tbuckley/cabot-search huggingface dataset:
PWE-139 Outcome of liver resection for non-colorectal and non-neuroendocrine liver metastases (NCRNNE)
Authors: R Dave, A Cockbain, E Hidalgo, R Prasad, P Lodge, G Toogood
Journal: Gut (2012)

<h3>Introduction</h3> The liver is a frequent site for tumour metastases, and surgery for colorectal liver metastases (CRLM) is well established, with survival rates accepted to be 50% in 5 years. However, surgery for NCRNNE has been approached with caution. We aimed to report the outcomes of surgery for NCRNNE in our unit, to determine the patterns of disease presentation, recurrence and survival. <h3>Methods</h3> We identified 78 patients who had liver resection from NCRCNNE primary tumours from 28 December 1992 to 2 August 2011 using a prospectively maintained database; Breast (N=19), Malignant Melanoma (N=4), Renal (N=10), Anal Squamous Cell Carcinoma (N=5), Lung (N=3), Sarcoma (N=15), GIST (N=13), Squamous-other (cervix, bile duct, oropharynx) (N=6) and Gastric Adenocarcinoma (N=3). The electronic records of all these patients were then retrospectively reviewed. We obtained data on patient demographics, presentation of disease, pathological data, recurrence and survival. Data were analysed using ANOVA and Kaplan–Meier tests. <h3>Results</h3> The age at diagnosis varied with tumour type; the youngest was sarcoma (46 years) and the oldest gastric (67 years). The progression to detectable liver disease was quickest with Anal Squamous Cell Carcinoma metastases (172 days), which also had a 60% recurrence rate within a mean of 192 days. Malignant Melanomas had a 100% recurrence rate, which occurred at a mean of 321 days. Breast metastases were the least likely to recur (33%) and had a long disease-free period between recurrences (468 days). The largest metastases were seen in sarcomas (67 cm) and the smallest in melanomas (28 cm). There was no significant correlation between size or number of tumours and survival. The 1- 3- and 5-year survival from the time of NCRCNNE metastectomy was 88%, 56% and 47% respectively, compared with 86%, 58% and 46% after CRLM metastectomy. Malignant Melanomas and Anal Squamous Cell Carcinoma had the poorest outcome; 100% mortality at 5 years. <h3>Conclusion</h3> Liver Resection is an effective treatment for metastases from NCRCNNE tumours in highly selective patients. In the right patient, surgery offers similar survival rates to resection of CRC metastases, but some tumour types do better than others, and a decision to proceed with resection should take into account the histological diagnosis, and an understanding of the behaviour of that tumour type. <h3>Competing interests</h3> None declared.
SAT0205 Blys up-regulation and salivary clonal B-cell expansion characterize sjögren’s syndrome-related lymphoproliferative disorders and correlate with the new ESSDAI score
Authors: L. Quartuccio, S. Salvin, M. Fabris, M. Maset, L. Corazza, E. Pontarini, M. Isola, S. De Vita
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Primary Sjögren's syndrome (SS) is characterized by an increased risk of lymphoma in patients with prelymphomatous manifestations (i.e., myoepithelial sialadenitis (MESA) or mixed cryoglobulinemia). Increased levels of B-lymphocyte stimulator (BLyS) characterize different autoimmune diseases, and in particular SS. <h3>Objectives</h3> Serum BLyS levels in SS-related B-cell lymphoproliferative disorders were studied, by integrating the results with the disease activity score and molecular analyses of B-cell expansion on the salivary glands. <h3>Methods</h3> 76 primary SS patients were studied. SS patients were distributed into four groups: a) SS without any lymphoproliferative disorder (n=34); b) SS with cryoglobulinemic vasculitis (CV) without overt lymphoma (n=14); c) SS with MESA (n=12); d) SS with overt lymphoma (n=16). Serum BLyS and molecular analyses of B cells in the salivary gland tissues, when available, were performed. Patients with SS and persistent parotid swelling underwent parotid biopsy. <h3>Results</h3> BLyS differed between SS subgroups, higher levels being documented in patients with B-cell lymphoproliferative disorders (as a whole group) versus SS without (1.85 (0.45-4.12) ng/ml vs 1.12 (0.56-1.98) ng/ml; p&lt;0.0001), and a significant difference was also observed between SS with frank lymphoma and SS without any lymphoproliferative disorder (p=0.0002). BLyS levels significantly correlated with the EULAR SS disease activity index (ESSDAI) (r=0.62, p&lt;0.0001, Spearman's test). Higher ESSDAI scores were observed in SS with overt lymphoma if compared with SS without a lymphoproliferative disorder [22.5 (16-35) vs 4.0 (0-16), p&lt;0.0001], or if compared with SS with CV [22.5 (16-35) vs 15.5 (7-25), p=0.005], who showed an intermediate result. Clonal B-cell expansion in the salivary glands rather than polyclonal B-cell expansion was associated with higher BLyS levels [1.98 (0.45-4.12) vs 1.15 (0.56-3.25) ng/ml; p=0.013)]. ESSDAI score was also significantly associated with B-cell clonal expansion in the salivary glands [21.0 (0-35) vs 6.0 (0-37), p=0.0003] and this association was confirmed even after excluding SS patients with lymphoma [17.5 (0-35) vs 6.0 (0-37), p=0.02]. <h3>Conclusions</h3> Higher BLyS levels and clonal B-cell expansion characterizes SS with B-cell lymphoproliferative disorders, even at pre-lymphomatous stages. This subgroup of SS patients showed the highest ESSDAI scores. This is the biologic rationale for targeting both the clonal B-cell expansion and the BLyS overproduction in SS patients with a B-cell lymphoproliferative disorder and high disease activity. <h3>Disclosure of Interest</h3> None Declared
Off-peak Detector Mimicking Ischemia on Myocardial Scan
Authors: STEVEN J. NITKE
Journal: Clinical Nuclear Medicine (1999)

