tbuckley/cabot-search huggingface dataset:
AB0034 IFN-Gamma-Producing VZV-Specific CD4 T-Cells in Patients with Rheumatoid Arthritis (RA)
Authors: G. Almanzar, E. Bienenstein, K. Höfner, M. Schmalzing, H.-P. Tony, J. Liese, M. Prelog
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> Varicella-zoster-virus (VZV) establishes a life-long latent infection with risk of reactivation in patients with autoimmune disorders receiving immunosuppressive/immunomodulatory therapy. <h3>Objectives</h3> The study was aimed to evaluate the VZV-specific cellular immune response in the presence of cytokine-blocking antibodies in rheumatoid arthritis (RA) patients and healthy controls (HC). <h3>Methods</h3> IFNgamma- and IL-6-producing-CD4+ and -CD8+ T-cells were determined following stimulation with VZV-antigen in the presence of anti-IL-6 or anti-TNFalpha antibodies in vitro. Intracellular cytokine production was determined by flow cytometry in RA patients and HC. <h3>Results</h3> No differences in the IFNgamma- and IL-6-producing CD4+ or CD8+ T-cells were found between RA and HC following VZV stimulation. In the presence of anti-IL-6 in vitro, VZV-specific CD4+ T-cells producing IFNgamma reduced in RA compared to HC (11.0% versus 7.9%). In the presence of anti-IL-6, VZV-stimulated cells showed a reduction of IL-6-producing-CD4+ T-cells compared to cells stimulated with VZV alone in RA (7.2% versus 4.8%). No differences were observed in CD8+ T-cells in RA or in CD4+/CD8+ T-cells in HC. In the presence of anti-TNFalpha in vitro, IL-6-producing-CD4+ T-cells of RA patients were lower following stimulation with VZV compared to HC (6.2% versus 9.2%). <h3>Conclusions</h3> The reduction of the CD4+ cellular immune response to VZV by blocking of TNFalpha and IL-6 in vitro suggests an important role of inflammatory cytokines in the modulation of the T-cell response to VZV in RA. The influence of different cytokines on the long-term anti-VZV cellular immunity in patients with autoimmune conditions may need further investigated to prevent VZV reactivation. <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.5781
P57 Fast track referral of patients with malignant mesothelioma is not associated with better survival
Authors: AK Datta
Journal: Thorax (2013)

<h3>Background</h3> Few studies have examined the effect on survival in lung cancer of fast-track referral, while those that do have questioned the utility of the two-week fast track referral rule <sup>1</sup>. Paradoxically, delayed referral was associated with longer survival <sup>2</sup>. No studies which examined this factor in mesothelioma survival have been published. We therefore examined the effect of mode of referral on survival in malignant mesothelioma. <h3>Methods</h3> All 88 patients with malignant mesothelioma in York and North Yorkshire between 2002 2011, where referral data was known, were examined for age at presentation, performance status (<b>PS</b>) and survival using Cancer Registry data with SPSS v19. <h3>Results</h3> Three categories of referral were identified: 33 Fast Track (<b>FT</b>), 20 non Fast Track (<b>NFT</b>) and 35 Acute Admission (<b>AA</b>). There was no difference in median [interquartile range] for age between <b>FT</b> (71.7 [68.3 74.6] years), <b>NFT</b> (69.4 [65.0 73.8 years) and <b>AA</b> (74.1 [70.7 77.5] years). <b>AA</b> patients had a worse <b>PS</b> (2 [1.4 2.2]) than <b>FT</b> (1 [0.7 1.3]) and <b>NFT</b> (1 [0.5 1.5]), <i>p = </i>0.03, analysis of variance (ANOVA). No difference was seen between <b>FT</b> and <b>NFT</b>. Survival was significantly shorter in <b>AA </b>(3 [2.4 8.1] months) than for <b>FT</b> (6 [6.6 14.2] months) and <b>NFT</b> (10 [8.4 16.4] months), <i>p = 0.01,</i> ANOVA. Results in the three groups are confirmed graphically using Kaplan-Meier survival analysis (<b>Fig.1</b>) <h3>Conclusions</h3> We have shown that patients admitted acutely with malignant mesothelioma have a worse performance status and shorter survival than patients referred to clinic either via the <b>FT</b> two week rule or <b>NFT.</b> No survival benefit was seen for <b>FT</b>, perhaps because they were more advanced at presentation, as has been shown for patients with lung cancer. <h3>References</h3> 1. Jones R <i>et al</i> (2001) Is the two week rule for cancer referrals working? <i>BMJ</i> 322, 1555 6 2. González- Barcala FJ <i>et al</i> (2010) Effect of delays on survival in patients with lung cancer. <i>Clin Trans Oncol</i> 12, 836 842
The Problem of Hiatus Hernia Complicated by Peptic Esophagitis
Authors: Gustaf E. Lindskog, John L. Kline
Journal: New England Journal of Medicine (1957)

