tbuckley/cabot-search huggingface dataset:
AB1001 Diffusing Capacity for Carbon Monoxide (DLCO) in a Group of Children with Juvenile Idiopathic Arthritis: A Case Control Study (Preliminary Data)
Authors: M. Lucantoni, D. Rapino, M. Marsili, V. Marzetti, R. Troiani, L. Breda, F. Chiarelli
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Juvenile idiopathic arthritis (JIA) is one of the most common chronic diseases of childhood. Interstitial lung disease (ILD) have been recently reported in JIA patients with increased frequency. Diffucing capacity for carbon monoxide (DLCO) is a commonly performed and clinically useful pulmonary function test that provides a quantitative measure of gas transfer in the lungs; it is often abnormal in patients with ILD. It has been known that there is a relationship between the development of pulmonary disease and treatment with various drugs such as methotrexate (MTX). <h3>Objectives</h3> The aim of this study is to evaluate total lung function and DLCO in JIA patients and to evaluate the relationship with disease activity and treatment. <h3>Methods</h3> 26 Caucasian patients with JIA were recruited with a control group of 15 healthy children. A full history, physical examination, current laboratory tests and full lung function tests including DLCO were performed in patients and controls. <h3>Results</h3> We found a reduction in DLCO values in JIA patients (mean 75%) versus controls (mean 100%, p=0.005). A sub-analysis demonstrated that the subgroup of patients on MTX had worse DLCO diffusion values compared to control group (mean 65% p=0.002). By contrast, the subgroup of JIA children taking other drugs did not present significant DLCO differences compared to controls. In addition, DLCO was significantly lower in patients with active disease compared to controls (mean 65% p=0.001), whereas no significant differences between patients with inactive disease and healthy controls was found. <h3>Conclusions</h3> This study showed a significant impairment of pulmonary DLCO in patients with JIA compared to controls. The main alterations in DLCO have been found in patient treated with MTX and in those with active disease. Moreover, a negative correlation between MTX therapy length and DLCO values was demonstrated. Further studies including larger populations are needed to confirm these data. <h3>References</h3> Schmelling H, Stephan V, Burdach S, et al. Pulmonary Function in Children with Juvenile Idiopatic Arthritis and effects of Methotrexate Therapy. Z Rheumatol 2002. 61(2):168-72. Knook LME, de Kleer IM, Van de Ent CK, et al. Lung Funcion abnormalities and respiratory muscle weakness in children with juvenile chronic arthiritis 1999. Eur Respir J. 14:529-533. <h3>Disclosure of Interest</h3> None declared
Binding Of VWF To Type IV Collagen: An Additional Collagen Binding Mechanism Beyond Types I, III, and VI Collagen?
Authors: Veronica H. Flood, Joan Cox Gill, Sandra L. Haberichter, Daniel B Bellissimo, Pamela A Christopherson, Kenneth D Friedman, Robert R. Montgomery, The Zimmerman Program Investigators
Journal: Blood (2013)
Recurrent Cholangitis Following “Successful” Treatment for Gallbladder Cancer
Authors: R Enns, J Baillie
Journal: Endoscopy (2001)

I am very pleased to introduce our guest discussant, Dr Robert Enns, MD, of Vancouver, Canada. A former graduate of the Duke Biliary Sweat Shop, Dr Enns has gone on to distinguish himself as an expert of hepatobiliary and pancreatic disorders in the Canadian gastroenterology community. His particular interests include the use of magnetic resonance imaging to study the pancreas and bile ducts, primary sclerosing cholangitis (PSC), and the management of complications of endoscopic retrograde cholangiopancreatography (ERCP). Welcome, Dr Enns.
PTH-202 Evaluation of the percussive pop technique to restore patency to long term central venous catheters in patients on home parenteral nutrition
Authors: M Small, S Patel, S Crowther
Journal: Gut (2015)

