tbuckley/cabot-search huggingface dataset:
Incidence of Early Loss of Pregnancy
Authors: Allen J. Wilcox, Clarice R. Weinberg, John F. O'Connor, Donna D. Baird, John P. Schlatterer, Robert E. Canfield, E. Glenn Armstrong, Bruce C. Nisula
Journal: New England Journal of Medicine (1988)

We studied the risk of early loss of pregnancy by collecting daily urine specimens from 221 healthy women who were attempting to conceive. Urinary concentrations of human chorionic gonadotropin (hCG) were measured for a total of 707 menstrual cycles with use of an immunoradiometric assay that is able to detect hCG levels as low as 0.01 ng per milliliter, with virtually 100 percent specificity for hCG in the presence of luteinizing hormone. Our criterion for early pregnancy — an hCG level above 0.025 ng per milliliter on three consecutive days — was determined after we compared the hCG levels in the study group with the levels in a comparable group of 28 women who had undergone sterilization by tubal ligation. We identified 198 pregnancies by an increase in the hCG level near the expected time of implantation. Of these, 22 percent ended before pregnancy was detected clinically. Most of these early pregnancy losses would not have been detectable by the less sensitive assays for hCG used in earlier studies. The total rate of pregnancy loss after implantation, including clinically recognized spontaneous abortions, was 31 percent. Most of the 40 women with unrecognized early pregnancy losses had normal fertility, since 95 percent of them subsequently became clinically pregnant within two years. (N Engl J Med 1988; 319:189–94.)
Unusual Injuries Induced by an Automobile Steering Wheel
Authors: ANDREW F. McLAUGHLIN, HANS VAN DER WALL
Journal: Clinical Nuclear Medicine (2000)

A gamut of injuries related to motor vehicle accidents has been reported in the literature. The authors describe two patients with unusual manifestations secondary to trauma from an automobile steering wheel. In one case, a pattern of injury related to tenosynovitis and bruising of the second metacarpal bones was sustained. In the other, a complex pattern of uptake was seen in the sternum and adjacent costochondral junction.
SAT0039 In vivo fluorescence-imaging of matrix metalloproteinase activity and response to therapy in an animal model of rheumatoid arthritis
Authors: I.H. Tarner, F. Werner, C. Schimmelpfennig, A. Deten, C. Oelkrug, U. Müller-Ladner, J. Boltze, A. Kranz, E. Neumann
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Prevention of joint destruction and thus patient disability is the most important long-term goal of rheumatoid arthritis (RA) therapy. However, despite intensive treatment efforts this goal is frequently not achieved. A non-invasive imaging technique that facilitates <i>in vivo</i> monitoring of the destructive process and the anti-destructive efficacy of anti-rheumatic drugs would be highly beneficial to improve RA therapy. <h3>Objectives</h3> For this purpose, we evaluated fluorescence-based <i>in vivo</i> molecular imaging of matrix metalloproteinase (MMP) activity in an animal model of RA to assess the process of inflammatory joint destruction, the efficacy of different anti-rheumatic drugs, and the optimal time point for treatment initiation. <h3>Methods</h3> MMP activity was detected by <i>in vivo</i> imaging of an MMP-activated, fluorescenctly labeled smart probe (MMPsense-680, PerkinElmer) in arthritic joints of mice with collagen-induced arthritis (CIA). Animals were imaged weekly 24 hours after intravenous probe injection for 4 weeks. Drug treatment included placebo (NaCl), dexamethasone (DXA, 0.5 μg/g body weight), etanercept (ETC, 5 μg/g) methotrexate (MTX, 10 μg/g) and ETC + MTX, starting either on day 28 (early) or on day 35 (late). <h3>Results</h3> <i>In vivo</i> fluorescence imaging showed a steep increase in MMP activity in placebo treated mice at the time of clinical arthritis manifestation that correlated well with the degree of clinical arthritis severity (r=0.715, p&lt;0.05) and slowly decreased over the following 3 weeks. DXA (n=8) and early ETC + MTX (n=9) treatment resulted in significantly lower clinical severity of arthritis compared with placebo, whereas early and late ETC monotherapy (n=9 and n=10, respectively), early and late MTX monotherapy (n=7 and n=9, respectively) as well as late ETC + MTX (n=9) had no significant effect. Correspondingly, MMP activity was found to increase only mildly from baseline at the time of clinical arthritis onset in the DXA and early ETC + MTX therapy groups and declined more rapidly compared with placebo and all other treatment groups. By contrast, MMP activity in the placebo and all other treatment groups reached significantly higher fluorescence values than DXA and early ETC + MTX. Interestingly, while MMP activity declined in all groups over time, it only returned to near-baseline levels in DXA treated animals. <h3>Conclusions</h3> In vivo fluorescence imaging of MMP activity in CIA allows effective monitoring of disease activity and treatment response. Early ETC + MTX and DXA therapies are superior to other treatment regimens. <h3>Disclosure of Interest</h3> None Declared
Established chronicity of psychotic symptoms in first-admission schizophrenic patients
Authors: T E Gift, J S Strauss, D W Harder, R F Kokes, B A Ritzler
Journal: American Journal of Psychiatry (1981)