IN the sixteenth century Ambroise Paré1 described the post-mortem findings in the first 2 reported cases of diaphragmatic hernia.‡ Nearly four centuries later Winklestein2 originated the term peptic esophagitis. Only within the past decade has the relation between diaphragmatic hernia and esophagitis become widely recognized. It is the purpose of this report to present the problem as seen on the Thoracic Surgical Service of the New Haven Hospital during the ten-year span, 1945–55.Case MaterialDuring this interval there were over 3000 admissions to the Thoracic Surgical Section. Twenty-nine patients, or about 1 per cent, had proved peptic esophagitis. Sixty-two . . .
PREDICTION OF CORONARY STENT PATENCY USING EXERCISE TREADMILL TEST
Authors: Jong Yop Pae, Hyuck-Jun Yoon, In-Cheol Kim, Yun-Kyeong Cho, Hyoung-Seob Park, Hyungseop Kim, Chang-Wook Nam, Seong-Wook Han, Seung-Ho Hur, Yoon-Nyun Kim, Kwon-Bae Kim
Journal: Journal of the American College of Cardiology (2015)
Reply to R. Simon
Authors: Michael F. Press, Leslie Bernstein, Jane Sullivan-Halley, Marc Buyse, Guido Sauter, Dennis J. Slamon
Journal: Journal of Clinical Oncology (2011)

