tbuckley/cabot-search huggingface dataset:
Successful use of a covered, retrievable stent to seal a ruptured mucosal flap safety valve during peroral endoscopic myotomy in a child with achalasia
Authors: T. Ling, Q. Pei, J. Pan, X. Zhang, Y. Lv, W. Li, X. Zou
Journal: Endoscopy (2013)

An 8-year-old boy was admitted to our hospital due to intermittent episodes of dysphagia over the past 5 years, which was severely affecting his physical growth and quality of life. He was diagnosed as having achalasia 3 years ago, and had twice undergone endoscopic balloon dilation. However, both times the dysphagia recurred very soon after the dilation procedure. The child was only able to swallow fluids at the time of admission.
Hemodynamic Effects of Intravenously Administered Sodium Citrate
Authors: John P. Bunker, Henrik H. Bendixen, Anna J. Murphy
Journal: New England Journal of Medicine (1962)

MARKED elevations of serum citrate have been reported to occur in man during multiple rapid transfusions of citrated blood.1 2 3 The possibility of harmful effects is well recognized but often discounted.2 , 4 In an attempt to separate the circulatory effects of citrate from many other potentially adverse effects of massive transfusion, we have studied the hemodynamic effects of intravenous infusions of sodium citrate in normal, lightly anesthetized man and in the dog.MethodsClinical MaterialSix patients, 5 females and 1 male, were studied. Their ages were thirty-one to forty-four, with an average of thirty-eight years. All were undergoing ligation and stripping . . .
SAT0095 Periarticular Bone Loss in Female Patients with Rheumatoid Arthritis: A Case-Control Study Using HR-PQCT
Authors: Y. Zhu, J. F. Griffith, L. Qin, V. W. Hung, T.-N. Fong, S.-K. Au, X.-L. Tang, A. W. Kwok, P.-C. Leung, E. K. Li, L.-S. Tam
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Periarticular bone loss is an early sign of bone involvement in rheumatoid arthritis (RA) and a predictor of subsequent radiographic erosion. High-resolution peripheral quantitative computed tomography (HR-pQCT) is a non-invasive 3D imaging technique capable of independent evaluation of cortical and trabecular components and their respective microstructural features. <h3>Objectives</h3> To investigate loss of cortical and trabecular volumetric bone mineral density (vBMD) and changes in microstructure at the second metacarpal bone in RA patients in comparison with healthy controls <h3>Methods</h3> For this cross-sectional study, images of the second metacarpal bone were obtained using HR-pQCT in a group of 56 middle-aged RA females (age: 48.5±8.1yrs, disease duration: 10.4±7.8yrs) and a group of 56 matched healthy females (age: 49.5±8.1yrs). HR-pQCT data acquisition yielded a series of 110CT slices proximal to the distal articular surface of the metacarpal head, providing measures of vBMD as well as cortical and trabecular microstructure. <h3>Results</h3> There were no significant differences between RA patients and controls in age, body height, body weight, menstrual status, and smoking and drinking habit. Cortical area was decreased significantly in RA patients (-21%, p=0.022) with preserved trabecular area (2.6%, p=0.242). RA patients had significantly decreased cortical (-9%, p=0.001) and trabecular vBMD (-11%, p&lt;0.0001), thinner cortices (-23%, p=0.011), decreased trabecular bone volume fraction (-11%, p&lt;0.0001), and thinner trabeculae (-10%, p=0.002). Trabecular number (-1%, p=0.848) and separation (4%, p=0.347) were comparable between the two groups. Decreases in trabecular vBMD and bone volume fraction in RA patients significantly correlated with increased disease activity, as reflected by higher C-reaction protein levels and Disease Activity Score in 28 Joints scores. On the other hand, increased functional disability, as reflected by higher Health Assessment Questionnaire score, significantly correlated with a decrease in cortical area, cortical vBMD and cortical thickness. <h3>Conclusions</h3> Periarticular bone loss in RA is both cortical and trabecular in origin and correlates with increased disease activity and severity. Particularly prominent in RA patients was a decrease in both cortical area and cortical thinning reflecting how periarticular cortical bone loss in RA patients occurs at both the periosteal and endocortical bone sites. <h3>References</h3> Fouque-Aubert A, Boutroy S, Marotte H, Vilayphiou N, Bacchetta J, Miossec P, Delmas PD, Chapurlat RD. Assessment of hand bone loss in rheumatoid arthritis by high-resolution peripheral quantitative CT. <i>Ann Rheum Dis</i> 2010;69(9):1671-6. <h3>Disclosure of Interest</h3> None Declared
Idiopathic Hypertrophic Subaortic Stenosis in the Elderly
Authors: Richard B. Whiting, W. John Powell, Robert E. Dinsmore, Charles A. Sanders
Journal: New England Journal of Medicine (1971)

