tbuckley/cabot-search huggingface dataset:
P241 Accuchek (TM) measurement of blood glucose correlates with true lab glucose measurement in children screened for cystic fibrosis related diabetes
Authors: A. J. Fall, A. Mallinson, A. Mill, D. S. Urquhart
Journal: Thorax (2011)

<h3>Background</h3> Screening for cystic fibrosis related diabetes (CFRD) is recommended as part of the cystic fibrosis annual review. For children over 10 an oral glucose tolerance test (OGTT) is recommended, but this is time consuming and adds to the burden of assessments and investigations of the annual review. As part of a proposed wider pragmatic study to evaluate the feasibility of home OGTT testing in this patient group, we assessed the level of agreement between blood glucose concentration measured by near-patient testing using the Accucheck glucometer and that measured in the laboratory using standard methods (True Lab Glucose—TLG). <h3>Methods</h3> 26 children with CF aged 1 yr–16 yrs undergoing annual review were studied. Blood taken at the time of venepuncture was tested for glucose concentration using an Accucheck glucometer, and results compared with TLG. For children under 10 a single, random blood glucose was tested using each method. For those aged 10 or over samples taken after an overnight fast, and 2 h after a standard OGTT oral glucose load were tested using each method. Bland and Altman statistics were used to assess limits of agreement between methods of glucose measurement. <h3>Results</h3> 31 pairs of glucose measurements were obtained. TLG measurements ranged from 4.1 to 10.6 mmol/l. Abstract P241 Figure 1 shows the Accucheck glucose measurement plotted against the TLG for each sample, and the line of equality. The agreement between Accucheck and TLG was investigated using the method of Bland and Altman and showed that the Accucheck gave results a mean (SD) of 0.26 (0.84) mmol/l higher than values obtained on TLG. <h3>Conclusions</h3> There is a clinically acceptable agreement between blood glucose measured by Accucheck compared with TLG. Just one child with a TLG result that might have prompted further investigation could have been missed, had Accucheck been the sole method used. This suggests that blood glucose measurement in the context of OGTT screening for CFRD could perhaps be performed using near-patient testing in an out of hospital setting (eg, by parents at home) without compromising test validity. Further research is needed to establish if this is the case.
Chronic Urticaria Due to Surgical Clips
Authors: Lloyd King, Anthony Fransway, R. Benton Adkins
Journal: New England Journal of Medicine (1993)

