tbuckley/cabot-search huggingface dataset:
PTH-238 An audit of preoperative feeding times in adult patients undergoing emergency general surgery
Authors: T Noone, M Nixon, Adam Revill, Gandrapu Srinivas
Journal: Gut (2015)

<h3>Introduction</h3> All patients are required to fast before general anaesthesia in order to reduce the risk of aspiration on induction. Fasting prior to surgery ensures minimal volume and acidity of stomach contents. Current guidelines suggest that adult patients should fast before undergoing surgery for 6 h with regard to food and 2 h for clear fluids.<sup>1</sup>For emergency surgery, it is advised that the patient be treated as though they have a full stomach, unless there has been adequate time to allow for following of normal guidelines. Control over operative and therefore fasting times for emergency surgery can be challenging. This audit aims to compare local practice to fasting guidelines, with respect to emergency surgery. <h3>Method</h3> This is a prospective audit of adult patients undergoing emergency surgery for a six-month period, from August 2014 to January 2015 in our District General Hospital. The data collection was randomised to various different working days throughout this time frame in order to avoid bias. Using current guidelines, the standard was set for fasting of 6 h for food and 2 h for clear fluids. <h3>Results</h3> 35 adult patients underwent emergency general surgery over 17 working days in the audit period. Paediatric patients were excluded. Patients ranged from 21–89 years, with an average age of 57 years. The average starvation for food was 22 h 18 min, with only one patient meeting the current guidelines. The average time for starvation for clear fluids was 10 h 39 min. The documentation around the administration of IV fluids was unreliable and therefore could not be analysed. <h3>Conclusion</h3> Patients were inappropriately starved pre-operatively, unintentionally in the majority of cases. The findings are unlikely to be specific to our hospital. These, along with the review of current fasting guidelines due to be published this year, should prompt a review of the delivery of emergency services. Both our general surgical and anaesthetic departments are currently looking into educating all members of the team regarding feeding times and the introduction of preoperative drinks, similar to those given prior to elective surgery. <h3>Disclosure of interest</h3> None Declared. <h3>Reference</h3> AAGBI Safety Guideline 2010 January, ‘Fasting guidelines in adults and children’, in <i>Pre-operative Assessment and Patient Preparation, The Role of the Anaesthetist</i>, The Association of Anaesthetists of Great Britain and Ireland, London, England, pp. 30–3
PTU-137 A technique for circular stapled cervical anastomosis in three phase minimally-invasive oesophagectomy
Authors: C Deutsch, F Rashid, B Tan, P Safranek
Journal: Gut (2015)

<h3>Introduction</h3> Minimally-invasive oesophagectomy (MIO) is an increasingly popular strategy for oesophageal cancer resection in appropriately selected patients. In three-stage procedures, the oesophagus and stomach are mobilised thoracoscopically and laparoscopically, with a mini-laparotomy for conduit formation and specimen removal. The conduit is then delivered into the neck for construction of the oesophagogastric anastomosis. Traditionally the anastomosis is either entirely hand-sewn, or is semi-mechanical. Here, we discuss the use of fully mechanical anastomosis using a circular stapler (CS) in selected patients and report the clinical details, early outcomes. <h3>Method</h3> Patients undergoing MIO at our centre from November 2014 were considered for CS anastomosis using a gastrointestinal circular stapler (Ethicon™, UK). The clinical conditions necessary for use of CS were assessed at the time of surgery, the primary criterion being the availability of a sufficiently long conduit. All patients receiving a successful fully mechanical anastomosis are included. <h3>Results</h3> Four patients underwent CS anastomosis. Age range was 58–79 and included 2 male and 2 female patients. The first case had an area of proximal Barrett’s dysplasia which would have required a high hand sewn anastomosis. Another patient had very significant comorbid factors including rheumatoid arthritis and long-term corticosteroid and methotrexate use. In all of these cases, the anastomosis was successfully formed on first attempt. No early leaks occurred. <h3>Conclusion</h3> Use of CS is described for minimally invasive two phase and open oesophagectomy, and is occasionally reported for three-stage MIO. The majority of surgeons use the either fully hand-sewn or partially mechanical techniques for cervical anastomoses. We describe a simple technique for a stapled neck anastomosis which is faster to construct and enables a more proximal oesophageal resection without difficulty. <h3>Disclosure of interest</h3> None Declared. <h3>References</h3> Price TN, Nichols FC, Harmsen WS, Allen MS, Cassivi SD, Wigle DA, Shen KR, Deschamps C. A comprehensive review of anastomotic technique in 432 esophagectomies. Ann Thorac Surg. 2013;95(4):1154–60 Li J, Shen Y, Tan L, Feng M, Wang H, Xi Y, Leng Y, Wang Q. See comment in PubMed Commons belowCervical triangulating stapled anastomosis: technique and initial experience. J Thorac Dis. 2014;6(3):S350–4
PSEUDOSARCOMATOUS DERMATOFIBROMA
Authors: Howard S. Yaffee
Journal: British Journal of Dermatology (1973)

