tbuckley/cabot-search huggingface dataset:
PWE-131 The First UK Multidisciplinary Diagnostic Centre: A Novel Cancer Diagnostic Service
Authors: D Chung, K Matoo, E Seward, R Haidry, M Chapman, S McCartney, S Shaw, N MacLean, K Pritchard-Jones, A Millar
Journal: Gut (2016)

<h3>Introduction</h3> Late diagnosis is thought to be a significant cause of the observed lower cancer survival in UK compared to equivalent countries worldwide. A significant proportion of patients with intra-abdominal cancer are often diagnosed after attending Emergency Departments with late stage disease, highlighting the fact that often symptoms of early upper gastrointestinal (UGI) cancer are nebulous and ill-defined. <h3>Methods</h3> A pilot Multidisciplinary Diagnostic Centre (MDC) at UCLH was established in June 2015. The MDC is for: (a) patients with severe but non-specific worrying symptoms, warranting rapid diagnosis but not qualifying for a '2 Week Wait' referral; (b) patients with severe symptoms for whom admission to hospital currently offers the only clinically appropriate route to timely care. The Centre aims to provide rapid access to specialist assessment and appropriate diagnostic tests, leading to a defined management plan within 28 days of referral, aligning to the Independent Cancer Taskforce recommendations. Initial assessment is by a clinical nurse specialist (CNS) with consultant support. Once the diagnostic tests are performed, follow up is by face to face consultant assessment. Feedback to the service was elicited by a series of phone calls to a proportion of referring doctors. <h3>Results</h3> Of the initial 91 patients, the majority of patients (47%, 43) presented with vague abdominal symptoms alone. A further 24% (22) of patients had unexplained weight loss. 93% of patients were offered an initial appointment to MDC within 5 working days. Relevant eventual clinical diagnoses were cancer of unknown primary (1), pancreatic cancer (1), adrenal adenoma (1) and intraductal papillary mucinous neoplasm of pancreas (1). Other non-cancer diagnosis include hiatus hernia (10%), irritable bowel syndrome (8%), and colonic/rectal polyp (5%). The majority of patients underwent CT scanning (54%) and UGI endoscopy (39%). Primary care feedback (n = 6) highlighted the importance even of non-cancer diagnoses. <h3>Conclusion</h3> The ability to provide a rapid access diagnostic clinic is feasible and will enable the NHS to achieve the Independent Cancer Taskforce recommendation on providing a definitive cancer diagnosis, or cancer excluded within 28 days. Cancer rates are in keeping with other cancer pathways. Input from CNS and efficient administration support are essential in ensuring the diagnostic journey is centred around the patients. We need to understand more about patient experience in this novel pathway, in particular whether rapid access to diagnostic tests and specialist opinion is being perceived as an excellent service. <h3>Disclosure of Interest</h3> None Declared
Analysis of Transcriptome, Mirnome and Genomic Profiles in Association with Clinical Outcome in a Prospective Series of Primary Plasma Cell Leukemia
Authors: Luca Agnelli, Pellegrino Musto, Katia Todoerti, Marta Lionetti, Laura Mosca, Sonia Fabris, Giacomo Tuana, Marzia Barbieri, Vitina Grieco, Gabriella Bianchino, Fiorella D'Auria, Teodora Statuto, Carmela Mazzoccoli, Luciana De Luca, Maria Teresa Petrucci, Fortunato Morabito, Massimo Offidani, Francesco Di Raimondo, Antonietta Falcone, Paola Omedè, Mario Boccadoro, Antonio Palumbo, Antonino Neri
Journal: Blood (2012)
SAT0102 Influence of Vaccination Program To Prevent Acute Respiratory Infection in Rheumatoid Arthritis
Authors: P. Rodriguez-Cundin, V. Calvo-Río, R. Blanco, L.C. Dominguez-Casas, N. Vegas-Revenga, C. Fernández Díaz, V. Portillo, F.M. Antolin, M.H. Rebollo-Rodrigo, M.A. Gonzalez-Gay
Journal: Annals of the Rheumatic Diseases (2016)