To the Editor: In April 1988 a 50-year-old woman was referred to the Mayo Clinic to determine the cause of her chronic urticaria. She had had a cholecystectomy in 1984. In 1986 persistent right upper abdominal pain and urticaria developed. All test results were normal except for a finding of marked sensitivity to ultraviolet light (ultraviolet A), which induced urticaria, severe headaches, and coughing. Plasma exchange but not treatment with antihistamines or corticosteroids induced a temporary remission of the urticaria. In June 1988 the patient was admitted to Vanderbilt University Hospital for further evaluation and plasma exchange. There was no . . .
SAT0456 Long-Term Outcome in Adult Patients with Juvenile Idiopathic Arthritis: Preliminary Results from a Greek Population
Authors: D. Dimopoulou, M. Trachana, P. Sidiropoulos, P. Tsitsi, A. Moihovitou, A. Garyfallos
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> During the last decade there is a growing evidence on the long-term outcome of patients with juvenile idiopathic arthritis (JIA). <h3>Objectives</h3> To describe the disease characteristics, course and long-term outcome of JIA in Greece. <h3>Methods</h3> Patients ≥ 18 years with an established JIA, a disease onset ≥5 years and no history of &gt; 6 months care from external rheumatologists, were enrolled in this retrospective, cohort study. Clinical, laboratory and radiographic examination were performed 17.2 years post-diagnosis. Outcome was assessed by the following tools: Health Assessment Questionnaire (HAQ), Juvenile Arthritis Damage Index (JADI), the modified Sharp/van der Heijde score of radiographic damage, while the general psychological distress, by the General Health Questionnaire (GHQ-28). Disease variables relating to the onset and course of the disease were retrospectively retrieved. <h3>Results</h3> A total of 102 (72 females) patients were enrolled. The disease age of onset (mean + SD) was 7.7±4 years, the interval from onset to last visit 17.2±6.7 years and the patients' current age 25±5.9 years. The disease type of onset was systemic arthritis in 13 (12.7%), persistent oligoarthritis in 8(7.8%), extended oligoarthritis in 22 (21.6%), polyarthritis RF negative in 19 (18.6%) polyarthritis RF positive in 11 (10,8%), psoriatic in 9 (8.8%), enthesitis-related arthritis in 18 (17.6%) and unclassified arthritis in 2 (1.9%). Eleven patients (10.8%) had a history of uveitis. Fifteen patients (14.7%) had additional autoimmune entities. At the last follow-up visit, 53 patients (52%) still had disease activity, according to the Wallace criteria. The remaining ones were in remission on or off medication (19, 38.7% and 24, 48.9%, respectively) or had inactive disease (6, 12.2%), but did not meet the criteria for remission. The mean patients' disease activity period during the study, was 52.6% while only 37 patients (37.7%) achieved remission off medication. After a median of 17.2 years of disease, 30 patients (29.4%) had moderate to severe disability on HAQ score, 89 (87.2%) had damage in ≥ 1 joint or joint group according to JADI A and 59 (57.8%) had extra-articular damage. The mean±SD total modified Sharp score was 153.6±140. The GHQ depicted impaired psychological status in 18 patients (18.7%). <h3>Conclusions</h3> In this cohort, about 38% of the patients achieved ≥ 1episode of remission off medication, which is in line to previous data. On the other hand, almost 30% of the study population had a significant disability and 87% had structural damage related to continuing disease activity over prolonged periods. <h3>References</h3> Minden K (2009). Horm Res 72:20-25 Lurati A et al (2009). J Rheumatol 36:1532-5 <h3>Disclosure of Interest</h3> None Declared
OUTCOMES OF PHYSICIAN-STAFFED VERSUS NON-PHYSICIAN STAFFED HELICOPTER TRANSPORT FOR ST-ELEVATION MYOCARDIAL INFARCTION
Authors: Sverrir Ingi Gunnarsson, Joseph Mitchell, Brenda Larson, Mary Busch, Zhanhai Li, S. Gharacholou, Amish Raval
Journal: Journal of the American College of Cardiology (2016)
Clinical Application of Tc-99m Tetrofosmin Scintigraphy in Patients With Cold Thyroid Nodules
Authors: SERDAR ERDEM, ÇINAR BAŜHEKIM, ESREF KIZILKAYA, MEHMET INCE, FEVZ KARSLI
Journal: Clinical Nuclear Medicine (1997)

We prospectively studied 26 patients with cold thyroid nodules (five malignant and 21 benign nodules) on Tc-99m pertechnetate scintigraphy to investigate the diagnostic value of Tc-99m tetrofosmin scintigraphy and color-Doppler sonography in differentiating malignant from benign thyroid nodules. In each patient, Tc-99m Tetrofosmin uptake in the nodule and intranodule vascularity were assessed semiquantatively. Both the uptake and vascularity were classified as low, Iso or high. Eight out of 26 nodules showed high Tc-99m tetrofosmin uptake; five of them were malignant. Eight (including four malignant tumors) out of 26 nodules showed increased vascularity compared with normal thyroid tissue on color-Doppler sonography. In six out of eight patients with high uptake of Tc99m-tetrofosmin, increased vascularity was observed. The sensitivity, specificity, negative predictive value, and positive predictive value of Tc-99m tetrofosmin scintigraphy and color-Doppler sonography were determined to be 100% and 80%, 85% and 80%, 62% and 50%, and 100% and 94%, respectively. We conclude that color-Doppler sonography seems to have limited value in the detection of malignant thyroid nodules. However, Tc-99m tetrofosmin scintigraphy is a sensitive method to use in diagnosing malignant nodules, although it is not specific for the detection of malignant nodules.
Case 11-1998
Authors: Gary R. Epler, Eugene J. Mark
Journal: New England Journal of Medicine (1998)

Presentation of CaseA 35-year-old woman was admitted to the hospital because of obstructive pulmonary disease with cystic changes on computed tomographic (CT) examination of the chest.The patient had been well until the age of 14 years, when she had the first of numerous episodes of cough with purulent sputum, which was treated with antibiotics. Asthma and obstructive lung disease were diagnosed. The administration of corticosteroids resulted in no improvement; she used several inhaled bronchodilators. During the three years before admission, the patient had more frequent bouts of pulmonary infection with intervening chronic production of sputum and exertional dyspnea, . . .
Over-the-scope clip system is effective for the closure of post-endoscopic submucosal dissection ulcer, especially at the greater curvature
Authors: N. Nishiyama, H. Mori, K. Rafiq, H. Kobara, S. Fujihara, M. Kobayashi, T. Masaki
Journal: Endoscopy (2014)

