tbuckley/cabot-search huggingface dataset:
SP0081 Imaging Juvenile Dermatomyositis
Authors: C. Malattia
Journal: Annals of the Rheumatic Diseases (2015)

Juvenile dermatomyositis (JDM) is a rare connective tissues disorder characterized by chronic inflammation that primarily affects the skin and skeletal muscles. Although during the past decade the prognosis of JDM has markedly improved, there are still patients with persistent active disease leading to potential irreversible damage and permanent disability. One of the major challenges in the clinical management of JDM is to accurately assess disease activity and to discriminate it from chronic damage, especially in patients with longstanding disease, whose muscle weakness may be due to a combination of ongoing muscle inflammation, necrosis, muscle atrophy and fatty replacement. The potential of musculoskeletal MRI for defining the contribution of each of these components to the patients weakness is well established. Water-sensitive sequences are very sensitive to the presence of inflammation and have the potential to support diagnosis, to guide muscle biopsy in an area of active disease and to monitor treatment response; T1 weighted images are suitable to visualize sign of chronic damage such AS muscle atrhophy and/or fatty infiltration of the muscles. Main indications for musculoskeletal MRI in JDM, technical issues and diagnostic accuracy, and newer MRI scanner techniques (i.e whole-body MRI) will be discussed thus providing an overview of the potential advantages of this imaging modality in estimating total disease burden, tailoring treatment and monitoring its efficacy. <h3>Disclosure of Interest</h3> None declared
A brief history of the cluster randomised trial design
Authors: Jenny Moberg, Michael Kramer
Journal: Journal of the Royal Society of Medicine (2015)

The cluster randomised trial is commonly considered a relatively new research study design.1–3 Here we trace to a few very early reports the idea of comparing interventions applied to groups of individuals, and through the evolution of this idea to the modern-day cluster randomised trial. This has been defined as a comparative study in which the units randomised are pre-existing (natural or self-selected) groups whose members have an identifiable feature in common, and in which outcomes are measured in all, or a representative sample of the individual members of the groups.1 Summaries of the reports of many of the examples of cluster randomised trials published before the methodological review of this research design by Donner et al.4 can be viewed in the James Lind Library (http://jameslindlibrary.org/topics/allocation-bias/cluster-allocation/ see Appendix for details of our literature search).
Complement Fixation in Animal Neoplasia. VI. Development of the Reaction in Various Breeds of Rabbits Carrying the Brown-Pearce Carcinoma2
Authors: Stuart W. Lippincott, Helen Thornton, Lester D. Ellerbrook, Mark C. Rhees, Conrad T. O. Fong, Helen M. Duncan
Journal: JNCI Journal of the National Cancer Institute (1953)

Journal Article Complement Fixation in Animal Neoplasia. VI. Development of the Reaction in Various Breeds of Rabbits Carrying the Brown-Pearce Carcinoma Get access Stuart W. Lippincott, Stuart W. Lippincott Search for other works by this author on: Oxford Academic PubMed Google Scholar Helen Thornton, Helen Thornton Search for other works by this author on: Oxford Academic PubMed Google Scholar Lester D. Ellerbrook, Lester D. Ellerbrook Search for other works by this author on: Oxford Academic PubMed Google Scholar Mark C. Rhees, Mark C. Rhees Search for other works by this author on: Oxford Academic PubMed Google Scholar Conrad T. O. Fong, Conrad T. O. Fong Search for other works by this author on: Oxford Academic PubMed Google Scholar Helen M. Duncan Helen M. Duncan Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 14, Issue 2, October 1953, Pages 395–410, https://doi.org/10.1093/jnci/14.2.395 Published: 01 October 1953 Article history Received: 06 May 1953 Published: 01 October 1953
Book: Difficult Consultations with Adolescents
Authors: Domhnall MacAuley
Journal: BMJ (2004)

Talking to a different generation can be like communicating with aliens. In the eyes of a 15 year old, someone of 20 is ancient, and people in their 30s know nothing about sex, spots, music, or clothes. You cannot dance, you dress like a chump, and you cause embarrassment if you kiss your wife. By 40, forget it. Let's face it, we are what teenagers would call a bunch of nerds.​nerds.




