tbuckley/cabot-search huggingface dataset:
AB1473-HPR Development of pharmaceutical care service within a paediatric rheumatology outpatients clinic
Authors: L. Grech, D. Aquilina, L.M. Azzopardi, A. Serracino Inglott, V. Ferrito, A.A. Borg
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> The role of the clinical pharmacist within an adult rheumatology multidisciplinary team has long been established <sup>1,2</sup>. In Malta however this service was not extended to cover the paediatric rheumatology out-patient clinic. <h3>Objectives</h3> The objective of this study was to introduce a pharmaceutical care service and create an ongoing pharmaceutical care model specifically for paediatric patients in order to ensure patient safety, education and seamless care. <h3>Methods</h3> A pharmaceutical care model rationale which highlights the role of the clinical pharmacist within the clinic was compiled, discussed with the consultant rheumatologist and disseminated to the paediatric clinic nurse. The individualized pharmaceutical care model includes mainly 3 sections. Section A records patient’s details and carer’s details, allergies, other co-morbidities and comments whereby any particular notes such as family history can be listed down. Section B consists of the first clinic date visit and drug history which is updated accordingly to the date of subsequent visits. Section C documents the pharmaceutical care plan. The pharmaceutical care plan categorizes drug therapy problems as actual or potential drug therapy problems, documents the pharmacist’s action, monitoring plans and seamless care requirements. A referral checklist for healthcare professionals wishing to contact the clinical pharmacist to discuss pharmaceutical care issues was developed and reviewed. An individualized patient pharmaceutical care record sheet was compiled to document pharmaceutical care issues identified within the clinic and/or follow up visits or appointments. <h3>Results</h3> Over a 12 month period between January 2011 and January 2012, the clinical pharmacist attended 6 paediatric clinic sessions. Out of a total of 32 patients seen together with the consultant, 15 required a pharmacist’s intervention. A total of 37 pharmaceutical care issues were identified and resolved with a mean 2.7 care issues per patient. The majority of the drug therapy problems (n=32 out of a total of 37) were classified as actual drug therapy problems whereas 5 were classified as potential drug therapy problems relating to potential adverse drug reactions. <h3>Conclusions</h3> The extension of pharmaceutical care model to the rheumatology paediatric population helped to further improve the quality care service offered. The individualised pharmaceutical care plan for each patient is an essential tool in providing documentation records for pharmaceutical care issues identified and seamless care. <h3>Disclosure of Interest</h3> None Declared
A5.08 Ultrasound assessment of clinical remission: Power doppler synovitis is associated with flare
Authors: HL Gul, F Ponchel, P Emery
Journal: Annals of the Rheumatic Diseases (2016)

<h3>Background and objectives</h3> Remission is the optimum treatment target for rheumatoid arthritis (RA). Although clinical remission is increasingly achieved, patients can still progress both structurally and functionally. Furthermore, many patients are unable to sustain clinical remission. There is a need for more objective measures of the remission state and predictors of flare. We aimed to assess whether Power Doppler (PD) ultrasound could predict stability of remission in patients with RA. <h3>Materials and methods</h3> 455 patients were selected from an inflammatory arthritis register based on a diagnosis of RA and with initially active disease who subsequently achieved a DAS28 score &lt;2.6 at a single visit. 291 had a follow-up visit (minimum follow-up 12 months). A DAS28 &gt;3.2 was considered as flare. Ultrasound data was available for 211 patients. <h3>Results</h3> Stable remission over 12 months was not associated with demographic parameters with the exception of longer disease duration. Patients with early RA receiving conventional synthetic (csDMARDs) were less stable than patients (with established RA) receiving biologic therapy +/- DMARDs. With respect to ultrasound data, more PD signal was associated with the inability to maintain remission (p = 0.036). ROC curve analysis was 0.395 for PD. Grey-scale changes were not informative. Sustained remission was associated with the number of tender joints (p = 0.05). <h3>Conclusion</h3> Demographic and clinical assessments (with the exception of tender joint counts) are not predictors of stable remission. A significant association with PD synovitis suggests that this is a more accurate measure of inflammation and characterisation of the remission state. This could potentially be used to predict flare in the clinical setting to help guide treatment.
Anastomoses hépatico-gastriques par échoendoscopies: utilisation des prothèses GIOBOR (Tae Wong®) partiellement couvertes
Authors: C Pesenti, E Bories, F Caillol, M Giovannini
Journal: Endoscopy (2012)

