tbuckley/cabot-search huggingface dataset:
MAG3 Renal Transplant Tomography
Authors: Nancy Neubauer, Leah Johnson, Michael Lemmers, Brenda Petri, Jeffrey S. Stevens
Journal: Clinical Nuclear Medicine (1996)

The authors encountered a renal transplant patient in whom tubular stasis permitted sufficient time to perform SPECT using Tc-99m MAG3. SPECT revealed a defect that was not apparent on the planar study. Renal biopsy showed acute vascular rejection. On a subsequent Tc-99m MAG3 SPECT study the defect had resolved.
P228 Patient experience of a nurse led therapeutic pleural aspiration service
Authors: N. Surange, J. A. Murray, S. C. O. Taggart
Journal: Thorax (2010)

Traditional models of care utilise the skills of a doctor to perform Therapeutic Pleural Aspiration (TPA). The procedure is often unplanned, rushed and performed by training doctors requiring supervision. At Salford Royal NHS Foundation Trust, we have trained the UKs first Lung Cancer Advanced Practitioner Nurse (LCAPN) to carry out TPA, as a bridge to alleviating chest symptoms prior to initiation of more definitive anti-cancer treatment and/or pleurodesis or as part of Best Suportive Care. From April 2009 to July 2010, our LCAPN carried out 41 planned TPAs independently in 23 individual patients with cancer related pleural effusion (11 lung cancers, 6 mesotheliomas, 6 other primaries) on the day ward, producing a total of 53 327 ml of fluid (mean 1300 ml). Patients were identified as suitable for TPA by the Lead Lung Cancer Clinician who used results from CT scan or same day Thoracic ultrasound scan to guide optimal site for needle placement using local anaesthesia (LA). Fluid was removed using the TRU-CLOSE suction drainage system. At the end of each procedure, patients were asked to complete a self-administered questionnaire based on their experience of the procedure, process of consent and comfort. Overall, the service was rated as excellent by 100% of patients. In particular, the service was rated highly for scheduling of TPA, information giving, consent, comfort and ability of LCAPN to perform the procedure. 76% of patients experienced either no pain or only mild discomfort and 21% experienced moderate discomfort, although this generally occurred at the end of the procedure. <h3>Conclusion</h3> Nurse led TPA for cancer related pleural effusion is an acceptable model of care for alleviating symptoms prior to more definitive anti-cancer treatment or as part of Best Supportive Care.
AB0834 Efficacy and safety of hizentra(®) in patients with inflammatory myopathies after a switch from subcutaneous therapy
Authors: R. Moretti, L. Paolini, S. Gambini, A. Gabrielli, M.G. Danieli
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> We have previously demonstrated the beneficial effect and the safety of subcutaneous immunoglobulin (SCIg) administration in active and refractory inflammatory myopathies. Hizentra (IgPro20; CSL Behring) is the first, 20% liquid preparation of human IgG specifically formulated for subcutaneous infusions. We here report on the switch to weekly subcutaneous infusions of Hizentra(®) in inflammatory myopathies. <h3>Objectives</h3> We demontrate efficacy of the new formulation of subcutaneous immunoglobulins with quality of life improvement. <h3>Methods</h3> Six severe idiopathic myositis (four with DM, two with PM), diagnosed according to the Bohan and Peter’s criteria, were switched to weekly subcutaneous infusions of Hizentra(®) at doses equivalent to their previous subcutaneous treatment. A standardized protocol including the Medical Research