tbuckley/cabot-search huggingface dataset:
SAT0113 Pulmonary Involvement in Rheumatoid Arthritis: is There A Role for Low-Complexity Medical Tests?
Authors: A.M. Kawassaki, D.A.S. Pereira, F.U. Kay, I.M.M. Laurindo, C.R.R. Carvalho, R.A. Kairalla
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> Depending on the method of screening, approximately 50% of rheumatoid arthritis (RA) patients may exhibit lung involvement, but most cases are subclinical. <h3>Objectives</h3> To evaluate whether simple methods can yield relevant disease information from RA patients. <h3>Methods</h3> RA patients from a Brazilian single terciary center were randomly selected for a cross-sectional clinical pulmonary evaluation, rest pulse oximetry, chest X-ray (CXR) and spirometry. Based on a prevalence assumption for abnormal spirometry of 30%, the sample size estimated for 1,000 patients at regular follow-up was 245, with 5% precision. The study was approved by local research ethics committee. Written informed consent was obtained from all participants. <h3>Results</h3> A total of 246 RA patients underwent complete assessments. Half of the population reported tobacco exposure. Spirometry was abnormal in 30% of the patients; CXR was abnormal in 45%, and pulse oximetry was abnormal in 13%. Normal CXR, spirometry and oximetry were observed simultaneously in only 41% of the RA patients. Tobacco exposure was associated with abnormal (p=0.006), obstructive (p=0.02) and restrictive (p=0.045) spirometry, and with abnormal (p=0.0005) and interstitial-patterned CXR (p=0.01). After adjusting for confounders, abnormal medical were associated with male gender (p=0.025), older age (p=0.004), positive rheumatoid factor (p=0.0003), disease duration (p=0.016) and smoking (p&lt;0.0001). Notably, signs of airway disease were observed in nearly half of the patients with low or absent tobacco exposure. <h3>Conclusions</h3> A combination of simple, non-hazardous, inexpensive pulmonary evaluation methods can diagnose pulmonary disease in RA patients. Our results lead us to suggest that asymptomatic patients with mild lung involvement should undergo regular pulmonary evaluations, with further investigation if new symptoms develop or in the case of disease progression. <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.6050
Vitamin C: How It May Protect Against Cancer Is Unclear
Authors: A. Aubertin
Journal: JNCI Journal of the National Cancer Institute (1991)

Journal Article Vitamin C: How It May Protect Against Cancer Is Unclear Get access Amy Aubertin Amy Aubertin Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 83, Issue 6, 20 March 1991, Pages 396–397, https://doi.org/10.1093/jnci/83.6.396 Published: 20 March 1991
P91 Are cases of granulomatous common variable immunodeficiency misdiagnosed as sarcoidosis in routine clinical practice?
Authors: P. Oppong, S. Banik, D. Derry
Journal: Thorax (2011)

<h3>Introduction</h3> Common variable immunodeficiency (CVID) is a primary immune disorder characterised by impaired B cell differentiation and hypogammaglobulinaemia. It predisposes to encapsulated bacterial infections, commonly affecting the respiratory tract. 8%–20% of CVID patients have a granulomatous form. Granulomatous CVID may share clinical features with sarcoidosis, namely persistent cough, breathlessness, fatigue, fever, and arthralgia. Non caseating granulomata in lymph node biopsies and elevated angiotensin converting enzyme levels occur in both conditions. Differentiation between the two conditions is essential to allow management with immunoglobulin replacement and avoidance of excessive corticosteroids. <h3>Method</h3> Patients with a diagnosis of “sarcoidosis” recorded in chest clinic letters between April 2009 and September 2010 were identified. Clinic letters, blood tests, histology and imaging were reviewed. <h3>Results</h3> 175 patients with a diagnosis of sarcoidosis were identified. 80% had lymphadenopathy and 62% pulmonary involvement. Dermatological, ocular, rheumatological and other involvement was found in 19%, 17%, 16% and 9% respectively. 24% had potential features of CVID, such as recurrent chest infections, sinusitis, bronchiectasis or inflammatory bowel disease. Total globulin had been measured in 172/175 (98%) patients. 45/172 (26%) had elevated total globulin; 3/172 (2%)had low total globulin levels. Immunoglobulins had been measured in 106/175 (61%). Immunoglobulins had been measured in: 20/28 (71%) of those with recurrent sinusitis or lower respiratory tract infections; 20/25 (80%) of those with bronchiectasis; and8/8 (100%) of those with both recurrent chest infections and bronchiectasis. Four patients had persistently low IgM, two had persistently low IgA and one had persistently low IgG. No single patient had polyclonal hypogammaglobulinaemia, but levels were not measured in 11/42 (26%) with potential features of CVID. <h3>Conclusion</h3> Our study identified a cohort of patients with a diagnosis of sarcoidosis and features associated with CVID. We found that immunoglobulins were not being routinely measured during the work-up of patients with sarcoidosis as recommended by the Map of Medicine. Recent review of 28 local CVID patients identified two who were initially misdiagnosed with sarcoidosis. In one case this misdiagnosis persisted for 8 years. Granulomatous CVID is uncommon, but respiratory physicians should ensure that their routine work-up for sarcoidosis excludes this treatable condition.
Catalonia tries to tackle growing waiting lists
Authors: X. Bosch
Journal: BMJ (1998)