La réalisation d'une «anastomose hépatico-gastrique» (AHG) par écho endoscopie peut être une alternative à lacholangiopancréatografie rétrograde endoscopique (CPRE) en cas d'échec pour sténose biliaire maligne, chez des patients en situation palliative. Nous rapportons ici notre expérience de nouvelles prothèses de type GIOBOR (Tae Wong®) partiellement couvertes.
Endoscopic closure of esophageal intrathoracic leaks: stent versus endoscopic vacuum-assisted closure, a retrospective analysis
Authors: M. Brangewitz, T. Voigtländer, F. Helfritz, T. Lankisch, M. Winkler, J. Klempnauer, M. Manns, A. Schneider, J. Wedemeyer
Journal: Endoscopy (2013)

<b>Background and study aim:</b> Placement of covered self-expanding metal or plastic stents (SEMS or SEPS) is an established method for managing intrathoracic leaks. Recently, endoscopic vacuum-assisted closure (EVAC) has been described as a new effective treatment option. Our aim was to compare stent placement with EVAC for nonsurgical closure of intrathoracic anastomotic leaks. <b>Patients and methods:</b> In a retrospective analysis we were able to identify 39 patients who were treated with SEMS or SEPS and 32 patients who were treated with EVAC for intrathoracic leakage. In addition to successful fistula closure, we analyzed hospital mortality, number of endoscopic interventions, incidence of stenoses, and duration of hospitalization. <b>Results:</b> In a multivariate analysis, successful wound closure was independently associated with EVAC therapy (hazard ratio 2.997, 95 % confidence interval [95 %CI] 1.568 – 5.729; <i>P</i> = 0.001). The overall closure rate was significantly higher in the EVAC group (84.4 %) compared with the SEMS/SEPS group (53.8 %). No difference was found for hospitalization and hospital mortality. We found significantly more strictures in the stent group (28.2 % vs. 9.4 % with EVAC, <i>P</i> < 0,05). <b>Conclusions:</b> EVAC is an effective endoscopic treatment option for intrathoracic leaks and showed higher effectiveness than stent placement in our cohort.
Adrenal Mass and Renal Vessels Mimicking Intestinal Bleeding on Tc-99m Red Blood Cell Scintigraphy
Authors: SEIGO KINUYA, TAKAHARU MASUNAGA, RYOYU TAKEDA, TAKATOSHI MICHIGISHI, NORIHISA TONAMI
Journal: Clinical Nuclear Medicine (1997)

Tc-99m red blood cell accumulation in an adrenal metastatic mass and pool activity in the left renal vessels mimicked findings of intestinal bleeding. Sequential images and tomographic images could avoid a false-positive result.
P159 Rate of chest x-rays (CXR) twelve months prior diagnosis of lung cancer
Authors: A. Dwarakanath, M. E. J. Callister
Journal: Thorax (2011)

<h3>Introduction</h3> UK 5 year survival from lung cancer lags behind other developed nations, and one suggested reason is late stage at diagnosis. Efforts are therefore underway to encourage patients to present earlier to primary care with chest symptoms, and to encourage earlier referral in primary care for CXR or clinic review. Stage at presentation varies between geographical areas, suggesting variability in referral even within UK regions. The reasons underlying this variability are unknown, but one possible explanation could be different patient behaviours or clinical practice in primary care. <h3>Aim</h3> To analyse the number of CXRs done 12 months prior to a confirmed diagnosis of lung cancer according to stage at presentation. <h3>Method</h3> We reviewed all patients with lung cancer discussed at the Lung MDT between December 2008 and May 2009. Cases of Small Cell Lung Cancer were excluded. The stage (IASLC 6th system), and number of CXRs performed within 12 month prior to diagnosis were recorded. Numbers of CXRs for each group were compared using Kruskal–Wallis test with Dunn9s post-test comparison. <h3>Results</h3> 223 NSCLC (stage 1 &amp; 2=61, stage 3=61, stage 4=101) and 32 SCLC (limited-12 &amp; extensive-20) were diagnosed. Median, IQR and range of number CXRs in the previous 12 months are displayed in Abstract P159 table 1. Patients presenting with stage IV lung cancer had undergone significantly fewer CXRs in the year prior to diagnosis compared to patients diagnosed with stage I/II lung cancer (p&lt;0.05) and those diagnosed with stage III disease (p&lt;0.05). There was no significant difference between the stage I/II and stage III disease. <h3>Conclusion</h3> Patients with late stage disease (Stage IV) appear to have fewer CXRs in the year prior to diagnosis than patients presenting with earlier disease. This may represent a reluctance to seek medical review for persistent respiratory symptoms, or reluctance among GPs to refer for CXR. Ongoing analysis is investigating rates of GP consultation and antibiotic prescription among these patients to try to discriminate between then possible explanations.
Myasthenia Gravis Developing Acutely after Partial Removal of a Thymoma
Authors: John H. Fisher, Charles G. Child
Journal: New England Journal of Medicine (1955)