Council (MRC) scale, the modified Rankin score, CK serum levels and daily prednisone dose, was used to evaluate patients and to assess disease activity, treatment response and quality of life. <h3>Results</h3> All patients showed a favourable clinical response with normal CK serum levels and improvement in MRC and Rankin modified scores. No relapse of the disease occurred: patients reported a good tolerance to Hizentra (®). Local reactions were mild and self-limiting (only one patient showed swelling). No serious Hizentra(®)-related adverse events were reported whereas they pointed an improved quality of life. Patients’ satisfaction was related to the shorter infusion times due to smaller infusion volumes, the easiness to handle the product and the possibility to store it a temperature up to 25°C. <h3>Conclusions</h3> Hizentra is an advance in the field of immunoglobulin therapy, which might offer benefits for home therapy, even in patients with autoimmune diseases. <h3>Disclosure of Interest</h3> None Declared
Abstract 3654: Clofarabine: factors influencing cytotoxicity and resistance in hematologic and solid malignancies
Authors: Xin Wang, Saeedeh Mirzaee, Kourosh Lotfi, Staffan Eriksson, Freidoun Albertioni
Journal: Cancer Research (2010)

Abstract Clofarabine is a new-generation nucleoside analog that was synthesized to combine the most favorable pharmacological properties of its congener fludarabine and cladribine. It acts as a strong inhibitor of DNA polymerase, DNA synthesis and ribonucletide reductase (R1/R2). Like other nucleoside analogues, clofarabine must be activated within cells to the 5′-triphodphate form initially by deoxycytidine kinase (dCK). In this study, the anticancer effect of clofarabine was investigated in three solid tumor cell lines, HCT116 (a colon carcinoma cell line), U1810 (a human non-small cell lung carcinoma cell line), and MCF7 (a mammary carcinoma cell line) and compared to four leukemic cell lines, CCRF-CEM, HL60, K562 and MOLT4. Clofarabine was investigated to enter into HCT116, U1810, and MCF7 in a clearly detectable manner by LigandTracer® White. At 10 µM a high signal is achieved and approaches equilibrium after 1∼2 hrs. Pre-incubation with 10 µM clofarabine resulted in rapid inhibition of thymidine incorporation and DNA synthesis. Induction of apoptosis by clofarabine was cell line dependent, but the average apoptotic level was higher in leukemic cell lines than solid tumor cell lines; however it seemed the sensitivity for apoptosis of cell line is correlated with the activity of dCK and thymidine kinase 1 (TK1) in the solid tumor cell lines. Upon treatment with 10 μM clofarabine for 24 hrs, apoptosis induction increased compared to untreated cells 3.1-, 2.9- and 2.1-fold; the activity of dCK 7.3-, 3.7- and 3.1-fold and the activity of TK1 4.2-, 1.4- and 1.2-fold in U1810, HCT116 and MCF7 cells, respectively. In general, the expression of R1, dCK and TK1 in leukemic cells was higher than in solid tumor cells, but the expression of R2, p53R2 and p53 varied among the cell lines. However, there was an inverse correlation between induction of apoptosis at 100nM clofarabine (upon 24 hours incubation) and the expression of p53R2 (spearman rank test −0.67, p=0.1). In addition, clofarabine treatment causes retardation in S-phase, which seems to be related to the activity of TK1 and the protein expression of R2 in U1810, HCT116 and MCF7 cells. This study is a first step to extend the application of clofarabine toward the solid tumors. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 3654.