TI-201 SPECT myocardial images were performed at rest on a Picker Prism 3000 triple head gamma camera followed by Tc-99m sestamibi stress SPECT myocardial imaging. Stress images showed significant depression of activity in all portions of the myocardium except the lateral wall, whereas rest images were normal, suggesting extensive ischemia. Investigation revealed a spontaneous peak shift in one camera head causing the apparent stress myocardial abnormality. Correction of the camera problem and repeated scanning revealed normal stress myocardial activity, emphasizing the need for fastidious quality control and raw data cine loop image review.
Familial Dependence of the Resting Metabolic Rate
Authors: Clifton Bogardus, Stephen Lillioja, Eric Ravussin, William Abbott, Joanna K. Zawadzki, Andrew Young, William C. Knowler, Ronald Jacobowitz, Patricia P. Moll
Journal: New England Journal of Medicine (1986)

Human obesity is known to be a familial disorder. We studied 130 nondiabetic adult southwestern American Indians (74 men and 56 women) from 54 families to determine whether the resting metabolic rate, as measured by indirect calorimetry, is a familial trait that is independent of individual differences in fat-free mass (estimated mass of metabolically active tissue), age, and sex. We found that most of the variance in the resting metabolic rate (83 percent, P less than 0.0001) was accounted for by three covariates--fat-free mass, age, and sex--and that fat-free mass was the most important determinant. Family membership accounted for an additional 11 percent (P less than 0.0001) of the variance in the resting metabolic rate. Thus, resting metabolic rate is a familial trait in this population, and it is independent of differences in fat-free mass, age, and sex. We also found that persons from families with lower resting metabolic rates were no more obese than persons from families with higher metabolic rates. This finding may be partly explained by the close correlation between fat-free mass and percentage of body fat (r = 0.81, P less than 0.0001), which indicates that the resting metabolic rate, as adjusted for fat-free mass, is already partly adjusted for obesity. Only prospective studies will elucidate whether the familial dependence of the resting metabolic rate is a contributing mechanism to the familial predisposition to obesity.
AB0668 Joint hypermobility, growing pains and obesity are mutually exclusive as causes of musculoskeletal pain in schoolchildren
Authors: F. Sperotto, M. Balzarin, M. Parolin, N. Monteforte, F. Vittadello, F. Zulian
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Chronic Musculoskeletal pain (MSP) is common in children and can be due to several non-inflammatory conditions such as the Benign Joint Hypermobility Syndrome (BJHS) and Growing Pains (GP). Since these conditions are often misdiagnosed, affected children frequently undergo several and sometimes invasive procedures which may delay the diagnosis. <h3>Objectives</h3> Aim of the study was to evaluate prevalence and clinical features of chronic non-inflammatory MSP in schoolchildren and to analyze causes and possible risk factors associated with this condition. <h3>Methods</h3> We conducted a cross sectional study in a cohort of healthy schoolchildren, aged 8-13 years, by collecting information and performing a physical examination. The clinical history was focused on presence and sites of MSP, defined as continuous or recurrent pain lasting more than 3 months, during the previous 6 months, with an intensity so high to interfere with the regular activities of daily living. We also investigated type of sport activities, presence of GP, defined as cramping bilateral limb pain typically occurring in the evening or at night and associated with a normal physical examination and family history for MSP. Clinical examination included body mass index, pubertal stage and musculoskeletal exam focused on the presence of hypermobility according with the Beighton Criteria (Beighton score ≥4/9). <h3>Results</h3> 289 schoolchildren, 143 females and 146 males, entered the study. Chronic MSP occurred in 30.4% of subjects, BJHS occurred in 13.1%. GJH was more frequent in symptomatic subjects than in asymptomatic ones (p= 0.054). Symptomatic subjects were more frequently pre-pubertal than pubertal (p=0.006). In general, GP, BJHS and obesity (OB) were mutually exclusive as causes of MSP as, among 88 symptomatic subjects, 52.3% had GP, 40.9% presented BJHS, 4.5% were OB and only two (2.3%) presented both BJHS and OB. After puberty, GP persisted in 66.7%, BJHS in 26.7% and in association with OB in 6.7%. <h3>Conclusions</h3> Approximately one third of schoolchildren suffer from MSP. These subjects should be carefully evaluated for the presence of GP, GJH and OB, which are mutually exclusive as causes of MSP. Pubertal stage plays an important role in the physiopathology of this condition and further studies are needed to explore this relationship during time. <h3>References</h3> Kirk JA, Ansell BM, Bywaters GL. The hypermobility syndrome: musckuloskeletal complaits associated with generalized joint hypermobility. Ann Rheum Dis 1967;26:419-425. Beighton P, Soloman L, Soskolne CL. Articular mobility in an African population. Ann Rheum Dis 1973;32:413-8. Peterson H Growing pains. Pediatr Clin North Am. 1986; 33: 1365-72. <h3>Disclosure of Interest</h3> None Declared
Idiopathic Left Ventricular Hypertrophy
Authors: Joel Morganroth, Walter L. Henry, Barry J. Maron, Chester E. Clark, Stephen E. Epstein
Journal: New England Journal of Medicine (1974)

