tbuckley/cabot-search huggingface dataset:
S69 HOT HMV UK: prevalence of persistent significant hypercapnia following acute exacerbation of COPD (AECOPD) requiring non-invasive ventilation (NIV)
Authors: P. Murphy, G. J. Gibson, M. I. Polkey, N. Hart
Journal: Thorax (2010)

<h3>Introduction</h3> Acute NIV is now standard therapy for hypercapnic respiratory failure (AHRF) complicating AECOPD. However, although chronic hypercapnia is an acknowledged poor prognostic factor in COPD and some data suggest a survival advantage with domiciliary NIV compared with oxygen alone, its use for chronic hypercapnic respiratory failure (CHRF) remains controversial.<sup>1</sup> Patients with CHRF who have recently been treated acutely with NIV for AECOPD may be a particularly appropriate group in whom to consider long term domiciliary NIV. <h3>Method</h3> We are conducting an RCT (HOT HMV UK) of domiciliary NIV plus oxygen against domiciliary oxygen alone in CHRF (defined as PaCO<sub>2</sub> &gt;7 kPa), focussing on patients who have recently received acute NIV for AECOPD, and we have evaluated the likely uptake of such treatment after resolution of the acute episode. All patients seen over a 5-month period at two tertiary centres for consideration of domiciliary NIV following acute NIV were assessed at least 2 weeks following resolution of AHRF and arterial blood gas analysis was performed. <h3>Results</h3> 38 patients received acute NIV for an AECOPD. Mean (±SD) age was 69±17 years and 50% were male, with PaCO<sub>2</sub> of 9.3±2.4 kPa at acute presentation. Eight (21%) patients died prior to review (six during initial admission, two shortly following discharge); four patients whose diagnosis was clarified as an overlap of obstructive sleep apnoea and COPD were treated on clinical grounds with NIV and one patient was already receiving domiciliary NIV. Of the remaining 25 patients, nine had PaCO<sub>2</sub> &lt;7 kPa at 2 weeks, leaving 16 (42%) with CHRF at 2 weeks post recovery. Importantly, seven (44%) of these did not wish to be considered for a clinical trial involving domiciliary NIV, the principal reason being poor tolerance during the acute episode. <h3>Conclusion</h3> More than 40% of patients requiring NIV for AHRF complicating AECOPD had CHRF with a PaCO<sub>2</sub> &gt;7 kPa, when assessed 2 weeks after discontinuation of acute NIV. However, nearly half of these reported negative experiences of acute NIV that made them reluctant to consider long term treatment.
Endoscopic ultrasound-guided jejunogastrostomy to perform endoscopic cholangiography in a patient with a modified Roux-en-Y hepaticojejunostomy
Authors: Rogério Colaiacovo, Augusto Carbonari, Lucio Rossini, Andre de Moricz, Erwin Santo, Marc Giovannini
Journal: Endoscopy (2014)