A5.5 Antibodies against Domain I of β2 Glycoprotein I in Antiphospholipid Antibody Syndrome
Authors: Cecilia Chighizola, Francesca Pregnolato, Claudia Grossi, Maria Gerosa, Gary Norman, Michael Mahler, Maria Orietta Borghi, Pier Luigi Meroni
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background and Objectives</h3> antibodies anti-phospholipids (aPL) react to proteins bound to PL, mainly β2glycoprotein I (β2GPI). Antibodies against β2GPI (aβ2GPI) exert a pathogenic role and represent a risk-factor for clinical manifestations of anti-phospholipid syndrome (APS). However, some aβ2GPI-positive subjects never develop APS-related clinical manifestations. This observation may be explained by the heterogeneity of aβ2GPI population, with autoantibody subgroups targeting different β2GPI epitopes. In particular, antibodies anti-domain I (aDI) but not domains IV and V (aDIV/V) of β2GPI have been associated with thrombotic events. Therefore, the aim of this study was to assess the prevalence of aDI and aDIV/V IgG in a cohort of aPL-positive patients. <h3>Material and Methods</h3> 58 patients with a diagnosis of primary APS (PAPS) according to the 2006 Sydney criteria have been included in this study. 38 PAPS patients (65.5%) presented with venous and/or arterious thrombothic events while 20 subjects (34.5%) had obstetric manifestations only. 15 aPL asymptomatic carriers were also recruited. All samples had been tested for LA and for aCL and aβ2GPI with home-made assays according to international guidelines. In the thrombotic PAPS group, 35/38 subjects (92.1%) were aβ2GPI IgG positive; aβ2GPI IgG positivity rate was 85% in the obstetric PAPS group (17/20 women); 80% of the asymptomatic aPL carriers displayed aβ2GPI IgG. IgG specificities against whole β2GPI, DI and DIV/V have been evaluated with a novel solid-phase chemiluminiscent assay (BioFlash and ELISA, INOVA Diagnostics). <h3>Results</h3> Out of the 73 aPL positive patients: 21% were positive for aβ2GPI, aDI and aDIV/V; 41% were positive for aβ2GPI and aDI but negative for aDIV/V; 4% were positive for aβ2GPI and aDIV/V but negative for aDI; 21% were aβ2GPI positive only; 4% were positive for aDIV/V; 9% were negative for antibodies against the whole molecule and the studied domains. The prevalence of aDI was 74% among patients with thrombotic pAPS and 60% among women with obstetric manifestations. 40% of aPL asymptomatic carriers were positive for aDI. We observed a strong correlation between aβ2GPI and aDI (p &lt;&lt; 0.01, r = 0.836) but not aDIV/V (p = 0.07, r = 0.216). <h3>Conclusions</h3> Most of the aβ2GPI positive sera displayed reactivity against DI, while aDIV/DV were detected in a low rate of patients. Our data suggest that DI is the immunodominant β2GPI epitope and that aDI are the main antibody population in APS patients. Future studies are warranted to better define the diagnostic and prognostic role of anti-DI in APS.
Safety and Cost Effectiveness of High-Osmolality as Compared with Low-Osmolality Contrast Material in Patients Undergoing Cardiac Angiography
Authors: Earl P. Steinberg, Richard D. Moore, Neil R. Powe, Ramana Gopalan, Amy J. Davidoff, Marc Litt, Sandra Graziano, Jeffrey A. Brinker
Journal: New England Journal of Medicine (1992)

Low-osmolality contrast agents produce fewer hemodynamic and electrophysiologic alterations during cardiac angiography, but they are 20 times more expensive than high-osmolality contrast agents. In a randomized, double-blind trial comparing a nonionic, low-osmolality contrast agent (Omnipaque 350) with a high-osmolality agent that does not avidly bind calcium (Hypaque 76) in 505 patients undergoing cardiac angiography, we determined the incidence of minor, mild, moderate, and severe adverse reactions, identified risk factors for such reactions, and evaluated the cost effectiveness of various strategies for the use of contrast material.