Idiopathic left ventricular hypertrophy is diagnosed when hypertrophy without dilatation appears to be present without apparent cause. Since asymmetric septal hypertrophy occurs commonly, and since it may present nonspecifically as left ventricular hypertrophy, we hypothesized that many patients with idiopathic left ventricular hypertrophy might in fact have asymmetric septal hypertrophy. We therefore evaluated echocardiographically 39 patients with idiopathic left ventricular hypertrophy diagnosed by physical findings or electrocardiographic criteria or both. All family members of patients with known asymmetric septal hypertrophy were excluded. Of the 39, 33 had asymmetric septal hypertrophy, six were normal, and none had evidence of idiopathic left ventricular hypertrophy. All six of those with normal echocardiograms had left ventricular hypertrophy solely by electrocardiographic criteria and were without cardiac symptoms, suggesting a false-positive diagnosis. If idiopathic left ventricular hypertrophy does exist as a separate entity, it must be uncommon. Most subjects believed to have this entity either have falsely positive criteria for that diagnosis or have asymmetric septal hypertrophy. (N Engl J Med 290:1047–1050, 1974)
Peginterferon Alfa-2a in Patients with Chronic Hepatitis C
Authors: Stefan Zeuzem, S. Victor Feinman, Jens Rasenack, E. Jenny Heathcote, Ming-Yang Lai, Edward Gane, John O'Grady, Jürg Reichen, Moises Diago, Amy Lin, Joseph Hoffman, Michael J. Brunda
Journal: New England Journal of Medicine (2000)

Covalent attachment of a 40-kd branched-chain polyethylene glycol moiety to interferon alfa-2a results in a compound (peginterferon alfa-2a) that has sustained absorption, a slower rate of clearance, and a longer half-life than unmodified interferon alfa-2a. We compared the clinical effects of a regimen of peginterferon alfa-2a with those of a regimen of interferon alfa-2a in the initial treatment of patients with chronic hepatitis C.
Gastric and Colonic Bypass Grafts
Authors: ROZET TATLIDIL, PETER CONTI
Journal: Clinical Nuclear Medicine (2001)

From the PET Imaging Science Center, Department of Radiology, University of Southern California, Los Angeles, California Received for publication October 1, 2000. Accepted February 28, 2001. Correspondence: Rozet Tatlidil, PET Imaging Science Center, Department of Radiology, University of Southern California, Los Angeles, California.
Messages associated with the Olympics are far from ideals
Authors: M. Daube
Journal: BMJ (2012)

