tbuckley/cabot-search huggingface dataset:
SAT0089 Non-Steroidal Anti-Inflammatory Drugs Have an Independent Effect on Synovial Vascularity Assessed by Musculoskeletal Ultrasound in Rheumatoid Arthritis
Authors: T. Fujimura, T. Fujimoto, R. Hara, N. Shimmyo, Y. Kobata, A. Kido, Y. Akai, Y. Tanaka
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Musculoskeletal ultrasound (MSUS) is useful in monitoring rheumatoid arthritis (RA) and is emphasized its high sensitivity for detecting synovitis and good correlation with clinical disease activity indices, such as Disease Activity Score (DAS28) and Simplified Disease Activity Index (SDAI). While power Doppler ultrasound (PDUS) is widely accepted for the precise assessment of synovial vascularity and the response to treatment, whether the usage of anti-rheumatic drug itself has an effect on PD signal in synovitis has been elusive. <h3>Objectives</h3> This study was undertaken to determine whether the usage of anti-rheumatic drugs correlate with the assessment of PDUS of synovitis in RA. <h3>Methods</h3> In this retrospective study, total 167 patients with RA were recruited. The patients had a mean age of 58.6 years (range 23-83) and a mean disease duration of 3.7 years (range 0.1-30.3). They were treated as follows: One hundred and five (62.9%) received non-steroidal anti-inflammatory drugs (NSAIDs), Sixty three (37.7%) received low-dose oral prednisolone (PSL), ninety nine (59.3%) received methotrexate (MTX), and thirty six (21.6%) received biologic agents. The clinical assessment parameters including DAS28, SDAI, and modified Health Assessment Questionnaire (mHAQ) as well as the usage of anti-rheumatic drugs were analyzed in this study. US assessment was performed at the bilateral wrists, MCP, and PIP joints. PDUS was graded semi-quantitatively (0 to 3) in each joint, and the sum of these gradings was estimated as PDUS score. The patient with scoring &gt;1 for PDUS was defined as PDUS positive. The association among PDUS score, the clinical assessment parameters, and the usage of anti-rheumatic drugs was explored by multivariate linear regression analysis. In the group of patients in DAS28 remission, multivariate logistic regression analyses were performed with PDUS positive as dependent variables. <h3>Results</h3> The rate of the patients having DAS28 remission was 23.3% (39/167) and that of PDUS positive in the group was 48.7% (19/39). SDAI, mHAQ, and NSAID usage were independently associated with increased scoring of PDUS in multivariate linear regression analysis. The usage of the other anti-rheumatic drugs was not associated with PDUS score. Within the group of patients with DAS28 remission, only the usage of NSAIDs was independently associated with an increase of PDUS positive patient. <h3>Image/graph</h3> <h3>Conclusions</h3> NSAIDs usage may accelerate the PD signal and result in higher scoring despite continuing remission state. Consideration should be given to the NSAIDs effect in assessing disease activity of RA using MSUS, particularly during remission. <h3>Disclosure of Interest</h3> None Declared
Effects of Ouabain on Impaired Left Ventricular Function in Acute Myocardial Infarction
Authors: Shahbudin H. Rahimtoola, M. Ziad Sinno, Ruben Chuquimia, Henry S. Loeb, Kenneth M. Rosen, Rolf M. Gunnar
Journal: New England Journal of Medicine (1972)

Abstract The effects of intravenous ouabain were assessed in 16 patients with a recent acute myocardial infarction. The mean ± S.E.M. of the values, before and one hour after ouabain, were as follows: left ventricular end-diastolic pressure, 24.8 ± 2.1 and 16.1 ± 2.5 mm Hg; left ventricular stroke work, 65.8 ± 9.5 and 80.9 ± 14.3 g-m per beat; peak first derivative of left ventricular pressure, 1798 ± 150, and 2081 ± 150 mm Hg per second; maximum velocity of contractile element shortening, 1.20 ± 0.04 and 1.41 ± 0.06 muscle lengths per second; and pre-ejection period corrected for heart rate, 135.0 ± 5.0, and 128.8 ± 3.6 msec. These changes were significant (p less than 0.05 for paired determinations). There were no significant changes in cardiac index, heart rate and mean arterial pressure. Although ouabain does not change cardiac output in patients with acute myocardial infarction, it causes significant improvement in other indexes of left ventricular performance.
THE PATHOLOGY AND DIAGNOSIS OF OBLIQUE FRACTURES.
Authors: W. J. MAYO
Journal: JAMA (1898)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Abstract 2834: Discovery of a novel class of prostaglandin e2 synthesis inhibitors with anti-tumor activity in colorectal cancer
Authors: Earlphia Sells, Federico Medda, Hui-Hua Chang, Vijay Gokhale, Christopher Hulme, Emmanuelle J. Meuillet
Journal: Cancer Research (2012)

