tbuckley/cabot-search huggingface dataset:
AB0855 Tuberculous Spondylodiscitis is not Unusual: about A Series of 35 Cases
Authors: Z. Alaya, D. Amri, N. El Amri, K. Baccouche, S. Belghali, H. Zeglaoui, E. Bouajina
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> Tuberculosis is enjoying a resurgence of interest, due to its current resurgence in the world. Osteoarticular location represents 3-5% of tuberculosis cases. Spondylodiscitis constitutes the most frequent location. <h3>Objectives</h3> The objective of our study was to describe the biological, therapeutic, clinical and radiological aspects of tuberculous spondylodiscitis. <h3>Methods</h3> This is a retrospective study of 35 cases of tuberculous spondylodiscitis collected in the Department of Rheumatology over a period of 15 years [1998-2013]. <h3>Results</h3> Our population consists of 14 men and 21 women with a sex ratio of 2/3. The mean age was 58.5 years [18-83]. Comorbidities noted were diabetes (n=4), renal failure (n=1) and systemic corticosteroid therapy (n=1). A history of tuberculosis was present in 4 patients. The circumstances of discovery were inflammatory spinal pain in 33 cases associated to general signs such alteration of the general state (n=22) and night sweats (n=11). Fever missing in 16 patients. Neurological impairment was objectified in 20 patients. Radicular pain was the most common manifestation. It was lumbosciatica (n=9), intercostal neuralgia (n=4), cruralgia (n=4) and cervico-brachial neuralgia (n=3). Motor deficit was objectified in 9 cases and vesicosphincteric disorders were noted in 4 patients. An array of spinal compression occurred in 6 cases. The mean disease duration was 8 months and a half. The biological inflammatory syndrome was absent in 2 cases. Plain radiographs were normal in 5 cases. CT performed in 22 cases and MRI performed in 25 cases showed an epiduritis in 18 cases, an infiltration of the soft parts in 12 cases, a soft parts abscess in 15 cases and root canal abscess in 7 cases. Spondylodiscitis was multistage in 4 cases and multifocal in 5 cases. Mycobacterium tuberculosis was isolated in 13 cases via a disco-vertebral puncture biopsy (n=5), via a puncture abscess (n=6), and a levy from another location (n=2). The tuberculous origin was retained in other cases based on clinical and radiological data. All patients were put on anti tuberculosis treatment. Surgery was required in 7 cases. The surgery was a decompressive laminectomy in 4 cases, a drain abscess in one case and the combination of two acts in two cases. The evolution was unfavorable in 2 cases with persistence of neurological sequelae. A case of vasculitis secondary to anti tuberculosis treatment was noted. <h3>Conclusions</h3> Tuberculous spondylodiscitis has often an insidious development which is causing a delay in diagnosis. Isolation of Mycobacterium tuberculosis is difficult. The diagnosis is often based on a beam of arguments. <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.4726
Abstract P4-17-05: Reconstructive breast surgery using an acellular dermal matrix: prospective outcomes of an observational, cohort study (POBRAD).
Authors: David Westbroek, Ash Kothari, Hisham Hamed, Olorunsola Agbaje, Michael Douek
Journal: Cancer Research (2012)

Abstract Withdrawn by Author Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P4-17-05.
Possible Role of Renin in Hypertension as Suggested by Renin-Sodium Profiling and Inhibition of Converting Enzyme
Authors: David B. Case, John M. Wallace, Hans J. Keim, Michael A. Weber, Jean E. Sealey, John H. Laragh
Journal: New England Journal of Medicine (1977)

To block renin activity, a nonapeptide converting-enzyme inhibitor was given to 65 seated hypertensive patients. Depressor responses occurred only when control plasma renin activity exceeded 2 ng of angiotensin I per milliliter per hour and correlated directly in amplitude with control plasma renin activity and with induced increments in activity (P<0.001 for both). Depressor responses, like renin activity, were characteristic for renin subgroups as defined by renin-sodium profiling. Before and after sodium deprivation, the nonapeptide reduced diastolic pressure in all patients with high renin (by 17.3 and 19.8 per cent) and most patients with normal renin (by 9.1 and 17.7 per cent). Low-renin patients remained unresponsive. This enzyme blockade may cause bradykinin accumulation. But if, as seems likely, depressor responses are due to blockade of angiotensin II formation, the results indicate that, irrespective of sodium balance, measurements of plasma renin activity reflect its contribution to blood-pressure maintenance. The results suggest broad participation of the renin system in common forms of hypertension (N Engl J Med 296:641–646, 1977)
Current Trend of Palliative Care Clinic (Pcc) Referrals and Their Impact on Symptom Burden in Patients (Pts) Who are Seen in Genitourinary Medical Oncology Clinic (Gumoc): Retrospective Analysis at an American Comprehensive Cancer Institute
Authors: N. Gupta, S. Gandhi, S. Anwar, R. Pili, Y. Satchidanand
Journal: Annals of Oncology (2014)
Long-Term Trends Worldwide in Ambient NO <sub>2</sub> Concentrations Inferred from Satellite Observations
Authors: Jeffrey A. Geddes, Randall V. Martin, Brian L. Boys, Aaron van Donkelaar
Journal: Environmental Health Perspectives (2015)

