tbuckley/cabot-search huggingface dataset:
Acute hepatitis E virus infection in patients with acute liver failure in China: Not quite an uncommon cause
Authors: Lin Wang, Jiabao Geng
Journal: Hepatology (2016)

Potential conflict of interest: Nothing to report. Author names in bold designate shared co‐first authorship. TO THE EDITOR: We read with interest the article by Fontana and colleagues published in Hepatology.1 The study tested anti‐hepatitis E virus (HEV) antibodies in samples from 681 American adults with acute liver failure (ALF). Anti‐HEV immunoglobulin M (IgM) was detected in only 3 (0.4%) patients and HEV RNA was not detected in any of them. The study concluded that HEV infection is a rare cause of ALF in the United States. The United States is a country with low endemicity of HEV and is dominated by genotype 3 HEV (HEV‐3).2 However, in China, HEV is hyperendemic and the dominant HEV subtype is HEV‐4.3 We have investigated the role of HEV infection in patients with ALF consecutively admitted to the People's Liberation Army (PLA) Liver Disease Center, Bayi Hospital, which is a tertiary hospital specialized in hepatology in Nanjing, Jiangsu (a province in eastern China with approximately 80 million people). The number of daily outpatient visits and monthly treated inpatients with relevant liver diseases to the PLA Liver Disease Center is nearly 250 and 300, respectively. In the period between January 2014 and August 2016, 291 patients with ALF were admitted and constitute the basis of this report (Fig. 1). Among these patients, anti‐HEV IgM (Wantai, Beijing, China) was positive in 19 male patients (19 of 291; 6.5%), in 10 (52.6%) of whom there was evidence of underlying chronic liver disease (CLD). HEV RNA was detected in the serum samples of 10 (10 of 19; 52.6%) patients, 4 (40%) of them in the 10 patients with underlying CLD. In all patients with positive HEV‐RNA, there were no other causes that would explain ALF. All isolates belonged to HEV‐4 genotype.Figure 1: Overview of the recruited patients. Among the 291 patients, 19 were positive for anti‐HEV IgM. Anti‐HEV IgG was found positive in 18 of them. Ten patients have positive HEV RNA results. Abbreviations: HB, hepatitis B; DILI, drug‐induced liver injury; AH, alcoholic hepatitis; AIH, autoimmune hepatitis; HA, hepatitis A.Mortality rate was higher in hepatitis E patients with underlying CLD (5 of 10; 50%) than in those who were solely infected with HEV (3 of 9; 33.3%). Although the difference was not significant statistically (Fisher's exact test, P = 0.6499). In general, our data suggest that acute HEV infection is not an uncommon cause of ALF in a highly endemic region, and, not unexpectedly, patients with underlying CLD who develop an acute‐on‐chronic infection with HEV have a higher mortality rate. In the future, larger, prospective, multicenter cohort study is required in order to further confirm these findings.
ATRA Based (Iraqi) Protocol for Children with Acute Promyelocytic Leukemia (APL) in Baghdad: Results in the First 8 Patients.
