tbuckley/cabot-search huggingface dataset:
F-18 FDG Accumulation in Inflamed Joints
Authors: Seiei Yasuda, Akira Shohtsu, Michiru Ide, Shigeharu Takagi, Toshio Mitomi, Yutaka Suzuki
Journal: Clinical Nuclear Medicine (1996)

A 55-year-old woman underwent a whole-body FDG PET study for cancer screening. In the PET images, high F-18 FDG uptake was noticed at the joints of the upper extremities. Her hands were deformed, and she had experienced morning stiffness. Blood tests revealed a raised erythrocyte sedimentation rate at 45 mm/hour and C-reactive protein 0.9 (normal, < 0.4). Testing for the rheumatoid factor yielded positive results. These physical and laboratory findings were compatible with the diagnosis of definite rheumatoid arthritis. It is worthy to note that elevated accumulation of F-18 FDG can be observed in Inflamed joints.
P117 Pulmonary Rehabilitation In The East Of England - 2.5-fold Variation In Completion Rates
Authors: L. Jongepier, R. Barlow
Journal: Thorax (2014)

<h3>Introduction and objectives</h3> Pulmonary Rehabilitation (PR) should be made available to all suitable people with COPD and various other chronic respiratory conditions.<sup>1</sup> An abundance of guidelines has been produced making recommendation on the quality of both the provision and commissioning of PR. Limited data is available on PR programme adherence rates and most study rates post COPD exacerbation. Recent IMPRESS Guidance suggested a target completion rate of 75% of offered sessions and stated the national average being less than 50%.<sup>2</sup> Our aim was to get an accurate regional perspective of completion rates of all PR service providers to use as a lever for improvement. <h3>Methods</h3> Prior to 2013/14 a regional PR group was formed to promote best practice, offer peer support and enable improvements through the collection of meaningful regional data. A data set was agreed and defined and during 2013/14 quarterly data was collected from 17/18 (95%) providers across all CCGs. The number of PR starters and completers (attending a minimum of 75% of the offered sessions) was collected. Data from all providers was compared. <h3>Results</h3> During 2013/14 4,737 patients started PR and 2935 patients attended at least 75% of the offered sessions. The average completion rate across the EoE was 62% with programmes varying more than 2.5-fold from 37% to 91%. 24% of providers had a completion rate of ≤50%, however another 24% had a completion rate of ≥75%. <h3>Conclusions</h3> Completion rate varied widely with a 2.5-fold variation between the best and worst performers. 24% had a completion rate of ≤50%. The regional average of 62% was below the suggested target rate of 75%. The reasons for this variation are not known, but will be investigated by the EoE PR group. <h3>References</h3> NICE. COPD: management of COPD in adults in primary and secondary care. 2010http://www.nice.org.uk/guidance/CG101 Impress (BTS and the primary care respiratory society – UK). Impress Guide to Pulmonary Rehabilitation. 2011.[www.impressresp.com/index.php?option=com_docam&amp;task=doc_view&amp;grid=41&amp;Itemid=82] Accessed on 07/07/13
FRI0187 Epidemiology Musculoskeletal Disorders and Rheumatic Diseases in Indigenous Communities of Oaxaca, Mexico: A Community-Based Study
Authors: F. Julian-Santiago, C. Garcia-Garcia, I. Garcia-Olivera, M.V. Goycochea-Robles, I. Pelaez-Ballestas
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> The prevalence of musculoskeletal diseases in indigenous communities in Mexico is unknown. As a response to this challenge, the Latin American Study Group of Rheumatic Diseases in Indigenous Peoples (GLADERPO) was created. This project lies within the framework of this regional effort. <h3>Objectives</h3> Estimate the prevalence of musculoskeletal disorders (MSK) and rheumatic diseases in indigenous communities of the State of Oaxaca (Chontal and Mixteca Alta) using the COPCORD (Community Oriented Program for the Control of Rheumatic Diseases) methodology. <h3>Methods</h3> Subjects ≥18 years of age from two indigenous communities of the Mixteca Alta and Chontal. This is a cross-sectional and analytical community-based census study using a house-by-house method, in which staff members who received standardized training administered previously cross-culturally validated COPCORD questionnaire (1) in the communities. Positive cases of MSK pain were reviewed by primary care physicians and a rheumatologist. <h3>Results</h3> 1,060 community residents were surveyed. The mean age was 46.9 years (SD 19.9; age range, 18 to 97 years), 642 (60.5%) of subjects were women; the mean education was 6.8 years (SD 4.7); 1,001 (94.4%) were employed; 679 (64.1%) were covered under National Health Insurance Programme (called "Seguro Popular"). 479 individuals (45.1%, 95% CI 42.1-48.2%) had MSK pain in the last 7 days. Of these, 110 (22.0%, 95% CI 19.2-26.9%) associated pain to a traumatic event; pain intensity was reported as "strong pain-severe pain" in 29.5%. Sites with pain in the last 7 days were the spine (44.1%), knees (22.2%), shoulders (5.3%), and elbows (4.1%). Diagnoses: back pain 164 (15.4%; 95% CI 13.3-17.7); osteoarthritis 156 (14.7%; 95% CI 12.6-16.9); rheumatic regional pain syndromes 27 (2.5%; 95% CI 1.6-3.6); rheumatoid arthritis 4 (0.3%; 95% CI 0.1-0.9); dermatomyositis 1 (0.09%; 95% CI 0.0-0.5), ankylosing spondylitis 1 (0.09%; 95% CI 0.0-0.5); systemic lupus erythematosus 1 (0.09%; 95% CI 0.0-0.5); gout 1 (0.09%; 95% CI 0.0-0.5). <h3>Conclusions</h3> The prevalence of MSK disorders in the indigenous communities of Mixteca and Chontal was 45.1%. Back pain and osteoarthritis were the most prevalent rheumatic diseases. We emphasize the overall prevalence of MSK pain in this indigenous population, generating a highly negative impact on the performance of daily activities. <h3>Acknowledgements</h3> To the municipal authorities of San Antonio Huitepec and San Carlos Yautepec. National Council for Science and Technology (CONACYT)- Salud 2001-01-162154. <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.2707
Predictors of Response to Exemestane as Primary Endocrine Therapy in Estrogen Receptor-Positive Breast Cancer.
Authors: N. Yoshimoto, S. Takahashi, Y. Ito, T. Yamashita, Y. Ando, T. Toyama, H. Sugiura, S. Kobayashi, Y. Fujii, H. Iwase, H. Yamashita
Journal: Cancer Research (2009)