Figure 1



Chris Donovan, Heather C Suckling

Radcliffe Medical Press, £21.95, pp 130 ISBN 1 85775 882 X

Rating: ★★★




The authors, who based their work on a project that evolved from the Royal College of General Practitioners' Adolescent Task Group, describe a series of case studies of consultations, which were discussed in Balint-style groups (small groups of general practitioners who meet to discuss cases to better their understanding of the emotional content of the doctor-patient relationship). Their project is an attempt to build bridges between the teenagers we used to be and the middle aged crumblies we have now become.

Well, the authors did try. They describe real consultations, disguising the doctors and patients, and give some insight into the group discussions. However cynical you may be about the 1980s culture of cosy group work, the method does allow people the security to explore feelings, anxieties, and concerns in a safe and supportive environment. And this book allows us, the readers, to watch from the sidelines. We general practitioners have all had consultations like these, seen the same patients, and struggled. We all recognise that feeling of failure when the surgery door closes, knowing we have missed something, got nowhere, or simply screwed up.

The quotations, from qualitative work, are most revealing. They tell us more about the doctors than the patients. For instance, one participant describes “the self imposed pressure making conscientious GPs believe that it is vitally important, when seeing teenagers, to get it right.” And what about when it goes wrong? “Where do GPs go for support when this happens?” Caring general practitioners will find it increasingly challenging to find enough time in the new model of primary care when “it is often necessary to build up a relationship with an adolescent patient before the GP gathers information.” But my favourite example is the teenage girl who told a ChildLine counsellor she would like to see a female doctor about contraception. When the counsellor asked the teenager if there was a female doctor in her practice she replied, “Yes, my mother.”

Bridging the generations is an impossible task. It is as difficult for us to understand adolescents as it is for them to understand us. Even these earnest colleagues are floundering, just like the rest of us.
Episode sequence in bipolar disorder and response to lithium treatment
Authors: G L Faedda, R J Baldessarini, M Tohen, S M Strakowski, C Waternaux
Journal: American Journal of Psychiatry (1991)

Analysis of five studies of episode sequence in bipolar disorder indicated A highly significant difference in lithium responses among sequences, favoring the mania or hypomania-depression-interval sequence over the depression-mania or hypomania-interval sequence by an odds ratio of 4.4 (p<0.00001)
Studies of superobesity: II. Psychiatric appraisal of jejuno-ileal bypass surgery
Authors: P Castelnuovo-Tedesco, D Schiebel
Journal: American Journal of Psychiatry (1976)

The authors studied 12 superobese women for 10 months to 3 years following jejuno-ileal bypass surgery. All patients had significant weight loss to near normal levels and were pleased with their newfound capabilities in the areas of physical, social, and sexual activities. Enhanced self-esteem, initiative, and assertiveness were noted. Although there were no serious postoperative psychiatric complications, patients experienced more mood lability and greater awareness of anxiety, depression, and irritability; their necessary adjustments in lifestyle strained relationships with spouses and parents in some cases. The principal drawback of the procedure was the occurrence in 7 patients of major somatic complications, with concomitant discouragement and apprehension.
PTU-062 Endoscopy workload following the introduction of faecal calprotectin (FCP) – does fcp testing reduce lower gi endoscopies? – part of a nice nhs adoption site study in wandsworth:
Authors: AA Soubieres, F Boa, S Davie, L Kent, F Uddin, A Poullis
Journal: Gut (2015)

