tbuckley/cabot-search huggingface dataset:
AB0428 An Exploratory Study of the Predictors of Good Eular Response, Das-28 Remission, Sustained Responses to TNF-Inhibitors Therapy in Refractory Rheumatoid Arthritis in Clinical Practice: Table 1.
Authors: R.H.A. Mohammed
Journal: Annals of the Rheumatic Diseases (2015)

Background  The recent era witnessed interesting advances in the therapeutic strategies of RA with TNF-I on top of the list.  Objectives  Prospectively survey factors favoring EULAR good response, DAS-28 remission, sustained response to tumor necrosis factor inhibitors (TNF-I) in biologic naive refractory RA patients.  Methods  Observational study, a follow up period of 2 years, patients randomly assigned to TNF-I (Infliximab 5mg/kg intravenous infusion, Adalimumab 40 mg subcutaneous every 2 weeks, etanercept 50 mg subcutaneous weekly). Baseline demographic features, DAS 28, functional score (health assessment questionnaire), Pain score (VAS), plain radiography, RF, ACCP-A, recorded. The primary outcome: % of patients who achieved the EULAR good response/remission [DAS-28] at 6 months, secondary measure: % of patients sustaining their initial response over 2 years.  Results  Eighty RA patients 64 females,16 males, mean age of 48.4±17.9 yrs, mean disease duration 7.3±5.9 yrs,mean DAS-28 6±1, HAQ 1.25±0.35, mean ESR 51.00±25.30 mm/hr, mean CRP 35.18±31.65 mg/l, 30 patients received infliximab, 30 received adalimumab, 20 received etanercept. At 6 months 56 patients (70%) achieved EULAR good response, 51.8% achieved DAS-28   Conclusions  Higher baseline IgM rheumatoid factor, a higher baseline hemoglobin concentrations, a lower baseline HAQ score, lack of radiographc erosions favored an EULAR good response at 6 months and were significant predictors for a sustained response to TNF-I.  References  Nozaki Y, Kinoshita K, Funauchi M, Matsumura I. A response of TNFα inhibitor treatment outcome in patients with rheumatoid arthritis. OA Immunology, 2013 Apr 01; 1(1):1.  Canhao H, Rodrigues AM, Mourao AF, Martins F, Santos MJ, Canas-Silva J et al. Comparative effetiveness and predictors of response to tumour necrosis factor inhibitor therapies in rheumatoid arthritis. Rheumatology (Oxford). 2012 Nov;51(11):2020-6.  Disclosure of Interest  None declared
Hepatitis B virus transmission from a nurse to a patient, France, 2005
Authors: I Poujol, N Floret, A Servant-Delmas, A Marquant, S Laperche, D Antona, F Lot, B Coignard
Journal: Eurosurveillance (2008)

Infection by the Hepatitis B virus (HBV), which is often asymptomatic at the acute phase, can progress to chronic liver disease, particularly when infection occurs early in life. Hepatitis B is mainly transmitted sexually or through blood or body fluids. Episodes of healthcare-associated transmission of HBV have been previously described [1-3]. Transmission of HBV results either from patient to patient through invasive healthcare procedures with improper disinfection of devices used between patient care or from a patient to a healthcare worker (HCW). Transmission can also take place from a chronically infected HCW to a patient. In those episodes, breaches in healthcare practices and standard precaution play a major role. Prevention of HBV transmission in healthcare settings also relies on the immunisation of HCW, which has been mandatory in France since 1991. HCW are considered immune if they have documented proof that they were vaccinated before 13 years of age, or if a positive anti-HBs antibody test is provided [4].
Case 28-1978
Authors: Richard C. Cabot, Robert E. Scully, James J. Galdabini, Betty U. McNeely, Burton D. Rose, Robert B. Colvin
Journal: New England Journal of Medicine (1978)

Presentation of CaseA 70-year-old man was admitted to the hospital because of peripheral edema.He was well until one year earlier, when he noticed slight ankle edema, which disappeared after a brief course of diuretic medication. One month before entry edema recurred, accompanied by confusion. A physician found hypertension and proteinuria and again prescribed a diuretic, without benefit. Ten days before admission the patient was seen at the clinic. The blood pressure was 180/95 mm Hg, and + + + peripheral edema was noted; the urea nitrogen was 57 mg, and the creatinine 2.4 mg per 100 ml. Hydrochlorothiazide, . . .
Some Observations on the Volume of the Nucleus of Spontaneous Hepatomas in Mice
Authors: Toru Miyaji, M.D.
Journal: JNCI Journal of the National Cancer Institute (1952)