Authors: Anna Maria Testi, Maria Luisa Moleti, Salma Abbas Nal-Hadad, Mazin Faisal Farhan Al-Jadiry, Franco Mandelli, Robert Foa
Journal: Blood (2004)
AB1087-HPR Non-Pharmacological, Non-Surgical Care in Hip and Knee Osteoarthritis: The View of Healthcare Providers
Authors: E.M. Selten, J.E. Vriezekolk, W.H. van der Laan, R.G. van der Meulen-Dilling, M.W. Nijhof, H.J. Schers, R. Geenen, C.H. van den Ende
Journal: Annals of the Rheumatic Diseases (2016)

<h3>Background</h3> Non-pharmacological, non-surgical treatment modalities are underused in the management of knee and hip osteoarthritis (OA)<sup>1</sup>. One possible explanation of this suboptimal use could be health care providers9 lack of knowledge about non-pharmacological, non-surgical treatment modalities which might act as a barrier for referring patients to these treatment modalities<sup>2</sup>. <h3>Objectives</h3> The objective of this qualitative study was to identify healthcare providers9 view on non-pharmacological, non-surgical care of knee and hip OA. <h3>Methods</h3> Semi-structured in-depth interviews with 24 healthcare providers working in the field of OA were held (rheumatologists, orthopaedic surgeons, physiotherapists and GPs). Interviews were transcribed verbatim and analysed using a three-step thematic approach consisting of open, axial and selective coding. Two independent researchers continuously reflected upon, compared, discussed and adjusted the coding. <h3>Results</h3> Eight themes were identified: 1) patients9 difficulties with weight reduction; 2) dieticians9 capabilities in weight reduction management; 3) healthcare providers9 responsibilities in weight reduction; 4) the importance of lifestyle advices; 5) (mis)trust in physiotherapy modalities; 6) the endorsement of non-pharmacological, non-surgical treatment to delay surgery; 7) dialogue between disciplines; 8) perceptions of healthcare providers9 roles. <h3>Conclusions</h3> This study identified multiple factors affecting the suboptimal use of non-pharmacological, non-surgical treatment modalities in knee and hip OA from the perspective of the healthcare provider. The results of this study may be used to improve healthcare providers9 knowledge and communication skills regarding weight reduction strategies. To enhance the cooperation between health care providers, opportunities should be created for easy referral to effective weight reduction programmes and to evidence-based physiotherapeutic interventions. <h3>References</h3> McHugh, GA, Luker, KA, Campbell, M, Kay, PR &amp; Silman (2007). A longitudinal study exploring pain control, treatment and service provision for individuals with end-stage lower limb osteoarthritis. Rheumatology 46(4), 631–637. Hofstede, SN, Vliet Vlieland, TPM, Van den Ende, CHM, Marang - van de Mheen, PJ, Nelissen, RGHH, Van Bodegom - Vos, L. (2014). Designing a strategy to implement optimal conservative treatments in patients with knee or hip osteoarthritis in orthopedic practice: a study protocol of the BART-OP study. Implementation Science 9:22. <h3>Disclosure of Interest</h3> None declared
B-Type Natriuretic Peptide (BNP) and Mitral Velocity E/A Ratio (MV E/A) Are Two Important Noninvasive Functional Indices of Cardiac AL Amyloidosis.
Authors: Peter Kabos, Qaiser Bashir, Robert Chen, JoAnn Lindenfeld, Han Myint, Choon Kee Lee
Journal: Blood (2007)
Towards a Pediatric Approach in Adults with Acute Lymphoblastic Leukemia (ALL): The GRAALL-2003 Study.
Authors: Françoise Huguet, Emmanuel Raffoux, Xavier Thomas, Thibaut Leguay, Patrice Chevallier, Martine Escoffre, Oumedaly Reman, Denis Caillot, Norbert Vey, Nicolas Boissel, Mathilde Hunault, Agnes Buzyn, Yves Chalandon, Andre Delannoy, Jean-Paul Vernant, Veronique Lheritier, Marie-Christine Bene, Elizabeth Macintyre, Norbert Ifrah, Herve Dombret
Journal: Blood (2006)
Complement Activation and Cytotoxicity In CLL Cells Treated with Alemtuzumab and Ofatumumab: Evidence for Multiple Mechanisms of Resistance to Complement Dependent Cytotoxicity
Authors: Nisar A Baig, Amy K Church, Grzegorz S. Nowakowski, Ronald P Taylor, Margaret A Lindorfer, Clive S. Zent
Journal: Blood (2010)
A Chemical Biology Screen Identifies Glucocorticoids as Inhibitors of C-Maf and C-Maf-Dependent Transactivation of Cyclin D2.
