tbuckley/cabot-search huggingface dataset:
Chemotherapy-Induced Macrophage Infiltration into Tumors Enhances Nanographene-Based Photodynamic Therapy
Authors: Yang Zhao, Chenran Zhang, Liquan Gao, Xinhe Yu, Jianhao Lai, Dehua Lu, Rui Bao, Yanpu Wang, Bing Jia, Fan Wang, Zhaofei Liu
Journal: Cancer Research (2017)

Abstract Increased recruitment of tumor-associated macrophages (TAM) to tumors following chemotherapy promotes tumor resistance and recurrence and correlates with poor prognosis. TAM depletion suppresses tumor growth, but is not highly effective due to the effects of tumorigenic mediators from other stromal sources. Here, we report that adoptive macrophage transfer led to a dramatically enhanced photodynamic therapy (PDT) effect of 2-(1-hexyloxyethyl)-2-devinyl pyropheophor-bide-alpha (HPPH)-coated polyethylene glycosylated nanographene oxide [GO(HPPH)-PEG] by increasing its tumor accumulation. Moreover, tumor treatment with commonly used chemotherapeutic drugs induced an increase in macrophage infiltration into tumors, which also enhanced tumor uptake and the PDT effects of GO(HPPH)-PEG, resulting in tumor eradication. Macrophage recruitment to tumors after chemotherapy was visualized noninvasively by near-infrared fluorescence and single-photon emission CT imaging using F4/80-specific imaging probes. Our results demonstrate that chemotherapy combined with GO(HPPH)-PEG PDT is a promising strategy for the treatment of tumors, especially those resistant to chemotherapy. Furthermore, TAM-targeted molecular imaging could potentially be used to predict the efficacy of combination therapy and select patients who would most benefit from this treatment approach. Cancer Res; 77(21); 6021–32. ©2017 AACR.
Propranolol 18F-FDG PET/CT
Authors: Renaud Ciappuccini, Stéphane Bardet, Nicolas Aide
Journal: Clinical Nuclear Medicine (2017)

A 76-year-old woman was referred for F-FDG PET/CT assessment of a colorectal cancer. A 9-cm F-FDG-avid fatty mass was depicted in the right thigh, suggesting either hibernoma or liposarcoma. Because MRI could not rule out well-differentiated liposarcoma, and biopsy was difficult, surveillance was decided. Follow-up PET/CT showed an increase of F-FDG uptake in the fatty mass. We repeated PET/CT after oral administration of 60 mg of propranolol 1 hour before F-FDG injection. A dramatic decrease in F-FDG uptake was observed, strongly supporting the diagnosis of hibernoma.
Medication Reconciliation vs Medication Review
Authors: Kristin M. Zimmerman, Teresa M. Salgado, Dave L. Dixon
Journal: JAMA (2017)

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
THU0559 Persistent pruritic skin lesions with dyskeratotic cells in upper layer of epidermis are specific and associated with high levels of serum il-18 in adult-onset still's disease
Authors: H Nishikawa, Y Taniguchi, N Aoyama, Y Terada
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Adult-onset Still9s disease (AOSD) is an acute and systemic inflammatory disorder that is characterized by high spiking fever, evanescent rash, arthralgia/arthritis and hyperferritinemia. However, recent reports showed that not only typical evanescent salmon-colored rash but also atypical skin lesions, persistent pruritic papules and plaques, could be associated with AOSD. <h3>Objectives</h3> The aim of this study is to assess the clinical significance of dyskeratotic cells in skin lesions of Japanese patients with AOSD. <h3>Methods</h3> We retrospectively assessed clinical and histological findings of skin lesions including persistent pruritic skin lesions in Japanese patients with AOSD (n=12). Moreover, we compared serological and histological finding of AOSD with that of dermatomyositis (DM) (n=6), drug eruptions (DE) (n=6), and Graft versus Host disease (GVHD) (n=6). <h3>Results</h3> AOSD with persistent pruritic skin lesions (n=7) histologically showed dyskeratotic cells only in upper layer of epidermis and horny layer without intraepidermal infiltrations of inflammatory cells. These dyskeratotic cells were positive by TUNEL and single stranded DNA (ssDNA) stainings, suggesting apoptotic cells. AOSD with evanescent rash (n=5) histologically showed no dyskeratosis. On the other side, the pathological findings of DM (n=6), DE (n=6) and GVHD (n=6) had dyskeratotic cells in all layers of epidermis with inflammatory cells infiltrations. Notably, AOSD with dyskeratosis (n=7) had significant higher levels of serum IL-18 (74,300∼307,000 pg/ml) than AOSD without dyskeratosis (n=5). <h3>Conclusions</h3> AOSD with persistent pruritic skin lesions is characterized and specific by prominent epidermal apoptosis, especially involving the upper layers. Therefore, it could play a pivotal role to recognize the atypical skin lesions of AOSD for correct early diagnosis. Finally, the high levels of serum IL-18 might be related with epidermal apoptosis of keratinocyte in AOSD. <h3>Disclosure of Interest</h3> None declared
