tbuckley/cabot-search huggingface dataset:
PMO-069 Line sepsis rates are significantly improved in parenteral nutrition patients by having a nutrition nurse
Authors: T Tsakok, P Blaker, K Patel, S O'Sullivan, A Doherty, H Morris, J Dunn, M McCarthy
Journal: Gut (2012)

<h3>Introduction</h3> Recent UK NCEPOD data highlights catheter line sepsis as a major complication of Parenteral Nutrition (PN). We hypothesise that a Specialist Nutrition Nurse may improve line sepsis rates by educating ward staff on line care. Our aim was to evaluate line complications in patients treated at Guy9s &amp; St Thomas9 Hospitals before and after this intervention. <h3>Methods</h3> Prospective dual-centre cohort study of patients started on PN over two 12-month periods (2005; 2010). Clinical data collected via pro forma, microbiology data via Electronic Patient Records. <h3>Results</h3> 221 patients were recruited (141 in 2010, 80 in 2005). From the 2010 cohort, 90 were ward-based, 57 on ICU. Duration of PN ranged from 1 to 171 days (mean 17). Access was established by central line (65%) or peripherally-inserted central (PICC) lines (35%). Use of PICC lines had increased since 2005 (84% central vs 16% PICC). The incidence of line sepsis was significantly lower in 2010 than in 2005 (11% vs 31%, Fisher9s test p=0.0002). In 2010 9/15 cases of line sepsis were confirmed by blood/line tip culture. Line complications were more likely to occur in patients on wards than ICU (34% vs 2%, Fisher9s test p&lt;0.0001). By contrast, rates of confirmed line sepsis were not significantly influenced by line type (Fisher9s test p=0.5). <h3>Conclusion</h3> This dual-centre audit demonstrates a significant reduction in catheter-related sepsis between 2005 (31%) and 2010 (11%). This is likely due to the introduction of a Nutrition Nurse to facilitate monitoring and line care in PN patients. The discrepancy in line sepsis rates between wards and ICU indicates that there is still scope to improve line care on wards. Increased use of peripherally-inserted feeding lines has had no impact on line sepsis rates. <h3>Competing interests</h3> None declared. <h3>Reference</h3> 1. <b>Stewart JAD</b>, Mason DG, Smith N, <i>et al.</i> A mixed bag—an enquiry into the care of hospital patients receiving parenteral nutrition. NCEPOD, 2010.
Abstract 4674: Associations between epidermal growth factor receptor polymorphism and survival in colorectal cancer patients treated with 5-FU based adjuvant chemotherapy
Authors: Ching-Yu Lai, Fung-Chang Sung, Ling-Ling Hsieh, Reiping Tang, Chih-Ching Yeh
Journal: Cancer Research (2011)

Abstract Introduction: Colorectal cancer (CRC) is the second most common cancer and the third leading cause of cancer deaths in Taiwan. 5-Fluorouracil (5-FU) is one of the first line anti-cancer drugs used in the chemotherapy for CRC in older to raise survival rate. Epidermal growth factor receptor (EGFR) plays an important role to regulate gene expression causing cellular proliferation and apoptosis may induce malignant tumors. This retrospective study examined the association between EGFR polymorphism and overall survival of CRC patients treated with 5-FU-based chemotherapy. Methods: A total of 499 patients diagnosed with CRC and received 5-FU-based chemotherapy after surgery between 1995 January and 2001 December was included in the present study. We genotyped the EGFR R497K (Arg 497 Lys) polymorphism using the polymerase chain reaction combined with the restriction fragment length polymorphism analysis (PCR-RFLP). Survival analyses on EGFR polymorphism were displayed with Kaplan-Meier curves and performed with log-rank test. The association between EGFR genotypes and survival was analyzed using Cox proportional hazard models. Result: After 13 years follow-up, the median survival year was 4.56. The distribution of EGFR genotype was not significantly different by patients’ clinicopathologic characteristics. No significant EGFR genetic effects on overall survival were found in the present study, even the adjustment for age, gender, or tumor stage in the Cox proportional hazard models. However, in stage IV CRC patients, compared to the EGFR Arg/Arg genotype, the EGFR Arg/Lys and Lys/Lys genotypes were related to better overall survival with hazard ratio (HR) of 0.75 (95% CI = 0.49 – 1.15) and 0.61 (95% CI = 0.38 – 0.98), respectively. The Kaplan-Meier curves also showed that stage IV CRC patients carrying the EGFR Lys allele had a better survival (log-rank p = 0.07). Conclusion: Our findings suggest that the EGFR R497K polymorphism may modify drugs activity to serve a prognostic predictor for stage IV CRC patients who receive 5-FU-based chemotherapy. 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 4674. doi:10.1158/1538-7445.AM2011-4674
P193 MOST AVAILABLE ASSAYS UNDERESTIMATE OR FAIL TO QUANTIFY HDV VIRAL LOAD IN SAMPLES FROM INFECTED PATIENTS: RESULTS OF THE 1 INTERNATIONAL QUALITY CONTROL
Authors: F. Le Gal, S. Brichler, F. Neri Pinto, E. Anouhal, W. Mansour, S. Chevret, E. Gordien
Journal: Journal of Hepatology (2014)
The Risk of Stroke in Patients with Acute Myocardial Infarction after Thrombolytic and Antithrombotic Treatment
Authors: A P Maggioni, M G Franzosi, E Santoro, H White, F Van de Werf, G Tognoni
Journal: New England Journal of Medicine (1992)