Abstract Endocrine therapy is the most important treatment of choice for estrogen receptor-positive breast cancer. Potential mechanisms for resistance to endocrine therapy involve estrogen receptor (ER)-coregulatory proteins and cross-talk between ER and other growth factor-signaling networks. However, the factors and pathways responsible for endocrine therapy resistance, particularly resistance to aromatase inhibitors, have not been clearly established. Sixteen postmenopausal patients with ERΑ-positive primary breast cancer were treated daily with 25 mg of exemestane (an aromatase inhibitor) for 6 months. Expressions of ERΑ, ERΒ, progesterone receptor (PgR), androgen receptor (AR), AIB1, aromatase, EGFR, HER2, Ki67, cyclin D1, p53, Bcl2, Stat5 and IGFBP5, and phosphorylations of ERΑ serine (Ser) 118, ERΑ Ser167, Akt Ser473 and p44/42 MAPK threonine (Thr) 202/ tyrosine (Tyr) 204 were examined by immunohistochemistry on pretreatment tumor biopsies and posttreatment surgical specimens. Analyses were made to test for correlations with response to exemestane. Of the 16 patients, 7 responded and 9 retained stable disease. High-level expression of AIB1 and phosphorylation of Akt Ser473 were significantly associated with a better response to exemestane, suggesting that these factors could be considered as predictors of exemestane response. Expressions of ERΑ, ERΒ, PgR, aromatase, Ki67, cyclin D1 and p53, and phosphorylations of ERΑ Ser118, ERΑ Ser167 and p44/42 MAPK Thr202/Tyr204 were decreased, whereas expressions of Stat5 and IGFBP5 were increased in posttreatment specimens compared to the values in pretreatment biopsies. Thus, the analysis of factors involved in the estrogen-dependent growth-signaling pathways may be useful in identifying patients responsive to exemestane. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 2041.
Abstract LB-470: Tumor suppressor role of microRNA-18b in melanoma
Authors: Altaf A. Dar, Shahana Majid, David de Semir, Vladimir Bezrookove, Mehdi Nosrati, Mohammed Kashani-Sabet
Journal: Cancer Research (2012)

