tbuckley/cabot-search huggingface dataset:
Meeting the needs of black and minority ethnic groups
Authors: C. Free, M. McKee
Journal: BMJ (1998)

The first paragraph of The New NHS highlights the government's commitment to reduce health inequalities. Access to health services is to be based on “need and need alone.” The white paper explicitly notes the importance of addressing variation in death rates and risk factors between different ethnic groups and emphasises the importance of ensuring that “black and minority ethnic groups are not disadvantaged” in their access to services.

Although the differences can be overstated, some health needs of black and minority ethnic groups differ from those of the indigenous population.1 In addition, some, such as refugees, have specific health needs. The new arrangements need to incorporate some means of ensuring that these particular needs are recognised.

The white paper gives general practitioners and community nurses a central role in assessing need, but general practitioners are trained to …
Spirometric Reference Values for Croatian Adriatic Elderly
Authors: Mladen Pavlović, Nina Smolej Narančić
Journal: European Respiratory Journal (2006)

The objective of this study was to derive predictive equations for flow/volume spirometry variables in Croatian elderly persons and to assess any differences between these variables when applying the new and other equation sets published for the adults, including the elderly due to secular trend. FVC, FEV1, and PEF were measured according to the ATS criteria in 651 subjects aged 65-86 yrs sampled randomly in the Croatian Adriatic population. After exclusion of ever-smokers and subjects with respiratory symptoms and/or diseases, 261 (107 M ; 154 W) subjects were included in the analyses. Reference equations and lower limits of normal were derived by sex using a linear model with height and age as predictors. The new FVC and FEV1 reference values were in close agreement with those given by the own previous equations for wide adult age range. They were lower than the estimates given by the EC equations in men. Prediction equations from North European, Mediterranean, and U.S. populations gave consistent overpredictions in men and women. The results support the use of age- and population-specific prediction equations for spirometry in the elderly.
Comparing the use and content of antenatal care in adolescent and older first-time mothers in 13 countries of west Africa: a cross-sectional analysis of Demographic and Health Surveys
Authors: Onikepe O Owolabi, Kerry L M Wong, Mardieh L Dennis, Emma Radovich, Francesca L Cavallaro, Caroline A Lynch, Adesegun Fatusi, Issiaka Sombie, Lenka Benova
Journal: The Lancet Child & Adolescent Health (2017)
FRI0213 Comparative effectiveness of abatacept, rituximab, tocilizumab and anti-tnf biological dmards in ra: results from the nationwide swedish register
Authors: T Frisell, M Dehlin, D Di Giuseppe, N Feltelius, A Kastbom, C Turesson, J Askling
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Many current guidelines rank abatacept (ABA), rituximab (RTX), tocilizumab (TOC), and the TNFi bDMARDs as equal in effectiveness for the treatment of RA, at least as second line therapies. This is mainly based on evidence from separate RCTs, with few direct comparisons and limited comparative effectiveness data from clinical practice. <h3>Objectives</h3> To describe outcomes in clinical practice among RA patients starting different bDMARDs as first bDMARD, and after switch from initial TNFi. <h3>Methods</h3> The Swedish Rheumatology Register was linked to nationwide registers with data on demographics and medical history. We included all patients with RA starting a first ever bDMARD, or switching to a new bDMARD after a TNFi as first bDMARD, in 2010 - 2014, with follow-up through 2015. Effectiveness was assessed at 1 year (±90 days) after starting therapy, and measured as 1) the proportion remaining on therapy, or the proportion remaining on therapy and with 2) Good EULAR response, 3) HAQ improvement &gt;0.2, 4) no swollen or tender joints. Relative response was estimated with log-binomial regression