Many trials in patients with acute myocardial infarction have demonstrated that thrombolytic therapy is not associated with an excessive risk of stroke, as compared with conventional treatment. However, the incidence of various forms of stroke in patients treated with different thrombolytic and antithrombotic regimens and the associated effect of risk factors for stroke are largely unknown.
Therapy of Adenocarcinoma of Unknown Primary: Are We Making Progress?
Authors: F. Anthony Greco
Journal: Journal of the National Comprehensive Cancer Network (2008)

Therapy for patients with unknown primary carcinoma is evolving and requires a detailed understanding of the various clinicopathologic subsets with more favorable prognoses. For the remainder, and most patients with unfavorable prognoses, data on current empiric chemotherapy with the newer drugs seems to show improved overall survival compared with older historical data, including comparisons with large retrospective series and prospective phase II trial results. Several recent clinical trials have recently documented long-term survival for a minority of patients. The survival of patients with several metastatic adenocarcinomas of known primary sites, including colon/rectum, lung, and pancreas, has been improved by the administration of chemotherapy alone or combined with biologic targeted drugs (bevacizumab, erlotinib). Approximately 60% of the patients with unknown primary adenocarcinoma have clinically occult primary sites of colon/rectum, lung, and pancreas. Many of these patients will also benefit from therapeutic regimens now proven to be useful for patients with these known primary sites. All available data make a convincing argument that progress is being made for the commonly seen patients with adenocarcinoma of unknown primary site, and is likely to continue as understanding of these and other neoplasms further evolves.
AB0313 Factors predicting disability in patients affected by long-standing rheumatoid arthritis treated with anti-TNF drugs: An observational study
Authors: M. Filippini, C. Bazzani, F. Atzeni, P. Sarzi Puttini, A. Marchesoni, E. Favalli, R. Caporali, L. Cavagna, R. Gorla
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> HAQ (Health Assessment Questionnaire) is related to working ability, the need for specialist examinations and the <i>quoad vitam</i> prognosis; so it is an appropriate means of summarising outcomes, as well as the direct and indirect costs of the disease, as has been shown by pharmacoeconomic analyses. Moreover evenafter 20 years of treatment with traditional or biological DMARDs, joint damage evaluated using the Larsen and Sharp score isless than 40% of the highest possible score and the reversibility of the HAQ score is close to 70%even in the case of late arthritis. <h3>Objectives</h3> This article describes the findings of an observational study designed to evaluate disability in patients with long-standing rheumatoid arthritis (RA) treated with anti-TNF agents. Theaims were to define the main predictors of disability during biological treatment and assess treatment strategies (the use of steroids and traditional DMARDs, a switch to another anti-TNF agent). <h3>Methods</h3> The study involved 1033 patients attending six Italian rheumatology departments, who werestratified on the basis of various clinical and demographic variables. Drug effectiveness was assessed by analysing disease functional status using the Health Assessment Questionnaire (HAQ). <h3>Results</h3> Disability significantly decreased after five years of anti-TNF therapy (ΔHAQ: -0.78, p&lt;0.05). The HAQ improvement was less in patients aged &gt;65 years, females, and those with a disease duration of more than 10 years, a higher comorbidity index, greater disease activity and disability at baseline, high titres of rheumatoid factor, and contraindications to combination therapy with traditional DMARDs. Steroids were useful in patients with greater baseline impairment. The patients treated with infliximab had a higher disability index at baseline, but showed greater improvement than those treated with etanercept or adalimumab. The results were confirmed by multivariate analysis. <h3>Conclusions</h3> The effect of anti-TNF therapy on the disability of patients with long-standing RA is certainly substantial, and the HAQ is a good means of evaluating the efficacy of biological treatment. <h3>References</h3> Aletaha D, Ward MM. Duration of rheumatoid arthritis influences the degree of functional improvement in clinical trials. Ann Rheum Dis. 2006; 65:227-33. Sokka T, Häkkinen A, Krishnan E, Hannonen P. Similar prediction of mortality by the health assessment questionnaire in patients with rheumatoid arthritis and the general population. Ann Rheum Dis. 2004; 63:494-7. Lloyd S, Bujkiewicz S, Wailoo AJ, Sutton AJ, Scott D. The effectiveness of anti-TNF-a therapies when used sequentially in rheumatoid arthritis patients: a systematic review and meta-analysis. Rheumatology 2010; 49:2313–21. <h3>Disclosure of Interest</h3> None Declared
Cardiac Drugs Could Improve Cancer Treatment
Authors: F. X. Mahaney
Journal: JNCI Journal of the National Cancer Institute (1988)

