tbuckley/cabot-search huggingface dataset:
SP0154 How to offer seminars on nutrition
Authors: C. Elling-Audersch
Journal: Annals of the Rheumatic Diseases (2018)

<h3></h3> Deutsche Rheuma-Liga (German Rheumatism League) Deutsche Rheuma-Liga (DRL) is a patient organisation that offers support to people with all rheumatic and musculoskeletal diseases (RMDs). We offer to our members information, various seminars, exercise classes and advice services. The main goal is to improve a patient's self-management. Most patients have questions concerning medication, but would like to know as well what other measures can be taken to improve their health. Nutrition and the question of a rheumatism diet is one of the great patients' demands. Based on a survey of our organisation (DRL) patients' information priorities are obvious and have led to offerings for patients. Our seminars for patients about nutrition are based on our nutrition booklet, on evidence-based information and on avoiding an esoteric content. All seminars deal with three key elements of self-management: nutrition, exercise and ergonomic kitchen aids. Based on the key messages of nutrition, the important aspects are not only to educate, but also to exercise, to communicate, to exchange experiences, to cook, to taste, to smell and to enjoy. We show ergonomic kitchen aids and explain their daily usefulness. My talk will consider organisational aspects as well, if an organisation wants to offer such seminars. In our experience combining nutrition, exercise and ergonomic aids are essential aspects of a healthy life and contribute to a person's rheumatic and/or musculoskeletal treatment successfully. <h3>Disclosure of Interest</h3> None declared
Motivational valence is determined by striatal melanocortin 4 receptors
Authors: Anna Mathia Klawonn, Michael Fritz, Anna Nilsson, Jordi Bonaventura, Kiseko Shionoya, Elahe Mirrasekhian, Urban Karlsson, Maarit Jaarola, Björn Granseth, Anders Blomqvist, Michael Michaelides, David Engblom
Journal: Journal of Clinical Investigation (2018)

It is critical for survival to assign positive or negative valence to salient stimuli in a correct manner. Accordingly, harmful stimuli and internal states characterized by perturbed homeostasis are accompanied by discomfort, unease, and aversion. Aversive signaling causes extensive suffering during chronic diseases, including inflammatory conditions, cancer, and depression. Here, we investigated the role of melanocortin 4 receptors (MC4Rs) in aversive processing using genetically modified mice and a behavioral test in which mice avoid an environment that they have learned to associate with aversive stimuli. In normal mice, robust aversions were induced by systemic inflammation, nausea, pain, and κ opioid receptor-induced dysphoria. In sharp contrast, mice lacking MC4Rs displayed preference or indifference toward the aversive stimuli. The unusual flip from aversion to reward in mice lacking MC4Rs was dopamine dependent and associated with a change from decreased to increased activity of the dopamine system. The responses to aversive stimuli were normalized when MC4Rs were reexpressed on dopamine D1 receptor-expressing cells or in the striatum of mice otherwise lacking MC4Rs. Furthermore, activation of arcuate nucleus proopiomelanocortin neurons projecting to the ventral striatum increased the activity of striatal neurons in an MC4R-dependent manner and elicited aversion. Our findings demonstrate that melanocortin signaling through striatal MC4Rs is critical for assigning negative motivational valence to harmful stimuli.
The Screening ECG and Cardiac Risks
Authors: Robert J. Myerburg
Journal: JAMA (2018)

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 Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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) 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
Dietary fat and cardiometabolic health: evidence, controversies, and consensus for guidance
Authors: Nita G Forouhi, Ronald M Krauss, Gary Taubes, Walter Willett
Journal: BMJ (2018)

Although difficulties in nutrition research and formulating guidelines fuel ongoing debate, the complexities of dietary fats and overall diet are becoming better understood, argue <b>Nita G Forouhi and colleagues</b>
Abstract 18744: Rising Costs of Adult Congenital Heart Disease Care: Does Gender Matter?
Authors: David A Briston, Elisa Bradley, Aarthi Sabanayagam, Ali N Zaidi
Journal: Circulation (2015)