<h3>Background</h3> Patients with autoimmune rheumatic diseases such as rheumatoid arthritis (RA) are at increased risk for infections, especially respiratory type. Immunization is a recommended measure to reduce these complications. <h3>Objectives</h3> Assess the incidence of acute respiratory infections (ARI), defined as one that causes hospitalization, before and after inclusion in a systematic vaccination program. <h3>Methods</h3> Prospective study in a cohort of 294 patients diagnosed with RA, were included in the vaccination program. This program includes: seasonal flu vaccine (october to april), pneumococcal (combined regimen 13-valent and 23-valent) and Haemophilus influenzae B. Only 7 patients (2.94%) refused vaccination. The follow-up time was from October 1st, 2011 (starting date) to June 30th, 2015. Information on ARI episodes before and after immunization was collected from the Hospital Information System, reviewing hospital records. <h3>Results</h3> 287 RA patients (225 women/62 men) were vaccinated, with an average age of 58.1 ± 12.7 years. RA was characterized at the time of vaccination by the time of evolution of RA 93 ± 95.9 months; 154 (53.65%) positive RF, 97 (33.8%) erosive and 40 (13.9%) with extra-articular manifestations (7 with pulmonary fibrosis). Only 42 (14.6%) were not taking any immunosuppressive or immunomodulatory therapy at the time of immunization. 147 patients were treated with Disease Modifying Antirheumatic Drugs (DMARD9s), mainly methotrexate, and 98 patients (34.1%) were with a TNFa inhibitor. Regarding the ARI, before inclusion in the vaccination program, 20 (7%) patients in the cohort studied had been admitted into the hospital for this reason. During follow-up, and subsequent immunization, only 6 of the 287 patients (2.1%) had ARI (Table 1). One of them had an ARI prior to vaccination program. This reduction from 7% to 2.1% achieved statistically significant difference (p=0.0017). <h3>Conclusions</h3> Incorporating a program of systematic vaccination in RA patients appears to be an effective prophylactic measure to prevent the ARI. <h3>Disclosure of Interest</h3> None declared
SAT0555 Proof of Concept – Study for The Evaluation of Healthy Joints and Periarticular Structures in Children
Authors: M. Naumann, N. Tzaribachev, G. Elmardenly, M. Eichner, G.-R. Burmester, M. Backhaus, S. Ohrndorf
Journal: Annals of the Rheumatic Diseases (2016)

<h3>Background</h3> Musculoskeletal ultrasonography (US) has become an important diagnostic tool for the diagnosis and follow-up of inflammatory joint diseases in pediatric rheumatology. However, there is lack of clinical studies in pediatric joint ultrasonography concerning normal findings of healthy joints and periarticular structures in children. <h3>Objectives</h3> The aim of the study was to evaluate normal values for the thickness of healthy joint cartilage, capsule and tendons of the hand (finger/wrist), elbow, hip, knee, ankle and forefoot in children by musculoskeletal ultrasound (US). Furthermore, power Doppler activity was measured. <h3>Methods</h3> The joints were assessed by four physicians experienced in musculoskeletal US with equally preset Esaote Mylab Twice with high frequency (13 to 18 MHz) probes. N=75 healthy children (41 boys, 34 girls) between 4.9–11.1 years (girls) and 4.3–13.1 years (boys) were included in the study. <h3>Results</h3> If there was no significant difference between girls and boys, common reference intervals were calculated (see attached Table 1). Otherwise, 95% separate reference intervals were defined for boys and girls each (not presented in abstract). Power Doppler US (PDUS) signals were measured in all joints. PDUS signals were found regularly, notably in the wrist and finger joints. <h3>Conclusions</h3> The reference intervals for healthy children are helpful for the interpretation of pathological findings in juvenile idiopathic arthritis (JIA). The intervals show a wide range; therefore pathology should be examined carefully. Especially in younger children, joint measurements might have different values due to the growing structures, which need further evaluation. Furthermore, PDUS signals in children can be quite common, depending on the joint region and the selected standard scan. <h3>Disclosure of Interest</h3> None declared
Effect of Supplemental Donor Human Milk Compared With Preterm Formula on Neurodevelopment of Very Low-Birth-Weight Infants at 18 Months
Authors: Deborah L. O’Connor, Sharyn Gibbins, Alex Kiss, Nicole Bando, Joan Brennan-Donnan, Eugene Ng, Douglas M. Campbell, Simone Vaz, Christoph Fusch, Elizabeth Asztalos, Paige Church, Edmond Kelly, Linh Ly, Alan Daneman, Sharon Unger
Journal: JAMA (2016)