THE relation between myasthenia gravis and thymic tumors remains obscure despite the fact that much careful study and thought has been given this fascinating subject. In the majority of reported cases in which myasthenia gravis has been associated with thymoma, the signs and symptoms of muscular weakness had existed from months to years before discovery of the tumor. In a few, however, the tumor was known to exist before the myasthenic difficulties appeared. Furthermore, although the appearance of myasthenia is usually gradual, it is well recognized that on occasion its symptoms may appear suddenly and dramatically.In 1951 Fershtand and . . .
IDENTIFICATION OF THE TWO-PHASE MECHANISM OF ENDOGENOUS OMEGA-6 FATTY ACID, ARACHIDONIC ACID, REGULATING VASCULAR INFLAMMATION BY TARGETING CYCLOOXYGENASE-2 AND MICROSOMAL PROSTAGLANDIN E2 SYNTHASE-1
Authors: Hironari Akasaka, Ke-He Ruan
Journal: Journal of the American College of Cardiology (2016)
Stat Bite NCI'S Natural Products Aequisition and Screening
Authors: T. Reynolds
Journal: JNCI Journal of the National Cancer Institute (1993)

Journal Article Stat Bite NCI'S Natural Products Aequisition and Screening Get access Tom Reynolds Tom Reynolds Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 85, Issue 17, 1 September 1993, Pages 1367–1368, https://doi.org/10.1093/jnci/85.17.1367 Published: 01 September 1993
Ga-67 Scintigraphy in a Patient With Infected Vascular Synthetic Graft
Authors: SOPHIE TURPIN, LUC BOUCHER
Journal: Clinical Nuclear Medicine (1997)

Ga-67 citrate scintigraphy has be used extensively to locate infectious foci. Infections of a synthetic vascular graft is a rare but catastrophic complication of aortobifemoral bypasses. They can be identified on Ga-67 or labeled leukocytes scans. Usually, they are seen as focal, sometimes ill-defined, uptake on Ga-67 scintigraphy. The authors report a case of an extensive aortobifemoral graft infection giving a "lambda" image in the abdomen
Managing the Dyspeptic Patient: Experience of a Single-Visit Dyspepsia Clinic
Authors: A Lobo, R Dickinson
Journal: Journal of the Royal Society of Medicine (1988)

During a one-year period, 206 of 245 patients referred directly to a single-visit dyspepsia clinic underwent gastroscopy after clinical consultation. Endoscopic findings enabled diagnosis in the majority and no complications occurred. In 12 patients with positive endoscopies there was an unrelated clinical diagnosis, and 23 with normal endoscopies had organic disease. Such a clinic has advantages both for patients in providing single-visit diagnosis and management for the majority, and for the hospital in reducing the load on outpatient services. Prior consultation may prevent both unwarranted use of endoscopy facilities and inappropriate diagnosis.
Jet injection of dyed saline facilitates efficient peroral endoscopic myotomy
Authors: Mouen Khashab, Ahmed Messallam, Payal Saxena, Vivek Kumbhari, Ernesto Ricourt, Gerard Aguila, Bani Roland, Ellen Stein, Monica Nandwani, Haruhiro Inoue, John Clarke
Journal: Endoscopy (2013)