Introduction: The profile of congenital heart disease (CHD) has shifted, now with more adults than children who have survived. Few studies have provided a global assessment of adult congenital heart disease (ACHD) healthcare cost in the United States. Methods: Data from the National Inpatient Sample (2002-2012) utilizing diagnostic ICD-9 codes for moderate and complex ACHD were analyzed. Hospital discharges, total billed and reimbursed amounts, gender and age disparities were evaluated. Results: There was an overall increase in ACHD discharges (Moderate CHD: 4,742 vs. 6,545, Severe CHD: 807 vs. 1,115), billed and reimbursed dollar amounts (Billed: $542,703,961 vs. $1,506,945,042, +178%; reimbursed: $221,417,779 vs. $432,797,543, +95%). Women had more discharges in 2002 but not in 2012 (men: women, 2002: 6,503 vs. 7,805; 2012: 7,715 vs. 7,200) [Figure 1A]. Gender-based billed amounts followed a similar trend (2002: $262,918,357 vs. $279,785,604; 2012: $844,923,857 vs. $$662,021,185; p=0.006) as did total reimbursed (2002: $107,766,175 vs. $113,651,604; 2012: $243,183,638 vs. $189,613,905, p=0.008) [Figure 1B,C]. Healthcare expenditure increased across all age groups: this was most prominent in the &gt; 44 vs. 18-44 yr. group (Billed: $617,589,813 vs. $346,652,267, p&lt;0.001; reimbursed: $136,013,528 vs. $75,366,237, p&lt;0.001). Conclusions: We are the first to report a change in the rate of gender-based ACHD hospitalizations, whereby men now account for more hospitalizations in the U.S. As ACHD discharges, billed and reimbursed amounts continue to rise over the last decade, we are also the first to demonstrate increased expenditure in older (&gt; 44 yrs.) ACHD patients, a pattern that we predict will continue to grow and requires future investigation.
Randomized, Double-Blind, Phase II Study of Temozolomide in Combination With Either Veliparib or Placebo in Patients With Relapsed-Sensitive or Refractory Small-Cell Lung Cancer
Authors: M. Catherine Pietanza, Saiama N. Waqar, Lee M. Krug, Afshin Dowlati, Christine L. Hann, Alberto Chiappori, Taofeek K. Owonikoko, Kaitlin M. Woo, Robert J. Cardnell, Junya Fujimoto, Lihong Long, Lixia Diao, Jing Wang, Yevgeniva Bensman, Brenda Hurtado, Patricia de Groot, Erik P. Sulman, Ignacio I. Wistuba, Alice Chen, Martin Fleisher, John V. Heymach, Mark G. Kris, Charles M. Rudin, Lauren Averett Byers
Journal: Journal of Clinical Oncology (2018)

Purpose Both temozolomide (TMZ) and poly (ADP-ribose) polymerase (PARP) inhibitors are active in small-cell lung cancer (SCLC). This phase II, randomized, double-blind study evaluated whether addition of the PARP inhibitor veliparib to TMZ improves 4-month progression-free survival (PFS). Patients and Methods A total of 104 patients with recurrent SCLC were randomly assigned 1:1 to oral veliparib or placebo 40 mg twice daily, days 1 to 7, and oral TMZ 150 to 200 mg/m
HUWE1 controls the development of non-small cell lung cancer through down-regulation of p53
Authors: Dong Yang, Daomei Cheng, Qiu Tu, Huihui Yang, Bin Sun, Lanzhen Yan, Hongjuan Dai, Jierong Luo, Bingyu Mao, Yi Cao, Xiaoping Yu, Hua Jiang, Xudong Zhao
Journal: Theranostics (2018)

Lung cancer is the most frequent cancer type and the leading cause of tumor-associated deaths worldwide.TP53 is an important tumor suppressor gene and is frequently inactivated in lung cancer.E3 ligases targeting p53, such as MDM2, are involved in the development of lung cancer.The E3 ligase HUWE1, which targets many tumor-associated proteins including p53, has been reported to be highly expressed in lung cancer; however, its role in lung tumorigenesis is unclear.Methods: The expression of HUWE1 and p53 in lung cancer cells was modulated and the phenotypes were assessed by performing soft agar colony forming assays, cell cycle analysis, BrdU incorporation assays, and xenograft tumor growth assays.The effect on tumorigenesis in genetically-engineered mice was also analyzed.The mechanism through which HUWE1 sustained lung cancer cell malignancy was confirmed by western blotting.HUWE1 expression in clinical lung cancer was identified by immunohistochemistry and validated by analyzing lung adenocarcinoma and lung squamous carcinoma samples from the Cancer Genome Atlas (TCGA) database.Finally, we assessed the association between HUWE1 expression and patient outcome using online survival analysis software including survival information from the caBIG, GEO, and TCGA database.Results: Inactivation of HUWE1 in a human lung cancer cell line inhibited proliferation, colony-forming capacity, and tumorigenicity.Mechanistically, this phenotype was driven by increased p53, which was due to attenuated proteasomal degradation by HUWE1.Up-regulation of p53 inhibited cancer cell malignancy, mainly through the induction of p21 expression and the down-regulation of HIF1α.Huwe1 deletion completely abolished the development of EGFRVIII-induced lung cancer in Huwe1 conditional knockout mice.Furthermore, survival analysis of lung cancer patients showed that increased HUWE1 expression is significantly associated with worse prognosis.Conclusion: Our data suggest that HUWE1 plays a critical role in lung cancer and that the HUWE1-p53 axis might be a potential target for lung cancer therapy.
PTH-037 High stent migration rates despite anchoring: a bournemouth experience in biliary self-expandable metal stents
Authors: Su Yin Lau, Ghassan El Sayed
Journal: Endoscopy (2018)

