tbuckley/cabot-search huggingface dataset:
P114 What Skills, Experience And Training Are Need To Work In Integrated Respiratory Specialist Roles And How Can We Roll These Posts Out In The Uk?
Authors: N. Roberts, M. Ward, I. Patel, J. Yorke, J. Williams, R. Walters, M. McKevitt, S. Edwards
Journal: Thorax (2014)

<h3>Aims</h3> There is an increased drive towards healthcare integration in the UK (UK) to adapt to new health care needs. In response to this, new ways of delivering care have been developed such as the provision of integrated respiratory specialists. This project set out to describe these roles, the key skills needed and how junior staff can aspire to these roles. <h3>Methods</h3> Semi-structured telephone interviews with 12 integrated care specialists or those currently working with integrated respiratory care teams were undertaken to explore and discuss the role of integrated respiratory specialists. <h3>Results</h3> Nine integrated specialists were interviewed (6 physicians, 2 nurses, 1 physiotherapist). One Specialist Trainee (StR), a general practitioner (GP) and a pharmacist were also interviewed. The integrated role was variable for participants; most were involved in MDTs, education for staff and developing guidance, with some involved in community or virtual clinics. Physicians were more likely to be involved in Acute Medical Unit reviews. Five interviewees had two joint leads with either two physicians, or a physician and a nurse. Key skills identified by the interviewees included respiratory specialist knowledge, prior primary care experience as well as knowledge of the NHS, commissioning and social services processes. Specific training included conflict management, advanced communication and research and evaluation skills (health economics and service evaluation). Three areas were highlighted to support the establishment of new posts: clear details about the posts and standards of care; embedding integrated care into training; increasing visibility of this new area and gaining support from appropriate organisations. <h3>Conclusions</h3> Interviewees highlighted that existing posts should be used as exemplars to provide junior staff with more information about these roles. Greater collaboration with professional societies such as the BTS, ERS and PCRS for education as well as to promote and advance these new potential career pathways should be undertaken. Funded by the British Thoracic Society.
The Role of FDG PET/CT in Patients with Locoregional Breast Cancer Recurrence and a Comparison to Conventional Imaging.
Authors: T. Aukema, E. Rutgers, W. Vogel, H. Teertstra, H. Oldenburg, M. Vrancken Peeters, J. Wesseling, N. Russell, R. Valdés Olmos
Journal: Cancer Research (2009)

Abstract Background: The prognosis and clinical management of patients with locoregional recurrence of breast cancer depends on the extent of the disease. Conventional work-up, consisting of bone scintigraphy, liver ultrasound, X-ray or CT of the thorax and MRI of the thoracic wall, may underestimate the local extent or miss the presence of distant metastases. The aim of this study was to evaluate the impact of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) on clinical management in patients with locoregional breast cancer recurrence amenable for locoregional treatment and compare the results with conventional imaging.Material and Methods: We performed a retrospective analysis of all patients referred for FDG PET/CT with locoregional breast cancer recurrence between January 2006 and August 2008. PET/CT findings were compared with results of additional imaging, pathology and follow-up. The impact of FDG PET/CT findings on clinical management of patients, was evaluated on the basis of clinical decisions obtained from patient files.Results: 56 patients were included. In 93% of the patients FDG PET/CT confirmed the locoregional recurrence. In 32 patients (57%) FDG PET/CT revealed additional tumour localisations. Distant metastases were detected in 11 patients on conventional imaging and in 23 patients on FDG PET/CT images (p&amp;lt;0,01). In 25 patients (45%), FDG PET/CT detected additional lesions not visible on conventional imaging. FDG PET/CT had an impact on clinical management in 27 patients (48%) by detecting more extensive locoregional disease or distant metastases. In 20 patients (36%) unnecessary mutilating surgery was prevented and treatment was changed to palliative systemic treatment. The sensitivity, specificity, accuracy, positive and negative predictive values of FDG PET/CT were respectively 97%, 92%, 95%, 94% and 96%.Discussion: FDG PET/CT, in addition to conventional imaging, plays an important role in staging patients with locoregional breast cancer recurrence since its result changed the clinical management in almost half of the patients. FDG PET/CT could potentially replace conventional staging imaging in patients with a locoregional breast cancer recurrence. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 5011.
Cortical astrocytes rewire somatosensory cortical circuits for peripheral neuropathic pain
Authors: Sun Kwang Kim, Hideaki Hayashi, Tatsuya Ishikawa, Keisuke Shibata, Eiji Shigetomi, Youichi Shinozaki, Hiroyuki Inada, Seung Eon Roh, Sang Jeong Kim, Gihyun Lee, Hyunsu Bae, Andrew J. Moorhouse, Katsuhiko Mikoshiba, Yugo Fukazawa, Schuichi Koizumi, Junichi Nabekura
Journal: Journal of Clinical Investigation (2016)