A new health plan for the Spanish state of Catalonia aims to reduce lengthy waiting lists by boosting local hospitals outside the main cities.

In recent years, responsibility for public services has been transferred from Spain's central government in Madrid to individual states, and Catalonia is seen as a good model for other states to follow.

A key objective of Catalonia's health plan is to decentralise resources to reduce the pressure on the main hospitals. These city hospitals would have fewer beds, deal with more …
Unusual Extravasation of Urine Diagnosed on Bone Scan
Authors: DAVID McHARG, JOHN BURKE
Journal: Clinical Nuclear Medicine (2000)

A 72-year-old man had a transurethral resection of the prostate gland for benign prostatic hypertrophy. Subsequently, bilateral intermittent groin pain and proximal thigh pain developed that was greater on the left than right and worse when seated. The bone scan performed 2 months after surgery to evaluate the possibility of pubic symphysitis or osteomyelitis revealed a surprising finding: A large collection of radiotracer in the soft tissues of the left proximal thigh posteromedially appeared to communicate with the bladder or proximal urethra. An extravasated urine collection (urinoma) in the left thigh with fistulous communication to the urethra or bladder was diagnosed.
Abstract 1712: Androgen receptor splicing variants promote therapeutic resistance in prostate cancer
Authors: Zhiyong Guo, Xi Yang, Feng Sun, Douglas E. Linn, Richeng Jiang, Hege Chen, Hegang Chen, Xiangtian Kong, Jonathan Melamed, Clifford G. Tepper, Hsing-Jien Kung, Angela M. H. Brodie, Joanne Edwards, Yun Qiu
Journal: Cancer Research (2010)