<h3>Introduction</h3> Endoscopic biliary drainage is effective in 90 percent of all attempted cases of biliary strictures and 80 percent of malignant biliary strictures. It carries lower morbidity compared to surgical and radiological approaches. Our aim is to review our practice of biliary self-expandable metal stents (SEMs) insertion in a high endoscopy volume district general hospital looking into stent related complications and benign biliary stricture remodelling. <h3>Methods</h3> 185 endoscopic retrograde cholangiopancreatography (ERCP) with biliary SEMs insertion were performed in 166 patients at the Royal Bournemouth Hospital between January 2010 and November 2016. We retrospectively reviewed the indications of biliary SEMs insertion, early and late stent related complications. Early complication is defined as adverse events and stent occlusion or migration within the first 7 days of stent deployment. <h3>Results</h3> Out of 185 ERCPs, 153 were done in 142 patients with malignant strictures, 27 done in 19 patients with benign strictures and 5 done for 5 patients with indeterminate strictures. 122 uncovered SEMs(UCSEMs) were inserted in malignant strictures whereas 30, 22 and 4 fully covered SEMs(FCSEMs) inserted in malignant, benign and indeterminate strictures respectively. Early complications from SEMs insertion include biliary infection (3.24%), pancreatitis (1.08%), bleeding (1.08%), perforation (0.54%), and failure of initial ERCP requiring repeat procedure (1.08%) across all biliary strictures. Rate of stent dysfunction in UCSEMs, FCSEMs and combined plastic and FCSEMs were 17.1%, 37.5% and 33.3% respectively. 12 out of 17 patients had benign strictures remodelled, with mean time from index ERCP to remodelling being 50.5 months (range 21.1–137.8 months). Benign stricture remodelling rate were 100% (4/4) in stone disease, 100% (1/1) in post-cholecystectomy related stricture and 58.3% (7/12) in chronic pancreatitis. <h3>Conclusions</h3> Our data appears comparable to larger studies. In our cohort there is a clear contrast in stent dysfunction between FCSEMs and UCSEMs. Biliary sepsis post SEMs insertion seems higher than the published European data and this probably reflects the change in practice in our hospital for advocating against antibiotic prophylaxis. Plastic stent within FCSEMs did not significantly reduce the risk of stent migration.
AB1467-HPR Measurement of cervical proprioception in patients with axial spondyloarthritis
Authors: T Ozen, E. Tonga, M.G. Polat, S. Akar
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Axial spinal inflammation and spinal posture disorders in axial spondyloarthritis (axSpA) may deteriorate proprioception which may be caused by pathologic involvement of spinal entheses containing proprioceptive afferents.<sup>1</sup> Cervical spine is one of the main inflammation area in axSpA.<sup>2</sup> Impaired cervical proprioception has negative effects on postural control system.<sup>3</sup> The cervicocephalic relocation mesure by laser pointer is found a reliable method to measure cervical sensory function in healty participants in a recent study.<sup>4</sup> And there is limited data that regarding cervical proprioception in axSpA. <h3>Objectives</h3> To examine the differences in cervical joint proprioception between patiens with axSpA and healthy subjects. <h3>Methods</h3> The cervical joint position errors (JPE) were measured to evaluate proprioceptive function accuracy in patients with 29 axSpA and 21 healthy subjects by laser pointer with cervical application. Neutral head position method was used to evaluate proprioception in flexion, extension, rotation and lateral flexion in right and left movement directions at sitting position (figure 1).<sup>5</sup> Three measures were performed, and the average of the three trials was used for analysis. The distance between zero spot and joint position which patient had been reconstructed was measured by centimetre. Spinal mobility evaluated by BASMI, function evaluated by BASFI and HAQ-S; disease activity defined by BASDAI, pain and fatigue were evaluated by VAS. <h3>Results</h3> There were 29 patients (21 men, mean (±SD) age; 41.4±10.9 years) and 21 healthy subjects (15 men, mean age 41.1±11.3 years). BASMI, HAQ-S and fatigue score were significantly higher in patients (BASMI values were 3.9±2.3 vs 1.3±0.7, p&lt;0.001; HAQ-S values were 2.1±0.8 vs 0.8±0.2, p&lt;0.001; fatigue values were 37.2±23.3 vs 16.2±14.9, p=0.001). The comparison of cervical JPE showed significantly larger errors (p&lt;0.05) in patients with axSpa, except right rotation (p=0.166) (table 1). <h3>Conclusions</h3> Cervical joint position sense is impaired in subjects with axSpa. Proprioceptive training may help to boost the effectiveness of rehabilitation. <h3>References</h3> [1] Pompeu JE, Romano RS, Pompeu SM, Lima SM. Revista brasileira de reumatologia. 2012;52(3):409–16. [2] Madsen OR. Rheumatol Int. 2018. doi: 10.1007/s00296–017–3920–1. [3] Malmström EM, Fransson PA, Jaxmar Bruinen T, Facic S, Tjernström F. Exp Brain Res. 2017;235(9):2755–2766. [4] Hatamvand S, Ghiasi F, Asgari Ashtiani A.R, Akbari A, Hossienifar M. International Journal of Medical Research &amp; Health Sciences, 2016, 5, 7S:598–603. [5] Alahmari K, Reddy RS, Silvian P, Ahmad I, Nagaraj V, Mahtab M. Braz J Phys Ther. 2017;21(4):259–267. <h3>Disclosure of Interest</h3> None declared
THU0691 Association between periodontitis and clinical response in rheumatoid arthritis patients under biological treatment
Authors: H.-H. Chen, D.-Y. Chen, L.-G. Huang
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Previous studies showed that periodontitis (PD) was a propagation factor for the severity of rheumatoid arthritis (RA) and our previous epidemiological study revealed that PD was associated with discontinuation risk of etanercept. <h3>Objectives</h3> To investigate the association between PD and the risk of 3 month clinical non-response using the Disease Activity Score (DAS)-based European League Against Rheumatism (EULAR) response criteria in RA patients under biological therapy. <h3>Methods</h3> We enrolled 111 RA patients treated with biologics, including etanercept (n=16), adalimumab (n=44), golimumab (n=7), tocilizumab (n=23), abatacept (n=14), and rituximab (n=7). A qualified periodontist performed the periodontal assessment, and the 3 month clinical response was determined DAS-based EULAR response criteria. We quantified the association between PD and the risk of non-response by calculating odds ratios (ORs) with 95% confidence intervals (CIs) using the logistic regression analysis, after adjusting for confounders including age, sex, tobacco use, RA disease duration, biologic treatment duration, rheumatoid factor and anti-citrullinated peptide antibody, erythrocyte sedimentation rate and C-reactive protein, concurrent medication, and diabetes. <h3>Results</h3> Of 111 RA patients, 83 (74.8%) had PD. 37 (44.6%) of PD patients received periodontal treatment within three months. After adjusting for potential confounders, PD patients had a higher risk of non-response to treatment than non-PD patients (OR, 4.20; 95% CI, 1.06–16.68; p=0.041). Compared with non-PD patients, the risk of non-response was significantly greater in PD patients who did not receive periodontal therapy (OR, 5.12; 95% CI, 1.16–22.56; p=0.031), but not in PD patients who received periodontal therapy (OR, 3.28; 95% CI, 0.72–15.06; p=0.126). Among those who were under under tumour necrosis factor inhibitor therapy (n=67), the risk of clinical non-response was markedly higher in those with PD (OR, 9.65; 95% CI, 1.33–70.04; p=0.025), particularly in those who did not receive periodontal therapy (OR, 14.39; 95% CI, 1.59–130.38; p=0.018). <h3>Conclusions</h3> In RA patients under biological therapy, an increased risk of clinical non-response to treatment was observed in patients with PD, especially among those who did not receive periodontal treatment. <h3>Reference</h3> [1] Chen HH, Chen DY, Lai KL, Chen YM, Chou YJ, Chou P, et al. Periodontitis and etanercept discontinuation risk in anti-tumor necrosis factor-naive rheumatoid arthritis patients: a nationwide population-based cohort study. Journal of clinical rheumatology: practical reports on rheumatic &amp; musculoskeletal diseases2013;19(8):432–8. <h3>Acknowledgements</h3> The authors would like to thank the Biostatistics Task Force of Taichung Veterans General Hospital, Taichung, Taiwan, ROC for statistical support. <h3>Disclosure of Interest</h3> None declared
Metachronous Medulloblastoma in a Child With Successfully Treated Neuroblastoma: Case Report and Novel Findings of DNA Sequencing
Authors: Agda Karina Eterovic, Ossama M. Maher, Joya Chandra, Ken Chen, Jason Huse, Wafik Zaky
Journal: Journal of the National Comprehensive Cancer Network (2018)

