tbuckley/cabot-search huggingface dataset:
PTH-139 A Unique Combined Gastroenterology/Rheumatology Clinic: the first Year
Authors: G Constable, F Bari, T Lawson
Journal: Gut (2013)

<h3>Introduction</h3> Articular problems affect many patients with inflammatory bowel disease (IBD) and joint symptoms are often difficult to control despite the therapeutic strategies aimed at controlling gut inflammation (1). Patients with inflammatory rheumatic conditions present a range of clinical problems to the gastroenterologist such as IBD, dysmotility, dysbiosis, liver dysfunction, nutritional problems and drug side effects. Patients often drift between the two specialties with inefficient communication and subsequent delay in a joined up approach to management. We therefore developed a joint gastroenterology/rheumatology clinic to improve the care of these complex patients and now report our experience of the first year. <h3>Methods</h3> The clinic is run by a consultant gastroenterologist (GC) and consultant rheumatologist (TL) and attended by both GI and rheumatology trainees, nurse practitioners and medical students. Patients are referred from the respective specialties by consultant or SpR grade physicians. Each patient is given a 30 minute time slot which allows time for assessment, discussion, treatment planning and any therapeutic intervention such as joint aspiration/injection. Most patients are referred back to the individual specialty clinics but where necessary follow up is continued in the combined clinic. All patients attending the clinic are invited to complete a satisfaction questionnaire and give written feedback. <h3>Results</h3> We present our experience of the first year of this innovative clinic detailing the wide range of clinical problems encountered together with anonymous patient feedback. We also present trainee, nurse and consultant perspectives on the value of the combined clinic. <h3>Conclusion</h3> Although there are many well established combined specialty clinics we believe this is the first report of a combined gastroenterology/rheumatology clinic. The patient feedback has been very positive with all patients finding the clinic of benefit. There are many other advantages including efficiency of patient management, reducing multiple attendances to specialty clinics, learning from each other and teaching of trainees and students. <h3>Disclosure of Interest</h3> None Declared. <h3>Reference</h3> Brakenhoff LKPM, van der Heijde DM, Hommes DW. IBD and arthropathies: A practical approach to its diagnosis and management. Gut (2011). 60 (10); 1426–1435.
Effect of serum from patients with idiopathic thrombocytopenic purpura on cultured endothelial cell growth
Authors: Tokuo Nakajima, Eizo Kakishita, Kiyoyasu Nagai
Journal: American Journal of Hematology (1987)

This study examined the effects of platelet-derived serum factors from patients with idiopathic thrombocytopenic purpura (ITP) on human umbilical cord vascular endothelial cell growth and DNA synthesis. Vascular endothelial cell growth factors were identified in the platelet extracts, and platelet-derived vascular endothelial cell growth factors with molecular weights of less than 10,000 were also identified in the sera. These growth factors were stable even after 30 minutes of heat treatment at 56 degrees C and acid treatment. When ITP patient serum was added to vascular endothelial cells, their growth capacity and DNA synthesis capacity were lower than when serum from normal subjects or patients with ITP in remission was added. This indicated that in ITP, impairment of vascular integrity and abnormal repair of the vascular walls that accompany thrombocytopenia may be causes of the predisposition to hemorrhage. The decrease in ITP of platelet-derived vascular endothelial cell growth factors with molecular weights of less than 10,000 was hypothesized to be a contributory factor.
The complex interplay between inflammation, the microbiota and colorectal cancer
Authors: Janelle C. Arthur, Christian Jobin
Journal: Gut Microbes (2013)

The microbiome has captured the attention of scientists from multiple research fields including ecology, immunology, microbiology and cancer biology. The microbial community living in the gastrointestinal tract is the most abundant and diverse niche of the human body and it is not surprising that microbiome research has predominantly focused upon this organ system. In this addendum, we summarize the latest developments in microbiome research on inflammatory bowel diseases and colorectal cancer. In addition, we highlight our recent findings that chronic intestinal inflammation modulates microbial community composition and the development of colorectal cancer. Our findings redefine the paradigm of inflammation-associated cancer by illuminating the key role of bacteria in development of colorectal cancer.
Clinical evaluation versus Doppler echocardiography in the quantitative assessment of valvular heart disease.
Authors: W M Jaffe, A H Roche, H A Coverdale, H F McAlister, J A Ormiston, E R Greene
Journal: Circulation (1988)

