tbuckley/cabot-search huggingface dataset:
Phase II trial of carboplatin, pemetrexed, and bevacizumab in metastatic nonsquamous (NSC) lung cancer.
Authors: Michael J. Guarino, Gregory A. Masters, David Biggs, Charles Schneider, Jamal Ghazi Misleh, Pamela S. Simpson, Kathiresan Suppiah, Timothy F. Wozniak, Stephen S. Grubbs
Journal: Journal of Clinical Oncology (2012)

e18122 Background: The trial was designed to examine PFS, OS and toxicities of a novel 3 drug combination in advanced NSC lung cancer. The first patient was entered 3/08 and the last in 5/11. Methods: Treatment consisted of Carboplatin AUC 5,Pemetrexed %00mg/m2, Bevacizumab 15mg/kg q21d x 6 cycles; then Bev maintenaince q3wk for up to one year. Eligibile pts. had metastatic non-squamous NSC lung ca, EGOG 0-1, first line Rx. Fifty patients were entered, all available for response and toxicity analysis: 26 M, median age 64, 45 white. Results: 52% RR by RECIST (2% CR, 50% PR); 26% SD. Median PFS 24 wks; median overall survival will be in excess of 49 weeks. 62% of patients received all planned 6 cycles and went on to maintenance. Treatment was out-patient and well tolerated with modest toxicities, including 2 DVT's, one PE, one TIA and one episode of F+N Conclusions: The 3 drug combination of Carboplatin, Pemetrxed and Bevacizumab for met NSC lung cancer is effective and well tolerated; and is a resonable choice of Rx for patients with non-squamous tumors hoping to avoid more neurotoxic or myelotoxic options.
幹細胞由来細胞外マトリックスの包括的なプロテオーム特性化【Powered by NICT】
Authors: Ragelle Heloiese, Naba Alexandra, L Larson Benjamin, Zhou Fangheng, Prijic Miralem, A Whittaker Charles, Del Rosario Amanda, Langer Robert, O Hynes Richard, G Anderson Daniel
Journal: Biomaterials (2017)
SAT0473 Prevalence of ultrasound abnormalities in patients with psoriatic arthritis in a clinical phase of minimal disease activity under anti-tnf treatment
Authors: P Macchioni, G Ciancio, G Sandri, A Zabotti, G Vukatana, L Montaguti, M Focherini, E Verduci, D Chessa, M Govoni, A Spinella, N Malavolta, F Zuliani, M Bruschi, F Mascella
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Few studies have analized the persistence of ultrasound (US) abnormalities in patients (pts) with Psoriatic Artritis (PA) during the phase of minimal disease activity (MDA) <h3>Objectives</h3> To investigate the prevalence of US alterations at enthesis, joint and tendon levels in pts with psoriatic arthritis (PA) during a phase of MDA. <h3>Methods</h3> Pts treated with anti-tumor necrosis factor (TNF) for at least 12 months and with at least 6 months duration of MDA were consecutively recruited at 6 Italian centers. In every center, the local rheumatologists provided PA pts to be examined by US. Personal history, demographic and clinical data were recorded. Each patient underwent the following US examinations: metacarpophalangeal (MCP), knee and tibio-tarsal (TT) joint, flexor and extensor tendon of hand digit, flexor and extensor tendon at carpal area, flexor and extensor tendon of foot, and enthesis of common extensor tendon insertion on the lateral epicondyle of the humerus, quadriceps tendon, patellar tendon, Achilles tendon and plantar fascia insertions on the calcaneus. Each examination were performed by rheumatologists expert in US, to assess synovitis (joint effusion, synovial proliferation, and power Doppler (PD) signal), and bone erosions, flexor tendon tenosynovitis, hand finger extensor tendon tenonitis, and enthesel involvement using an Esaote MyLabClass with a 5–13 or 6–18 MHz linear probe. The following elementary lesions were assessed at each enthesis: morphologic abnormalities (hypoechogenicity and/or thickening), entheseal calcific deposits, cortical abnormalities (bone erosion and/or proliferation), adjacent bursitis and intraenthesis and perienthesis (tendon body and/or bursa) PD signal. All US findings were scored using a 4 degree semiquantitative scoring system. US acute enthesitis was defined by the presence of entheseal edema or PD signal. US chronic entheseal alterations by the presence of calcifications, erosions, or enthesophytes. US peripheral active synovitis if synovial hypertrophy was associated with the presence of PD signal. US examinator were blind of clinical data of the pts. <h3>Results</h3> Sixty-three pts were recruited (mean age 53±13y, mean PA duration 13±8y, mean MDA duration 21±11m). At US examination 66.7% of pts had at least one peripheral joint involved (17.5% had peripheral active synovitis), 47.6% had acute enthesitis and 95.2% chronic enthesopathy. US bursitis was present in 22.2% of pts, 3.7% had hand extensor finger tendon involvement. <h3>Conclusions</h3> Joint, entheseal and tendon abnormalities have a high prevalence in PA patients treated with anti-TNF during MDA. <h3>Disclosure of Interest</h3> None declared