Some Observations on the Volume of the Nucleus of Spontaneous Hepatomas in Mice Get access Toru Miyaji, M.D. Toru Miyaji, M.D. Special Research Fellow Laboratory of Pathology, National Cancer Institute3Bethesda, Md. Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 13, Issue 3, December 1952, Pages 627–645, https://doi.org/10.1093/jnci/13.3.627 Published: 01 December 1952 Article history Received: 14 June 1952 Published: 01 December 1952
Soundings: Just like that
Authors: Liam Farrell
Journal: BMJ (2001)

Bull Materia they called him, “The Breaker of Rocks.” His implacable courage and indomitable will had driven him headlong across jungle, mountain, and river, and he bestrode Africa like a colossus. Now, his quest at last concluded, he stepped forward to shake hands with the frail elderly man whom he had sought relentlessly for so long.

“Dr Livingstone, I presume,” he said, his voice thick with a legendary resonance of suppressed emotion and consummated longing. But the legend does not tell the whole story, for Henry Morton Stanley had something more to say: “By the way, Doc, I have a bit of a cough; could I have some antibiotics? And what about an X-ray, my leg's giving me jip?”

Once a doctor, always a doctor; ours is a high and noble destiny. The same austere moral code that ordains that we stop at road traffic accidents also compels us to listen to strangers on the train recounting how they discovered an ingrowing toenail protruding from their scrotum. We can never entirely lay down our onerous responsibilities. Wherever there are sick people there will always be doctors, with the unfortunate corollary that wherever there are doctors, there will always be sick people.

After all these years I am still proud to be a doctor. I still remember the first time I put on a white coat and hung a stethoscope around my neck; like the first time I had sex, although without the sweat and with less protection, and with more ridicule from those more experienced.

We are never naked, we wear the silken cloak of our esoteric knowledge wherever we go, and sometimes we can still receive the respect due to our calling.

Even as late as the 1980s one of the less self-indulgent Doonesbury cartoon strips had an emaciated person with AIDS telling his parents that he contracted the disease from a resident at the University of California in Los Angeles. As his father bows his head in grief, his mother says, “Wow, you dated a doctor?”

My Auntie Mary was a simple country woman, and to her, doctors were different from us, a kind of aristocracy. I remember telling her I was going to become a doctor and that I was off to medical school for six years. I could see her thinking about it and she went away and came back a while later and said, “And can you become a doctor just like that?”
Migraine and risk of cardiovascular disease in women: prospective cohort study
Authors: Tobias Kurth, Anke C Winter, A Heather Eliassen, Rimma Dushkes, Kenneth J Mukamal, Eric B Rimm, Walter C Willett, JoAnn E Manson, Kathryn M Rexrode
Journal: BMJ (2016)

<b>Objective</b>&nbsp;To evaluate the association between migraine and incident cardiovascular disease and cardiovascular mortality in women. <b>Design</b>&nbsp;Prospective cohort study among Nurses' Health Study II participants, with follow-up from 1989 and through June 2011. <b>Setting</b>&nbsp;Cohort of female nurses in United States. <b>Participants</b>&nbsp;115 541 women aged 25-42 years at baseline and free of angina and cardiovascular disease. Cumulative follow-up rates were more than 90%. <b>Main outcome measures</b>&nbsp;The primary outcome of the study was major cardiovascular disease, a combined endpoint of myocardial infarction, stroke, or fatal cardiovascular disease. Secondary outcome measures included individual endpoints of myocardial infarction, stroke, angina/coronary revascularization procedures, and cardiovascular mortality. <b>Results</b>&nbsp;17 531 (15.2%) women reported a physician's diagnosis of migraine. Over 20 years of follow-up, 1329 major cardiovascular disease events occurred and 223 women died from cardiovascular disease. After adjustment for potential confounding factors, migraine was associated with an increased risk for major cardiovascular disease (hazard ratio 1.50, 95% confidence interval 1.33 to 1.69), myocardial infarction (1.39, 1.18 to 1.64), stroke (1.62, 1.37 to 1.92), and angina/coronary revascularization procedures (1.73, 1.29 to 2.32), compared with women without migraine. Furthermore, migraine was associated with a significantly increased risk for cardiovascular disease mortality (hazard ratio 1.37, 1.02 to 1.83). Associations were similar across subgroups of women, including by age (&lt;50/≥50), smoking status (current/past/never), hypertension (yes/no), postmenopausal hormone therapy (current/not current), and oral contraceptive use (current/not current). <b>Conclusions</b>&nbsp;Results of this large, prospective cohort study in women with more than 20 years of follow-up indicate a consistent link between migraine and cardiovascular disease events, including cardiovascular mortality. Women with migraine should be evaluated for their vascular risk. Future targeted research is warranted to identify preventive strategies to reduce the risk of future cardiovascular disease among patients with migraine.
Endoscopic ultrasound imaging of pancreatic duct ascariasis
Authors: Piyush Somani, Malay Sharma, Amit Pathak, Amol Patil, Avinash Kumar, Srijaya Sreesh
Journal: Endoscopy (2016)

