tbuckley/cabot-search huggingface dataset:
Intraluminal injection of indigo carmine facilitates identification of the afferent limb during double-balloon ERCP
Authors: T. Yano, H. Hatanaka, H. Yamamoto, K. Nakazawa, N. Nishimura, S. Wada, K. Tamada, K. Sugano
Journal: Endoscopy (2012)

Double-balloon endoscopy facilitates endoscopic retrograde cholangiopancreatography (ERCP) in patients with a Roux-en-Y anastomosis [1]. However, it is difficult to identify the afferent limb during double-balloon ERCP [2]. According to retrospective data from February 2007 to January 2009, the rate of accurate identification was 50 % (14/28). We report a useful technique to identify the afferent limb of the Roux-en-Y anastomosis during double-balloon ERCP.
The Incidental Suggestive Meningioma Presenting as High 18F FP-CIT Uptake on PET/CT Study
Authors: In-Uk Song, Sang-Hoon Lee, Yong-An Chung
Journal: Clinical Nuclear Medicine (2013)

A 76-year-old woman with about a 13-month history of bradykinesia, gait disturbance and resting tremor of right upper extremity was referred to Nuclear Medicine Department. A PET-CT with 229 MBq of F FP-CIT was performed to diagnose suspected early Parkinson's disease (PD). The PET-CT showed a mass lesion with highly intense focal dopamine transporter uptake in the right frontal lobe. A subsequent brain magnetic resonance image also showed a mass in the right frontal lobe demonstrating homogeneous enhancement and extensive surrounding edema, highly suggestive of a brain tumor.
Cathepsin A mediates susceptibility to atrial tachyarrhythmia and impairment of atrial emptying function in Zucker diabetic fatty rats
Authors: Dominik Linz, Mathias Hohl, Stefan Dhein, Sven Ruf, Jan-Christian Reil, Mostafa Kabiri, Paulus Wohlfart, Sander Verheule, Michael Böhm, Thorsten Sadowski, Ulrich Schotten
Journal: Cardiovascular Research (2016)

Type 2 diabetes (T2D) is an independent risk factor for atrial fibrillation (AF) and stroke. The serine protease cathepsin A (CatA) is up-regulated in diabetes and plays an important role in the degradation of extracellular peptides. This study sought to delineate the role of CatA for the development of atrial remodelling under diabetic conditions. Zucker Diabetic Fatty rats (ZDF) were treated with vehicle (n = 20) or CatA-inhibitor (SAR; 50 mg/kg; n = 20), and compared with age-matched non-diabetic littermates (Ctr, n = 20). Left-atrial (LA) emptying function [magnetic resonance imaging (MRI)] and atrial electrophysiological parameters were measured before sacrifice for histological and biochemical analysis. The impact of enhanced cardiac CatA expression on atrial remodelling was determined using CatA-transgenic mice. At the age of 9.5 months, atrial tissues of ZDF rats showed increased CatA gene expression and CatA-activity, along with increased AF-susceptibility and impaired LA-emptying function. CatA-inhibition reduced CatA-activity in ZDF comparable to Ctr values and decreased LA-fibrosis formation and connexin 43 lateralization. This was associated with shorter median duration of LA-tachyarrhythmia (12.0 ± 1.7 vs. 1.2 ± 0.47 s, P < 0.01) induced by burst pacing and diminished regions of slow conduction. Cardiac MRI revealed better LA-emptying function parameters (active per cent emptying: 29 ± 1 vs. 23 ± 2%, P < 0.01) after CatA-inhibition. CatA-inhibition reduced LA bradykinin-degrading activity in ZDF. Transgenic mice overexpressing CatA demonstrated enhanced atrial fibrosis formation and increased AF-susceptibility. T2D leads to arrhythmogenic atrial remodelling in ZDF rats. CatA-inhibition reduces LA bradykinin-degrading activity in ZDF and suppresses the development of atrial structural changes and AF-promotion, implicating CatA as an important mediator for AF-substrate in T2D.
Abstract P2-06-20: Hormonal Criteria for Assessment of Menopause: Role of Anti-Mullerian Hormone
Authors: RT Chatterton, SA Khan, RE Heinz, T Kmiecik, D. Scholtens
Journal: Cancer Research (2010)