The course of schizophrenia before a patient's first admission is important theoretically, prognostically, and from a preventive psychiatric perspective. However, there is little systematically collected information on this topic. In this evaluation of a representative sample of first-admission schizophrenic patients, there was a wide variation in chronicity of psychotic symptoms before admission, with 20% of the patients having been symptomatic for more than 2 years and 28% for less than 1 week. Delusions of grandeur, delusions of reference, and suspiciousness were more common in the more chronic patients than in the most acute patients; symptoms of withdrawal and retardation showed the opposite pattern. The authors discuss the implications of these findings for prognosis, prevention, and theory.
OC-086 Survival Benefit of FDG-Pet Oriented Surgery for Recurrent Colorectal Cancer
Authors: H Ishikawa, A Watanabe, T Mukogawa, M Nakatani, Y Nishiguchi, M Matsusaka, S Ko
Journal: Gut (2013)

<h3>Introduction</h3> Pivotal treatment for localised recurrent colorectal cancer is surgical resection. Fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) has been accepted as an effective tool to identify disease localizations for patients with known or suspected recurrent colorectal cancer. This study is to analyse the survival benefit of FDG-PET on the diagnosis and indication of surgical intervention for <h3>Methods</h3> Consecutive 61 patients, with known or suspected recurrence of colorectal cancer based on elevation of tumour markers or abnormal findings on the follow-up CT image, underwent FDG-PET for 85 times between December 2003 and September 2009. Patients were aged between 39 and 94 years (median 66); 35 were male, 22 were Duke’s A or B stage, and 31 had a history of colon cancer. The average period between operation and first FDG-PET was 24 months (range 4–114). Of 61 cases 50 had elevated serum CEA or CA19–9 (82.0%). For each case the diagnosis of FDG-PET image was compared with that of CT image and the final diagnosis. <h3>Results</h3> Recurrence developed 2 times in average (range 1–6). Of 61patients five were identified recurrence by FDG-PET solely and indicated operation for 7 times. One of four shows disease-free survival for 70 months after common iliac replacement operation. FDG-PET showed one false – positive and three false – negative findings. Totally, the sensitivity of FDG-PET was 93.3% and its accuracy was 91.8%, whereas those of CT were 85.0% and 83.6%, respectively. Of 61patients 19 had diffused disease spread by FDG-PET findings and were judged as contraindication of operation and the other 42 with localised disease spread received operation for 90 times (liver 28, lung 14, local 37, local with distant meta 5, etc.). Cumulative 1-year and 3-year survival ratios of operation cases after first recurrence were 95% and 80%, whereas, those of contraindication cases were 60% and 25%, respectively. At present, the median survival period after recurrence of operation cases was longer than that of contraindication cases ( 37months v.s. 13months ). Our results suggested that one FDG-PET oriented operation roughly corresponded to one year survival benefit with restart. <h3>Conclusion</h3> Conclusion: FDG-PET could identify malignant lesions at earlier stage, and was an effective modality to evaluate not only disease spread but distant metastasis for recurrence of colorectal cancer. In this study, we first concretely demonstrated that FDG-PET oriented surgical indication had survival benefit for recurrent colorectal cancer. <h3>Disclosure of Interest</h3> None Declared
Case 32-1983
Authors: Richard C. Cabot, Robert E. Scully, Eugene J. Mark, Betty U. McNeely, James R. Lehrich, E. Tessa Hedley-Whyte, Nancy L. Harris
Journal: New England Journal of Medicine (1983)