Thirty-two per cent (14 of 44) of patients with idiopathic hypertrophic subaortic stenosis catheterized at the Massachusetts General Hospital were over the age of 60; in only five (36 per cent) of these patients was the diagnosis considered before catheterization. Comparison of these (median age, 65) with younger patients (median age, 39) revealed striking similarity in symptomatology, physical findings and routine laboratory data. However, three of the older patients (21 per cent) exhibited diastolic blowing murmurs (p less than 0.01), and two (14 per cent) had aortic-valve calcification on x-ray study (p less than 0.05); both were absent in younger patients. All older patients had resting left ventricular outflow-tract gradients (53 ± 9 mm [mean ± S.E.M.], of mercury) whereas 23 per cent of the younger patients had absent resting gradients (32 ± 5 mm [mean ± S.E.M.] of mercury) (p less than 0.05). Thus, a substantial number of patients with idiopathic hypertrophic subaortic stenosis are elderly. The diagnosis in such cases is obscured, however, not only by age but also by certain features that suggest coronary or valvular disease.
AB0635 A comparison of three different types of synovial fluid preservation to study the stability of monosodium urate and calcium pyrophosphate dihydrate crystals
Authors: L. Kienhorst, R. Eijgelaar, M. Janssen
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Gout and pseudogout are frequent causes of inflammatory joint diseases. The gold standard to diagnose these diseases is synovial fluid analysis by the use of polarized light microscopy (PLM). This technique is used in less than 10% of all gout patients referred to rheumatologists.<sup>1</sup> Increase in the availability of synovial fluid analysis for general practioners (GPs) could improve the accuracy of the diagnoses of gout and pseudogout. Therefore synovial fluid should be able to be preserved in order to have time for transportation to and analysis with PLM.<sup>2-3</sup> <h3>Objectives</h3> To compare three different types of synovial fluid preservation aiming to determine crystal stability in synovial fluid to assess the feasibility of preservation of synovial fluid for off-site analysis. <h3>Methods</h3> Synovial fluid samples of 10 patients with a gout arthritis, 10 patients with a pseudogout arthritis and 10 control patients have been divided over 30 cuvets of at least 40 mcL each. 10 cuvets were stored at -20° C, 4° C and room temperature, respectively. No additives were added to the synovial fluid. All samples will be analyzed with PLM at 1, 2, 3, 4, 5, 6, 7, 8, 12 and 24 weeks. The parameters observed are the amount of crystals per view field, the size of the largest crystal, the amount of leucocytes per view field, the presence of microtophi, and the presence of intracellular crystals. <h3>Results</h3> The preliminary results of 5 gout, 2 pseudogout and 8 control patients are analyzed at baseline, after 3 and after 6 weeks of preservation. At room temperature 40% and 60% of the monosodium urate (MSU) crystals, and 50% and 50% of the calcium pyrophosphate dihydrate (CPPD) crystals were visible after 3 and 6 weeks, respectively. At 4° C MSU crystals were identified in 60% and 40%, and in 100% and 50% of the CPPD crystals after 3 and 6 weeks, respectively. At -20° C 80% and 80% of the MSU crystals, and 100% and 50% of the CPPD crystals were seen at 3 and 6 weeks, respectively. In the control patients no crystals were detected after 3 and 6 weeks. <h3>Conclusions</h3> A large amount of the MSU and CPPD crystals seem to be visible in synovial fluid after 3 and 6 weeks of preservation without additives at room temperature, 4° C and -20° C. This can increase the availability of synovial fluid analysis for GPs to improve the accuracy of the diagnoses of gout and pseudogout. <h3>References</h3> Owens, D., et al. (2008). A survey of the management of gout in primary care. Ir Med J 101(5): 147-9. Galvez, J., et al. (2002). Delayed examination of synovial fluid by ordinary and polarised light microscopy to detect and identify crystals. Ann Rheum Dis 61(5): 444-7. Kerolus, G., et al. (1989). Is it mandatory to examine synovial fluids promptly after arthrocentesis ? Arthritis Rheum 32(3): 271-8. <h3>Disclosure of Interest</h3> None Declared
Abstract 4394: Identification of molecular determinants of response to GSK1120212B, a potent and selective MEK inhibitor, as a single agent and in combination in RAS/RAF mutant non-small cell lung carcinoma cells
Authors: Li Liu, Shi Hong, Vivian Zhang, Tona Gilmer
Journal: Cancer Research (2011)

