tbuckley/cabot-search huggingface dataset:
Unusual Uptake of 18FDG by a Hepatic Adenoma
Authors: Pacôme Fosse, Sylvie Girault, Julien Hoareau,, Aude Testard, Olivier Couturier, Olivier Morel
Journal: Clinical Nuclear Medicine (2013)

Hepatic adenoma is a rare, benign tumor (with potential for malignant degeneration) and its diagnosis is difficult because its presentation is highly variable in medical imaging, particularly with MRI. In such cases, the use of a hepatic biopsy is usually recommended. (18)FDG-PET/CT provides a very significant predictive value for malignant hepatic lesions. In addition, the occurrence of an (18)FDG-avid benign tumor is a rare event. We hereby present the case of a patient with advanced breast cancer for whom an (18)FDG-PET/CT showed a focal hepatic uptake. A subsequent biopsy provided a diagnosis of a hepatic adenoma.
Abstract 5001: Epigenetic networks in breast cancer
Authors: Chunmei Liu, Shoulian Dong, Junko Stevens
Journal: Cancer Research (2012)

Abstract Epigenetic mechanisms are essential for normal development and maintenance of normal gene expression patterns in humans. Recent studies suggest that epigenetic alterations may be the key initiating events in some forms of cancers and global changes in the epigenome are a hallmark of cancers. Phospholipase D (PLD) catalyzes the hydrolysis of phophatidylcholine to generate the lipid second messenger phosphatidic acid (PA) and choline and regulates multiple cellular pathways. Elevated expression of PLD1 promoted cell proliferation and has been associated with the progression and metastasis of multiple cancers. In this work, we showcased the applications of our new epigenetic tools by elucidating the changes in chromatin organization (3C), DNA methylation and microRNA expression that underlies the aberrant expression level of PLD1 in breast cancers. Differences in PLD1 expression and the epigenetic network between tamoxifen responsive (MCF-7) and non-responsive (MDA-MB-231) breast cancer cell lines were compared to associate epigenetic changes with their cancer phenotypes. Effects of DNA demethylation and histone acetylation induced by methyltransferase inhibitor (5-aza-2′-deoxycytidine) and histone deacetylase inhibitor (Trichostatin A) were also investigated to provide insights into the molecular mechanisms of epigenetic drugs. 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 5001. doi:1538-7445.AM2012-5001
Testicular cyclic nucleotide and adrenal catecholamine metabolism following chronic exposure to cadmium
Authors: Radhey L. Singhal
Journal: Environmental Health Perspectives (1981)

Cadmium (Cd) produces injurious effects on reproductive function and has been implicated in the pathogeneses of hypertension. The present article summarizes available data on alterations in the cyclic AMP system of testicular and prostatic tissue as well as in catecholamine metabolism in adrenal glands following exposure to Cd and subsequent withdrawal. Daily Cd (1 mg/kg IP) for 45 days decreased prostatic and testicular weights of mature male rats. In prostate, chronic treatment with Cd reduced cyclic AMP levels to 57% of normal values which appeared to be due to the decrease in adenylate cyclase activity since cyclic AMP metabolism by phosphodiesterase was not significantly altered. Cyclic AMP binding to prostatic protein kinase was increased following Cd administration as was the activity of the cyclic AMP-dependent form of protein kinase. In contrast to the prostate, testicular adenylate cyclase was stimulated by Cd treatment. However, the endogenous cyclic AMP levels remained unaffected since the increase in testicular adenylate cyclase was offset by a concomitant increase in the activity of phosphodiesterase. Although the activities of the cyclic AMP-dependent and the independent forms of testicular protein kinase were significantly depressed, the binding of cyclic AMP to protein kinase from testes of Cd-treated rats was not affected. Discontinuation of treatment for 28 days in rats that had previously been given the heavy metal for 45 days resulted in at least a partial reversal of several of the cadmium-induced changes in cyclic AMP metabolism of the rat prostate and testes. However, the weight of the prostate glands remained essentially in the same range as that seen in the “treated group.” Data suggest that cyclic AMP metabolism in both the primary and the secondary reproductive organs is altered following chronic Cd treatment and that some changes persist even 28 days following the termination of daily exposure to the heavy metal. Cd treatment also increased adrenal weights and augmented the levels of adrenal norepinephrine and epinephrine as well as the activity of tyrosine hydroxylase. Discontinuation of the heavy metal treatment for 28 days, in rats previously injected with Cd for 45 days, restored the activity of tyrosine hydroxylase as well as the amount of norepinephrine and epinephrine. In contrast, adrenal weights were restored only partially following withdrawal of Cd treatment. Evidence indicates that the changes in adrenal catecholamine metabolism may be the result of stress induced by chronic exposure to this heavy metal. In addition, some of the untoward effects such as hyperglycemia and arterial hypertension seen during Cd toxicity might be related to increased synthesis of epinephrine in adrenal glands.
THU0558 Calcifying Tendinitis of the Shoulder: Comparison between Management with Early Mobilization or Use of Sling
Authors: C.A. Guillen Astete, A. Boteanu, C. Bouroncle Alaluna, S. Garrote Corral, M. Llop Vilaltella
Journal: Annals of the Rheumatic Diseases (2014)