As transmission intensity has declined in Senegal, so has the genetic complexity of circulating <i>Plasmodium falciparum</i> parasites, resulting in specific genotypes emerging and persisting over years. We address whether changes in parasite genetic signatures can alter the immune repertoire to variant surface antigens, and whether such responses can influence the expansion or contraction of specific parasite genotypes in the population. We characterize parasites within genotypic clusters, defined as identical by a 24-SNP molecular barcode and a haplotype identifier for other highly polymorphic loci; we measure expression of variant surface antigens (VSA) such as PfEMP-1 by transcript expression typing and expressed <i>var</i> DBL1<i>α</i> sequencing in ex vivo and short-term adapted RNA samples; and we measure IgG responses against VSAs from short-term adapted parasites. We find that parasites within genotypic clusters are genetically identical at other highly polymorphic loci. These parasites express similar Ups <i>var</i> classes and largely the same dominant <i>var</i> DBL1<i>α</i> sequences ex vivo. These parasites are recognized similarly by anti-VSA antibodies after short-term adaptation to culture; however, antibody responses do not correlate with genotype frequencies over time. Both genotype-specific and multiple genotype-reactive surface IgG responses are observed in this population. Parasites with identical genomes are extremely similar in their expression and host antibody recognition of VSAs. Monitoring changes in population-level parasite genomics and transmission dynamics is critical, as fluctuations will influence the breadth of resulting host immune responses to circulating parasite genotypes. These findings suggest shared immune recognition of genetically similar parasites, which has implications for both our understanding of immunity and vaccine development strategies in malaria elimination settings.
A multicenter prospective study of the real-time use of narrow-band imaging in the diagnosis of premalignant gastric conditions and lesions
Authors: Pedro Pimentel-Nunes, Diogo Libânio, Jorge Lage, Diogo Abrantes, Miguel Coimbra, Gianluca Esposito, David Hormozdi, Mike Pepper, Silvia Drasovean, Jonathan White, Daniela Dobru, James Buxbaum, Krish Ragunath, Bruno Annibale, Mário Dinis-Ribeiro
Journal: Endoscopy (2016)

<b>Background and aim: </b>Some studies suggest that narrow-band imaging (NBI) can be more accurate at diagnosing gastric intestinal metaplasia and dysplasia than white-light endoscopy (WLE) alone. We aimed to assess the real-time diagnostic validity of high resolution endoscopy with and without NBI in the diagnosis of gastric premalignant conditions and to derive a classification for endoscopic grading of gastric intestinal metaplasia (EGGIM). <b>Methods: </b>A multicenter prospective study (five centers: Portugal, Italy, Romania, UK, USA) was performed involving the systematic use of high resolution gastroscopes with image registry with and without NBI in a centralized informatics platform (available online). All users used the same NBI classification. Histologic result was considered the diagnostic gold standard. <b>Results:</b> A total of 238 patients and 1123 endoscopic biopsies were included. NBI globally increased diagnostic accuracy by 11 percentage points (NBI 94 % vs. WLE 83 %; <i>P</i> < 0.001) with no difference in the identification of <i>Helicobacter pylori</i> gastritis (73 % vs. 74 %). NBI increased sensitivity for the diagnosis of intestinal metaplasia significantly (87 % vs. 53 %; <i>P</i> < 0.001) and for the diagnosis of dysplasia (92 % vs. 74 %). The added benefit of NBI in terms of diagnostic accuracy was greater in OLGIM III/IV than in OLGIM I/II (25 percentage points vs. 15 percentage points, respectively; <i>P</i> < 0.001). The area under the curve (AUC) of the receiver operating characteristic (ROC) curve for EGGIM in the identification of extensive metaplasia was 0.98. <b>Conclusions:</b> In a real-time scenario, NBI demonstrates a high concordance with gastric histology, superior to WLE. Diagnostic accuracy higher than 90 % suggests that routine use of NBI allows targeted instead of random biopsy samples. EGGIM also permits immediate grading of intestinal metaplasia without biopsies and merits further investigation.
Impact of 123I-Ioflupane SPECT in Patient Management
Authors: Luca Dellavedova, Andrea Giorgetti, Lorenzo Stefano Maffioli
Journal: Clinical Nuclear Medicine (2015)