Abstract Introduction: The difficulty in establishing the time of menopause poses a problem in many breast cancer research studies. We sought to determine the value of adding anti-mullerian hormone (AMH) to the accuracy of designating hormonal signs of menopause in 179 women who were recruited for a case-control study of nipple aspirate fluid (NAF) biomarkers. Methods: A questionnaire was administered to obtain medical and reproductive history, self-reported menstrual cycle length, last menstrual period and age. Serum estradiol, progesterone, FSH, and AMH were measured in a blood sample obtained on the day of the study encounter. Criteria for premenopause were: serum FSH &amp;lt;30 mIU/ml, AMH &amp;gt;0.08 ng/ml, estradiol (E2) &amp;gt;30 pg/ml, and menstrual periods of 25 to 35 days. For postmenopause the inverse of the hormone levels and no menstrual periods for &amp;gt;12 mo and age &amp;gt;52 years was used. Serum progesterone (P4) concentration of &amp;lt;3 ng/ml provided confirmation of postmenopause. Results: The age range was from 35 to 69 years (median 51). By self-report (amenorrhea &amp;gt;12 mo and age) 76 subjects were premenopausal; 70 were postmenopausal and 33 subjects were perimenopausal. Table: Designation of menopausal state based on hormonal criteria: Concordance of individual measures with the designation based on all criteria (percentages). Table FSH was found to be discordant in 1 (1.1%) of premenopausal subjects and in 5 (5.3%) of postmenopausal subjects. AMH was found to be discordant in 21 (24.7%) of premenopausal subjects and 6 (6.4%) of postmenopausal subjects. Estradiol was discordant in 13 (15.3%) of premenopausal subjects and in 7 (7.4%) of postmenopausal subjects. Progesterone was &amp;lt;3 ng/ml in all of the postmenopausal subjects. The combination of FSH and AMH predicted 100% of the grouping based on all measures; FSH and E2 predicted 99.9%. The absence of progesterone is a certain criterion for postmenopause but adds nothing to the designation of premenopause. Comment: An accurate determination of the hormonal and reproductive status of women is critically important in studies relating hormones to breast cancer risk. The loss of ovarian hormones has long-term implications, and the menopausal status at the time of sampling determines the recent and current hormonal exposure. Using the hormonal criteria, all women in this study could be classified as pre-or postmenopausal. Adding AMH to the usual hormones did not improve the designation based on the other criteria. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P2-06-20.
Sequestered Collection in Association With Infected Arthroplasty
Authors: L Emmett, G Storey, E Marel, H Van Der Wall
Journal: Clinical Nuclear Medicine (2000)

An 82-year-old man had bilateral total knee replacements for severe osteoarthritis. The early postoperative course was complicated by infection of the left knee prosthesis, which was treated with intravenous antibiotics. Infection persisted for 6 months after operation, necessitating removal of the prosthesis and insertion of gentamicin-impregnated spacers. After an additional course of antibiotics, the infection appeared quiescent. The patient was referred for a leukocyte scan to assess the extent and the location of any residual infection. The leukocyte scan revealed a sinus tract extending into the anterior thigh. One week later, a draining sinus developed at the site identified in the study. A sinogram confirmed no communication between the collection and the left knee.
SP0157 Which Option is the Most Cost-Effective?
Authors: B. Fautrel
Journal: Annals of the Rheumatic Diseases (2014)