Ascaris lumbricoides infestation is endemic in tropical countries. Most infections by A. lumbricoides are asymptomatic, but they can produce a wide spectrum of manifestations including hepatobiliary and pancreatic complications. Pancreatic ascariasis is a rare entity. In a study of 500 patients with hepatobiliary and pancreatic disease due to A. lumbricoides infection, only seven had pancreatic ascariasis [1], and there are few case reports of ascariasis-induced acute pancreatitis [2]. Mechanisms of acute pancreatitis associated with ascariasis include invasion of the pancreatic duct, the ampullary orifice, and both the common bile duct and the pancreatic duct [3].
SAT0514 Mosaic Tetrasomy 9P: A Mendelian Condition Associated with Pediatric-Onset Overlap Myositis
Authors: M.-L. Frémond, C. Gitiaux, D. Bonnet, T. Guiddir, Y. Crow, L. de Pontual, B. Bader-Meunier
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Pediatric-onset inflammatory myositis (IM) and systemic lupus erythematosus (SLE) are rare inflammatory diseases. They result from the complex interaction between genetic and environmental factors. An increasing number of Mendelian conditions predisposing to the development of SLE have been recently identified. They mostly include monogenic conditions, especially type I interferonopathies, associated with an up-regulation of type I interferon (IFN), a key cytokine in SLE and some IM pathogenesis. <h3>Methods</h3> Here, we report on a pediatric-onset overlap myositis in a 6-year-old girl who carries mosaic tetrasomy 9p. <h3>Results</h3> The patient presented with myositis overlapping with lupus-like features. Myositis was characterized by a proximal muscular weakness and HLA class I antigens myofiber overexpression on muscle biopsy. Lupus-like manifestations consisted in pericarditis, pleuritis, and positive ANA and anti-SSA antibodies. Complete remission was achieved with three pulses of methylprednisolone, followed by an oral course of steroids in combination with mycophenolate mofetyl. Analysis of tetrasomy 9p showed mosaic tetrasomy in 9p24.3p12 region, including the type I IFN cluster, and increased expression of interferon (IFN)-regulated genes was found. <h3>Conclusions</h3> These data suggest that mosaic tetrasomy 9p is a new monogenic interferonopathy predisposing to inflammatory myositis and lupus-like features. Therefore, unexplained inflammatory muscle or other organ involvement in patients carrying mosaic tetrasomy of the type IFN cluster of chromosome 9p should lead to the search for IM and/or lupus-like disease, and karyotype should be performed in SLE or IM patients with mental retardation. <h3>References</h3> Crow YJ. Type I interferonopathies: a novel set of inborn errors of immunity. Ann N Y Acad Sci. 2011 Nov;1238:91–8 Ernste FC, Reed AM. Recent advances in juvenile idiopathic inflammatory myopathies. Curr Opin Rheumatol. 2014 Nov;26(6):671–8. <h3>Disclosure of Interest</h3> None declared
SAT0333 Use of Glitazones and The Risk of Elective Hip Or Knee Replacement: A Population Based Case-Control Study
Authors: J.T.H. Nielen, B. van den Bemt, A. Lalmohamed, A. de Boer, A. Boonen, P.C. Dagnelie, P. Emans, F. de Vries
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Osteoarthritis (OA) is the most common musculoskeletal condition in the elderly population. However, to date, no disease modifying drug exists for this disease. In vivo studies have shown that glitazones may be used as anti-arthritic drugs. (Kobayashi, 2005; Boileau, 2007). <h3>Objectives</h3> To determine the risk of total joint replacement (TJR) with the use of glitazones. <h3>Methods</h3> A population based case-control study was performed using the Clinical Practice Research Datalink (CPRD). Cases (n=94,609) were defined as patients &gt;18 years of age who had undergone TJR surgery between 2000 and 2012. Controls were matched by age, gender and general practice. Conditional logistic regression was used to estimate the risk of total knee (TKR) and total hip replacement (THR) associated with use of glitazones. We additionally evaluated risk of TJR in current glitazone users compared to DM patients using other antidiabetic drugs (ADs). In order to determine a dose effect relationship, we also stratified glitazone users by total number of prescriptions prior to surgery. <h3>Results</h3> There is no difference in risk of TKR (OR=1.11 (95% CI=0.95-1.29)) or THR (OR=0.87 (95% CI=0.74-1.02)) between glitazone users and patients not using glitazones. Furthermore, there is no difference in risk of TKR (OR=1.03 (95% CI=0.88-1.22)) and THR (OR=0.90 (95% CI=0.75-1.08)) when glitazones users are compared to other AD users. Finally, we did not find a dose response effect with increasing number of prescriptions. <h3>Conclusions</h3> This study did not find any evidence for an anti-arthritic effect of glitazones. <h3>References</h3> Boileau et al. Arthritis and Rheumatism, 2007; Kobayashi et al. Arthritis &amp; Rheumatism, 2005. <h3>Disclosure of Interest</h3> J. Nielen: None declared, B. van den Bemt Grant/research support from: Pfizer, Roche, Speakers bureau: Pfizer, Roche, Abbvie and MSD, A. Lalmohamed Grant/research support from: Netherlands Organisation for Scientific Research (NWO), A. de Boer: None declared, A. Boonen Grant/research support from: Amgen Abbvie, Pfizer and Merck, Speakers bureau: Pfizer, UCB and Sandoz, P. Dagnelie: None declared, P. Emans Grant/research support from: Stryker, Active implants, Carbylan Biosurgery, DSM Biomedical, Regentis, Speakers bureau: Biomet and Push braces, F. de Vries: None declared
Increasing incidence of resistance to trimethoprim and ciprofloxacin in epidemic Salmonella typhimurium DT104 in England and Wales
Authors: E J Threlfall, L. R. Ward, B Rowe
Journal: Eurosurveillance (1997)