Air pollution is associated with morbidity and premature mortality. Satellite remote sensing provides globally consistent decadal-scale observations of ambient nitrogen dioxide (NO2) pollution.We determined global population-weighted annual mean NO2 concentrations from 1996 through 2012.We used observations of NO2 tropospheric column densities from three satellite instruments in combination with chemical transport modeling to produce a global 17-year record of ground-level NO2 at 0.1° × 0.1° resolution. We calculated linear trends in population-weighted annual mean NO2 (PWMNO2) concentrations in different regions around the world.We found that PWMNO2 in high-income North America (Canada and the United States) decreased more steeply than in any other region, having declined at a rate of -4.7%/year [95% confidence interval (CI): -5.3, -4.1]. PWMNO2 decreased in western Europe at a rate of -2.5%/year (95% CI: -3.0, -2.1). The highest PWMNO2 occurred in high-income Asia Pacific (predominantly Japan and South Korea) in 1996, with a subsequent decrease of -2.1%/year (95% CI: -2.7, -1.5). In contrast, PWMNO2 almost tripled in East Asia (China, North Korea, and Taiwan) at a rate of 6.7%/year (95% CI: 6.0, 7.3). The satellite-derived estimates of trends in ground-level NO2 were consistent with regional trends inferred from data obtained from ground-station monitoring networks in North America (within 0.7%/year) and Europe (within 0.3%/year). Our rankings of regional average NO2 and long-term trends differed from the satellite-derived estimates of fine particulate matter reported elsewhere, demonstrating the utility of both indicators to describe changing pollutant mixtures.Long-term trends in satellite-derived ambient NO2 provide new information about changing global exposure to ambient air pollution. Our estimates are publicly available at http://fizz.phys.dal.ca/~atmos/martin/?page_id=232.
A3.06 Distinct expression pattern of peripheral tissue-restricted antigens in human LYMPH node stromal cells during the earliest phases of rheumatoid arthritis
Authors: J Hähnlein, TH Ramwadhdoebe, JF Semmelink, M Safy, KP van Lienden, M Maas, DM Gerlag, PP Tak, TBH Geijtenbeek, LGM van Baarsen
Journal: Annals of the Rheumatic Diseases (2016)

<h3>Background</h3> In mice lymph node stromal cells (LNSCs) maintain peripheral tolerance through the presentation of peripheral tissue-restricted antigens (PTAs) and negative regulation of T-cells. However, little is known about PTA expression in human LNSCs. We hypothesise that deregulated expression of PTAs by human LNSCs might underlie the pathogenesis of autoimmune diseases like rheumatoid arthritis (RA). <h3>Objective</h3> To investigate the expression and possibleregulation of several disease-related PTAsin human LNSCs derived from healthy donors and individuals having systemic autoimmunity. <h3>Methods</h3> LNSCs were cultured from freshly collected lymph node needle biopsies obtained from 25 patients with rheumatoid arthritis (RA), 24 individuals positive for autoantibodies but without clinical apparent disease (RA-risk group) and 14 seronegative healthy controls. Expression of PTAs and the transcription factors DEAF1 and AIRE possibly regulating PTA expressionwere assessed by qPCR. Aire wasfurther investigated on protein level. LNSCs from five donors of each study group were stimulated with TNFα pluslymphotoxin α1β2 or poly (I:C) to study the regulation of PTA under inflammatory conditions. <h3>Results</h3> Human LNSCs expressed the PTAs RRAD (Ras-related associated with diabetes), PLP1 (proteolipid protein 1), GAD1(glutamate decarboxylase 1) and the RA-related geneENO1 (Enolase 1(alpha)), but not AFP (alpha-fetoprotein). The expression of RRAD was slightly lower in RA-risk individuals which reached significance inRA patients (P = 0.04), especially in ACPA negativeRA patients (P = 0.0007). In contrast GAD1 mRNA levelswere significantly increased in RA-risk individuals (P = 0.01) with a trend towards increased expression in RA patients. Expression of ENO1 and PLP1 was similar in all donor groups. <i>Invitro</i> stimulation increased the expression of RRADin all donor groups to a similar extent. LNSCs express the transcription factors DEAF1andAIRE with Aire protein detected in the nucleus of LNSCs. <h3>Conclusion</h3> Here we show for the first time that human LNSCs express disease-related PTAs as well as the transcription factors DEAF1and Aire, which supports their rolein tolerance induction. Already during the earliest phases of RA a differential PTA expression pattern is observed in LNSCs. Future studies are needed to investigate whether the distinct PTA expression pattern in LNSCs has an aberrant effect on T-cell regulation.
US Highlights
Authors: Douglas Kamerow
Journal: BMJ (2006)