SAT0233 Estimation of the Ankylosing Spondylitis Disease Activity Score (ASDAS) Threshold Value Which Corresponds to the Basdai Eligibility Criterion for Initiation of ANTI-TNF Therapy
Authors: D. Solmaz, P. Cetin, M. Birlik, I. Sari, S. Akar, F. Onen, N. Akkoc
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> ASDAS value of ≥ 2.1 has been proposed as a threshold to define high disease activity and as a suitable cut-off for eligibility for anti-TNF therapy. However, using this criterion results in more patients being eligible for anti-TNF treatment (1), as compared to the BASDAI cut-off ≥ 4 which is an eligibility criterion for anti-TNF therapy in many countries. In Turkey a BASDAI score ≥ 5 is required. <h3>Objectives</h3> To estimate the ASDAS-CRP threshold values corresponding to BASDAI scores of ≥4 and ≥5. <h3>Methods</h3> Data were obtained from the local clinical database which contains slightly over 500 AS patients. Patients with full data for ASDAS-CRP and BASDAI at baseline were included in this analysis. Mean ASDAS CRP and BASDAI values were compared by Spearman correlation. Receiver operating characteristic (ROC) curves was constructed to assess the cut-off points of ASDAS-CRP values that correspond to BASDAI scores of 4 and 5. Each cut-off point was calculated on the basis of the best trade-off values between sensitivity and specificity. <h3>Results</h3> 396 patients (291 M; 44 ±12.0) were identified with complete data at baseline for this analysis. Mean disease duration was 9.4 ± 8.2. Mean BASDAI, BASFI and BASMI scores were 3.6 ± 2.3, 2.9 ± 2.6, 3.9 ± 1.9, respectively. HLA B27 was positive in 65% of the tested patients. 83.7% of the patients were using NSAID and 20.7% of patients were using anti TNF agents. There was very good correlation between ASDAS CRP and BASDAI when tested by Spearman (p&lt;0.001; r=0.9). Of the patients with ASDAS ≥ 2.1 (n=296), 43.5% had a BASDAI score &lt;4 and 59.7% BASDAI &lt;5 (Table). Agreement between ASDAS≥2.1 and BASDAI≥4 was found to be only fair (n=0.39). The best trade-off ASDAS-CRP value corresponding to BASDAIscores of 4 and 5 were 2.9 (80% sensitivity and 77% specificity; AUC: 0.88) and 3.0 (81% sensitivity and 74% specificity; AUC: 0.86), respectively. <h3>Conclusions</h3> The ASDAS value that corresponds to the recommended BASDAI cut-off ≥4 for initiation of anti-TNF therapy is higher than the recommended ASDAS threshold of ≥ 2.1. Most likely, BASDAI eligibility criterion will continue to be widely used for selecting AS patients for anti-TNF therapy, until the reimbursement regulations include an ASDAS based criterion. <h3>References</h3> Fagerli KM, Lie E, van der Heijde D, Heiberg MS, Kaufmann C, Rodevand E, et al. Selecting patients with ankylosing spondylitis for TNF inhibitor therapy: comparison of ASDAS and BASDAI eligibility criteria. Rheumatology. 2012 Aug;51(8):1479-83. PubMed PMID: 22499062. <h3>Disclosure of Interest</h3> None Declared
Outcome of Patients with Esophageal Carcinoma and Suspicious Celiac Lymph Nodes as Determined by Endoscopic Ultrasonography
Authors: W. A. Marsman, M. van Wissen, J. J. Bergman, J. J. van Lanschot, H. Obertop, G. N. Tytgat, P. Fockens
Journal: Endoscopy (2004)

Background and Study Aims: The management of patients with esophageal cancer with malignant celiac lymph nodes (CLNs) is controversial. In this study we evaluated the management and survival of patients with positive CLN findings on endoscopic ultrasonography (EUS) and compared the outcome in surgically treated patients with that of nonsurgically treated patients. Patients and Methods: The EUS database of the Academic Medical Center was retrospectively searched for patients with esophageal carcinoma and EUS-positive CLN. Follow-up comprised the review of medical charts and contact with general practitioners. Results: From 1993 through 2000, 78 patients with esophageal carcinoma and suspicious CLN were eligible for inclusion in this study. The median survival of patients with CLN size < 2 cm was 13.5 months vs. 7.0 months for patients with CLN size >2 cm (P = 0.01). In a multivariate model, CLN size was the only predictive factor for poor patient survival. Of the 78 study patients, 13 underwent a surgical resection and 65 received nonsurgical treatment. The surgical group was significantly younger and all patients in this group had CLN size < 2 cm. The median survival for the surgical group was 13.7 months vs. 13.5 months for the nonsurgical group with CLN size < 2 cm (P = 0.63). Conclusions: In this retrospective study, CLN size was a significant predictor for poor survival. The surgically treated patients had a medium-term survival similar to that of nonsurgically treated patients with a CLN size < 2 cm. These findings underline the prognostic value of CLN size in patients with esophageal carcinoma.