A 43-year-old woman had been diagnosed with intrahepatic duct stones and referred in 2007 for cholecystectomy and modified Roux-en-Y hepaticojejunostomy. A jejunal loop had been fixed to the anterior wall of the stomach for future endoscopic access, if necessary ([Fig. 1]). The patient had remained asymptomatic for 5 years, but then presented with multiple episodes of cholangitis. Magnetic resonance cholangiography in 2012, showed intrahepatic duct stones. Conventional endoscopic retrograde cholangiopancreatography (ERCP) failed. Thus a decision was taken to perform endoscopic extraction of the biliary stones by accessing the jejunal loop, guided by endoscopic ultrasound (EUS).
AB0921 Secondary Macrophage Activation Syndrome: Report of 13 Clinical Cases and the Difference between the 4 Groups of Diseases: Table 1
Authors: C.A. Egües Dubuc, C. Meneses Villalba, N. Errazquin Aguirre, M. Uriarte Ecenarro, I. Hernando Rubio, O. Maiz Alonso, I. Bañegil Espinoza, J. Cancio Fanlo, M. Yague Asensio, E. Uriarte Isacelaya, J. Belzunegui Otano
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> The secondary macrophage activation syndrome (SMAS) is a group of diseases that include the: Autoimmune (AI), Hemato-Oncological (HO), Infectious (Inf) and Oncological (Onco). We make a review of the the cases presented in a our hospital. <h3>Objectives</h3> Describe the characteristics demographic, clinical, laboratory, treatment, underlying disorders and mortality of patients diagnosed with SMAS. <h3>Methods</h3> A cohort was studied retrospectively of patients diagnosed with SMAS between the period December/2008-January/2014 by reviewing medical records from the diagnosis until January/2014. The nominal variables were: diagnosis, treatments during hospitalization and after discharge. Dichotomous variables were: sex, fever, organomegaly, mortality, admission to the Intensive Care Unit (ICU) and recurrence of SAMS. Quantitative variables were: age, laboratory findings, hospital stay, days from admission to the bone marrow biopsy (BMB). Patients were divided into 4 groups (AI, HO, Inf and Onc). The variables were analyzed between the 4 groups and between AI and HO. Quantitative variables showed asymetric distribution so it showed with the median and interquartile range. For the bivariate analysis the Kruskal-Wallis, Pearson Chi Square and Fisher9s Exact tests were used. <h3>Results</h3> 13 patients (6 female) with median age of 54 (32-63) were found: 5 with AI diseases (2 Systemic Lupus Erythematosus, 2 Adult Still9s Disease and 1 IgG4 associated disease), 5 HO diseases (3 Non Hogkin Lymphoma, 1 acute myeloid leukemia and 1 Lymphoma of Natural Killers cells), 2 Inf. diseases (<i>Campylobacter jejuni</i> and human immunodeficiency virus) and 1 Onc. disease (Chemotherapy in Glioblastoma multiforme). Table shows the descriptive and bivariate analysis of the most important variables. The treatments used were: glucocorticoids in all patients, immunoglobulins in 8 (3 AI, 2 HO, 2 Onc. and 1 Inf.), Cyclosporine in 8 (5 AI and 3 HO), anakinra in 4 (2 HO and 2 AI), tocilizumab and chemotherapy in 2 HO. <h3>Conclusions</h3> We found that leukopenia was lower in AI disease than HO diseases with statistically significant p. AI diseases had worse prognosis, increased mortality and hospital days than other diseases. <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.5055
Pulsatile Secretion of Human Chorionic Gonadotropin in Normal Adults
Authors: W.D. Odell, J. Griffin
Journal: New England Journal of Medicine (1987)

We used very sensitive and specific monoclonal-antibody sandwich assays for human chorionic gonadotropin (hCG) and human luteinizing hormone (hLH) to measure both hormones in serum samples from normal men and women. When single serum samples from 92 men were studied, 73 percent had detectable hCG. In normal men, the amount of detectable hCG averaged 8.9 pg per milliliter, with a range of less than 3.0 to 160 pg per milliliter (biologic potency = 13,450 IU per milligram). In postmenopausal women the hCG level averaged 111 pg per milliliter and ranged from 32 to 510. In women of reproductive age the hCG level varied with the menstrual cycle. Gonadotropin-releasing hormone administered to 10 normal men increased both hCG and hLH. When daily serum samples were studied throughout a normal menstrual cycle, hCG concentrations paralleled those of hLH; follicular-phase concentrations were higher than those of the luteal phase, and there was a midcycle ovulatory peak of hCG coincident with the hLH peak. When hCG was measured every 10 minutes for six hours in eight postmenopausal women, distinct pulses were detected in parallel with those of hLH: hLH pulsed at a mean (+/- SEM) frequency of 0.56 +/- 0.08 pulses per hour; hCG pulsed at 0.54 +/- 0.07 pulses per hour. The mean pulse durations were 89 +/- 22 and 56 +/- 20 minutes for hLH and hCG, respectively. We conclude that hCG is produced in a pulsatile fashion, probably by the pituitary, in all normal adults.
Affordable Care Act will boost incomes of poorest people, study shows
Authors: M. McCarthy
Journal: BMJ (2014)

People in the bottom fifth of the income distribution in the United States will see their incomes rise by almost 6% by 2016 as a result of the Affordable Care Act, and those in the bottom 10th will see a rise of more than 7%, said a new study.1

Although changing the income distribution in the US was not a stated objective of the law, the 2010 health reform legislation may do more to …
Large bleeding rectal varices treated with endoscopic ultrasound-guided coiling and cyanoacrylate injection
Authors: Ahmed Messallam, Vivek Kumbhari, Payal Saxena, Alba Azola, Anthony Kalloo, Mouen Khashab
Journal: Endoscopy (2014)

There is no consensus as to the optimal treatment strategy for bleeding rectal varices. Current endoscopic options include endoscopic injection sclerotherapy and band ligation. We present the successful use of endoscopic ultrasound (EUS)-guided coil placement and cyanoacrylate injection in obliterating symptomatic large rectal varices.
Case 20-1997
Authors: Richard L. Kradin, Eugene J. Mark
Journal: New England Journal of Medicine (1997)