Abstract Androgen receptor (AR) plays a key role in progression to incurable castration-resistant prostate cancer. Recently, we and others have identified multiple alternatively spliced AR isoforms in hormone refractory prostate cancer cells. These AR splice variants contain the intact N-terminal transactivation domain and the DNA binding domain, but lack the ligand binding domain. They function as constitutively active transcription factors and their activity is independent of androgen or anti-androgens. Our tissue microarrays analysis on 429 human prostate tissue samples revealed that AR3, one of the major AR splice variants, is significantly up-regulated during prostate cancer progression and AR3 expression level is correlated with the risk of tumor recurrence after radical prostatectomy. Overexpression of AR3 confers castration-resistant growth of prostate cancer cells, whereas specific knockdown of AR3 expression in hormone-resistant prostate cancer cells attenuates their growth under androgen-depleted conditions, suggesting an indispensable role of AR3 in castration-resistant growth of prostate cancer cells. Furthermore, our gene expression microarray analysis showed that AR3 regulates a unique set of target genes which are not regulated by the prototype AR, suggesting that AR3, as an independent transcription factor, utilizes a distinct transcription programs to achieve its distinct and specific biological functions which are important for castration-resistant growth. In addition to its role in the androgen-ablation resistance, the AR isoforms may also be involved in chemotherapeutic resistance. We found that AR3 is overexpressed in chemotherapeutic resistant prostate cancer cell lines that are more tumorigenic, compared with their parental drug-sensitive lines. Therefore, aberrant expression of AR splicing variants may be a general mechanism underlying the development of multiple therapeutic resistances in prostate cancer. Taken together, our data suggest that AR3 may potentially serve as a prognostic marker to predict patient outcome in response to hormonal and chemo therapy, and targeting these AR splicing variants may offer more effective treatment for advanced prostate cancer. 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 1712.
Genomic and functional analyses of Mycobacterium tuberculosis strains implicate ald in D-cycloserine resistance
Authors: Christopher A Desjardins, Keira A Cohen, Vanisha Munsamy, Thomas Abeel, Kashmeel Maharaj, Bruce J Walker, Terrance P Shea, Deepak V Almeida, Abigail L Manson, Alex Salazar, Nesri Padayatchi, Max R O'Donnell, Koleka P Mlisana, Jennifer Wortman, Bruce W Birren, Jacques Grosset, Ashlee M Earl, Alexander S Pym
Journal: Nature Genetics (2016)
FRI0412 Urinalysis Findings and Renal Pathology in Japanese Patients with Lupus Nephritis: Table 1.
Authors: K. Nakanishi, R.L. McGill, M. Kinjo
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> Renal biopsy is crucial to establish the pathologic classification of lupus nephritis (LN), but urinalysis is usually evaluated first. Active urinary sediment (hematuria or cellular casts) is conventionally interpreted as evidence for proliferative LN (Class III or IV), whereas nephrotic range proteinuria (&gt;3.5 g per day) suggests membranous LN (Class V). <h3>Objectives</h3> The aim of this study was to correlate urinalysis findings with renal pathology in Japanese patients with LN. <h3>Methods</h3> Medical records were reviewed at Okinawa Chubu Hospital to locate all patients with systemic lupus erythematosus who had a renal biopsy from 2001 to 2013. After exclusion of two patients with missing urinalyses, 83 biopsies performed on 66 patients were included. Data were collected on clinical features, medications and laboratory data. <h3>Results</h3> Mean age was 32 ± 14 years; 57 of 66 (86%) were female. Active urinary sediment was reported in 53 of 83 (64%); nephrotic range proteinuria in 26 of 83 (31%) and sub-nephrotic range proteinuria (0.5 to 3.5 g per day) in 45 of 83 (54%). Discrepancies between urinalysis findings and renal pathology were common (Table). Active urinary sediment was absent in 13 of 52 (25%) of patients with Class IV or IV/V and 4 of 9 (44%) with Class III or III/V. Nephrotic range proteinuria was seen more often in Class IV (16 of 39, 41%) than Class V (4 of 12, 33%), although this difference was not statistically significant (P=0.63). Proteinuria was sub-nephrotic or absent in 21 of 29 (72%) with Class V, III/V or IV/V. <h3>Conclusions</h3> Among patients with biopsy-proven LN, conventional interpretations of urinalysis findings were frequently discordant with renal pathology. Membranous LN was predominantly non-nephrotic and proliferative LN was non-nephritic in one-quarter of cases. These data suggest that a renal biopsy is necessary for accurate diagnosis of patients with suspected LN. <h3>References</h3> Austin HA. Clinical evaluation and monitoring of lupus kidney disease. Lupus 1988; 7(9):618-621. Hahn BH, McMahon M, Wilkinson A, et al. American college of rheumatology guidelines for screening, treatment, and management of lupus nephritis. Arthritis Care Res (Hoboken). 2012; 64:797-808. Weening JJ, D9Agati VD, Schwartz MM, Seshan SV, Alpers CE, Appel GB, Balow JE, Bruijn JA, Cook T, Ferrario F, et al. The classification of glomerulonephritis in systemic lupus erythematosus revisited. J Am Soc Nephrol. 2004; 15(2):241–250. <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.2834
DISECCIÓN SUBMUCOSA ENDOSCÓPICA EN NEOPLASIAS GÁSTRICAS AL INICIO DE LA CURVA DE APRENDIZAJE: FACTORES RELACIONADOS CON LA DURACIÓN DEL PROCEDIMIENTO Y LAS COMPLICACIONES
Authors: JC Marín-Gabriel, J Díaz Tasende, P Hernán-Ocaña, A González-Blanco, S Rodríguez Muñoz, AJ Del Pozo García, M Alonso-Riaño, F Colina-Ruizdelgado, M Pérez Carreras, A Domínguez-Rodríguez, G Castellano Tortajada
Journal: Endoscopy (2013)

