tbuckley/cabot-search huggingface dataset:
The quantity and quality of α-gal-specific antibodies differ in individuals with and without delayed red meat allergy
Authors: D. Kollmann, B. Nagl, C. Ebner, W. Emminger, S. Wöhrl, C. Kitzmüller, S. Vrtala, A. Mangold, H.-J. Ankersmit, B. Bohle
Journal: Allergy (2016)

IgG to galactose-α-1,3-galactose (α-gal) are highly abundant natural antibodies (Ab) in humans. α-Gal-specific IgE Ab cause a special form of meat allergy characterized by severe systemic reactions 3-7 h after consumption of red meat. We investigated 20 patients who experienced such reactions and characterized their α-gal-specific IgE and IgG responses in more detail.α-Gal-specific IgE was determined by ImmunoCAP. IgE reactivity to meat extract and bovine gamma globulin (BGG) was assessed by immunoblotting and ELISA, respectively. In some experiments, sera were pre-incubated with α-gal or protein G to deplete IgG Ab. α-Gal-specific IgG1-4 Ab in individuals with and without meat allergy were assessed by ELISA.In immunoblots, BGG was the most frequently recognized meat protein. Binding of IgE and IgG to BGG was confirmed by ELISA and completely abolished after pre-incubation with α-gal. Neither the depletion of autologous α-gal-specific IgG Ab nor the addition of α-gal-specific IgG Ab from nonallergic individuals changed the IgE recognition of BGG of meat-allergic patients. Meat-allergic patients showed significantly higher α-gal-specific IgG1 and IgG3 Ab than nonallergic individuals, whereas the latter showed significantly higher levels of α-gal-specific IgG4 Ab.Patients with delayed meat allergy display IgE and IgG Ab that selectively recognize the α-gal epitope on BGG. Their enhanced α-gal-specific IgE levels are accompanied by high levels of α-gal-specific IgG1 devoid of IgE-blocking activity. This subclass distribution is atypical for food allergies and distinct from natural α-gal IgG responses in nonallergic individuals.
The States
Authors: John K. Iglehart
Journal: New England Journal of Medicine (1994)

In the absence of federal action, many states, squeezed by recession1 and spiraling health care costs, have approved or are moving toward the enactment of legislation that would reform the way health care is paid for and provided within their borders. The legislation ranges from comprehensive plans with the goal of providing all citizens with health insurance through public subsidies and coverage financed jointly by employers and employees to less ambitious laws that reform the small-group insurance market, establish new cost-containment mechanisms, or create study commissions. State medical societies have generally been supportive of these reform efforts, except when legislatures . . .
AB0244 Correlation Between Serological and Clinical Markers in Rheumatoid Arthritis
Authors: C. Carrasco, J.L. Άlvarez, J.M. Salazar
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Anticyclic citrullinated peptide antibodies (ACCP) are considered a diagnosis criteria for rheumatoid arthritis (RA). However, it is unknown if there is a correlation between the levels of these antibodies and the disease activity, or their utility for the individual follow-up. <h3>Objectives</h3> The aim of this study is to investigate the association between disease activity and levels of ACCP and rheumatoid factor (RF) in RA patients. As disease activity markers, Disease Activity Score (DAS28 PCR), Simplified Disease Activity Index (SDAI) and a Spanish version of the Health Assessment Questionnaire (HAQ) are used. <h3>Methods</h3> DAS28 (PCR), SDAI and HAQ were evaluated in 62 sera of 42 RA patients, diagnosed according to the American College of Rheumatology/European League Against Rheumatism 2010 classification criteria. In all of them, AACP (Thermofisher) and RF were measured. <h3>Results</h3> When we analyze the different correlations between AACP, RF and DAS28 (PCR), SDAI and HAQ, we find no correlation between then. Figure 1: Pearson correlation (<i>r</i>) among serological data - anticyclic citrullinated peptide antibodies (ACCP) and rheumatoid factor (RF) - and clinical data - Disease Activity Score 28 (DAS28 PCR), Simplified Disease Activity Index (SDAI) and Health Assessment Questionnaire (HAQ) - in diagnosed RA patients. <h3>Conclusions</h3> We find no correlation between serological and disease activity markers in RA patients. Consequently, although ACCP and RF are essential for the RA diagnosis, are not useful as disease activity indicators, and their continuous measurement in the monitoring of patients would not be indicated. <h3>Disclosure of Interest</h3> None declared
Serum-free Growth and Karyotype Analyses of Cultured Normal and Tumorous (SqCC/Y1) Human Buccal Epithelial Cells
Authors: K Sundqvist, P Kulkarni, S S Hybbinette, F Bertolero, Y Liu, R C Grafström
Journal: Cancer Communications (1991)