THU0478 Determination of comorbidities in fibromyalgia syndrome
Authors: U Bilge, T Kaşifoğlu, NS Yaşar Bilge, H Balcıoğlu, YE Sarı, M Kayhan, I Ünlüoğlu
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Although fibromyalgia syndrome is diagnosed by excluding other possible diagnosis based on the patient9s clinical features, in recent the studies, it was shown that comorbid diseases affect the course of fibromyalgia. <h3>Objectives</h3> The aim of this study is to evaluate the comorbid diseases of patients with fibromyalgia and to determine the rates of comorbid diseases <h3>Methods</h3> In this study, age, gender and comorbid diseases of patients above 18 years and diagnosed with fibromyalgia by a were evaluated in the database system of the hospital retrospectively. <h3>Results</h3> A total of 509 patients were examined in our study. 51 of the patients were male, 458 were female (mean age was 50.24±12.32). Of the patients, 345 (67.8%) had at least one comorbid disease while 164 (32.2%) had no comorbid disease. In the study, 187 of the patients (36.7%) had cardiovascular diseases, 157 of the patients (30.8%) had endocrine diseases, 63 of the patients (12.4%) had rheumatologic diseases, 30 of the patients (5.9%) had neurological diseases, 14 of the patients (2.8%) had other autoimmune diseases, 10 of the patients (2.0%) had cancers, 129 of the patients (25.3%) had mental disorders, 45 of the patients (8.8%) had chronic lung diseases, 37 of the patients (7.3%) had osteoporosis, 11 of the patients (2.2%) had other diseases (chronic pancreatitis, chronic renal failure, nephrotic syndrome, deep vein thrombosis, hepatitis serology positivity, pulmonary thromboembolism, organ transplantation). <h3>Conclusions</h3> FMS is an important disease that is increasing in frequency in recent years. FMS, which can be seen with many diseases, is in fact related to physicians from many branches, and it is useful to evaluate FMS patients with their comorbid conditions on their follow-up. <h3>References</h3> Choy EH &amp; Mease PJ. Key symptom domains to be assessed in fibromyalgia (outcome measures in rheumatoid arthritis clinical trials). Rheumatic Disease Clinics of North America, 2009; 35(2):329–337. Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, et al. The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Arthritis &amp; Rheumatism, 1990; 33(2):160–172. Soran N, Altındağ Ö, Demirkol A, Sallı A, Yılmaz H, Kocabaş H, et al. Depression level and relation with clinical parameters in fibromyalgia syndrome. Rheumatism, 2008; 23:1–4. <h3>Disclosure of Interest</h3> None declared
SAT0438 Psoriatic arthritis and nodal osteoarthritis can be differentiated using hand radiographs: a novel method
Authors: S Bahadur, A Zavareh, C Hughes, R Mandegaran, S Subesinghe, B Kirkham
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> One of the difficulties of rheumatology practice is the differentiation of Psoriatic Arthritis (PsA) and Nodal Osteoarthritis (NOA) in some patients with distal interphalangeal joint involvement. MRI and ultrasound imaging, have recently been demonstrated as inconclusive in some cases (1,2). This differentiation is critical, as treatment for these debilitating conditions is completely different. <h3>Objectives</h3> To establish a scoring system of radiographic joint and soft tissue features to differentiate PsA from NOA. <h3>Methods</h3> We devised a scoring system for hand radiographs of interphalangeal joints, soft tissue and bone features, allocated major and minor weighting. The scoring system was then tested in a single blind analysis of hand radiographs from 48 patients with PsA, 50 with NOA and 1 with RA (incorrectly classified as PsA at study entry) seen between 2008 and 2016. Anonymised patient images