tbuckley/cabot-search huggingface dataset:
PTH-096 Management of Hepatocellular Carcinoma (HCC) In A Tertiary HPB Centre- Lessons from The South East Coast-The Royal Surrey County Hospital (RSCH)
Authors: C Kelly, M Pericleous, I Bagwan, T Worthington, M Gallagher, C Tibbs, T Dhillon, N Karanjia, A Ala
Journal: Gut (2016)

<h3>Introduction</h3> The UK is facing an epidemic of liver disease, with end stage liver disease and HCC increasingly reported. Biannual surveillance is recommended (BSG, EASL, AASLD) for cirrhotic patients to aid early HCC diagnosis. Resection and transplantation remain the treatment options with curative intent. Our tertiary HPB centre covers a population of 2.1 million in the South of England and has seen an increasing number of referrals to our regional HCC MDT. Here we present our experience on our cohort from 2010 current <h3>Methods</h3> HCC patients were identified from MDT records as well as histology specimens, oncology and hepatology clinical records. Medical records including primary care were reviewed where necessary. Statistical analysis was performed using SPSS v21 <h3>Results</h3> 113 patients were managed in our centre during the examined period. There was a 7 fold increase in the number of patients receiving treatment in the last 12 months (n = 45). The median age at presentation was 70 years. The ratio of female: male was 1:3.2. HCC was established histologically in 36% (biopsy n = 20 and resection n = 21), the rest on tumour markers and radiology. 57% had cirrhosis. In those with liver disease the commonest diagnoses were viral hepatitis, ALD &amp; NASH. The mean overall survival (OS) was 12 months. Overall and disease free survival with resection was 34 and 30 months respectively which is significantly higher than other groups (p &lt; 0.001). The median OS comparing cirrhotics and non cirrhotics (10 months v 13 months) was not statistically significant. No significant survival difference was seen with gender or age (cut off 70 yrs). Analysis of resected patients showed mean survival for patients with 1 tumour was 42.5 months and more than 1 tumour 22.5 months <h3>Conclusion</h3> Our experience demonstrates a significant number of HCC resections in livers with normal histological sampling and non-cirrhotic livers, agreeing with literature describing HCC rates of up to 40% in specific non-cirrhotic populations. The success of our resections is complemented by the recent availability of loco regional therapy (SIRT, TACE &amp; RFA) in our unit. Patients with compensated cirrhosis and advancing age should still be considered for resection given its curative intent and long-term outcomes. Our data shows consideration should be given to widening HCC surveillance guidelines to capture these high-risk groups with early or no liver disease <h3>Reference</h3> 1 Williams R, Aspinall R, Bellis M, <i>et al</i>. Addressing liver disease in the UK: a blueprint for attaining excellence in health care and reducing premature mortality from lifestyle issues of excess consumption of alcohol, obesity, and viral hepatitis. <i>Lancet</i> 2014;<b>384</b>:1953–97. <h3>Disclosure of Interest</h3> None Declared
Long Term Survival Report of the UKCLL02 Trial: A Phase II Study of Subcutaneous Alemtuzumab In Patients with Fludarabine Refractory CLL (on Behalf of the NCRI CLL Trials Sub-Group)
Authors: Abraham M Varghese, Hazem A. Sayala, Paul Moreton, Richard A Jones, Andy Rawstron, J Sheila, Paul Evans, Carter Anthony, Claire E. Dearden, Estella Matutes, Andrew R. Pettitt, Daniel B. Kennedy, Sharon Barrans, Lisa Worrillow, Peter Hillmen
Journal: Blood (2010)
Associations of occupational standing with musculoskeletal symptoms: a systematic review with meta-analysis
Authors: Pieter Coenen, Lisa Willenberg, Sharon Parry, Joyce W Shi, Lorena Romero, Diana M Blackwood, Christopher G Maher, Genevieve N Healy, David W Dunstan, Leon M Straker
Journal: British Journal of Sports Medicine (2016)

Objective Given the high exposure to occupational standing in specific occupations, and recent initiatives to encourage intermittent standing among white-collar workers, a better understanding of the potential health consequences of occupational standing is required. We aimed to review and quantify the epidemiological evidence on associations of occupational standing with musculoskeletal symptoms. Design A systematic review was performed. Data from included articles were extracted and described, and meta-analyses conducted when data were sufficiently homogeneous. Data sources Electronic databases were systematically searched. Eligibility criteria Peer-reviewed articles on occupational standing and musculoskeletal symptoms from epidemiological studies were identified. Results Of the 11 750 articles screened, 50 articles reporting 49 studies were included (45 cross-sectional and 5 longitudinal; n=88 158 participants) describing the associations of occupational standing with musculoskeletal symptoms, including low-back (39 articles), lower extremity (14 articles) and upper extremity (18 articles) symptoms. In the meta-analysis, ‘substantial’ (&gt;4 hours/workday) occupational standing was associated with the occurrence of low-back symptoms (pooled OR (95% CI) 1.31 (1.10 to 1.56)). Evidence on lower and upper extremity symptoms was too heterogeneous for meta-analyses. The majority of included studies reported statistically significant detrimental associations of occupational standing with lower extremity, but not with upper extremity symptoms. Conclusions The evidence suggests that substantial occupational standing is associated with the occurrence of low-back and (inconclusively) lower extremity symptoms, but there may not be such an association with upper extremity symptoms. However, these conclusions are tentative as only limited evidence was found from high-quality, longitudinal studies with fully adjusted models using objective measures of standing.
