tbuckley/cabot-search huggingface dataset:
SAT0432 Performance of the New EULAR/ACR 2013 Classification Criteria for Systemic Sclerosis in the Clinical Practice: A Single Center Experience
Authors: K. Stefanantoni, N. Iannace, I. Sciarra, M. Vasile, M. Caucci, M.C. Saturno, G. Valesini, V. Riccieri
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Systemic Sclerosis (SSc) is an autoimmune disease with high morbididy and mortality (1). American Rheumatology Association (ARA) classification criteria of 1980 have low sensibility for early and mild disease forms (2) while the new ACR/EULAR 2013 classification criteria seem to have a greater sensibility (3). <h3>Objectives</h3> To verify the performace of the new criteria in clinical pratice in a cohort of SSc patients referred to our center dedicated to the diagnosis and treatment of SSc. <h3>Methods</h3> We enrolled 190 patients with a clinical diagnosis of SSc or UCTD/VEDOSS made by an expert clinician. All patients underwent clinical, laboratoristic and instrumental evaluations according to the EUSTAR and VEDOSS recommendations. Finally we applied ACR classification criteria of 1980 and the new EULAR/ACR 2013 classification criteria for SSc to all patients. <h3>Results</h3> Among the 190 patients enrolled, 14 were males (7.3%) and 176 (92.7%)were females. One hundred six patients (71.5%) had a clinical diagnosis of SSc (50 with diffuse disease form, 86 with limited disease form) and 94 (68.1%) satisfied ACR criteria of 1980. Fifty-four patients had a clinical diagnosis of UCTD/VEDOSS (28.4%). Applying the new EULAR/ACR criteria of 2013, among the 190 patients, 152 were classified as SSc. Only 134 over 136 (98.5%) patients with clinical diagnosis of SSc and only 19 over 54 (35.1%) patients with UCTD/VEDOSS were classified as SSc according to the new criteria. Sensibility and specificity of new EULAR/ACR criteria of 2013 were 97.7% and 64.8% respectively against 69% and 96.2% obtained using the ACR criteria of 1980. Moreover patients with new SSc diagnosis seem to have a significant higher number of capillaroscopic alterations and were more frequently anti-centromere positive respect to the patients that didn9t satisfy the new criteria (p&lt;0.000001 e p=0.0001 respectively). <h3>Conclusions</h3> Our study confirms a greater sensibility of the new EULAR/ACR 2013 criteria for SSc respect to the ACR criteria of 1980. This performance allows to better classify patients with early or mild disease forms. Moreover we can speculate that the presence of capillaroscopic alterations and anti-centromere positivity are highly suggestive for the development of an established form of SSc. <h3>References</h3> Mayes MD: Arthritis Rheum. 2003 [No authors listed]: Arthritis Rheum. 1980 van den Hoogen et al.: Arthritis Rheum. 2013 <h3>Disclosure of Interest</h3> None declared
AB0591 Organ Damage Evaluation and Risk Factors in a Cohort of 511 Sle Patients
Authors: M. Taraborelli, N. Martinazzi, M.G. Lazzaroni, L. Andreoli, M. Fredi, Y. El Masri, S. Cartella, I. Cavazzana, M. Taglietti, M. Frassi, F. Franceschini, A. Tincani
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Systemic lupus erythematosus (SLE) is still burdened by a significant morbidity and mortality. <h3>Objectives</h3> To determine the prevalence of organ damage, with related risk factors, and mortality in a cohort of SLE patients. <h3>Methods</h3> The clinical records of patients fulfilling the American College of Rheumatology (ACR) criteria for SLE, followed for at least 1 year in our center were retrospectively reviewed. Organ damage was assessed by the Systemic Lupus International Collaborating Clinics/ACR Damage Index (DI) at 1 year after diagnosis and then every 5 years, from the beginning until the end of the follow-up in our center. Disease activity was measured by the SLE Disease Activity Index (SLEDAI) 2K at the beginning of the follow-up. The comparison of characteristics between patients with and without damage at the end of their follow-up was performed by the Chi Square9s, Fisher9s exact and Student9s t test as appropriate; p&lt;0.05 was considered significant. <h3>Results</h3> This study included 511 SLE patients (92% females, 95% Caucasians), followed in our Unit between 1972 and 2014, with a mean age at diagnosis of 33 years (±13) and a mean disease duration at the end of the follow-up of 16 (±9) years. One year after diagnosis 40% of patients with measurable DI (n=400) had accrued some damage and its prevalence gradually increased over time (Table I). At 1 year