Metachronous neoplasms have rarely been reported in patients with neuroblastoma. This report presents the clinical case of a 23-month-old child who was diagnosed with an anaplastic medulloblastoma 5 months after completing treatment for stage IV neuroblastoma. The patient was treated with complete surgical resection and adjuvant chemoradiation followed by maintenance chemotherapy at an outside institution and came to our institution for further management. A pathologic diagnosis and review of both the suprarenal and posterior fossa masses were performed, as well as a genetic analysis of both cerebellar tumor tissue and blood using next-generation gene sequencing. At our institution, the patient was submitted to induction chemotherapy followed by high-dose chemotherapy and autologous stem cell transplantation and remains free of disease 2 years after completion of treatment. Genetic analysis revealed multiple somatic copy number variations with most deleted genes located in 2q37, a region which harbors genes involved in epigenetic regulation and tumor suppression. A homozygous deletion was found in the TSC2 gene, which is a clinically actionable gene, and patients with activating deletions in TSC2 can potentially be eligible for basket clinical trials with mTOR inhibitors. Germline single nucleotide variants were also identified in multiple genes involved in cancer (ALK, FGFR3, FLT3/4, HNF1A, NCOR1, and NOTCH2/3), cancer predisposition (TP53, TSC1, and BRCA1/2), and genes involved in DNA repair (MSH6, PMS2, POLE, and ATM). Metachronous neoplasms are rare and challenging to treat, hence genetic analysis and referral are needed to exclude hereditary cause. DNA sequencing of the tumor and germline can help identify alterations that increase predisposition or can be used to guide treatment decisions on recurrence and when standard options fail.
Role of FDG PET/CT scan in preoperative pancreatic cancer staging.
Authors: Bhargavi Ghanta, Thavam C. Thambi-Pillai, Gary Timmerman, Christopher Fischer, Annie Nelson, Jonathan Scott Bleeker
Journal: Journal of Clinical Oncology (2018)