Abstract Prostaglandin E2 (PGE2), a key mediator of inflammation, is the most common prostanoid with various bioactivities and has been associated with many pathologies. Thus, inhibition of PGE2 synthesis and its action has been suggested in the treatment of inflammatory-associated diseases, including cancer. Microsomal Prostaglandin E2 Synthase-1 (mPGES-1) is an enzyme downstream of the cyclooxygenases (COXs) in the PGE2 biosynthesis pathway. mPGES-1, which is one of the three PTGES isoforms, is constitutively expressed in many cancers, including colon cancer. The potential role for this enzyme in tumorigenesis has been reported. Since inhibition of COXs lead to side effects due to the global reduction of other key prostaglandins, targeting downstream m-PGES-1 might be a better therapeutic strategy for cancers. In order to identify novel small molecule inhibitors of mPGES-1, we have screened several libraries in silico and used published scaffolds exhibiting anti-inflammatory properties to initiate our study. As a result, 10 compounds were identified by molecular docking simulations using the reported crystal structure of mPGES-1. Subsequently a total of 32 analog compounds were synthesized or purchased and tested for their ability to inhibit COX-2 in vitro activity as well as for their ability to inhibit PGE2 production in an HCA-7 colorectal cancer cell line. We show that 16 of the 32 compounds reduced PGE2 synthesis by over 80% at 1 µM, with only one of these compounds inhibiting more than 30% of COX-2 activity at 5 µM in vitro. Furthermore, one compound, PGE0056 (EC50= 0.37 ± 0.06 µM), exhibited anti-tumor activity after 10 days at 100mg/kg i.p. in HCA-7 colon cancer xenograft mouse model. Following treatment with PGE0056, PGE2 production was reduced in the blood of scid mice. In summary, our data suggest that these new identified compounds exert anti-tumor activity at least in part through inhibition of the COX2/mPGES-1 enzymes within the PGE2 synthesis pathway. 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 2834. doi:1538-7445.AM2012-2834
Taking Our Medicine — Improving Adherence in the Accountability Era
Authors: Lisa Rosenbaum, William H. Shrank
Journal: New England Journal of Medicine (2013)

Interview with Dr. Lisa Rosenbaum on nonadherence and ways to improve patients' adherence to medication regimens. (18:46)Download Many U.S. patients do not adhere to prescribed medication regimens, ultimately costing the United States $100 billion to $290 billion annually. As physician payment is increasingly tied to patient outcomes, nonadherence poses new challenges and opportunities.
Villar's Nodule — Umbilical Endometriosis
Authors: Chia-Sui Weng, Yuh-Cheng Yang
Journal: New England Journal of Medicine (2011)

A 37-year-old woman presented with a brownish tumor protruding from her umbilicus, noting that it bled cyclically, with her menstrual period. Her medical history was significant for dysmenorrhea and recent resections of endometriomas.
Paradigm Shifts in Heart-Failure Therapy — A Timeline
Authors: Chana A. Sacks, John A. Jarcho, Gregory D. Curfman
Journal: New England Journal of Medicine (2014)

As we enter a new era of treatment for heart failure with reduced ejection fraction, historical perspective is provided in a timeline (at NEJM.org) of 26 randomized, controlled trials in heart-failure treatment that have been published in the Journal since 1986.
18F-FDG PET Increases Visibility of Bone Lesions in Relapsed Multiple Myeloma
Authors: Esther G.M. de Waal, Riemer H.J.A. Slart, Marnix J. Leene, Philip M. Kluin, Edo Vellenga
Journal: Clinical Nuclear Medicine (2014)