Long-term treatments to ameliorate peripheral neuropathic pain that includes mechanical allodynia are limited. While glial activation and altered nociceptive transmission within the spinal cord are associated with the pathogenesis of mechanical allodynia, changes in cortical circuits also accompany peripheral nerve injury and may represent additional therapeutic targets. Dendritic spine plasticity in the S1 cortex appears within days following nerve injury; however, the underlying cellular mechanisms of this plasticity and whether it has a causal relationship to allodynia remain unsolved. Furthermore, it is not known whether glial activation occurs within the S1 cortex following injury or whether it contributes to this S1 synaptic plasticity. Using in vivo 2-photon imaging with genetic and pharmacological manipulations of murine models, we have shown that sciatic nerve ligation induces a re-emergence of immature metabotropic glutamate receptor 5 (mGluR5) signaling in S1 astroglia, which elicits spontaneous somatic Ca2+ transients, synaptogenic thrombospondin 1 (TSP-1) release, and synapse formation. This S1 astrocyte reactivation was evident only during the first week after injury and correlated with the temporal changes in S1 extracellular glutamate levels and dendritic spine turnover. Blocking the astrocytic mGluR5-signaling pathway suppressed mechanical allodynia, while activating this pathway in the absence of any peripheral injury induced long-lasting (>1 month) allodynia. We conclude that reawakened astrocytes are a key trigger for S1 circuit rewiring and that this contributes to neuropathic mechanical allodynia.
Endoscopic submucosal dissection of high grade intraepithelial neoplasia of the head and neck in a patient after surgical resection of esophageal cancer
Authors: Yu-qi He, Ai-qin Li, Xin Wang, Kuang-I Fu, Jian-qiu Sheng
Journal: Endoscopy (2015)

Patients with esophageal squamous cell carcinoma (SCC) frequently develop second primary SCC of the head and neck (HNSCC) synchronously and/or metachronously [1]. Previous studies reported that narrow-band imaging (NBI) was useful for identifying HNSCC at an early stage [2] and that endoscopic submucosal dissection (ESD) [3] could be used for treatment. In this report, we describe a case of early-stage HNSCC developing metachronously 1.5 years after esophageal cancer surgery that was detected and successfully treated.
Abstract SY04-01: Skin stem cells in silence, action, and cancer
Authors: Elaine Fuchs
Journal: Cancer Research (2012)