Campbell asks if the London Olympic Games will increase physical activity, in view of Sebastian Coe’s claim that, “London’s vision is to reach young people all around the world . . . with the inspirational power of the Games.”1

The International Olympic Committee, which oversees the games, claims that a “fundamental objective” of Olympic marketing is “to control and limit the commercialisation …
P519 CD133+ HEMATOPOIETIC STEM CELLS REINFUSION IN END-STAGE LIVER DISEASE (ESLD): FINAL RESULTS OF A PHASE I CLINICAL TRIAL
Authors: C. Margini, L. Brodosi, S. Lorenzini, L. Catani, V. Giudice, R. Giordano, A. Casadei, D. Sollazzo, F.G. Foschi, M. Baccarani, M. Bernardi, R. Lemoli, P. Andreone
Journal: Journal of Hepatology (2014)
P7 POLYMORPHISMS IN CYP3A AND ABC SUBFAMILY B MEMBER 1 GENES ARE ASSOCIATED WITH INTERPATIENT VARIABILITY OF TACROLIMUS METABOLISM
Authors: M. Maschmeier, V.R. Cicinnati, S. Iacob, G. Wu, A. Radtke, T. Schomacher, I. Kabar, A. Hüsing, C. Wilms, H. Schmidt, S. Beckebaum
Journal: Journal of Hepatology (2014)
FRI0235 Alterations in peripheral B cell subsets of patients with anca associated vasculitides (AAVS) after immunosuppressive therapy:
Authors: N. Venhoff, N. Effelsberg, F. Haessler, R. Draeger, D. Lebrecht, R.E. Voll, U. Salzer, M. Schlesier, J. Thiel
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> B lymphocytes are involved in the pathogenesis of AAVs by the production of cytokines/chemokines and autoantibodies. Immunosuppressive therapy is effective in AAVs but may lead to a decline in serum immunoglobulin (Ig) concentrations and to changes in the peripheral B cell compartment. <h3>Objectives</h3> To assess the effect of immunosuppressive treatment on the peripheral B cell compartment in AAV patients. <h3>Methods</h3> In 36 AAV patients a retrospective analysis of Ig concentrations and flowcytometry of peripheral B-cells was conducted. A group of 26 healthy donors served as control. <h3>Results</h3> 33 of 36 AAV patients were treated with cyclophosphamide (CYC) prior to analysis (median cumulative dose 14.5g; IQR 5.825-30). At the time of analysis 29 patients were treated with prednisone (median dose 5mg/d; IQR 3.75-8.75), eight received methotrexate (MTX), six azathioprine (AZA), six leflunomide (LEF), four mycophenolate mofetile, and eleven patients had no DMARD. Decreased IgG serum concentrations (&lt;7g/L) were detected in 14 patients. Compared to healthy controls absolute cell counts and relative percentages of lymphocytes and CD19+ B cells were significantly decreased in AAV patients (Table 1). Notably, IgD+CD27+ marginal zone B cells were significantly decreased in AAV patients both in absolute cell counts and relative percentages. IgD+CD27- naive B cells, IgD-CD27+ memory B cells, IgA+ B cells, transitional B cells and plasmablasts were significantly decreased in absolute numbers but not in relative percentages. In the subgroup of AZA treated patients absolute numbers of all B cell subpopulations except for IgA+ B cells and plasmablasts were reduced. In LEF treated patients only IgD+CD27+ B cells were reduced. In MTX-treated patients only IgD+CD27+ B cells were reduced both in absolute numbers and percentage while IgD+CD27- and IgD-CD27+ B cells, IgA+ B cells and plasmablasts were decreased only in absolute numbers. <h3>Conclusions</h3> Immunosuppressive therapy leads to a decrease in absolute numbers of CD19+ B cells and all examined B cell subpopulations, while IgD+ CD27+ MZ-like B cells showed also a relative decrease. <h3>Disclosure of Interest</h3> None Declared
mTOR modulates cellular fat metabolism by regulating stearoyl-CoA desaturase 1 transcription.
Authors: D Luyimbazi, A Akcakanat, L Zhang, Y Zheng, F Meric-Bernstam
Journal: Cancer Research (2009)

