tbuckley/cabot-search huggingface dataset:
PWE-303 The accuracy of magnetic resonance imaging in the management of rectal cancer – are we meeting the standard?
Authors: C Ray, S Brown, J Park, A Renwick, P Horgan, S Moug, M Vella
Journal: Gut (2015)

<h3>Introduction</h3> Magnetic Resonance Imaging (MRI) of the pelvis informs treatment strategy in rectal cancer. Complex multidisciplinary treatment plans are formulated on the basis of TNM status and proximity of the tumour to the circumferential resection margin (CRM). Previous studies<sup>1</sup>report a high degree of MRI accuracy. We sought to assess the regional performance of MRI assessment of CRM. <h3>Method</h3> A total of 150 consecutive patients with rectal cancer who underwent staging MRI were identified from a prospectively collected audit database comprising 6 units within Greater Glasgow and Clyde (West of Scotland Colorectal Cancer Managed Clinical Network) between April 2012 and March 2013. Pre-operative MRI prediction of circumferential resection margin (CRM) involvement was studied in both groups receiving neoadjuvant therapy and those proceeding directly to surgical resection. In all cases the MRI prediction of CRM was compared with final pathological assessment of CRM status. Patients who had metastatic disease at initial diagnosis, did not undergo MRI or did not proceed to surgical resection were excluded. <h3>Results</h3> Of 102 patients who underwent resection of rectal cancer (either APR or anterior resection) 74 patients proceeded directly to surgery and 28 underwent neoadjuvant chemoradiotherapy prior to resection. Four patients were found to have an involved CRM at final pathological analysis (4%) (2 in the group proceeding direct to resection and 2 in the neodjuvant therapy group). The specificity of MRI prediction of CRM involvement, in the direct-to-surgery cohort was 100% (95% CI 95–100), and negative predictive value (NPV) was 97% (95% CI 90–99). However in the group receiving neoadjuvant therapy prior to resection, the post-treatment MRI had a specificity of 53% (95% CI 33–73) and NPV of 100% (95% CI 76–100). <h3>Conclusion</h3> Pelvic MRI has become commonplace in the staging of rectal cancer. The prediction of CRM involvement is critical to complex decision making<sup>2</sup>about treatment modalities and in particular whether neoadjuvant therapy is instituted. Local institution of MRI assessment has resulted in a favourably low rate of CRM involvement at final pathology (4%). A high NPV allows selective use of neoadjuvant therapy for those at risk of an involved CRM. <h3>Disclosure of interest</h3> None Declared. <h3>References</h3> Diagnostic accuracy of preoperative magnetic resonance imaging in predicting curative resection of rectal cancer: prospective observational study. MERCURY Study Group. BMJ. 2006 Oct 14;333(7572):779 Multicenter Evaluation of Rectal cancer ReImaging pOst Neoadjuvant (MERRION) Therapy. Hanly AM, Ryan EM, Rogers AC, McNamara DA, Madoff RD, Winter DC; MERRION Study Group. <i>Ann Surg</i>. 2014. Apr;259(4):723–7. doi: 10.1097/SLA.0b013e31828f6c91. PMID:23744576
Innate lymphoid cells promote lung tissue homeostasis following acute influenza virus infection
Authors: Laurel A. Monticelli, Gregory F. Sonnenberg, Michael C. Abt, Theresa Alenghat, Carly G.K. Ziegler, Travis A. Doering, Jill M. Angelosanto, Brian J. Laidlaw, Cliff Y. Yang, Taheri Sathaliyawala, Masaru Kubota, Damian Turner, Joshua M. Diamond, Ananda W. Goldrath, Donna L. Farber, Ronald G. Collman, E. John Wherry, David Artis
Journal: Nature Immunology (2011)
Ebola in Africa - Discoveries in the past decade
Authors: R  R Arthur
Journal: Eurosurveillance (2002)