Presentation of CaseA 31-year-old man was admitted to the hospital because of persistent fever and cranial-nerve defects.He was well until eight months earlier, when fatigue, anorexia, and intermittent fever developed, followed by the onset of a cough; during the next few months he lost 16 kg in weight. Six months before admission he entered another hospital, where physical examination showed cervical lymphadenopathy. An x-ray film of the chest (Fig. 1) revealed a left pleural effusion and a widened mediastinum. Microscopical examination of a biopsy specimen of a cervical lymph node and a specimen of bone marrow disclosed caseating . . .
SAT0088 First year rapid radiological progression is the best predictor of further progression in early arthritis: Results of the ESPOIR cohort
Authors: G. Tobon, A. Saraux, C. Lukas, F. Gandjbakhch, X. Mariette, B. Combe, V. Devauchelle-Pensec
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> One of the major goal in the treatment of early arthritis is to prevent articular destruction. Several factors predicting joint destruction have been identified but the rapidity of progression during the first year has never been evaluated. <h3>Objectives</h3> To determine in a large cohort of early arthritis, if the rapid progression during the first year was a predictor of further rapid progression during the next two years. <h3>Methods</h3> 813 patients with arthritis of less than 6 months were included in the prospective French “ESPOIR” cohort. Standardized radiographs of hand, wrist and foot in postero-anterior view (PAV) were performed at inclusion, one, two and three years. Inter and intraobserver variabilities were assessed. All the radiographs were examined by a blinded reader for modified Sharp score. The speed of progression was defined at one year (between M0 and M12: FIrst year Radiological Evolution (FIRE)) and after the next two years (between M12 and M36: (FUrther Radiographic Evolution (FURE)). The patients with a speed of annual progression of more than 2.5 in the erosion or joint space narrowing and 5 for the total Sharp score were considered as rapid progressor (rp). <h3>Results</h3> 535 patients have a complete set of radiographs. Among them 7% (35/500) received biological treatment before one year. None of them had FURE-rp erosion. For the 500 remaining patients without biologics, the correlation between narrowing and erosion progression during the first year was low (r: 0.3). During the first year, 37/500 (7.4%) did not have radiographic progression and 25% (123/500) were rapid progressor. During the following years, 53/500 (10.5%) had FURE-rp for erosion, 146/500 (29%) and 92/500 (18.4%) for total Sharp score. The presence of RF or ACPA in both set of classification criteria (1987 ACR or ACR/EULAR criteria), and the item 7 of the 1987 ACR criteria were associated with FURE-rp for erosion narrowing or total score. FIRE erosion, narrowing or total score were associated with all FURE-rp (p&lt;0.0001). Using logistic regression, FURE-rp erosion was best predicted by the serological item, the level of Il-6, FIRE-rp for total score and erosion at inclusion. FURE-rp narrowing was predicted by the serological item, the level of Il-6 and FIRE-rp total score. FURE-rp total score was predicted by the serological item, the level of Il-6, FIRE erosion and erosion at inclusion. When items were combined, the FIRE criteria performed better than other criteria to predict FURE-rp. <h3>Conclusions</h3> The first year radiological progression is an independent predictor of further rapid progression in early arthritis. <h3>Disclosure of Interest</h3> None Declared
Abstract 1622: Possible role of visfatin in hepatoma progression and the effects of branched-chain amino acids on visfatin-induced proliferation in human hepatoma cells
Authors: Masahito Shimizu, Soranobu Ninomiya, Hisataka Moriwaki
Journal: Cancer Research (2012)

Abstract Obesity and related metabolic abnormalities, including adipocytokine dysbalance, are risk factors for hepatocellular carcinoma (HCC). Visfatin, an adipocytokine that is highly expressed in visceral fat, is suggested to play a role in the progression of human malignancies. Branched-chain amino acids (BCAA) reduces the incidence of HCC in obese patients with liver cirrhosis and prevents obesity-related liver carcinogenesis in mice. In this study, we investigated the possible role of visfatin on HCC progression and the effects of BCAA on visfatin-induced proliferation of HCC cells. In patients with HCC, serum visfatin levels were significantly correlated with stage progression and tumor enlargement. Visfatin preferentially stimulated the proliferation of HepG2, Hep3B, and HuH7 human HCC cells compared with Hc normal hepatocytes. Visfatin phosphorylated ERK, Akt, and GSK-3β proteins in HepG2 cells. LY294002 (a PI3K inhibitor), PD98059 (a MEK1 inhibitor), CHIR99021 (a GSK-3β inhibitor), and BCAA significantly inhibited visfatin-induced proliferation in HepG2 cells. BCAA also inhibited phosphorylation of GSK-3β, increased cellular levels of p21, caused cell cycle arrest in G0-G1, and induced apoptosis in HCC cells in the presence of visfatin. These findings suggest that visfatin plays a critical role in the proliferation of HCC cells and may be associated with the progression of this malignancy. In addition, BCAA might inhibit obesity-related liver carcinogenesis by targeting and, possibly, by overcoming the stimulatory effects of visfatin. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 1622. doi:1538-7445.AM2012-1622
SP0180 Health professionals workshop session: “I’ve been asked to review a clinical guideline – where do I start?”
Authors: M. Stoffer, L. van Bodegom-Vos, H. Lund, T. Vliet Vlieland
Journal: Annals of the Rheumatic Diseases (2012)