Journal Article Cardiac Drugs Could Improve Cancer Treatment Get access Francis X. Mahaney, Jr. Francis X. Mahaney, Jr. Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 80, Issue 15, 5 October 1988, Pages 1190–1191, https://doi.org/10.1093/jnci/80.15.1190 Published: 05 October 1988
Case 11-2013
Authors: Daniel P. Ryan, Alison M. Friedmann, Matthew D. Schmitz, Russell J.H. Ryan
Journal: New England Journal of Medicine (2013)

A 4-year-old boy was admitted to this hospital because of fever and abdominal pain. Imaging revealed a periappendiceal mass; purulent fluid was aspirated, and symptoms resolved with antibiotics. One week later, pain recurred. A diagnostic procedure was performed.
P693Pulsatile pressure-induced myogenic response of mouse cerebral arteries is impaired by aging
Authors: Z Springo, P Toth, S Tarantini, Z Tucsek, WE Sonntag, A Csiszar, Z Ungvari, A Koller
Journal: Cardiovascular Research (2014)

Background: Aging is associated with increased incidence of cerebrovascular disorders, but the age-dependent changes in local vasomotor mechanisms are not completely understood. Myogenic autoregulation of cerebral vessels in response to static changes in perfusion pressure protects the microcirculation from high pressure and volume. Recently it was shown that aging impairs static myogenic regulation of cerebral vessels, however effects of aging on responses of cerebral arteries to pulsatile pressure are not known. Thus, we tested the hypothesis that aging impairs myogenic responses of cerebral arteries to increases in pulsatile pressure. Methods and Results: Middle cerebral arteries (MCA) were isolated from young (3 mo) and aged (24 mo) C57BL/6 mice and then cannulated. Young and aged MCAs developed similar myogenic tone in response to stepwise, steady-state increases in intraluminal P. Young MCAs exhibited significant myogenic adaptation to sinusoidal pulsatile pressure (PP, amplitude: 40 mmHg, frequency: 450/min). While in myogenic-inactive MCAs each PP elicited a ~7% distension in synchrony with the PP, in young myogenic-active MCAs the amplitude of the diameter changes induced by the PP was significantly attenuated (~2%) in the range of autoregulation. The myogenic tone curves of young MCAs were similar to steady and pulsatile pressures. In aged MCAs, the cyclic changes in diameter induced by the PP were increased, but the development of myogenic tone in response to PP was impaired. Conclusion: Collectively, aging impairs myogenic adaptation of cerebral arteries to pulsatile pressure, which likely promotes the development of cerebromicrovascular injury, such as cerebral microbleeds and blood brain barrier disruption by allowing the high pressure to penetrate the distal portion of the cerebral microcirculation.
P527 ACUTE CHANGES IN PORTAL PRESSURE GRADIENT (PPG) AFTER PTFE-COVERED TIPS IN CIRRHOTIC PATIENTS WITH PORTAL HYPERTENSIVE COMPLICATIONS: INTRAINDIVIDUAL COMPARISON OF 6-mm AND 8-mm STENT DILATATION
Authors: A. Luca, R. Miraglia, L. Maruzzelli, M. D'Amico, F. Tuzzolino
Journal: Journal of Hepatology (2014)
Chronic CSF Leak Into the Peritoneal Cavity Shown by Radionuclide Cisternography:
Authors: DAVID M. ASHLEY, R. EDWARD COLEMAN, HERBERT FUCHS, GUY DEAR, BRIAN GINSBERG, FERNANDO M. ZALDUONDO, HENRY S. FRIEDMAN, DARYLL LONGEE
Journal: Clinical Nuclear Medicine (1997)