Abstract MicroRNAs play important roles in gene regulation, and their expression is frequently dysregulated in various tumors. Here, we report that expression of miR-18b is significantly suppressed in melanoma specimens when compared with nevi. miR-18b is silenced in melanoma cell lines due to hypermethylation and is re-expressed by 5-AZA-deoxycytidine (5-AZA) in melanoma cell lines. miR-18b overexpression suppressed cell survival, colony formation, invasiveness and migratory ability and induced apoptosis in melanoma cell lines. Stable overexpression of miR-18b suppressed melanoma cell proliferation, colony formation, and tumor cell growth in-vivo. miR-18b reverses epithelial-to-mesenchymal transition in melanoma cell lines and its expression was induced by the chemotherapeutic drug cisplatin. These results demonstrate a novel role for miR-18b as a tumor suppressor in melanoma. 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 LB-470. doi:1538-7445.AM2012-LB-470
Abstract P2-12-01: Prospective Evaluation of Joint Symptoms in Postmenopausal Women Initiating Aromatase Inhibitors for Early Stage Breast Cancer
Authors: KD Crew, Makarem D Chehayeb, D Awad, K Kalinsky, M Maurer, G Kranwinkel, L Brafman, D Fuentes, DL Hershman
Journal: Cancer Research (2012)

Abstract Background: Aromatase inhibitors (AIs) are widely prescribed to postmenopausal women for the adjuvant treatment of hormone-sensitive breast cancer (BC). However, musculoskeletal complaints can lead to nonadherence and early discontinuation. The aim of this study was to characterize the natural history of the AI-induced arthralgia syndrome and determine predictors of worsening symptoms. Methods: Postmenopausal women with stage I-III BC initiating adjuvant AI therapy were enrolled. All patients completed the following questionnaires at baseline and every 3 months for a year: Modified Brief Pain Inventory-Short Form (BPI-SF), Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index and the Modified Assessment of Chronic Rheumatoid Affections of the Hands (M-SACRAH). Higher scores reflect worse symptoms. Quality of life was assessed using the Functional Assessment of Cancer Therapy-Endocrine Subscale (FACT-ES). Hand grip strength was measured at each visit with a Martin dynamometer. Paired t-tests were performed to compare follow-up evaluations to baseline. Linear Regression was performed to evaluate the association between baseline symptoms and change in symptoms. Results: A total of 169 patients have been consented, 3-month data is available on 102; 6-month data on 85. Median age: 63 (42–89); White/Black/Asian/Hispanic: 61.48/30.33/3.28/25.6; median BMI (kg/m2): 28 (12–50). Compared to baseline, there was a statistically significant increase in BPI pain severity and endocrine related symptoms on the FACT-ES at 3 and 6 months. Significant changes in the BPI pain interference, M-SACRAH pain and stiffness, WOMAC function, physical well-being on the FACT-ES, trial outcome index and pinch grip strength were seen at 3 months; however these changes did not remain significant at 6 months. Logistic regression models evaluating predictors of patient reported outcome measures and grip strength were performed. Baseline score was the strongest predictor of worsening symptoms (p &amp;lt; 0.01) after correcting for age, prior chemotherapy and baseline joint conditions. Conclusions: Treatment with adjuvant AI therapy is associated with significant worsening of joint pain and stiffness which is most prominent at the 3 months evaluation. Patients with baseline joint symptoms are at greatest risk for worsening symptoms on AIs. Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P2-12-01.
SAT0053 Persistence of Subclinical Joint Activity in Rheumatoid Arthritis Joints
Authors: M. Gärtner, F. Alasthi, G. Supp, P. Mandl, J. Smolen, D. Aletaha
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> Ultrasound (US) assessment was shown to be a sensitive tool for the evaluation of joint activity in patients with rheumatoid arthritis (RA). Synovial effusion and synovial hypertrophy can be evaluated by gray scale (GS), while hypervascularisation, as a marker of inflammation, can be measured using power Doppler signals (PD). Both types of signals are highly sensitive, and may persist even in clinical inactivity, i.e. when swelling or tenderness are absent. It is conceivable that such subclinical US signals may resolve if clinical inactivity is sustained, but this has not yet been shown during long-term follow-up. <h3>Objectives</h3> To investigate the persistence of subclinical US signals in previously clinically active joints in relation to prolonged clinical inactivity. <h3>Methods</h3> We performed US imaging including GS and PD, each graded on a four point scale (0=no, 1=mild, 2=moderate and 3=marked) of 22 joints of the hands of RA patients. We then selected all joints with no clinical activity at the time of the US examination. Based on a routine clinic database with 3-monthly joint assessments, the last time point of clinical joint activity (swelling, tenderness or both) was identified. The time between the last clinical joint activity and the current sonographic assessment in that joint was determined and persistence of subclinical US activity was estimated for all patients and all joints. <h3>Results</h3> We assessed a total of 1980 joints in 90 RA patients. 1329 (67.1%) joints were positive on GS and 410 (20.7%) showed PD signals. The median (IQR) time between the last visit exhibiting swollen or tender joint(s) and the US assessment showing PD/GS-signals in the same now clinically inactive joint(s) was 3.6 (1.2; 6.3) and 3.5 (1.3; 5.6) years, respectively. We found that the time between last clinical activity (swelling and/or tenderness) and positive sonographic assessment was significantly shorter in joints showing GS signals ≥2 than in joints with GS=1 (median [IQR] 2.6 [0.6; 2.6] vs. 3.9 [1.9; 6.6]; p&lt;0.001), for PD signals there was also a trend towards shorter periods of clinical remission in highly active joints (median [IQR] of 2.4 [0.5; 5.3] for PD≥2 vs. 4.3 [1.0; 6.2] for PD=1; p=0.066). In joints showing highly positive GS and PD signals (both ≥2), the time to the last clinical activity was even shorter, with a median of 1.4 years. (Figure 1) <h3>Conclusions</h3> We conclude that subclinical joint activity is long lasting in RA joints in clinical remission, but resolves over time. The latter is indicated by a shorter period from last clinical activity for strong signals (PD ≥2, GS ≥2) as compared to weak signals (PD ≤1, GS ≤1). <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.3247
Case 15-1972
Authors: Peter M. Yurchak, Benjamin Castleman
Journal: New England Journal of Medicine (1972)