Background Generally, early mobilization in patients with subacromial shoulder tendinitis has shown a benefit in terms of recovery of function. By their nature, subacromial acute calcifying tendinitis might be an exception, however there are no studies that have compared the mobilization with rest or sling use in such patients. Objectives To compare benefits of early movement and rest with sling in patients diagnosed by acute subacromial calcifying tendinitis. Methods We reviewed the clinical chart of patients with acute subacromial calcifying tendinitis of three different centers that carry on a similar management of this patology. This protocol includes radiological, ultrasound diagnosis and eventually the realization of infiltration of glucocorticoid assisted real-time ultrasound. Patients were classified in cases (patients without symptomatic improvement) and controls (patients with satisfactory symptoms control defined by its reincorporation to normal activity). We used as cutoff time: 30 days after diagnosis ±10 days. We evaluated the exposure to immobilization with a sling at least 12 hours per day. No patient had been infiltrated with glucocorticoids. All patients were diagnosed with ultrasound or radiology of shoulder and all were treated with NSAIDs and/or opioids. Results One hundred twenty subacromial acute calcifying tendinitis diagnosis were established between 2011 and 2013, of which 77 were included for presenting baseline data and control at one month. Their corresponding medical records were reviewed and grouped according to clinical outcome once made the corresponding review. Thirty patients (38.9%) were considered as cases (no improvement) and 47 (61.1%) were considered controls (return to normal activity). The gender ratio and mean age of the two groups was similar. The proportion of patients receiving NSAIDs, NSAIDs and opioids or opioids alone was similar in the two groups. Twenty-four cases had used the sling according to indication (51.06%) while 23 had not used or had used less than half the time indicated (48.94%). Furthermore, 24 controls had used the sling (80.0%) while 6 (20.0%), no (p value =0.0154 bilateral, Fisher). Conclusions Immobilization with sling appears to be associated with better clinical response in the acute management of subacromial calcifying tendinitis. Although early mobilization in other forms of tendinitis of the shoulder is fairly widespread, inflammatory pathophysiology of calcifying tendinitis, secondary to a mechanical phenomenon of subacromial entrapment, could justify that early mobilization play a deleterious role in the rehabilitation of these patients and it would therefore be inadvisable. Disclosure of Interest : None declared DOI 10.1136/annrheumdis-2014-eular.5911
Aspirin for the Prevention of Cancer Incidence and Mortality: Systematic Evidence Reviews for the U.S. Preventive Services Task Force
Authors: Jessica Chubak, Evelyn P. Whitlock, Selvi B. Williams, Aruna Kamineni, Brittany U. Burda, Diana S.M. Buist, Melissa L. Anderson
Journal: Annals of Internal Medicine (2016)

Background: Cancer is the second leading cause of death in the United States. Purpose: To conduct systematic reviews of aspirin and 1) total cancer mortality and incidence in persons eligible for primary prevention of cardiovascular disease (CVD) and 2) colorectal cancer (CRC) mortality and incidence in persons at average CRC risk. Data Sources: MEDLINE, PubMed, and the Cochrane Central Register of Controlled Trials through January 2015 and relevant references from other reviews. Study Selection: Trials comparing oral aspirin versus placebo or no treatment in adults aged 40 years or older were included. Two investigators independently reviewed abstracts and articles against inclusion and quality criteria. Data Extraction: Data from 20 good- or fair-quality trials were abstracted by one reviewer and checked by another. Data Synthesis: In CVD primary prevention trials, cancer mortality (relative risk [RR], 0.96 [95% CI, 0.87 to 1.06]) (10 trials; n = 103 787) and incidence (RR, 0.98 [CI, 0.93 to 1.04]) (6 trials; n = 72 926) were similar in aspirin and control groups over 3.6 to 10.1 years. In CVD primary and secondary prevention trials, 20-year CRC mortality was reduced among persons assigned to aspirin therapy (RR, 0.67 [CI, 0.52 to 0.86]) (4 trials; n = 14 033). Aspirin appeared to reduce CRC incidence beginning 10 to 19 years after initiation (RR, 0.60 [CI, 0.47 to 0.76]) (3 trials; n = 47 464). Limitations: Most data were from clinically and methodologically heterogeneous CVD prevention trials. Outcome assessment and follow-up length varied across studies. Data on non-CRC cancer types and subgroups were limited. Conclusion: In CVD primary prevention populations, aspirin's effect on total cancer mortality and incidence was not clearly established. Evidence from CVD primary and secondary prevention studies suggested that aspirin therapy reduces CRC incidence and perhaps mortality approximately 10 years after initiation. Primary Funding Source: Agency for Healthcare Research and Quality.
Highly Vascular Breast Cancer Detected on a Tc-99m RBC Gated Cardiac Blood Pool Imaging Study
Authors: ISMET SARIKAYA, MAYUR PATEL, LAWRENCE E. HOLDER
Journal: Clinical Nuclear Medicine (2000)