Epithelial cell cultures were obtained following tryptic digestion of normal human buccal mucosa. Primary cultures exhibited markedly higher colony-forming efficiencies and growth rates using fibronectin/collagen-coated, as compared to non-coated culture dishes and a serum-free MCDB 153 medium developed for epidermal epithelial cells than a similar medium previously developed for buccal explant outgrowth cultures. At the preferred conditions, the cells could be transferred at least 5-fold, divided at about one population doubling per day, and commonly underwent 60 population doublings resulting in yields of 10(8) to 10(11) cells per cm2 mucosal specimen. Moreover, these conditions successfully cultivated a buccal carcinoma cell line (SqCC/Y1) for several months. The carcinoma cells were resistant to factors that inhibited growth or induced differentiation of normal cells, i.e., transforming growth factor type beta 1, Ca2+, or serum. Karyotype analyses of SqCC/Y1 cells showed 63 to 83 chromosomes per metaphase and consistent occurrences of monosomy 1, tetrasomy 19 and 20, as well as trisomy 22, and at least 7 marker chromosomes, whereas cells obtained from non-cancerous donors were diploid. It is concluded that the similarly defined culture conditions may now be applied to study characteristics of both normal and tumorous buccal epithelial cells.
A memorable patient: And a memorable day
Authors: Bryan Scaife
Journal: BMJ (2004)

It was January 1956 and the day on which I was to undertake the final part of “Conjoint surgery, clinical and viva.” I presented myself at Queen's Square and was conducted into the examination hall to meet my “long case.” He was a cheerful Cockney who, I realised, was no stranger to Queen's Square. With the minimum of fuss, he told me his history and his diagnosis: “It was a TB hip, doc.” Only a couple of weeks previously I had examined such a case in the outpatients clinic.

I completed the details of the history before embarking on the examination, and when I had finished I thought that I had covered everything.

“What have you found, doc?”

Briskly, and with all the confidence of youth, I reeled off the findings.

“OK, but what about telescopic movement?”

Although I had observed shortening on the affected side, was this something that, in my haste and misplaced zeal, I had forgotten? Quickly, and with the examiner coming towards me, I measured it and found about 2 inches of shortening. I gave the history and findings to the examiner, but I must say when I mentioned telescopic movement I saw a hint of a smile cross the patient's face.

The short cases seemed to be straightforward, and so I went on to the royal college for the viva. When all this was over there was about two hours to wait before the results were announced.

All the candidates, some hundred in number, gathered in a hall to learn their fate. At 5 pm a college porter, resplendent in his uniform, appeared and called out each candidate individually, checking each identity by examination number and by name. Those who had been successful, of whom I was one, were invited to go upstairs to be congratulated by the examiners. This was a wonderful tradition but not without stress, particularly for those who failed and had to slink downstairs and away in the night.

I travelled home to Yorkshire to acquaint my parents with my success and to tell my long suffering fiancee that we could at last get married, notwithstanding the fact that I should earn only £415 a year—a sum far short of her earnings.
Soundings: Suicidal thinking
Authors: Imre Loefler
Journal: BMJ (2006)

Suicide was medicalised long before birth and death were. The church considered suicide a grave sin and refused to bury people who had ended their lives “by their own hand,” as did Judas, who—according to the Gospel of St John—hanged himself. It may be argued that Judas had good reason to do so; nevertheless, the construct that suicide is the result of insanity secured Christian burial for many centuries.

Whether religious or not, most people think that destroying oneself is against human nature and therefore irrational.

Psychiatrists regard suicide as a matter under their jurisdiction, because a proportion of people who take their own lives are “mentally ill,” whatever that may mean. The guidelines casualty departments use to treat people who have attempted suicide imply that such people are considered insane.

One wonders what psychiatrists think of religious suicide? Religious suicide usually poses as self sacrifice in the process of killing others and has been considered a heroic deed eligible for sanctification. The motivation of a suicide bomber, a Kamikaze pilot, many a crusader, knight, and martyr, was and is the belief in some sort of reward in an afterlife. Religious fanaticism may be considered as social pathology but is it, at the individual level, a psychiatric disorder?