Presentation of CaseA 74-year-old man was admitted to the hospital because of increasing dyspnea and a cough.The patient had been well until five months earlier, when dyspnea developed with a cough that produced minimal amounts of clear sputum. An antibiotic was prescribed, but it was ineffective. Another antibiotic was administered three weeks later, again without success. The dyspnea worsened over the next few weeks, and the patient could not play golf or maintain his active lifestyle.Seven weeks before the current admission, the patient entered another hospital. The temperature was 38.1°C. The white-cell count was 17,100 per cubic . . .
Scintigraphy of Gluteal Tendonopathy
Authors: Andrew Strokon, Kate Archer, Mohamed Mourad, Hans Van Der Wall
Journal: Clinical Nuclear Medicine (2003)

STROKON, ANDREW M.B.B.S., F.R.A.C.S., F.A.ORTH.A.; ARCHER, KATE M.B.B.S.; MOURAD, MOHAMAD M.B.B.S.; VAN DER WALL, HANS M.B.B.S., PH.D., F.R.A.C.P. Author Information
Suggested Personnel Additions to Department of Medicine Training Programs
Authors: Morton D. Bogdonoff
Journal: New England Journal of Medicine (1987)

The most important phase in the training of internists is the period spent as interns and residents. The outstanding places for such training have been the university medical centers. During the past decade, however, the clinical character of the patients in these centers has changed so dramatically that university programs may no longer provide the most comprehensive training.Departments of medicine in university medical centers are now divided into a number of specialized intensive care units for patients with acute severe illness, with the remainder of the general care beds being devoted to patients with chronic severe illness, frequently in . . .
AB0513 The Clinical Significance of Rarely Seen Staining Patterns of anti Nuclear Antibodies: Table 1.
Authors: F. Cosan, S.U. Ilikhan, I. Tekin
Journal: Annals of the Rheumatic Diseases (2014)

Background Anti nuclear antibodies (ANA) are one of the key diagnostic analyse for autoimmune diseases in rheumatological practice. The staining patterns of ANA include two main subgroups; nuclear and cytoplasmic staining patterns. In clinical practice the main five nuclear staining patterns (homogen, peripheral, granular, centromer, nucleolar)are used for diagnosis. The clinical significance of cytoplasmic patterns is unclear. Objectives We aimed in this study to determine the clinical significance of rarely seen ANA staining patterns. Methods Our study group is consisted of 224 patients (40 male, 184 female) who admitted with arthralgia to rheumatology outpatient clinic and found ANA positivity with the titer at least 1/320. ANA analysing was performed with IFA (Euroimmun) and ENA with immune blot (Euroimmun). Results The frequency of homogeneous pattern was 13,8%, granular pattern 19,6%, cytoplasmic pattern 17%, centromer 5,4%, nucleolar 16,5%, nucleolar granular 4,9%, nucleolar homogenous 4,9%, mitbody 10,3%, actine 4,5%, vimentin 3,1%, tropomyosin 0,9%, fibrillarin 1,3%, peroxisomes 2,2%, pcna 1,8%, golgi 2,7%, spindle fiber 3,6%, lamin 2,2%, centriol 3,6%, ribosomal-p 2,7%, mitochondrial 1,8%. The distribution of ANA patterns according the clinical findings is shown in [Table-1][1]. We found that rarely seen patterns could be associated with autoimmune diseases. Cytoskleton related patterns are associated with SPA in comparing to the other patterns. Nucleolar homogeneous, nucleolar granular, golgi and mitochondrial patterns are found the most spesific patterns in our study. The most RA associated patterns are found homogeneous and mitbody patterns. The most nonspesific patterns were granular in commen patterns and centriol in rarely seen patterns. View this table: Table 1. The association of ANA staining patterns with diseases Conclusions The rarely seen patterns may be significant for autoimmune diseases. The titre and the descriptive pattern information should be reported for rarely seen patterns. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.6079 [1]: #T1
THU0415 Changing Patterns in Prescribing in Rheumatoid Arthritis:
Authors: A. Mian, J. Galloway, S. Steer, I. Scott, G. Kingsley, D.L. Scott
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> Prescribing patterns in Rheumatoid Arthritis have evolved over recent decades. There is now clear evidence that combination DMARDs and biologics can acheive better disease control. This is guided by the treat to target initiative aiming for remission in all patients. <h3>Objectives</h3> We have used observational data to determine changes in prescribing patterns since 1996. We set out to describe the % of patients with RA being treated with individual DMARDs, combination therapy, systemic steroids and biologics. <h3>Methods</h3> Our study included 1492 RA patients attending two rheumatology centres. They comprised four groups of clinic attenders attending between 1996 and 2013. We collected data on the use of DMARDs, systemic steroids and biologics. Data were also collected on the proportion of patients not receiving any immunosuppressive therapy. <h3>Results</h3> More patients received immunosuppressive treatment with 14% of all RA patients and 16% of intermediate disease activity group not on any treatment in 2012-13 compared with 32% and 23% in the 1996-97 cohort. Methotrexate remains the most frequently prescribed DMARD across all cohorts, however the more contemporaneous cohorts have higher exposure to hydroxychloroquine, sulfasalazine and leflunomide. Conversely, few patients (&lt;1%) were prescribed azathioprine, penicillamine and gold in 2009-10 and 2012-13 compared to earlier cohorts. The % of patients treated with combination therapy has increased, however almost half of patients remain on a single DMARD (46%). The proportion of patients treated with biologics has steadily increased from 0 to 1996-97, 4% in 2001-03 to 17% and 21% in the two later cohorts. Systemic steroid use has fluctuated over time, prescribed in 14% in 2012-13. <h3>Conclusions</h3> Increasing numbers of patients are being treated with immunosuppression. The choice of DMARD has changed from fewer patients being prescribed gold, penicillamine and azathioprine, to more patients being treated with methotrexate, hydroxychloroquine, sulfasalazine and leflunomide. Whilst the uptake of combination DMARD therapy and biologics has increased, approximately half of patients remain on a single DMARD only. This may be due to a number of reasons including physician choice, patient choice and drug intolerance. Further research is needed to explore this issue. There are still patients not on immunosuppression, suggesting that we are not treating to target, and not achieving tighter targeted control in all patients. Further research into why patients who have not achieved remission are not being treated with combination therapy is needed. The role of biologics in moderate disease activity patients to further try and achieve remission needs to be explored. <h3>Disclosure of Interest</h3> : None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.5399
Abstract 1690: Differential autophagy activation in KRAS and EGFR mutant lung adenocarcinomas.
Authors: Maria L. Rodriguez, Ines Pulido, Margaret Soucheray, Daniel Crespo, Fatima Al-shahrour, Takeshi Shimamura, Angel Ortega, Julian Carretero
Journal: Cancer Research (2013)