were assessed by a Musculoskeletal (MSK) Radiologist, blind to clinical information. Radiological diagnosis was then compared with clinical diagnosis. We taught the method to 2 rheumatology and 1 radiology trainees over 1 hour, who then independently assessed the same radiographs. <h3>Results</h3> The MSK radiologist reported normal hand radiographs in 5 patient sets. Of the remaining 94 patient sets, the scoring system correctly allocated 100% of images into PsA, NOA or RA. Notably, 2 patients with NOA who subsequently developed PsA several years later, and 1 patient with seropositive RA, initially misclassified as PsA, were correctly identified by the MSK radiologist. Trainees using the system also achieved good agreement, after removing radiographs assessed as normal; Rheumatology trainees: 88% and 67% correct; Radiology trainee: 70% correct. <h3>Conclusions</h3> This initial single-centre study shows our novel radiological scoring system is effective at differentiating patients with PsA from NOA. Radiographs provide an accurate, time-efficient (for both clinician and patient) and inexpensive test. We also show that trainees can learn this scoring system with moderate accuracy after a short educational programme. We are currently carrying out a detailed analysis of the scoring system to optimise accuracy and ease of use by non-radiologists. <h3>References</h3> McGonagle D, Hermann KG, Tan AL. Differentiation between osteoarthritis and psoriatic arthritis: implications for pathogenesis and treatment in the biologic therapy era. Rheumatology. 2015;54:29–38. Yumusakhuylu Y, Kasapoglu-Gunal E, Murat S et al. A preliminary study showing that ultrasonography cannot differentiate between psoriatic arthritis and nodal osteoarthritis based on enthesopathy scores. Rheumatology. 2016; 55:1703–4. <h3>Disclosure of Interest</h3> None declared
Sperm count in Swedish clinical stage I testicular cancer patients following modern adjuvant treatment.
Authors: Kristina Weibring, Carina Nord, Olof Stahl, Jakob Eberhard, Katinka Sandberg, Stefan Arver, Aleksander Giwercman, Gabriella Elisabeth Cohn-Cedermark
Journal: Journal of Clinical Oncology (2016)

4542 Background: Little is known regarding sperm production following modern adjuvant treatment in clinical stage I (CSI) testicular cancer (TC).Methods: 182 TC patients aged 18-50 were prospectively included during 2001-2006 at any given time within 5 years of orchiectomy. Semen samples were delivered post op and 6, 12, 24, 36 and 60 months (T0-T60) after completion of therapy. Sperm concentration (SC) and total sperm number (TSN) were used as measurements of testicular function. Results: Treatment groups were: radiotherapy 1.8 Gy x 14 to a total dose of 25.2 Gy to the paraaortic and ipsilateral iliac lymph nodes (RT n = 70), one cycle of adjuvant BEP (Bleomycin, Etoposide, Cisplatin, 5 day regimen) (BEP n = 62), one cycle of adjuvant Carboplatin AUC 7 (Carb n = 22), and patients managed by surveillance (SURV n = 28). The mean SC and mean TSN increased slightly over time, T0-T60, except for the RT group where an obvious decrease was seen at T6 followed by recovery. At T12 compared to baseline, there was a significant increase in mean SC in the surveillance, BEP and Carb groups. A numerical but not significant increase in mean TSN at T12 compared to baseline was seen in all treatment groups except the RT group. At T12, no significant differences between the treatment groups BEP, Carb or RT overall, in mean SC or mean TSN compared to the surveillance group (p 0.11 and p 0.28) were found. Longitudinal studies showed that the majority of the patients in all four groups showed no deterioration in SC and TSN one year post treatment and most seemed to be rather stable thereafter. Except for in the BEP group, azospermia was observed in all treatment groups in a total of 11 patients. Only one azospermic patient became normospermic (Carb group). Conclusions: No clinically significant long-term effect on sperm concentration or total sperm number associated to modern adjuvant treatment in CSI TC was found. However, a number of patients have low sperm counts after orchiectomy and remain subfertile also after adjuvant treatment. Spermbanking should be offered preferably before orchiectomy as assisted reproductive measures may be necessary regardless of any treatment given.