What to Believe and Do About Statin-Associated Adverse Effects
Authors: Paul D. Thompson
Journal: JAMA (2016)

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
Overcoming multidrug resistance via simultaneous delivery of cytostatic drug and P-glycoprotein inhibitor to cancer cells by HPMA copolymer conjugate
Authors: Ladislav Sivak, Vladimir Subr, Jakub Tomala, Blanka Rihova, Jiri Strohalm, Tomas Etrych, Marek Kovar
Journal: Biomaterials (2016)
SP0028 How To Differentiate Normal from Abnormal Capillaroscopic Patterns: Role of in Early Diagnosis
Authors: V. Smith
Journal: Annals of the Rheumatic Diseases (2016)

The difference between a normal capillaroscopy and an "abnormal" capillaroscopy is important in the differential diagnosis between a primary Raynaud9s phenomenon (=not linked to any condition) from a secondary RP. A normal capillaroscopic pattern, by qualitative assessment, is characterized by a homogeneous distribution of hairpin shaped capillaries as a "comb-like structure", with a density of between 9–14 capillaries per mm. Yet, there exists a wide intra- and inter-individual variety in a normal population (non-specific variations) which will be discussed during the workshop. An abnormal capillaroscopic image due to systemic sclerosis (SSc) is characterized by (a combination) of specific changes (giants, capillary loss, hemorrhages and abnormal shapes (ramifications)). Depending on their relative prevalence three SSc-patterns are described by Cutolo et al. with a 200 magnification videocapillaroscope: the "early", "active" and "late" scleroderma pattern. The combination of the presence of a scleroderma pattern on capillaroscopy with the presence of an SSc-specific antibody in a patient with Raynaud9s phenomenon allows the "early" diagnosis of SSc. When the patient also has "puffy" fingers he/she meets the VEDOSS criteria for very early diagnosis of SSc. In patients with connective tissue diseases "other than" SSc and diseases of the scleroderma spectrum there are no "unique" capillary patterns. A variety of capillary abnormalities (change in morphology, dimension, presence of hemorrhages) have been observed. These abnormalities by themselves are not predictive of any defined condition and may be referred to as non-specific abnormalities. <h3>Disclosure of Interest</h3> None declared
Genetic Predictors of Hemoglobin F Response to Hydroxyurea in Sickle Cell Anemia
Authors: Vivien A Sheehan, Thad A Howard, Aniko Sabo, Uma Nagasaswamy, Jacy R Crosby, Brian Davis, Alexander H Li, Eric Boerwinkle, Richard A Gibbs, Russell E. Ware, Jonathan M Flanagan
Journal: Blood (2012)
PTH-128 Gastroenterology Registrar of The Week: A Solution for AUGIB Endoscopy Training?