Cerebrospinal fluid (CSF) leak is a well-documented complication of a spinal puncture that is performed for both diagnostic and therapeutic purposes. The use of radionuclide cisternography in the diagnosis of cerebrospinal fluid leaks is well established and has been reported as effective in securing the diagnosis of CSF fluid leak after lumbar puncture. The use of an epidural blood patch is effective in repairing 96-98% of such leaks and is thought to work by both forming a dural plug and by reducing the volume of the subarachnoid space. The authors report a 7-year-old boy who had recurrent medulloblastoma and developed a CSF leak into the peritoneal cavity after a course of intrathecal 4-hydroxycyclophosphamide. An initial Tc-99m human serum albumin CSF flow study before therapy was normal. A further course of intrathecal therapy was planned; however, delayed images on a repeat CSF flow study showed tracer activity throughout the abdomen intraperitoneally, indicating a leak of CSF from the thecal sac presumed to be at the sight of the recent spinal puncture. A CT myelographic study showed maximal epidural contrast at the L4-5 level, which extended from L4 through the S1 level. After 5 months of continual leak, an epidural blood patch was performed using autologous blood. A repeat CSF flow study performed 2 weeks after this procedure showed resolution of the CSF leak.
A comparison of early intensive methotrexate/mercaptopurine with early intensive alternating combination chemotherapy for high-risk B-precursor acute lymphoblastic leukemia: a Pediatric Oncology Group phase III randomized trial
Authors: SJ Lauer, JJ Shuster, DH Mahoney, N Winick, S Toledano, L Munoz, G Kiefer, JD Pullen, CP Steuber, BM Camitta
Journal: Leukemia (2001)
AB0180 Relationship between area level socio-economic deprivation and autoantibody status in rheumatoid arthritis patients: Multicentre cross-sectional study
Authors: S.L. Mackie, J.C. Taylor, S. Twigg, S.G. Martin, S. Steer, J. Worthington, A. Barton, A.G. Wilson, L.J. Hocking, A. Young, P. Emery, J.H. Barrett, A.W. Morgan
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Socio-economic deprivation is known to be associated with an adverse prognosis in rheumatoid arthritis (RA); some of this may be due to differential interaction of individuals with their healthcare providers after symptom onset. Rheumatoid factor (RF) and anti-citrullinated peptide antibody (ACPA) status can precede clinical onset of RA by up to ten years and thus may provide a unique insight into factors affecting immunological events in the pre-clinical stage. In support of this, ACPA-positive and ACPA-negative RA have distinct genetic and environmental risk factors. <h3>Objectives</h3> To assess the association between area level socio-economic deprivation and the phenotype of RA, defined by RF and ACPA status, and to determine whether any observed association can be explained by smoking. <h3>Methods</h3> Logistic regression analysis of 6298 patients with RA, defined by American College of Rheumatology classification criteria modified for genetic studies. Analysis was stratified by cohort/recruitment centre. Socio-economic deprivation was measured using the Townsend index. <h3>Results</h3> Deprivation predicted RF but not ACPA positivity, independent of smoking. The odds ratios (OR) for trend across tertiles of deprivation, adjusted for smoking, gender, period of birth and cohort/recruitment centre, were: 1.14 (95% confidence interval (CI) 1.01 to 1.29) for RF, and 1.01 (95% CI 0.87 to 1.16) for ACPA. Even after adjusting for deprivation, smoking was strongly associated with ACPA positivity (OR 1.38, 95% CI 1.22 to 1.55). There was no evidence of any effect modification by the RA risk alleles (<i>HLA-DRB1</i> shared epitope and <i>PTPN22</i> rs2476601) that are known to modify the effect of smoking on ACPA and RF positivity. <h3>Conclusions</h3> Amongst patients with RA, deprivation predicted RF positivity, but not ACPA positivity. The effect of deprivation did not appear to be explained by smoking. We avoided case-control response bias by performing a case-only analysis. Deprivation may be a marker for previously-unrecognised, potentially modifiable environmental influences on the immunological phenotype of RA. Furthermore, given the known associations of RF positivity with prognosis and response to treatment in RA, these findings have potential implications for resource allocation and healthcare delivery. <h3>Disclosure of Interest</h3> None Declared
Mortality rates at 10 years after metal-on-metal hip resurfacing compared with total hip replacement in England
Authors: Adrian R Kendal, Daniel Prieto-Alhambra, Nigel K Arden, Andrew Carr, Andrew Judge
Journal: British Journal of Sports Medicine (2016)