THU0302 Histology findings in giant cell arteritis (GCA) and their relationship with the ultrasound results: analysis of data from the tabul study (temporal artery biopsy vs ultrasound in diagnosis of giant cell arteritis)
Authors: CB Ponte, S Monti, S Singh, A Hutchings, A Diamantopoulos, B Dasgupta, WA Schmidt, RA Luqmani
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Although temporal artery biopsy (TAB) has been the gold standard for diagnosis of GCA, ultrasound has superior sensitivity but lower specificity. Occasionally, histological evidence of inflammation is restricted to the <i>vasa vasorum</i>, the periadventitial small vessels, or both, which could limit the diagnostic sensitivity of ultrasound for GCA. Moreover, false positive ultrasound results have been described in patients with arteriosclerosis on histology. <h3>Objectives</h3> To compare histologic findings with ultrasound results from patients with suspected GCA included in the TABUL study (a multinational study to assess the relative performance of ultrasound and TAB for diagnosing GCA). <h3>Methods</h3> All patients with newly suspected GCA underwent an ultrasound of both temporal and axillary arteries, followed by a TAB, within 7 days of commencing glucocorticoid therapy. TAB pathological diagnoses were analysed and the different histologic features were compared with the ultrasound results using Chi-square or Fisher exact tests. <h3>Results</h3> Results for TAB and ultrasound were available in 388 patients (69% with a final clinician9s diagnosis of GCA). An artery was definitely obtained in 363 (94%) TABs; the pathological diagnosis was GCA in 104 (29%) cases, arteriosclerosis in 35 (10%), normal in 203 (56%) and other conditions in 21 (6%). All TABs compatible with GCA also had a final clinician9s diagnosis of GCA (73% with positive ultrasound). Table 1 shows that ultrasound positivity occurred more frequently in patients where the media was the predominant site of inflammation (p=0.01). The ultrasound result was positive in 9 (26%) cases where TAB was consistent with arteriosclerosis, 8 (89%) of whom had a final clinician9s diagnosis of GCA. The ultrasound was positive in 64 (32%) cases where TAB was normal, 52 (81%) of whom had a final clinician9s diagnosis of GCA. <h3>Conclusions</h3> Amongst patients with suspected GCA, ultrasound is more likely to be positive when histological inflammation is predominantly present in the intima-media. No significant correlation between histologic findings and negative ultrasound results was found, but the small number of cases with predominant <i>vasa vasorum</i> infiltrates in our cohort limited this analysis. There was only one false positive ultrasound in patients with arteriosclerosis on TAB. <h3>Disclosure of Interest</h3> None declared
High-STEACS Algorithm missed fewer patients with acute MI than the ESC Pathway in the ED
Authors: Andrew Worster, Peter Kavsak
Journal: Annals of Internal Medicine (2017)

ACP Journal Club19 September 2017High-STEACS Algorithm missed fewer patients with acute MI than the ESC Pathway in the EDAndrew Worster, MD, MSc, Peter Kavsak, PhD, FCACB, FACB, FCCSAndrew Worster, MD, MScMcMaster University, Hamilton, Ontario, Canada (A.W., P.K.)Search for more papers by this author, Peter Kavsak, PhD, FCACB, FACB, FCCSMcMaster University, Hamilton, Ontario, Canada (A.W., P.K.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/ACPJC-2017-167-6-034 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationChapman AR, Anand A, Boeddinghaus J, et al. Comparison of the efficacy and safety of early rule-out pathways for acute myocardial infarction. Circulation. 2017;135:1586-96. https://pubmed.ncbi.nlm.nih.gov/28034899Clinical Impact RatingsEmergency Med: Hospitalists: Cardiology: References1 Kavsak PA, Worster A, Ma J, et al. High-sensitivity cardiac troponin risk-cutoffs for acute cardiac outcomes at emergency department presentation. Can J Cardiol. 2017;33:898-903. [PMID: 28668141] Google Scholar2 Kavsak PA, Jaffe AS, Greene DN, et al. Total analytic error for low cardiac troponin concentrations (≤ 10 ng/L) by use of a high-sensitivity cardiac troponin assay. Clin Chem. 2017;63:1043-5. [PMID: 28325814] Google Scholar Author, Article, and Disclosure InformationAffiliations: McMaster University, Hamilton, Ontario, Canada (A.W., P.K.)This article was published at Annals.org on 5 September 2017. