tbuckley/cabot-search huggingface dataset:
SAT0479 Increased Serum Light Levels Correlate with Disease Progression and Severity of Interstitial Pneumonia in Patients with Dermatomyositis
Authors: T. Kotani, T. Takeuchi, T. Ishida, R. Masutani, K. Isoda, K. Hata, S. Makino, T. Hanafusa
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Dermatomyositis (DM) is frequently complicated with interstitial pneumonia (IP), causing increased morbidity and mortality. It is important to identify a useful serum marker associated with the progression, severity, and prognosis of DM-IP patients. Activated CD8+ T cells play an important role in the pathogenesis of DM-IP. LIGHT (the name of which is derived from 'homologous to lymphotoxins, exhibits inducible expression, competes with herpes simplex virus glycoprotein D for herpes simplex virus entry mediator [HVEM], and expressed by T lymphocytes') is a member of the TNF superfamily and activates CD4+ and CD8+ T cells, monocytes and macrophages, natural killer cells, immature dendritic cells, and platelets. LIGHT mainly binds to the HVEM receptor on T cells and transmits co-stimulatory signals. HVEM signals stimulated by LIGHT more strongly induce CD8+ T cells than CD4+ T cells. LIGHT has been reported as a biomarker of inflammatory diseases, such as rheumatid arthritis, ankylopoietic spondylarthritis, inflammatory bowel disease, and atopic dermatitis, but its association with the pathology of DM-IP has not been clarified. <h3>Objectives</h3> Serum CD8+ T-cell activator, LIGHT, and Th1/Th2/Th17 cytokines were measured in DM-IP patients and compared with clinical parameters to investigate their usefulness. <h3>Methods</h3> The correlations between the clinical findings and serum LIGHT and Th1/Th2/Th17 cytokine levels were investigated in 21 patients with DM-IP (14 with rapidly progressive IP [RPIP] and 7 with chronic IP [CIP], including 4 fatal cases of IP). <h3>Results</h3> The median serum LIGHT level was 119 (16-335.4) pg/mL, which was higher than that in healthy control subjects and DM patients without IP. The median serum IL-6 level was 14.7 (2.4-154.5) pg/mL (n=13). The other cytokines were detected in only a few patients. The median serum LIGHT level in DM-RPIP patients (156 [49.6-335.4] pg/mL) was significantly higher than that in DM-CIP patients (94.3 [16-164.2] pg/mL) (<i>P</i> =0.02). The serum IL-6 level did not correlate with either progression or outcome of DM-IP. ROC curve analysis determined a serum LIGHT level of ≥120 pg/mL to be the cut-off value for the rapid progression of DM-IP. Serum LIGHT levels correlated significantly with %DLco (<i>R</i> =0.55, <i>P</i> =0.04) and total ground-glass opacity scores (<i>R</i> =0.72, <i>P</i> =0.0002). The serum LIGHT level significantly decreased to 100.5 (12.4-259.3) pg/mL 4 weeks after treatment initiation (<i>P</i> =0.04). <h3>Conclusions</h3> The serum LIGHT level may be a promising marker of disease progression and severity in patients with DM-IP. <h3>Disclosure of Interest</h3> None declared
Racial and Ethnic Disparities in Research Studies: The Challenge of Creating More Diverse Cohorts
Authors: Lindsey Konkel
Journal: Environmental Health Perspectives (2015)

