tbuckley/cabot-search huggingface dataset:
OP0265 A 24-Hour Proteinuria Cutoff Level of 0.7 Gram After 12 Months of Treatment Best Predicts Long-Term Renal Outcome in Lupus Nephritis: Data from the Maintain Nephritis Trial:
Authors: F. Tamirou, B.R. Lauwerys, M. Dall'Era, M. Mackay, B. Rovin, R. Cervera, F.A. Houssiau
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Data from the Euro-Lupus Nephritis Trial (ELNT) indicated that a proteinuria &lt;0.8g/d at 12 months after randomization is the single best predictor of good long-term renal outcome (1). <h3>Objectives</h3> The current analysis is aimed at testing the validity of this proteinuria cutoff level in another lupus nephritis (LN) patient population, taking advantage of the long-term MAINTAIN Nephritis Trial data set (2). <h3>Methods</h3> The MAINTAIN Nephritis Trial is an European-based randomized trial performed in 105 LN patients comparing azathioprine and mycophenolate mofetil as maintenance therapy, after induction with low-dose Euro-Lupus intravenous cyclophosphamide. Renal relapse rate was similar in the two groups and early proteinuria decrease within the first year predicted long-term renal function (2). For this analysis, aimed at defining the best cutoff proteinuria level, we selected patients with at least 7 years of follow-up for whom proteinuria measurement was available at month 3 (n=81), 6 (n=80) or 12 (n=80). Good and poor long-term renal outcome was defined as serum creatinine ≤1mg/dl and &gt;1mg/dl at last follow-up, respectively. Sensitivity and specificity were calculated for each proteinuria level, as predictor of good long-term renal outcome. Receiver Operating Characteristic (ROC) curves (area under the curve; AUC) were drawn and the best proteinuria cutoff value at each time point was determined based on Youden index. 95% confidence intervals (CI) were calculated. <h3>Results</h3> The best proteinuria cutoff value (<i>i. e.</i> the point on the ROC curve furthest to the equality line, defined by Youden index) at month 3, 6 and 12 is indicated in the Table below, as well as their sensitivity and specificity (±95%CI) as predictor of good renal outcome. The AUCs (between 0.73 and 0.78) confirmed accuracy of the test. A proteinuria cutoff of 0.7g/day optimized sensitivity and specificity at month 12. Quite interestingly, this value is very close to the 0.8g/day at month 12 computed from the ELNT data (1). <h3>Conclusions</h3> A 24-hour proteinuria cutoff level of 0.7 gram after 12 months of treatment best predicts long-term renal outcome in LN, confirming the ELNT data. We suggest that this target value be used as primary outcome in LN induction trials. <h3>References</h3> Dell9Ara M et al. Predictors of Long-Term Renal Outcome in Lupus Nephritis Trials: Lessons Learned from the Euro-Lupus Nephritis Cohort. Arthritis Rheumatol 2015; in press. Tamirou F et al. Long-term follow-up of the MAINTAIN Nephritis Trial, comparing azathioprine and mycophenolate mofetil as maintenance therapy of lupus nephritis. Ann Rheum Dis 2015; in press. <h3>Disclosure of Interest</h3> None declared
AB0629 Neutrophil/Lymphocyte Ratio and Mean Platelet Volume in Behçet's Disease: Table 1.