adjusting for potential confounders. <h3>Results</h3> Patients starting non-TNFi were older than those starting a TNFi, had lower socioeconomic status, and more often a history of diseases including malignancy, serious infections, and diabetes. After switch from TNFi, those starting non-TNFi also had higher disease activity. Non-TNFi were associated with better drug survival and higher proportion reaching response outcomes compared to TNFi as first bDMARD. After switch from TNFi, RTX and TOC, but not ABA, were associated with significantly better drug survival and response. Differences remained after adjusting for identified potential confounders. <h3>Conclusions</h3> Despite channeling of older and sicker individuals to non-TNFi-bDMARDs, treatment outcomes were in general better in these groups, particularly for TOC and RTX. In interpreting this, the risk of residual confounding should be remembered, and that we did not include safety or long term outcomes. <h3>Acknowledgements</h3> The ARTIS registry has been, or is, supported by agreements with Abbvie, BMS, MSD, Pfizer, Roche, Samsung, and UCB. <h3>Disclosure of Interest</h3> T. Frisell: None declared, M. Dehlin: None declared, D. Di Giuseppe: None declared, N. Feltelius: None declared, A. Kastbom Consultant for: Bristol-Myers Squibb, Pfizer, Roche, UCB, Paid instructor for: Bristol-Myers Squibb, Pfizer, Roche, UCB, C. Turesson Grant/research support from: Abbvie, Pfizer, Roche, Consultant for: MSD, Pfizer, Roche, Paid instructor for: Abbvie, Bristol-Myers Squibb, Janssen, MSD, Pfizer, Roche and UCB, J. Askling Grant/research support from: Abbvie, UCB, Pfizer, Merck, Samsung, Roche, Lilly
Childhood osteosarcoma: Evaluation of 94 cases. A single institution study
Authors: I. Ayan, R. Kebudi, H. Ozger, F. Yaman Agaoglu, O. Gorgun, B. Bilgic, L. Eralp, Y. Dizdar, E. Darendeliler
Journal: Journal of Clinical Oncology (2009)

10040 Background: Osteosarcoma is the most frequent bone tumor in children and adolescents. The aim of this study is to evaluate the demographic characteristics, therapy, and long term outcome of children with osteosarcoma in a single institution. Methods: Between January 1990 and December 2006, 94 children (53 male, 41 female) with a median age of 13 (5–16) years and a histopathologic diagnosis of osteosarcoma were treated with an institutional chemotherapy regimen comprising of 6 courses (3 pre-, 3 postoperatively) of epirubicin (90 mg/m2), cisplatin(100 mg/m2), and ifosfamide(2 g/m2 × 3 days) every 3 weeks. Results: The median follow-up time was 36 (2–219) months. 68 patients were alive at the time of analysis. 26 patients died; 20 of disease, 5 of toxicity, and 1 of second malignancy (acute myeloid leukemia). 90% of the patients had a limb salvage. 5 and 10 year OS for all patients were 64.7 % ( [95 % CI] 74.8–52.94 %) and 62.2 % (95 % CI 74.6–49.9 %), respectively. 5 and 10 year EFS for all patients was 51.8 % (95% CI 40.2–63.4 %). 5 and 10 year OS for nonmetastatic patients were 78.3 % (95% CI 66.9–89.7 %) and 75.1 %(95% CI 62.6–87.6), vs. 13.5 % 5 year OS for metastatic patients(95% CI 0–30.8 %) (p&lt; 0.001). 5 and 10 year EFS for nonmetastatic patients was superior to those with metastatic disease [62.4 % (95% CI 49.9–79.9 %) vs. 6.9 % (95% CI 0–19.9 %)) (p&lt;0.001). A total of 33 patients experienced relapse and/or progression at a median of 9 months (range 0–40 months). 10 year OS for 18 patients (11 metastatic at diagnosis) who progressed during preoperative chemotherapy was 13 % vs. 75 % for those who didnot have progressive disease (p&lt; 0.001). The rate of histologically good response to preoperative chemotherapy was 64.5 %. Histologic response (&lt;90 percent necrosis vs ≥90 percent) significantly correlated with 5 year EFS (31 % vs 67.6 %, p=0.023) but not with OS (57.7 % vs 76.5 %, p=0.13). Conclusions: The presence of metastases at diagnosis was the most significant characteristic influencing outcome. Our results demonstrate that the combination of epirubicin, cisplatin, and ifosfamide is an active and reasonably well-tolerated regimen for childhood osteosarcoma. No significant financial relationships to disclose.