The usefulness of 123I-ioflupane imaging for detecting loss of functional dopaminergic neuron terminals in the striatum of patients with clinically uncertain parkinsonian syndromes is well known, especially to differentiate essential tremor from parkinsonisms. Here we present a case of a patient suspected of essential tremor but not responding to standard therapy, in which the results of DaTscan were fundamental to set up an alternative therapeutic approach.
AB0804 Increased Carotid Intima-Media Thickness in Psoriatic Arthritis Patients Compared with Systemic Lupus Erythematosus Patients and Healthy Controls: Table 1.
Authors: A. Dünya, H. Yarkan, P. Cetin, G. Can, N. Akkoc, F. Onen
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Patients with psoriatic arthritis (PsA) and systemic lupus erythematosus (SLE) are at increased risk of atherosclerosis. An increased carotid intima-media thickness (IMT) is considered to be a marker of early atherosclerosis. <h3>Objectives</h3> The aim of this study was to investigate carotid IMT in patients with PsA and compare it with those in patients with SLE and healthy controls. <h3>Methods</h3> Non-diabetic patients with PsA and age and body mass index (BMI) matched, non-diabetic patients with SLE, and healthy controls were included in this study. Bilateral carotid IMTs were evaluated by using B-mode ultrasonography in PsA patients and compared with those in SLE patients and healthy controls. <h3>Results</h3> There were 42 PsA patients (30 female, 12 male; mean age: 45.36±8.9 years) who fulfilled CASPAR criteria and 38 patients (37 female, 1 male; 41.2±13.0 years) who fulfilled the 1982 revised American College of Rheumatology (ACR) criteria for SLE. Thirthy healthy hospital workers (27 female, 3 male; mean age 41.2±6.8 years) were recruited as healthy controls. The frequency of hiperlipidemia was found to be significantly higher in patients with PsA than SLE patients and healthy controls (p&lt;0.001) but hypertension was more common in SLE patients (p=0.002). While serum CRP levels were higher in PsA patients than control patients and healthy controls, SLE patients had higher ESR levels than the both control groups (p&lt;0.001). The mean carotid IMT was found to be higher in PsA patients (0.76mm ±0.15) in comparison with the SLE patients (0.58±0.11) and healthy control group (0.57±0.12) (p&lt;0.001). <h3>Conclusions</h3> This study shows that carotid IMT measurements are higher in PsA patients than SLE patients and healthy controls. A higher hyperlipidemia frequency and male predominancy in PsA patients may be partly responsible for the increased carotid IMT compared with SLE patients. <h3>Disclosure of Interest</h3> None declared
Spectral analysis of cyclic symptoms in late luteal phase dysphoric disorder [published erratum appears in Am J Psychiatry 1990 Jul;147(7):964]
Authors: S K Severino, S W Hurt, R D Shindledecker
Journal: American Journal of Psychiatry (1989)

Fifty-eight subjects self-referred for premenstrual difficulty were evaluated for late luteal phase dysphoric disorder through a spectral analysis technique applied to prospective symptom ratings. Data from the Schedule for Affective Disorders and Schizophrenia--Life-time Version were used to group the subjects according to the absence or presence of past or present psychiatric disorders. The two psychiatric groups were compared with regard to both patterns of significant symptom change and premenstrual symptom severity. Differences between the groups are used to discuss issues regarding the reliable identification of late luteal phase dysphoric disorder and the impact of other psychiatric disorders on this syndrome.
AB1238-HPR The Effects of Dynamic Lumbar Stabilization Exercises on Low Back Pain, Functional Disability and Depression in Mothers with Disabled Children: Table 1.
Authors: N. Uzun, S.N. Arman, D. Tarakci, S.N. Arman, E. Tarakci
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Having a disability brings about different hardness for child and his/her parents, for especially mothers (1). The mothers with disabled children are overburdened by the demands of caregiving responsibilities such as transfers. Mothers with disabled children complain various degrees of low back pain, functional disability and depression symptoms (2). <h3>Objectives</h3> The aim of the study was to investigate the effects of dynamic lumbar stabilization exercises on low back pain, functional disability and depression in mothers with disabled children. <h3>Methods</h3> 42 mothers of disabled children diagnosed with cerebral palsy were included of the study. Visual Analog Scale (VAS) was used to assess low back pain of mothers. Functional disability was assessed with Oswestry Disability Index (ODI). Beck Depression Inventory (BDI was used to assess depression of mothers. Gross Motor Function Classification System Expanded and Revised (GMFMCS-ER) was used to assess motor function level of disabled children. Dynamic lumbar stabilization exercises (DLSE) were set a home exercise program for 12 weeks. The exercise program was performed 3 days a week with 5 repetitions in 3 sets to begin with and repetitions were gradually increased until they reached 15. Exercises were conducted under the supervision of a physiotherapist who instructed the patients initially on an individual basis. They initially performed the exercises individually as well. Home exercise program was reviewed by the physiotherapist once a month. All mothers were examined twice, once before the exercise program and once 12 weeks later. <h3>Results</h3> The mean age was 35.10±6.53 years of mothers and mean of GMFCS of the children was 3.35±1.57. Scores of VAS, ODI and BDI before and after exercise program were shown in Table 1. After the exercise program, significant differences were found all parameters (p&lt;0.05). <h3>Conclusions</h3> This study demonstrated that mothers with disabled children complain of low back pain because they do activities such as care and transfer for disabled children and in addition to, severe low back pain may leads to functional disabilities along with depression symptoms in mothers with disabled children. DLSE should used to decrease low back pain, functional disabilities and depression symptoms in mother with disabled children. Therefore, we suggest that mothers with disabled children should do exercise regularly. <h3>References</h3> Ellis JB, Hirsch JK. Reasons for living in parents of developmentally delayed children. Res Dev Disabil. 2000; 21: 323-7. Andersen JH, Kaergaard A, Frost P, et al. Physical, psychosocial, and individual risk factors for neck/shoulder pain with pressure tenderness in the muscles among workers performing monotonous, repetitive work. Spine 2002; 27: 660-667. <h3>Disclosure of Interest</h3> None declared
Magnetic Multivalent Trehalose Glycopolymer Nanoparticles for the Detection of Mycobacteria
Authors: Xuan Chen, Bin Wu, Kalana W. Jayawardana, Nanjing Hao, H. Surangi N. Jayawardena, Robert Langer, Ana Jaklenec, Mingdi Yan
Journal: Advanced Healthcare Materials (2016)