<b>Background and study aims:</b> Peroral endoscopic myotomy (POEM) is technically challenging and time consuming. Repeated injection of dyed saline during tunneling is performed to enhance the demarcation between the submucosal layer and the muscularis propria. This process requires exchanging the knife for a catheter to spray dyed saline and is time consuming. This study aimed to describe a new method of injecting dyed saline through an integrated water jet channel during POEM. <b>Patients and methods: </b>POEM was performed using a triangular tip knife. Repeated jet injection of saline mixed with indigo carmine was performed whenever the submucosal dissection plane became unclear. <b>Results:</b> The study cohort consisted of nine patients (8 achalasia, 1 Jackhammer esophagus). All procedures were technically feasible and successful without any complications and resulted in the patients’ Eckhardt’s scores returning to normal. The mean submucosal tunnel length was 13.3 cm and the mean myotomy length was 9.9 cm. The mean procedure time was 127 minutes. <b>Conclusion:</b> The modified POEM technique with use of jet injection of dyed saline is simple and may render POEM easier and more efficient than the standard dissection method.
Colonic gallstone ileus treated with radiologically guided extracorporeal shock wave lithotripsy followed by endoscopic extraction
Authors: R. Muratori, V. Cennamo, M. Menna, P. Cecinato, L. Eusebi, G. Mazzella, F. Bazzoli
Journal: Endoscopy (2012)

Gallstone ileus is a rare cause of mechanical bowel obstruction due to the passage of a solitary large gallstone into the gastrointestinal tract through a cholecystoenteric fistula [1]. Early surgical intervention is the treatment of choice; however, the surgical mortality rate is high as most patients are elderly and many suffer from concomitant diseases [2]. Ultrasound-guided extracorporeal shock wave lithotripsy (ESWL) has been suggested as an effective, noninvasive therapeutic alternative to surgery. Cases of jejunal and gastric gallstone ileus treated with ESWL have already been described [3] [4] [5]. However, the use of ultrasound-guided ESWL is limited in the colon because the stones are often not radiopaque or only partially calcified, and are frequently covered by intestinal gas, which prevents clear localization of the gallstone. We describe a case of gallstone ileus of the colon that was successfully treated with radiologically guided ESWL that visualized the obstruction by focusing on a metallic clip that had been inserted during a previous rectosigmoidoscopy.
Evaluation of the Radioactive Rose-Bengal Test for the Differential Diagnosis of Obstructive Jaundice in Infants
Authors: H. Ghadimi, A. Sass-Kortsak
Journal: New England Journal of Medicine (1961)

THE clinical differentiation of atresia of the extrahepatic bile ducts from the intrahepatic conditions causing obstructive jaundice has been a challenge to pediatricians from the time when these two conditions were first described in the medical literature. Surgical correction within the first four weeks of life is mandatory in isolated atresia of the extrahepatic bile ducts if irreversible changes in the parenchyma are to be avoided.1 The importance of early operation has been emphasized by a number of investigators.2 3 4 "Neonatal hepatitis" and other intrahepatic conditions, causing an "obstructive" jaundice clinically indistinguishable from that due to extrahepatic atresia, are not amenable . . .
SAT0161 Serum Anti-Citrullinated Protein Antibody Positivity Increased the Risk of Rheumatoid Arthritis-Related Pulmonary Disease in Patients with Rheumatoid Arthritis: A Meta-Analysis
Authors: J. Zhu, Y. Zhou, X. Chen, J. Li
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> Extra-articular manifestations (EAMs) are common in patients with rheumatoid arthritis (RA) and are associated with increased morbidity and early mortality. It has been revealed that anti-citrullinated protein antibody (ACPA) may be associated with increased risk for further EAMs. However, an inconsistent association has been reported between the serum ACPA level and RA-related pulmonary disease risk. <h3>Objectives</h3> We collected the inconsistent studies and systematically analysed whether serum ACPA positivity increased the risk of pulmonary disease in patients with RA. <h3>Methods</h3> An electronic search was performed in the PubMed, ScienceDirect, and SpringerLink databases for studies published up to August 2013. The distributions of the serum ACPA level in cases and controls were obtained from eligible studies. The risk of RA-related pulmonary disease associated with the serum ACPA positivity was estimated by the odds ratio (<i>OR</i>) and 95% confidence interval (<i>95%</i><i>CI</i>). According to the heterogeneity results, a fixed-effects model or a random-effects model was used to calculate the pooled <i>OR.</i> Publication bias and sensitivity analyses were conducted. <h3>Results</h3> Overall, 243 patients with RA-related pulmonary disease and 1442 RA patients as controls were included in the meta-analysis. The results showed that the pooled <i>OR</i> was 2.621 (<i>95% CI</i>, 1.561-4.403, <i>p</i>≤0.001) for the increased risk of RA-related pulmonary disease due to the serum ACPA positivity. In the Caucasian population subgroup, an increased <i>OR</i> was 3.453 (<i>95% CI</i>, 1.798-6.630, <i>p</i>≤0.001), whereas no association was found in the Asian population subgroup. Additionally, we further revealed that serum ACPA positivity indicated a higher risk for interstitial lung disease and fibrosis (ILD, IPF) among RA patients (<i>OR</i>=4.679, <i>95% CI</i>, 2.071-10.572, <i>p</i>≤0.001). The heterogeneity, publication bias, and sensitivity analyses had no statistical significance in all groups. <h3>Conclusions</h3> This is the first meta-analysis to reveal that serum ACPA positivity is highly associated with the risk of RA-related pulmonary disease, particularly RA-related ILD and IPF. Limitations includ that subgroup analyses were performed only for patients with RA and concurrent ILD or IPF. Other RA-related pulmonary disease risk analyses were conducted using pooled data. No further subgroup analysis was performed according to the confounding factors due to the limitation from the original research. Further more careful prospective studies with larger sample sizes and well-controlled confounding factors are required to confirm our findings. <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.1668
The genetic characterization of acute promyelocytic leukemia with cryptic t(15;17) including a new recurrent additional cytogenetic abnormality i(17)(q10)
Authors: M Kim, J Lim, Y Kim, K Han, D H Lee, N G Chung, B Cho, H K Kim, K S Eom, C-K Min, W-S Min
Journal: Leukemia (2007)
PWE-132 Association Between Smoking And Liver Fibrosis In Primary Biliary Cirrhosis
Authors: A Mantaka, M Koulentaki, D Sifaki-Pistolla, A Voumvouraki, E Marinidou, N Papiamonis, M Tzardi, E Kouroumalis
Journal: Gut (2014)