<h3>Importance</h3> For many very low-birth-weight (VLBW) infants, there is insufficient mother's milk, and a supplement of pasteurized donor human milk or preterm formula is required. Awareness of the benefits of mother's milk has led to an increase in use of donor milk, despite limited data evaluating its efficacy. <h3>Objective</h3> To determine if nutrient-enriched donor milk compared with formula, as a supplement to mother's milk, reduces neonatal morbidity, supports growth, and improves neurodevelopment in VLBW infants. <h3>Design, Setting, and Participants</h3> In this pragmatic, double-blind, randomized trial, VLBW infants were recruited from 4 neonatal units in Ontario, Canada, within 96 hours of birth between October 2010 and December 2012. Follow-up was completed in July 2015. <h3>Interventions</h3> Infants were fed either donor milk or formula for 90 days or to discharge when mother's milk was unavailable. <h3>Main Outcomes and Measures</h3> The primary outcome was the cognitive composite score on the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) at 18 months' corrected age (standardized mean, 100 [SD, 15]; minimal clinically important difference, 5 points). Secondary outcomes included Bayley-III language and motor composite scores, growth, and a dichotomous mortality and morbidity index. <h3>Results</h3> Of 840 eligible infants, 363 (43.2%) were randomized (181 to donor milk and 182 to preterm formula); of survivors, 299 (92%) had neurodevelopment assessed. Mean birth weight and gestational age of infants was 996 (SD, 272) g and 27.7 (2.6) weeks, respectively, and 195 (53.7%) were male. No statistically significant differences in mean Bayley-III cognitive composite score (adjusted scores, 92.9 in donor milk group vs 94.5 in formula group; fully adjusted mean difference, −2.0 [95% CI, −5.8 to 1.8]), language composite score (adjusted scores, 87.3 in donor milk group vs 90.3 in formula group; fully adjusted mean difference, −3.1 [95% CI, −7.5 to 1.3]), or motor composite score (adjusted scores, 91.8 in donor milk group vs 94.0 in formula group; fully adjusted mean difference, −3.7 [95% CI, −7.4 to 0.09]) were observed between groups. There was no statistically significant difference in infants positive for the mortality and morbidity index (43% in donor milk group, 40% in formula group) or changes in growth<i>z</i>scores. <h3>Conclusions and Relevance</h3> Among VLBW infants, use of supplemental donor milk compared with formula did not improve neurodevelopment at 18 months' corrected age. If donor milk is used in settings with high provision of mother's milk, this outcome should not be considered a treatment goal. <h3>Trial Registration</h3> isrctn.org Identifier:ISRCTN35317141
What's Your Tanner? An Analysis of the Impact of Sickle Cell Disease Phenotype on Pubertal Development and Body Mass
Authors: Patrice L Capers, Beatrice E Gee, Hyacinth I Hyacinth, Gale W Newman, Jonathan K Stiles, Alexander Quarshie, Ifeyinwa Osunkwo, Jacqueline M Hibbert
Journal: Blood (2011)
FRI0319 The Risk of Pulmonary Embolism and Deep Venous Thrombosis in Systemic Lupus Erythematosus in The United Kingdom: A Population-Based Study: Table 1.
Authors: A. Jorge, L. Lu, H. Choi
Journal: Annals of the Rheumatic Diseases (2016)

<h3>Background</h3> Many studies have found that patients with SLE have a substantially increased risk of cardiovascular complications. However, the magnitude of the risk for venous thromboembolism (VTE) has not been well quantified in this patient group, particularly within the general population context. <h3>Objectives</h3> Our objective was to determine magnitude and temporal trend of the risk of venous thromboembolism (VTE), pulmonary embolism (PE), and deep vein thrombosis (DVT) in individuals with incident systemic lupus erythematosus (SLE) in the general population. <h3>Methods</h3> Using the Health Information Network (THIN) database, a population database that includes 11.1 million patients, 6.2% of the population of the United Kingdom, we conducted a cohort study of all patients with incident SLE and up to 10 age-, sex-, and entry time-matched individuals from the general population. SLE patients were identified by read codes for systemic involvement of lupus, excluding cutaneous-only disease. We compared incidence rates of PE, DVT, and VTE between the two groups and within the SLE group according