Abstract MEK, a downstream effector for RAS, RAF and receptor tyrosine kinases, represents a promising target for treatment of RAS/RAF mutated Non Small Cell Lung Carcinoma (NSCLC). GSK1120212B is a highly potent and selective oral MEK inhibitor currently in phase II clinical trials. To identify markers of response to GSK1120212B and to generate hypotheses for effective combination therapies, we characterized baseline signaling pathways and gene expression profiles in a panel of 29 NSCLC lines with RAS/RAF mutations and determined their sensitivity to GSK1120212B, erlotinib (EGFR inhibitor), everolimus (mTOR inhibitor), docetaxel and the combination of GSK1120212B with these agents. Inhibition of cell growth and induction of apoptosis were determined after 72 and 24 hours of treatment, respectively. GSK1120212B potently inhibited cell growth (IC50≤ 50 nM) in 13/29 (45%) of the lines and induced apoptosis in 8/29 (28%) of cell lines. We also identified genes such as TGFA, EREG, LGALS3, CTNND1, ARHGEF3, KLF4, RPH3AL, STN2, TWIST2 and FOXC1 whose expression levels were highly associated with the response to GSK1120212B. Cell signaling analyzed at baseline demonstrated that sensitivity to GSK1120212B was associated with high levels of pMEK, low levels of pAKT/pFOXO3a and wild-type PTEN, and resistance was associated with high levels of pAKT/pFOXO3a or mutations of PTEN/PIK3CA/CTNNB1 in RAS/RAF mutant lines. These results suggest combination approaches for cell lines resistant to single agent GSK1120212B. Erlotinib or everolimus alone showed little activity in RAS/RAF mutant lines. The combination of GSK1120212B and erlotinib was synergistic and/or enhanced cell growth inhibition in 6 out of 10 RAS/RAF mutant lines tested, three of which had HER1 amplification or over-express TGFA and EREG. The combination of GSK1120212B and everolimus enhanced cell growth inhibition in 25/29 (86%) of cell lines and increased apoptosis in 12/28 (43%) of RAS/RAF mutant lines. Intriguingly, the RAS/RAF mutated lines that were sensitive to GSK1120212B alone as measured by induction of apoptosis were less responsive to docetaxel. Further, the combination of GSK1120212B and docetaxel was synergistic or increased apoptosis in 20/28 RAS/RAF mutated lines. Our results provide a strong rationale for testing GSK1120212B and these combinations in the clinic and warrant further investigation of the gene expression signatures and genetic mutations in patients to ultimately improve treatment outcome in RAS/RAF mutated NSCLC. 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 4394. doi:10.1158/1538-7445.AM2011-4394
Scientists Find Better Ways To Find Better Drugs
Authors: K. Smigel
Journal: JNCI Journal of the National Cancer Institute (1991)