<h3></h3> Cost-effectiveness research has been developed to assess the balance between the additional costs incurred by a new medication, a new device or a new disease management strategy (incremental costs) and the health benefit associated with the studied innovation (incremental effectiveness). Such analyses have been extensively used for therapeutic innovation, especially biologics assessment. Despite many methodological concerns, there is a strong agreement in developed countries on the cost-effectiveness at an acceptable value of biologic agents in rheumatoid arthritis (RA) patients with inadequate response to synthetic DMARDs. In early RA, the incremental cost-effectiveness ratio of biologic agents is high compared to synthetic DMARDs, usually above the commonly acceptable thresholds. To assess the cost-effectiveness of health care organization or patient trajectory is more challenging. Resources, i.e., are available general practitioner (GP) and rheumatologists and their difference in terms of costs is way lower than the difference between synthetic DMARDs and biologics. In terms of access to specialized care, several options have been proposed from clinical practice tools to rapidly refer an early arthritis patient to the rheumatologists up to dedicated early arthritis clinics. In this domain, costs are probably not the main driver for decision makers. Effectiveness of patient trajectory organization is probably more relevant whatever the perspective, i.e., the combination of rapidity of making the adequate diagnosis as well as the simplicity in terms of delay and distance to achieve this. <h3>Disclosure of Interest</h3> B. Fautrel Grant/Research support from: AbbVie, MSD, NORDIC Pharma, Pfizer, Consultant for: AbbVie, BMS, MSD, NORDIC, Pfizer, Roche, UCB <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.6339
PARE0005 What happens if the cooperation with your member associations will be born new development plan?
Authors: M. Jaakson, G. Kreintzberg
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Estonia's population is 1,3 million and about 250 000 of them suffering some kind of rheumatic diseases. Disease and its impact on the ability of understanding makes the life of rheumatic patients. We have heard and listened to more than 1 000 people of our members linking the opinions that you expect and need to understand the rheumatic patientsfrom Estonian Rheumatism Associations. The message is clear: rheumatic patients and our members and their representation of the human, civil, social and economic rights protection in Estonia and internationally; Increased awareness of rheumatic diseases, treatment and support options - those affect what is actually living with them, you can do to improve the diagnosis of an after life; Increased awareness of the Estonian Rheumatism Association and our members of the- of our existence and activities. This time we decided to write our Development plan for 10 years and to change method how to write it. <h3>Objectives</h3> The Estonian population has easy access to information on rheumatic diseasesand rheumatic patients are able to access the best possible services and support. Society is aware of the rheumatic diseases, defined as the extent of the impact of disease and the importance of early diagnosis and prevention. Rheumatic patients are more involved in society, with a positive mindset and makeinformed choices of their illness. Rheumatic diseases are among the priority diseases at the national level. Estonian Rheumatism Association is as recognized throughout Estonia as a single representation of rheumatic patients. Estonian Rheumatism Associations and our members have their own goals and self-confident, focused and professional. <h3>Methods</h3> There was a meeting of the Board members and Executive manager with trainer, who explained the needs and expectations of the new Development plan. Then, two seminars were attended by leaders of members and key players, the board, executive team and the audit committee. Seminars aimed to assess the sustainability of the organization and its activities and capabilities. The first seminar to be a specialist in the Estonian Chamber of Disabled People, the way the roof of the organization funding and what the performance indicators used inevaluation, etc. Development Working Group was formed, which was responsible forthe input from the development plan seminars to explain and write goals. The second seminar workshops were completed to achieve those specific objectivesspelled out the basic objectives and indicators. <h3>Results</h3> A new developmentplan until 2020. The new developmentplan was a result of the completion of the new realistic goals. <h3>Conclusions</h3> We believe that the new development plan prepared by such a method is important in ensuring a strong organizational sustainability, because the plan includes the inputs given by the members. The new development plan is realistic and optimistic. <h3>Disclosure of Interest</h3> None Declared
Flagship “seven day working” hospital doesn’t provide full seven day service, doctors say
Authors: Gareth Iacobucci
Journal: BMJ (2015)

Doctors at a flagship NHS hospital cited by the UK government as one of the first to deliver routine services seven days a week have questioned ministers’ claims.

The prime minister, David Cameron, and the health secretary for England, Jeremy Hunt, have repeatedly hailed Salford Royal NHS Foundation Trust as the prototype for the government’s grand vision for full seven day working in the NHS.

Cameron told a press conference earlier this year that “everything is working at the weekend” in Salford and said that the trust’s working practices were an example for the whole NHS to follow.1 Hunt has been similarly effusive in his praise for Salford’s seven day working.2

But anonymous quotations from employees at the trust, collected by the GP …
Abstract 689: Validation of antibodies to Estrogen Receptor ≤ and quantitative assessment of ERα1 and ERα5 expression in breast cancer
Authors: Hallie Wimberly, Leigh C. Murphy, Bruce Haffty, David Rimm
Journal: Cancer Research (2012)