The Challenge of Creating More Diverse Cohorts Minority populations are much less likely than their white counterparts to be included in studies on environmentally related diseases, even those that disproportionately affect minority communities.A failure to create more racially diverse research cohorts, some experts say, could exacerbate existing health disparities.
SAT0115 Rheumatoid Arthritis Also Disadvantages Female and Younger Patients for Cardiovascular Disease: Results of a Systematic Review with Meta-Analysis
Authors: J. Fransen, S.M. Kazemi-Bajestani, S.J. Bredie, C.D. Popa
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> The increased cardiovascular (CV) risk in rheumatoid arthritis (RA) patients is not explained by traditional risk factors. In the general population CV risk is higher in males than in females, and risk increases with age. It may be that the load of RA increases the risk in female and in younger patients, but whether this risk augmentation occurs and to which extent is unclear. <h3>Objectives</h3> To analyse whether the influence of age and gender on CV risk differs in RA patients as compared to the general population, using meta-analysis of direct comparative studies. <h3>Methods</h3> Systematic literature searches were performed in MEDLINE, Cochrane Library and EMBASE databases (1980 to December 2013). Two reviewers independently identified observational studies that reported incidence of CV events (morbidity and mortality) in RA patients compared to the general population, stratified for gender and/or age. One reviewer extracted data on comparative statistics (incidence rate ratio (IRR) or standardized mortality rate, standardized morbidity rate), stratified for age, gender and nature of event (ischaemic stroke, coronary artery disease, combined CV events). Cochrane9s Review Manager software 5 was used for meta-analysis. Results were combined weighted for group size in a random effects model, and were presented in forest plots. Heterogeneity was analysed using I<sup>2</sup>. <h3>Results</h3> We identified 1167 unique references, 60 were reviewed full-text and 14 studies were included (8 with ischaemic stroke data, 7 with coronary artery disease data, 12 with CV data). Compared to the general population, female and male RA patients have a similar higher risk (95% CI) to develop ischaemic stroke, with an IRR of 1.35 (1.30 – 1.40) and 1.31 (1.21 – 1.43) respectively. The excess risk to develop coronary artery disease was slightly higher in RA females with an IRR of 1.65 (1.54 – 1.76) compared to RA males with an IRR of 1.55 (1.41 – 1.69). The same kind of results were seen in combined CV disease, with an IRR of 1.57 (1.49 – 1.66) for females and 1.51 (1.43 – 1.59) for males. Younger RA patients had the highest excess risk for CV disease as compared to the general population, with an IRR (95% CI) of 2.39 (1.64 – 3.48) if &lt;50 years; 1.86 (1.63 – 2.11) if 50-65 years; and 1.27 (1.17 – 1.39) if &gt;65 years. Differences between age groups were significant (p&lt;0.0001) and the same relation was seen for females and males. Mortality studies were too few to analyse further. <h3>Conclusions</h3> The excess risk on CV disease is similar for female and male RA patients and the excess risk is largest in the youngest patients. Thus, RA also disadvantages the female and younger patients for CV disease, which should guide clinical practice. <h3>Disclosure of Interest</h3> None declared
PWE-277 Results of an ‘opt-out’ laparoscopic approach to colorectal cancer resections and factors influence opting out and conversion
Authors: A Torrance, R Evans, A Hussain, A Tsiamis
Journal: Gut (2015)

<h3>Introduction</h3> The incidence of laparoscopic colorectal cancer surgery has been increasing year on year in the UK. The 2014 NBOCAP showed 45% of all resections were completed laparoscopically with a conversion rate of 9.6% although variation still exists across the country. At our institution, all colorectal resections are attempted by laparoscopic approach unless deemed inappropriate at MDT discussion. This study aims to review the success of this “laparoscopic first” approach in elective resections and identify factors that my influence conversion rate. <h3>Method</h3> A retrospective review of a prospectively maintained database of all colorectal cancer resections from 01/03/2013 – 31/10/2014 was performed. Data was colected on patient age, gender, BMI, co-morbidity (including previous abdominal surgery), colorectal MDT outcome, surgeon/patient preference of approach, initial surgical approach, conversion and reason for conversion. <h3>Results</h3> 201 colorectal cancer resections were identified. 164 (81.6%) were elective cases and all of these were discussed pre-operatively at colorectal MDT. 141 (86%) procedures were planned and started laparoscopically with conversion to an open procedure in 10 (6.1%) cases. Overall, 80% of cases were completed laparoscopically. MDT planned for open procedure in 23 (14%) elective cases. Reasons for this were because of advanced tumour size/stage in 10 (43.5%) patients, other pathology requiring surgery in 7 (30.4%) patients (hysterectomy for cancer, gastrectomy for cancer, abdominal aortic aneurysm, suspected Crohn’s disease on staging investigations), an obstructing tumour in 2 (8.7%) patients and surgeon preference in 4 (17.4%) patients. Elective conversion was due to adhesions in 6 (60%) patients, a bulky/locally advanced tumour in 2 (20%) patients and a narrow pelvis in 2 (20%) patients. No difference was demonstrated in conversion rate according to age, obesity or gender. <h3>Conclusion</h3> We have demonstrated that eighty per cent of our patients were able to undergo laparoscopic resection of their colorectal cancer using this ‘opt-out’ laparoscopic-first approach. By considering previous surgery, large or locally invasive tumours and coexisting pathology need for conversion can also be limited. <h3>Disclosure of interest</h3> None Declared.
Gliomas
Authors: Huan J. Chang
Journal: JAMA (2010)