Press et al 1 concluded that "TOP2A coamplification, not HER2 amplification, is the clinically useful predictive marker of an incremental response to anthracycline-based chemotherapy."I do not believe that this conclusion is justified on the basis of the data they examined.To evaluate whether a marker is predictive for benefit from a drug, one should compare (either prospectively or by using archived specimens from a previous trial) outcomes for patients who were randomly assigned to receive a regimen containing the drug or the same regimen not containing the drug, and one should examine how this treatment effect (ie, hazard ratio) depends on marker status. 2 The studies Press et al 1 examined did not permit such an evaluation.The closest one could come to a direct analysis of whether TOP2A amplification is a predictive marker of anthracycline effectiveness was an analysis that Press et al did not comment on.In trial BCIRG-006 of the Breast Cancer International Research Group, patients with HER2amplified tumors were randomized to receive ACT (doxorubicin, cyclophosphamide, docetaxel), ACTH (ACT plus trastuzumab), or TCH (docetaxel, carboplatin, trastuzumab).A comparison of the ACTH regimen with the TCH regimen isolates the value of the anthracycline relative to carboplatin with both in the presence of trastuzumab.In Figure 3 of the article by Press et al, 1 outcomes for these two regimens seem equivalent both for TOP2A-amplified and for TOP2Aunamplified tumors.In the patients with amplified tumors, there were 35 events on treatment with ACTH compared with 42 events on treatment with TCH; in the patients with unamplified tumors, there were 87 events on ACTH compared with 92 on TCH.Consequently, on the basis of the only relevant direct randomized comparison of anthracycline use available in the authors' data, there is no evidence that the efficacy of the anthracycline depends on TOP2A status.The authors base their conclusions on indirect evidence.In both the BCIRG-006 adjuvant study and the H0648g, the original trastuzumab metastatic disease licensing study, the investigators compared an anthracycline regimen not containing trastuzumab with the same anthracycline regimen administered with trastuzumab.They noted that trastuzumab did not seem to improve outcome in the small subset of patients with amplified TOP2A but that it did improve outcome for patients without TOP2A amplifications.
PC0004 Educational programs for physicians in diagnosis and treatment of ankylosing spondylitis in kazan (russia)
Authors: L. Myasoutova, S. Lapshina
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> At present, the average time interval between appearance of the first signs of ankylosing spondylitis (AS) and the correct diagnosis is 7-8 years. This fact leads to delay of potentially effective therapy. <h3>Objectives</h3> To evaluate the effectiveness of educational activities for general practitioners (GP) in AS detection. <h3>Methods</h3> The educational schools are conducted to identify the inflammatory back pain, diagnosis and treatment of AS for GPs since January 2010. At these schools primarily discusses the criteria for chronic inflammatory back pain (ASAS), the possible clinical picture at the onset of the disease (arthritis, uveitis, enthesitis etc.), the importance of timely assessment of laboratory parameters (erythrocyte sedimentation rate, CRP), the identification of HLA-B27, modern imaging techniques (X-ray and MRI) and the possibility of disease-modifying therapy in the early stages of disease <h3>Results</h3> valuation of the results was carried out according to analysis of outpatient rheumatological report from Rhematological Center in Kazan for 2009-2010. After the schools in 2010 among all patients consulted by rheumatologists, the proportion of patients with AS increased to 6.3% (575 patients) compared with 2009 (4.5%, 378 patients). The number of patients with AS, who came first, increased from 118 (31.2%) to 190 (33.05%) patients. In 2009, the primary patients with AS were sent by different doctors to rheumatologist with other diagnoses in 78% of cases. In 2010, the percentage difference of primary diagnoses decreased to 14%. <h3>Conclusions</h3> Educational programs for primary care physicians are essential and contribute to early diagnosis of AS, the timely appointment of therapy, improve quality of life. Experience in conducting educational activities in Kazan has led to improved detection of the AS by primary care physicians and timely referral to a rheumatologist. <h3>Disclosure of Interest</h3> None Declared
SAT0464 Remission at 6 as well as at 9 months predicts good long-term outcome in early rheumatoid arthritis patients with non-biological treatment:
Authors: K. Britsemmer, L.H.V. Tuyl, D.V. Schaardenburg, M. Boers
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Recently, an American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) collaboration redefined remission in rheumatoid arthritis (RA). <h3>Objectives</h3> To validate if remission predicts later good long-term outcome in terms of radiological progression and physical functioning in an early arthritis cohort. <h3>Methods</h3> Patients from the Amsterdam Jan van Breemen Research Institute with RA (1987 ACR criteria), and not using biologicals, were included in the analysis. ACR/EULAR remission status (Boolean) was evaluated at 6 and 9 months. Long-term outcome included radiographs of hands and feet (scored by the Sharp- van der Heijde (SvH) method) and the health assessment questionnaire (HAQ). Good long-term outcome was defined as 1) stable X-ray score (change &lt;1 in SvH), 2) low score on the HAQ (HAQ change ≤0 AND HAQ score consistently ≤0.5) and 3) both stable X-rays scores AND stable low HAQ scores between year 1 and 2 and between year 2 and 3. To analyze the ability of remission to predict good long-term outcome likelihood ratios and logistic regression were used. <h3>Results</h3> We studied 359 patients with mean age 54 (SD 13), 70% female, median symptom duration 6 (3-7) months, and median swollen joint count and tender joint count 8 (4-11) and 6 (3-10), respectively. Mean DAS28 was 5,1 (1,2). Six percent of patients reached remission at 6 months, while 24% of all patients were in minimal disease activity state defined as DAS28&lt;2.6. At 9 months these proportions were 11% and 25%, respectively. In the second year after inclusion 43% of the patients had radiographic progression (median progression 3 [2-8]). Between year 2 and 3 37% had radiographic progression (median progression 3 [2-6]). In 35% HAQ outcomes were good and in 20% both long-term outcomes were good between year 1 and 2. Between year 2 and 3 these proportions were 32% and 21%, respectively. Patients in remission at 9 months, but not at 6 months, had a significantly increased likelihood of a good outcome in terms of stable HAQ and stable HAQ/Sharp between year 1 and 2 (table 1). Furthermore, remission at 6 as well as at 9 months was significantly predictive for good outcome in terms of stable HAQ and stable HAQ/Sharp between year 2 and 3 (table 1). <h3>Conclusions</h3> In this early RA cohort not on biological treatment, good long-term outcome in terms of radiological progression and physical functioning between year 1 and 2 after inclusion was predicted by remission at 9 months, and between year 2 and 3 after inclusion by remission at 6 as well as at 9 months. <h3>Disclosure of Interest</h3> None Declared
A pilot study of monoclonal antibody cG250 and low dose subcutaneous IL-2 in patients (pts) with advanced renal cell carcinoma (RCC)
Authors: I. D. Davis, Z. Liu, W. Saunders, F. T. Lee, V. Spirkoska, W. Hopkins, F. Smyth, E. W. Hoffman, L. J. Old, A. M. Scott
Journal: Journal of Clinical Oncology (2004)