ocular (13%), central nervous system (12%) and skin (8%) damage were the most frequent whereas ocular, skin and musculoskeletal were the most frequent sites of damage (40%) at 35 years. Different features were significantly associated to damage (Table II). The main causes of death in 35 patients (7%) were cancer (33%) and organ failure (22%) after a mean disease duration of 13 years. <h3>Conclusions</h3> The organ damage that accumulates over time in SLE is partly linked to disease activity, partly defined by clinical profiles (neuro-SLE, renal disease and Antiphospholipid Syndrome) that may require aggressive treatments. New, more effective and less toxic drugs could limit the progression of this process. <h3>Disclosure of Interest</h3> None declared
Fellowships Grants and Awards March 2004 Toxicogenomics
Journal: Environmental Health Perspectives (2004)

Partnerships (BRPs) for basic, applied, and translational multi-disciplinary research that addresses important biological or medical research problems.In the context of this program, a partnership is a multi-disciplinary research team that applies an integrative, systems approach to develop knowledge and/or methods to prevent, detect, diagnose, or treat disease or to understand health and behavior.The partnership must include appropriate bioengineering or allied quantitative sciences in combination with biomedical and/or clinical components.The Principal Investigator (PI) also serves as the
PWE-321 Non-operative management of colorectal cancer in the elderly. are we getting it right?
Authors: G Harris, M Courtney, L Newton, S Mills
Journal: Gut (2015)

<h3>Introduction</h3> Decision making regarding resection of colorectal cancer (CRC) is difficult in the very elderly. Risks associated with surgical intervention are high. Patients are more likely to be frail and have comorbidites which lead to death or debility in a shorter time frame than that dictated by an unresected CRC. Outcomes of operatively managed patients are well documented but those of the non-operatively managed less so. We aim to determine the outcomes of non-operative management in the very elderly with CRC to better inform clinician decision making and discussions with patients regarding treatment options. <h3>Method</h3> All patients aged 80 or more diagnosed with colorectal cancer between 01/04/2010 and 31/03/2014 were identified from a prospectively populated database in a single NHS Trust. Details of demographics, cancer site, stage and management were extracted. Primary outcomes were one-year mortality and, in those managed without resection, reasons for non-operative management. Two-tailed fisher’s exact test was used to compare mortality rates in the non-operative group (s) compared to the operative group. <h3>Results</h3> 1240 patients were diagnosed with CRC over this four year period, of whom 292 (154 male, 138 female) were over 80 years at the time of diagnosis (median 84.5, range 80–100). Of these, 141 (48.3%) underwent formal resection, 15 (5.1%) local resection, and 136 (46.6%) no resection. One year mortality in those who had a resection was 21.8% compared to 69.1% in those managed non-operatively (p &lt; 0.0001). Reasons for non-operative management were inoperable tumour (2.9%), metastatic disease (39.7%), patient choice (7.3%) and frailty (37.8%). Mortality rates in these four subgroups were as follows; inoperable 100% (p = 0.003), metastatic disease 90% (p &lt; 0.0001), patient choice 30% (p = 0.694) and frailty 46% (p = 0.001). <h3>Conclusion</h3> It is no surprise that overall, resectional surgery improves 1 year survival. Analysis of the subgroups however, does raise some interesting questions. Resectional surgery is almost certainly inappropriate in metastatic or locally advanced disease but it is of particular note that the difference in 1 year mortality in the other three subgroups is not that marked. This does raise two questions; is patient selection for resective surgery optimal and to what extent is the CRC actually the determinate of survival in this patient cohort. Assessment of fitness for surgery in this Trust is currently relatively subjective, it is possible that a more objective assessment (such as cardiopulmonary exercise testing) would improve patient selection. Whether this would also change the proportion resected is unknown. To understand the extent to which CRC is the determinate of survival, information is needed about cause of death, further work is ongoing to establish that. <h3>Disclosure of interest</h3> None Declared.