Journal Article PSEUDOSARCOMATOUS DERMATOFIBROMA Get access Howard S. Yaffee Howard S. Yaffee Department of Dermatology Boston University School of Medicine Boston, Massachusetts U.S.A Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 89, Issue 6, 1 December 1973, Page 651, https://doi.org/10.1111/j.1365-2133.1973.tb07597.x Published: 01 December 1973
Differential Regulation by Interleukin-4 and Interferon-λ of an Autologous Melanoma-specific Cytotoxic T-Cell Clone and the Tumor-infiltrating Lymphocytes from Which It Was Established
Authors: T Yamada, E C Holmes, S H Golub
Journal: Cancer Communications (1990)

To investigate the specificity of human tumor-infiltrating lymphocytes (TIL) against autologous tumors, TIL from five metastatic melanoma patients were expanded with rIL-2 and assessed for cytotoxicity in chromium release assays. TIL from a patient showing preferential cytotoxicity against autologous melanoma cells were further analysed. TIL were cloned by limiting dilution. Four out of 27 clones showed substantial cytotoxicity against autologous melanoma and one clone, designated as No. 8a-5 (CD3+, CD4-, CD8+, CD56-), selectively killed autologous melanoma but did not kill six different allogeneic melanoma, K562, or autologous or allogeneic Con A lymphoblast targets. Cytotoxicity of No. 8a-5 cells was inhibited by anti-HLA class I MAb (w6/32), by anti-beta 2-microglobulin MAb, and by anti-CD3 (OKT3) MAb, suggesting that the specific cytotoxicity was HLA class I-restricted and that the clone utilized the T-cell receptor complex for recognition of targets. Pretreatment with rIFN-gamma increased the sensitivity of autologous melanoma targets to lysis by No. 8a-5 cells. Exogenous rIL-4 enhanced [3H]TdR incorporation by these TIL. In contrast, rIFN-gamma reduced the sensitivity of the autologous melanoma to lysis by uncloned TIL, and rIL-4 suppressed the cytotoxicity and cell proliferation of uncloned TIL. These results indicate that both specific and non-specific cytotoxic cells can be developed from the same TIL and that these can be differentially regulated.
Life and Death and the Physician
Authors: J. R. E.
Journal: Annals of Internal Medicine (1967)