to SLE disease duration. We calculated hazard ratios (HRs), adjusting for confounders. <h3>Results</h3> Among 1494 individuals with SLE (87.1% female, mean age 50 years), there were 13 cases of DVT and 14 of PE. Among the 10,473 individuals without SLE, there were 38 cases of DVT and 33 of PE. The incidence rates of PE, DVT, and VTE were 1.6, 1.4, and 2.9 per 1000 person-years in the SLE group, whereas the corresponding rates were 0.5, 0.6, and 1.1 per 1000 person-years among individuals without SLE. Compared with non-SLE individuals, the multivariable HRs among SLE patients were 3.17 (95% CI, 1.65–6.10), 3.42 (95% CI, 1.72–6.81), and 3.14 (95% CI, 1.94, 5.07) for PE, DVT and VTE, respectively. The age-, sex-, BMI-, and entry time-matched incidence ratios for PE, DVT, and VTE were highest during the first year after SLE diagnosis 14.30 (95% CI, 4.02–50.82), 8.70 (95% CI, 1.74–43.40), and 10.82 (95% CI, 3.91–29.90), respectively. HRs remained similar after adjusting for covariates including BMI, smoking, relevant comorbidities, and use of pertinent medications. <h3>Conclusions</h3> These findings provide population-based evidence that patients with SLE are at a considerably increased risk of VTE, especially within the first year after SLE diagnosis. Increased vigilance for this potentially fatal outcome and its modifiable risk factors appears warranted in this patient population, particularly early after disease onset. <h3>Disclosure of Interest</h3> None declared
Hematopoietic Stem Cell Transplantation from HLA Identical Sibling Forsickle Cell Disease an International Survey on Behalf of Eurocord-Monacord, EBMT Paediatric Disease Working Party and CIBMTR
Authors: Barbara Cappelli, Francoise Bernaudin, Annalisa Ruggeri, Myriam Labopin, Fernanda Volt, Belinda Pinto Simoes, Alina Ferster, Sophie Dupont, Josu de la Fuente, Jean-Hugues Dalle, Marco Zecca, Marie Robin, Mark C. Walters, Nathalie Dhedin, Gerard Michel, Patrick Lutz, Benedicte Neven, Yves Bertrand, Jean Pierre Vannier, Mouhab Ayas, Susanne Matthes, Hanadi Elayoubi, Agnes Devergie, Chantal Kenzey, Franco Locatelli, Christina Peters, Vanderson Rocha, Mary Eapen, Eliane Gluckman
Journal: Blood (2015)
OP0239 Dissecting The Molecular Basis of Immune Cell Accumulation in The Inflamed Joint Using A Murine Model of Rheumatoid Arthritis
Authors: C.T. Prendergast, R.A. Benson, I.B. McInnes, J.M. Brewer, P. Garside
Journal: Annals of the Rheumatic Diseases (2016)

<h3>Background</h3> The molecular control of the “ebb and flow” of inflammatory cells into and out of the joint during the initiation, maintenance and resolution of inflammation in Rheumatoid Arthritis (RA) remains unclear. <h3>Objectives</h3> To characterise the ingress and egress of immune cells into inflamed joints, and identify the key molecular pathways regulating their migration in real time <i>in vivo</i>. <h3>Methods</h3> We developed a “breach of self tolerance” murine model of articular inflammation [1]. Using this model in conjunction with mice expressing the photoswitchable fluorescent protein kaede [2], we characterized the migration of cells from the inflamed joint (after photoswitching) to the draining lymph nodes. Flow cytometry of excised lymph nodes allowed the identification and phenotypic characterization of photoswitched cells that could only have originated from the inflamed joint. Using the same approach we identified and sorted cells that migrated to the draining lymph nodes and those that remained in the joint. RNA-seq analysis of these populations identified genes differentially regulating cellular retention in, and egress from, the inflamed joint to the draining lymph node. <h3>Results</h3> The key populations identified exiting the inflamed joint and entering the draining lymph node were CD4<sup>+</sup> and CD8<sup>+</sup> T cells, FoxP3<sup>+</sup> Treg, B cells and CD11c<sup>+</sup> DCs. The populations present in the inflamed joint comprised mainly CD4<sup>+</sup> T cells, CD11c<sup>+</sup> DCs and Ly6G<sup>+</sup> neutrophils. Analysis of RNA-seq data revealed pathways and genes previously highlighted as characteristic of RA in patient studies. More specifically focusing on cell migration, adhesion and movement pathways has indicated genes associated with the egress of immune cells from the inflamed joint. <h3>Conclusions</h3> We have identified key gene expression profiles that may be important for the migration of cells from the inflamed joint, which may provide targets for therapeutic manipulation. <h3>References</h3> Maffia P, Brewer JM, Gracie JA, Ianaro A, Leung BP, Mitchell PJ, et al. Inducing experimental arthritis and breaking self-tolerance to joint-specific antigens with trackable, ovalbumin-specific T cells. J Immunol. 