Gliomas Brain cancers are either primary (starting in the brain) or metastatic (starting somewhere else in the body and then moving to the brain).Gliomas are primary brain tumors involving glial cells, which provide nutrients, oxygen, and other support to neurons (nerve cells).Malignant (characterized by progressive and uncontrolled growth) gliomas are the most common primary brain tumors, accounting for about 10 000 primary malignant brain tumors diagnosed yearly in the United States.They are a common cause of cancer death in persons 15 to 44 years old and affect more men than women.Senator Edward Kennedy recently died of a malignant glioma.The March 10, 2010, issue of JAMA includes an article about a woman with a glioma.
Moral Hazard in Pediatrics
Authors: Donald Brunnquell, Christopher M. Michaelson
Journal: The American Journal of Bioethics (2016)

"Moral hazard" is a term familiar in economics and business ethics that illuminates why rational parties sometimes choose decisions with bad moral outcomes without necessarily intending to behave selfishly or immorally. The term is not generally used in medical ethics. Decision makers such as parents and physicians generally do not use the concept or the word in evaluating ethical dilemmas. They may not even be aware of the precise nature of the moral hazard problem they are experiencing, beyond a general concern for the patient's seemingly excessive burden. This article brings the language and logic of moral hazard to pediatrics. The concept reminds us that decision makers in this context are often not the primary party affected by their decisions. It appraises the full scope of risk at issue when decision makers decide on behalf of others and leads us to separate, respect, and prioritize the interests of affected parties.
Elevated plasma tricyclic levels with therapeutic doses of imipramine
Authors: M J Garvey, V B Tuason, R A Johnson, R H Valentine, T B Cooper
Journal: American Journal of Psychiatry (1984)

Nine (15%) of 59 patients treated with imipramine at doses of 150 to 300 mg/day had steady-state plasma levels greater than 500 ng/ml. Low capacity for hydroxylation was found in all six patients for whom hydroxy metabolites were measured. Maximum tricyclic levels in the nine study patients were comparable to levels found in tricyclic antidepressant overdoses (651-2439 ng/ml). No study patient experienced any adverse effects: QRS durations were all less than 100 msec, and a mildly dry mouth was the most commonly reported side effect (five of nine patients). Depressive symptoms recurred in three patients when their imipramine dose was decreased.
Pathogenesis of Chronic Subdural Hematoma
Authors: S KONDO
Journal: JAMA (1963)

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Prevalence of Cholesterol Treatment Eligibility and Medication Use Among Adults — United States, 2005–2012
Authors: Carla Mercado, Ariadne K. DeSimone, Erika Odom, Cathleen Gillespie, Carma Ayala, Fleetwood Loustalot
Journal: MMWR Morbidity and Mortality Weekly Report (2015)