We tested the hypotheses that Doppler echocardiography has a higher accuracy than clinical evaluation in the detection of significant aortic and mitral valvular heart disease and that Doppler echocardiography is highly accurate as compared with cardiac catheterization for the assessment of valvular disease severity. Thus, cardiac catheterization for the assessment of valve lesion severity may be unnecessary in selected patients. We prospectively evaluated 75 consecutive patients, ages 20-74 years (mean, 52 years), with clinically suspected valvular heart disease. Specific clinical and Doppler echocardiographic criteria were used to categorize each valve lesion as absent, insignificant, or significant. Criteria for a significant lesion at cardiac catheterization was an aortic or mitral valve area less than 1.1 or 1.5 cm2, respectively, or equal to or greater than 3+ cm2 aortic or mitral regurgitation at angiography. In all valve lesions, Doppler echocardiography had a higher overall accuracy than clinical evaluation. Increases in accuracies of 28%, 19%, 15%, and 7% occurred for mitral stenosis, aortic stenosis, aortic regurgitation, and mitral regurgitation, respectively, resulting in overall accuracies of 97%, 100%, 95%, and 96%. Clinical evaluation alone made 28 errors (37% of patients and 19% of valve lesions assessed), and 17 of these errors (23% of patients and 12% of valve lesions) would have resulted in inappropriate management. In only four (24%) of these 17 patients, the attending cardiologist would not have proceeded to assess the valve at cardiac catheterization.(ABSTRACT TRUNCATED AT 250 WORDS)
The Association Between Glucose Abnormalities and Heart Failure in the Population-Based Reykjavík Study
Authors: Inga S. Thrainsdottir, Thor Aspelund, Gudmundur Thorgeirsson, Vilmundur Gudnason, Thordur Hardarson, Klas Malmberg, Gunnar Sigurdsson, Lars Rydén
Journal: Diabetes Care (2005)

OBJECTIVE—Diabetes is an independent risk factor for heart failure, whereas the relation between heart failure and abnormal glucose regulation (AGR) needs further evaluation. We studied this combination in the Reykjavík Study. RESEARCH DESIGN AND METHODS—The Reykjavík Study, a population-based cohort study during 1967–1997, recruited 19,381 participants aged 33–84 years who were followed until 2002. Oral glucose tolerance tests and chest X-rays were obtained from all participants. Cases were defined in accordance with World Health Organization criteria for type 2 diabetes or AGR (impaired glucose tolerance or impaired fasting glucose) and European Society of Cardiology guidelines for heart failure. RESULTS—The overall prevalence of type 2 diabetes and heart failure was 0.5% in men and 0.4% in women, while AGR and heart failure were found in 0.7% of men and 0.6% of women. Among participants with normal glucose regulation, heart failure was diagnosed in 3.2% compared with 6.0 and 11.8% among those with AGR and type 2 diabetes, respectively. The prevalence of type 2 diabetes in the age-group 45–65 years increased in both sexes during the period (P for trend = 0.007). The odds ratio was 2.8 (95% CI 2.2–3.6) for the association between type 2 diabetes and heart failure and 1.7 (1.4–2.1) between AGR and heart failure. CONCLUSIONS—There is a strong association between any form of glucometabolic perturbation and heart failure. Future studies in this field should focus on all types of glucose abnormalities rather than previously diagnosed diabetes only.
Spontaneous Reduction of Testicular Torsion During Scrotal Imaging
Authors: ??DWIN R. WILLGRESS, ERNEST J. CAMPONOVO, AARON M. KISTLER, PETER F. GOYER, EUGENE D. SILVERMAN
Journal: Clinical Nuclear Medicine (1989)

A patient with clinical and imaging evidence of testicular torsion spontaneously detorsed following initial imaging with normalization of testicular image.
Methotrexate in the treatment of cancer; report of the proceedings of a symposium at the Royal Society of Medicine, 18 September, 1961, sponsored by Lederle Laboratories, a Division of Cyanamid of Great Britain, Ltd
Authors: Warren N. Bell
Journal: JAMA (1963)