The number of Clinical Guidelines (CG) is constantly increasing and the quality of CGs differs largely. For this reason, a critical appraisal with standardized instruments is important. The aims of this appraisal are to determine the quality of CGs and to ensure that those with the highest quality will be disseminated and implemented. An appropriate international standard for assessing the methodological quality of CGs represents the "Appraisal of Guidelines for Research and Evaluation (AGREE II) Instrument" (www.agreetrust.org). Part of the workshop will be an introduction to the AGREE II Instrument as well as a practical exercise on the AGREE II Instrument including a plenary discussion of the results. <h3>Disclosure of Interest</h3> None Declared
Abstract 5682: Modeling the pharmacological importance of endoxifen for the treatment of ER-positive breast cancer in premenopausal patients
Authors: Philipp Y. Maximov, Russell E. McDaniel, V. Craig Jordan, Hiltrud Brauch
Journal: Cancer Research (2012)

Abstract Long term adjuvant tamoxifen therapy for five years is the antiestrogenic standard of care for ER-positive breast cancer in premenopausal patients. The metabolic activation of tamoxifen by CYP2D6 to endoxifen remains controversial to plan the treatment of patients with breast cancer. However, all retrospective studies focus entirely on postmenopausal patients and no studies have been undertaken in the relevant premenopausal treatment population. We have addressed the issue of the pharmacological importance of endoxifen to control the estrogen-stimulated growth of four ER-positive breast cancer cell lines (MCF-7, T47-D, BT-474 and ZR-75). We have modeled the actual estrogen environment in the laboratory (estradiol plus estrone) based on previous data from premenopausal patients taking tamoxifen (Jordan et al, JNCI 2001; 83:1488-91). Our strategy was to evaluate the anti-proliferative actions of actual concentrations of tamoxifen, N-desmethyltamoxifen and 4-hydroxytamoxifen combined, based on the actual measurements reported for these metabolites in patients who were extensive metabolizers (EM), intermediate metabolizers (IM) or poor metabolizers (PM) (Mürdter et al, Clin Pharmacol Ther 2011; 89:708-17). These data were then compared with similar anti-proliferative experiments in the four cell lines, using endoxifen obtained from four sources (Mayo Clinic, University of Indiana, Institut für Klinische Pharmakologie (IKP) and the Fox Chase Cancer Center). Each cell line was evaluated with the clinically relevant circulating levels of estrogen, with and without the inclusion of the different endoxifens at the published concentrations from EM, IM and PM. It is important to note that all synthetic endoxifen currently available is an impure mixture of geometric isomers. Therefore, results obtained are only an estimate of the efficacy of endoxifen in the patient. To address this issue, we have specifically synthesized the appropriate isomer of endoxifen as a fixed ring compound that can no longer isomerize. We have previously used this strategy to discover the actual pharmacology of the two geometric isomers of 4-hydroxytamoxifen (Murphy et al, Mol Pharm 1990; 38:737-43). The results demonstrate the essential requirement with the appropriate concentration of endoxifen necessary to block estrogen-mediated cell replication. Acknowledgements: This work (VCJ) was supported the subcontract under the SU2C (AACR) Grant number SU2C-AACR-DT0409; the Susan G Komen For The Cure Foundation under Award number SAC100009. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 5682. doi:1538-7445.AM2012-5682
Prognosis of Abdominal Aortic Aneurysms
Authors: Martin P. Nevitt, David J. Ballard, John W. Hallett
Journal: New England Journal of Medicine (1989)