511 Background: Guidelines do not recommend routine FDG PET/CT (PET) as preoperative staging for pancreatic cancer, although many single center series have demonstrated that PET can lead to changes in management in a sizable minority of patients. We performed a retrospective analysis of patients undergoing PET for potentially resectable pancreatic adenocarcinoma at our institution to help define the utility of PET in this setting. Methods: We reviewed patients with pancreatic adenocarcinoma diagnosed at our center from June 2010 to May 2017 and included patients with pancreatic adenocarcinoma felt to be potentially resectable following standard staging studies [computed tomography (CT), magnetic resonance imaging (MRI) and endoscopic ultrasound (EUS)] who also underwent preoperative PET. Data collected and analyzed included: demographics, pre-PET staging, CA19-9 levels, PET results and surgical outcomes. Results: Forty eight patients with pancreatic adenocarcinoma felt to be surgically resectable underwent PET. PET changed management in 4/48 (8.3%) of these patients. In all 4 of these patients, hepatic metastatic disease was detected on PET and planned surgery was canceled; metastatic disease was confirmed by biopsy in 1 of these patients. 1/48 (2.1%) of patients had a false positive PET scan, where a focus of suspected metastatic disease on PET was biopsied and found to be benign, allowing the patient to proceed to surgery. 3/48 (6.3%) of patients had a false negative PET; 2 patients had hepatic metastatic disease and one had peritoneal disease discovered during surgery. Mean time from negative PET to surgery in these 3 patients was 31 days (range 21-45). Degree of CA19-9 elevation and primary tumor FDG avidity did not correlate with detection of metastatic disease on PET. Conclusions: PET changed management in a smaller number of patients in this cohort than in many previously reported series with a nearly equal number of patients with false negative PET results proceeding to unnecessary surgery. These results are consistent with the currently uncertain role of PET in preoperative staging for pancreatic cancer and further work must be undertaken to optimize presurgical staging in this population.