by placental microparticles and IL- 8 and their presence in preeclampsia [J].Hum Immunol, 2005, 66(11): 1146–54. Hakkim A, Furnrohr BG, Amann K, et al. Impairment of neutrophil extracellular trap degradation is associated with lupus nephritis [J]. Proc Natl Acad Sci U S A, 2010, 107(21): 9813–18. <h3>Disclosure of Interest</h3> None declared
Safety and Efficacy of Rituximab Plus Bendamustine in Relapsed or Refractory Diffuse Large B-Cell Lymphoma Patients
Authors: Annalisa Arcari, Annalisa Chiappella, Vanessa Valenti, Luca Zanlari, Monica Tani, Roberto Marasca, Maria Giuseppina Cabras, Michele Spina, Alberto Santagostino, Fiorella Ilariucci, Giuseppe Carli, Pellegrino Musto, Paolo Savini, Dario Marino, Francesco Ghio, Massimo Gentile, Maria Christina Cox, Roberta Della Seta, Daniele Vallisa
Journal: Blood (2014)
Epidemiology of Acute Kidney Injury in Critically Ill Children and Young Adults
Authors: Ahmad Kaddourah, Rajit K. Basu, Sean M. Bagshaw, Stuart L. Goldstein
Journal: New England Journal of Medicine (2016)

The epidemiologic characteristics of children and young adults with acute kidney injury have been described in single-center and retrospective studies. We conducted a multinational, prospective study involving patients admitted to pediatric intensive care units to define the incremental risk of death and complications associated with severe acute kidney injury.
Deferasirox (Exjade®) in Pediatric Patients with β-Thalassemia: Update of 4.7-Year Efficacy and Safety from Extension Studies
Authors: Antonio Piga, Gian Luca Forni, Antonis Kattamis, Christos Kattamis, Yesim Aydinok, Martha Rodriguez, Lisa Rojkjaer, Renzo Galanello
Journal: Blood (2008)
A phase IB study of ipilimumab with peginterferon alfa-2b in patients with unresectable melanoma
Authors: Andrew S. Brohl, Nikhil I. Khushalani, Zeynep Eroglu, Joseph Markowitz, Ram Thapa, Y. Ann Chen, Ragini Kudchadkar, Jeffrey S. Weber
Journal: Journal for ImmunoTherapy of Cancer (2016)

Ipilimumab and peginterferon alfa-2b are established systemic treatment options for melanoma that have distinct mechanisms of action. Given the need for improved therapies for advanced melanoma, we conducted an open-label, single institution, phase Ib study to assess the safety and tolerability of using these two agents in combination.Study treatment consisted of ipilimumab given every 3 weeks, for a total of four infusions, concurrent with peginterferon alfa-2b administered subcutaneous weekly for a total of 12 weeks. This was followed by maintenance therapy with peginterferon alfa-2b administered subcutaneously weekly for up to 144 additional weeks. The study was designed as a two-stage dose escalation scheme with continuous dose-limiting toxicity monitoring during the induction phase.Thirty one patients received at least 1 dose of study treatment and 30 were assessable for efficacy endpoints. We found that ipilimumab at 3 mg/kg dosing with peginterfeon alfa-2b at 2 μg/kg/week was the maximum tolerated dose of this combination. The incidence of grade 3 drug-related adverse events (AEs) was 45.2%. There were no grade 4/5 AEs. The overall response rate was 40% by immune-related response criteria. Median progression-free survival was 5.9 months. The median overall survival was not reached with at a median follow-up of 35.8 months.We report that the combination of ipilimumab at 3 mg/kg dosing combined with peginterfeon alfa-2b at 2 μg/kg/week demonstrated an acceptable toxicity profile and a promising efficacy signal. Further study of this combination is warranted.ClinicalTrials.gov identifier: NCT01496807, Registered December 19th, 2011.
Targeting Destruction of Mcl-1 by Activation of Protein Phosphatase 2A In CLL and B-Cell Lymphomas
Authors: Dale J. Christensen, Jessica Oddo, Karen Bond, Alicia Volkheimer, Youwei Chen, Evan Davis, Jon P. Gockerman, Louis F. Diehl, Carlos de Castro, Joseph O. Moore, Michael P Vitek, J. Brice Weinberg
Journal: Blood (2010)
Translocation t(14;19)(q32;q13) Is a Rare Abnormality in CLL and Associated with Trisomy 12, an Unmutated IgVH Status and a Distinct Gene Expression Profile.
Authors: Claudia Haferlach, Sonja Rauhut, Sylvia Merk, Frank Dicker, Susanne Schnittger, Wolfgang Kern, Martin Dugas, Torsten Haferlach
Journal: Blood (2007)
PTU-018 The Emperor’s New Clothes: An Alternative Perspective on Colonoscopy
Authors: HE Ojidu, M McAlindon
Journal: Gut (2016)