Within the past decade, Ebola haemorrhagic fever (EHF) has been recognised for the first time in four countries. Our understanding of the epidemiology, clinical aspects, laboratory diagnosis and control measures for EHF has improved considerably as a result of the outbreaks in these countries and the re-emergence that has occurred in another. The coordinated international responses to several of the large EHF outbreaks serve as models for controlling epidemics of other communicable diseases. This report is a chronological overview of the EHF outbreaks in Africa during the past decade, including the recent epidemics in Gabon and the Republic of the Congo, and highlights new discoveries and some of the remaining challenges.
SP0186 Barriers and Facilitators for Applying Optimal Exercise Intensity in Rheumatic and Musculoskeletal Diseases
Authors: E. Hurkmans
Journal: Annals of the Rheumatic Diseases (2015)

It is generally known that obtaining and maintaining a sufficient level of physical activity is an important health goal in patients with rheumatic and musculoskeletal diseases. Exercises have been shown to have a positive effective on for example aerobic capacity, muscle strength and daily functioning. Furthermore, the safety of exercises has been established as well. Various studies have shown that patients with rheumatic and musculoskeletal diseases have difficulties in starting and/or continuing exercises, whether or not of vigorous or moderate intensity. Studies also have shown that a large part of this population has problems with reaching the optimal intensity. The reason for these problems can be very diverse. In this presentation barriers and facilitators to start and continue exercises and reach the optimal level of exercise intensity will be discussed. Differenct perspectives on possible barriers and facilitations will be presented. <h3>Disclosure of Interest</h3> None declared
PWE-220 Percutaneous transhepatic biliary drainage and stenting: a single centre experience
Authors: V Kronsten, A Speirs, F Ahmad, M Gibson, J Booth, N Chandra
Journal: Gut (2015)

<h3>Introduction</h3> Percutaneous transhepatic biliary drainage (PTBD) and stenting, though invaluable in relieving difficult biliary obstruction, carry a high morbidity and mortality. This retrospective study examined the incidence and nature of procedure-related complications and survival in a large district general hospital. <h3>Method</h3> Between April 2010 and December 2013, 66 consecutive patients who underwent PTBD were studied by analysing the radiology database and patient hospital records. <h3>Results</h3> 61% of patients were male. Median age at time of procedure was 72.5 years (interquartile (IQ) range 61–80.75). 90.9% of patients had malignancy and 9.1% had benign disease (gallstones (7.6%), chronic pancreatitis (1.5%)). The most common indication for PTBD was primary pancreaticobiliary cancer (71.2%), followed by secondary liver metastases (19.7%). 53% had occlusion at the distal common bile duct; 39.4% at the hilum; 7.5% had intrahepatic obstruction. Endoscopic retrograde cholangiopancreatography had been performed previously in 77.3%. Prior to intervention 37.9% were treated for cholangitis. 92% received antibiotics (treatment or prophylaxis) pre-procedure. Median pre-procedure bilirubin was 275 μmol/L (IQ range 156–357 μmol/L). A one-step procedure was performed in 51.5%. 48.5% underwent 2 or more interventions. Unilateral drainage was carried out in 68.2%, bilateral in 16.7% and a rendezvous procedure in 6%. 84.8% received antibiotics post-procedure. Overall procedural success was high, with technical success and relief of biliary obstruction achieved in 93.9%. Drainage was effective at reducing bilirubin levels by greater than 50% at 7 days post-procedure in 68.2% (median bilirubin 108 μmol/L(IQ range 53–166)). 33.3% of patients experienced at least one complication post-PTBD. Culture positive cholangitis was seen in 19.7%. Acute kidney injury was detected in 12.1%. Other complications included abscess formation (9.1%), procedure failure (6.1%), haemorrhage (4.5%), pneumonia (3%), stent occlusion at 1 month (3%), stent migration at 1 month (1.5%) and local wound infection (1.5%). Inpatient mortality was 24.2% and 30-day mortality was 28.8%. Deceased patients at 30 days had significantly higher creatinine levels (p = 0.02) and significantly lower albumin levels (p = 0.003) pre-intervention than surviving patients. <h3>Conclusion</h3> This study highlights that complication and mortality-rates remain high post-PTBD and lays emphasis on the need for national guidelines on peri-procedural management, and careful patient selection. We demonstrate that our performance at a large district general hospital is comparable to national data.<sup>1</sup> <h3>Disclosure of interest</h3> None Declared. <h3>Reference</h3> Uberoi R, Robertson I. First Biliary Drainage and Stent Audit Report. The British Society of Interventional Radiology, 2009.
Radiotherapy for Non–Small Cell Lung Cancer Induces DNA Damage Response in Both Irradiated and Out-of-field Normal Tissues
Authors: Shankar Siva, Pavel Lobachevsky, Michael P. MacManus, Tomas Kron, Andreas Möller, Richard J. Lobb, Jessica Ventura, Nickala Best, Jai Smith, David Ball, Olga A. Martin
Journal: Clinical Cancer Research (2016)