Are all people who contemplate or commit suicide depressed, mentally disturbed, or religious fanatics? There may be rational reasons to want to arrange one's own death. Socrates drank hemlock in full possession of his mental powers. Cleopatra chose the venom of the asp to avoid humiliation. The writer Arthur Koestler took poison because he was old, ill, and had lost his creativity. The Hungarian novelist Sandor Marai shot himself, having taken handgun handling lessons from the police, because he was lonely, old, and barren.

With increasing life expectancy and incurable chronic disease, rational suicide is bound to become more common. A new species is suicide by writ: “just in case” instructions with regard to the discontinuation of life support.

Suicide is not necessarily a matter of insanity, irrationality, or despair, and it is not primarily of medical concern. Would Goering, if he had had a psychiatrist, have preferred the gallows to cyanide?
Cardiovascular Monitoring With Trastuzumab Therapy
Authors: Alison M. Brann, Melody A. Cobleigh, Tochi M. Okwuosa
Journal: JAMA Oncology (2016)

This Viewpoint questions the necessity of frequent cardiovascular monitoring for patients receiving trastuzumab therapy and proposes that intense monitoring be reserved for patients with risk factors shown to be associated with congestive heart failure.
AB0216 MTOR as a Downstream Signaling in Human Vascular Smooth Muscle Cells Exposed to Scleroderma Anti-Pdgfrα Autoantibodies
Authors: T. Spadoni, S. Svegliati, C. Fischietti, D. Amico, A. Gabrielli
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Vascular injuriy is an early event in scleroderma (SSc). It precedes fibrosis and involves small vessels (1). The cellular changes in early lesions are loss of endothelial cells, proliferation of pericytes and vascular smooth muscle cells, and precence of immune cells in the perivascular space. We recently demonstrated that IgG isolated from sera of SSc scleroderma patients induced NOX4-derived reactive oxygen species (ROS) in smooth muscle cells (SMCs) through the activation of PDGFRα receptor (2). Modulation of ROS generation led to influence migration, proliferation and collagen production in SMCs. Mammalian target of rapamycin (mTOR) is a serine/threonine kinase that acts as a major activator of cell growth and proliferation. mTOR has also been shown to play a role in vascular SMCs proliferation and when dysregulated has been implicated in vascular remodeling (3). <h3>Objectives</h3> The aim of this study was to investigate the role of mTOR as a downstream signaling of SSc IgG in SMCs activation. <h3>Methods</h3> IgG were isolated from sera of SSc patients by affinity chromatography. SMCs from human pulmonary artery were purchased from Lonza. Total RNA was isolated, reverse-transcribed, and quantitative real-time PCR reactions were performed using SYBR-Green Master Mix. To analyzed protein expression, cells were lysed and subjected to western blot with specific antibodies. For immunocytochemistry, cells were fixed in PFA, permeabilized and labelled with specific antibodies to be evaluated through fluorescence microscopy. Migration was performed using the scratch test. <h3>Results</h3> SMCs were treated with various concentrations of rapamycin (1-10 nM), inhibitor of mTOR, or the same amount of vehicle (DMSO) for 48 hours, and then incubated with PDGF (15 ng/ml) or SSc IgG (200 μg/ml) for further 24 hours. Rapamycin was able to reverse the effects of PDGF and SSc IgG. Inhibition of mTOR led to a significant decrease in proliferation and migration rate (40%), and collagen expression (54%) in SMCs exposed to SSc IgG compared to untreated cells. <h3>Conclusions</h3> Our data demonstrate that mTOR is a crucial downstream signaling of SSc IgG effects through PDGFRα pathway, and is involved in the modulation of migration, proliferation and collagen expression in SMCs. These findings support the recent observation that mTOR is largely involved in collagen regulation in SSc dermal fibroblasts (4), suggesting an important role of this serine/threonine kinase in the signaling pathways involved in the development of SSc. <h3>References</h3> Gabrielli et al. N Engl J Med 2009;360:1989-2003. Amico et al. Ann Rheum Dis 2011;70(S3):491. Augusto et al. C J Cardiol 2014;30:482-484. Tamaki et al. J Dermatol Science 2014;74:251-259. <h3>Disclosure of Interest</h3> None declared
PTU-266 Does participation in bowel cancer screening programme (BCSP) affect emergency admission in patients with bowel cancer?
Authors: M Al Ani, A Moinie, E Ekalakouti, Q Iqbal, A Prabhudesai
Journal: Gut (2015)