Abstract INTRODUCTION: Estrogen receptors are members of the nuclear hormone receptor family that play an important role in breast carcinogenesis and response to endocrine therapy. Though the role of ERα in breast cancer has been studied extensively, little is known about the alternative isoform ERα. ERα has significant sequence homology to ERα but is located on a different chromosome and maintains both overlapping and unique functional attributes. Five variants resulting from alternative splicing of the C-terminal region of ERα exist. The relevance of ERα variants in breast cancer outcomes and response to therapy is difficult to assess because of conflicting results in the literature, likely due to variable methods used to assess ERα in patient tumors. METHODS: Antibodies against ERα variants (ERα1: ThermoScientific PPG5/10; ERα2/cx: Serotec Clone 57/3; ERα5: Serotec Clone 5/25) were validated for staining specificity by siRNA knockdown of ESR2 as well as staining reproducibility on FFPE tissue by quantitative immunofluorescence (QIF) using AQUA technology (HistoRx). QIF staining of validated antibodies was then assessed on two separate breast cancer cohorts. RESULTS: ERα1 and ERα5, but not ERα2/cx, antibodies were found to be sensitive, specific and reproducible, as shown by reduction in signal after siRNA knockdown in cell lines and reproducible QIF scores on a set of breast cancer control cases. ERα1 and ERα5 expression is significantly associated in both cohorts examined (R*2=.224, p&amp;lt;0.0001). However, ERα1 does not show significant association with patient outcome or response to endocrine therapy. In contrast, ERα5 is associated with worse recurrence free survival (log rank p=0.0500) and, though it shows no association with response to tamoxifen, it predicts response to chemotherapy (log rank p=0.0393). CONCLUSIONS: Validation of ERα antibodies reveals that not all reagents are specific for the expected isoforms. Assessment of breast cancer cohorts using validated reagents show that ERα1 is not associated with outcome while ERα5 is both prognostic and predictive. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 689. doi:1538-7445.AM2012-689
316 REVERSAL OF HEPATIC FIBROSIS IN AN INDUCED MODEL OF CHRONIC LIVER INJURY BY G-CSF-, PLERIXAFOR- OR G-CSF+PLERIXAFOR-MOBILIZATION OF HEMATOPOIETIC STEM CELLS
Authors: E. Tsolaki, E. Gounari, N. Zogas, E. Athanasiou, E. Siotou, M. Yiangou, A. Anagnostopoulos, E. Yannaki
Journal: Journal of Hepatology (2013)
AB0203 The role of estrogens on the production of IL-21 in patients with systemic lupus erythematosus
Authors: J. Lee, S.M. Jung, J.H. Lee, J.M. Kim, M.-L. Cho, S.-K. Kwok, J.H. Ju, K.-S. Park, S.-H. Park, H.-Y. Kim
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Systemic lupus erythematosus (SLE) is an autoimmune disease in which various organs and tissues are damaged through abnormal immune responses mediated by tissue-binding autoantibodies. Though, the exact pathogenic mechanism is not clearly elucidated, estrogens are thought to play an important role because over 90% of SLE patients are women. IL-21 is an important cytokine which is produced by T cells, especially Th17 and induces B cell activation. Thus, it has been suggested that IL-21 plays a critical role in the pathogenesis of autoimmune diseases. <h3>Objectives</h3> We investigated the effect of estrogens on the production of IL-21 and subsequent B cell activation in SLE patients. <h3>Methods</h3> Peripheral blood mononuclear cells (PBMCs) were obtained from peripheral blood of SLE patients and healthy controls. CD4+ T cells, non CD4+ T cells, B cells were isolated using micro beads. The expression of IL-21 and its receptors was assessed by ELISA (serum) and real time PCR (PBMCs, CD4+ cells). The level of immunoglobulin G secreted by activated B cells were measured with specific ELISA. <h3>Results</h3> The expression of IL-21 and its receptors in serum, PBMC, and CD4+ T cells was higher in patients with SLE compared to healthy controls. The production of IL-21 was increased when the cells are stimulated with estrogen in dose- and time- dependent manners. IL-21 production was decreased in the presence of MAP kinase (MEK, p38, JNK) inhibitors. B cells of healthy controls showed an increased antibody production when they were co-cultured with estrogen-stimulated CD4+ T cells of patients with SLE. IL-21 antibodies suppressed the increased antibody production of the co-culture systems. <h3>Conclusions</h3> This study revealed a possible role of estrogens in the pathogenesis of SLE. Estrogens increase the production of IL-21 by activating CD4+ T cells via MAP kinase dependent pathways in SLE patients. <h3>Disclosure of Interest</h3> None Declared
Severity of Metabolic Acidosis as a Determinant of Bicarbonate Requirements
Authors: Serafino Garella, Clare L. Dana, Joseph A. Chazan
Journal: New England Journal of Medicine (1973)