PTH-031 Application of the clip-band traction method for gastric endoscopic submucosal dissection
Authors: S Budihal, A Parra-Blanco, N Gonzales, K Ragunath, D Nicholas, R Mansilla, S Sansone, M Yamada, T Uraoka
Journal: Endoscopy (2017)

<h3>Introduction</h3> Endoscopic Submucosal Dissection (ESD) is still limited in Western countries. The phase of submucosal dissection is the most challenging one due to the reduced visibility of the dissection plane. The Clip-Band traction method has shown to be useful and safe in animal models. This study aimed to evaluate the results of gastric ESD in humans with this method. <h3>Method</h3> Patients with epithelial gastric neoplasias as indicated for endoscopic resection according to the expanded Japanese criteria, underwent ESD with different knives plus the Clip-Band method. Performance of ESD, en bloc/curative resection, histological diagnosis and complications were evaluated. <h3>Results</h3> 21 lesions (19 patients; age 68 years±10 years) by four endoscopists (16,2,2,1 cases). According to Paris Classification there were 8(IIa), 2(IIa+IIb), 3(IIa+IIc), 1(Ib), 1(Ib+Ic), 1(IIc+III),1(l+lla) and 4 subepithelial lesions. Location was in the upper body (1), mid body (4), lower body (10), antrum (6). The time (median, range) for the circumferential cutting was 22 min (2-100), for the dissection after having applied the traction method 18 min (5-126), and the total dissection time 55 min (6-171). The maximum diameter(median, range) of the specimen was 3.0 cm (1.1–4.7), and the dissection speed (median, range) was 0.085cm<sup>2</sup>/min(0.03–0.35). There were neuroendocrine tumours(3), inflammatory fibroid polyp (1), neoplasia (17) (Low grade intraepithelial neoplasia 3, high grade intraepitheial neoplasia 7, Intramucosal carcinoma 7). En bloc resection was achieved in all cases; in 2 neuroendocrine lesions the vertical margin was positive (one of them requiring additional surgery). There was one case of delayed bleeding. <h3>Conclusion</h3> The Clip-Band method for gastric ESD provides good results, and can be applied in different gastric locations. The dissection phase is simplified, as the time for the dissection phase (the most challenging part of gastric ESD) is similar to the time for circumferential cutting. However randomised studies will be required to prove this. <h3>Disclosure of Interest</h3> None Declared
生体模倣生分解性人工抗原提示細胞は黒色腫治療のためのPD‐1遮断と相乗作用【Powered by NICT】
Authors: A K Kosmides, R A Meyer, J W Hickey, K Aje, K N Cheung, J J Green, J P Schneck
Journal: Biomaterials (2017)
2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction: Executive Summary
Authors: Patrick T. O’Gara, Frederick G. Kushner, Deborah D. Ascheim, Donald E. Casey, Mina K. Chung, James A. de Lemos, Steven M. Ettinger, James C. Fang, Francis M. Fesmire, Barry A. Franklin, Christopher B. Granger, Harlan M. Krumholz, Jane A. Linderbaum, David A. Morrow, L. Kristin Newby, Joseph P. Ornato, Narith Ou, Martha J. Radford, Jacqueline E. Tamis-Holland, Jacqueline E. Tommaso, Cynthia M. Tracy, Y. Joseph Woo, David X. Zhao
Journal: Circulation (2012)
Prediction of tumor necrosis fraction using combined volumetric and metabolic indices derived from FDG-PET/CT in osteosarcoma patients receiving neoadjuvant chemotherapy
Authors: B. Park, H. Park, H. Min, H. Kang, H. Im, S. Kim
Journal: Journal of Clinical Oncology (2009)