Acute Methotrexate-Induced Crystal Nephropathy
Authors: Alexandre P Garneau, Julie Riopel, Paul Isenring
Journal: New England Journal of Medicine (2015)

Methotrexate-induced nephrotoxicity is not uncommon, although intrarenal methotrexate crystals have been elusive. This case shows methotrexate crystals deposited within the kidney tubules of a patient with methotrexate-induced nephropathy.
P204 S-ADENOSYLMETHIONINE (SAM) MODULATES ANTIOXIDANT ENZYMES EXPRESSION IN HEPATOMA CELL LINE EXPRESSING HCV NON-STRUCTURAL PROTEINS
Authors: S.A. Lozano Sepulveda, P. Cordero Pérez, L.E. Muñoz Espinosa, A.M. Rivas Estilla
Journal: Journal of Hepatology (2014)
OP0070 Inequity: Level of Education is Associated with Access to Biologic DMARDS Even in A Country with Highly Developed Social Welfare (NORWAY):
Authors: P. Putrik, S. Ramiro, E. Lie, A.P. Keszei, T. Uhlig, T.K. Kvien, D. van der Heijde, R. Landewé, A. Boonen
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> Biologic DMARDs (bDMARDs) have greatly improved the outcome of rheumatoid arthritis (RA). Investigating possible inequities in access to bDMARDs across socio-economic factors is important, and such analyses could provide clinicians and healthcare decision makers with useful information. <h3>Objectives</h3> To explore whether there are differences in initiation rates for a first bDMARD across age, gender and educational status among RA patients. <h3>Methods</h3> Data from the Norwegian NOR-DMARD study (2000-2012) was used. Only patients who were DMARD naïve at entrance into the study were included in the analyses. The first prescription of any bDMARD was the event of interest. In order to assess impact of education, age and gender on time to first bDMARD, two Cox regression models were built using forward step-wise modelling strategy. The first model included baseline predictors; the second was a time-varying model accounting for clinical information of all other visits between study inclusion and either start of bDMARD or censoring. Interactions between education and either year of baseline visit or age were tested. <h3>Results</h3> In total, 1861 patients were included (mean age at baseline 56 yrs, 68% females), and 368 patients received a bDMARD in the time of the period of observation (mean time to bDMARD 2.60 yrs). In both models, the socio-economic factors age and education were significant predictors of time-till-prescription (prescription of a first bDMARD), with lower hazard ratios (HR) for lower education and older age (Table). Education and age consistently and significantly contributed to the model. Effect of lower education was more pronounced in later years (HR<sub>low vs. high education</sub> =0.17 and 0.34 in patients who entered the cohort in 2008-2011, in time-varying and baseline models, respectively). <h3>Conclusions</h3> Well-educated and younger patients apparently have potentially decisive advantages with regard to access to expensive treatments, even a country with highly developed welfare like Norway. A stronger effect of education in later years might be explained by changes in prescription practice and social trends towards longer education. Findings are relevant as the impact of age and education on access might result in avoidable adverse impact on health. <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.2036
981 PREVALENCE AND RISK FACTORS FOR HEPATITIS B AND C AMONG PATIENTS ATTENDING A GERMAN EMERGENCY DEPARTMENT – IS A RISK ASSESSMENT QUESTIONNAIRE A USEFUL PRE-SCREENING TOOL?
Authors: M. Muche, F. Darstein, A. Stein, J. Hofmann, S. Pfaffenbach, R. Somasundaram
Journal: Journal of Hepatology (2013)
Jejunal Lipoma as a Source of Gastrointestinal Bleeding
Authors: J D Slavin, Q T Islam, R P Spencer, H Martinez
Journal: Clinical Nuclear Medicine (2000)

A 56-year-old man with known cirrhosis had gastrointestinal bleeding. Gastric aspiration did not reveal the presence of blood. A bleeding study (Tc-99m pyrophosphate red blood cells) showed an immediate and persistent blush in the upper abdomen and evidence of active gastrointestinal bleeding. At surgery, a bleeding site was identified in an intrajejunal mass. The mass proved to be a lipoma. A literature review of four series of gastrointestinal lipomas (102 cases) did not identify any as originating within the jejunum.