Abstract Purpose: To study the response of irradiated and out-of-field normal tissues during localized curative intent radiotherapy. Experimental Design: Sixteen patients with non–small cell lung carcinoma (NSCLC) received 60 Gy in 30 fractions of definitive thoracic radiotherapy with or without concurrent chemotherapy. Peripheral blood lymphocytes (PBL) and eyebrow hairs were sampled prior, during, and after radiotherapy. Clinical variables of radiotherapy dose/volume, patient age, and use of chemoradiotherapy were tested for association with γ-H2AX foci, a biomarker of DNA damage that underlies cellular response to irradiation. Results: Radiotherapy induced an elevation of γ-H2AX foci in PBL, representing normal tissues in the irradiated volume, 1 hour after fraction one. The changes correlated directly with mean lung dose and inversely with age. γ-H2AX foci numbers returned to near baseline values in 24 hours and were not significantly different from controls at 4 weeks during radiotherapy or 12 weeks after treatment completion. In contrast, unirradiated hair follicles, a surrogate model for out-of-field normal tissues, exhibited delayed “abscopal” DNA damage response. γ-H2AX foci significantly increased at 24 hours post-fraction one and remained elevated during treatment, in a dose-independent manner. This observed abscopal effect was associated with changes in plasma levels of MDC/CCL22 and MIP-1α/CCL3 cytokines. No concordant changes in size and concentration of circulating plasma exosomes were observed. Conclusions: Both localized thoracic radiotherapy and chemoradiotherapy induce pronounced systemic DNA damage in normal tissues. Individual assessment of biologic response to dose delivered during radiotherapy may allow for therapeutic personalization for patients with NSCLC. Clin Cancer Res; 22(19); 4817–26. ©2016 AACR. See related commentary by Verma and Lin, p. 4763
Tuberculosis in Immigrants
Authors: K Viskum
Journal: BMJ (1962)

Three cases of tuberculosis in immigrants are described here. The manifestations of tuberculosis in this group are often different from those seen in Danes--in casu tuberculosis of the lymph nodes, skin, bone, and intestines. Diagnosis is difficult, as Danish doctors are not familiar with the clinical picture. Language problems are common and often necessitate the presence of an interpreter. Immigrants tend to move around without notifying the responsible doctor and the resources needed to find them may not be readily available. These factors may cause a considerable delay--from months to years--in the diagnosis and treatment. Doctors examining immigrants from Africa and Asia should be aware of tuberculosis as a possible cause of disease. Secretion and biopsies from fistulae, chronic ulcerations, lymph nodes, and abscesses should always be cultured for Mycobacterium tuberculosis. The Mantoux reaction can be misleadingly negative in patients suffering from severe tuberculosis. Identification of Mycobacterium tuberculosis is not necessary for treatment--that decision is made on the clinical picture. On the other hand material for a bacteriological diagnosis should always be obtained, because of possible resistance problems.
Effects of Smoking During Pregnancy: Review with a Preview
Authors: H J HERON
Journal: JAMA (1963)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
<i>In vivo</i> MR and Fluorescence Dual-modality Imaging of Atherosclerosis Characteristics in Mice Using Profilin-1 Targeted Magnetic Nanoparticles
Authors: Yabin Wang, Jiangwei Chen, Bo Yang, Hongyu Qiao, Lei Gao, Tao Su, Sai Ma, Xiaotian Zhang, Xiujuan Li, Gang Liu, Jianbo Cao, Xiaoyuan Chen, Yundai Chen, Feng Cao
Journal: Theranostics (2015)