10539 Background: Maximum standardized uptake values (mSUV) might not reliably reflect the chemotherapy response in osteosarcoma especially when treatment response within tumors is heterogenous. The purpose of this study was to compare the usefulnesses of various FDG PET/CT indices for predicting tumor response to neoadjuvant chemotherapy and to identify the most appropriate one in osteosarcoma. Methods: Thirteen patients with primary osteosarcoma (age 14±2.9 yrs, ranged 10–19 yrs) that had undergone FDG PET/CT scans before and after neoadjuvant chemotherapy were enrolled. The authors measured mSUV, metabolic tumor volumes (MTV), and total lesion glycolysis (TLG) in each PET/CT scan. MTVs were calculated by summing voxels with SUV greater than 1.5, 2, 2.5 and 3.0, and with % mSUV greater than 20%, 25%, 30% and 35%. Histopathologic necrosis fractions were compared with the above-mentioned PET/CT parameters and their pre- to post-treatment ratios (MTV ratio, rMTV; mSUV ratio, rSUV; TLG ratio, rTLG). Results: Histopathologic necrosis fractions ranged from 3% to 99% (62.2%±37.7%). rMTV and rTLG values were found to be correlated with histopathologic necrosis fractions (R 2 =0.45–0.65, p&lt;0.05), whereas, mSUV and MR image volumes (MRV), both before and after treatment, rSUV values, and rMRV values were not. With regard to rMTV and rTLG values obtained using various MTV criteria, the highest correlation was observed for a rTLG value of 2.5 mg/ml (R 2 =0.65, p=0.001). Five patients were classified as responders and 8 as poor-responders to neoadjuvant chemotherapy defined as those with chemotherapy-induced necrosis fractions of ≥90% and &lt;90%, respectively. The rSUVs of responders and poor-responders were not different, but rMTV and rTLG values showed a trend toward difference, although statistically not significant (p=0.110 and 0.106, respectively). The sensitivity and specificity of rTLG were 100% and 62.5%, respectively, at an SUV cut-off of 0.13. Conclusions: In our osteosarcoma patient population, TLG and MTV, which represent combined metabolic and volumetric indices, were found to predict tumor response better than pre- or post-treatment mSUV or rSUV. No significant financial relationships to disclose.
01.08 Metabolic symbiosis between cells of the inflamed joint
Authors: Kalvin Sahota, Martin Fitzpatrick, Andrew Filer, Jane Falconer, Stephen P Young
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Metabolism underlies the function of all cells, and this is particularly true of the musculoskeletal system with its high energy requirements for normal function of muscle and maintenance and growth of bones. In disease, energy requirements are even greater, with the whole body metabolic rate being around 10% higher in a rheumatoid arthritis patient compared to a healthy control. <h3>Objectives</h3> To understand the metabolic perturbations in RA we have investigated the metabolomics of synovial fibroblasts and the major infiltrating immune cells in the joint, T lymphocytes and macrophages. <h3>Methods</h3> Synovial fibroblasts were grown from biopsies of early and established RA, and CD4 lymphocytes and M1 and M2 macrophages were derived from healthy control blood. Metabolites in cell extracts were identified using NMR spectroscopy and lymphocyte metabolic flux assessed using the Seahorse metabolic flux analyser. <h3>Results</h3> Synovial fibroblasts from RA were glycolytically active compared to normal cells, consuming glucose and producing lactate. Lactate applied exogenously to macrophages induced substantially higher IL6 production following LPS stimulation. Furthermore, IL6 exposure of CD4 T cells prior to antiCD3/CD28 activation promoted glycolysis and enhanced proliferation. <h3>Conclusion</h3> We suggest a unique metabolic symbiosis may exist between the major cells involved in RA pathogenesis which may augment and reinforce their function and thus the chronic inflammatory destructive processes involved in RA.