Abstract Stem cells have the ability to self-renew long term and differentiate into one or more tissues. Typically, stem cells are used sparingly to replenish cells during normal homeostasis. This is particularly true of adult tissues which undergo relatively infrequent or periodic turnover. However, stem cells must also have the ability to respond quickly in response to injury, where they must be mobilized to undergo rapid tissue regeneration. How stem cells balance self-renewal and differentiation is of fundamental importance to our understanding of normal tissue maintenance and wound repair. Moreover, increasing evidence suggests that the regulatory circuitry governing this balancing act is at the root of some types of tumors both in mice and in humans. The skin is an excellent model system to understand how stem cells function in normal tissue generation and how this process goes awry in cancer. Using skin as our paradigm, we've been dissecting how extrinsic signaling to stem sets off a cascade of changes in transcription that governs the activation of stem cells during tissue development, homeostasis and hair regeneration. Our findings have provided us with new insights into our understanding of the process of stem cell activation, and in so doing have revealed mechanisms which are also deregulated in a variety of different human cancers. As importantly in understanding how stem cells are activated is learning about the signals that instruct stem cells to stop making tissue. Our recent discoveries on this topic have led us to the realm of identifying cancer stem cells (tumor-initiating cells) of squamous cell carcinomas of the skin. The second most abundant form of cancer world-wide, skin squamous cell carcinomas also establish a paradigm for many life-threatening cancers of lung, esophagus, breast, cervix, prostate, throat and oral tissues. We've demonstrated that when purified and introduced directly into the skin of a host recipient, a single cancer stem cell from a skin squamous cell carcinoma can generate a new squamous cell carcinoma that is similar in properties to the parent tumor. We show that cancer stem cell numbers and aggressiveness are predicated on the tumor microenvironment and on the ability of cancer stem cells to respond to it. The striking differences between the microenvironments of cancer stem cells and their normal counterparts seems likely to contribute to why their expression profiles are also markedly distinct. Our findings have major implications for our understanding of stem cells and cancer. [This work was supported by the HHMI and grants from the National Institutes of Health and The Emerald Foundation] 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 SY04-01. doi:1538-7445.AM2012-SY04-01
Commentary: Biomarker Strategies to Evaluate the Environmental Effects of Chemicals
Authors: Colin H. Walker
Journal: Environmental Health Perspectives (1998)

Environmental risk assessment of chemicals depends on the production of toxicity data for surrogate species of mammals, birds, and fish and on making comparisons between these and estimated or predicted environmental concentrations of the chemicals.This paper gives an overview of biomarker assays and strategies that might be used as alternatives, that is, to replace, reduce, or refine currently used ecotoxicity tests that cause suffering to vertebrates.In the present context a biomarker is a biologic response to an environmental chemical at the individual level or below which demonstrates a departure from normal status.Of immediate interest and relevance are nondestructive assays that provide a measure of toxic effect in vertebrate species and that can be used in both laboratory and parallel field studies.A major shortcoming of this approach is that such assays are currently only available for a limited number of chemicals, primarily when the mode of action is known.Nondestructive assays can be performed on blood, skin, excreta, and eggs of birds, fish, reptiles, and amphibians.An interesting recent development is the use of vertebrate cell cultures, including transgenic cell lines that have been developed specifically for toxicity testing.The ultimate concern in ecotoxicology is the effects of chemicals at the level of populations and above.Current risk assessment practices do not address this problem.The development of biomarker strategies could be part of a movement toward more ecologic end points in the safety evaluation of chemicals, which would effect a reduction in animal tests that cause suffering.
Transpapillary EUS-guided retrograde puncture of the biliary tree as an alternative for failed rendezvous procedure
Authors: Vera Santos, Nuno Nunes, Filipa Ávila, Ana Rego, José Pereira, Nuno Paz, Maria Duarte
Journal: Endoscopy (2014)

Endoscopic retrograde cholangiopancreatography (ERCP) is a first-line therapeutic method for obstructive biliary pathologies. Rarely, this procedure fails to obtain access and/or drainage of the biliary tree [1]. Until recently, such patients could be managed only via a percutaneous or surgical approach. An emerging alternative is endoscopic ultrasound (EUS)-assisted biliary access and drainage, namely rendezvous procedure. However, this technique is unsuccessful in 25 % of patients [2].
Alcoolisation des cystadénomes mucineux pancréatiques: résultats à court terme d'une étude bicentrique rétrospective sur 14 kystes
Authors: F Caillol, L Poincloux, E Cruzille, E Bories, C Pesenti, G Monges, G Bommelaer, M Giovannini
Journal: Endoscopy (2012)