Editorials1 September 1967Life and Death and the PhysicianJ. R. E.J. R. E.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-67-3-669 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe issues of life and death are no strangers to the practicing physician. Daily he confronts them in the persons of his patients—endeavoring to detect and diminish disease, to promote health, to relieve suffering, to confound death. Sooner or later "death comes to all men," as he well knows, but his is the task to put off for his patient that day. The patient, whether he cherishes life with gusto or clings to life with despair, looks to his physician for all the help and hope that one human being can give another in a time of need. In this... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byElectrophilic polyfluoroalkylating agents based on sulfonate estersIn Memoriam: J. Russell Elkinton, MD, MACP, FRCP(L); 1910–2002; Editor, Annals of Internal Medicine, 1960–1971Edward J. Huth, MD, Editor EmeritusReactions of Women to Perinatal Death 1 September 1967Volume 67, Issue 3_Part_1Page: 669-669 ePublished: 1 December 2008 Issue Published: 1 September 1967 PDF downloadLoading ...
Predicting MDS Response to Drug Therapies Based on a New Method of Interpreting the MDS Mutanome
Authors: Cindy Medina, Leylah Drusbosky, Myron Chang, Shireen Vali, Ansu Kumar, Neeraj Kumar Singh, Taher Abbasi, Mikkael A. Sekeres, Mar Mallo, Francesc Sole, Rafael Bejar, Christopher R. Cogle
Journal: Blood (2015)
FRI0288 Role of Physical Exercice Program in Patients with Osteoporosis
Authors: R.I. Marcu, S. Patru, A.C. Bighea, R. Traistaru, R.S. Popescu
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Having an important negative impact not only on bone health, but also on general health, with serious consequences as the fragility fractures, osteoporosis had became a major public health problem, with high socio-economic cost. <h3>Objectives</h3> The aim of this study was to assess the efficacy of a 6 months ambulatory exercise program on functional status and quality of life in women with postmenopausal osteoporosis. <h3>Methods</h3> The randomized, controlled, observational study included 81 patients with postmenopausal osteoporosis, mean age 68.7±7.3 years, randomly assigned to a control group (40 patients) and an exercise group (42 patients). All patients were diagnosed with osteoporosis based on DEXA assessment and had a stable cardiovascular status. All patients continued to take their prescribed medication for osteoporosis. They followed exercise programs based on increasing spinal mobility, muscular strength and endurance, improving balance, coordination, respiratory exercises. The patients in the control group continued their daily living activities. The evaluation was made at the beginning of the study and after 6 months based on spinal mobility, muscular strength, pain assessment on a Visual Analogue Scale (VAS) and quality of life evaluation using SF-36 Questionnaire. <h3>Results</h3> The benefits of the kinetic programs were shown by a significant improvement on spinal mobility and muscular strength for spinal extensor and abdominal flexor muscles. For muscular strength, the values we obtained followed an ascendant curve for all the tested muscular groups and the results had high statistic significance. Pain, evaluated on a Visual Analogue Scale, had a mean decrease of 3.558 points and the results were also high statistic significant (p=0.000054). For SF-36 Questionnaire, the best results were obtained for vitality (37.2% amelioration), mental health (20.8% amelioration) and body pain (53.5% amelioration) domains and were also statistic significant (p&lt;0.05). The results for the control group remained basically unchanged. The compliance of the study participants was very good: only three patients did not completed the 6 months training program. <h3>Conclusions</h3> The physical exercise program improves both functional status and quality of life in patients with postmenopausal osteoporosis by increasing spinal mobility and muscular strength and by reducing pain. Kinetic programs that combine aerobic exercise with exercises for increasing muscular strength and endurance, balance and coordination should be introduced in the rehabilitation programs of patients with osteoporosis without medical contraindications for moderate level exercise. <h3>Disclosure of Interest</h3> None declared
Doxycycline Inducible Melanogenic Vaccinia Virus as Theranostic Anti-Cancer Agent
Authors: Lorenz Kirscher, Xosé Luis Deán-Ben, Miriam Scadeng, Angelika Zaremba, Qian Zhang, Christina Kober, Thomas Felix Fehm, Daniel Razansky, Vasilis Ntziachristos, Jochen Stritzker, Aladar A. Szalay
Journal: Theranostics (2015)

We reported earlier the diagnostic potential of a melanogenic vaccinia virus based system in magnetic resonance (MRI) and optoacoustic deep tissue imaging (MSOT).Since melanin overproduction lead to attenuated virus replication, we constructed a novel recombinant vaccinia virus strain (rVACV), GLV-1h462, which expressed the key enzyme of melanogenesis (tyrosinase) under the control of an inducible promoter-system.In this study melanin production was detected after exogenous addition of doxycycline in two different tumor xenograft mouse models.Furthermore, it was confirmed that this novel vaccinia virus strain still facilitated signal enhancement as detected by MRI and optoacoustic tomography.At the same time we demonstrated an enhanced oncolytic potential compared to the constitutively melanin synthesizing rVACV system.
Psychosomatic medicine in the seventies: an overview
Authors: Z J Lipowski
Journal: American Journal of Psychiatry (1977)

The author discusses the theoretical, investigative, clinical, and teaching aspects of psychosomatic medicine in the seventies. Major research and clinical developments are discussed in relation to key theoretical postulates and concepts. The rapidly expanding field of psychosomatic medicine is far more divant than ever before. Its hallmarks include a multifactorial approach to the study of health and disease, formulation of testable hypotheses and their careful validation, concern with the clinical applicability of research, and development of integrative theories. Current advances in the field have far-reaching inplications for medicine, psychiatry, and the behavioral sciences.
CML Patients In Clinical Trials Represent Fairly Well The General Population Of CML Patients: A Comparative Analysis Of 5803 Patients From The EUTOS Registry
Authors: Verena S Hoffmann, Doris Lindoerfer, Markus Pfirrmann, Susanne Saussele, Andreas Hochhaus, Jutta Engel, Joelle Guilhot, Gianantonio Rosti, Jiri Mayer, Karel Indrak, Fausto Castagnetti, Anna Turkina, Andrey Zaritskey, Juan Luis Steegmann, Andrzej Hellmann, Noortje Thielen, Francisco Cervantes, Bengt Simonsson, Adriana Colita, Richard E. Clark, Antonio Almeida, Boris Labar, David Marin, Gert J. Ossenkoppele, Andrija Bogdanovic, Irina Dyagil, Kimmo Porkka, Stephen O'Brien, Laimonas Griskevicius, Panagiotis Panagiotidis, Josef Thaler, Irena Zupan, Sandra Lejniece, Hele Everaus, Tamás Masszi, Frederiki Melanthiou, Rüdiger Hehlmann, Joerg Hasford, Michele Baccarani
Journal: Blood (2013)
Abstract 2935: A novel HSP70 inhibitor demonstrates potent anti-myeloma activity
Authors: Charvann K. Bailey, Anna Budina, Maureen Murphy, Yulia Nefedova
Journal: Cancer Research (2015)