Introducción: La DSE es una técnica de reciente introducción en nuestro país. Objetivo: Identificar los factores relacionados con la duración de la DSE y la aparición de complicaciones. Material y Métodos: Se recogieron prospectivamente los datos de 15 lesiones resecadas en el Hospital Universitario 12 de Octubre de Madrid y 1 realizada en el Hospital Sanitas La Moraleja. Resultados: Se llevaron a cabo 16 D.S.E.s entre septiembre de 2008 y junio de 2013. Se detectaron 1 enfisema gástrico (6,25%) y 2 casos de hemorragia digestiva (12,5%). La mediana de duración de la técnica fue de 132 min. No se detectó asociación estadísticamente significativa entre los minutos empleados para la DSE (mediana; rango intercuartílico) y los siguientes factores: lesión proximal vs. distal (180; 114 vs. 105; 112; p= 0,09), ausencia o desarrollo de complicaciones (107; 101 vs. 180; 0; p= 0,15), diámetro < 20 vs. ≥20 mm (124; 145 vs. 150; 86; p= 0,49), técnica DSE pura vs. híbrida (112,5; 98 vs. 162,5; 128; p= 0,31), resección fragmentada vs. en bloc (177,5; 144 vs. 113,5; 98; p= 0,22) o empleo de 1 único bisturí vs. ≥2 knives (132,5; 109 vs. 143,5; 109; p= 0,79). Tampoco se detectaron diferencias estadísticamente significativas entre el porcentaje de complicaciones y los factores evaluados: lesión proximal vs. distal (40% vs. 9,1%; p= 0,21), diámetro < 20 vs. ≥20 mm (33,3% vs. 10%; p= 0,52), técnica DSE pura vs. híbrida (10% vs. 33,3%; p= 0,52), resección fragmentada vs. en bloc (33,3% vs. 10%; p= 0,52) o empleo de 1 único bisturí vs. ≥2 knives (37,5% vs. 0%; p= 0,2). Conclusión: En las 16 neoplasias gástricas precoces tratadas mediante DSE no se detectó asociación entre la aparición de complicaciones y la localización de la lesión, el tamaño de la misma o la técnica empleada.
Abstract 1907: Pancreatic cancer risk update: Associations with meat-derived carcinogen intake in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) cohort
Authors: Kristin E. Anderson, Steven J. Mongin, Rashmi Sinha, Rachael Stolzenberg-Solomon, Myron D. Gross, Regina G. Ziegler, Jerome E. Mabie, Adam Risch, Sally S. Kazin, Timothy R. Church
Journal: Cancer Research (2011)

Abstract Epidemiological studies report positive associations between high-temperature cooked meat intake and pancreatic cancer. We assessed the association between dietary intake of heterocyclic amines (HCAs) and benzo(a)pyrene (BaP)_mutagens formed in meat cooked at high temperatures_and incident exocrine pancreatic cancer in a prospective cohort. Methods: The 62,581 subjects randomized to screening in the multi-center Prostate, Lung, Colorectal and Ovarian Screening Trial (PLCO) who completed a dietary survey at study entry, which assessed meat intake, cooking methods, and doneness preferences defined the cohort. Subjects were surveyed annually for incident cancers through 2007; information was also obtained from physicians, next-of-kin, state registries, and national mortality data. A National Cancer Institute research database (CHARRED) was used to estimate intake of HCA, BaP, and mutagenic activity (Mutagenic Activity Index) from the dietary survey data. The proportional hazard ratios (HRs) for risk of pancreatic cancer were estimated from multivariate-adjusted survival analyses. Results: During follow-up (median: 10 yrs), 248 cases of exocrine pancreatic cancer were confirmed. Intake of well- and very-well done meat was generally associated with increased risks. For example, intake of very well done steak yielded an HR (95% confidence interval) of 1.43 (0.80, 2.56). Using estimated mutagen intake, significant elevations in the risk of pancreatic cancer were found in the upper quintiles of the Mutagenic Activity Index, with HRs of 1.81 (1.16, 2.83) and 1.87 (1.16, 3.02) for quintiles 4 and 5, respectively, relative to the lowest quintile. Significantly increased risks were also associated with exposure high levels of two specific mutagens: 2-amino-3,4,8-trimethylimidazo[4,5-f]quinoxaline (DiMeIQx) and 2-amino-3,8-dimethylimidazo [4,5-f]quinoxaline (MeIQx). The HRs for DiMeIQx for quintiles 4 and 5 were 1.31 (0.86, 1.98) and 1.81 (1.20, 2.74), respectively, while those for MeIQx were 1.34 (0.87, 2.06) and 1.75 (1.11, 2.76). All three of these exposures exhibited significant positive trends in risk as their intake increased (P for linear trend: 0.01-0.03). Conclusion: Additional follow-up of this cohort has provided stronger evidence that consumption of well-done meat with elevated mutagen levels from high temperature cooking confers an increased risk of pancreatic cancer. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 1907. doi:10.1158/1538-7445.AM2011-1907
TCTAP A-109 Accounting for Right Atrial Pressure in the Calculation of Fractional Flow Reserve Significantly Increases the Number of Physiologically Significant Stenoses Suitable for Revascularization
Authors: Christopher Michael Cook, Ricardo Petraco, Sayan Sen, Sukhjinder Nijjer, Rasha Al-Lamee, Jason Tarkin, Carlo Di Mario, Javier Escaned, Justin E. Davies
Journal: Journal of the American College of Cardiology (2015)
FRI0526 Ipsilateral lower extremity joint involvement increases the risk of poor pain and function outcomes after hip or knee arthroplasty
Authors: J. A. Singh, D. Lewallen
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Recent studies have demonstrated the association of contralateral extremity strength and contralateral knee pain on outcomes 2-3 years after TKA. To our knowledge, there are no published studies describing the effect of ipsilateral lower extremity joint involvement on medium-term patient-reported outcomes (PROs), i.e., pain and function after hip or knee arthroplasty. <h3>Objectives</h3> To assess the association of ipsilateral knee/hip pain on short- and mid-term pain and function outcomes after total hip or knee arthroplasty (THA/TKA) <h3>Methods</h3> In this prospectively cohort study, we used the data from the Mayo Clinic Total Joint Registry to assess the association of ipsilateral knee or hip joint involvement with moderate-severe pain and moderate-severe functional limitation at 2- and 5-year follow-up after primary and revision THA and TKA using multivariable-adjusted logistic regression analyses. <h3>Results</h3> At 2-year, 3,823 primary THA, 4,701 primary TKA, 1,218 revision THA and 725 revision TKA were studied. After adjusting for multiple covariates, ipsilateral knee pain was significantly associated with outcomes after primary THA (all p-values &lt;0.01): (1) moderate-severe pain: at 2-years, odds ratio (OR), 2.3 [95% confidence interval (CI), 1.5, 3.6]; at 5-years, OR 1.8 [95% CI:1.1, 2.7]; (2) moderate-severe functional limitation: at 2-years, OR 3.1 [95% CI:2.3, 4.3]; at 5-years, OR 3.6 [95% CI:2.6, 5.0]. Ipsilateral hip pain was significantly associated with outcomes after primary TKA (all p-values &lt;0.01): (1) moderate-severe pain: at 2-years, OR 3.3 [95% CI:2.3, 4.7] ]; at 5-years, OR 1.8 [95% CI:1.1, 2.7]; (2) moderate-severe functional limitation: at 2-years, OR 3.6 [95% CI:2.6, 4.9]; at 5-years, OR 2.2 [95% CI:1.6, 3.2]. Similar associations were noted for revision THA and TKA patients. <h3>Conclusions</h3> Presence of ipsilateral joint involvement after THA or TKA is strongly associated with poor pain and function outcomes. A potential way to improve outcomes is to address ipsilateral lower extremity joint involvement. <h3>Disclosure of Interest</h3> None Declared
A Review of: “Ezekiel J. Emanuel, Robert A. Crouch, John D. Arras, et al., eds. 2004. <i>Ethical and Regulatory Aspects of Clinical Research: Readings and Commentary</i>”
Authors: Howard Mann
Journal: The American Journal of Bioethics (2005)