In addition to evaluating primary disease, radionuclide studies often provide additional useful information. In this report, the authors describe a woman with stage 3 breast cancer of her left breast, in whom a large focal area of blood pool activity was observed on a Tc-99m RBC gated cardiac blood pool imaging study (MUGA). This corresponded to the biopsy-proved infiltrating ductal breast carcinoma.
Stemming the Brain Drain — A WHO Global Code of Practice on International Recruitment of Health Personnel
Authors: Allyn L. Taylor, Lenias Hwenda, Bjørn-Inge Larsen, Nils Daulaire
Journal: New England Journal of Medicine (2011)

The world faces a shortage of about 4.3 million health professionals required for delivering essential services. The WHO Global Code of Practice on the International Recruitment of Health Personnel addresses the migration of health workers from lower-income countries.
AT-35INTERMITTENT HIGH DOSE (PULSATILE) ERLOTINIB FOR EGFRvIII MUTANT RECURRENT MALIGNANT GLIOMAS: A PILOT CLINICAL TRIAL
Authors: Andrew Lassman, Christian Grommes, Katherine Panageas, Fabio Iwamoto, Lisa DeAngelis, Thomas Kaley, Igor Gavrilovic, Elena Pentsova, Antonio Omuro, Christina Corpuz, Samuel Briggs, Daniel Otap, Weige Qin, Justin Cross, Ingo Mellinghoff
Journal: Neuro-Oncology (2014)

BACKGROUND: Kinase inhibitors targeting driver mutations are active in several cancers, but have shown only minimal activity against malignant gliomas (MGs). Inadequate drug delivery when administered at the maximum tolerated daily dose may contribute to limited efficacy. Transient inhibition of oncogenic kinases has been shown in experimental models to irreversibly commit cancer cells to death. Therefore, we explored the feasibility of high-dose intermittent (“pulsatile”) kinase inhibitor therapy in a molecularly defined population of patients with recurrent MGs. METHODS: Eligible patients had a recurrent MG harboring EGFRvIII mutation (PCR), age ≥18, KPS ≥ 60, and prior temozolomide and radiotherapy. Prior EGFR inhibitors or bevacizumab were exclusionary. A surgical arm treated patients pre- and post-operatively. All received 2000 mg once weekly of the oral EGFR TKI erlotinib. RESULTS: We enrolled 22 patients (7 women), median age 58 (range 41-81); 18 (82%) had GBMs and 4 anaplastic gliomas. Serum pharmacokinetic (PK) analysis from the first 8 patients demonstrated median Cmax of approximately 7500ng/ml, ten-fold higher than reported for routine daily erlotinib dosing (150 mg). Treatment was well tolerated: no one discontinued for toxicity, and there were no grade ≥4 agent-related adverse events (AEs). Grade 3 AEs were rash (n = 3), fatigue (2), lymphopenia (1), and hyper-bilirubinemia (1). Among those with GBM, one patient has an ongoing complete response (>31 months); two others had less durable improvement of EGFRvIII mutant disease; median survival was 10 months and progression-free survival 1.4 months. CONCLUSION: Pulsatile dosing of kinase inhibitor therapy is feasible and safe, and represents a promising new approach to enhance drug delivery for patients with MG. Full PK results and molecular correlations will be presented.
A new technique for delivering a polyglycolic acid sheet to cover a large mucosal defect: the Swiss roll method
Authors: Kunihiro Tsuji, Hisashi Doyama, Hiroyoshi Nakanishi, Kazuhiro Matsunaga, Shinya Yamada
Journal: Endoscopy (2014)