Authors: A. Balkarli, A. Kucuk, H. Babur, F. Erbasan
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Behçet9s disease does not have specific laboratory findings or a pathological physical examination sign. There are many suggested markers for inflammation in BD. Studies on this issue have shown that IL-6, IL-1β, TNF-α, thrombomodulin, E-selectin, VEGF, total homocysteine, α-1 antitrypsin, α-2 macroglobulin are the considered markers associated with BD. Recently, reports have concluded that the neutrophil/lymphocyte ratio (NLR) and mean platelet volume (MPV) are indicators for systemic inflammation. To the best of our knowledge, there is no research in the literature that evaluates both MPV and N/L ratio for patients with Behçet9s disease. <h3>Objectives</h3> With this retrospective study, we researched the effects of MPV and NLR on the activity of Behçet9s disease and susceptibility to thrombosis. <h3>Methods</h3> 186 patients with Behçet9s disease, who met the inclusion criteria, were separated into two groups as following: 120 patients with active Behçet9s disease (Group I) and 66 patients with inactive Behçet9s disease (Group II). 79 healthy subjects as controls were included in the study. <h3>Results</h3> MPV was similar between all three groups. CRP was statistically higher in the active BD group when compared to the inactive BD group and the control group. CRP of the inactive BD and the healthy control group were similar. In addition, ESR was found higher than the control group in both active and inactive BD groups, whereas ESR of the active BD group was higher than the inactive BD group. N/L ratio was found statistically higher in the active BD group when compared to inactive BD and healthy control groups, while the N/L ratio of inactive BD and healthy control groups were found similar to each other. While MPV, CRP, and NLR didn9t statistically differ between active BD subgroups with and without thrombosis, ESR was statistically and significantly higher in the active BD group with thrombosis when compared to the active BD group without thrombosis. <h3>Conclusions</h3> The data obtained from the present study showed that the patients with BD are exposed to chronic inflammation. And the N/L ratio may be a simple, inexpensive, and convenient diagnostic marker of active BD. <h3>Disclosure of Interest</h3> None declared
FRI0316 Cost-Effectiveness Analysis of HLA-B5801 Genotyping in the Treatment of Gout Patients with Chronic Renal Insufficiency in Korea
Authors: D.-J. Park, J.-W. Lee, K.-E. Lee, S.-H. Park, S.-S. Lee
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Allopurinol-induced severe cutaneous adverse reactions (SCARs) are relatively rare, but cause high rates of morbidity and mortality. Studies have shown that the HLA-B5801 allele and renal impairment are strongly associated with SCARs. Recent American College of Rheumatology guideline recommends that, prior to treatment with allopurinol, the HLA–B5801 genotype of gout patients at high risk for SCARs, including Korean patients with chronic renal insufficiency, should be determined. However, whether such genotyping is cost-effective is unknown. <h3>Objectives</h3> In this study, we evaluated the cost-effectiveness of HLA-B5801 genotyping for treatment of gout in patients with chronic renal insufficiency in Korea. <h3>Methods</h3> A decision analytic model over a time period of 12 months was employed to compare the cost and outcomes of treatment informed by HLA-B5801 genotyping with that of a conventional treatment strategy using a hypothetical cohort of gout patients with chronic renal insufficiency. Direct medical costs were obtained from real SCAR patients from two tertiary hospitals. Outcomes were measured as a total expected cost and an incremental cost-effectiveness ratio. <h3>Results</h3> In the base model, the total expected cost and probability of continuation of gout treatment without SCARs with the conventional and HLA-B5801 screening strategies were US $1,193 and US $1,055, and 97.8% and 100%, respectively. The result was robust according to sensitivity analyses. <h3>Conclusions</h3> Our model suggests that gout treatment informed by HLA-B5801 genotyping is less costly and more effective than treatment without genotyping, and HLA-B5801 genotyping could considerably reduce the occurrence of allopurinol-induced SCARs and related deaths. <h3>Disclosure of Interest</h3> None declared
Harmonisation of national influenza surveillance morbidity data from EISS: a simple index
Authors: H Uphoff, J  M Cohen, D M Fleming, A Noone
Journal: Eurosurveillance (2003)

The European Influenza Surveillance Scheme is a collaboration with 18 member countries (2001/02) which monitors the activity and impact of influenza by collecting morbidity and virological data in primary care facilities throughout the winter season each year. Despite being in principle similar in the surveillance concept, the indicators used and observations made are very different. Different healthcare systems and organisational needs (eg a certificate of illness for the employer) influence the consultation behaviour. Furthermore, and partly as a result of differences in the healthcare systems, the definitions used for the numerator and denominator when calculating morbidity rates are different. Thus comparative interpretation of participating countries' morbidity data is extremely difficult. Reporting 'harmonisation' by using equivalent numerators and denominators is one option but is difficult to achieve in the short term. Moreover, several additional issues would need to be considered, for example, the need for continuity of surveillance and whether such steps would indeed result in direct comparability etc. A simple index was tested, through which the impact of influenza morbidity in any one year is compared with what is considered a 'usual' epidemic in that country. The index in principle describes numerically the extent to which the influenza-attributable excess morbidity in the current epidemic in each country is within, exceeds, or is less than a range typical for an influenza epidemic. In this pilot study, the usefulness of such an index is explored with the example of eight countries for the seasons 1999/2000 and 2000/01. A fine tuning of the methods has not yet been performed.