<h3>Introduction</h3> The aim of the BCSP is the detection of early colorectal cancer in order to improve overall prognosis. In this study, we looked at the impact of participation in the BCSP on emergency admissions related to colorectal cancer (CRC). <h3>Method</h3> A retrospective analysis of all patients presenting with a confirmed diagnosis of CRC and were eligible for Faecal Occult Blood testing (FOBt) between 2009 and 2014 at Hillingdon Hospital was carried out (n = 174). The response to FOBt was obtained from the national screening hub. The mode of admission was determined by accessing discharge summaries, the MDT database and the patient assessment service. A responder was defined as a patient who sent a FOBt sample back at any point, and a non-responder as any patient who failed to send back a sample. <h3>Results</h3> Of the 174 patients, we had 64 (37%) responders and 110 (63%) non-responders. 24 patients presented as emergencies, of which 75% (n = 18) were non-responders, in comparison to 25% (n = 6) responders. 32 patients had incurable disease, of which 23 (72%) were non-responders in comparison to 9 (28%) responders. <h3>Conclusion</h3> Patients who did not participate in the BCSP had a threefold increase in risk of presenting with a colorectal cancer related emergency, and they were also two and half times more likely to have incurable disease. Although our numbers are small the difference between the responders and non-responders is evident. <h3>Disclosure of interest</h3> None Declared.
Pork related trichinellosis: emergence of a new mode of transmission?
Authors: J C Desenclos
Journal: Eurosurveillance (1999)

In this issue, Eurosurveillance publishes a report about two outbreaks of trichinellosis - of eight and 44 cases, respectively - that occurred in the German state of Northrhine-Westfalia from October to December 1998. Well conducted epidemiological invest
Clinical Advantages of Interictal SPECT Coregistered to Magnetic Resonance Imaging in Patients with Epilepsy
Authors: TOHRU SHIGA, KOICHI MORITA, AKIHIRO TAKANO, CHIETSUGU KATOH, FUMIHIRO NAKAMURA, ERIKO TSUKAMOTO, TSUKASA KOYAMA, HIDEHIRO IIDA, NAGARA TAMAKI
Journal: Clinical Nuclear Medicine (2001)

The aim of this study was to investigate the clinical value of coregistration of interictal SPECT and magnetic resonance imaging (MRI) in patients with partial epilepsy.Seventeen patients with partial epilepsy were examined with I-123 IMP or Tc-99m ethyl cysteinate dimer SPECT during the interictal phase. The SPECT images were automatically coregistered to axial T1 weighted MRIs. Asymmetry indexes (AIs) were calculated in both nonregistered images and coregistered images.SPECT images showed areas of decreased tracer uptake in 12 patients. In two patients, the relation between the tumor and the extent of decreased uptake became more accurate in the coregistered images. In five cases, the coregistered images clearly showed that the decreased uptake was located in the sulcus. The AIs were significantly reduced from 14.29 +/- 7.23 to 5.86 +/- 3.48 (P < 0.001) after the images were coregistered in these cases. In five cases, the coregistered images indicated that the decreased areas were in agreement with the cortical findings. No significant differences in the AIs were observed in these cases (16.50 +/- 6.19 versus 17.83 +/- 4.45). Thus, the coregistered images were useful not only to differentiate actual hypoperfusion from artificial hypoperfusion resulting from partial volume effects but also to improve the accuracy of AIs.The coregistration of interictal perfusion SPECT and MRI is useful not only to provide precise functional and anatomic mapping but also to improve the accuracy of calculations of the semiquantitative analysis of regional cerebral blood flow parameters during the interictal state of epilepsy.
PTU-008 Enhancing professional behaviour in gastrointestinal endoscopy: development of a behavioural marker tool for assessment of endoscopic non-technical skills
Authors: A Haycock, K Woolf, S Thomas-Gibson
Journal: Gut (2010)