Authors: S Budihal, P Wurm
Journal: Gut (2016)

<h3>Introduction</h3> Much concern surrounds Gastroenterology Specialist Registrar(StR) endoscopy training, especially in regards to endoscopic management of Acute Upper Gastrointestinal Bleeding (AUGIB). Recent evidence suggests there has been a decline in exposure and experience in AUGIB endoscopy.<sup>1</sup> In July 2013 our Hospital introduced a Consultant led and Registrar supported Monday to Friday, 9 to 5 pm in-reach service. It comprises of a morning visit to the acute medical units and a daily inpatient emergency list. This study looked at registrar AUGIB endoscopy training after its implementation. <h3>Methods</h3> Endoscopy reports of patients presenting with haematemesis, melena or both who had undergone gastroscopy during the period of 1<sup>st</sup> of March 2015 to 31<sup>st</sup> August 2015 were retrieved using the endoscopy reporting tool Unisoft and were then analysed. Reports where StRs were the primary operator were considered. Number of procedures, haemostatic intervention and nature of haemostasis was analysed. This was then compared to data from the year before implementation (01/03/2012 to 31/08/2012). <h3>Results</h3> A total of 7 StRs (5 Full Time and 2 Less than Full Time) performed gastroscopies on AUGIB patients as first operators under Consultant supervision. Over the 6 month period a total of 166 gastroscopies were undertaken(Mean 24). On 26 occasions, endoscopic intervention(EI) was performed(Mean 4). On average, 16% of the AUGIB patients required EI. In cases of Non Variceal Bleeding, Dual therapy was applied in 87.5% of the cases. In the remaining cases Haemospray was used. On average each StR was able to perform one case of oesophageal variceal banding and one case where Haemospray was utilised. Data from the 2012 cohort in comparison showed a total of 66 gastroscopies over 6 months with 13 EI by 5 StRs. On average 13 procedures and 2.6 EIs were performed by each StR.Dual therapy was applied in only 28.5% of the cases. <h3>Conclusion</h3> The introduction of the Registrar of the Week Service provides a valuable opportunity for StRs to be trained in endoscopic haemostasis and acquire exposure to AUGIB patients. As per this study each StR on an average performed endoscopy on 24 AUGIB patients. If this is extrapolated, each StR will be able to perform 48 procedures in 1 year and 240 procedures over 5 years. In the case of EI, on average a StR can perform around 4 interventions over 6 months, which comes to 8 per year and 40 in a 5 year programme which is significantly better than in the previous cohort and other centres.<sup>1</sup> Hospitals should consider developing similar services not only to meet demands for 24/7 Consultant led AUGIB endoscopy service but provide adequate endoscopic training provision for current specialist registrars in order to ensure future competent and confident Consultants. <h3>Reference</h3> 1 Penny HA, Kurien M, Wong E, <i>et al</i>. <i>Frontline Gastroenterology</i> 2016;<b>7</b>:67–72. <h3>Disclosure of Interest </h3> None Declared
High Expression of the Ca2+-Binding Proteins S100A8 and S100A9 Cause Glucocorticoid Resistance in MLL-Rearranged Infant Acute Lymphoblastic Leukemia.
Authors: Jill Hagelstein, Pauline Schneider, Jasper de Boer, Esther Hulleman, Owen Williams, Rob Pieters, Ronald W. Stam
Journal: Blood (2009)
Synergistic Cytarabine:Daunorubicin Ratios Delivered by CPX-351 to Human Leukemia Xenografts Is Associated with Liposome-Mediated Bone Marrow Drug Accumulation, Intracellular Delivery of Encapsulated Agents to Leukemia Cells, and Increased Efficacy.
Authors: Lawrence Mayer, Wahseng Lim, Nancy Dos Santos, Sherwin Xie, Andrea Hopkins, Ruby Huang, Lindsey Wilkins, Sarah Kelly, David Bermudes, Troy Harasym, Paul Tardi
Journal: Blood (2008)
SP0122 Kinase Inhibitors: Clinical Aspects
Authors: G.S. Firestein
Journal: Annals of the Rheumatic Diseases (2016)

Kinases play a critical role in inflammatory disease and immune regulation. They are critical molecules that transduce signals from the environment, including cytokines and toxic exposures. Their participation in human rheumatic disease has been confirmed through the testing and introduction of kinase inhibitors to treat various immune-mediated diseases. Janus kinase inhibitors, for example, are effective in rheumatoid arthritis, psoriasis and many others. These observations create opportunities for targeting other pathways and kinases that play a role in B cell activation and differentiation, stress responses, and cytokine signaling. Our experience with kinase inhibitors also demonstrates that the specific kinase and its inhibitor must be carefully matched to the pathogenic process. Several unsuccessful clinical development programs, such as p38 MAP kinase or Syk, show that the balance between efficacy, clinical indication, and toxicity need to be carefully considered. The future, however, is bright because there is an abundance of potential targets. Carefully designed clinical trials, use of biomarkers to stratify patients, and patience will pay off we new and creative ways to treat our patients. <h3>Disclosure of Interest</h3> None declared
MRD-Directed Post-Remissional Therapy Dramatically Improves Outcome of Adult Patients with High Risk AML by Implementing Allogeneic Transplant Option
Authors: Francesco Buccisano, Luca Maurillo, Maria Ilaria Del Principe, Raffaella Cerretti, Maria Antonietta Irno Consalvo, Daniela Fraboni, Paola Panetta, Selenia Campagna, Licia Ottaviani, Chiara Sarlo, Gottardo De Angelis, Concetta Ditto, Luigi Di Caprio, Maria Giovanna Cefalo, Emanuele Ammatuna, Fabio Duranti, Francesco Lo Coco, William Arcese, Sergio Amadori, Adriano Venditti
Journal: Blood (2010)
Elevated Tricuspid Regurgitation Jet Correlates with Decreased Brachial Artery Relaxivity In Sickle Cell Anemia Patients on Chronic Transfusion Therapy.