This book is a composite of a group of papers presented at a symposium of the Royal Society of Medicine on Sept 18, 1961. It opens with a review of the biochemistry and pharmacology of methotrexate and the clinical significance of some recent work. This is followed by a section on the systemic use of the agent, both alone and in combination with other cancer chemotherapeutic agents; there are included sections on the infusion use of methotrexate and the intrathecal use in acute leukemia involving the central nervous system. The material presented is a very worthwhile addition to the library of those interested in cancer chemotherapy. In particular, the discussion section following each major group of papers is very worthwhile, as it presents the review of many experts in these fields. The papers are fully reproduced with colored or black-and-white photographs, as well as charts. This symposium adequately points out
Superior vena cava syndrome. Rapid histologic diagnosis by ultrasound-guided transthoracic needle aspiration biopsy.
Authors: J C Ko, P C Yang, A Yuan, D B Chang, C J Yu, H D Wu, L N Lee, S H Kuo, K T Luh
Journal: American Journal of Respiratory and Critical Care Medicine (1994)

We prospectively analyzed the diagnostic yield and safety of ultrasound (US)-guided transthoracic needle aspiration biopsy in the histologic diagnosis of 40 patients with superior vena cava (SVC) syndrome. During a 4-yr period, 40 patients with SVC obstruction were admitted to National Taiwan University Hospital. Of these patients 10 had histologic confirmation by sputum cytology (3 patients), fiberoptic bronchoscopy with biopsy (2 patients), or lymph node biopsy (5 patients) at admission. A total of 30 undiagnosed patients underwent real-time ultrasonographic (US) evaluation as well as color Doppler imaging. Patients with tumor detectable by US underwent US-guided transthoracic needle aspiration biopsy. Of the 30 patients who received US chest examination, 29 had widening of the upper mediastinal shadows in the chest radiographs. In 27 patients tumors were detected by chest US. After assessment of collateral vessels by color Doppler US, these 27 patients underwent US-guided transthoracic needle aspiration biopsies; histologic diagnoses were confirmed in 25. The diagnostic yield was 83.3%. The mean duration from admission to histologic diagnosis was 2.1 days. None of the patients developed complications. We conclude that chest US and color Doppler images are useful tools for evaluation of patients with SVC syndrome. US-guided transthoracic needle aspiration biopsy appears to be a safe, effective, and rapid approach for obtaining an accurate histologic diagnosis. Specific treatment can thus be initiated without delay.
Stethoscope Acoustics
Authors: PAUL Y. ERTEL, MERLE LAWRENCE, RICHARD K. BROWN, AARON M. STERN
Journal: Circulation (1966)

This paper describes a fully calibrated and standardized acoustical test method for evaluating the transmission patterns and the filtration patterns of intact stethoscopes. An essential component of the test system is the artificial ear which duplicates the acoustical contribution of the average human ear to the stethoscope's acoustics. The transmission patterns of bell-type stethoscopes fall into four distinct groups which correspond to their basic design features. Shallow bells and single tubing design both result in attenuation at higher frequencies. A deep, trumpet-shaped bell with double tubing design may provide amplification at higher frequencies. Diaphragms attenuate the transmission acoustics of stethoscopes. When the low frequencies are selectively attenuated, high frequencies are heard more distinctly. Some diaphragms were found to attenuate at all frequencies. The acoustical performance of any stethoscope is critical. Any attenuation of clinically significant sounds of low intensity may render them totally inaudible. The majority of stethoscopes tested (bell and diaphragm chestpieces) attenuate high frequency sounds. The adoption of stethoscopic performance criteria is urged. Few modern stethoscopes show any significant acoustical improvement since the time of Laennec.
Long-term protective effect of UR-12670 after warm renal ischemia in uninephrectomized rats
Authors: Joan Torras, Josep Maria Cruzado, Marta Riera, Enric Condom, Natalia Duque, Immaculada Herrero, Manuel Merlos, Lluis Espinosa, Nuria Lloberas, Jesus Egido, Josep Maria Grinyó
Journal: Kidney International (1999)
Inducible targeting of IL-13 to the adult lung causes matrix metalloproteinase– and cathepsin-dependent emphysema
Authors: Tao Zheng, Zhou Zhu, Zhongde Wang, Robert J. Homer, Bing Ma, Richard J. Riese, Harold A. Chapman, Steven D. Shapiro, Jack A. Elias
Journal: Journal of Clinical Investigation (2000)