A multivalent trehalose-grafted poly(lactic acid) is synthesized and encapsulated with iron oxide magnetic nanoparticles. The magnetic micelles interact with Mycobacterium smegmatis to form orange clusters. Very little particle interaction is found on Staphylococcus epidermidis 35984 or Escherichia coli ORN 208. The presented new approach to the detection of mycobacteria does not require molecular biology reagents or sophisticated instruments. As a service to our authors and readers, this journal provides supporting information supplied by the authors. Such materials are peer reviewed and may be re-organized for online delivery, but are not copy-edited or typeset. Technical support issues arising from supporting information (other than missing files) should be addressed to the authors. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
OC-068 A systematic review and meta-analysis of clonidine in diarrhoea or intestinal transit: clonidine has an objective anti-diarrheal effect
Authors: KC Fragkos, N Zarate-Lopez
Journal: Gut (2015)

<h3>Introduction</h3> Clonidine has been considered an alternative treatment (usually after other treatments have failed) for refractory diarrhoea. The evidence is scarce in the literature and not conclusive. The purpose of the present paper is to gather available evidence and provide a systematic and more complete answer with regards to the effectiveness of clonidine for diarrhoea irrespective of clinical background. <h3>Method</h3> We performed a systematic review of clonidine and its effect on diarrhoea or intestinal transit. Pubmed/Medline, Scopus, EMBASE, and Google Scholar were searched including key words of diarrhoea, bowel and clonidine. Twenty two papers were found describing the treatment of diarrhoea (15 trials and 7 case reports). The data were categorised into tables. Meta-analysis was performed on the 15 papers. Meta-analysis was performed with a random effects model of the standardised mean difference and heterogeneity was quantified with I-square and publication bias was assessed with Egger’s test. All test were performed in Stata 12.0 and RevMan 5.3. <h3>Results</h3> The meta-analysis included 15 studies with total sample size 386 subjects (82 Males; sample size range 2–88, median sample size 13; mean age of subjects 40.3). Clonidine (median dose per day 300 mcg, usually divided into 2 or three doses orally or full dose transdermal) has been used for treatment of diarrhoea in irritable bowel syndrome, ileostomy diarrhoea, short bowel syndrome, diabetic diarrhoea, withdrawal associated diarrhoea, faecal inctoninence and cholera. Studies were also performed on healthy volunteers. Results indicate an impressive effect of clonidine on diarrhoea with a significant decrease of stool volume to intestinal transit or stool frequency (SMD = –1.78 [–2.46, –1.10]. There is however significant heterogeneity (I-square = 87%) and publication bias ash hown by the funnel plot and Egger’s test (p = 0.05). <h3>Conclusion</h3> Clonidine is effective for treatment of diarrhoea and should be considered as an alternative when all other medications have failed. <h3>Disclosure of interest</h3> None Declared.