Salmonella typhimurium definitive phage type (DT) 104 (= DT104) with chromosomally-encoded resistance to ampicillin, chloramphenicol, streptomycin, sulphonamides, and tetracyclines (= R-type ACSSuT) has become increasingly common in humans in England and
SAT0406 Lupus Arthropathy: the Different forms of Deforming Arthropathy
Authors: L. Messuti, A. Zoli, G. Marino, L. Petricca, M. Nowik, M.R. Gigante, V. Varriano, E. Gremese, B. Tolusso, G. Ferraccioli
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Systemic lupus erythematosus (SLE) is a chronic autoimmune disease which can affected all organs of the body. Joints are affected in up to 90% of SLE patients with a variable involvement degree from minor arthralgia without erosions or deformity to an erosive arthropathy and severe functional disability (1). <h3>Objectives</h3> To evaluate demographic, clinical and serological characteristics of SLE patients with persistent lupus arthropathy and then to compare them with the group of patients with SLE and rheumatoid arthritis overlap disease (RHUPUS). <h3>Methods</h3> We evaluated 574 consecutive patients with a diagnosis of SLE according to the ACR (American College of Rheumatology) criteria, of which 76% with joint involvement. We considered only the 268 patients who had active joint symptoms (arthralgia or arthritis) or who had a recent history of frequent relapse/relapse remitting arthropathy. Then we analyzed organ involvements and autoantibody profile, expecially anti-citrullinated peptides antibodies (ACPA) and Rheumatoid factor (RF). At last we evaluated the differences with RHUPUS patients. <h3>Results</h3> Of the 268 SLE patients with persistent joint involvement (age 43.4±14.3 years, female 91.0%, disease duration 11.2±4.2 years), 71% presented the joint involvement at the onset of the lupus disease, occurring in 58% of cases with arthritis and in 42% with arthralgias, while 29% of patients developed the joint involvement in the follow-up; among them, 63% presented arthralgia and only 37% arthritis. 17 patients had RHUPUS. When we compared the 17 patients with RHUPUS and 251 patients with lupus arthropathy, patients with RHUPUS are tendentially older than patients with SLE arthropathy (49.6±13.3 vs 43.0±14.3 years, respectively, p=0.06) even though they had a shorter disease duration (6.8±5.1 vs 11.5±8.4 years, respectively, p=0.02). They also had more serositic involvement but a minor skin and renal involvement. In addition, the patients with RHUPUS had a more positivity percentage of anti-SSA, ACPA (47.1% vs 1.2%, p≤0.001) and RF (64.7% vs 16.3%), a more erosive arthropathy and they needed aggressive therapy. Moreover, in the lupus arthropathy, the RF positivity is similar between SLE patients with arthritic involvement and patients with only arthralgias (16.3% vs 16.4%, respectively, p=0.97). <h3>Conclusions</h3> This study seems to show that there are not demographic, clinical or laboratory characteristics that can early distinguish patients with arthralgia and arthritis. Moreover RHUPUS seems confirmed as an overlap syndrome characterized by the presence of bone erosions and the positivity of ACPA in association with arthritis. <h3>References</h3> Fernantez A et al. Lupus arthropathy: a case series of patients with rhupus. Clinical Rheumatology 2006; 25: 164–7. <h3>Disclosure of Interest</h3> None declared