Les kystes mucineux du pancréas sont des lésions d'évolution maligne avec un temps de transformation maligne estimé à 10 ans. Le traitement de référence est une chirurgie lourde et morbide pour ces lésions non dégénérés. Nous rapportons une expérience bi-centrique de traitement par alcoolisation de ces lésions kystiques pancréatiques.
SP0214 Differences across Europe in the Delivery of Patient Education – What Should BE Done?
Authors: K. Niedermann
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> Patient education (PE) is "a planned, interactive process between patients and health professionals (HPs), aimed at supporting and enabling patients to manage their life with arthritis and optimising their health and well-being" [1]. PE is considered an integral part of the management of inflammatory arthritis (IA) and new issues such as pharmacological treatment options and the risk for developing cardiovascular diseases have increased the importance of PE interventions. Although provision of PE is assumed to be a role for all HPs, the degree of participation from different HPs in PE activities is likely to be different across European countries. <h3>Objective</h3> The aim of the presentation is to give an overview of (1) the differences in the delivery of PE and (2) the involvement of HPs across Europe and discuss possible reasons for this and what could be done to improve the standards of PE. <h3>Discussion</h3> Determinants for PE provision and HPs9 involvement are found on different levels: a) The various health care systems, with its available financial and structural resources; b) The education of HPs in European countries that take place in different systems and may define the status of the HPs, their competencies and availability and ultimately their professional roles; c) The wide variations in the roles of rheumatology HPs, which translate into large variability in HPs9 involvement in PE activities; and d) The wide variations in the roles of the patients in the different countries. In some countries, patients are considered as PE receivers and HPs as the experts, with main focus of knowledge delivery. In other countries, patients are actively involved and considered as experts in living with the disease and its associated challenges and thus the HPs aim to facilitate the patients9 adjustments in living with their condition, using multi-professional approaches and new technology interactively. <h3>Conclusions</h3> There is a need to define standards for the delivery of PE in patients with IA in Europe. An important step towards this aim may be the development of evidence-based recommendations for PE. However, the successful implementation of such recommendations across Europe may depend on knowledge about the current status of the PE activities and the involvement of HPs in the different countries. <h3>References</h3> Task Force definition of patient education, EULAR recommendations/points to consider for patient education of people with inflammatory arthritis. Amsterdam, July 2013 Stamm T, Hill J. Extended roles of non-physician health professionals and innovative models of care within Europe: results from a web-based survey. Musculoskeletal Care. 2011 Jun;9(2):93-101. <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.6212
FRI0391 The Association between Type I Interferon Response, Complement Activation and Clinical Findings in Systemic Lupus Erythematosus
Authors: K. Sacar, O.N. Pamuk, G.E. Pamuk, M.S. Uyanik, S. Donmez
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> The complement system plays an important role in systemic lupus erythematosus (SLE) and it might be a therapeutic target for therapy. Type I interferon (IFN) response and type I IFN-induced gene expression are generally enhanced in SLE. Therefore, it was suggested that type I IFN response played a role in SLE pathogenesis. <h3>Objectives</h3> We evaluated some biomarkers associated with type I IFN response and complement activation in SLE; and determined their relationship with clinical findings. <h3>Methods</h3> We included 94 SLE patients (88 females, 6 males, mean age: 39 years) and 101 healthy controls (87 females, 14 males, mean age: 38 years). SLE patients9 clinical and laboratory data were obtained from medical records. Complement factor H, complement fragments Bb, C3a-des-arg, ficolin-2, sCXCL-12 (plasma stromal cell derived factor, SDF-1), sCXCL-10 (IP-10), neutrophil activation-related LL-37, and BLyS levels were determined with ELISA kits. <h3>Results</h3> SLE patients had significantly higher sCXCL-12 (646.9±859.1 vs. 242.8±240.8, p=0.001), sCXCL-10 (469.6±537.9 vs. 262.9±351.4, p=0.012), and complement fragments Bb (4.36±2.2 vs 3.68±2.5, p=0.046) levels than healthy controls. C3a-des-arg (4.14±2.2 vs. 4.94±1.4, p=0.003) and LL-37 (3.74±1.8 vs. 5.5±1.6, p&lt;0.001) levels were significantly lower in SLE group than in the control group. Ficolin-2 and BLyS levels were similar in both groups. When SLE patients whose SLEDAI scores were active and inactive were compared, it was seen that sCXCL-10 was significantly higher in the former group (p=0.023). SLE patients with arthritis had significantly higher sCXCL-12 (p=0.003), BLyS (p=0.03), sCXCL-10 (p=0.001) and complement fragments Bb (p=0.004) levels than SLE patients without arthritis. SLE patients with neurologic involvement had significantly lower C3a-des-arg level when compared to other SLE patients (3.23±1.56 vs 4.43±2.04, p=0.022). C3a-des-arg level was significantly higher in SLE patients with thrombocytopenia than SLE patients without thrombocytopenia (5.44±2.64 vs 4.03±1.98, p=0.043). sCXCL-10 correlated with SLEDAI score (r=0.33, p=0.014), disease duration (r=0.26, p=0.05), and BLyS level (r=0.59, p&lt;0.001). BLyS was found to correlate with LL-37 (r=0.27, p=0.033) and disease duration (r=0.39, p=0.002). Complement fragment Bb correlated with CRP level (r=0.3, p=0.005). <h3>Conclusions</h3> Our results support the roles of type I IFN response and complement activation in the pathogenesis of SLE. sCXCL-12, sCXCL-10, C3a-des-arg, LL-37, and complement fragments Bb might be used as biomarkers in SLE and they might be useful to define certain clinical subgroups. <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.3752
Abstract 1411: Calcium-depending formation of bone metastases in patients with renal cell carcinoma
Authors: Elke Schneider, Frederik Roos, Christian Hampel, Joachim W. Thüroff, Walburgis Brenner
Journal: Cancer Research (2012)