How do 10 year mortality rates compare between patients undergoing metal-on-metal (MoM) hip resurfacing and those undergoing total hip replacement in England?Patients in England with hip osteoarthritis who underwent MoM hip resurfacing between 1999 and 2012 have reduced long term mortality compared with those who underwent cemented and uncemented THR.
Case 37-1991
Authors: Richard C. Cabot, Robert E. Scully, Eugene J. Mark, William F. McNeely, Betty U. McNeely, S.J. Lipson, J.X. O'Connell
Journal: New England Journal of Medicine (1991)

Presentation of CaseA 47-year-old woman was admitted to the hospital because of severe back pain and an osteosclerotic lesion of the 11th thoracic vertebral body.The patient was well until 11 weeks earlier, when she lifted a 9-kg bag of seed. On the next day back pain developed and worsened. Three days later she was seen at another hospital, where a diagnosis of back strain was made and naproxen and acetaminophen—codeine were prescribed. One week later the pain improved, and the patient returned to work.During the next 5 weeks mild pain persisted and then worsened 31 days before . . .
Rubella: Reinfection of Vaccinated and Naturally Immune Persons Exposed in an Epidemic
Authors: Dorothy M. Horstmann, Harvey Liebhaber, George L. Le Bouvier, Donald A. Rosenberg, Scott B. Halstead
Journal: New England Journal of Medicine (1970)

The protective efficacy of vaccine-induced and naturally acquired immunity was compared in a prospective study of a rubella epidemic among military recruits. The population consisted of 190 men in the following categories with respect to immunity to rubella: 26 who were susceptible, 15 vaccinees who had been immunized two to three months previously and 149 who were naturally immune. As a result of the epidemic all 26 susceptible men were infected; rubella virus was recovered from the throats of 11. On the basis of hemagglutination-inhibiting and complement-fixing antibody responses, 80 per cent of those vaccinated and 3.4 per cent of those who were naturally immune were reinfected. Virus was recovered from the throat of one vaccinee, but from none of the reinfected naturally immune men. If precipitin antibody results are included, 100 per cent of vaccinees responded serologically. None of those reinfected became ill; among the susceptible men the ratio of inapparent to apparent infections was approximately 2:1.
Advances in targeted therapies XIV
Authors: Ferry C Breedveld, J R Kalden, Josef S Smolen
Journal: Annals of the Rheumatic Diseases (2013)

The papers brought together in this supplement of the Annals of the Rheumatic Diseases constitute summaries of presentations at the 14th International Symposium on Advances in Targeted Therapies, which was held from 28 March till 1 April 2012. As such, these presentations represent the state-of-the-art on the biology of mechanisms of action and pathophysiology of tumour necrosis factor (TNF), as well as other important mediators of inflammation. Current knowledge on the means and consequences of blocking TNF or other molecules or cellular mechanisms is presented as well.

We are grateful to Drs Crofford, …