2558 Background: The median survival of pts with metastatic RCC is 10 months. No therapy has been shown to improve the survival of these pts. cG250 is a chimeric monoclonal antibody (MoAb) that recognizes the CAIX/MN antigen. cG250 induces Ab-dependent cellular cytotoxicity (ADCC) responses in vitro that can be enhanced by IL-2. Our previous trial using cG250 alone showed it is safe, that tumor-specific targeting is high and that the T½ of cG250 in the circulation is long. We studied the effects of adding daily low-dose subcutaneous (sc) IL-2 to cG250 for treatment of clear cell RCC. Methods: The endpoints of the trial were toxicity; immunological effects (human anti-chimeric antibodies [HACA], ADCC, natural killer [NK] and lymphokine-activated killer cell [LAK] activity); cG250 biodistribution and pharmacokinetics (PK); and antitumor effects. Eligible pts had unresectable metastastic or locally advanced clear cell RCC with measurable or evaluable disease. Nine pts were treated as follows. cG250: 10 mg/m2/week (wk) x 6wk (1st and 5th doses trace-labeled with 131I). IL-2: 1.25x106 IU/m2/day x 6wk. Results: Treatment was generally well tolerated with no adverse events attributable to cG250. Two pts required 50% dose reduction of IL-2 due to toxicity. No HACA was detected. Labeled cG250 showed excellent targeting of tumor deposits. cG250 PK: T½α 22.96±12.53 hrs, T½β 135.20±46.90. IL-2 did not affect cG250 PK. ADCC and/or LAK cell activity was enhanced in some pts. No antitumor responses were observed. Conclusions: Weekly cG250 with daily low-dose sc IL-2 is well tolerated. IL-2 does not influence the PK or biodistribution of cG250 and does not increase HACA. Some pts showed enhanced ADCC or LAK activity. Other strategies for enhancing the antitumor effect of cG250 are being explored. No significant financial relationships to disclose.
Adult T-Cell Leukemia With Invasion by Malignant Cells of the Parotid Glands Diagnosed by Ga-67 Imaging
Authors: JUN FUKUZAWA, TADAYUKI AKAISHI, HIDEICHI TANAKA, KYOKO NAKANISHI, MOTOI OKADA, TAKASHI HANEDA, KENJIRO KIKUCHI
Journal: Clinical Nuclear Medicine (1996)

Adult T-cell leukemia (ATL) shows several initial signs such as lymphadenopathy. Although oral cavity dryness is uncommon as an initial symptom of ATL, we encountered a case of a man who complained of just such an initial symptom and routine examination and the clinical course indicated that he was suffering from ATL. Further examination with Ga-67 citrate scintigraphy and a postmortem study showed that lymphadenopathy had been induced by invasion by ATL cells of both parotid glands. Therefore, ATL should be considered in patients with an initial symptom of oral cavity dryness and enlargement of the parotid glands.
Prevalence and therapeutic relationships of pericardial effusions in patients with leukemia
Authors: K. R. Sampat, V. Garcia-Gutierrez, A. Rossi, S. Pierce, J. Cortes, H. Kantarjian, G. Garcia-Manero
Journal: Journal of Clinical Oncology (2009)

7067 Background: Little is known regarding the prevalence and natural history of pericardial disease in patients with leukemia. Recently, there have been reports of an increased incidence of pericardial effusions (PEf) in patients receiving histone deacetylase inhibitors (HDACi) such as MGCD0103. Although a direct causal relationship has not been established yet, this complication may have a significant impact for the future development of this class of drugs. To study this issue, we retrospectively analyzed a large cohort of patients with leukemia, who were evaluated at MD Anderson Cancer Center (MDACC), to determine the prevalence, timing, and characteristics of PEf in leukemia. Methods: We reviewed 3,327 patients with acute myeloid leukemia (AML, N = 1,809, 54%), acute lymphocytic leukemia (ALL, N = 494, 15%), or myelodysplastic syndrome (MDS, N =1,024, 31%), who were seen at MDACC from August 2003 to July 2008. Of this group, 1,982 patients (60%) had an echocardiogram at some point during their care at MDACC. Data regarding diagnosis, timing, effusion size, and prior therapy was collected in the 401 patients (20.2%) that had echocardiographic evidence of PEf. Results: The overall prevalence of PEf was 21.7%, 21.1%, and 19.9% (p = 0.72) in patients with AML, ALL, and MDS, respectively. In the 401 total patients with PEf, 22.8%, 25.0%, and 18.4% (p = 0.33) of these effusions were found before treatment in the three disease categories, respectively. The rest occurred after some form of chemotherapy, accounting for 77.2%, 75.0%, and 81.6% (p = 0.73) of the total PEf by disease, respectively. Most PEf were of minimal size (67%) overall. No differences in effusion characteristics, including severity, were observed among different types of therapies including HDACi. Conclusions: PEf are relatively common in patients with leukemia at initial presentation and are usually asymptomatic. Their incidence increases with therapy administration although it appears that this is not a process related to specific classes of treatment or type of leukemia. No significant financial relationships to disclose.
Patulous Eustachian Tube Causing Hypermobile Eardrums
Authors: Chao-Yin Kuo, Chih-Hung Wang
Journal: New England Journal of Medicine (2014)