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoHERDOO2 identified women at low risk for recurrence after 5 to 12 mo of anticoagulation for a first unprovoked VTE Paul Kruger and John Eikelboom Metrics Cited byHigh-sensitivity troponin assays for early rule-out of acute myocardial infarction in people with acute chest pain: a systematic review and economic evaluation 19 September 2017Volume 167, Issue 6Page: JC34KeywordsAcute coronary syndromeAcute myocardial infarctionAlgorithmsEmergency departmentHigh sensitivity cardiac troponinIschemiaResearch laboratoriesSafetyTroponinUnstable angina ePublished: 19 September 2017 Issue Published: 19 September 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Ibrutinib, fludarabine, cyclophosphamide, and obinutuzumab (GA101) (iFCG) for previously untreated patients with chronic lymphocytic leukemia (CLL) with mutated IGHV and non-del (17p).
Authors: Nitin Jain, Philip A. Thompson, Jan Andreas Burger, Gautam Borthakur, Prithviraj Bose, Zeev Estrov, Alessandra Ferrajoli, Varsha Gandhi, William Plunkett, Wanda Lopez, Hagop M. Kantarjian, Susan Mary O'Brien, Michael J. Keating, William G. Wierda
Journal: Journal of Clinical Oncology (2017)

7522 Background: Pts with mutated IGHV ( IGHV-M) have favorable long-term outcomes after FCR. Methods: We designed an investigator-initiated phase II trial with ibrutinib, fludarabine, cyclophosphamide, and obinutuzumab (iFCG) for previously untreated pts with IGHV-M CLL (NCT02629809). The intent was to limit FC to 3 courses, potentially reducing short- and long-term toxicity, while maintaining efficacy through addition of ibrutinib and obinutuzumab. Key eligibility included age ≥18, IGHV-M, no del17p. Pts received 3 courses of iFCG. G-CSF was not mandated. Primary endpoint: CR/CRi with bone marrow (BM) MRD-neg (4-color flow-cytometry) after 3 courses of iFCG. Pts meeting primary endpoint received ibrutinib with obinutuzumab (iG) for C3-6, then ibrutinib C7-12. Pts not achieving primary endpoint received iG (C4-12). All pts who are MRD neg at 1 year will stop all therapy, including ibrutinib. Pts MRD+ at 1 year may continue ibrutinib. Historic C3 BM MRD-neg with FCR in IGHV-M 26% (Strati, Blood 2014). Target BM MRD-neg after iFCG x3 is 45%. Sample size 45. Results: 23 pts started treatment. Median age 59 yrs (25-71). Prognostic markers [del13q (n=17), negative (n=3); trisomy 12 (n=3)]. 18 pts completed 3 courses of iFCG and had initial response assessment (the remaining 5 pts too early). All 18 pts had a response; 14/18 (78%) achieved MRD-neg in BM at 3 month with 7/18 achieving CR/CRi (all MRD neg). No pt has progressed, and all but one continue to receive treatment. Of the 23 pts, 11 pts had G3-4 neutropenia and 5 pts had G3-4 thrombocytopenia. 4 pt had neutropenic fever. 1 pt who achieved MRD-neg CR developed pulmonary MAC infection, and declined further therapy. 1 pt had atrial fibrillation. G3 ALT developed in 3 pts. FC was dose reduced in 10 pts; ibrutinib dose-reduced in 2 pts. Conclusions: iFCG achieves high rate of MRD-neg remission after 3 courses. Pt enrollment continues, and updated results will be presented at the ASCO meeting. Clinical trial information: NCT02629809. [Table: see text]
THU0590 The use of a portfolio among young rheumatologists: results of an emeunet survey
Authors: M Van Onna, F Sivera, V Navarro-Compán, E Nikiphorou, A Moltό, S Ramiro
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Portfolios are increasingly used in medical education. A portfolio may stimulate deep learning, deliver summative assessment and encourage reflection on clinical practice. A portfolio is seen as the key connection between learning at the organizational and the individual level. <h3>Objectives</h3> To (1) explore the perceptions of young rheumatologists about the use of a portfolio and to (2) study the barriers and facilitators when implementing a portfolio at a national and international level. <h3>Methods</h3> A survey was sent by email to all EMEUNET (Emerging EULAR Network) members. EMEUNET is a group of young rheumatologists and researchers within EULAR-member countries. Descriptive statistics were used to analyse initial data collected (Nov-Dec 2016). Weighted averages were calculated (i.e. mean in which each item being averaged is multiplied by a number (weight) based on the item9s relative importance). <h3>Results</h3> 132 participants responded (64% female; mean age 33.5 years (SD 4.3 years); 34 countries). In total, 56.3% of participants were working as rheumatologists; 32.8% were rheumatologists in training. 