This study aims to explore non-invasive imaging of atherosclerotic plaque through magnetic resonance imaging (MRI) and near-infrared fluorescence (NIRF) by using profilin-1 targeted magnetic iron oxide nanoparticles (PF1-Cy5.5-DMSA-Fe3O4-NPs, denoted as PC-NPs) as multimodality molecular imaging probe in murine model of atherosclerosis.PC-NPs were constructed by conjugating polyclonal profilin-1 antibody and NHS-Cy5.5 fluorescent dye to the surface of DMSA-Fe3O4-nanoparticles via condensation reaction. Murine atherosclerosis model was induced in apoE(-/-) mice by high fat and cholesterol diet (HFD) for 16 weeks. The plaque areas in aortic artery were detected with Oil Red O staining. Immunofluorescent staining and Western blot analysis were applied respectively to investigate profilin-1 expression. CCK-8 assay and transwell migration experiment were performed to detect vascular smooth muscle cells (VSMCs) proliferation. In vivo MRI and NIRF imaging of atherosclerotic plaque were carried out before and 36 h after intravenous injection of PC-NPs. Oil Red O staining showed that the plaque area was significantly increased in HFD group (p<0.05). Immunofluorescence staining revealed that profilin-1 protein was highly abundant within plaque in HFD group and co-localized with α-smooth muscle actin. Profilin-1 siRNA intervention could inhibit VSMCs proliferation and migration elicited by ox-LDL (p<0.05). In vivo MRI and NIRF imaging revealed that PC-NPs accumulated in atherosclerotic plaque of carotid artery. There was a good correlation between the signals of MRI and ex vivo fluorescence intensities of NIRF imaging in animals with PC-NPs injection.PC-NPs is a promising dual modality imaging probe, which may improve molecular diagnosis of plaque characteristics and evaluation of pharmaceutical interventions for atherosclerosis.
AB0679 The Presence of Myositis Autoantibodies in Inflammatory Myopathies Does not Exclude the Association with Neoplasms
Authors: A. Faten, L. Laadhar, I. Ben Ghorbel, H. Houman, M. Kallel-Sellami
Journal: Annals of the Rheumatic Diseases (2015)