Authors: Xinliang Mao, A. Keith Stewart, Rose Hurren, Alessandro Datti, Chang Xin Shi, Yuan-Xiao Zhu, Kyle Lee, Rodger Tiedemann, Yanina Eberhard, Seth J. Corey, Jeff Wrana, Aaron D. Schimmer
Journal: Blood (2006)
AB0632 Association between Interstitial Pulmonary Involvement and Microvaculature Changes in Systemic Sclerosis
Authors: R. Bečvář, M. Tomcik, S. Skacelova, J. Stork, A. Slovakova
Journal: Annals of the Rheumatic Diseases (2016)

<h3>Background</h3> Pulmonary disease is the leading cause of mortality in patients with systemic sclerosis (SSc). Baseline gas transfer (DLCO) and FVC levels have traditionally been used as measures of disease severity and reductions in both parameters have been associated with increased mortality in the interstitial lung disease of SSc. In SSc the reduced capillary density leads to a reduced blood flow, to tissue ischemia. Tissue hypoxia usually initiates the formation of new blood vessels from the pre-existing microvasculature. Nailfold capillaroscopy is a safe, noninvasive routine way for the microvascular investigation <h3>Objectives</h3> The aim of this study is to assess the association between capillaroscopic abnormalities and parameters of interstitial lung involvement in patients with SSc. <h3>Methods</h3> All patients underwent routine clinical examination (dyspnea, cough, crepitus), pulmonary function tests, DLCO (alveolitis grade and fibrosis), blood gases and HRCT scan of chest (1). Microvasculature changes were assessed using nailfold videocapillaroscopy (NVC) which was performed by two independent examiners. The obtained images were analysed anonymously by two investigators blinded for the clinical and serum status of SSc patients and classified as early, active and late pattern, non specific or normal picture (2). For statistical evaluation Poisson9s correlation coefficient and T-test were used. <h3>Results</h3> Total 42 patients (38 females) were investigated: 30 individuals with limited form, 7 with diffuse, 3 patients with scleroderma sine scleroderma, 1 with overlap syndrome and 1 with undifferentiated connective tissue disease. The mean age ± standard deviation (SD) of the whole cohort was 51±22 years and the mean disease duration ± SD was 10±7 years. 3 patients (7.5%) had early NVC pattern, 12 patients (30%) had active, 10 (58%) late pattern, and 17 (37.5%) had nonspecific changes or normal picture. The patients with late NVC pattern exhibited more often mild to moderate alveolitis, decreased FEV1 and FVC and DLCO. When correlating NVC patterns with clinical findings, pulmonary function test and HRCT scans we found only an association of low significance with dyspnea and alveolitis grade (both p&lt;0.1). <h3>Conclusions</h3> In our study NVC patterns did not seem to correlate with severity of interstitial lung disease in SSc patients <h3>References</h3> Corrado A et al. Joint Bone Spine. 2010, Cutolo M et al. J Rheumatol. 2000 <h3>Acknowledgement</h3> This study was performed with support of CMH Research Projects No 00000023728. <h3>Disclosure of Interest</h3> R. Bečvář Consultant for: Actelion, M. Tomcik: None declared, S. Skacelova: None declared, J. Stork: None declared, A. Slovakova: None declared
PTU-139 A Retrospective Study Assessing The Clinical Yield of Diagnosing Small Bowel Bacterial Overgrowth Using Lactulose Hydrogen Breath Test
Authors: S Khan, F Bukhari, I Miah, S Alavi, T Wong, J Sanderson, J Jafari
Journal: Gut (2016)

<h3>Introduction</h3> Small intestinal bacterial overgrowth (SIBO) negatively affects both the structure and function of the small intestine leading to a number of acute and chronic symptoms. The lactulose hydrogen breath test (LHBT) is commonly used to detect SIBO. However, little is known to what extent the diagnosis made by this method can affect the patient’s clinical state. The aim of this study was to assess whether patients diagnosed with SIBO using LHBT respond clinically to SIBO treatment. <h3>Methods</h3> All the patients who were diagnosed with SIBO by LHBT within the last 12 months prior to December 2016 were retrospectively contacted. A visual analogue scale (VAS) on a scale of 0–10 was used to score the severity of their top 3 symptoms pre and post treatment. 0 being the lowest and 10 being the highest severity of each symptom. Positive LHBT was considered as raise of hydrogen &gt;12 ppm against baseline within the first 60 min of the study. A paired t-test was conducted to evaluate the significance of the differences; P value &lt;0.05 was considered as significant. <h3>Results</h3> 17 patients were included (10 female, median age 40.5, age range 26–70). All these patients were prescribed antibiotics (AB). Reduction of the symptom 1 and 2 were significant pre vs post treatment but not the symptom 3 (P values respectively: &lt;0.006, &lt;0.009, and &lt;0.1). Comparing the total symptom counts also showed significant reduction in the severity of the symptoms (P &lt;).0001). Analysis of the severity of individual types of symptoms, significant improvement was found in bloating (p &lt; 0.0967), flatulence (p &lt; 0.0247), abdominal discomfort/pain (p &lt; 0.0279) and diarrhoea (p &lt; 0.042). <h3>Conclusion</h3> The findings of this study suggest that patients diagnosed with SIBO using LHBT effectively respond to treatment (i.e. AB). Using raise of hydrogen &gt;12 ppm against baseline within the first 60 min of the study is a reliable criteria to diagnose SIBO. Further studies with larger number of patients is required to confirm the findings of this study. <h3>Disclosure of Interest</h3> None Declared
Change in a 17-gene genomic prostate score over time in men with low- and intermediate-risk prostate cancer managed with active surveillance.