In a new analysis of the saline versus albumin fluid evaluation (SAFE) study, the investigators examined (doi: 10.1136/bmj.38985.398704.7C) clinical outcomes of over 6000 Australian patients in intensive care who had been randomized to receive either saline or albumin for their fluid resuscitation. Whether their initial serum albumin levels were high or low, there was no difference in mortality, length of stay, or other outcome variables between the two groups. In an accompanying editorial (doi: 10.1136/bmj.39029.490081.80), J L Vincent points out that the SAFE study was undertaken to establish not whether albumin was better than saline, but whether it was as safe, which it was. He argues that no one would use albumin for all patients needing fluids and advocates a trial comparing albumin and saline in ICU patients who are at increased risk of complications. 

Can increased physical activity reduce weight in preschool children? John Reilly et al performed a randomized controlled trial (doi: 10.1136/bmj.38979.623773.55) in 36 Scottish preschools with 545 children. Half the schools received a physical activity intervention consisting of three 30 minute physical education classes, classroom posters, and home resource packs. The other half served as controls. At six and 12 months, there was no difference between the BMI scores in the two groups of children, although the intervention group children had better movement skills. Antronette Yancey writes in an editorial (doi: 10.1136/bmj.39021.605683.BE) that this result is unsurprising given the “dose” of the intervention and the fact that it was probably applied inconsistently in real world settings. Correct implementation of programs, as well as increased comprehensiveness, are probably needed to show a change in children's weights. 

Finally, this week's issue has an ethical debate (doi: 10.1136/bmj.38950.645799.55) about whether it can ever be ethical to withhold prenatal testing. The case in point involves a fetus at risk for the gene for Huntington's disease, which is detectable in utero. The disease is universally fatal but does not appear until young adulthood. Some ethical guidelines call for providing prenatal diagnosis only if the parents are planning to abort a fetus that is found to be affected. Martin Delatycki argues that it is appropriate to withhold the test if the parents are not planning an abortion on the grounds of autonomy—otherwise they will be denying their future child the right to determine when and if he learns his diagnosis. Rony Duncan and Bennett Foddy disagree, citing several arguments: in the first trimester, the fetus is part of the mother's body and she should not be denied knowledge about her own body; a couple can never “know” with 100% certainty whether or not they will abort a fetus; and no one should be placed in the untenable position of having to lie to obtain a medical diagnostic test. As genetic medicine becomes more widespread, dilemmas such as this will likely increase.
A Double-Blind, Randomized, Placebo-Controlled, Dose-Frequency Study of Intravenous Ketamine in Patients With Treatment-Resistant Depression
Authors: Jaskaran B. Singh, Maggie Fedgchin, Ella J. Daly, Peter De Boer, Kimberly Cooper, Pilar Lim, Christine Pinter, James W. Murrough, Gerard Sanacora, Richard C. Shelton, Benji Kurian, Andrew Winokur, Maurizio Fava, Husseini Manji, Wayne C. Drevets, Luc Van Nueten
Journal: American Journal of Psychiatry (2016)