<h3>Introduction</h3> Functioning central venous catheters (CVC) are essential for the delivery of home parenteral nutrition (HPN). Occluded CVC result in delayed treatment and increased risk of infection. Various techniques to restore patency have been described in this patient group, however the percussive POP technique has not been evaluated. The POP technique generates shock waves through the CVC loosening the obstruction, allowing it to be extracted, rather than introduced into the patient.<sup>1</sup>This study aimed to evaluate the technique in patients on HPN. <h3>Method</h3> Occlusions between January 2012 and December 2014 were recorded. Total occlusion indicated the CVC could not be flushed, partial indicated resistance. Techniques used to salvage the CVC and outcomes were recorded. 1st line techniques were clearing the hub of any physical matter with a 21G needle and POP technique where a 2.5 ml Luer lock syringe with 1ml 0.9% sodium chloride was attached directly to the CVC hub (tip pointing down). The plunger was then pulled up 1 ml and released. This was repeated until blood backflow or debris was seen in the syringe. 2nd line involved Urokinase 10,000 units or 70% alcohol. Primary outcome was catheter salvage. Other outcomes were CVC rupture, “ballooning” (where the CVC becomes permanently stretched), bacteraemia or recurrence of occlusion within 30 days of intervention. <h3>Results</h3> There were 39 occlusions (30 total, 9 partial) in 27 patients; occlusion rate 0.1 per 1000 CVC days. 25 patients had CVC, 2 patients ports. Patency was restored in 38 (97%) episodes. The 1 unsuccessful episode was a total occlusion in a port resistant to all methods. The 30 total occlusions occurred in 19 patients; 17 patients CVC, 2 patients port. Patency restored on 29 (97%) occasions. Hub clearout used in 5 (17%) episodes, in 2(7%) this was the only method used. POP technique used for 28 (93%) episodes, 3(10%) following hub clearout. Urokinase used in 4 (13%) episodes. In 2 cases patency was restored by the POP technique but with some residual resistance. Urokinase was instilled using the POP technique on 1 occasion. Alcohol was only used once and was unsuccessful. Of the 9 partial occlusions, patency was restored in all. Hub clearout alone was used in 7(78%) occasions. POP technique used in 2(22%) episodes and once with Urokinase (11%). There were no catheter ruptures, “ballooning” or bacteraemia. There was 1 recurrence of total occlusion in a patient on a trial off HPN who was non compliant with weekly CVC flushing. <h3>Conclusion</h3> The results indicate that restoring patency using the percussive POP technique is safe and effective. In addition, it is simple and inexpensive. Urokinase may have an additional role alongside non pharmaceutical methods, but is not often required. <h3>Disclosure of interest</h3> None Declared. <h3>Reference</h3> Stewart D. <i>Care of the critically ill</i>2001;17(3)
Is the UK spending more than we thought on healthcare (and much less on social care)?
Authors: John Appleby
Journal: BMJ (2016)

John Appleby assesses the latest figures on UK health spending 

New international accounting conventions suggest that the United Kingdom is spending much more on healthcare, both publicly and privately, than previously thought. The latest spending figures for 2014 published by the Office for National Statistics (ONS), adjusted to comply with the Organisation for Economic Cooperation and Development’s (OECD) system for health accounts,1 have added around £21bn (€27bn; $30bn) to health spending—an overnight leap of 13% from the previous estimate for 2014. It also means that total public and private spending on health jumps from 8.7% of gross domestic product (GDP) to 9.9%. Can this be true, and what does it mean?

What it doesn’t mean is any material change in actual spending. The budget for the NHS, for example, has not suddenly increased. But it does have implications for how UK health (and social) care spending …
Consistent dexamethasone suppression test results with mania and depression in bipolar illness
Authors: C D Godwin, L B Greenberg, S Shukla
Journal: American Journal of Psychiatry (1984)

Dexamethasone suppression tests (DSTs) were given to nine bipolar patients in both depressed and manic phases of their illness. In seven patients DST results were consistent between episodes; six patients had positive tests in both depression and mania.
P-glycoprotein Mediates Postoperative Peritoneal Adhesion Formation by Enhancing Phosphorylation of the Chloride Channel-3
Authors: Lulu Deng, Qin Li, Guixian Lin, Dan Huang, Xuxin Zeng, Xinwei Wang, Ping Li, Xiaobao Jin, Haifeng Zhang, Chunmei Li, Lixin Chen, Liwei Wang, Shulin Huang, Hongwei Shao, Bin Xu, Jianwen Mao
Journal: Theranostics (2015)