The technique of endoscopic submucosal dissection (ESD) has been coming into widespread use and gradually becoming a standard treatment for early gastric cancers. However, perforation is a serious complication with peritonitis and the need for emergency surgery [1]. Performing ESD on lesions at the greater curvature is especially difficult, and perforation tends to occur easily [2]. We report our experience of three cases of mucosal gastric cancer at the greater curvature which were treated by ESD.
SEVERE SYMPTOMATIC AORTIC STENOSIS: MEDICAL TREATMENT VERSUS TRANSCATHETER AORTIC VALVE IMPLANTATION: A REAL WORLD ANALYSIS OF ADMISSION PROFILES, COST, AND MORTALITY USING THE SECURE ANONYMISED INFORMATION LINKAGE (SAIL) DATABANK
Authors: Majd Protty, Phillip Freeman, Omar Aldalati, Arron Lacey, William King, Richard Anderson, Dave Smith
Journal: Journal of the American College of Cardiology (2015)
Abstract 295: IDO drives tumor-promoting, pathogenic inflammation in lung
Authors: Courtney Smith, Mee-Young Chang, Hollie Flick, James DuHadaway, Laura Mandik-Nayak, Lisa Laury-Kleintop, Katherine Parker, Daniel Beury, Suzanne Ostrand-Rosenberg, George C. Prendergast, Alexander J. Muller
Journal: Cancer Research (2012)

Abstract First identified as a mediator of acquired immune tolerance of the ‘foreign’ fetus from maternal immunity, the tryptophan-catabolizing enzyme IDO (indoleamine 2,3-dioxygenase) has since been implicated in tumor escape from the host immune system. Insight into the intricate role of IDO in the classical DMBA/TPA skin carcinogenesis model suggested that inflammatory tumor environments can induce IDO production resulting in de novo tumor development. In the genetically deficient model of IDO, mice show resistance to tumor formation. This provided a basis for our current studies exploring the importance of IDO in the microenvironment of the lung. To this end, we have investigated both primary tumor formation and metastatic disease in the lungs of IDO-deficient mice using the KRAS-induced lung adenocarcinoma and the metastatic 4T1 breast cancer models. Elevation of the inflammatory cytokine IL6 was associated with tumor outgrowth in the lungs in both models but was greatly attenuated with the loss of IDO, consistent with the in vitro demonstration that IDO activity markedly potentiates IL6 production. MDSCs (myeloid derived suppressor cells) exhibited reduced T cell suppressive activity when isolated from tumor-bearing, IDO-deficient animals that could be rescued by ectopic production of IL6 in the tumor. IL6 production could likewise reverse the pulmonary metastasis resistance exhibited by IDO-deficient mice. Interestingly, while there is a clear role of the immune system in lung tumor and metastatic outgrowth, IDO-deficient mice appear to have reduced vascularization in the lung which may partly contribute to reduced tumor formation. Together, these findings genetically validate IDO as a therapeutic target in the settings of pulmonary cancer and metastasis and establish the importance of IDO as a driver of IL6 production and MDSC function. Furthermore, the correlation of IDO to angiogenesis may be a new insight into the role of this enzyme in cancer. 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 295. doi:1538-7445.AM2012-295
Abstract 5220: Increased expression of formyl peptide receptor (FPR) and formyl peptide receptor like-1 (FPRL1) correlates with high-risk clinical/histologic features in melanoma
Authors: Nitin Chakravarti, Vijay G. R. Peddareddigari, Carla L. Warneke, Marcella M. Johsnon, Patrick Hwu, Victor G. Prieto
Journal: Cancer Research (2011)