<h3>Introduction</h3> Following the quality improvement programme introduced to pave the way for the UK Bowel Cancer Screening Programme (BCSP), there was an improvement in caecal intubation rate from 76.9% in 1999 to 92.3% in 2011.<sup>1</sup> 90.2% suffered mild discomfort or less, although this was assessed and reported by the endoscopist. 53.6% of symptomatic patients had abnormal examinations but it was not clear how many of the pathologies identified were incidental findings. We aimed to determine the percentage of patients whose colonoscopy findings explained their symptoms (the diagnostic yield) and to compare endoscopist and patient assessment of colonoscopy tolerance. <h3>Methods</h3> Endoscopists and patients undergoing colonoscopy independently provided a Gloucester comfort score (GCS 1: comfortable; 5: severe discomfort). Endoscopic and subsequent histological findings were recorded. <h3>Results</h3> Symptomatic patients (n = 107; 46.7% male, mean age 55.0±1.6 yrs) were younger than BCSP patients (n = 46; 65.2% male, mean age 67.0±0.9; P &lt; 0.001, two sample T test). In the symptomatic group, in whom the diagnostic yield was 17%, moderate to severe discomfort (GCS 4–5) was reported by endoscopist and patient in 21.7% and 46.2% (P = 0.001, Mann Whitney) and in the BCSP group, by 21.8% and 26.1% (P = 0.6) respectively. Moderate to severe patient discomfort was more common in the symptomatic than BCSP group (P = 0.019), but overall was less common in males than females (P &lt; 0.02). Sedation had no effect on tolerance (P = 0.9). <h3>Conclusion</h3> Almost half of patients having diagnostic colonoscopy reported moderate to severe discomfort, which was markedly underestimated by endoscopists. If the true diagnostic yield is only 17%, it would seem appropriate to offer patients a less invasive, better tolerated alternative as a first line test. Procedural tolerance was much better in the BCSP, where endoscopists were more accurate in grading patient discomfort, which may partly be explained by the male predominance. However, GCS 4–5 scores were still three times as common as reported in the national audit. <h3>Reference</h3> 1 Gavin DR, <i>et al</i>. <i>Gut</i> 2013;<b>62</b>:242–249. <h3>Disclosure of Interest</h3> None Declared
Detection of the NUP214-ABL Rearrangement in T-ALL by High-Density Oligonucleotide Arrays: Evidence of the Value of This Approach in the Identification of Gene Amplifications.
Authors: Sabina Chiaretti, Simona Tavolaro, Emanuela Ghia, Cristina Ariola, Caterina Matteucci, Roberta Maggio, Antonella Vitale, Jerome Ritz, Cristina Mecucci, Anna Guarini, Robert Foà
Journal: Blood (2005)
Complete Remissions Observed in Acute Myeloid Leukemia Following Prolonged Exposure to SGN-33 (lintuzumab), a Humanized Monoclonal Antibody Targeting CD33.
Authors: Azra Raza, Joseph G. Jurcic, Gail J. Roboz, Michael Maris, Joseph Stephenson, Brent L. Wood, Bhaskar Rege, Laurie E. Grove, Jonathan G. Drachman, Eric L. Sievers
Journal: Blood (2007)
AB0548 Cardiac Involvement in Patients with Antiphospholipid Syndrome: A Case Series with a Long-Term Follow-Up: Table 1
Authors: A.I. Martínez-Vidal, C. Vázquez-Triñanes, I. Villaverde-Άlvarez, A. Rodríguez-Gόmez, A. Soto-Peleteiro, A. Argibay, M. Freire, B. Sopeña, A. Rivera
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Antiphospholipid syndrome (APS) is a multisystem disease, and the heart may be affected from 10 to 50% in some series [1,2]. Heart valve lesions are the most frequent manifestations. Coronary arteries and myocardium may be also affected. Other findings include chronic thromboembolic pulmonary hypertension and accelerated atherosclerosis. Some studies have suggested a higher incidence of cardiac involvement in patients with secondary APS or those with higher titers of antiphospholipid antibodies. However, cardiac involvement in APS are not yet well known because there are few published series and most of them have a short-term follow-up. <h3>Objectives</h3> The aim of our study was to determine the prevalence and the type of cardiac involvement in patients with APS. Also, risk markers of cardiac involvement in these patients were attempted to identify. <h3>Methods</h3> A case series of patients with APS diagnosed and followed for a long period in a specific unit of Thrombosis and Vasculitis was conducted. Clinical and laboratory data were collected in a retrospective manner. To attempt to identify risk markers of cardiac involvement, patients with cardiac manifestations were compared with patients without heart involvement. Chi2 and t-student were used, using the statistical package SPSS18.0. <h3>Results</h3> 32 patients with APS were included, 21 (66%) female, mean age 64.3±16.44 years [range 34-84], with a mean follow-up of 9.2 years (median 7 years). 8 patients (25%) had a secondary APS: 3 SLE, 2 Sjögren9s syndrome, 1 rheumatoid arthritis, 1 systemic sclerosis and 1 demyelinating disease. 4 (13%) were pure obstetric APS, 9 (28%) had an arterial thrombosis, 9 (28%) had a venous thrombosis and 10 (31%) had mixed events (arterial, venous, and obstetric). 23 (72%) of patients had a cardiovascular risk factor (hypertension, dyslipidemia, type 2 DM). 19 patients of 32 with APS (59%) had cardiac involvement. 15 patients (79%) had valve disease (7 mitral valve, 3 aortic valve and 5 both mitral and aortic valves), and 8 (26%) had a coronary ischemic event. No patients had pulmonary hypertension. The comparison results between the two groups are shown in the following table. <h3>Conclusions</h3> More than half of patients with APS had cardiac involvement. Heart valve disease was the most frequent manifestation, almost always mitral valve. No patients had pulmonary hypertension. The only risk marker of cardiac involvement in our series was the age; patients with cardiac involvement were 10 years older on average. <h3>References</h3> Cardiac involvement in the antiphospholipid syndrome. Tenedios F et al. Lupus 2005. 14(9):691-696. Cardiac manifestations in antiphospholipid syndrome. Soltész P et al. Autoimmun Rev. 2007;6(6):379-86. <h3>Disclosure of Interest</h3> None declared
Blood and Resource Utilization in Cancer Patients with Chemotherapy-Induced Anemia (CIA) in the Pre- and Post-National Coverage Determination (NCD) Timeframes: Results From An Electronic Medical Record Study.
Authors: Tanya Burton, Luke Boulanger, Kay Larholt, Chris L. Pashos, R. Scott McKenzie, Mekré Senbetta, Janice Lopez, Devi Sundaresan, Peggy Preusse, Christopher Seidler
Journal: Blood (2009)
AB0695 Bone Quality Assessment by The Trabecular Bone Score in Spondyloarthritis
Authors: K. Boussoualim, H. Marotte, T. Thomas
Journal: Annals of the Rheumatic Diseases (2016)