Background  The association between idiopathic inflammatory myopathies and neoplasms (paraneoplastic syndrome) has been widely studied in the literature, particularly in patients with dermatomyositis (DM).  Objectives  The objective of this study was to determine the profile of myositis-specific (MSA) and myositis associated autoantibodies (MAA) in patients with paraneoplastic myopathy.  Methods  We identified all patients with paraneoplastic myopathy addressed by the Internal Medicine Department to the Immunology Department of the “La Rabta” Hospital between January 2006 and February 2014 for immunological tests. The MSA (anti-Mi-2, anti-Jo-1, anti-PL-7, anti-PL-12, anti-EJ, anti-OJ, anti-SRP) and MAA (anti-Ku, ani-PM-Scl75, anti-PM-Scl100, anti-Ro-52) were detected by immunodot (Euroimmun®).  Results  We identified 8 patients with paraneoplastic myopathy (4 women and 4 men) with a mean age of 50.7 years. All had DM. The associated neoplasms affected various sites: nasopharynx, lung, colon, cervix, breast, etc. Two patients had an associated Sjogren9s syndrome. Half of the patients (4/8) had at least one autoantibody: Three patients had 2 autoantibodies and one patient had one autoantibody.  Among MSA, anti-Mi-2 and anti-SRP were positive in 1/8 cases each. No patient had anti-synthetase antibodies (anti-Jo-1, PL-7, PL-12, EJ and OJ). Among MAA, anti-PM-Scl75 and Ro-52 were positive in 1/8 and 4/8 cases, respectively. No patient had anti-Ku nor anti-PM-Scl100.  Conclusions  Initially, the presence of MSA or MAA was an argument against the paraneoplastic nature of myopathy. Later, other authors reported that nearly 5% of paraneoplastic myopathy had these autoantibodies. These data need to be confirmed on a larger cohort with searching for anti-TIF1-γ antibodies (Transcriptional intermediary factor 1-gamma), which seems most specific of paraneoplastic myopathies.  Disclosure of Interest  None declared
Travels in Time
Authors: Gary Stein
Journal: JAMA (2016)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Early identification of renal problems in patients receiving chronic lithium treatment
Authors: A H Samiy, P B Rosnick
Journal: American Journal of Psychiatry (1987)

Serum beta 2-microglobulin and creatinine values were compared with creatinine clearance in 20 lithium-treated patients. beta 2-microglobulin, but not creatinine, correlated significantly with creatinine clearance, indicating that beta 2-microglobulin is a more sensitive test than serum creatinine for monitoring glomerular filtration rate in chronic lithium therapy.
Regulation of the Circulation
Authors: Howard L. Bleich, Emily S. Boro, Eugene Braunwald
Journal: New England Journal of Medicine (1974)

THE first part of this presentation summarized the regulation of cardiac output by heart rate, stroke volume and the factors that influence them. Of equal importance to the regulation of the circulation is the distribution of the output to the vascular beds.Peripheral Vascular BedThe magnitude of the variation in blood flow in various organs is shown in Figure 8. Tissues, such as skeletal muscle and salivary glands, that exhibit a wide range of metabolic activity manifest an especially high basal vascular tone that is reduced when the tissue performs work — that is, becomes metabolically active.22 For example, the . . .
SP0180 The Tumor Immune Microenvironment: A Target for Check-Point Therapies
Authors: W.H. Fridman
Journal: Annals of the Rheumatic Diseases (2015)

The immune microenvironment of human tumors is highly complex and is composed of all populations of lymphoïd and myeloblastic cells. The immune contexture, which takes into account the density, location and functional orientation of immune cells, is a major prognostic factor for patient9s survival. In most cancers, a strong infiltration of memory CD8 T cells and a Th1 correlates with longer survival of patients with primary or metastatic cancer. Howewer, the expression of immune check-point molecules, such as PD-1, LAG3, TIM3 on lymphocytes and of their ligands on tumor cells or myeloid cells greatly affect the progostic impact of the anti-tumor immune response. Tertiary Lymphoid Structures, similar to those found in auto-immune inflammed sites, are essential sites for shaping effective, or exhausted, anti-tumor immune reactions.The immune contexture,its buiding and its modulation will be discussed in the light of the exploding use of immune check point modulators in cancer, with consequences on auto-immune and inflammatory diseases. <h3>Disclosure of Interest</h3> W. Fridman Consultant for: SERVIER, LFB, SANOFI, PIERRE FABRE MEDICAMENT
The future of state mental health programs for the chronic psychiatric patient in the community
Authors: R L Okin
Journal: American Journal of Psychiatry (1978)

The author explores the problems facing the chronic psychiatric patient in the community and discussed the response of federal and state governments to these problems. Errors of the past and present are delineated and corrective actions are suggested for the future. Finally, it is argued that if society is able to meet the challenge posed by the chronic psychiatric patient in the community it will simultaneously have set up mechanisms to solve the problems of other disabled and disadvantaged groups of people as well.