Abstract Melanoma is an aggressive malignancy with a relatively high metastatic rate, responsible for almost 60% of lethal skin tumors. Despite numerous efforts, there is still a need to better understand the molecular pathways involved in malignant melanoma metastasis. FPR and its variant FPRL1, which belong to the GPCR family, have been shown to be involved in metastasis of glioma and ovarian tumor cells via activation of various signaling cascades. It is unknown whether expression of these receptors contributes to the pathogenesis of melanoma. In order to test the hypothesis that aberrant expression of these GPCRs plays a significant role in melanoma progression, we have performed semiquantitative immunohistochemical analysis of FPR and FPRL1 in benign nevi (n=49), primary melanomas with and without metastasis (n=130), and melanoma metastases (n=47 cases). A significant positive correlation was observed between the percentage of positive cells and staining intensity for FPR (p=0.001) and FPRL1 (p=0.009) with progression from benign nevi to primary melanoma. Significantly higher levels of FPR were observed in those lesions having higher Breslow thickness (p=0.044) and ulceration (p=0.019), which are well-established markers of poor clinical outcomes in patients with cutaneous melanoma. On the other hand, lesions showing a radial growth pattern expressed low levels of FPR (p=0.027). A gain in FPRL1 staining was seen in lesions displaying microscopic satellitosis (p=0.051). Disease-specific survival was significantly shorter in patients with increased cytoplasmic expression of FPR (log rank test, p=0.022). Thus, overexpression of FPR and FPRL1 correlates with disease progression and high-risk clinical and histologic features in melanoma. In addition, FPR expression is associated with shorter disease-free survival. Therefore, these markers may be an important therapeutic target in patients with melanoma. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 5220. doi:10.1158/1538-7445.AM2011-5220
Chronic Traumatic Aneurysm of the Thoracic Aorta
Authors: Israel Steinberg
Journal: New England Journal of Medicine (1957)

A NEURYSMS of the thoracic aorta due to blunt trauma are likely to occur at the top of the descending aorta just distal to the origin of the left subclavian artery and insertion of the ligamentum arteriosum.1 Sudden death may occur if all layers of the aorta rupture. If the adventitia is spared, there is hemorrhage due to partial aortic rupture, producing a mediastinal hematoma that at first obscures the arch and then tends to localize at the top of the aorta adjacent to the aortic knob and form a chronic false aneurysmal sac.In a series of 5 cases . . .
FRI0204 Patient Global Estimates of Status Vary More than Physician Global Estimates, and Estimates Become Increasingly Discordant from ONE Another at Both High and Low Extremes of Disease Activity:
Authors: K.A. Gibson, G. Luta, T. Pincus
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> Global estimates by both patient (PATGL) and physician (DOCGL) are concordant within 2 units on a 0-10 visual analog scale (VAS) in about 40-65% of encounters, while discordance of PATGL&gt;DOCGL occurs in about 25-60% and DOCGL&gt;PATGL in about 10-20%.<sup>1</sup> DOCGL is expected to be higher if DOCGL&gt;PATGL than if DOCGL=PATGL, and might be expected to be lower if PATGL&gt;DOCGL. However, this matter has not been examined extensively. <h3>Objectives</h3> To analyze DOCGL and PATGL according to whether DOCGL&gt;PATGL, DOCGL=PATGL or PATGL&gt;DOCGL in 225 patients with various rheumatic diseases seen in a general rheumatology clinic in Australia. <h3>Methods</h3> All patients completed a multidimensional health assessment questionnaire (MDHAQ), which includes PATGL, pain (PN), and physical function (FN), each scored 0-10. RAPID3 (routine assessment of patient index data) is calculated as a 0-30 scale from 3 0-10 scores for FN, PN and PATGL. The rheumatologist assigned a DOCGL for each patient on a 0-10 VAS identical to the PATGL VAS. PATGL and DOCGL were compared for concordance or discordance in 225 individual patients, classified in 3 groups: PATGL=DOCGL, i.e., both scales within 2 units of each other; PATGL&gt;DOCGL by ≥2 units; or DOCGL&gt;PATGL by ≥2 units. DOCGL, PATGL and RAPID3 were compared in these 3 groups, using Kruskal-Wallis tests to analyze statistical significance. <h3>Results</h3> Among 225 encounters, PATGL&gt;DOCGL was seen in 80 (36%), PATGL=DOCGL in 118 (52%) and DOCGL&gt;PATGL in 27 (12%), similar to published reports.<sup>1</sup> Median DOCGL was 3.5 in concordant encounters (PATGL=DOCGL), compared to 4.0 when DOCGL&gt;PATGL or when PATGL&gt;DOCGL (p=0.078). By contrast, median PATGL was 3.8 when PATGL=DOCGL, compared to 1.0 when DOCGL&gt;PATGL and 7.0 when PATGL&gt;DOCGL (p&lt;0.001). The range of medians in all categories was 3.0–5.5 for DOCGL, 1.0–7.5 for PATGL and 5.8–18.3 for RAPID3. <h3>Conclusions</h3> Discordance between PATGL and DOCGL is driven largely by variation in PATGL rather than DOCGL. DOCGL was higher in patients in whom DOCGL&gt;PATGL vs DOCGL=PATGL, as expected, but also was higher in encounters in which PATGL&gt;DOCGL, which was unexpected. Efforts to understand and reduce discordance may result in better care and outcomes. <h3>References</h3> Barton JL, Imboden J, Graf J, et al. Arthritis Care Res 2010;62:857-64 <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.3945
Ga-67 Imaging in a Rare Case of Bellini Duct Carcinoma
Authors: E Gotoh, A Ohishi, K Kawakami
Journal: Clinical Nuclear Medicine (1998)