A high blood level of low-density lipoprotein cholesterol (LDL-C) remains a major risk factor for atherosclerotic cardiovascular disease (ASCVD), although data from 2005 through 2012 has shown a decline in high cholesterol (total and LDL cholesterol) along with an increase in the use of cholesterol-lowering medications. The most recent national guidelines (published in 2013) from the American College of Cardiology and the American Heart Association (ACC/AHA) expand previous recommendations for reducing cholesterol to include lifestyle modifications and medication use as part of complete cholesterol management and to lower risk for ASCVD. Because changes in cholesterol treatment guidelines might magnify existing disparities in care and medication use, it is important to describe persons currently eligible for treatment and medication use, particularly as more providers implement the 2013 ACC/AHA guidelines. To understand baseline estimates of U.S. adults on or eligible for cholesterol treatment, as well as to identify sex and racial/ethnic disparities, CDC analyzed data from the 2005-2012 National Health and Nutrition Examination Surveys (NHANES). Because the 2013 ACC/AHA guidelines focus on initiation or continuation of cholesterol treatment, adults meeting the guidelines' eligibility criteria as well as adults who were currently taking cholesterol-lowering medication were assessed as a group. Overall, 36.7% of U.S. adults or 78.1 million persons aged ≥21 years were on or eligible for cholesterol treatment. Within this group, 55.5% were currently taking cholesterol-lowering medication, and 46.6% reported making lifestyle modifications, such as exercising, dietary changes, or controlling their weight, to lower cholesterol; 37.1% reported making lifestyle modifications and taking medication, and 35.5% reported doing neither. Among adults on or eligible for cholesterol-lowering medication, the proportion taking cholesterol-lowering medication was higher for women than men and for non-Hispanic whites (whites) than Mexican-Americans and non-Hispanic blacks (blacks). Further efforts by clinicians and public health practitioners are needed to implement complementary and targeted patient education and disease management programs to reduce sex and racial/ethnic disparities among adults eligible for treatment of cholesterol.
The effect of CYP2C19 polymorphism on the tolerability of ARQ 197: Results from phase I trial in Japanese patients with metastatic solid tumors.
Authors: T. Nishina, T. Hirashima, K. Sugio, K. Muro, S. Akinaga, H. Maeda, T. Takahashi, T. Naito, H. Murakami, H. Yasui, N. Boku, N. Yamamoto
Journal: Journal of Clinical Oncology (2011)