PRESENTATION OF CASEFirst admission. A 63-year-old man was admitted to the hospital because of dyspnea.He had been well until five weeks earlier, when he fell while at work and experienced pain in the left leg. X-ray films of the ankle showed no fracture, but his activity was limited by persistent discomfort. Three days before entry exertional dyspnea and orthopnea developed and progressed in severity, and on the evening of admission he was severely dyspneic at rest.Thirty years previously he had been treated for syphilis. There was a history of overweight and of smoking two packages of cigarettes . . .
P4-09-33: The Prognostic Significance of Metaplastic Carcinoma of the Breast – A Comprehensive Comparison Study with Common Breast Cancers.
Authors: H-W Lai, S-J Kuo, D-R Chen, S-T Chen
Journal: Cancer Research (2011)

Abstract Purpose : Metaplastic carcinoma of the breast (MCB) is a rare histological subtype of breast cancer with incidence less than 1%. Due to its rarity, the clinical characteristics and prognostic significance of MCB compared with other common breast cancer, such as infiltrating ductal carcinoma (IDC) and infiltrating lobular carcinoma (ILC) are not clear and controversial between different reports. We performed a multi-institutional cases collective comparison study to evaluate the clinical characteristics and prognostic status with IDC and ILC. Materials and methods : Cases of MCB were enrolled from 4 medical centers in Taiwan. Forty-five MCB patients combined with 1777 IDC and 53 ILC patients from cancer registry database of Changhua Christian Hospital (CCH) comprised the current study. The patients’ demographic data, tumor characteristics and prognosis of MCB were analyzed and compared with IDC, and ILC. To further clarify the prognostic difference between MCB and IDC, a case control analysis was performed to minimize the effect of tumor size, lymph node status and other clinicopathologic factors. The disease free survival (DFS) and overall survival (OS) between groups were compared. Results : Compared with IDC, MCB was associated with older age, larger tumor size, lesser lymph node positive rate, higher distant metastasis, higher tumor grade, lower ER positive tumor, and higher triple negative breast cancer subtype (TNBC). Compared with IDC, MCB was associated with worse OS (p=0.031), but no difference in DFS (p=0.071). While MCB was not statistically different from ILC in both DFS and OS (p=0.132 and 0.289, respectively). To eliminate the influence of other prognostic factors, 135 cases controlled IDC with comparable clinicopathologic parameters were enrolled to compare with those 45 MCB patients. Compared with cases controlled IDC group, the MCB patients remained showed poorer OS (p=0.040), but not different in DFS (p=0.439). Conclusion : MCB was associated with poorer OS compared with IDC, and this poorer prognosis was related to tumor behavior rather than clinicopathologic factors. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P4-09-33.
PWE-177 Acute bleeding from upper GI tract angiodysplasia
Authors: P Phull, N Nagrath
Journal: Gut (2012)