Authors: Michael S. Leapman, Janet E. Cowan, Hao Gia Nguyen, Matthew R. Cooperberg, Peter Carroll
Journal: Journal of Clinical Oncology (2016)

124 Background: A biopsy-based RT-PCR assay (Oncotype DX Prostate Assay) providing a Genomic Prostate Score (GPS) as a measure of tumor aggressiveness has been validated as a predictor of adverse pathologic and oncologic outcomes. We sought to evaluate the change in GPS results among men with favorable-risk prostate cancer (PCa) managed with active surveillance (AS). Methods: We identified men with low and intermediate-clinical risk PCa managed with AS at our institution receiving a minimum of two GPS tests on serial prostate biopsy. GPS ranges from 0 (least) to 100 (most aggressive disease). We described the change in assay results and clinical risk designation over time and reported the subsequent clinical outcome (definitive treatment versus continued AS). For men receiving treatment with radical prostatectomy (RP) the occurrence of adverse pathological findings was defined by the presence of high grade (Gleason pattern ≥ 4+3) or non-organ confined disease ( ≥ pT3a). Results: 31 men were identified who underwent serial GPS testing at a median of 12 months. The median change in GPS was an increase of 1 point (IQR -7, 13). Fourteen (45%) patients experienced an increase in NCCN risk classification, including 3 from very-low to intermediate and 11 from low to intermediate risk. Following serial GPS testing 7 patients (23%) underwent radical prostatectomy. Among surgically treated patients, 3 had adverse pathology due to pT3a disease and the mean change in GPS prior to treatment was an increase of 13 points (IQR -7, 18); all of whom were intermediate clinical risk at the time of surgery. This study was limited by the small sample size and the uncontrolled decision to pursue definitive therapy. Conclusions: Serial change in a tissue based gene expression assay on serial biopsy during AS was non-static. Magnitude of GPS change may identify men at risk for adverse pathological findings, although larger series are required to validate such an endpoint during AS.
Acute Myeloid Leukemia — Many Diseases, Many Treatments
Authors: Elihu Estey
Journal: New England Journal of Medicine (2016)

Patients with acute myeloid leukemia (AML) generally receive stereotypical treatment.1 For example, young patients receive cytarabine for 7 days and an anthracycline for 3 days (known as “7+3 induction”). Thus treated, some groups, predictably, have an approximately 50% chance of “cure” (“favorable risk”) whereas others, also predictably, have a survival of 6 to 18 months (“unfavorable risk”). This nonrandom heterogeneity after homogeneous treatment suggests that, like pneumonia, AML is several diseases.Today, AML is primarily defined according to leukemia-cell karyotype and an increasing number of molecular aberrations.2 It follows that different types of AML should ideally be treated differently. This . . .