Cholesterol Granuloma
Authors: Patrick Martineau, Matthieu Pelletier-Galarneau, Eugene Leung
Journal: Clinical Nuclear Medicine (2015)

Cholesterol granulomas are benign lesions, rarely seen in the breast, which are indistinguishable from malignancy on anatomical imaging. The FDG PET/CT of a patient referred for melanoma staging revealed a mildly FDG-avid, soft tissue nodule in the left breast. This finding was felt unlikely to represent metastatic melanoma due to the relatively low level of uptake. The lesion was not seen on follow-up mammography. Ultrasound-guided biopsy was performed, which identified this lesion as a cholesterol granuloma. This case illustrate that cholesterol granuloma can be misinterpreted as a malignant lesion on both anatomical imaging and FDG PET/CT.
Case 27-2001: Waldenström's Macroglobulinemia
Authors: Harvey E Finkel, Noopur Raje
Journal: New England Journal of Medicine (2002)

To the Editor: Changes in policy on the use of antimicrobials must be based on a broad perspective reflecting microbial epidemiology, ecology, and resistance.The three reports on specific areas of the overall problem of antimicrobial resistance in the October 18 issue 1-3 are valuable, but the authors reach beyond the scope of their results in the conclusions they draw.Gorbach's editorial 4 includes conclusions and assertions that are unsupported by his citations.A ban on the use of antimicrobials in livestock feed could have unintended consequences and undesirable net effects on the environment, economy, and public health.Such a ban could result in increased morbidity and mortality in livestock, jeopardizing food and byproducts.There could also be a substantial increase in animal manure.The potential negative consequences to public health and the environment go far beyond the potential negative effects on livestock profitability.There are now science-based guidelines and stringent regulations for the judicious use of antimicrobials in food-producing animals. 5,6t is unknown whether banning antimicrobials in livestock feed would reduce the incidence of resistant infections in humans.Premature closure of this important debate now by imposition of a ban would lead us to overlook other approaches that could be more beneficial and less costly to society.It is imperative that we use solid science and examine the expected ramifications when proposing changes in antimicrobial-use policy.
The psychiatric assessment of a Vietnamese refugee through art
Authors: E A Burch, C H Powell
Journal: American Journal of Psychiatry (1980)

liver and urine from fatal poisoning. Acta Pharmacol Toxicol 9. Greenblatt DJ, Allen MD, Noel BJ, Ct al: Acute overdosage 34:16-26, 1974 with benzodiazepine derivatives. Clin Pharmacol Ther 21:4978. Nasilowski W, Sybirska H, Gajdzinska H: Legal-medical and 514, 1977 toxicological evaluation of 18 lethal cases of poisoning by phe10. Reynolds PC, Som CW, Herrmann PW: Loxapine fatalities. nothiazine derivatives. Z Rechtsmed 74:293-299, 1974 Clin Toxicol 14:181-185, 1979
AB0352 Diabetes Mellitus in Patients with Rheumatoid Arthritis
Authors: I. Kostoglou-Athanassiou, A. Tzanavari, C. Katsavouni, N. Kalaycheva, T. Banti, P. Athanassiou
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> In rheumatoid arthritis (RA) glucose metabolism may be affected either by the autoimmune inflammatory disease itself, or by the treatment used to manage the disease. Metabolic syndrome seems to be prevalent in RA patients. <h3>Objectives</h3> The aim was to study the prevalence of diabetes mellitus type 2 and metabolic factors related to the development of atherosclerosis within a cohort of RA patients cared for within a single rheumatology department. <h3>Methods</h3> Within a cohort of 204 RA patients, aged 29-88 (mean ± SEM) 62.87±08.86 