Information is incomplete about the rate of expansion of abdominal aortic aneurysms and the risk of rupture in relation to their size. To address these questions, we conducted a population-based study. Of the 370 residents of Rochester, Minn., with an aneurysm initially diagnosed from 1951 through 1984, 181 had the aneurysm documented by ultrasound examination. Among the 103 patients who underwent more than one ultrasound study, the diameter of the aneurysm increased by a median of 0.21 cm per year. Only 24 percent had a rate of expansion of 0.4 cm or more per year. Among the 176 patients who had an unruptured aneurysm at the time of the initial ultrasound study, the cumulative incidence of rupture was 6 percent after 5 years and 8 percent after 10 years. However, the risk of rupture over five years was 0 percent for the 130 patients with an aneurysm less than 5 cm in diameter and 25 percent for the 46 patients with an aneurysm 5 cm or more in diameter. All 16 patients who had ruptures had aneurysms that were 5 cm or more in diameter at the time of the rupture. These population-based data challenge the clinical perception that aneurysms typically expand at a rate of 0.4 to 0.5 cm per year. Our data also suggest that for aneurysms less than 5 cm in diameter the risk of rupture is considerably lower than has been reported previously. However, the risk of rupture is substantial for aneurysms 5 cm or more in diameter.
Gastric metastasis of a renal cell carcinoma presenting as a polypoid mass
Authors: Emrah Kumcu, Mehmet Gönültas, Hatǐce Ünverdǐ, Sema Hücümenoğlu
Journal: Endoscopy (2014)

Renal cell carcinomas (RCCs) account for approximately 3 % of adult malignancies. More than 50 % of RCCs are detected incidentally, and in approximately one-third of patients, RCCs have metastasized at the time of initial diagnosis [1]. The sites of metastasis include the lungs (75 %), soft tissues (36 %), bones (20 %), liver (18 %), skin (8 %), and central nervous system (8 %) [2]. Gastric metastases of RCC are extremely rare, with only 23 cases reported in the literature [3]. We describe here a case of metastatic RCC presenting as a polypoid mass 7 cm in diameter.
AB1412 Nurses can achieve very good agreement with physicians for joint counts in rheumatoid arthritis – a feasible training method
Authors: P. Cheung, M. Dougados, V. Andre, N. Balandraud, G. Chales, I. Chary-Valckenaere, E. Chatelus, E. Dernis, G. Gill, M. Gilson, S. Guis, G. Mouterde, T. Marhadour, M. Nguyen, S. Pavy, F. Pouyol, P. Richette, A. Ruyssen-Witrand, M. Soubrier, L. Gossec
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> "Tight control" of rheumatoid arthritis (RA) necessitates regular disease activity assessment using clinical joint counts. However, joint counts take time, and are not always performed in busy clinics [1]. Nurses are now increasingly involved in joint count assessment but training for joint counts is not standardised. <h3>Objectives</h3> Evaluate an effective method of teaching nurses to perform 28-joint counts (tender and swollen). <h3>Methods</h3> This was the first phase of a national study (COMEDRA).Twenty nurses from university rheumatology centers without any joint count experience were allocated to a rheumatologist from their center (trainer). Training program consisted of 2 phases: Phase 1 was a centralized 4 hour training session, with (a) a one-hour lecture and demonstration, and (b) practical sessions on patients with the trainers. Phase 2 involved further practice on 20 patients in their own hospitals; with 10 nurses randomized to (i) one additional comparative assessment with the trainer for patient 10, and 10 nurses to (ii) no further training (but a separate assessment by the trainer at patient 10). Strength of agreement was measured between each nurse and his/her trainer, through prevalence adjusted biased adjusted kappa (PABAK); poor agreement &lt;0.20, Fair agreement 0.20-0.40, Moderate Agreement 0.40-0.60, Good agreement 0.60-0.80, Very good agreement 0.80-1.00. <h3>Results</h3> Mean pooled PABAK for swollen joint agreement at baseline was 0.67 (95%CI 0.57, 0.77). By the end of the training program, this increased to 0.82 (95%CI 0.80, 0.93). There were successive improvements in swollen joint PABAK at each assessment point and by the end of training; everyone had achieved a swollen joint PABAK &gt;0.60 with their trainer except 2 nurses. Most of the improvement was seen during Phase 2. In Phase 2, swollen joint agreement improved for those who had the additional training; from PABAK 0.71 (95%CI 0.57, 0.84) to 0.83 (95%CI 0.70, 0.96), but not for those who had no further training; PABAK 0.79 (95%CI 0.53, 1.0) to 0.80 (95%CI 0.62, 0.99). The agreement for tender joints remained very good throughout Phase 1 and 2 with PABAK &gt;0.80 at each assessment point. <h3>Conclusions</h3> Nurses can effectively learn how to perform swollen and tender joint counts with this teaching method. Swollen joint agreement improved significantly. This method can be practically applied in the clinical setting. <h3>References</h3> Pincus T, Segurado OG. Ann Rheum Dis 2006; 65: 820-2. <h3>Disclosure of Interest</h3> None Declared