Abstract Lung cancer is the leading cause of cancer deaths in western countries, and adenocarcinomas (LADs) are the most frequent histological subtype. The aberrant activation of the kinases promotes plethora of tumorigenic processes, mainly through PI3K and MAPK oncogenic pathways leading to oncogene addiction. The activation of PI3K pathway deregulates mTOR, a master kinase for cell growth and autophagy. Autophagy can be pro- or anti- tumorigenic, however its roles in protecting tumors exposed to metabolic stress under chemotherapy are considered as a survival mechanism for the tumors leading to acquired resistance. Consequently, the inhibition of autophagy is an attractive therapy to prevent the emergence of acquired resistance. Activating mutations in EGFR and KRAS are mutually exclusive and are the most frequent oncogene activation in LAD. There are considerable differences in the control of signalling pathways including PI3K-mTOR axis. Therefore, it is hypothesized that the susceptibility to autophagy differs depending on EGFR or KRAS mutational status. To test the hypothesis, we applied nutrient-starvation conditions, the most well-known inducer of autophagy, to a panel of LAD cell lines bearing known EGFR or KRAS mutations. As a positive control, cells were treated with rapamycin, which also induced autophagy inhibiting MTOR activity. Autophagy activation was analyzed by: i) Western blot of LC3-II and p62/SQSTM1 protein levels, that measures autophagy flux and autophagic protein degradation, respectively; and ii) autophagolysosome detection and lysosomal activity by fluorescent microscopy. Our data suggest that KRAS-mutant LAD cell lines are able to activate autophagy, whereas EGFR-mutant are not, under starvation stress. Furthermore, we found a potential interaction between mutant EGFR and Beclin 1 (BECN1, a protein required for the initiation of the autophagosome) at the cell membrane proximity, using co-immunolocalization by confocal microscopy and immunoprecipitation followed by Western blot. Together, these data provide a compelling rationale to investigate anti-autophagy therapy in mutant KRAS LADs and warrant further investigation in the regulation of autophagy via a novel link between Beclin1 and mutant EGFR. Citation Format: Maria L. Rodriguez, Ines Pulido, Margaret Soucheray, Daniel Crespo, Fatima Al-shahrour, Takeshi Shimamura, Angel Ortega, Julian Carretero. Differential autophagy activation in KRAS and EGFR mutant lung adenocarcinomas. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 1690. doi:10.1158/1538-7445.AM2013-1690
AB0227 Extra Articuar Manifestations of Rheumatoid Arthritis - A Hospital Based Study in Albania
Authors: B. Hebibasi, E. Harja, J. Kucaj
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> The frequency of Extra-articular manifestations of Rheumatoid arthritis differs in various populations. They have been mostly found in patients with positive Rheumatoid Factor and positive ANA. <h3>Objectives</h3> To identify the presence and the frequency of extra-articular manifestations in hospitalized patients and calculate the correlation between their presence and positive RF, positive ANA. <h3>Methods</h3> 162 patients with Rheumatoid Arthritis, hospitalized in the Universitary Center Hospital of Tirana during Feb 2010 – May 2011, were included in the study. All the patients fulfilled the ACR criteria of 1987 for Rheumatoid Arthritis. RF and ANA were measured in all of them. The presence of EA manifestations was studied in all of them. Since there are no unified criteria for the evaluation of EA manifestations, we used the criteria from the reference.The test of logistic regression was used to calculate the correlation between EA presence and positive Rheumatoid Factor and ANA. <h3>Results</h3> Of the 162 patients included in the study, 120 were females, 43 males. Mean age of patients 51.9 years. Mean duration of the disease 7.93 years. Extra-articular manifestations were found in 93 (56.8) patients. Their frequency was: Anemia 29.4%, Thrombocytosis 14.1%, Cutaneous Vasculitis 9.8%, Nervous System Manifestations 9.2%, Muscular Manifestations 17.2%, Rheumatoid Nodules 8%, Raynaud Phenomena 9.2%, Sicca Syndrome 13.5%, Pulmonary Manifestations 6.7%, Cardiac Manifestations 6.1%. Rheumatoid Factor was positive in 38% of the patients. ANA was positive in 35.5% of the patients. They were mostly positive in patients with EA manifestations, but the correlation was not statistically significant p&gt;0.05. <h3>Conclusions</h3> The presence of positive Rheumatoid Factor in patients with Rheumatoid Arthritis in Albania differs from other populations (38%). The most frequent EA manifestations in patients with Rheumatoid Arthritis are Anemia (29.4%), Muscular manifestations (17.2%), Thrombocytosis (14.1%), Sicca Syndrome (13.5%). Positive RF and positive ANA were found mostly in patients presenting with EA manifestations, but their correlation was not statistically significant, p&gt;0.05. <h3>References</h3> Best Practice &amp; Research Clinical Rheumatology Vol. 21, No. 5, pp. 907–927, 2007doi:10.1016/j.berh.2007.05.007 Extra-articular manifestations and complications of rheumatoid arthritis <h3>Acknowledgements</h3> Prof. Dr. Tafaj Argjend <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.5742
Abstract 4040: MicroRNAs that chemosensitize the apoptotic effect of 17-AAG
Authors: Larn Hwang, Tina Treece, Neil Desai, Vuong Trieu
Journal: Cancer Research (2010)