PTH-059 The Absence of Clear Pathways Leads to Poor Utilisation of Faecal Calprotectin in Primary Care and Failure to Comply with Nice Guidance
Authors: D Penman, P Flanagan, G Pritchard, L Harding
Journal: Gut (2016)

<h3>Introduction</h3> Irritable bowel syndrome (IBS) has a prevalence of around 15% in the UK and up to 20% are referred to secondary care. Current practice shows that GPs are excellent at identifying and referring cases of inflammatory bowel disease (IBD) but due to the high prevalence of IBS, 60% of outpatient colonoscopies performed are normal. Faecal Calprotectin (FCP) is recommended by NICE to assist differentiating IBD from IBS in patients where cancer isn’t suspected. This was expected to speed the time to diagnosis, reduce referrals and unnecessary endoscopies. Implementation across the UK is patchy. Locally the test was instituted for primary care without the development of an agreed care pathway as recommended by NICE. <h3>Methods</h3> A retrospective audit of 193 consecutive patients with primary care initiated FCP tests from 01/02/15-02/02/15 were reviewed. Referral information, demographics, blood results, endoscopy and histology reports as well as patient outcomes were extracted from hospital and primary care IT systems using a standardised proforma. 10 paediatric cases were excluded. We aimed to assess the outcomes of testing in the absence of agreed clinical guidelines. <h3>Results</h3> Complete data was available for 183 adult patients. 29.5% did not meet NICE criteria for FCP testing. 20% met criteria for suspected colorectal cancer referral. 91.2% of patients with negative results (FCP &lt; 50 mcg/g) were managed in primary care and only 54% of patients with a positive result (&gt;100) were referred for further investigation. 28.6% of patients with indeterminate results (50–100) had a repeat test, of which 70% were persistently abnormal but only 20% were subsequently referred. No patients were assessed for factors which may cause false positive results. 82% of endoscopies were performed in patients with a positive FCP. 14% of the patients scoped were diagnosed with IBD, all had a positive FCP but only 37% had abnormal blood tests. <h3>Conclusion</h3> Use of FCP testing in the absence of a clear pathway leads to poor compliance with NICE guidance and is inappropriate in nearly 1/3<sup>rd</sup> of patients. There is clear reliance on the negative predictive value to avoid referral but this approach does not account for the highly variable pre-test probability and consequent detrimental effect on reliability. FCP is used too often in patients with unclear indications: upper GI symptoms; short symptom duration or suspected cancer criteria. False positive confounders do not appear to be considered, resulting in inconsistent retesting of indeterminate results. The results suggest that without a clear pathway FCP is commonly misused and misinterpreted, with the potential to delay or even fail to diagnose major GI pathology. This supports the use of a clear pathway for testing which we have now developed. <h3>Disclosure of Interest</h3> None Declared
THU0607 Effectiveness and Persistence of Golimumab across Rheumatic Disease Indications in Clinical Practice: Results from The National Swedish Register: Table 1.
Authors: D. Di Giuseppe, T. Frisell, J. Askling
Journal: Annals of the Rheumatic Diseases (2016)

<h3>Background</h3> Real life evidence regarding the effectiveness and discontinuation of golimumab across indications is limited. <h3>Objectives</h3> To describe the effectiveness and persistence of golimumab in a real-life setting, in rheumatoid arthritis (RA), ankylosing spondylitis (AS), psoriatic arthritis (PsA), and other spondyloarthropathies (SpA), in relation to disease activity at treatment initiation. <h3>Methods</h3> The national Swedish Rheumatology Quality Register (SRQ) was used to identify patients starting treatment with golimumab between 2009 and 2014. Effectiveness was assessed using the difference between start of treatment and at the 6 months visits (defined as 110–240 days from start of treatment) of different measures of disease activity. Persistence was evaluated using Kaplan Meier curves and Cox proportional hazard model. <h3>Results</h3> A total of 2984 patients (1366 RA (69% were RF positive), 655 PsA, 499 AS and 464 SpA) started treatment with golimumab. The percentage of bionaïve patients was similar across indications (from 46% in AS to 48% in RA). There was positive response at 6 months across all indications, according to DAS28, HAQ, tender and swollen joint counts (TJC and SJC), patient global health, pain, EQ-5D, CRP and SR (Table 1). Proportion of persistence was highest in AS (69% at 1 year, 56% at 2, and 50% at 3), and was lowest in PsA (60%, 49%, and 42%). Across all indications, the hazard ratio of discontinuation was higher among women, lower among bionaïve compared to non-bionaïve patients, and 34% higher among RA patients &gt;65 years old compared to RA patients 56–65 years old. There was no association between age and discontinuation among patients with other indications, and between DAS28 and HAQ and discontinuation in RA and SpA. <h3>Conclusions</h3> In this real-life national cohort, patients on golimumab experienced clinical improvement. Persistence is dependent on contextual factors rather than disease activity at start, and is better in AS than in RA. <h3>Disclosure of Interest</h3> None declared
Baseline Characteristics of 65 Subjects in the Correction of Anemia with Darbepoetin alfa (DA) in the Community-Dwelling Frail Elderly (CAFÉ) Study.