years the incidence of diabetes mellitus and metabolic factors related to the development of atherosclerosis was studied. In the cohort of RA patients ESR was 37.12±1.57 mm/h, CRP 1.56±0.15 mg/dl and the disease activity index DAS28 was 3.80±0.13, 49% being positive for rheumatoid factor and 23% having positive anti-CCP antibodies. <h3>Results</h3> Within the cohort of 204 RA patients 45 (22.06%) were found to suffer from diabetes mellitus type 2, 5 being on therapy with a combination of insulin and oral antidiabetic agents, 10 on oral antidiabetic agents, and the rest on diet only. Within the cohort of RA patients morning glucose concentration was 110±2.6 mg/dl (mean ± SEM), cholesterol concentration 200.3±2.98 mg/dl, HDL cholesterol 55.64±1.18 mg/dl, LDL cholesterol 123.19±2.41 mg/dl and triglyceride 125.4±3.7 mg/dl. Within the cohort of RA patients 33 had hyperlipidemia requiring therapy with lipid lowering agents, mainly statins and in 2 cases a combination of statin and fenofibrate. <h3>Conclusions</h3> Diabetes mellitus type 2 seems to be prevalent amongst patients with RA, hyperlipidemia being also prevalent. The disease itself, which is related to an autoimmune inflammatory process and the medications required for its management may affect blood glucose metabolism adversely. <h3>References</h3> Straub RH. Insulin resistance, selfish brain, and selfish immune system: an evolutionarily positively selected program used in chronic inflammatory diseases. Arthritis Res Ther 2014;16 (Suppl 2):S4. Jiang P, Li H, Li X. Diabetes mellitus risk factors in rheumatoid arthritis: a systematic review and meta-analysis. Clin Exp Rheumatol 2014 [Epub ahead of print]. <h3>Disclosure of Interest</h3> None declared
Abdominal Surgery
Authors: Claude E. Welch
Journal: New England Journal of Medicine (1975)

AppendixAcute AppendicitisTo consider the nonoperative treatment of appendicitis in a paper on advances in surgery seems to be a contradiction; yet this is the method by which many patients are treated in the People's Republic of China. As I witnessed a year ago, patients are given their choice of early operation or conservative treatment that consists of herb medicines (probably laxatives) and acupuncture. From Tientsin the following figures were submitted. Nine hundred and ninety-five patients were treated conservatively; only 6.2 per cent failed to improve and required operation; only two deaths occurred. A follow-up report on 400 patients . . .
AML1-MTG8 leukemic protein induces the expression of granulocyte colony-stimulating factor (G-CSF) receptor through the up-regulation of CCAAT/enhancer binding protein epsilon
Authors: Kimiko Shimizu, Issay Kitabayashi, Nanao Kamada, Tatsuo Abe, Nobuo Maseki, Kazumi Suzukawa, Misao Ohki
Journal: Blood (2000)
Complications of Colonoscopy
Authors: W H Schwesinger, B A Levine, R Ramos
Journal: Annals of Internal Medicine (2006)

Colonoscopy, when performed for appropriate indications and by experienced, competent personnel, is a remarkably safe procedure. The occasional complications which occur may be the result of pneumatic, mechanical or electrical injuries to the colon or may develop as secondary disorders involving other organ systems. Most complications can be successfully prevented by adequately preparing both the endoscopist and the patient and by avoiding colonoscopy when specific contraindications are present. Should complications occur, their management generally follows established surgical principles. Even though colonoscopy has made a dramatic impact upon the diagnosis of and therapy for disease of the large intestines, it is important for practitioners to be mindful of its limitations. Future developments, applied rationally, can be expected to extend its usefulness and further improve its safety.