Endoscopic tissue shielding with polyglycolic acid (PGA) sheets (Neoveil; Gunze Co., Kyoto, Japan) and fibrin glue (Beriplast P CombiSet; CSL Behring Pharma, Tokyo, Japan) is a promising method for preventing postoperative complications [1] [2] [3]. However, this technique is thought to be inefficient for covering large mucosal defects because it takes time to deliver many small PGA sheets. Accordingly, we devised and implemented a new technique involving the delivery of a single large PGA sheet.
SAT0512 Fracture Healing of Distal Radius Fractures Assessed by High-Resolution Peripheral Quantitative Computed Tomography, Bone Strength Analysis and Biomarkers
Authors: J. de Jong, S. Bours, P. Willems, J. Arts, T. van Geel, P. Brink, B. van Rietbergen, P. Menheere, J. van den Bergh, P. Geusens
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Fracture healing is a dynamic process, in which an inflammatory reaction induces bone resorption and formation in order to repair the fracture and restore bone strength. In contrast to plain radiographs, high resolution peripheral quantitative computed tomography (HR-pQCT) allows to visualize trabecular and cortical bone three dimensionally. From these 3D images bone strengths based on µFEA can be calculated. <h3>Objectives</h3> Evaluate the different stages of bone formation and bone resorption during the fracture healing process and relate the pattern of bone formation and resorption to the HR-pQCT derived bone parameters. <h3>Methods</h3> 18 women, aged 64±8 years, with a stable distal radius fracture were included and underwent HR-pQCT scanning (XtremeCT, Scanco Medical, Switzerland) of the fractured radius at 1-2 weeks post-fracture (baseline) and 3-4 weeks, 6-8 weeks and 12 weeks post-fracture. From the HR-pQCT images bone mineral density was assessed for the trabecular and the cortical region and using the 3D models, trabecular thickness and bone stiffness were calculated. Blood samples were collected at each visit for measurement of PINP, ICTP and hs-CRP. A linear mixed effect model with time post-fracture as fixed effect was used to detect significant changes from baseline. Correlations between the HR-pQCT parameters and the biomarkers were calculated using the Spearman's correlation coefficient. <h3>Results</h3> During the fracture healing period, trabecular density and thickness and bone stiffness increased by 20%, 28% and 33%, respectively (all p&lt;0.01), while cortical density decreased by 2.9% (p&lt;0.05). Mean hs-CRP was 3.78±6.33 mg/L and was correlated negatively with the increase in trabecular density (r=-0.78, p&lt;0.001) and PINP (r=-0.321, p&lt;0.01). PINP temporarily increased and PINP and ICTP were intercorrelated at visit 1 and 2 (r=0.48, p&lt;0.001). No significant correlations were found between the HR-pQCT parameters and the biomarkers. <h3>Conclusions</h3> These results open the perspective that a combination of HRpQCT and markers of inflammation and bone remodeling allow to study in detail the factors that are involved in normal and impaired fracture healing, and potentially also the effects of medications in optimizing the natural process of fracture healing. <h3>Disclosure of Interest</h3> J. de Jong: None Declared, S. Bours: None Declared, P. Willems: None Declared, J. Arts: None Declared, T. van Geel: None Declared, P. Brink: None Declared, B. van Rietbergen Consultant for: Scanco Medical AG, P. Menheere: None Declared, J. van den Bergh: None Declared, P. Geusens: None Declared
Effect of anticoagulation therapy on bleeding and thromboembolic events (TEs) in the AVADO phase III study of docetaxel (D) ± bevacizumab (BV) in inoperable locally recurrent (LR) or metastatic breast cancer (mBC).
Authors: A Wardley, C Lohrisch, A Joy, S Young, F Yi, A Marme, L Dreosti, J Albanell, M Muñoz, DW Miles
Journal: Cancer Research (2009)