Evaluation of antianginal drugs.
Authors: G Nyberg
Journal: Circulation (1982)

To the Editor:The concern regarding modulation of cardiovascular responses to calcium-entry blocking drugs by ,3-adrenergic blockers was introduced by Drs.Oesterle and Schroeder in their editorial, "Calcium-entry Blockade, Beta-adrenergic Blockade and the Reflex Control of Circula- tion" (Circulation 65: 669, 1982).It has been demonstrated amply that all calcium-entry blocking drugs, by definition, directly slow sinus rate, slow conduction from atria to ventricles, depress myocardial contractile force and relax vascular smooth muscle, either when studied in vitro or in intact circulations with total autonomic blockade. [1][3] Experimental observations in conscious, instrumented animals with intact autonomic nervous systems, however, indicate that calcium-entry blocking drugs often produce cardiovascular effects that are qualitatively different from these 'direct" actions.For example, intravenous verapamil produces tachycardia in conscious dogs.4. 5 Positive chrono- tropic responses also result from the administration of nifedipine and diltiazem.5,6 Oesterle and Schroeder indicated incorrectly that a study by Urquhart et al.7, a poster presentation at the AHA annual meeting in 1981, used doses of diltiazem, nifedipine and verapamil that produced equivalent degrees of peripheral vasodilation: the study actually used doses which were equihypotensive.Oesterle and Schroeder also fail to point out that Urquhart et al.7 obtained their results in dogs with partial coronary artery occlusion and did not report the doses of the three drugs in the abstract.The abstract shows, in direct contrast to a number of published studies, that verapamil produced bradycardia and that diltia- zem produced a marked tachycardia, while nifedipine had little effect on heart rate.At the same time, we8 showed that equihypotensive i.v.doses of diltiazem, nifedipine and verapamil consistently produce ta- chycardia in conscious healthy dogs.Heart rate was increased least by diltiazem and considerably more by verapamil and nifedipine.These results are consistent with recenty reported clinical studies.9It thus appears that the direct cardiac depressant action of the calcium entry blockers are significantly modulated by the autonomic nervous system and are further affected by experimental myocardial ischemia.
Diuretic renogram in a patient with a urinary diversion: avoiding a false-positive diagnosis of obstruction with an indwelling catheter.