原因不明の心嚢液・左胸水貯留で発症し,診断に難渋した心臓血管肉腫の一例
Authors: 赤澤康裕, 松岡研, 玉井敬人, 坂田泰史, 山口修, 水野裕八, 小谷順一, 坂田泰彦, 平野賢一, 角辻暁, 大津欣也, 南都伸介, 山下静也, 横山恵信
Journal: Circulation (2009)
Detection of BRAF kinase mutations in melanoma, ovarian, and prostate carcinomas: Evidence for tumor heterogeneity in clinical samples
Authors: A. J. Litterman, M. Yancovitz, R. Shapiro, R. Berman, A. Pavlick, F. Daarvishian, S. Blank, P. Lee, I. Osman, D. Polsky
Journal: Journal of Clinical Oncology (2009)

11031 Background: Several studies have provided evidence that solid tumors are polyclonal malignancies, an observation which may contribute to difficulties in achieving durable treatment responses. In some patients, molecularly targeted therapies may be compromised due to heterogeneity among tumor subclones. In this study we compared conventional DNA sequencing with a fluorescent-based mutant-specific PCR (MS-PCR) assay to detect the BRAF hotspot mutation V600E in a large panel of patient tumors, including paired primary and metastatic tumors from individual patients. Methods: BRAF MS-PCR and conventional sequencing were performed on DNA from 304 tumors (112 melanoma, 110 ovarian, 82 prostate) to determine the presence of the BRAFV600E hot-spot mutation. Among the melanomas were 18 matched primary and metastatic specimens, and 40 metastatic specimens from 19 patients, each of whom had 2 or more metastases. Results: DNA sequencing detected mutations in 5/110 (4.5%) ovarian tumors, 1/82 (1.2%) prostate tumors, and 36/112 (32%) melanomas. In contrast, the MS-PCR assay detected mutations in 12/110 (11%) ovarian tumors, 15/82 (18%) prostate tumors and 85/112 (76%) melanomas. The presence of contaminating normal tissue was scored for each melanoma sample, but excess normal tissue did not influence the results using either methodology. In all cases mutations detected by sequencing were also detected by MSPCR. Among 18 patients with matched primary and metastatic melanoma, 8/18 (44%) had discordant results including 2 patients with mutant primary tumors and wild-type metastases; among the 19 patients with multiple metastases 5/19 (26%) had discordant (both wild-type and mutant) tumors. Conclusions: Using a highly sensitive BRAF mutation detection method, we observed substantial evidence for heterogeneity within clinical tumor specimens. This was especially true in melanoma samples, where multiple specimens from individual patients differed with respect to the presence of the mutant BRAF allele. These results suggest that failures of molecularly targeted therapies, such as those directed against mutant BRAF, may be due in part to a lack of clonality among the tumors under treatment. No significant financial relationships to disclose.
A VIDEO ANALYSIS OF MECHANISMS OF SHOULDER INJURIES IN AUSTRALIAN RULES FOOTBALL AND A COMPARISON TO OTHER FOOTBALL CODES
Authors: Laura M Schwab
Journal: British Journal of Sports Medicine (2017)

Background Shoulder injuries are common in Australian Rules football and often lead to considerable time out due to injury. There are no published studies regarding the mechanisms of shoulder injury in Australian Rules football which may influence medical management and rehabilitation. Objective To identify from video analysis mechanisms of shoulder injury in Australian Rules football (ARF) and compare those to mechanisms sustained in other codes of football. Design Retrospective, video analysis, two independent assessors. Setting Elite Australian Rules football league. Participants 26 elite males, age 18–28 years. Assessment of Risk Factors Medical staff confirmed all injuries which was defined as an injury causing a player to miss a match. Digital footage of 26 shoulder injuries was obtained from the 2015 playing season. Main Outcome Measurements Mechanism of shoulder injury, history of previous shoulder injury, time of injury, use of taping during the game and if the player required surgery. This data was then compared to previously published video analysis studies on rugby shoulder injuries. Results Three common mechanisms of shoulder injury exist in ARF; 1) tackling, with forced hyperextension of the players arm, 2) direct impact with the ground or another player 3) overhead marking where the arm is in some degree of abduction &amp; external rotation. The final mechanism differs to rugby where a try scorer, forced hyper-flexion mechanism is more common to the code. Almost half of the players injured in the 2015 season required surgery and a quarter had a history of previous shoulder pathology. A high number of injured players were taped at the time of the incident. There was no significant association between injury incidence and game quarter. Conclusions Systematic video analysis of shoulder injuries can provide a greater understanding of the likely pathology sustained from each mechanism and then may aid the development of injury prevention methods. Crossover exists between football codes with common mechanisms found however elite ARF has a unique mechanism to the code.