AB0509 Hip Joint Protection and Falling Numbers of Total Hip Arthroplasties in Cases of Rheumatoid Arthritis: Does Medication Work?
Authors: T. Kawasaki, N. Okumura, T. Mimura, K. Oda, S. Imai, Y. Matsusue
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Some recent reports indicate that the number of total hip arthroplasty (THA) procedures for RA patients worldwide has been decreasing in recent years. Bone destruction inhibition by use of methotrexate (MTX) and biological drugs has been suggested as a possible reason. However, few studies have investigated whether hip joint destruction in RA patients was altered by treatment with such new drugs. <h3>Objectives</h3> The purpose of this study was to examine whether the number of RA cases requiring THA has shown a decreasing trend, and to identify any reason for a change. <h3>Methods</h3> We investigated the records of all patients with RA who underwent a THA procedure at our hospital from January 2000 through December 2014. All cases were sorted by date into 3 groups: the first 5 years (from 2000 to 2004), the middle 5 years (from 2005 to 2009), and the final 5 years (from 2010 to 2015). We noted the number of THA cases each year, age at surgery, duration of RA, and medications administered. In addition, 2 investigators independently evaluated pre-operative X-ray findings using the Larsen classification<sup>1</sup> to determine whether the number of severe cases (Larsen grade 5) of hip joint destruction changed during the study period. <h3>Results</h3> In the 15 year period there were 786 primary THA cases in our hospital, of which 67 (8.5%) were RA cases. The number of THA showed a decreasing tendency, as 29 cases occurred from 2000 to 2005 and 19 from 2009 to 2014, a decrease of approximately 30%. There was little change in patient background in regard to age at surgery and duration of RA. The rate of steroid use decreased from 82.8% to 57.9%, whereas the rate of MTX use increased from 31.0% in the first 5 years to 73.7% in the final 5 years. Furthermore, the rate of biological drug use increased from 0% in the first 5 years to 31.6% in the final 5 years. Cases classified as Larsen grade 5 (Figure 1a) by X-ray evaluation decreased to only two cases in the middle 5 years and a single case in the final 5 years from 8 cases in the first 5 years (Figure 1b). <h3>Conclusions</h3> The number of patients who underwent THA for RA was decreased and the patient medications administered were also changed. Preoperative X-ray evaluations showed that cases of severe joint destruction (Larsen grade 5) were remarkably decreased. We consider that bone destruction of hip joint can be inhibited by use of MTX and biological drugs. <h3>References</h3> Larsen A, et al. Radiographic evaluation of rheumatoid arthritis and related conditions by standard reference films. Acta Radiol Diagn 1977;18:481–91. <h3>Disclosure of Interest</h3> None declared
Mechanical prophylaxis is a heparin-independent risk for anti–platelet factor 4/heparin antibody formation after orthopedic surgery
Authors: Seiji Bito, Shigeki Miyata, Kiyoshi Migita, Mashio Nakamura, Kazuhito Shinohara, Tomotaro Sato, Takeharu Tonai, Motoyuki Shimizu, Yasuhiro Shibata, Kazuhiko Kishi, Chikara Kubota, Shinnosuke Nakahara, Toshihito Mori, Kazuo Ikeda, Shusuke Ota, Takeshi Minamizaki, Shigeru Yamada, Naofumi Shiota, Masataka Kamei, Satoru Motokawa
Journal: Blood (2015)