Abstract Background: 17-allylamino-demethoxy geldanamycin (17-AAG) inhibits the chaperone function of heat shock protein 90 (Hsp90) and promotes the proteasomal degradation of its client proteins. 17AAG also induced the mitochondrial release, accumulation of mitochondrial-derived activator of caspases, resulting in apoptosis. 17-AAG is currently in development for the treatment of cancer. MicroRNAs (miRNAs) are small, noncoding RNAs that regulate expression of many genes and play a significant role in cancer and possibly in Hsp90 signaling. Therefore, a screen of miRNA mimics and inhibitors was conducted for chemosensitization to 17-AAG. Methods: To identify individual microRNAs that synergizes with 17AAG, microRNA libraries were screened for apoptotic activity against HT29 cells when co-treated with 17AAG. The microRNAs were transfected into HT29 cells 48 hrs before treatment with 17AAG. After 72 hrs of 17AAG exposure, apoptosis was quantitated by the release of caspase 3/7. The effects of these miRNA on cellular protein, mRNA, and miRNA profile were also examined using microarray technology. Results: Four miRNAs were identified which had potent chemosensitization effect on cells exposed to 17-AAG. These miRNA are different in sequence and did not synergize with one another. Alone they did not induce apoptosis; however, when combined with 17-AAG, they increased the apoptotic activity of 17-AAG up to 4 folds. Possible mechanism of action for these miRNAs was examined by microarray analysis which suggested that they act on the Hsp90/70 pathway to enhance the activity of 17-AAG. Conclusions: Four miRNAs were identified as chemosensitizers for 17-AAG. These miRNAs could provide the basis for determination of tumor types that will be sensitive to 17-AAG, as well as a potential biomarker for predicting 17-AAG effectiveness. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 4040.