Authors: Jon Detterich, Adam Bush, Roberta Miyeko Kato, Suvimol Sangkatumvong, Daniel Gardner, Michael Khoo, Herbert Meiselman, John Wood, Thomas D. Coates
Journal: Blood (2010)
PTH-105 Introduction of Transjugular Intrahepatic Portosystemic Shunt (TIPSS) Service for Refractory Ascites in A Non-Transplant Liver Unit
Authors: MU saleem, A lawson, C salmon, N taylor, A austin
Journal: Gut (2016)

<h3>Introduction</h3> TIPSS has been shown to be an effective treatment for patients with refractory ascites (RA).The majority of TIPSS procedures in the UK are performed in a transplant centre. In 2009, Derby Teaching Hospitals introduced TIPSS service. The aim of our study was to evaluate our experience and assess its impact on the care of this patient group. <h3>Methods</h3> 56 successful TIPSS procedures were performed between May 2009 and August 2015, 32 for RA were included in this analysis.Data on patient demographics, aetiology of liver disease, inpatient bed days (6 months before and after the procedure), Model for End-Stage Liver Disease (MELD) scores, Child-Pugh score, procedure details, clinical outcomes, mortality and complications were collected retrospectively from our centres clinical results database.Complete response was defined as no further need for paracentesis and partial if frequency reduced to &gt;50%. <h3>Results</h3> 25/32 (78%) patients were male with a median age of 58 years (range, 39–77 years). 30 patients were Child-Pugh class B, 2 Child-Pugh C, with a median MELD and MELD Na of 11 (range, 6-16) and 14 (range, 6–22) respectively. Alcoholic Liver Disease was most common aetiology of cirrhosis (86.5%) followed by non-alcoholic fatty liver disease (6.45%). Pre-TIPSS and post-TIPSS hepatic venous pressure gradients (HVPG) were 20 mmHg (range, 10–30) and 8 mmHg (range, 1–21) respectively. Cumulative mortality at 1, 3, and 12 months was 3%, 9%,and 18% (n = 28) respectively. One early death (within 30 days) was secondary to pneumonia. Ascites resolved completely after the first procedure in 66% and partially in 6% of patients.Cummulative response rate was 24, 62 and 90 percent at 30,60 and 90 days respectively. Five patients (16%) showed no improvement in RA, of whom 2 underwent liver transplantation. 9 patients (28%) developed hepatic encephalopathy (HE), 5 of whom (16%) developed refractory HE, with 3 patients requiring TIPSS reduction. The number of inpatient days reduced from 23 (range, 4-52) days in the 6 months pre-TIPSS to 8 (range 0–48) in the 6 months post TIPSS. The main reason for hospital admission was elective admission for ascites drainage. <h3>Conclusion</h3> A safe and effective TIPSS service for patients with refractory ascites can be successfully introduced into a comprehensive secondary care liver service by careful patient selection and technical proficiency. Excellent outcomes with acceptable complication rates can be achieved for patients with a significant reduction in resource utilisation (inpatient bed days and paracentesis). An established elective service is an important precursor for the provision of early and rescue TIPSS for variceal bleeding. <h3>Disclosure of Interest</h3> None Declared
Prognostic Implications of Autoimmune Complications of Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma (CLL/SLL) and Other Chronic B Cell Lymphoproliferative Disorders (CLPD).