Authors: V La Fata, A Ramachandran, J Galt, T E Keane, R Halkar
Journal: Clinical Nuclear Medicine (2001)

LA FATA, VITO M.D.,*; RAMACHANDRAN, ANIL M.D.,*; GALT, JAMES Ph.D.,*; KEANE, THOMAS E. M.D.†; HALKAR, RAGHUVEER M.D.* Author Information
A Study of a Urine Extract Test for Cancer&lt;xref ref-type="fn" rid="fn1"&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/xref&gt;
Authors: J L FARRINGER
Journal: JNCI Journal of the National Cancer Institute (1952)

A Study of a Urine Extract Test for Cancer John L. Farringer, Jr., M. D. John L. Farringer, Jr., M. D. The Institute of Pathology, University of Tennessee, and The John Gaston Hospital, Memphis, Tenn. Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 12, Issue 6, June 1952, Pages 1225–1236, https://doi.org/10.1093/jnci/12.6.1225 Published: 01 June 1952 Article history Received: 04 February 1952 Published: 01 June 1952
Preliminary safety results of a phase II trial comparing two schedules of lapatinib (GW572016) as first line therapy for advanced or metastatic non-small cell lung cancer
Authors: H. J. Ross, G. R. Blumenschein, A. Dowlati, J. Aisner, J. R. Rigas, M. Stanislaus, L. H. Leopold
Journal: Journal of Clinical Oncology (2005)

7099 Background: Lapatinib (GW572016) is an oral reversible, dual tyrosine kinase inhibitor of ErbB1 and ErbB2. Sixty three pts (as of July 6, 2004) with advanced or metastatic NSCLC, including a subset of 15 pts with BAC, adenocarcinoma with BAC features, or no smoking history, were enrolled in a randomized, phase II study of lapatinib given either 1500 mg once a day (QD; 33 pts) or 500mg twice a day (BID; 30 pts) until disease progression. Methods: Safety and efficacy were assessed every 4 and 8 wks respectively. Results: As of Nov 8, 2004, no Grade 4 adverse events (AE) were reported in the QD group. In the BID group, 4 pts (13%) had Grade 4 AE including single incidences of dyspnoea, pulmonary embolism, ARDS, hypoxia, respiratory distress and cerebrovascular accident. All were assessed by the investigator as unrelated to lapatinib. Grade 3 AE in the QD and BID groups respectively included diarrhea (12%, 0%), nausea (9%, 3%), vomiting (9%, 3%), fatigue (3%, 3%), dyspnoea (3%, 7%), anorexia (3%, 0%) and back pain (0%, 7%). Only 1 pt (BID) experienced a Grade 3 (≥ 20%) decrease in LVEF which resolved upon discontinuation. The most common AE of Grade 1/2 for QD and BID dosing respectively were: diarrhea (27%, 26%), nausea (15%, 3%), vomiting (6%, 3%), rash (24%, 26%), fatigue (12%, 17%), dyspnoea (3%, 10%), anorexia (12%, 10%) and back pain (6%, 10%). 18 (QD) and 21 (BID) pts have withdrawn from the study. Only 1 (3%; QD) and 3 (10%; BID) withdrew due to an AE. 10 pts have died (4 QD, 6 BID). One death (BID) was due to a Grade 5 AE (pulmonary embolism) assessed as possibly related to study drug. All other deaths were either non-drug related or due to progression of lung cancer. Conclusion: Both doses and schedules of lapatinib were well tolerated. Safety and efficacy evaluations are ongoing. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration GlaxoSmithKline GlaxoSmithKline GlaxoSmithKline GlaxoSmithKline GlaxoSmithKline
Midtracheal Stricture
Authors: M E Doerfler, D P Naidich
Journal: New England Journal of Medicine (1996)

Figure 1. A 47-year-old woman presented with dyspnea on exertion and a history of having awoken at night with a sensation of choking twice in the previous week. She had been discharged from the hospital three weeks earlier, after an episode of severe adult respiratory distress syndrome following blunt chest trauma. She had required mechanical ventilation for nearly three months with an endotracheal tube and tracheostomy during that hospitalization. The tracheostomy was performed after 10 days of endotracheal intubation.On examination the patient had stridorous breath sounds; flexible laryngoscopy showed a normal pharynx. A flow-volume loop demonstrated marked limitation of . . .