P-glycoprotein (P-gp) is encoded by the multidrug resistance (MDR1) gene and is well studied as a multi-drug resistance transporter. Peritoneal adhesion formation following abdominal surgery remains an important clinical problem. Here, we found that P-gp was highly expressed in human adhesion fibroblasts and promoted peritoneal adhesion formation in a rodent model. Knockdown of P-gp expression by intraperitoneal injection of MDR1-targeted siRNA significantly reduced both the peritoneal adhesion development rate and adhesion grades. Additionally, we found that operative injury up-regulated P-gp expression in peritoneal fibroblasts through the TGF-β1/Smad signaling pathway and histone H3 acetylation. The overexpression of P-gp accelerated migration and proliferation of fibroblasts via volume-activated Cl(-) current and cell volume regulation by enhancing phosphorylation of the chloride channel-3. Therefore, P-gp plays a critical role in postoperative peritoneal adhesion formation and may be a valuable therapeutic target for preventing the formation of peritoneal adhesions.
Clinic
Authors: Joseph A Capriotti
Journal: JAMA (2004)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Angiotensin II modulates glomerular capillary permselectivity in rat isolated perfused kidney.
Authors: R Lapinski, N Perico, A Remuzzi, F Sangalli, A Benigni, G Remuzzi
Journal: Journal of the American Society of Nephrology (1996)

Studies in experimental animals and humans have documented that inhibition of the renin-angiotensin system by angiotensin-converting enzyme inhibitors reduces urinary protein excretion rate and retards the development of renal injury. Here we sought to investigate whether angiotensin II (All) modified the size-selective properties to macromolecules of the glomerular capillary barrier in isolated perfused rat kidney preparation. Compared with basal values, continuous All infusion into the renal artery at the rate of 3 or 8 ng/min, but not at 0.6 ng/min, induced a progressive and significant increase in urinary protein excretion rate. Evaluation of the sieving properties of the glomerular barrier by fractional clearance of polydisperse Ficoll showed that All significantly enhanced the filtration of tracer molecules of radil > or = 34A. All-induced changes in urinary protein excretion rate and in Ficoll fractional clearance were completely prevented by pretreatment with the specific All Type 1 receptor antagonist SR 47436.
Screening for the Lynch Syndrome
Authors: Scott D Ramsey
Journal: New England Journal of Medicine (2005)

to the editor: Hampel and colleagues (May 5 issue) 1 suggest that a universal screening program for the detection of microsatellite instability in patients with colorectal cancer is feasible and probably desirable. However, it will not be inexpensive. We have estimated that such a screening program would cost in excess of $57,000 per germ-line– mutation carrier detected. 2 Furthermore, the benefits to the proband are modest, since neither treatment nor outcome is likely to change on the basis of test results. The cost-effectiveness of such a program thus depends heavily on the ability to locate and test relatives, since they have the most to gain from early initiation of colorectal-cancer screening. Hampel and colleagues do not report the total number of living relatives of the 23 probands with a deleterious mutation; they report only the number who received counseling and testing. Finally, screening strategies that start with evaluation of probands’ family history, such as the Bethesda guidelines, 3
CXCR2 Inhibition Profoundly Suppresses Metastases and Augments Immunotherapy in Pancreatic Ductal Adenocarcinoma
Authors: Colin W. Steele, Saadia A. Karim, Joshua D.G. Leach, Peter Bailey, Rosanna Upstill-Goddard, Loveena Rishi, Mona Foth, Sheila Bryson, Karen McDaid, Zena Wilson, Catherine Eberlein, Juliana B. Candido, Mairi Clarke, Colin Nixon, John Connelly, Nigel Jamieson, C. Ross Carter, Frances Balkwill, David K. Chang, T.R. Jeffry Evans, Douglas Strathdee, Andrew V. Biankin, Robert J.B. Nibbs, Simon T. Barry, Owen J. Sansom, Jennifer P. Morton
Journal: Cancer Cell (2016)