Authors: Karin F. Giordano, Ding Wei, Slager L. Susan, Schwager M. Susan, Call Timothy, Shanafelt Tait, Phyliky L. Robert, Bone D. Nancy, Kay E. Neil, Zent S. Clive
Journal: Blood (2005)
Retrospective Evaluation of 90 Children with Essential Thrombocytemia: The AIEOP Experience
Authors: Maria Caterina Putti, Fiorina Giona, Caterina Consarino, Gian Mario Fiori, Paola Giordano, Saverio Ladogana, Momcilo Jankovic, Concetta Micalizzi, Andrea Pession, Paolo Pierani, Ugo Ramenghi, Margherita Scapin, Luciana Teofili, Fabio Tucci, Katia Tettoni, Andrea Giulio Zanazzo, Maria Luigia Randi
Journal: Blood (2008)
Hematopoietic Cell Transplantation - Comorbidity Index (HCT-CI) as a Surrgoate Marker for Predition of Transplant Outcome for Pateints (pts) with Multiple Myeloma (MM) Undergoing Autologous Stem Cell Transplantation (ASCT): High HCT-CI Score Predicts for Poor Outcome.
Authors: Mohamed I. Farhat, Ronald Myint, Stephanie A. Gregory, Parameswaran Venugopal, Mohamad Kassar, Alla Gimelfarb, Marta Batus, Julie Nangia, John Maciejewski, Amanda Law, Henry C. Fung
Journal: Blood (2007)
Circulating Endothelial Cells Are an Indicator of Response to Treatment in Acute Myeloid Leukemia Patients.
Authors: Agnieszka Wierzbowska, Tadeusz Robak, Anna Krawczynska, Agata Wrzesien-Kus, Agnieszka Pluta, Barbara Cebula, Piotr Smolewski
Journal: Blood (2005)
PTU-128 Prevalence and Management of Irritable Bowel Syndrome Seen in Colorectal Surgery and Gastroenterology Clinics
Authors: J Shearer, P Luthra, AC Ford
Journal: Gut (2016)

<h3>Introduction</h3> Irritable bowel syndrome (IBS) in the UK accounts for a large proportion of patients seen in secondary care. Pathways to the diagnosis of IBS are not standardised, and patients are often reviewed outside a luminal Gastroenterology service. We examined the burden of IBS in both Colorectal Surgery and Gastroenterology clinics. <h3>Methods</h3> All patients seen with IBS in either Gastroenterology (GE) or Colorectal Surgery (CS) clinics over a 1 month period January to February 2014 at Leeds Teaching Hospitals NHS Trust were identified. The following data were retrospectively recorded: age/sex of the patient, investigations prior to diagnosis, number of visits to that speciality clinic, number and type of medications prescribed, and final placement of the patient. We compared management of patients in both settings using a Chi-squared test. <h3>Results</h3> There were a total of 76 patients with IBS seen in CS clinics (mean age 49.6 years, 39 (51.3%) female) and 57 patients in GE clinics (mean age 39.1 years, 39 (68.4%) female). The number and type of investigations requested prior to diagnosis are detailed in Table 1. In CS clinics, colonic imaging (colonoscopy, sigmoidoscopy or barium enema) was requested in 70 (92.1%) patients, compared with 39 (68.4%) patients in GE clinics (P = 0.001). Cross-sectional imaging was utilised in 36 (47.4%) patients in CS clinics, compared with 19 (33.3%) patients in GE clinics (P = 0.15). Serological testing for coeliac disease was not performed in 22 (29.9%) patients in CS clinics, and 5 (8.8%) patients in GE clinics (P = 0.008). For the CS clinic patients the mean number of visits was 2.7 (range 1–14) with 22 (28.95%) patients offered prescribed therapy. In the GE clinic patients the mean number of visits was 2.5 (range 1–5), with 43 (75.4%) patients offered prescribed therapy (P &lt; 0.001). Nine (11.8%) patients were seen by both services. Twenty-six (45.6%) patients were referred to a dietician from the GE clinic, but none from the CS clinic (P &lt; 0.001). No patients were referred for hypnotherapy or psychological therapy from either clinic. <h3>Conclusion</h3> These data highlight the need for a more consistent referral process, and a more specialised approach to the management of this patient group. This should be based on current guidelines for the management of IBS using evidence-based treatments and with easy access to dietetic, psychological, and specialist nurse support. <h3>Disclosure of Interest</h3> None Declared
Excellent Therapeutic Results Achieved in Salvage Therapy for Steroid-Refractory Grades III-IV Acute Gvhd with Basiliximab and Etanercept: A Multicenter Prospective Study
Authors: Yamin Tan, Haowen Xiao, Jianping Lan, Yi Luo, Jimin Shi, Jingsong He, Xiaoyu Lai, Weiyan Zheng, Zhen Cai, He Huang
Journal: Blood (2015)