AB0266 Association of Health Assessment Questionnaire with Range of Motion of Large Joints in Patients with Rheumatoid Arthritis
Authors: H. Motomura, I. Matsushita, A. Kaneko, K. Kanbe, K. Arai, Y. Kuga, A. Abe, T. Matsumoto, N. Nakagawa, K. Nishida, T. Kimura
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Health Assessment Questionnaire (HAQ) is often used to assess functional disabilities, and is closely associated with disease activity and radiographic joint damage in patients with rheumatoid arthritis (RA)<sup>1</sup>. Joint range of motion (ROM) is also affected by inflammation and joint destruction in RA. However, the relationship between HAQ and large joint ROM still remains. <h3>Objectives</h3> To examine the association of HAQ with clinical parameters including ROM of large joints in patients with RA. <h3>Methods</h3> We have examined 62 patients with RA that were resistant to disease-modifying anti-rheumatic drugs (DMARDs). The mean age was 58.7 years and mean disease duration was 10.2 years. We measured ROM of cervical spine and large joints (bilateral shoulder, elbow, hip, knee and ankle joints), CRP, MMP-3 DAS28-ESR, SDAI, CDAI, degree of large joint damage (ARASHI status score<sup>2</sup> and HAQ. Correlations of parameters were estimated by Spearman9s rank correlation coefficient. Differences were considered significant if two-sided P-values were &lt;0.05. <h3>Results</h3> HAQ was well correlated with DAS28-ESR, SDAI and CDAI as expected. HAQ was not correlated with total ARASHI status score. However, HAQ was significantly correlated with shoulder flexion (r=0.38, P&lt;0.01), shoulder abduction (r=0.37, P&lt;0.01), elbow flexion (r=0.28, P&lt;0.05) and ankle plantar flexion (r=0.27, P&lt;0.05). <h3>Conclusions</h3> We showed that HAQ was associated with ROM of large joint in patients with RA. Specifically, shoulder, elbow and ankle plantar flexion were important determinants of HAQ and, therefore, should be monitored to guide treatment. <h3>References</h3> Drossaers-Bal KW, et al. Arthritis Rheum. 1999; 42; 1854-1860. Kaneko A, Matsushita I, et al. Mod Rheumatol. 2013; 23; 1053-1062. <h3>Disclosure of Interest</h3> None declared
PWE-317 Too old for the enhanced recovery programme; do age related differences in enhanced recovery compliance affect surgical outcomes after colorectal resections?
Authors: F Rickard, S Hallam, L Wood, J Shabbir
Journal: Gut (2015)

<h3>Introduction</h3> Enhanced recovery after surgery (ERAS) is associated with reduced length of stay and improved outcomes in colorectal surgery.<sup>1,2</sup>It is unclear if ERAS can be safely implemented in elderly patients undergoing complex colorectal resections. The aim of this study was to evaluate the feasibility and compliance of ERAS in patients undergoing colorectal surgery. <h3>Method</h3> A prospective database of consecutive series of patients undergoing colorectal resections with ERAS between August 2012 to December 2014 was evaluated. Patients were divided into two groups: ≤ 70 years and ≥ 70 years. Endpoints studied were length of stay (LOS), readmissions, morbidity, mortality, and compliance with ERAS. <h3>Results</h3> Of a total of 455 patients , 295 were ≤ 70 years (median age 60) and 160 patients were ≥ 70 years (median age 77). There was no significant difference in compliance with ERAS in two groups, 78.6% V 80%. There were no significant differences in LOS (median 7 days versus 6 days (p 0.53), re-admission rates 8.75% vs. 5.93% (p = 0.36), re-operation rate 6.88% vs. 4.44% (p = 0.37) and mortality rates 0% vs. 1.48% (p = 0.73) between two groups. <h3>Conclusion</h3> This data suggests that ERAS can be successfully implemented in older patients. There is no statistically significant difference in outcomes i.e mortality, length of stay (LOS), re-admission and re-operation rates between two groups. <h3>Disclosure of interest</h3> None Declared. <h3>References</h3> Eskicioglu C1, Forbes SS, Aarts MA, Okrainec A, McLeod RS. ERAS programs for patients having colorectal surgery: a metanalysis of randomised trials. <i>J Gastrointest Surg</i>. 200;13(12):231–2329 ERAS Compliance Group. The Impact of Enhanced Recovery Protocol Compliance on Elective Colorectal Cancer Resection: Results From an International Registry. <i>Ann Surg</i>. 2015 Jan 23
Phase I study of the CDK inhibitor dinaciclib (SCH 727965) in patients (pts) with relapsed/refractory CLL.