Cigarette smoke exposure is the major cause of chronic obstructive pulmonary disease (COPD). However, only a minority of smokers develop significant COPD, and patients with asthma or asthma-like airway hyperresponsiveness or eosinophilia experience accelerated loss of lung function after cigarette smoke exposure. Pulmonary inflammation is a characteristic feature of lungs from patients with COPD. Surprisingly, the mediators of this inflammation and their contributions to the pathogenesis and varied natural history of COPD are not well defined. Here we show that IL-13, a critical cytokine in asthma, causes emphysema with enhanced lung volumes and compliance, mucus metaplasia, and inflammation, when inducibly overexpressed in the adult murine lung. MMP-2, -9, -12, -13, and -14 and cathepsins B, S, L, H, and K were induced by IL-13 in this setting. In addition, treatment with MMP or cysteine proteinase antagonists significantly decreased the emphysema and inflammation, but not the mucus in these animals. These studies demonstrate that IL-13 is a potent stimulator of MMP and cathepsin-based proteolytic pathways in the lung. They also demonstrate that IL-13 causes emphysema via a MMP- and cathepsin-dependent mechanism(s) and highlight common mechanisms that may underlie COPD and asthma.
The Major Histocompatibility Complex — Genetics and Biology
Authors: Fritz H. Bach, Jon J. van Rood
Journal: New England Journal of Medicine (1976)

The LD StoryRejection of an allograft is thought to involve lymphocyte-mediated immune response against non-self MHC antigens. As such, several tests have been proposed that use the biologic response of lymphocytes to foreign antigens as a measure of histocompatibility. We shall limit our discussion to two tests: the mixed leukocyte culture (MLC) and cell-mediated lympholysis (CML) assays.The MLC27,28 test provided an in vitro model in which lymphocytes were used both as the cells that could respond to foreign antigens and as the stimulators carrying those antigens. Thus, lymphocytes of a potential recipient (e.g., A) . . .
Fever, Its Biology, Evolution, and Function
Authors: Phil Gunby
Journal: JAMA (1980)

Can fever be beneficial? The author suggests that, under certain circumstances, it can be. For example, he writes, many micro-organisms are killed by elevations in temperatures corresponding to moderate fevers, and there may be indirect effects on immune response such as, perhaps, increased susceptibility of lysosomes to breakage and improvement in the ability of granulocytes to kill engulfed microorganisms. In any case, he contends, this is an area that needs more study.  Whether or not you agree with the implications drawn from the data presented, this is an interesting summary of a number of studies on fever. There also are extensive references for those interested in pursuing the subject further.
Acute Onset of Dyspnea Associated With Colonoscopy
Authors: James R. Dexter
Journal: JAMA (1980)

WE PRESENT this case to demonstrate that the increase in abdominal pressure associated with colonoscopy may result in visceral herniation through a chronic diaphragmatic defect. <h3>Report of a Case</h3> A 67-year-old man was referred for colonoscopy because a sigmoid polyp had been demonstrated by barium enema examination. He was otherwise in good health and denied previous illness or injury except for blunt upper abdominal trauma and several rib fractures during an automobile accident in 1939. Subsequent chest roentgenograms had shown an elevated right hemidiaphragm. During the colonoscopy, a 1.5-cm polyp on a long stalk was transected from the sigmoid colon with electrocautery. Shortly thereafter, the patient complained of sudden dyspnea and asked to sit up. Breath sounds were diminished in the right hemithorax. The abdomen was moderately distended but nontender, and the liver was palpable 7 cm below the costal margin. Initially, bowel sounds were absent but were later noted
Predictors of Late deaths among patients with clinical stage I melanoma who have not had bony or visceral metastases within the first 5 years after diagnosis
Authors: Calvin L. Day, Martin C. Mihm, Arthur J. Sober, Matthew N. Harris, Alfred W. Kopf, Thomas B. Fitzpatrick, Robert A. Lew, Terence J. Harrist, Frederick M. Golomb, Allen Postel, Patrick Hennessey, Stephen L. Gumport, John W. Raker, Ronald A. Malt, A. Benedict Cosimi, William C. Wood, Daniel F. Roses, Fred Gorstein, Darrell Rigel, Robert J. Friedman, Medwin M. Mintzis
Journal: Journal of the American Academy of Dermatology (1983)
Abstract 1188: Cell-of-origin determines genetic selection and defines T-cell acute lymphocytic leukemia sub-types in mouse models
Authors: Katherine E. Berquam-Vrieze, Kishore Nannapaneni, Oksana Zagorodna, Charles Mullighan, David K. Meyerholz, Neal Copeland, Nancy Jenkins, C. Michael Knudson, Todd Scheetz, Adam J. Dupuy
Journal: Cancer Research (2010)