CXCR2 has been suggested to have both tumor-promoting and tumor-suppressive properties. Here we show that CXCR2 signaling is upregulated in human pancreatic cancer, predominantly in neutrophil/myeloid-derived suppressor cells, but rarely in tumor cells. Genetic ablation or inhibition of CXCR2 abrogated metastasis, but only inhibition slowed tumorigenesis. Depletion of neutrophils/myeloid-derived suppressor cells also suppressed metastasis suggesting a key role for CXCR2 in establishing and maintaining the metastatic niche. Importantly, loss or inhibition of CXCR2 improved T cell entry, and combined inhibition of CXCR2 and PD1 in mice with established disease significantly extended survival. We show that CXCR2 signaling in the myeloid compartment can promote pancreatic tumorigenesis and is required for pancreatic cancer metastasis, making it an excellent therapeutic target.
Soundings: New England journal
Authors: James Owen Drife
Journal: BMJ (1999)

Sunday: United States immigration officials are scary. In my student days they sniffed my toothpaste—or was it the Customs? The huge shoulder badges still intimidate me, even here in Shannon airport where the lady with the stamp tries to inject world weary gruffness into her west of Ireland brogue.

Monday: “Grand rounds” suggests big processions from bed to bed, or a series of cases with obscure Bostonian diagnoses to challenge the visiting professor. It actually means a lecture. What is grand is that at 7 30 am people actually turn up. Interns in theatre pyjamas munch takeaway bagels. Should a talk be different at this hour, I wonder, like the morning’s laid back weather forecast compared with the evening’s?

Tuesday: Going to Harvard the taxi driver speaks in Russian into a mobile phone. “Where are you from?” we ask. “St Petersburg,” he replies sadly. “Very beautiful,” we say. Long pause. “Yes,” he murmurs. Chekovian despair fills the cab.

Wednesday: Boston has umpteen centres of excellence. I express envy, and a local doctor smiles wryly. “I think of us,” he says, “as a care centre for people who are still trying to prove something to their mothers.”

Thursday: Another state, another bagel. I’ve adjusted to early rising—or remained on British summer time. And I’ve learnt that jokes are acceptable over breakfast. American medicine, unlike ours, still has a sense of humour.

Friday: Downtime. In Newport, Rhode Island, near the church where the Kennedys were married, is a street of empty chateaux. A lady from the Preservation Society shows visitors the marbled opulence built by Gatsby-style fortunes. “Before unions,” mutters a man in a check shirt.

Saturday: Salem’s tourist industry is based mainly on hick witchcraft, with palmists and models of crones on broomsticks. A judge in the 1692 trials is buried here and on adjacent ground is a memorial to the people he hanged. There is a posy on each of 19 stones, and carved quotations: “O Lord, help me. I am wholly innocent.” The surrounding tackiness makes it all the more moving. Arthur Miller compared the Salem witch hunts to McCarthyism, but each generation makes the same mistake in a different way. Ours has its own martyrs to political correctness. I suppose we should be pleased we have not hanged them.
Recurrent rectovaginal fistula: treatment with self-expanding metal stents
Authors: Antonietta Lamazza, Enrico Fiori, Alberto Schillaci, Antonio Sterpetti, Emanuele Lezoche
Journal: Endoscopy (2015)

Postoperative rectovaginal fistula is a rare complication after colorectal resection for cancer. This adverse event results in a scenario of fear and misunderstanding for the patient [1] [2] [3] [4] [5] [6]. Often, local inflammation, widespread infection, friability of the vaginal and rectal tissue, and the inevitably reduced perfusion of blood to the lower end of the rectum make any form of treatment hazardous and likely to cause complications. Even in cases in which the fistula heals, altered colorectal motility is common.
A comparison of carboplatin with paclitaxel and cisplatinum with 5-fluorouracil in definitive chemoradiotherapy in esophageal cancer patients.
Authors: Judith Honing, Justin Smit, Christina Muijs, Johannes Burgerhof, Jannet Beukema, John Theodorus Plukker, Geke Hospers
Journal: Journal of Clinical Oncology (2014)