Introduction Conflicting data for the role that cigarette smoking may play in Primary Biliary Cirrhosis (PBC) have been reported. Some studies have suggested an association of smoking with a more advanced fibrotic stage. The aim of the present study therefore was to assess the association between smoking and a) the severity of histological findings at the time of diagnosis, b) the immunological features of a genetically homogeneous and geographically defined population of PBC patients. Methods Smoking history data were collected from 171 PBC patients of Cretan origin (163 female) using a standardised questionnaire. Diagnosis was based on standard biochemical, Immunological and histological criteria. Liver biopsy was performed in 148 patients at diagnosis. Liver fibrosis and histological inflammatory activity were semi-quantified according to a METAVIR-based classification system. Odds ratios (OR) were assessed using logistic regression analysis. Results Smoking history prior to diagnosis was reported in 56 patients (32,7%%). Twenty-six patients (15,2%) were active smokers at diagnosis. Male gender (AOR 8.19, 95% CI: 3.014–11.937), alcohol intake >20 g/d (AOR, 2.20, 95% CI: 1.029–4.099), severe steatosis (AOR, 5.31, 95% CI: 2.019–9.919)), and F3–F4 fibrosis stage (AOR 1.21 95% CI: 1.015–3.031), but not piecemeal necrosis grade, bile duct paucity and cholangitis, or immunological laboratory data, were associated with smoking history. Multiple logistic regression analysis identified smoking intensity, years of passive smoking and significant necroinflammatory histological activity as independent risk factors of advanced liver fibrosis (F3–F4 stage) at diagnosis, adjusted for age, gender, BMI and alcohol consumption. For every pack-year increase in smoking intensity there was a 3.2 times higher likelihood of advanced fibrosis (95% CI: 2.018–6.294). Conclusion Our study results confirm the previously reported link between smoking history and the risk of advanced liver fibrosis at diagnosis in PBC. The mechanism by which smoking may accelerate the histological progression of PBC is unknown and larger studies are needed to define it. Disclosure of Interest None Declared.
1057 ANTI-TUMOR ACTIVITY OF THE mTOR INHIBITOR RAD001, THE DUAL mTOR/PI3-KINASE INHIBITOR BEZ235 AND THE PI3-KINASE INHIBITOR BKM120 CORRELATES WITH IMPAIRMENT OF OXIDATIVE PHOSPHORYLATION IN HCC
Authors: M.M. Kirstein, A.E. Boukouris, D. Pothiraju, L.E. Buitrago-Molina, S. Marhenke, J. Orlik, F. Kühnel, M.P. Manns, A. Vogel
Journal: Journal of Hepatology (2013)