Personalizing Therapies With Ex Vivo Pharmacological Responses May Uncover The Differences Between IDA-DNR-MIT Among European AML Protocols
Authors: Pau Montesinos, David Martinez, Raimundo Garcia Boyero, Jaime Pérez de Oteyza, Pascual Fernandez, Josefina Serrano, Angeles Fernandez, Pilar Herrera, Arancha Alonso, Ataulfo Gonzalez, Concepcion Bethancourt, Esperanza Lavilla, Juan Antonio Vera, Begoña Navas, Gabriela Rodriguez, Juan Antonio Lopez, Santiago Jimenez Bravo de Laguna, Adriana Simiele, Bernardo Gonzalez, Jose Angel Hernandez Rivas, Raul Cordoba, Consolación Rayón, Carmen Burgaleta, Jordi Sierra, Iñaki Troconiz, Ignacio Ortega, Andrew G. Bosanquet, Daniel Primo, Pilar Hernandez-Campo, Julian Gorrochategui, Jose L. Rojas, Teresa A. Bennett, Belen Liebana, Rocio Lopez, Joan Ballesteros, Federico Moscardo, Miguel Sanz, Joaquín Martínez
Journal: Blood (2013)
Silent Myocardial Ischaemia during Endoscopic Retrograde Cholangiopancreatography
Authors: S. Johnston, A. McKenna, T. Tham
Journal: Endoscopy (2003)

Myocardial ischaemia may occur during endoscopic retrograde cholangiopancreatography (ERCP) and this may predispose patients to ischaemic complications, although the incidence and risk factors for mycocardial ischaemia during ERCP have not been studied in detail. The aim of this study was to determine the incidence of myocardial ischaemia, as defined by ST changes on electrocardiography during ERCP, and whether or not any intervention predisposes to an increased risk of myocardial ischaemia.Consecutive patients undergoing ERCP at a single centre were included. Continuous Holter electrocardiograph recordings were carried out during ERCP. ST depression was defined as > 1 mm lasting for longer than 1 minute. The time of interventions during ERCP was recorded prospectively and related to the Holter recordings.There were 41 patients in the study (14 men, 27 women; median age 66 years, range 21 - 88). Nine patients (22 %) experienced ST depression during the procedure, of whom four (10 %) showed significant ST depression (> or = - 2 mm). Of these, five had no previous cardiac history and normal electrocardiographic findings, three had no previous cardiac history but had abnormal electrocardiographic findings and one had a previous cardiac history and abnormal electrocardiographic results. ERCP interventions associated with the episodes of ST depression were administration of sedation ( n = 6, P < 0.01) endoscopic sphincterotomy ( n = 4), balloon trawl ( n = 1), basket trawl ( n = 3) and stent replacement ( n = 1) ( P > 0.05 for the rest). No cardiac complications occurred.Myocardial ischaemia occurred in approximately one-quarter of patients during ERCP, and over half of these had no previous cardiac history and normal baseline electrocardiography results. Myocardial ischaemia often accompanied the use of sedation and intubation of the patient, but specific therapeutic interventions were not associated with the onset of ischaemia.