Patient education in patellofemoral pain: potentially potent and essential, but under-researched
Authors: Michael Skovdal Rathleff, Janus Laust Thomsen, Christian J Barton
Journal: British Journal of Sports Medicine (2017)

Louise is 19 years old and a keen runner. During the past 3–4 months, she gradually developed anterior knee pain, which was slowing her down. She has had similar knee pain before, but never this bad. Louise consults her healthcare practitioner and is diagnosed with patellofemoral pain (PFP), for which many recommended treatments with varying levels of supporting evidence exist.1 2 How should we guide the shared decision-making that will determine which treatment Louise tries first? Some treatments will require Louise to see a specialist physiotherapist who can instruct on changing her running technique (ie, gait retraining), while others require a physiotherapist who can prescribe a series of appropriate hip and knee exercises, foot orthoses or teach her to tape her knee. These interventions can be costly to the individual and the healthcare system, with most needing multiple sessions. Patient education, including strategies for self-management of knee pain, is another treatment which may help Louise. Education can be provided in both primary and secondary care, can be relatively inexpensive and may not require …
SAT0482 Subclinical enthesopathy in psoriatic patients and its relation to other disease parameters: an ultrasound study
Authors: W Gouda, M Ismail, M Doma
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Psoriasis is a chronic immune-mediated inflammatory skin disease characterized by reddish, thick patches covered with marked silvery scaling [1]. In about 70% of the patients, psoriasis is present many years before the onset of psoriatic arthritis [2]. The early recognition and therapeutic intervention especially with the new biologic treatments is critical to prevent the destructive and debilitating changes of psoriatic arthritis [3]. Enthesitis is inflammation at the attachment of tendons and ligaments to the bones, has been suggested as being the unifying feature of psoriatic arthritis, and the disease can be considered an enthesis associated disorder rather than primary synovitic arthropathy [4]. <h3>Objectives</h3> We aimed to correlate the subclinical enthestitis in patients with psoriasis detected by means of power Doppler (PD) ultrasonography (US) with other disease parameters. <h3>Methods</h3> 50 persons with a definite diagnosis of psoriasis with no clinical evidence of arthritis or enthesitis were selected. All patients underwent complete clinical assessment included Psoriasis severity (PASI) score, body mass index (BMI), PDUS evaluation of Achilles, quadriceps, patellar entheses and plantar aponeurosis. US findings were scored according to the Glasgow Ultrasound Enthesitis Scoring System (GUESS). <h3>Results</h3> In 18 of 50 of patients (36%) PDUS found signs indicative of enthesopathy. The Achilles enthesis had the highest number of PDUS signs of enthesopathy (33.3%), followed by distal patellar enthesis (22.2%), proximal patellar enthesis (16.7%), quadriceps enthesis (16.7%), and plantar aponeurosis enthesis (11.1%) with variable enthesial morphostructural abnormalities. The GUESS score was directly correlated with age (p=0.012), disease duration (p=0.044), PASI (p=0.035), BMI (p=0.011), hyperuricemia (p=0.011). <h3>Conclusions</h3> In addition to the importance of PDUS as a complimentery tool in examination of entheses in psoriatic patients, the presence of high PASI score together with the increased BMI and hyperuricemia in addition to long disease duration could be considered as predictive parameters for the presence of psoriatic enthesitis. <h3>References</h3> Menter A, Gottlieb A, Feldman SR, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis, section 1. Overview of psoriasis and guide lines of care for the treatment of psoriasis with biologics. J Am Acad Dermatol. 2008; 58(5):826–50. Dimitrios TB, Ioannis OT. Psoriatic arthritis. In: Klippel JH, ed.Primer on the Rheumatic Diseases. Atlanta, GA: Arthritis Foundation, 1997: 175–179. Rozenblit M, Lebwohl M. New biologics for psoriasis and psoriatic arthritis. Dermatol Ther. 2009; 22(1):56–60. McGonagle D, Conaghan PG, Emery P. Psoriatic arthritis: a unified concept twenty years on. Arthritis Rheum. 1999; 42:1080–7. <h3>Disclosure of Interest</h3> None declared
Bone scan index at baseline as a tool for predicting hematologic toxicity in metastatic castration-resistant prostate cancer patients eligible for radium-223 treatment.