Authors: J. M. Flynn, J. A. Jones, L. Andritsos, K. A. Blum, A. J. Johnson, J. Hessler, E. Wiley, N. A. Heerema, J. Poon, K. A. Small, Y. Jou, D. Zhang, P. Statkevich, M. R. Grever, R. Bannerji, J. C. Byrd
Journal: Journal of Clinical Oncology (2011)

6623 Background: Dinaciclib is a potent and selective inhibitor of CDKs 1, 2, 5, and 9, with anti-CLL activity in ex vivo assays. Methods: Phase 1 trial to determine the recommended phase 2 dose (RPTD) of dinaciclib in CLL pts as a 2-hour IV infusion on days 1, 8 and 15 of a 28-day cycle. The 5 mg/m2 starting dose is based on significant CLL cell kill in preclinical assays. Results: 33 pts treated in 5 dose cohorts (5, 7, 10, 14 and 17 mg/m2). RPTD is 14 mg/m2. Median age is 62 (43-79) yrs, 42% ≥65 yrs, 67% Rai stage 3 or 4, 64% bulky disease, and 45% del 17p. Median # of prior therapies is 4 (1-12). 91% received fludarabine. 36% received flavopiridol. Median # of treatment cycles given is 5 (1-16). 9 pts received 6-8 cycles. 5 pts received 10-16 cycles. 15 partial responses (PR) by 1996 NCI-WG CLL criteria, with 4 pts proceeding to allogeneic SCT. Responders included 7 pts >65 yrs, 9 bulky disease, 14 prior fludarabine, and 5 prior flavopiridol. PR in 62.5% of pts (10/16) at the RPTD. PR in 47% of del 17 pts (7/15). Pts followed to disease progression, death, or dropout. Of 33 treated pts, 24 censored (follow-up 3.1 to 73.0 weeks) without disease progression or death. 9 pts progressed or died with a time to event of 1.1 to 16.1 weeks. Median PFS not yet reached. Rapid decrease in MCL-1, in 25 of 27 pts assayed by Western blot, confirms PD activity. PK analysis shows dinaciclib is rapidly eliminated with t1/2 of 2.1 to 3.8 hrs. Exposure is dose related with no drug accumulation in plasma. Common treatment related adverse events include neutropenia, anemia, thrombocytopenia, hyperglycemia, hypocalcemia, increased AST, diarrhea, and leukopenia. DLTs of bacterial pneumonia and tumor lysis syndrome (TLS) requiring temporary dialysis were observed at 17 mg/m2. A 2nd case of TLS requiring dialysis occurred in the RPTD 10 pt expansion cohort. 5 cases of TLS, 2 requiring dialysis, have occurred. Data will be presented on an ongoing cohort of 6 pts to determine if a step-up from 10 mg/m2 Day 1 to 14 mg/m2 Day 8 reduces the occurrence of TLS. Conclusions: Dinaciclib has an acceptable safety profile and demonstrates promising clinical activity in heavily pre-treated CLL patients with bulky disease or del 17p. Further studies, in CLL and related B-cell malignancies, are warranted.
Case 68-1962
Authors: Leslie J. DeGroot, Wallace A. Jones
Journal: New England Journal of Medicine (1962)

Presentation of CaseA sixty-five-year-old Chinese restaurant owner entered the hospital because of abdominal pain.Four months previously he began to experience diffuse, intermittent periumbilical pain that was unrelated to food or activity. The pain subsequently involved both flanks anteriorly, the lower lumbar region, the left upper quadrant of the abdomen and the left costovertebral angle. He became progressively fatigued and anorectic and lost 20 pounds in weight. He noticed a recent increase in a lifelong tendency to constipation, but no nausea, vomiting, melena or diarrhea occurred. Three months before admission a Graham test was reported as negative. Two months . . .