AB0532 Thyroid Dysfunction in Patients with Systemic Lupus Erythematosus
Authors: D.V. Monova, S. Monov, R. Shumnalieva, E. Peneva, M. Todorova, R. Lasarova
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Objectives</h3> The aim of this study is to assess thyroid dysfunction and the presence of anti-thyroid antibodies in patients with systemic lupus erythematosus (SLE), and its association with disease characteristics and activity. <h3>Methods</h3> 167 patients with SLE underwent laboratory evaluation for serum free T3, free T4, TSH (Thyroid-Stimulating Hormone). SLE patients with abnormal thyroid function test (TFT) and/or positive history of thyroid disease were further tested for antithyroglobulin antibody (Ab TG) and antithyroid peroxidase antibody (AbTPO). Patients who were tested negative for both of these autoantibodies were further tested for thyrotropin receptor antibody. <h3>Results</h3> 119 patients were euthyroid, 11 patients had subclinical hyperthyroidism, 6 – hyperthyroidism, 19 - subclinical hypothyroidism, and 12 - overt hypothyroidism. The SLE patients with hypothyroidism had statistically significant higher Ab TG, SLEDAI and SLAM score than the euthyroid and patients with subclinical hyperthyroidism, but no statistically significant difference between all groups as regard Ab TPO. There was a positive correlation between Ab TG levels and disease activity. The proportion of SLE patients with antithyroglobulin antibodies were found in higher frequency among the hypothyroid subgroup as compared to the hyperthyroid subgroup. Among the patients in the hyperthyroid subgroup, one patient had antithyroglobulin antibody, one patient had TSH receptor antibody and manifested signs characteristic of Grave9s disease. <h3>Conclusions</h3> The thyroid dysfunction is frequent in SLE patients. Hypothyroidism were more likely to occur in SLE patients. There are a positive correlation between Ab TG levels and disease activity and negative correlation with free T3 and free T4. It is prudent to screen all SLE patients for thyroid dysfunction. <h3>Disclosure of Interest</h3> None declared
AB0400 High Prevalence of Vitamin D Deficiency and Insufficiency in Patients with Either Rheumatic or Inflammatory Bowel Diseases
Authors: V. Bruzzese, L. Ridola, A. Zullo, C. Hassan, R. Lorenzetti, M.L. Severino, P. Scolieri, C. Marrese, A. Picchianti Diamanti, B. Laganà
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Vitamin D deficiency has been reported in patients with chronic inflammatory conditions, such as rheumatic and inflammatory bowel diseases (IBD). <h3>Objectives</h3> To assess vitamin D status in patients with either rheumatic or IBD, receiving biologic or disease-modifying antirheumatic drugs (DMARDs) therapies. <h3>Methods</h3> In this cross-sectional study, serum vitamin D of consecutive patients were measured. Patients receiving vitamin D supplementation were excluded. Vitamin D levels &gt;30 ng/mL (75 nmol/L) were considered normal, insufficiency is defined as a concentration of 20 to 30 ng/mL (50 to 75 nmol/L), and deficiency when levels were &lt;20 ng/mL (50 nmol/L). <h3>Results</h3> A total of 181 patients, including 136 with rheumatic (M/F: 36/100; Median age: 60 years, range 26-84; Rheumatoid arthritis: 87; Psoriatic arthritis: 38; Ankylosing spondilitis: 8; Polymyalgia rheumatica: 3) and 45 with intestinal diseases (M/F: 30/15; Median age: 52 years, range 32-68; Crohn9s disease: 24; Ulcerative colitis: 21) were enrolled. A total of 119 patients were receiving biologic therapy and 62 DMARDs. Vitamin D deficiency/insufficiency was detected in as many as 84 (61.8%) and in 34 (75.6%) patients with rheumatic disease or IBD, respectively. IBD patients showed significantly lower vitamin D levels than rheumatological patients (28.7±19.1 <i>vs</i> 22.5±10.3; P&lt;0.01). Among rheumatic disease patients, the prevalence of Vitamin D deficiency (50.7% <i>vs</i> 29.5%; p=0.01), insufficiency (28% <i>vs</i> 11.5%; p=0.02), and deficiency-insufficiency (78.7% <i>vs</i> 41%; p&lt;0.001) was significantly higher in patients receiving biologic therapy than in those treated with DMARDs. <h3>Conclusions</h3> Prevalence of Vitamin D deficiency/insufficiency was very high in both rheumatic disease and IBD patients, particularly in those receiving a biologic therapy. Vitamin D levels should be investigated also in IBD patients, the deficiency being even more frequent than in rheumatic disease patients. <h3>Disclosure of Interest</h3> None declared