<h3>Background</h3> Many patients affected by spondyloarthritis are at risk of fracture due to the bone9s fragility although their bone mineral density (BMD) is not significantly decreased. Other tools are needed to assess changes in the bone of these patients. The Trabecular Bone Score (TBS) is a bone quality assessment tool that analyses variations of the grey level of a densitometric image. It was evaluated among post-menopausal women and in secondary osteoporosis. It may help to discriminate patients with osteoporosis fractures. <h3>Objectives</h3> To evaluate the TBS in a population of spondyloarthritis as a bone quality indicator and look for the clinical and biological factors correlating to the values of the TBS. <h3>Methods</h3> Patients who met the criteria of a spondyloarthritis diagnosis and who had a measure of BMD were selected. All these patients came for the setting up or the changing of a biotherapy. Clinical and laboratory data were collected at the same time as the BMD measurement.The TBS measurements were obtained immediately from dual-energy X-ray absorptiometry spinal images. A TBS was considered normal above 1.34, distorted between 1.34 and 1.2 and very distorted below 1.2. <h3>Results</h3> Ninety-eight patients participated in the study. The average age was 40.2 years and the average duration of the disease9s evolution was of 8.2 years. A spinal BMD lower than -1 and -2.5 T-score was respectively observed in 17% and 3% of patients. The average TBS was lowered to 1.34. The spinal BMD correlated positively to the values of TBS (r=0.61), whereas the duration of the disease9s evolution (r = -0.24), its activity level (r= -0.33) and the serum PTH levels (r= -0.27) correlated negatively to the TBS. This association persisted in multivariate analysis. More than half of patients with a BMD above the threshold of a -2.5 T-score had an altered TBS. The relashionship observed between the rates of the PTH and the TBS, which we do not find with the BMD, suggests that a part of the changes of the bone structure in inflammatory rheumatism such as the spondyloarthritis, would be under the dependence of the PTH regardless of the BMD. <h3>Conclusions</h3> This study shows that TBS provides additional and independent information from the simple BMD measure on bone status of patients with inflammatory rheumatism. It appears necessary to carry out studies on a larger scale to analyse the discriminating power of the TBS in the prediction of fragility fracture to a greater extent. <h3>Disclosure of Interest</h3> None declared
Phase I/II Trial of Lenalidomide and High Dose Melphalan with Autologous Stem Cell Transplantation for Relapsed Myeloma
Authors: Nina Shah, Peter F. Thall, Patricia S Fox, Qaiser Bashir, Jatin J. Shah, Simrit Parmar, Partow Kebriaei, Yago Nieto, Uday R. Popat, Chitra M Hosing, Krina K. Patel, Pei Lin, Elizabeth J Shpall, Robert Z. Orlowski, Richard E. Champlin, Muzaffar H. Qazilbash
Journal: Blood (2014)
An ankle that just didn’t look right
Authors: Alistair R M Macey, Charitra Grama
Journal: BMJ (2016)