Abstract The cell-of-origin has yet to be identified for most forms of cancer. However, such knowledge would provide insight into the earliest events that initially distinguish a tumor cell from its normal cell-of-origin. Understanding and identifying these events are critical, as these early genetic changes may create targets that can be exploited therapeutically. Unfortunately, the tools to address this question have only recently become available. We have recently completed a forward genetic screen to examine how altering the cell-of-origin affects genetic selection in cancer. To accomplish this we made use of a Cre-inducible Sleeping Beauty (SB) system to initiate transposon mutagenesis in hematopoietic stem cells (HSCs), thymic progenitor cells (TP) or late stage CD4+/CD8+ thymocytes (DP). Each of these approaches produced predominantly T-cell lymphomas with different characteristics. Analysis of transposon-induced mutations in each of the three lymphoma models revealed clear differences in their genetic profiles. For instance, the HSC model was defined by frequent mutations in Notch1 (∼58%). By contrast, lymphomas in the DP model did not have Notch1 mutations, but instead had frequent mutations in Myc, Gfi1, Whsc1 and Akt2. Interestingly, tumors that were initiated in thymic progenitor cells had a genetic profile similar to that seen in the HSC or the DP model. Recently, a sub-type of T-cell acute lymphoblastic leukemia (T-ALL), called early thymic progenitor ALL (ETP-ALL) was described in which the tumor cells resembled ETPs in both surface marker and mRNA expression. In addition, ETP-ALL patients have a much worse prognosis than typical T-ALL patients. We compared gene expression signatures from a subset of HSC and DP lymphomas to that of ETP-ALL and typical T-ALL. Interestingly, tumors from the DP model have a similar gene expression to human ETP-ALL, while HSC tumors show a greater resemblence to typical T-ALL. Our data indicate that ETP-ALL may not arise from an early thymic progenitor, but from a differentiated T-cell that has undergone anaplastic transformation. The implications of this study are that cell-of-origin cannot be inferred from analysis of protein or gene expression patterns in tumors. Our findings also suggest that differentiation state of the cell-of-origin plays a critical role in determining what types of mutations will be selected during transformation. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 1188.
Response: Conflicting data on the prognostic significance of FLT3-TKD mutations in cytogenetically normal acute myeloid leukemia (CN-AML) might be related to many factors, including techniques used to detect FLT3-TKD, differences in patient populations studied, and treatment regimens
Authors: Susan P. Whitman, Guido Marcucci, Amy S. Ruppert, Krzysztof Mrózek, Clara D. Bloomfield
Journal: Blood (2008)
Subendocardial resection for refractory ventricular tachycardia: Effects on ambulatory electrocardiogram, programmed stimulation and ejection fraction, and relation to outcome
Authors: Michael G. Kienzle, John U. Doherty, Denis Roy, Harvey L. Waxman, Alden H. Harken, Mark E. Josephson
Journal: Journal of the American College of Cardiology (1983)
Cyclic thrombocytopenia in a patient treated with cyclosporine for refractory idiopathic thrombocytopenic purpura
Authors: Tsunemichi Shirota, Hirobumi Yamamoto, Hiroaki Fujimoto, Yoshimi Harada, Kiyoshi Okada, Hiroyuki Uchida, Hisashi Roppongi, Toru Hayashi
Journal: American Journal of Hematology (1997)

Cyclic thrombocytopenia (CT) is a rare disorder with cyclic changes of the platelet counts. Though the pathogenesis of this disorder has not been clarified, recent reports suggest that periodic destruction and/or ineffective production of platelets may be important causes of the disease. We report a case of a patient with refractory idiopathic thrombocytopenic purpura (ITP) in whom CT developed after cyclosporine A (CyA) therapy. There was an inverse relation between platelet counts and the serum levels of platelet-associated immunoglobulin G (PAIgG). The ploidy of bone marrow megakaryocytes also had an inverse relation with platelet counts. When the platelet count was low, the ploidy of megakaryocytes increased (P < 0.01). The number and area of bone marrow megakaryocytes were unrelated to platelet counts. These results indicate the possibility of platelet destruction caused by immunological mechanisms in CT. Cyclosporine A could have certain but fluctuating regulatory effects against antibody production for circulating platelets, which could lead to cyclic changes of the platelet counts. This case also suggests that CyA can be effective in severe refractory ITP. Regulatory mechanisms of platelet production and destruction and appropriate doses of CyA should be further studied in autoimmune-mediated thrombocytopenias. Am. J. Hematol. 56:272–276, 1997. © 1997 Wiley-Liss, Inc.