Whole-body x-ray (WBX) is used for detecting skeleton abnormalities in patients with multiple myeloma (MM). An alternative might be 18F-FDG PET, which makes use of metabolic changes of malignant cells. The aims of this study were to evaluate whether 18F-FDG PET detects more lesions compared with WBX in patients with relapsing MM and to define its prognostic value. In addition 1-α-D-(5-deoxy-5-[F]-fluoroarabinofuranosyl)-2-nitroimidazole (18F-FAZA) scan and immunohistochemical staining on bone marrow were performed to define whether FDG uptake coincides with angiogenesis-related tumor hypoxia.18F-FDG PET (n = 44) and 18F-FAZA-PET (n = 5) were performed in patients with relapsed MM. Bone marrow biopsies (n = 20) were evaluated for hypoxia inducible factors (HIF) 1α and 2α, vascular endothelial growth factor, glucose transport proteins 1 and 3, and the microvessel density.New lesions were more frequently demonstrated on 18F-FDG PET than on WBX (P = 0.000001). 18F-FDG PET was not predictive for progression-free survival and overall survival. Immunohistochemical staining on bone marrow biopsies demonstrated a significant increase in microvessel density and elevated expression of vascular endothelial growth factor, HIF-2α, and glucose transport protein 3 by the malignant plasma cells. However, HIF-1α expression and 18F-FAZA scan results were negative.Our results demonstrate that 18F-FDG PET is relevant for diagnostic purposes compared with WBX in relapsing MM. The enhanced uptake of 18F-FDG PET is likely related to the activation of the HIF-2α signaling pathway but probably independent of hypoxia-induced signaling in view of the negative findings on both 18F-FAZA-PET and HIF-1α expression.
P222 Short And Long-term Consequences Of Pneumothorax Following Ct-guided Lung Biopsy For Lung Malignancy
Authors: E. Johnson, A. MacKenzie, S. Tsim, K. Blyth
Journal: Thorax (2014)

<h3>Introduction and objectives</h3> Pneumothorax (PTX) is a common complication of Computed Tomography-guided lung biopsy (CTLB). We sought to quantify the short and long-term consequences of post-CTLB PTX in patients with lung malignancy. <h3>Methods</h3> We retrospectively reviewed case records and imaging of all who underwent CTLB in NHS Greater Glasgow and Clyde between August 2011 and August 2012. Patient characteristics (including diagnosis, lung function and blood results), biopsy characteristics, 30-day mortality, PTX management and survival were recorded. Lesion size, depth and maximum PTX depth were directly measured on digitally-stored PACS images. Patients were classified into no PTX, non-significant PTX (nsPTX) and significant PTX (sPTX), which was defined as any PTX which required pleural intervention. Differences in patient and biopsy characteristics between groups were identified by ANOVA and quantified by Tukey’s Multiple Comparisons Test. Kaplan-Meier curves were plotted and differences quantified by log-rank, log-rank for trend and Hazard Ratios. Results are mean (±SD). <h3>Results</h3> 324 CTLB were performed. Malignancy was confirmed in 285/324 (88%). Mean age was 70(±11) years. 84/285 (29%) developed a PTX. 17/285 (6%) developed a sPTX. There were no deaths related to CTGLB (30-day mortality: 100% in all groups). SPTX were larger than nsPTX (34(±6) mm vs. 19(±6) mm, p = 0.0003). Other factors associated with sPTX were lesion size and depth (see Figure 1 (a and b)), larger needle gauge (p &lt; 0.0001), higher FEV1 (p = 0.01) and lower DLco (p = 0.049). Length of stay (LoS) was longer in sPTX (5.8(±5.9) days, p &lt; 0.0001) and nsPTX (1.7(±2.3) days, p &lt; 0.0001) than No PTX (0.7(±0.9) days), but long-term survival was better (see Figure 1 (c and d)). This survival difference was pronounced in a sub-group of patients with a peripheral non-small cell lung cancer (defined as a lesion depth ≤ 0 mm, n = 53). <h3>Conclusions</h3> CTGLB was associated with a low rate of sPTX (6%) and no short-term mortality. sPTX was associated with lung function indicative of emphysema and smaller, deeper lesions. The latter association likely explains the apparent survival advantage found in PTX patients but any long-term survival disadvantage seems unlikely. Post-CTLB PTX may be a positive sign in peripheral NSCLC, possibly inferring resectablilty.
Abstract P2-05-02: Optical Parameters of Breast Cancer before and after Chemotherapy
Authors: H Ogura, D Yamashita, H Nasu, C Teruya, E Ohmae, K Yoshimoto, T Suzuki, Y Ueda, M Oda, Y Yamashita, H. Sakahara
Journal: Cancer Research (2010)