In the treatment of metabolic acidosis, the dose of sodium bicarbonate is usually calculated on the assumption that administered bicarbonate distributes in a space equivalent to 50 per cent of body weight. In a patient with profound metabolic acidosis the apparent space of distribution of bicarbonate was over 200 per cent of body weight, although no excessive ongoing acid production or external bicarbonate losses were evident, suggesting that the pre-existing plasma bicarbonate concentration can influence the apparent space of distribution of bicarbonate. This hypothesis was tested with a standard dose of bicarbonate (2.5 mmoles per kilogram of body weight) in 16 dogs with low, normal or high plasma bicarbonate concentration. The concentration increased by 2.8, 5.0 and 5.6 mmoles per liter in the three groups respectively, indicating that the proportion of administered bicarbonate passing into the intracellular space increases with decreasing concentration. In conditions of profound metabolic acidosis, commonly recommended amounts of bicarbonate may produce unexpectedly small increments in the plasma concentration. (N Engl J Med 289:121–126, 1973)
Histological Characterization of 47 Breast Cancers with Neoplastic Meningitis Evolution.
Authors: E. Le Rhun, P. Devos, M. Baranzelli, M. Faivre-Pierret, J. Bonneterre, J. Bonneterre
Journal: Cancer Research (2009)

Abstract IntroductionAround 5% of patients with breast cancer develop neoplastic meningitis (NM). The prognosis of NM in this population is supposed to be better with a median survival time of 7 months if treated with intrathecal therapy, systemic treatment and adapted supportive care (versus 4-6 weeks if untreated). This evolution needs to be detected as early as possible and it is necessary to identify tumors with such a risk. We report histological characteristics in 47 breast cancers with leptomeningeal treated in our institution for the last 2 years.Aim of the studyTo identify histopathological characteristics of breast cancer predictive of leptomeningeal evolution.Patients and methods47 consecutive female breast cancer patients were diagnosed with neoplastic meningitis on the basis of cerebrospinal fluid (CSF) cytology and/or cerebrospinal MRI plus clinical symptoms. These patients were matched with 47 breast cancer's patients without leptomeningeal evolution, according to age at breast cancer diagnosis (+/- 2 years), year of breast cancer diagnosis (+/- 2 years) and use of systemic chemotherapy as initial treatment of breast cancer. Differences between the 2 groups of patients were analyzed using usual statistical methods (t-test, Chi square test).ResultsAt the time of NM diagnosis, the median (min-max) age of patients with NM was 51 (26-76) years. Median delay after breast cancer diagnosis was 33 months (0-193). Brain, hepatic, bone, lung metastases were present in respectively 47%, 43%, 47% and 19%. CSF cytology was positive in 72%, median proteinorachia was 0,75 g/l (0,17–16,12); cerebrospinal MRI was also positive in 87%. At the time of breast cancer, median age was 49 (25-70) years. Initial breast samples were tumor biopsy in 43%, partial mastectomy in 31% and total mastectomy in 27%. Breast tumors were invasive ductal carcinoma in 84% with histoprognostic grade II/III in 49/42%, MSBR grade I/II in 52/47%. Grade 3 of differentiation was observed in 68%, grade 3 of anisonucleosis in 59% and grade 1 of mitosis in 48%. In the tumors, estrogen/progesterone receptors (ER/PR) were detected in 67/48% and HER2 overexpression was observed in 24%. 19% of the tumors were triple negative. Vascular emboli were detected in 58% of the cases. Tumors were T2 in 43%, N+ in 66% and M+ in 14%. Significant differences between initial breast cancers with or without NM evolution concerned histological type (p = 0,043), ER (p = 0,004) and PR (p = 0,023), triple negative status (p = 0,009) and initial metastatic status (p &amp;lt; 0,007).ConclusionsCarcinomatous meningitis preferentially occurs in invasive lobular tumors without hormonal receptors, particularly in triple negative tumors and in tumors metastatic upfront. HER2 overexpression is not a risk factor of NM, as is observed with brain metastases. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 6013.
INCIDENCE, PREDICTORS AND IMPACT OF STROKE AFTER PERCUTANEOUS CORONARY INTERVENTION FOR ACUTE CORONARY SYNDROMES: RESULTS FROM THE PROMETHEUS REGISTRY
Authors: Gennaro Giustino, Usman Baber, Samantha Sartori, Shunsuke Aoi, Melissa Aquino, Jaya Chandrasekhar, William Weintraub, Sunil Rao, Sandra Weiss, Timothy Henry, Samir Kapadia, Kanhaiya Poddar, Anthony DeFranco, J. Muhlestein, Catalin Toma, Mark Effron, Stuart Keller, Brian Baker, Stuart Pocock, Roxana Mehran
Journal: Journal of the American College of Cardiology (2016)