104 Background: In esophageal cancer (EC) patients not eligible for surgery definitive chemoradiation (dCRT) with curative intent using cisplatinum with 5-fluorouracil (5-FU) is the standard regime. Nowadays carboplatin and paclitaxel are also often used. In this study we compared survival and toxicity rates between both regimens. Methods: This multicentre study included 102 patients treated in five centres in the North Netherlands from 1996 till 2008. Forty-seven patients received cisplatinum/5-FU and 55 patients carboplatin/paclitaxel. Results: Overall survival (OS) was not different between the cisplatinum/5-FU and carboplatin/paclitaxel group (P=0.879, Hazard Ratio [HR] 0.97 confidence interval [CI] 0.62-1.51), with a median survival of respectively 16.1 (CI 11.8-20.5) and 13.8 (CI 10.8-16.9) months. Median disease free survival (DFS) was comparable (P=0.760, HR 0.93 CI 0.60-1.45) between the cisplatinum / 5-FU group (11.1 months, CI 6.9-15.3) and the carboplatin/paclitaxel group (9.7 months, CI 5.1-14.4). Groups were comparable except clinical T-stage was higher in the carboplatin/paclitaxel group (P=0.008), but a high clinical T-stage (cT4) was not related to OS and DFS in a univariate analysis (P=0.250 and P=0.201). A higher percentage of patients completed the carboplatin / paclitaxel regimen (82% compared to 57%, P=0.01). Hematological and non-hematological toxicity (≥ grade 3) was significantly lower in the carboplatin / paclitaxel group (4% and 18%) than in the cisplatinum/5-FU (19% and 38%, P=0.001). Conclusions: In this study we show comparable outcome, in terms of DFS and OS for carboplatin/paclitaxel compared to cisplatinum/5-FU as dCRT treatment in EC patients. Toxicity rates were lower in the carboplatin/paclitaxel group together with a higher treatment compliance. Carboplatin/paclitaxel as an alternative treatment for cisplatinum/5-FU is a good candidate regimen for further evaluation.
PWE-291 Falling emergency operation rates and reduced mortality after colon cancer surgery in england: a cohort study
Authors: BE Byrne, CA Vincent, J Stebbing, A Darzi, OD Faiz
Journal: Gut (2015)

<h3>Introduction</h3> Recent years have seen many changes within colorectal surgery. Laparoscopic techniques, fast track management, and bowel cancer screening have become widespread. This study examined changes in surgical treatment and outcomes for colon cancer over time against background registration rates, with subgroup analysis by urgency and age. <h3>Method</h3> Annual data on colon cancer registrations and population size was obtained. Administrative data were used to identify adults undergoing colonic resection for cancer in England between April 1998 and March 2012. Cancer registrations, treatment and mortality rates were age-standardised. The proportion of registrations undergoing surgery was examined, and subgroups were analysed by urgency of admission and age group. Temporal trends were assessed using the Joinpoint Regression Program (National Cancer Institute, USA). <h3>Results</h3> The standardised rate of colon cancer registration rose from 27.1 to 29.1 per 100 000 population. The proportion of registrations undergoing surgery fell, from approximately 67% to 57% (Annual Percentage Change = −1.44, <i>p &lt; 0</i>.05), due to a significant fall in non-elective operating; the elective treatment rate did not change. Postoperative 90-day mortality rates fell across all age groups for elective and non-elective surgery, from approximately 6.5% to 3% and 19% to 13%, respectively. <h3>Conclusion</h3> Colon cancer registrations increased over time. The surgical treatment rate per colon cancer fell, due to falling rates of non-elective surgery. Possible explanations include improved early detection of colon cancer, changes in case selection, and improvements in non-surgical treatments. Postoperative mortality fell significantly after elective and non-elective surgery for all age groups. Considered together, these findings suggest a global improvement in the quality of surgical care for colon cancer. Future studies should include non-surgical treatments with information on stage of cancer at presentation. <h3>Disclosure of interest</h3> None Declared.
Day hospital treatment of borderline patients: a clinical perspective
Authors: M J Pildis, G J Soverow, C Salzman, J G Wolf
Journal: American Journal of Psychiatry (1978)

The authors suggest that day hospitalization can provide a useful therapeutic framework for patients with borderline personality organization without creating the ego regression often seen in such patients during 24-hour hospitalization. The lack of room and board facilities and of contact with patients who need 24-hour hospitalization plus the maintenance of contact with the people in the patient's nonhospital life facilitate treatment in this setting.