A 66 year old man fell down 14 steps and was subsequently unable to weight bear due to pain in the ankle. The foot was swollen and deformed, but radiographs showed no ankle fracture. Clinical findings and a radiograph that “just didn’t look right” prompted orthopaedic referral (fig 1⇓). The patient was taken urgently to the operating theatre. What is the diagnosis?



Fig 1  Lateral radiograph of the left ankle



### Answer

A fracture dislocation of the talus with disruption of the subtalar and talonavicular joints.

### Discussion

Dislocation of …
Consolidation and Maintenance Immunotherapy with Rituximab Improve Progression Free Survival within ZAP-70 Positive Chronic Lymphocytic Leukemia (CLL).
Authors: Giovanni Del Poeta, Maria Ilaria Del Principe, Luca Maurillo, Francesco Buccisano, Adriano Venditti, Rita Marini, Giovanna Suppo, Antonella Zucchetto, Fabrizio Luciano, Maria Cantonetti, Valter Gattei, Paolo de Fabritiis, Sergio Amadori
Journal: Blood (2006)
FRI0637-HPR The Effects of Clinical Pilates Exercises on Kinestesia and Position Sense in Patients with Osteoarthritis of The Knee: Table 1
Authors: P. Kisacik, S. Oksuz, S. Oksuz, G. Arın, G. Arın, A. Akdogan, A. Akdogan, O. Dogan, O. Dogan, E. Karabulut, E. Karabulut, E. Unal, E. Unal
Journal: Annals of the Rheumatic Diseases (2016)

<h3>Background</h3> Proprioception is a deep perception which constitutes kinesthesia and position sense. In particular, it is extremely affected due to cartilage degeneration in patients with osteoarthritis (OA) of the knee (1–3). Although exercise treatment is suggested as an effective method in OA, there is no study that investigates the effects of clinical pilates exercises on proprioception in patients with OA of the knee. <h3>Objectives</h3> The aim of this study is to investigate the effects of clinical pilates exercises on kinesthesia and position sense in patients with knee OA. <h3>Methods</h3> 39 patients with knee osteoarthritis defined as Kellgren-Lawrence (K-L) grade1 and 2 at mean age 55.95± 5.54 years and disease duration 6.59± 3.15 years were participated in this study (Control group; 20 patients, Exercise group; 19 patients). Exercise group attended in clinical pilates exercises sessions for three times a week (one hour session) during ten weeks. Kinesthesia and position sense were assessed with PMS-1000 Proprioception Test, Sport Expert Proprioceptional Sports Tech. Instrument. All measurements were repeated after ten weeks. <h3>Results</h3> Although the kinesthesia perception of patients improved (p&lt;0.05), position sense did not improve in exercise group (p&gt;0.05). There were no improvements in control group according to pre- and post-treatment values. <h3>Conclusions</h3> As a conclusion, clinical pilates exercises should be kept in mind in terms of kinesthesia in patients with OA of the knee. We recommended that in further OA-related-studies using clinical pilates exercises, position sense should be examined in more detail. <h3>References</h3> Felson DT, Gross KD, Nevitt MC, Yang M, Lane NE, Torner JC, et al. The effects of impaired joint position sense on the development and progression of pain and structural damage in knee osteoarthritis. Arthritis and rheumatism. 2009;61(8):1070–6. van der Esch M, Steultjens M, Harlaar J, Knol D, Lems W, Dekker J. Joint proprioception, muscle strength, and functional ability in patients with osteoarthritis of the knee. Arthritis and rheumatism. 2007;57(5):787–93. Cammarata ML, Dhaher YY. Associations between frontal plane joint stiffness and proprioceptive acuity in knee osteoarthritis. Arthritis care &amp; research. 2012;64(5):735–43. <h3>Disclosure of Interest</h3> None declared