Abstract Introduction: Although a number of molecules have been implicated in the process of formation of cancer metastases, the organ-selective nature of cancer cells is still poorly understood. Renal cell carcinoma (RCC) often metastasize into bones, a calcium enriched tissue. We analyzed the influence of the calcium sensing receptor (CaSR) in RCC and an enhanced extracellular calcium concentration in processes of metastatic spread. Material and Methods: In 33 matched RCC specimens, 11 non-metastasized, 11 metastasized into the lung and 11 metastasized into bones five years after nephrectomy, CaSR was quantified by RT-PCR and Western blot analyses. To investigate the influence of enhanced extracellular calcium on the formation of metastases, primary RCC cells were isolated from patients developing bone, lung and no metastasis five years after nephrectomy (each 3 cell lines). Cell proliferation after calcium treatment (2.5, 5 and 10 µM) was quantified by BrdU incorporation. Cell migration was determined in a Boyden chemotaxis assay with calcium as chemotactical agent (10 µM). Expression and activity of intracellular signal transduction mediators were analyzed by a human phospho kinase array and Western blot analyses. Results: Compared to non-metastasizing RCC, CaSR mRNA expression was 10.8-fold increased and CaSR protein level was 1.5-fold increased in tumor specimens of patients developing bone metastases. In primary RCC cells with a high bone metastastic potential CaSR expression was 3.7-fold higher compared to non-metastasizing RCC cells. Calcium treatment of bone-metastasizing RCC cells, but not of non-metastasizing cells, induced a concentration dependent enhancement of proliferation. In a Boyden chamber experiment with calcium as chemo attractant, RCC cells from patients with bone metastases showed a 9.4-fold higher migratory potential compared to cells from patients without metastases. In lung metastatic RCC cells migration was only 1.7-fold enhanced. The enhanced proliferation and migration of cells with high potential to build bone metastases seem to be caused by an activation of Akt and a highly increased integrin alpha 5 expression. Additionally, the tumor suppressor PTEN was markedly reduced in tumors metastasizing into bones and after calcium treatment, promoting tumor progression. Conclusion: Our results indicate that formation of bone metastases of RCC is caused by an enhanced expression of the CaSR. Extracellular calcium has a promoting effect on cell migration and proliferation of bone metastasizing RCC cells via Akt signalling and integrin alpha 5. 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 1411. doi:1538-7445.AM2012-1411
Intermittent “Intermittent” Hydronephrosis
Authors: S Turpin, G Drouin
Journal: Clinical Nuclear Medicine (2001)

From the Department of Nuclear Medicine* and the Division of Urology,† Department of Surgery, Centre Hospitalier Universitaire de Montréal, Hôtel-Dieu, Montréal, Canada Received for publication September 25, 2000. Revision accepted January 22, 2001. Correspondence: Sophie Turpin, Department of Nuclear Medicine, Hôtel-Dieu de Montréal, 3840 St-Urbain, Montréal, Canada, H2W 1T8.