2516 Background: ARQ 197 is a selective, non-ATP competitive inhibitor of c-MET, a receptor tyrosine kinase implicated in tumor cell migration, invasion and proliferation. ARQ 197 is mainly metabolized by CYP2C19. The ratio of the poor metabolizer (PM) of CYP2C19 in Asians is reported to be around 20 % while it is very low in Caucasians. Recommended phase II dose (RP2D) of ARQ 197 in western countries was determined to be 360 mg bid.In this monotherapy phase I study in Japanese patients (pts) with metastatic solid tumors, we examined the drug's safety profile, pharmacokinetics and preliminary antitumor activity and determined RP2D in PM pts as well as extensive metabolizer (EM) pts. Methods: ARQ 197 was administered orally at 8 dose levels from 70 to 360 mg bid in a standard 3+3 dose escalation design. We enrolled PM and EM pts separately from 120 mg bid. Results: Forty-seven pts consisted of 33 EM pts (median age: 61.0 yrs; ECOG PS 0/1: 15/18; median prior therapies: 4) and 14 PM pts (median age: 59.5 yrs; ECOG PS 0/1: 6/8; median prior therapies: 4) were treated. The most common drug-related adverse events were fatigue, leukopenia, anemia, neutropenia and anorexia. Gr.4 neutropenia occurred in 1 of 6 EM pts at 360 mg bid and 3 of 7 PM pts at 240 mg bid, which identified each dosage as RP2D for EM and PM respectively. Cmax and AUC0-12 increased in a dose-dependent manner up to 300 mg bid in the EM cohorts and up to 240 mg bid in the PM. At 240 mg bid, the ARQ 197 Cmax and AUC0-12 of PM pts were 1.5-fold and 1.9-fold higher than those of EM pts respectively. Pts who had a relatively high exposure of ARQ 197 such as Cmax > 4,000 ng/mL or AUC0-12 > 40,000 ng.h/mL on day 1 tended to experience Gr.4 neutropenia regardless of CYP2C19 genotype. Two NSCLC pts, both of whom were PM at 240 mg bid, achieved partial response and 16 pts (34.0%) had stable disease (SD) for >= 16 weeks, especially 6 of 25 pts (24.0 %) in NSCLC had SD for >= 28 weeks. Conclusions: ARQ 197 was well tolerated in PM pts as well as EM pts. CYP2C19 genotype clearly affected the exposure to ARQ 197 which led different RP2Ds, 360 mg bid for EM pts and 240 mg bid for PM pts. ARQ 197 monotherapy showed a clear sign of activity. Further study is warranted.
FRI0216 Oblique View Radiographs are Better in Diagnosing Sacroiliitis
Authors: Z. Hu, M. Qiu, J. Qi, Q. Lv, Z. Lin, J. Gu
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Radiograph of anteroposterior (AP) view of pelvis is usually used to diagnose sacroiliitis. Magnetic resonance imaging (MRI) can detect lesions early in the disease course before they can be seen on radiography. The severity of sacroiliitis may be different as detected by MRI or by AP view X-ray. The oblique view of pelvis may provide additional information that make it closer to the finding of MRI than AP view X-ray. <h3>Objectives</h3> To determine whether oblique radiographs of the sacroiliac (SI) joints provide significant diagnostic advantage to a single AP projection of the pelvis in establishing the presence and severity of sacroiliitis as compared with MRI. <h3>Methods</h3> Radiographs (both AP pelvis and oblique projections) and MR images of 392 SI joints were obtained from 196 patients with an established diagnosis of spondyloarthritis (SpA) and were graded according to New York criteria by 3 readers (2 radiologists and 1 rheumatologist). The inconsistent results were re-discussed by all readers until consensus obtained. We compared the data of radiographs (both AP and oblique views) with the results of MRI. <h3>Results</h3> 7.1% SI joints were graded 1, 26.5% graded 2, 51.0% graded 3, and 15.3% graded 4 on AP view radiographs; 14.3% SI joints were graded 1, 43.9% graded 2, 34.7% graded 3, and 7.1% graded 4 on oblique view radiographs; while 14.3% SI joints were graded 1, 40.8% graded 2, 39.8% graded 3, and 5.1% graded 4 on MRI. 60.2% SI joints were graded identically whether on AP or oblique view X-ray. The agreement rate between oblique views and MRI (90.8%) was significantly higher than that between AP views and MRI (63.3%) (p&lt;0.05). 12 patients would be diagnosed of ankylosing spondylitis (AS) by AP view radiographs, while who would be read as having non-radiography SpA (nr-SpA) by oblique view X-ray or MRI. No patient was diagnosed of AS on oblique view X-ray or MRI, while who was read as having nr-SpA on AP view radiograph. <h3>Conclusions</h3> Oblique radiographs had closer agreement in severity score of sacroiliitis with MRI than AP pelvis radiographs. Oblique view radiographs may provide advantage to a single AP projection of the pelvis in diagnosing sacroiliitis. <h3>References</h3> Van der Linden S, Valkenburg HA, Cats A: Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria. Arthritis Rheum1984; 27(4): 361-8. Battistone MJ, Manaster BJ, Reda DJ, Clegg DO. Radiographic diagnosis of sacroiliitis–are sacroiliac views really better? J Rheumatol. 1998 Dec;25(12):2395-401. <h3>Disclosure of Interest</h3> None declared
Correlation Between Cancers of the Cervix and Penis: Reply
Authors: Joseph F. Fraumeni, Jr.
Journal: JNCI Journal of the National Cancer Institute (1983)

Journal Article Correlation Between Cancers of the Cervix and Penis: Reply Get access Joseph F. Fraumeni, Jr. Joseph F. Fraumeni, Jr. Division of Cancer Cause and Prevention National Cancer Institute National Institutes of Health Public Health Service U.S. Department of Health and Human Services Bethesda, Maryland 20205 Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 71, Issue 3, September 1983, Pages 427–428, https://doi.org/10.1093/jnci/71.3.427-a Published: 01 September 1983