P10 Risks of low molecular weight Heparin in suspected pulmonary embolism
Authors: L. Watkins, S. Rafeeq, N. McMullan, P. Stockton, S. Twite, S. Agarwal
Journal: Thorax (2011)

<h3>Background</h3> National Patients Safety Agency (NPSA) issued a statement in July 2010 highlighting the risks associated with the prescription of low molecular weight Heparins (LMWHs). Evidence of harm has been reported due to dosing errors caused by failure to weigh patients and calculate creatinine clearance. <h3>Aim</h3> We hypothesised that harm associated with prescription of LMWHs is underreported on the national reporting and learning system (NRLS). We performed a retrospective study to evaluate the frequency of harm associated with LMWHs in patients admitted with a suspicion of pulmonary embolism (PE). <h3>Results</h3> 70 patients investigated for suspected PE in an acute teaching hospital during September 2010 were reviewed. Mean age 58 years (median 61), 60% female. The majority of patients presented with breathlessness (64%) and pleuritic chest pain (54%). There was no documentation of clinical probability in 69% of notes, however 73% of imaging requests had clinical probability scores recorded. Eight patients (26%) did not have any risk factors for venous thrombo-embolism. Four patients had CT pulmonary angiogram following an inconclusive perfusion scan. The majority of the patients (70%) were weighed prior to prescribing LMWH. Five (7%) patients had their weight estimated and 14 (20%) had no documentation of weight. Creatinine clearance was &lt;30 ml/min in three patients, one patient had their LMWH adjusted accordingly. More than half of patients (53%) received incorrect dose of LMWH. No LMWH related complication was recorded in any patient. <h3>Conclusion</h3> This small cross sectional study has limitations. Larger studies are needed to evaluate the frequency of harm associated with incorrect prescription of LMWH.
Abstract 582: hTERT inhibition stimulates cyclooxygenase2 (COX2) expression in cancer cells and synergizes with celecoxib to exert anti-cancer effects.
Authors: Tiantian Liu, Magnus Björkholm, Dawei Xu
Journal: Cancer Research (2013)

Abstract Telomerase and telomerase reverse transcriptase (hTERT) confer cancer cells sustained proliferation and survival potentials through telomere lengthening dependent and independent activities. Targeting telomerase or hTERT is thus a novel anti-cancer strategy. However, telomerase/hTERT inhibition alone has minimal clinical efficacy. We explored the relationship between hTERT and oncogenic cyclooxygenase 2 (COX2) and evaluated the synergistic anti-cancer effects of targeting both hTERT and COX2. hTERT depletion in gastric and cervical cancer cells led to robust increases in mRNA and protein levels of COX2. The COX2 promoter activity increased substantially in hTERT-depleted cancer cells. Mechanistically, hTERT depletion led to the activation of p38 MAPK that was responsible for the stimulation of COX2 gene transcription. hTERT depletion or the COX2 inhibitor celecoxib alone did not affect gastric cancer cell survival, while their combination synergistically killed them both in vitro and in vivo. Taken together, hTERT induces COX2 expression in cancer cells and simultaneously targeting hTERT and COX2 synergistically kills cancer cells, which may help path a new avenue in telomerase-based cancer therapeutics. Citation Format: Tiantian Liu, Magnus Björkholm, Dawei Xu. hTERT inhibition stimulates cyclooxygenase2 (COX2) expression in cancer cells and synergizes with celecoxib to exert anti-cancer effects. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 582. doi:10.1158/1538-7445.AM2013-582 Note: This abstract was not presented at the AACR Annual Meeting 2013 because the presenter was unable to attend.