Abstract Objectives: To analyze optical parameters of cancer before and after chemotherapy in breast cancer patients.Patients and Methods: Absorption coefficient (µa) and reduced scattering coefficient (µs') of cancer and contra-lateral normal region before and after chemotherapy were measured by using TRS-20SH (Hamamatsu Photonics K.K.). A pulsed laser of 760, 800, and 830 nm wave-length was irradiated at multiple sites in both breasts with time-resolved spectroscopy method and scattered light was analyzed by photon diffusion equation. A total of ten breast cancer patients who underwent neoadjuvant chemotherapy participated in the trial. Written informed consent was obtained from all of the patients.Results: Absorption coefficient (µa, 1/cm) of breast cancer was significantly higher than that of contra-lateral normal region before chemotherapy. In 800 nm wave-length, absorption coefficient of breast cancer decreased significantly after chemotherapy (before:0.0927, after;0.0498, p=0.002). Although absorption coefficient of contra-lateral normal region also decreased (before:0.0561, after;0.0437, p=0.006), cancer showed more significant decrease than contra-lateral normal region (cancer:-43.1%, normal region;-19.0%, P&amp;lt;0.01). Figure 1. Absorption coefficient (pa, cm-1), at 800rim (cancer-normal) Similar results were observed in 760 and 830 nm wave-length. There was no difference in reduced scattering coefficient (µs') between before and after chemotherapy in both breast cancer and contra-lateral normal region. Conclusion: The absorption coefficient of cancer was significantly higher than that of contra-lateral normal region before chemotherapy and decreased significantly after chemotherapy. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P2-05-02.
PTH-135 Examining the Attitudes, Perceptions and Barriers of Bowel Screening Wales Stakeholders
Authors: D Snelling, H Heard
Journal: Gut (2013)