Objective: Ketamine, an N-methyl-d-aspartate glutamate receptor antagonist, has demonstrated a rapid-onset antidepressant effect in patients with treatment-resistant depression. This study evaluated the efficacy of twice- and thrice-weekly intravenous administration of ketamine in sustaining initial antidepressant effects in patients with treatment-resistant depression. Method: In a multicenter, double-blind study, adults (ages 18–64 years) with treatment-resistant depression were randomized to receive either intravenous ketamine (0.5 mg/kg of body weight) or intravenous placebo, administered over 40 minutes, either two or three times weekly, for up to 4 weeks. Patients who discontinued double-blind treatment after at least 2 weeks for lack of efficacy could enter an optional 2-week open-label phase to receive ketamine with the same frequency as in the double-blind phase. The primary outcome measure was change from baseline to day 15 in total score on the Montgomery-Åsberg Depression Rating Scale (MADRS). Results: In total, 67 (45 women) of 68 randomized patients received treatment. In the twice-weekly dosing groups, the mean change in MADRS score at day 15 was −18.4 (SD=12.0) for ketamine and −5.7 (SD=10.2) for placebo; in the thrice-weekly groups, it was −17.7 (SD=7.3) for ketamine and −3.1 (SD=5.7) for placebo. Similar observations were noted for ketamine during the open-label phase (twice-weekly, −12.2 [SD=12.8] on day 4; thrice-weekly, −14.0 [SD=12.5] on day 5). Both regimens were generally well tolerated. Headache, anxiety, dissociation, nausea, and dizziness were the most common (≥20%) treatment-emergent adverse events. Dissociative symptoms occurred transiently and attenuated with repeated dosing. Conclusions: Twice-weekly and thrice-weekly administration of ketamine at 0.5 mg/kg similarly maintained antidepressant efficacy over 15 days.
Conflict of Interest in the Debate over Calcium-Channel Antagonists
Authors: Henry Thomas Stelfox, Grace Chua, Keith O'Rourke, Allan S. Detsky
Journal: New England Journal of Medicine (1998)

Physicians' financial relationships with the pharmaceutical industry are controversial because such relationships may pose a conflict of interest. It is unknown to what extent industry support of medical education and research influences the opinions and behavior of clinicians and researchers. The recent debate over the safety of calcium-channel antagonists provided an opportunity to examine the effect of financial conflicts of interest.
SAT0300 Significance of Association between HLA-C*06 and Psoriatic Arthritis. A Preliminary Report.
Authors: R. Sokolik, K. Bogunia-Kubik, J. Świerkot, K. Gębura, L. Korman, P. Wiland
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> HLA-Cw6 has been found to be associated with early onset psoriasis (PSO) type I. Psoriatic arthritis (PsA) is an inflammatory arthritis with psoriasis. The main feature of PsA is peripheral arthritis or axial manifestation. The arthritis usually follows the diagnosis of psoriasis by about 10 years. PsA is a complex genetic disorder that results from an interplay between multiple genetic environmental factors. The exact pathogenesis of PsA is unclear. <h3>Objectives</h3> The aim of the study was to assess the significance of the association between the HLA-C*06 and PsA. <h3>Methods</h3> The study group consisted of 50 patients with PsA (32 men and 18 women) hospitalized at the Rheumatology Clinic of Medical University in Wroclaw, Poland, in 2012. The median age of patients was 45 years. PsA was diagnosed by the criteria recommended by CASPAR group. The average duration of PsA and PSO was 7 and 15 years, respectively. The patients were typed for the HLA-C alleles using HLA Ready Gene C low kit (Inno-train Diagnostik GmbH, Germany). DNA was extracted from peripheral blood taken on EDTA using Maxwell 16 Blood DNA Purification Kit (Promega Corp., USA) following the recommendation of the manufacturer. <h3>Results</h3> HLA-C*06 was detected in 26 out of 50 patients (52%). The frequency of HLA-C*06 among PsA patients was significantly higher (26/50 vs. 36/123, OR=5.24, p&lt;0.001) than those described for Polish healthy population [Łuszczek et al. <i>Immunol Lett</i> 2002 and Szczekowska Dobosz et al. <i>Int J Immunogenet</i> 2005]. Among 26 patients with HLA-C*06, 22 patients (85%) had polyarthritis (22/26 vs. 15/24 HLA-C*06, p=0.08) while among 4 patients presented with spondyloarthritis only one was carrying HLA-C*06 (1/4 vs. 25/46, ns). Eighteen (36%) PsA patients presented with severe disease (PASI &gt;10, BSA &gt;10, more than five swollen and tender joints) and were subjected to anti-TNF-alpha therapy (adalimumab, etanercepet). Among those patients 14 were HLA-C*06 positive as compared to 12 patients out of 32 with less severe disease (14/18 vs. 12/32, p&lt;0.01). <h3>Conclusions</h3> Individuals carrying the HLA-C*06 alleles are five times more likely to develop PsA. HLA-C*06 positive PsA patients develop more severe disease (requiring anti-TNF-alpha treatment) and more frequently present with polyarticular pattern of PsA. Our results confirm the association between HLA-C*06 allele and PsA and, furthermore, suggest that HLA-C*06 may be a prognostic factor of PsA severity. <h3>Disclosure of Interest</h3> None Declared
Novel Gene Translocations Involving TYK2 in Cutaneous CD30-Positive Lymphoproliferative Disorders
Authors: Thirunavukkarasu Velusamy, Mark J. Kiel, Anagh A Sahasrabuddhe, Delphine C.M. Rolland, Catherine A Dixon, Nathanael G. Bailey, Bryan L Betz, Noah A. Brown, Alexandra C Hristov, Ryan A. Wilcox, Roberto N. Miranda, L. Jeffrey Medeiros, Yoon K Jeon, Megan S Lim, Kojo S.J. Elenitoba-Johnson
Journal: Blood (2014)
Abstract P2-14-02: A Pilot Study of Vascular Endothelial Growth Factor Inhibition with Pazopanib in Patients (pts) with Lymphedema Following Breast Cancer Treatment
Authors: KD Miller, C Brown, SM Perkins, BP Schneider, A Storniolo, GW. Sledge
Journal: Cancer Research (2010)