Abstract Abstract #6030 mTOR (mammalian target of rapamycin) signaling is a central regulator of cell growth and proliferation. Rapamycin and its analogues have been shown to inhibit breast cancer cell growth in preclinical models, and are actively being pursued in clinical trials. We performed a high-throughput microarray polysome analysis to identify novel genes whose expression was regulated by rapamycin at the level of transcription or translation. In three breast cancer cell lines representing different breast cancer subtypes, we found a significant decline in polysome-associated mRNA for stearoyl-CoA desaturase 1 (SCD1), the rate-limiting enzyme in monounsaturated fatty acid synthesis. Insulin and insulin-like growth factor, both activators of mTOR, increase SCD1 expression. Rapamycin and PI3K inhibitors decrease SCD1 protein, as does mTOR siRNA. Quantitative RT-PCR of total, polysomal and monosomal RNA, northern analysis and stability studies demonstrate that rapamycin regulates SCD1 at the level of transcription. Furthermore, rapamycin inhibits the SCD1 promoter activation by mevinolin, an inhibitor of cholesterol biosynthesis. We demonstrate that mTOR regulates SCD1 expression. This establishes a novel link between cell signaling and cancer cell fat metabolism. In doing so, we also present SCD1 as a potential marker of response to treatment by mTOR inhibitors. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 6030.
Patient safety attitudes in core surgical trainees
Authors: A. Geraghty, A. Renwick, S. Yalamarthi, C. McIlhenny
Journal: International Journal of Surgery (2015)

s / International Journal of Surgery 23 (2015) S15eS134 S105 Conclusion: OT-based teaching is perceived as a valuable use of time during a surgical clerkship. The OT environment is complex and students’ experiences are variable. The student-surgeon relationship is a strong determinant of desirable experiences. 0780: PATIENT SAFETY ATTITUDES IN CORE SURGICAL TRAINEES A. Geraghty , A. Renwick , S. Yalamarthi , C. McIlhenny . 1 Patient Safety Board, RCSEd, UK; Victoria Hospital Kirkcaldy, UK; Royal Alexandra
The BMA annual representative meeting Doctors oppose resiting of juniors' contracts Private hospital given kiss of life From the local medical committee conference There should be an alternative to target net remuneration Core element of general medical services must be defined GMSC will have triennial elections
Authors: L. Beecham
Journal: BMJ (1995)

# The BMA annual representative meeting {#article-title-2}

Unless three issues are resolved urgently the profession's vision for the future of medicine will not be achieved, Dr Sandy Macara told the BMA's annual representative meeting this week. In his opening address the chairman of the BMA council said that, firstly, there must be a planned, phased increase in the consultant establishment in order to implement the Calman report on specialist medical training. Secondly, the increasing bureaucratic pressure on general practitioners must be relieved and an acceptable alleviation of their out of hours commitment secured. Thirdly, more consultant posts must be provided in public health medicine and means found to enable its skills to be deployed across the NHS.

In 1994 Dr Macara had talked about healing in a wounded NHS. That remained true in 1995. There remained a famine of positive policies in the government--a failure to acknowledge reality as it force feeds the public on a diet of indigestible statistics. What could the profession do? Its duty was clear--those who understood health care had to continue to prescribe the remedies. Two myths had to be laid to rest. Firstly, that the profession was against change. “We revel in it, when it is for the better, when it provides new weapons in the conflict against disease, weapons tested and proven in clinical trials.” The second myth was that the profession was against competition. Doctors opposed competition for business in health care but “we relish competing with the forces of death and disease in the battle for life and death.”

During the session the persistence of the consultants' negotiators had averted the threat of the imposition of local pay and delivered a more equitable arrangement for discretionary payments, which involved management but depended on peer review. Unfortunately, the persistence of the general practitioners had not been so rewarded and …
European drug agency criticises Roche for failing to report adverse reactions and patient deaths
Authors: J. Wise
Journal: BMJ (2012)

The Swiss company Roche has been criticised for failing to inform the European Medicines Agency of up to 80 000 possible adverse reactions from its drugs, including 15 161 deaths in the United States.

The reports had been collected through a US patient support programme sponsored by Roche but had not been included in the company’s global safety database as required by the European agency’s pharmacovigilance regulations.

The reports related to a range of drugs provided by Genentech, Roche’s US subsidiary. Genentech produces cancer treatments, such as bevacizumab (which it markets as Avastin) and trastuzumab (Herceptin), and ranibizumab (Lucentis) …
Traitement des complications hémorragiques de la cholangio-pancréatografie rétrograde endoscopique par mise en place d'une prothèse biliaire couverte expansive
Authors: JC Valats, P Bauret, B Hanslik, N Funakoshi, P Blanc
Journal: Endoscopy (2011)

Introduction: La cholangio-pancréatografie rétrograde endoscopique (CPRE), surtout lorsqu'elle est associée à une sphinctérotomie, peut se compliquer d'hémorragies digestives résistantes aux gestes endoscopiques classiques d'hémostase.