Bellini duct carcinoma is a very rare disease originating from the collecting tubules of the kidney. Ga-67 imaging was performed in a patient who had primary malignancy in the left kidney and worked every metastases. Ga-67 uptake was seen in both the primary neoplasm and metastases. The tumor was found to be a Bellini duct carcinoma.
Abstract 2210: Global levels of H3K27me3 track with differentiation in vivo and are deregulated by MYC in prostate cancer
Authors: Laxmi Gurunatham Pellakuru, Tsuyoshi Iwata, Bora Gurel, Angelo M. De Marzo
Journal: Cancer Research (2012)

Abstract Both embryonic stem cells and various cancer cell types contain abundant amounts of decondensed chromatin. However, the molecular mechanisms responsible for altering chromatin states in stem cells and cancer cells are not well understood. One factor may be the oncogenic transcription factor, MYC. MYC is overexpressed in many tumor types and affects a wide array of essential cellular processes including ribosome and mitochondrial biogenesis, metabolism, and cell cycle progression. MYC is also a key factor in reprogramming of somatic adult cells into induced pluripotent stem cells. Less well known is that MYC also affects global chromatin structure where it is required to maintain open or active chromatin. We hypothesize that in prostate cancer, MYC affects global chromatin structure keeping it in a more open conformation thus maintaining the cells in a less differentiated state resembling that of stem cells. We show by immunohistochemistry that compared to the more differentiated luminal cells, less differentiated stem-like cells in the basal compartment of the human and mouse prostate contain lower levels of the polycomb heterochromatin mark, H3K27me3. This link to the differentiated state of normal cells is also found in a number of other human and rodent tissues characterized by hierarchical differentiation and rapid turnover of stem cell compartments. Further, in MYC-driven prostate cancers in mice, global levels of H3K27me3 are reduced in both prostatic intraepithelial neoplasia (PIN) and invasive adenocarcinoma lesions. This pattern of global H3K27me3 reduction in PIN and invasive prostate cancers is also observed in humans, correlates with global chromatin decondensation, and correlates with increased markers of disease aggressiveness (e.g. Gleason score and pathological stage). In prostate and breast cancer cells, experimentally forced reductions in MYC levels result in increased global levels of H3K27me3. These findings suggest that increased levels of decondensed chromatin in normal stem/progenitor cells and in cancer cells are associated with global loss of the H3K27me3 polycomb mark, and furthermore, MYC overexpression could be one mechanism for this H3K27me3 deregulation. 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 2210. doi:1538-7445.AM2012-2210
Diagnostic Implications of Pericardial, Pleural and Pulmonary Involvement in Cardiovascular Disease
Authors: Louis Wolff
Journal: New England Journal of Medicine (1951)

THE conditions that must be considered in differential diagnosis in patients with a history of chest pain are many. They comprise diseases of the gastrointestinal tract, spinal column, lungs and mediastinum, infections of various sorts, myocarditis, acute myocardial infarction, acute pericarditis, pulmonary embolism and dissecting aneurysm. The greatest difficulty is encountered in differentiating acute myocardial infarction, acute idiopathic pericarditis, pulmonary embolism and dissecting aneurysm. All these conditions are characterized by chest pain, fever, leukocytosis, increased sedimentation rate and an abnormal electrocardiogram. There may be remarkable similarities in these manifestations of the four diseases, but close scrutiny of the history, laboratory . . .