Abstract Purpose: Lymphedema is a significant long-term complication of primary therapy for breast cancer. VEGF has a major impact on vascular permeability and lymphangiogenesis. In a prior case control study, we found a significant increase in serum VEGF-C (median 6895 vs. 5349 pg/mL, p=0.0016) in women with lymphedema compared to women without lymphedema suggesting inhibition of VEGF-C as a potential therapeutic strategy. Methods: Pts with significant unilateral lymphedema were treated with pazopanib 800 mg/day continuously. Baseline assessments include arm volume, interstitial fluid pressure (IFP), extracellular fluid volume by lymphometer (ECF), quality of life (QOL) and plasma VEGF-C,-D, and R3. IFP was measured serially for 24 hours after the first treatment; arm volume, ECF, QOL, and plasma VEGF-C/D/R3 are assessed every 4 weeks. Results: Ten pts were enrolled. Median duration of lymphedema was 3.5 years (0.7-8.2) Median time since surgery was 5.1 years (1.0-14.2); median time since radiation (n=9) was 4.7 years (0.4-8.8). Complete IFP data are available in 7 pts. Baseline IFP was significantly higher in the affected compared to unaffected arm (mean 5.73 vs. -1.78 mmHg; p=0.0005). Mean IFP in the affected arm decreased an average of 76% 24 hours after initiation of pazopanib (5.73 vs. 1.56 mmHg; p=0.0061). Toxicity was greater than anticipated with grade 3 fatigue (n=3), arthralgia (n=2), and anorexia (n=1); three pts discontinued therapy prior to the first post-treatment assessment. Five pts met the definition of response with a ≥25% reduction in excess arm volume four weeks after initiating treatment. ECF significantly (p=0.014) decreased as well though the mean difference in excess arm volume did not significantly change (p=0.06). Conclusions: Preliminary data supports the hypothesis that VEGF plays a role in the development and/or persistence of lymphedema after local therapy for breast cancer. Pazopanib acutely decreases IFP, leading to a decrease in ECF and modest improvement in arm volume but results in significant toxicity at the dose used on this study. Subsequent studies will explore a lower dose of pazopanib in this population. This study was supported by the Breast Cancer Research Foundation with pazopanib supplied by GSK. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P2-14-02.
Tc-99m HMPAO Brain Perfusion SPECT Images in a Patient with Portal-Systemic Encephalopathy
Authors: HITOYA OHTA, RIKI MATSUMOTO, TOMONOBU KATO, NAOMI TOMONO, TATSUO SHIMIZU
Journal: Clinical Nuclear Medicine (1998)

Tc-99m HMPAO SPECT brain perfusion was performed in a patient with portal-systemic encephalopathy. Decreased perfusion to both parietal lobes and increased perfusion to the basal ganglia bilaterally were demonstrated. After successful treatment, these findings improved. Some authors have reported reduced cerebral blood flow in portal-systemic encephalopathy. However, to our knowledge, there have been no reports describing a case in which both increased perfusion and decreased perfusion are recognized simultaneously.