Journal Article Scientists Find Better Ways To Find Better Drugs Get access Kara Smigel Kara Smigel Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 83, Issue 19, 2 October 1991, Pages 1370–1372, https://doi.org/10.1093/jnci/83.19.1370 Published: 02 October 1991
AB0949 Treatment in mono-/oligo- and polyarthritic patients; a study on the swedish early psoriatic arthritis cohort (SWEPSA)
Authors: U. Lindqvist, T. Husmark, G.-M. Alenius, P.T. Larsson, A. Teleman, M. Geijer, E. Theander
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> The diverse features of psoriatic arthritis (PsA) with clinical classification changes over time and with difficulties to outline treatment recommendations causes suboptimal assessment in many cases. <h3>Objectives</h3> Patients with symptoms and signs of PsA have been documented in the Early Swedish Psoriatic arthritis Register (SwePsA). <h3>Methods</h3> Patients referred to the clinics within two years of onset of PsA were included in the register and followed up according to the program for SwePsA (1). Classification at inclusion and 5 years later was performed by the same rheumatologists according to the ClASsification Criteria for Psoriatic Arthritis (CASPAR) or ASAS. <h3>Results</h3> At classification on inclusion patients with mono- or oligoarticular (MO) disease were most frequent with 47% of 208 patients. Forty-two percent were classified as polyarticular (P) disease. Nine percent had axial involvement and 2% were in remission. One third of patients with MO disease were treated with DMARD. At reclassification on 5 year followup 80% remained MO patients and 18% were in remission. Treatment of 55% of P patients with DMARD or anti-TNF-alpha was performed and at reclassification after 5 years 40% had a MO disease and 8% were in remission (p=0.041). Minimal disease activity (MDA) (2) was assessed and patients with MO disease had significantly more frequent MDA compared to P patients at 5 year followup (p=0,047). Treatment of MO patients did not improve the number of patients reaching MDA at reevaluation. Neither was there any significant difference between treated and untreated MO patients reaching remission at 5 year followup. Also patients with P disease did not fulfill the criteria for MDA more often if treated with DMARD and/or anti-TNF-alpha compared to nontreated patients. On the contrary all P patients that reached remission were nontreated patients (p=0.006). There was a gender difference with more men reaching MDA (p=0.006) and remission (p=0.043) compared to women at 5 year followup. MDA and remission was achieved more frequent in patients before 40 years of age- <h3>Conclusions</h3> The effects of treatment in PsA patients in clinical practice are not clear-cut and need to be further evaluated. <h3>References</h3> Lindqvist U,Alenius G-M, Husmark T, Thunder E, Holmström G. For the Psoriatic Arthritis Group of the Swedish Society for Rheumatology. The Swedish early psoriatic arthritis register: two-year follow up. A comparison with early rheumatoid arthritis. J Rheumatol 2008;35:668-73 Coates L, Cook R, Lee KA, Chandran V, Gladman DD. Frequency, predictors, and prognosis of sustained minimal disease activity in an observational psoriatic arthritis cohort.Arthritis Care Res 2010;62:970-6 <h3>Disclosure of Interest</h3> None Declared
SAT0359 The Number of Episodes of Acute Inflammation are Associated to Both Acute Gastrointestinal and Renal Complications Attributed to Nsaids in Patients with Gout
Authors: F. Perez-Ruiz, A. Herrero-Beites
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Untreated or undertreated gout is characterized by recurrent episodes of acute inflammation (EAIs) of joint structures, called gout flares, and flares are commonly treated with non-steroidal anti-inflammatory drugs (NSAIDs). Proper control of hyperuricemia is associated with a decrease to none of EAIs (1). <h3>Objectives</h3> To evaluate risk factors associated with gastrointestinal and renal complications attributed to NSAIDs in patients with gout in a cohort of patients in which variables of gout severity are available. <h3>Methods</h3> Retrospective analysis of a cohort of 904 gout patients in whom general variables (age, gender, renal function, ethanol intake, hypertension, hyperlipidemia, diabetes, vascular events, diuretic use) and also variables related to gout and severity of gout (hyperuricemia, number for flares per year, presence of tophi, joint distribution, X-ray involvement, previous urate-lowering therapy) are available for analysis. Outcomes considered were perforation, bleeding, and obstruction (PBO) for gastrointestinal events, and loss of renal function for acute renal failure (ARF) following the RIFLE classification (risk, injury, and failure) for renal events. Variables associated to increased risk with Kaplan-Meier survival analysis were tested with multivariate Cox survival analysis, using time from onset of gout to the event as time exposed to NSAIDs. <h3>Results</h3> Gout-related variables, such as the number of flares, polyarticular disease and presence of tophi were associated with higher risk of PBO events, along with variables previously associated in the literature, such as age and ethanol intake. The number of flares was also associated with higher risk of renal events, as were other variables also described in the literature, such as age, previous chronic renal disease, the use of diuretics, and presence of previous vascular events. Interestingly patients never treated previously with urate-lowering therapy also showed a higher risk or renal events (Table). <h3>Conclusions</h3> The number of flares is a common risk for both gastrointestinal and renal complications in patients with gout. Other variables related to chronic gout, such as polyarticular distribution or presence of tophi was associated with increased risk of gastrointestinal events. <h3>References</h3> Doherty M, Jansen TL, Nuki G, Pascual E, Perez-Ruiz F, Punzi L et al. Gout: why is this “curable” disease so seldom cured? Ann Rheum Dis 2012;10.1136/annrheumdis-2012-201687. <h3>Acknowledgements</h3> Thanks to Mrs. Rosario Lopez Santamaría for cordination and administrative support <h3>Disclosure of Interest</h3> F. Perez-Ruiz Consultant for: Ardea, Savient, Menarini, Astra, Metabolex, Pfizer, Novartis, SOBI, Speakers bureau: Menarini, A. HERRERO_BEITES: None Declared
The need to base empirical antibiotic regimens on clinical cure rates
Authors: Andrew Kirby
Journal: BMJ (2016)