Educational material for instruction in the ethics of clinical research is widely available in the form of journal articles, books, and, more recently, in multiple venues and formats on the Interne...
Pit Pattern in Colorectal Neoplasia: Endoscopic Magnifying View
Authors: S. Kudo, C. Rubino, C. Teixeira, H. Kashida, E. Kogure
Journal: Endoscopy (2004)

In vivo studies of the micro structure of the mucosal surface began in stomach diseases earlier than in colonic diseases, but a clear magnified image is difficult to obtain, because the gastric mucosa is often too damaged by gastric acid and/or inflammation in relation to Helicobacter pylori infection. In contrast, a normal colon is usually free of inflammatory changes, thus suitable for magnified observation. The surface micro structure of colorectal epithelium was first analyzed using dissecting microscopes on resected specimens in the 1970s. The surface morphology in normal rectal mucosa was described by Bank et al. [1], and subsequent investigations have demonstrated structural alterations in colorectal epithelial neoplasms. In the early 1980s Nishizawa et al. [2] stressed that the normal colonic mucosa, adenoma, and adenocarcinoma showed their own characteristic surface structures. Kawano et al. analyzed the stereomicroscopic pit pattern of depressed colorectal carcinoma [3]. The development of magnifying fiber colonoscopes in the 1980 s enabled the micro structure of the various colorectal lesions to be seen in vivo [4]. The advent of commercially available highresolution magnifying video colonoscopes (up to x 100) in the 1990 s accelerated the study of the microstrucrures of colonic lesions [5] [6] [7] . The combination of chromoscopy and magnifying colonoscopy is useful for detecting small localized lesions, for differential diagnosis, and for determining not only the lateral extent but also the depth of a lesion. Some investigators have also reported the analysis of the diffuse mucosal changes in inflammatory bowel diseases using magnifying colonoscopes.