Abstract Multiple myeloma (MM) is a hematological cancer characterized by clonal proliferation of malignant plasma cells that produce monoclonal immunoglobulin. Because they secrete excess amounts of immunoglobulins, MM cells are typically under proteotoxic stress and utilize multiple mechanisms including molecular chaperones to maintain protein homeostasis. The chaperone HSP70 (heat shock protein 70) is overexpressed in MM. Therefore, we sought to evaluate whether targeting HSP70 with a novel HSP70 inhibitor would have a therapeutic benefit in MM. Toward this end, a panel of human MM cells lines including H929, RPMI-8226, MY-5, U266 and MM1s were tested for the IC50 to PET-16, an HSP70 inhibitor. Treatment with PET-16 resulted in a significant decrease in the viability of all MM cells tested with an IC50 value range from 3.5-7.2uM as was determined by the Alamar Blue assay. Decreased MM cell viability after treatment with PET-16 was due to induction of cellular apoptosis as was determined by Annexin V binding assay using flow cytometry. Because MM cells typically exist under hypoxic conditions, and hypoxia is known to decrease the efficacy of some chemotherapeutic agents, we analyzed the efficacy of PET-16 under hypoxia (1% oxygen). There was no difference in anti-MM effect of PET-16 in cells cultured under hypoxia as compared to those cultured in normoxic conditions. Taken together, our data suggest that targeting HSP70 with the novel HSP70 inhibitor PET-16 could be a viable potential strategy for treatment of MM. Citation Format: Charvann K. Bailey, Anna Budina, Maureen Murphy, Yulia Nefedova. A novel HSP70 inhibitor demonstrates potent anti-myeloma activity. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 2935. doi:10.1158/1538-7445.AM2015-2935
PTH-314 Curative management for stage IV rectal cancer – has the potential improved?
Authors: N Rajendran, K Yap, Y Kaneko, B Thomson, S Ngan, M Michael, C Lynch, SK Warrier, AG Heriot
Journal: Gut (2015)

<h3>Introduction</h3> The aim of the study was to assess the change in survival outcomes of patients with stage IV rectal cancer treated with curative intent over a 25 year period. <h3>Method</h3> A retrospective review was undertaken on all patients referred to an oncology centre between 1987 and 2013 with Stage IV rectal cancer at their initial presentation that were treated for cure. Data was collected on demographics, therapeutic interventions, and survival. Information included initial treatment if undertaken at the referring hospital. Data was divided across time points (1987–2000, 2001–2013) and Kaplan-Meier analysis was undertaken for survival across the period of review. <h3>Results</h3> A total of 108 patients were identified with stage IV rectal cancer at the time of referral [mean age 59.7 (range 30–87)], 70 male:38 female. At referral 83 patients had liver metastases, 44 had lung metastases and 19 had other metastases. Follow-up was available in 96 patients. Neoadjuvant chemoradiotherapy was given to 66% of patients. Of the 97 patients for whom data were available, 89 patients had resection of the rectal primary (92.7%). 56% had adjuvant chemotherapy, 10% had adjuvant chemoradiotherapy. Metastasectomy was undertaken in 40.9% patients (34/83 patients) with liver mestastases and 36.4% (16 /44 patients) with lung metastases. Overall 1 year, 3 year and 5 year survival improved significantly over time (1987–2000 vs. 2001–2013 cohorts; 1 year 80% vs. 96%; 3 year 25% vs. 57%, 5 year 17% vs. 46% respectively [p &lt; 0.01]). <h3>Conclusion</h3> The survival outcomes for patients treated for stage IV rectal cancer demonstrate more patients have been treated with curative intent and 5-year survival has improved significantly. <h3>Disclosure of interest</h3> None Declared.
Disseminated intravascular coagulation
Authors: M Armijo Moreno, F Camacho Martínez, R Naranjo Sintes, J Linares Solano, M T Gutiérrez Salmeron, R Armijo Lozano, E Herrera Ceballos, L Díaz-Flores, F De Dulanto
Journal: Nature Reviews Disease Primers (2016)
PTU-145 Prophylactic total gastrectomy for hereditory gastric cancer syndrome
Authors: F Rashid, C Suo, B Tan, S Richardson, R Fitzgerald, M Di Pietro, M Tischkowitz, M O’Donovan, RH Hardwick
Journal: Gut (2015)