Introduction Angiodysplasia is a relatively uncommon cause of acute upper GI bleeding (AUGIB). The aim of this study was to characterise the presentation, management and outcome of this condition. Methods Retrospective audit of upper GI endoscopies (UGIE) performed at our institution between 1 January 2007 and 30 June 2010. Data were extracted from the endoscopy reporting software (Unisoft) database using search terms “angiodysplasia,” “angioma” and “telangiectasia” for oesophageal, gastric and duodenal diagnoses. These three terms were grouped together as “angiodysplasia” for analysis. The casenotes for all patients presenting with haematemesis and/or melaena were reviewed. Results During the 42-month period of the audit, a total of 15 482 UGIEs were performed. A diagnosis of upper GI tract angiodysplasia was recorded in 199 procedures, representing 132 patients. Of these, 38 were excluded as they had presented with chronic anaemia and 55 patients had undergone UGIE for other indications. 39 patients had presented with haemetemesis and/or melaena. Of these six were excluded from further analysis as the diagnosis of angiodysplasia was not confirmed at subsequent endoscopy; a further seven patients had co-existing lesions which were thought to have accounted for the bleeding. Therefore, the results are presented for 26 patients; the mean age was 70 yrs (range 34–91) and 15 (59%) were males. Twelve (44%) were taking aspirin/NSAIDs, and five (19%) were on anticoagulant therapy. Mean haemoglobin level at presentation was 9.4 g/dl (range 4.0–14.9). Three (11%) of patients had a past history of AUGIB of unknown source; two (7.4%) of patients had a history of previous bleeding from known angiodysplasia. Von Willebrand's disease was noted in three (11%) of patents; four (14.8%) of patients had documented aortic stenosis, with a further two (7.4%) having had an aortic valve replacement. The 26 patients experienced 42 separate admissions (single admission—18 patients, eight patients >1 admission) with AUGIB during the study period. In 39 (93%) of these episodes the presentation was with melaena, and three (7%) with haematemesis plus melaena. Active bleeding was seen in 13 (30%) of these episodes, with luminal blood present in a further four (9%) cases. Endoscopic therapy with argon plasma coagulation or heater probe was undertaken in 35 (81%) of these episodes. Seven (26%) of the patients required additional therapy with either Octreotide, Thalidomide or Tranexamic Acid for uncontrolled or recurrent bleeding. There were no deaths observed due to GI bleeding. Conclusion Acute bleeding from upper GI tract angiodysplasia can be managed successfully by endoscopic therapy in the majority of patients, but approximately a third of patients will experience recurrent bleeding requiring additional medical therapy. Competing interests None declared.
Polypes gastriques sporadiques, quelle prise en charge? Expérience d'un service marocain
Authors: R Goubraim, M Salihoun, N Kabbaj, L Amrani, I Serraj, Z Chaoui, M Acharki, M Nya, N Amrani
Journal: Endoscopy (2012)

Les polypes gastriques (PG) sont des lésions sessiles ou pédiculées faisant saillie sur la paroi gastrique. Ils sont souvent de diagnostic endoscopique fortuit et se rencontrent au cours de 2 à 5% des endoscopies hautes. Le but de ce travail est de préciser les caractéristiques cliniques, endoscopiques et histologiques des PG sporadiques ainsi que leur prise en charge thérapeutique.