2004;173(1):151–6. Tomura M, Yoshida N, Tanaka J, Karasawa S, Miwa Y, Miyawaki A, et al. Monitoring cellular movement in vivo with photoconvertible fluorescence protein “Kaede” transgenic mice. Proc Natl Acad Sci U S A. 2008;105(31):10871–6. <h3>Acknowledgement</h3> This research is funded by Arthritis Research UK, and supported by the Arthritis Research UK Rheumatoid Arthritis Pathogenesis Centre of Excellence (RACE). <h3>Disclosure of Interest</h3> None declared
A Phase III PETHEMA/GEM Randomized Trial of Postransplant (ASCT) Maintenance in Multiple Myeloma: Superiority of Bortezomib/Thalidomide Compared with Thalidomide and Alfa-2b Interferon,
Authors: Laura Rosiñol, María Teresa Cibeira, Maria Victoria Mateos, Joaquin Martinez, Albert Oriol, Ana Isabel Teruel, Dolores Hernández, Javier López, Javier de la Rubia, Miquel Granell, Juan Besalduch, Luis Palomera, Yolanda González, Maria Asunción Etxebeste, Joaquín Díaz-Mediavilla, Miguel T Hernández, Felipe de Arriba, Adrian Alegre, Juan José Lahuerta, Jesus F San Miguel, Joan Blade
Journal: Blood (2011)
A Proof of Principle Clinical Trial in Myelodysplastic Syndromes of Non-Cytotoxic Differentiation Therapy with Decitabine,
Authors: Yogen Saunthararajah, Reda Z Mahfouz, Ricki Englehaupt, Joy Juersivich, Lisa Durkin, Tomas Radivoyevitch, Kathleen Cooper, Manual Afable, Robert Dean, Anjali S. Advani, Matt Kalaycio, Ronald Sobecks, Edward A. Copelan, Eric D. Hsi, Jaroslaw P. Maciejewski, Mikkael A Sekeres
Journal: Blood (2011)
AB0582 Mortality in Patients with Systemic Sclerosis – A Single Center Experience
Authors: A. Balbir-Gurman, H. Attamna, M.A. Nahir, Y. Braun-Moscovici
Journal: Annals of the Rheumatic Diseases (2016)

<h3>Background</h3> Patients (pts) with systemic sclerosis (SSc) experience higher mortality rates. <h3>Objectives</h3> To assess the mortality and causes of death in SSc pts9 cohort at our center. <h3>Methods</h3> The data were retracted from the Rambam EUSTAR database (220 pts, years 2004–2013) and completed from pts9 files; demographic, clinical and laboratory data, malignancy cases, the reason of death were analyzed. Comparisons were made between the deceased pts and surviving pts with similar disease duration. Proportional hazards models of Kaplan-Meier survival analysis and student9s T-test were used for statistical analysis. Data found to significantly affect survival in a first univariate analysis were entered in a multivariate Cox proportional hazards model. Causes of death were analyzed using standard descriptive statistics. Data characterized pts with malignancy were incorporated in the logistic regression model. <h3>Results</h3> 47 (21.4%) pts deceased (age 53±15 years, disease duration 9.8±11 years, females 76.6%, diffuse disease 27.6%). Causes of death were: pulmonary fibrosis (PF), pulmonary arterial hypertension (PAH), right and left heart failure (CHF, 27.7% and 19.1%); infections (17.0%), malignancies (17.0%), renal crisis (6.4%), gastrointestinal complications (GIT) (2.1%), and others (10.64%). Survival was significantly affected by: older age at diagnosis (P=0.011), male gender (P=0.049), reduced lung volumes and diffusing capacity (P=0.014 and p=0.001), PF (P=0.002), PAH (P&lt;0.001), CHF (P&lt;0.001), use of diuretics (P&lt;0.001), arrhythmias (P&lt;0.001), malignancy (P=0.003), proteinuria (P=0.003), and GIT complications (P=0.027). Malignancy was reported in 14/47 (29.8%) pts: lungs 23.5%, GIT 17.7%, genitourinary tract 17.7%, other 41.2%. Malignancy was not an independent predictor of mortality. <h3>Conclusions</h3> In this study the leading cause of death in SSc pts was cardiopulmonary complications, followed by malignancy and infections; renal and GIT complications were less frequent. High index of suspicion and early diagnosis of main SSc complications will allow early intervention and may hopefully change the fate of SSc pts. <h3>Disclosure of Interest</h3> None declared