The prevalence of antibiotic resistance is important information commonly relied on when choosing empirical antibiotic regimens. But too much is being asked of these laboratory data, which should not dictate empirical antibiotic regimens.

Laboratory determined antibiotic resistance rates are a product of policies for the microbiological testing of infections and antibiotic …
The Appearance of Epidural Extranodal Marginal Zone Lymphoma (MALToma) on F-18 FDG PET/CT and Post Hoc PET/MRI Fusion
Authors: Stephan Probst, Jason Mayo, Tibor Moskovits, Kent Friedman
Journal: Clinical Nuclear Medicine (2011)

A 27-year-old woman previously treated for extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALToma) underwent F-18 FDG PET/CT for restaging, which demonstrated intense uptake in the lumbosacral thecal sac and adjoining nerve roots, with subtle increased paraspinal soft tissue. Contrast-enhanced MRI of the spinal cord performed 2 days later confirmed the enhancing lower lumbar and sacral epidural lymphomatous masses with resultant moderate to severe compression of the thecal sac and bilateral neural foraminal stenosis. Post hoc PET/MRI fusion was performed, proving that the enhancing masses on contrast-enhanced MRI were indeed the etiology of the hypermetabolic signal detected on the prior PET/CT. This case serves to illustrate the infrequently encountered, but virtually pathognomonic appearance of epidural involvement of lymphoma, which is easiest to recognize on maximum intensity projection images.
Peter Douglas Jackson
Authors: Rumy Kapadia
Journal: BMJ (2016)

It would be fair to say that Peter Douglas Jackson would rather be remembered, above all else, as an operatic tenor/baritone than an ENT surgeon.

He was born in Cumbria, the son of a Methodist minister and an accomplished artist. Having gained a general FRCS (Ed) in 1961 he later leaned towards ear, nose, and throat medicine. He passed his Diploma in Laryngology and Otology in 1967 and gained his FRCS (Eng) in ENT medicine from London in 1968.

He was senior house officer at Alder Hey Children's Hospital, Liverpool, moving to RSO at Hallam Street Hospital, West Bromwich, and then at the Royal Infirmary, Edinburgh. From here he joined …
Giant Pulmonary Chondroid Hamartoma
Authors: Elizabeth Lio, Dara L. Aisner, Frederic B. Askin, Jennifer J. Kwak
Journal: Clinical Nuclear Medicine (2014)

A 35-year-old man presented to the emergency department with a worsening cough and a history of unintended weight loss. Chest radiograph revealed a giant mass occupying the left hemithorax. On CT scan, the mass measured over 20 cm and shifted the heart into the right hemithorax. Bone scan demonstrated multifocal radiotracer uptake within coarse intratumoral calcifications. Biopsy revealed no malignant cells. However, malignancy was clinically suspected due to size, and FDG PET/CT was performed. Mild FDG uptake was present in the mass. The mass was excised, and pathologic examination revealed the rare diagnosis of a giant pulmonary chondroid hamartoma.