A 20-year-old man presented with a history of popping sounds in both ears during deep breathing. Audiometry showed normal hearing. Otoscopy revealed indrawn and severely atrophic eardrums that moved outward on nasal expiration and inward on inspiration, shown in a video.
Obesity and postmenopausal breast cancer: impact on risk, tumour stage and survival in an Irish population.
Authors: LA Healy, AM Ryan, S Rowley, EM Connolly, MJ Kennedy, T Boyle, JV Reynolds
Journal: Cancer Research (2009)

Abstract Abstract #6089 Background &amp;#x2028; The evidence that obesity adversely affects women's health is overwhelming and indisputable. The risk of postmenopausal breast cancer increases with obesity. Furthermore it is reported that obesity is associated with poorer prognosis of breast cancer.&amp;#x2028; Objective&amp;#x2028; To assess the relationship between obesity and postmenopausal breast cancer by examining the incidence, tumour size, pathological stage, axillary nodal involvement and survival in an Irish population.&amp;#x2028; Design &amp; Setting&amp;#x2028; A retrospective case control study was undertaken in 200 patients presenting to a tertiary centre between 1998-2006. Data were compared to 519 healthy female controls. Multivariate logistic regression models were used to calculate the odds ratio (OR) of developing postmenopausal cancer according to body mass index (BMI), as well as the impact BMI has on tumour size, nodal involvement, pathological stage and survival. Actuarial survival was calculated from date of diagnosis by the Kaplein-Meier method and comparisons between the groups were made by the log rank test.&amp;#x2028; Results&amp;#x2028; Postmenopausal breast cancer patients were significantly heavier than age matched controls with 65% being overweight or obese versus 54% of controls (p=0.030). A dose dependent relationship existed between BMI and postmenopausal breast cancer incidence. The adjusted odds ratio was 2.2 (95%CI 1.3-3.7) for individuals in the highest BMI quartile compared to the lowest BMI quartile (P=0.002). Using common cut-offs for BMI, obese patients had double the risk of postmenopausal breast cancer compared to normal weight patients OR 2.04 (95%CI 1.3-3.3; p=0.004). There was no difference in symptomatic detection, assessment or treatment of breast cancer, however operative times were significantly longer for obese patients (P=0.05). Obesity was associated with larger tumours (P= 0.002) and a later stage of disease at presentation (P=0.026) but not with axillary nodal involvement (P=0.332). Median and overall survivals were equivalent (P=0.172) when comparing obese to non obese.&amp;#x2028; Conclusion&amp;#x2028; Obese women are twice as likely to get postmenopausal breast cancer compared to normal weight women. Understanding why obese women have a higher breast cancer incidence may lead to more effective breast cancer prevention and treatment interventions. Obesity is a preventable risk factor for breast cancer and given the high and increasing prevalence of obesity in Ireland, obesity needs to be addressed on a national level with targeted lifestyle treatment programs. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 6089.
The Relationship of Uric Acid Levels and Atrial Fibrillation Prevalence in Turkish Population
Authors: Burak Hünük, Özgür Çağaç, Okan Erdoğan, Alper Kepez, Bülent Mutlu, Muzaffer Değertekin, Çetin Erol
Journal: Journal of the American College of Cardiology (2013)
Evaluation of a Patient With a Brain Abscess Caused by Nocardia Asteroides Infection With Ga-67 and Tc-99m HMPAO Leukocytes
Authors: PIERGIUSEPPE ORSOLON, BRUNO BAGNI, GIOVANNI TALMASSONS, UGO PAOLO GUERRA
Journal: Clinical Nuclear Medicine (1997)

A female patient with nocardia interstitial pneumonia developed an abscess in the left parietal lobe. Nocardia asteroides was isolated from the brain abscess at craniotomy. Fifteen days later, a brain MRI showed a mass at the craniotomy site. Recurrent abscess was suspected and Ga-67 brain SPECT showed increased uptake in the left parietal area. Five days later, Tc-99m HMPAO leukocyte brain SPECT showed only a weak uptake in the same region. The different results of the two radionuclides are difficult to explain and could be related to a complex mechanism of uptake, bacterial resistance, and specific therapy.