<h3>Introduction</h3> Renewed focus on patient safety has highlighted the need for competency based assessment and training in medicine. Much of the current emphasis is on improving training and assessment of technical skill. However, work in other high-risk industries such as aviation show that errors and adverse outcomes are often not due to failure of technical skill, but other factors such as breakdown in communication and poor decision making, which are often termed "non-technical skills". Two qualitative studies were performed; the first defined a taxonomy of non-technical skills specific to gastrointestinal endoscopy. The second developed a tool based on observable behavioural markers which can be used for assessment and training purposes. <h3>Methods</h3> In a semi-structured interview study, nine consultant endoscopists were asked to recount an actual critical incident to elicit examples of where human factors were implicated in situations that have adversely affected patient safety in endoscopy. Transcripts of the interviews were analysed using a framework approach from which a non-technical skills taxonomy was developed. This taxonomy was then used to identify behavioural markers from four quad-split video recordings of bowel cancer screening colonoscopy lists. These markers were grouped together to produce a behavioural marker assessment tool. <h3>Results</h3> The interview analysis gave rise to a taxonomy of 33 non-technical skills in 14 categories. These were divided into general skills (Communication, Teamwork, Leadership, Confidence, Emotional Control), pre-procedural skills (Planning), procedural skills (Assessing situation, Judgement and Decision-making, Focus, Awareness, Problem Recognition, Problem Management, Responsibility), and post procedural skills (Responsibility, Reflection). Review of the colonoscopy recordings using this taxonomy elicited examples of 13 behavioural elements in four general categories (Communication and Teamwork, Situation Awareness, Leadership, Judgment and Decision Making). Directly observed examples of good and poor behaviour were mapped to all but four of the 33 non-technical skills identified in the interview study. <h3>Conclusion</h3> These two qualitiative studies have produced a tool to allow assessment and feedback regarding key observable non-technical skills needed by gastrointestinal endoscopists. The tool will need to be validated in a wider range of endoscopy practise both in terms of level of competence (construct validity) and different endoscopic procedures. It can potentially be used alongside a knowledge and technical skills training and assessment to provide more complete training and evaluation of professional behaviour within this field.
THU0555 Idiopathic Granulomatous Mastitis; A New Autoimmune Disease
Authors: J.M. Sanint, A. Olive, S. Rodriguez, A. Prior, J.F. Julian, A. Mariscal
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Idiopathic Granulomatous Mastitis (IGM) is a rare benign inflammatory breast disease. It presents as a painful breast mass in young women. The histologic presence of non caseating granulomas confined within breast lobules together with negative microbiologic finding, including mycobacteria and fungal cultures often confirms diagnosis. Its etiology and pathogenesis remains a subject for debate. It poses a problem of differential diagnosis because it clinically resembles other forms of mastitis and, most importantly, carcinomatous mastitis <h3>Objectives</h3> The purpose of this work is to study epidemiology, clinical and paraclinical characteristics, pathological anatomy features and treatment of IGM. <h3>Methods</h3> Retrospective review of clinical and radiological data of 7 women with confirmed IGM diagnosed between 2008 and 2014 in a university hospital with a catchment area of 850,000 inhabitants diagnosis <h3>Results</h3> 7 patients were diagnosed with IGM. Average age at diagnosis of 37.6 years (range: 29-46). Three of them were multiparous. Mean follow-up was one year; one patient did not attend clinical control. Patients were of multiethnic origin: 3 (42.8%) Caucasian, 2 (28.6%) Southeast Asia (China), 1 (14.3%) Latin (mestizo) and 1 (14.3%) Arabic. They clinically presented as a malignant mammary neoplasia or as an infection. All radiologically demonstrated (mammography and ultrasound) as suspected malignant lesions and the diagnosis was made by histological examination after core needle biopsy guided by ultrasound. The first symptom was: 2 (28.6%) breast abscess, breast mass 4 (57.1%) and breast pain in one (14.3%). The lesion was located in 5 patients left breast and right breast in one. Predominated in upper quadrants. All patients underwent mammography and ultrasound findings of suspected malignancy and ultrasound-guided percutaneous biopsy gave the diagnosis. The evidence of autoimmunity and microbiological cultures were negative in all patients. All patients were treated with glucocorticoids at doses of 30 mg reduced the dough until its demise. Two patients required surgical drainage to start. No recurrences were observed <h3>Conclusions</h3> IGM is a rare entity. Differential diagnoses should include malignant mammary neoplasia. The diagnosis is confirmed by pathologic examination. The treatment is medical with glucocorticoid. The prognosis of this disease remains favorable <h3>Disclosure of Interest</h3> None declared