Investigating the heterogeneity of alkylating agents’ efficacy between genders: A meta-analysis of randomized trials comparing cyclophosphamide and ifosfamide (MAIAGE study).
Authors: Brice Fresneau, Michael Paulussen, Alan Hackshaw, Douglas S. Hawkins, JAMES R Anderson, Ian Robert Judson, Uta Dirksen, Ian J. Lewis, Hendrik Van Den Berg, Nathalie Gaspar, Hans Gelderblom, Jeremy Whelan, Joachim Boos, Keith Wheatley, Jean-Pierre Pignon, Marie-Cécile Le Deley, Gwenael Le Teuff
Journal: Journal of Clinical Oncology (2015)

e21500 Background: A marginal interaction between gender and type of alkylating agent (cyclophosphamide or ifosfamide) on event-free survival was observed in the randomized controlled trial (RCT) Euro-EWING99-R1 for Ewing sarcomas. To better judge of the reliability of this interaction, we performed a meta-analysis of RCTs assessing cyclophosphamide vs. ifosfamide. Methods: A systematic review and meta-analysis on individual patient data for any type of cancer were performed. The endpoints were progression-free survival (PFS) and overall survival (OS). The hazard ratio (HR) [95% confidence interval] of the treatment-by-gender interaction was assessed using a multivariable Cox regression model (fixed and random approach). The heterogeneity of interaction between trials was evaluated using a 3-order interaction term. Results: Meta-analysis included 1528 patients from 3 RCTs, in pediatric and young adult sarcomas: Euro-EWING99-R1 (n = 856), EICESS92 (n = 155) and IRS-IV (n = 517). With a median follow-up of 6.8 years, 424 failures and 325 deaths, a marginal (p = 0.065) overall difference for PFS was observed between the four groups defined by treatment arm and gender. Multivariable analysis tended to identify poorer PFS in males treated with cyclophosphamide vs. ifosfamide (HR = 1.26[0.99; 1.61] p = 0.06), whereas PFS was not significantly different in females receiving cyclophosphamide or ifosfamide (HR = 0.96[0.70; 1.31] p = 0.80). However, the treatment-by-gender interaction was not significant (HR = 1.31[0.89; 1.95] p = 0.17). No significant heterogeneity for interaction term was observed (p = 0.36) despite apparent discrepancies: HREE99= 1.74[1.00; 3.02], HREICESS92= 1.21[0.40; 3.68] and HRIRS-IV= 0.93[0.48; 1.82]. Results were very similar with a random approach. Similar results were observed for OS. Conclusions: The meta-analysis could neither confirm nor refute the hypothesis of a treatment-by-gender interaction on efficacy outcomes. Identification of sex differences in toxicity profiles between alkylating agents should be investigated and could lead to gender-adaptations in children and young adults with sarcoma.
[18F]FDG PETシグナルは星状細胞グルタミン酸輸送により駆動される
Authors: Zimmer Eduardo R, Parent Maxime J, Souza Debora G, Leuzy Antoine, Lecrux Clotilde, Kim Hyoung‐Ihl, Gauthier Serge, Pellerin Luc, Hamel Edith, Rosa‐Neto Pedro
Journal: Nature Neuroscience (2017)