Abstract Abstract #1035 Background: In first-line mBC, the anti-VEGF monoclonal antibody BV (Avastin®) has demonstrated PFS improvement when combined with taxanes in two large phase III trials (E2100 and AVADO). Thromboses and bleeding are among the possible side effects of BV. Pts receiving full-dose anticoagulation therapy have historically been excluded from clinical trials of BV due to the hypothetical risk of bleeding and TEs. AVADO enrolled pts receiving full-dose anticoagulation provided that their level of anticoagulation was stable for ≥2 weeks prior to study entry. We investigated the incidence of bleeding and arterial and venous TEs (ATEs; VTEs) in pts receiving concomitant anticoagulation therapy in AVADO.&amp;#x2028; Methods: Pts with inoperable LR or mBC, with no CTx 6 months prior to randomisation (12 months if taxane-based), ECOG PS 0–1 and adequate LVEF were eligible for enrolment. 736 pts were randomised to D 100mg/m2 + placebo (PL) or D + BV 7.5 or 15mg/kg. D was administered q3w for ≥9 cycles, BV/PL q3w until disease progression or unacceptable toxicity. Anticoagulation therapy was defined as coumarin, heparin or low molecular weight heparins.&amp;#x2028; Results: Safety data are available from 730 pts. Grade ≥3 TEs and grade ≥3 bleeding were each reported by six pts (1.2%) who received BV, compared with nine pts (3.9%) and two pts (0.9%), respectively in the control arm. Eleven pts received anticoagulants at study entry (PL: 4, BV 7.5mg/kg: 6, BV 15mg/kg: 1) and 73 pts began anticoagulants during the study (PL: 21, BV 7.5mg/kg: 26, BV 15mg/kg: 26). No grade ≥3 ATEs were reported in pts receiving anticoagulation therapy either before or during the study.&amp;#x2028; &amp;#x2028; Conclusions: The rate of grade ≥3 ATEs, VTEs and bleeding events was relatively low in the entire study and did not appear to increase with BV use. The incidence of TEs and bleeding events was not increased relative to the control arm in the subpopulation of pts receiving anticoagulants concurrently with BV, although patient numbers are small, particularly for bleeding events. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 1035.
AB0559 Hypokalemic Paralysis in Primary Sjogren Syndrome: is IT A Distinct Clinical Subset Which Requires Lifelong Potassium Supplementation Rather than Immunosuppressants?
Authors: V.K. Jain, P.T. Antony, C.B. Mithun, B.K. Singh, S. Mehra, J. Usdadiya, V.S. Negi
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> Primary Sjögren9s syndrome (pSS) is a systemic autoimmune disorder with predominant involvement of exocrine glands in middle aged females. It may involve extra-glandular tissues such as lung, liver, kidney, pancreas, skin, and central nervous system. Clinically significant renal involvement in pSS is rare and interstitial nephritis is the commonest histopathological finding<sup>1</sup>. The resulting tubular defects may present with failure to concentrate urine (hyposthenuria) and type I (distal) renal tubular acidosis characterized by hyperchloremic metabolic acidosis and hypokalemia. We describe a series of 15 cases of pSS who presented with hypokalemic periodic paralysis as the initial manifestation. Their clinical features; biochemical and immunological parameters are compared and contrasted with those without hypokalemic weakness. <h3>Objectives</h3> To explore the clinical, biochemical, serologic features, and therapeutic responses in Primary Sjogrens syndrome (pSS) patients who presented with hypokalemic paralysis as the initial manifestation. <h3>Methods</h3> Sixty patients of pSS (diagnosis based on modified European-American classification criteria) are on our follow up from November 2009 to August 2012. A few of these patients were diagnosed following admission to emergency services with hypokalemic paralysis. They were compared for differences in clinical features, biochemistry and serological parameters with pSS patients without hypokalemic paralysis. <h3>Results</h3> Symptomatic hypokalemia was the presenting symptom in 15 out of 60 (25%) primary SS. All patients in the hypokalemic paralysis group were females and with a lower age of onset (27.8±8.3 vs 38.85±11.5 yrs). Six of 15 (40%) patients did not have the classical sicca symptoms. All patients with hypokalemic paralysis had biochemical features of distal renal tubular acidosis and high titers of anti SSA antibody. During a mean follow up of sixteen months, only two patient developed relapse of hypokalemic weakness following stoppage of potassium supplements. <h3>Conclusions</h3> There exists a distinct subset of pSS who present with onset at younger age, distal RTA, hypokalemic paralysis and high titres of anti SSA antibody sometimes even without characteristic exocrinopathy. Genetic analysis may help in further characterization of these patients. Therefore, all young females presenting with hypokalemic paralysis should be investigated for underlying pSS. <h3>References</h3> Andreas V. Goules, Ioanna P. Tatouli, Haralampos M. Moutsopoulos, Athanasios G. Tzioufas. Clinically Significant Renal Involvement in Primary Sjögren9s Syndrome. Clinical Presentation and Outcome. Arthritis &amp; Rheumatism.2013 Nov;65(11):2945–53 <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.1739