Authors: Shalin Kothari, Ahmad Sharif-Tabrizi, Kristopher Attwood, Dominick M Lamonica, Ellis Glenn Levine, Saby George
Journal: Journal of Clinical Oncology (2017)

e16513 Background: The prognosis of castration-resistant prostate cancer with skeletal metastasis (CRPCSM) is poor. The ALSYMPCA trial led to the approval of radium-223 (Ra223) in such patients. Factors that could predict hematologic toxicities associated with Ra223 remain poorly defined. We analyzed the utility of bone scan index (BSI) at baseline (BSI-B) as a predictive marker for such toxicities. Methods: This is a retrospective study of CRPCSM patients without visceral metastasis who received Ra223 at Roswell Park Cancer Institute from 2013 to 2015. BSI was defined utilizing the estimation of a numerical index (max, 70.8% for diffuse skeletal involvement) that expresses the fractional involvement of each bone by tumor. BSI-B values were classified into &lt; first quartile ( &lt; Q1), between first and third quartile (Q1-Q3), and &gt; third quartile ( &gt; Q3). The associations between BSI-B and different hematologic parameters [hemoglobin (Hgb), platelets (Plt), absolute neutrophil count (ANC)] over the Ra223 treatment duration were evaluated using linear mixed models. Results: A total of 79 patients were included in this analysis. The median Gleason score was 8 (range: 4-10) and the median age at first Ra223 was 71 years. Seventy percent of patients received 5 or more doses of Ra223. There was a significant association between BSI-B and Hgb (p = 0.005) and Plt (p = 0.011) levels at baseline and at all time points. The &gt; Q3 BSI-B was associated with a greater drop in Plt from an elevated baseline with subsequent treatments of Ra223 [drop from a mean of 293.5±21.3 x10 9 /L (n = 19) to 132.2±48.8 x10 9 /L (n = 9) after sixth Ra223]; while such a decline was not observed for lower BSI-B (p &lt; 0.001). The ANC decreased with each Ra223 in patients with &gt; Q3 BSI-B but not in the ones with lower BSI-B (p = 0.003). Conclusions: Our work demonstrates that hematologic parameters at baseline and during Ra223 treatment are associated with higher BSI-B values, raising the possibility of BSI-B as a valuable tool for predicting the risk of cytopenias before initiating Ra223 in CRPCSM patients. Prospective validation is needed to confirm the utility of our findings.
AB0702 Improvement of fatigue in patients with spondyloarthritis treated with anti-tnf therapy: a prospective study in a real-life setting
Authors: S Desouches, E Gaigneux, K Louati, L Lemeunier, C Beauvais, J Sellam, F Berenbaum
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Besides randomized controlled trials evaluating biologic agents on fatigue, the impact of anti-TNF therapy on this crucial symptom has been poorly assessed in a real-life setting (1). <h3>Objectives</h3> To assess the early effect of etanercept (ETN) on fatigue-related outcomes in spondyloarthritis (SpA) patients in a real-life setting. <h3>Methods</h3> This prospective study included patients with active SpA fulfilling ASAS 2009 axial or peripheral criteria requiring an anti-TNF. All patients were treated with ETN 50mg weekly. BASDAI, BASFI, functional assessment of chronic illness therapy-fatigue (FACIT-F) (0 maximum and 52 the minimum of fatigue) and visual analogic scale of fatigue (VAS-F) (0 the minimum -100 maximum of fatigue) were assessed at inclusion at the time of ETN beginning (M0) and 4±1 months later (M4). The primary outcome was the M0-M4 change of VAS-F. The secondary outcomes were i) the M0-M4 change of FACIT-F ii) the frequency of patients who met improvement according to FACIT-F (defined as the minimal clinically important difference of FACIT-F corresponding to a 4-points decrease (FACIT-F responders). To determine whether fatigue change was related to disease activity improvement, a correlation between M0-M4 changes of BASDAI and VAS-F or FACIT-F was determined. <h3>Results</h3> 30 SpA patients were enrolled (60% women, mean age ± standard deviation 39±8 years-old, axial SpA 83%, mean BMI 26±4, 80% ETN as a 1st line). Mean BASDAI improved at M4 (M0 48±20 versus M4 36.5±22; p=0.04) as well as VAS-F (M0 69±18 vs M4 52±24; p=0.01). The frequency of patients having VAS-F&gt;50/100 was 86% at M0 and decreased at 36% at M4. Conversely, no significant change was observed concerning FACIT-F (M0 24.5±24 versus M4 28.8±11: p=0.36). At M4, 64% patients were FACIT-F responders. FACIT-F and VAS-F M0-M4 changes were highly correlated (r=0.78, p&lt;0.0001). Despite no correlation between BASDAI and FACIT-F M0-M4 changes (r=0.36, p=0.1), a trend was observed for BASDAI and VAS-F M0-M4 changes in the same fashion (r=0.36, p=0.07). Interestingly, there was no baseline clinical characteristic associated with subsequent better fatigue improvement. <h3>Conclusions</h3> This real-life study investigating the early effect of etanercept therapy on fatigue in SpA patients showed that fatigue (according to VAS-F) significantly improved while effect on FACIT-F was less pronounced. This improvement was explained, only in part, by disease activity improvement. <h3>References</h3> Chauffier K, et al Clin Exp Rheumatol. 2013;31:864–70. <h3>Acknowledgements</h3> Grant from Pfizer. <h3>Disclosure of Interest</h3> None declared