49.6% of the participants indicated that a portfolio was already used by rheumatology fellows working at their institution; in 71.9% of these cases, this portfolio was also used at a national level. 50.4% of participants did not use a portfolio during their training; of these, 86.7% (strongly) agreed that a portfolio might be a useful tool. Several barriers for successful implementation of a portfolio were identified by the participants. The main barrier was that a portfolio was not developed at a national level, and if developed at a national level, there were often no incentives to use it (Table 1). According to participants, the top 3 competencies that should be collected and reflected upon in the portfolio were (weighted average; importance 0 (not important) – 10 (extremely important)): practical skills (e.g. ultrasound) (8.2); correct use of diagnostics and therapeutic armamentarium (7.9); clinical skills (e.g. history taking) (7.8). The skills chosen as the least important to be included in a portfolio were: information on management tasks (6.5); promoting hospital-based care (e.g. writing a protocol) (6.6); theoretical and clinical knowledge (6.7). <h3>Conclusions</h3> A portfolio is generally considered a valuable tool and half of the participants already work with it. However, several barriers may prevent optimal implementation. Developing a core set of rheumatology-oriented competencies and a template for a portfolio to be used across institutions and eventually countries could promote implementation and harmonize training. <h3>Disclosure of Interest</h3> None declared
AB0928 Fatigue in fibromyalgia reflects overall burden of disease
Authors: M Antivalle, A Batticciotto, F Rigamonti, MC Ditto, MC Gerardi, R Talotta, A Mutti, P Sarzi-Puttini
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Fatigue in fibromyalgia is a very common and disabling symptom, being reported by over 75% of patients. However, the relationship between fatigue and the different manifestations of fibromyalgia has not been convincingly elucidated. <h3>Objectives</h3> Aim of the our work was to study the relationship between fatigue, pain, and somatic symptoms in fibromyalgia. <h3>Methods</h3> 123 patients with fibromyalgia classified according to 2010 criteria were studied, 113 Females and 10 Males, mean age 47.41±11.21 years, mean disease duration 6.83±6.52 years. Fatigue was assessed by FACIT-Fatigue questionnaire (13 items, score 0–52, higher values representing less fatigue), and results were correlated to the number of Tender points (TP), to Widespread Pain Index (WPI), to Symptom severity Scale (SSS), and to Polysymptomatic Distress Scale (PDS) values. Correlations were computed by parametric or non parametric methods as appropriate. <h3>Results</h3> Average FACIT-Fatigue score (22.51±10.6) was lower than the 25th percentile of the general population (35), and was not correlated to age or to disease duration (p&gt;0.05). FACIT-Fatigue showed statistically significant inverse correlations with the number of tender points (r = -.303, p=0.001), WPI score (r=-0.329, p&lt;0.001), SSS score (r=-0.651, p&lt;0.001), PSD score (r=-0.522, p&lt;0.001), and with the total number of somatic symptoms (r=-0.594, p&lt;0.000) (Fig. 1, right panel). Furthermore, for each of the 40 somatic symptoms suggested by 2010 criteria, the presence of the symptoms was associated with higher levels of fatigue (Fig 1, left panel). <h3>Conclusions</h3> The results of our study confirm that fatigue is a prominent feature of fibromyalgia. Higher levels of fatigue reflect higher levels of widespread pain, and a higher burden of somatic symptoms. <h3>Disclosure of Interest</h3> None declared
Effect of Lorazepam With Haloperidol vs Haloperidol Alone on Agitated Delirium in Patients With Advanced Cancer Receiving Palliative Care
Authors: David Hui, Susan Frisbee-Hume, Annie Wilson, Seyedeh S. Dibaj, Thuc Nguyen, Maxine De La Cruz, Paul Walker, Donna S. Zhukovsky, Marvin Delgado-Guay, Marieberta Vidal, Daniel Epner, Akhila Reddy, Kimerson Tanco, Janet Williams, Stacy Hall, Diane Liu, Kenneth Hess, Sapna Amin, William Breitbart, Eduardo Bruera
Journal: JAMA (2017)

The use of benzodiazepines to control agitation in delirium in the last days of life is controversial.