<h3>Introduction</h3> Service evaluation is of paramount importance for the continued improvement and development of any health intervention and there is very little documented evidence that examines the attitudes and perceptions of Bowel Screeing Wales (BSW) stakeholders. Anecdotal evidence has suggested several factors that contribute towards the uptake of bowel screening in Wales, such as, lack of understanding around screening, the nature of the test, and the will to complete the test, but this evidence has not been evaluated or documented. <h3>Methods</h3> A qualitative descriptive approach was undertaken and semi-structured interviews were conducted with stakeholders at the Royal Welsh Show, Builth Wells, Powys during July 2012 to gauge their attitudes, perceptions, and barriers towards bowel screening. Inclusion criteria was for all eligible men and women aged between 60–74 years who have been invited to be screened. <h3>Results</h3> 42 participants agreed to take part in the interview (19 male and 23 female) of which 31 participants reported completing their bowel screening test with 12 participants reporting they had not. The results indicate that participants are aware of cancer and have a very basic knowledge regarding bowel cancer but are not necessarily aware of the function of the bowel screening programme. A content analysis framework was developed (Newell &amp; Burnard, 2006) which identified two major themes; health beliefs and health behaviour. This service evaluation suggests that participant’s perceived susceptibility influences their decisions to take part. Participants who are not aware of BSW or the risks associated with bowel cancer will not complete the kit. Furthermore, this service evaluation suggests that participants who do not present with symptoms are also less-likely to complete their kit. Furthermore, only a very small number of participants sited fear or anxiety as a contributing factor for participating even though they were aware that the kit was to test for cancer. Majority of the participants who declined the invitation suggested that this was due to dealing with their faecal matter. It is interesting to note that their reasons for not completing their kit were lethargy and apathy. <h3>Conclusion</h3> Service evaluations are essential in understanding the attitudes and perceptions of stakeholders. The findings from this service evaluation suggest that participants have a limited knowledge of the risks associated with bowel cancer and know very little about the programme but perceive screening to be important. However participants perceived severity and susceptibility are contributing factors in their participation to accept or decline the invitation to be screened. <h3>Disclosure of Interest</h3> D. Snelling Employee of: Bowel Screening Wales, H. Heard: None Declared <h3>Reference</h3> Newell, R; Burnard, P (2006) Research for evidence-based practise. Blackwell publishing. Oxford. UK.
SAT0010 Common epitope structure of HLA-DPB1 in systemic sclerosis
Authors: J. Lee, H.J. Kim, H.K. Lee, J.A. Park, H.W. Kim, Y.W. Song, E.B. Lee
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Specific alleles of HLA-DPB1 (HLA-DPB1*0901, *1301, *0301) were found to be most strongly associated with anti-topoisomerase I (Topo-I)-positive systemic sclerosis (SSc) in multiethnic genome-wide association study and HLA-analysis (1, 2). However, structural basis on which HLA-DPB1 alleles can bind Topo-I peptides is unknown. <h3>Objectives</h3> To find common characteristics of amino acid sequences in the risk HLA-DPB1 alleles and to reveal the possible mode of binding with Topo-I. <h3>Methods</h3> We enrolled 127 Korean patients with SSc who were diagnosed as SSc according to the preliminary classification criteria of American College of Rheumatology and 548 healthy Korean controls. We compared amino acid sequences of the risk HLA-DPB1 alleles with non-risk alleles, focusing on known HLA-DP binding motifs. After revealing common peptides from risk alleles of HLA-DPB1, molecular dynamic simulation was conducted to show binding structures against hypothetically chosen sequences of amino acids in Topo-I. <h3>Results</h3> The triplet of negative charged amino acids in three critical sites were associated with SSc. At amino acid position 55-57, 67-69, and 82, 84-85 of HLA-DPB1, negatively charged amino acids were prevalent, which includes glutamine or lysine. The patients who have 3 negative charged triplets show OR of 5.99 (95% CI=2.17-16.6, p=1.8×10<sup>-4</sup>) for SSc and those who have 2 negative charged triplets show OR of 6.37 (95% CI=2.35-17.3, p=7.1×10<sup>-5</sup>) or 3.89 (95% CI=1.39-10.9, p=6.5×10<sup>-3</sup>), while those who do not have triplets have referent OR of 1.00. When peptides from Topo-I (peptide A (KD<b>R</b>EH<b>R</b>H<b>K</b>EH<b>K</b>K) and peptide B (KL<b>L</b>KE<b>Y</b>G<b>F</b>CI<b>M</b>D)) were selected to simulate interaction with "high risk" HLA-DP allele (HLA-DPB1*0901) and "low risk" allele (HLA-DPB1*040101), peptide A and B fit more closely into the binding cleft of HLA-DPB1*0901 than HLA-DPB1*040101. (Figure 1) <h3>Conclusions</h3> SSc-susceptible HLA-DPB1 alleles share negative charged amino acid triplets at critical positions in their peptide binding groove. <h3>References</h3> Zhou, X., et al., Arthritis Rheum, 2009. 60(12): p. 3807-14. Arnett, F.C., et al., Ann Rheum Dis, 2010. 69(5): p. 822-7. <h3>Disclosure of Interest</h3> None Declared
Oral Choline Administration to Patients with Tardive Dyskinesia
Authors: John H. Growdon, Madelyn J. Hirsch, Richard J. Wurtman, William Wiener
Journal: New England Journal of Medicine (1977)

We gave pharmacologic doses of choline to patients with tardive dyskinesia in an attempt to suppress involuntary facial movements. Choline is the physiologic precursor of acetylcholine, and its administration elevates brain acetylcholine levels in laboratory animals and, possibly, in human beings. Hence, we thought that its use could benefit patients with diseases like tardive dyskinesia, which is believed to result from deficient central cholinergic tone. Twenty patients with stable baccal-lingual-masticatory movements took oral doses of choline for two weeks according to a double-blind crossover protocol. Plasma choline levels rose from 12.4 +/- 1.0 to 33.5 +/- 2.5 nmol per milliliter (mean +/- S.E.M.; P less than 0.001) during this period. Choreic movements decreased in nine patients, worsened in one and were unchanged in 10. Thus, oral doses of choline can be useful in neurologic diseases in which an increase in acetylcholine release is desired.