Authors: Andrew S. Artz, Sean X. Leng, Shing-shing Yeh, Patrick J. McKenna, Samisha N. Thomas, Paul Audhya, Steve Doucette, Irene Q. Flores, Z. Shana Geloo, William B. Ershler
Journal: Blood (2007)
Gene Targeting Meets Cell-Based Therapy: Raising the Tail, or Merely a Whimper?
Authors: Alexandria P. Cogdill, Peter A. Prieto, Alexandre Reuben, Jennifer A. Wargo
Journal: Clinical Cancer Research (2016)

Abstract Appreciation of the immune effects of targeted agents has grown, and efforts to combine these agents with immunotherapy are underway to enhance therapeutic responses. Multiple ongoing trials are examining this concept; however, nuances exist with regard to timing, sequence, and combinatorial strategies. Clin Cancer Res; 23(2); 327–9. ©2016 AACR. See related article by Deniger et al., p. 351
Antithrombotic Properties of DU-176b, a Novel, Potent and Orally Active Direct Factor Xa Inhibitor in Rat Models of Arterial and Venous Thrombosis: Comparison with Fondaparinux, an Antithrombin Dependent Factor Xa Inhibitor.
Authors: Toshio Fukuda, Chikako Matsumoto, Yuko Honda, Nobutoshi Sugiyama, Yoshiyuki Morishima, Toshiro Shibano
Journal: Blood (2004)
Inhibition of Bortezomib-Induced Apoptosis in Chronic Lymphocytic Leukemia by Red Blood Cell Uptake.
Authors: Luise M.C. Wheat, Susan L. Kohlhaas, Johan Monbaliu, Roland De Coster, Aneela Majid, Renata J. Walewska, Gerald M. Cohen, Martin J.S. Dyer
Journal: Blood (2005)
Classic Cardiovascular Risk Factors and Certain Comorbidities May Contribute to the Risk of Thrombembolic and Bleeding Events in Patients with Classical Myeloproliferative Neoplasms
Authors: Susanne Isfort, Andrea Kaifie, Karla Schmitt, Edgar Jost, Tim H. Bruemmendorf, Steffen Koschmieder
Journal: Blood (2015)
A Novel Reduced Intensity Conditioning Regimen Induces a High Incidence of Sustained Donor Neutrophil and Platelet Engraftment After Double-Unit Cord Blood Transplantation
Authors: Doris M Ponce, Craig S. Sauter, Devlin Sean, Marissa N Lubin, Anne Marie R Gonzales, Nancy A. Kernan, Andromachi Scaradavou, Sergio Giralt, Jenna D Goldberg, Guenther Koehne, Miguel-Angel Perales, James W. Young, Ann A Jakubowski, Hugo R Castro-Malaspina, Esperanza B. Papadopoulos, Juliet N Barker
Journal: Blood (2012)
Impact of Allogeneic Stem Cell Transplantation (ASCT) on Outcome of Biphenotypic Acute Leukemia (BAL):.
Authors: Amrita Y. Krishnan, Karen L. Chang, Henry C. Fung, Margaret O’Donnell, Ravi Bhatia, Ricardo Spielberger, Vinod Pullarkat, Anthony Stein, Neil Kogut, Mark Kirschbaum, Ellen Bolotin, Clarence SarkodeeAdoo, Andrew Dagis, Nigel Cheng, Stephen J. Forman
Journal: Blood (2004)