THU0572 Association between retroperitoneal fibrosis and malignancy: a possible paraneoplastic syndrome
Authors: SJ Lee, JS Eun, EY Lee, GB Bae, EJ Nam, YW Song, YM Kang
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Retroperitoneal fibrosis (RPF) are associated with malignancies. However it is unclear what is the incidence of malignancies and whether particular malignancies are more prevalent in RPF. <h3>Objectives</h3> The objective of this study was to examine standardized incidence ratios (SIRs) of cancers in patients with retroperitoneal fibrosis (RPF) compared with age- and sex-matched general population. <h3>Methods</h3> Medical records of 111 patients diagnosed as having RPF by computed tomography, positron emission tomography and/or histological evaluation were reviewed. Forty one cases of cancers, which were confirmed by biopsies, were identified in 35 patients with RPF. SIRs were calculated for cancers, cancer types, and age at cancer diagnosis and stratified according to RPF-cancer intervals compared with general population in Korea. <h3>Results</h3> The mean ± SD age at RPF diagnosis was 59.1±14.9 years, and 69.4% of the patients were male. The cancer SIR (95% confidence intervals) in patients with RPF relative to age- and sex-matched individuals in the general population was 3.18 (2.23 - 4.41) [2.65 (1.7 - 3.94) in men; 5.34 (2.76 - 9.32) in women]. The most frequent cancer was unspecified urinary organ cancers with SIR of 733.41 (238.14 – 1711.53). SIRs of multiple myeloma [27.58 (3.34 – 99.64)], renal cell cancers [9.53, (1.15 - 34.42)] and unspecified cancers [16.92, (2.05 - 61.12)] were also significantly higher than in general population. Whereas cancers were most frequently developed in the eighth decade of life, the peak SIR was observed in the fifth decade (8.41, 2.29 – 21.53). When stratified by RPF-cancer intervals, SIR was 6.85 (4.55 - 9.90) within 2 years of RPF diagnosis, while no significant increase in SIR was found out of 2 years. Malignancies (n=28) within 2 year of RPF diagnosis included unspecified urinary organ cancer (n=4), stomach cancer (n=4), lung cancer (n=4), colon cancer (n=3), renal cell cancer (n=2), pancreatic cancer (n=2), unspecified cancer (n=2), rectal cancer (n=1), gallbladder cancer (n=1), non-Hodgkin lymphoma (n=1), multiple myeloma (n=1), prostate cancer (n=1), thyroid cancer (n=1) and gastrointestinal stromal tumor (n=1). Predominant origin of these malignancies were epithelial cell types [transitional cell carcinomas (n=4), adenocarcinoma (n=16)]. <h3>Conclusions</h3> RPF was strongly associated with cancers, particularly within 2 years of RPF diagnosis. Our results indicate that cancer screening in patients with RPF should may be performed regularly up to 2 years after RPF diagnosis. <h3>References</h3> Temporal relationship between cancer and myositis identifies two distinctive subgroups of cancers: impact on cancer risk and survival in patients with myositis. Kang EH, Lee SJ et al Rheumatology (Oxford). 2016 Sep;55(9):1631–41. <h3>Disclosure of Interest</h3> None declared