<h3>Introduction</h3> 1–3% of gastric cancers arise from hereditary predisposition syndromes. E-cadherin gene (CDH1) mutations are the best characterised of these and confer a life-time risk of approximately 80% for patients developing diffuse gastric cancer. Currently, the only definitive treatment available is prophylactic total gastrectomy (PTG). We present our experience of open PTG, focusing on the early outcomes. <h3>Method</h3> Twenty four consecutive patients with CDH 1 mutation underwent PTG from 2005 to 2014 (median age 33, range 22–51). All patients had at least one gastroscopy with biopsies taken according to the Cambridge Protocol and were assessed by a multi-disciplinary team within a high-volume Cancer Centre. All patients had an open posterior vagal sparing total gastrectomy with stapled oesophagojejunal anastomosis and Roux-en-Y reconstruction by a single surgeon. Twenty three patients had a D0.5 -1 lymphadenectomy; one patient with suspected invasive tumour had a D2 resection. Nasogastric tubes and abdominal drains were not used. Patients were mobilised on the first postoperative day with epidural analgesia. Oral fluids were restarted on postop day 3 and diet on day 5. <h3>Results</h3> There were two postoperative complications (8%) but no deaths; One patient had a jejuno-jejuno anastomotic leak 10 days after surgery requiring revisional surgery but made a full recovery. Another patient had bleeding which was managed conservatively with transfusion. Two patients developed anastomotic strictures and were successfully treated with endoscopic balloon dilatation. Median follow-up to date is 5 years (range: 3 months to 9 years). Histology showed scattered microscopic foci of intramucosal signet ring carcinoma (pT1a) in 23/24 patients (96%); the median number of foci was 7 (range: 1–182). No invasive tumours were found, all nodes were negative for tumour and all longitudinal margins were clear. The median lymph node yield was 5.5 (range: 1–26) and median hospital stay was 8 days (range: 6–10). <h3>Conclusion</h3> Open PTG can be performed with acceptable mortality and morbidity. Our challenge for the future is to offer minimally invasive PTG without increasing the risks. <h3>Disclosure of interest</h3> None Declared.
Further Observations on the Chromosomes of Chinese Hamster Cells in Tissue Culture&lt;xref ref-type="fn" rid="FN1"&gt;2&lt;/xref&gt;
Authors: Denys K. Ford, Resa Wakonig, George Yerganian
Journal: JNCI Journal of the National Cancer Institute (1959)

The chromosome complements of 3 Chinese hamster cell strains and a methylcholanthrene-treated subline varied during observation periods of 12 to 22 months. The complements were formed basically from multiples of the haploid constitution, and in 1 strain the normal diploid complement persisted as the predominant pattern for many months. Abnormalities of varying types began to appear soon after a culture was initiated, and in some sublines particular abnormal chromosome patterns persisted for many months, while in others variation was continuous. Except in the rare, markedly polyploid and partially disintegrated metaphases, the normal morphology of the individual chromosomes was usually maintained. Thus the metaphase chromosomes could nearly always be identified, though exact similarity to the normal types was not found when deletions resulted in partial loss of chromosome arms. Telocentric chromosomes, not present in the normal diploid complement, were a feature of most strains and in some cases could be related to centromeric misdivision with persistence of 1 or 2 arms as functioning chromosomes. Other aberrant chromosome forms could not be identified with normal chromosome types. The changes in chromosome complements in these nonclonal cultures were fluctuating events unassociated with obvious changes in cultural or morphological appearances. A characteristic chromosome pattern with an unusual chromosome form appeared in a methylcholanthrene-treated subline of 1 cell strain, 5 months after exposure to the carcinogen. Subsequently, however, this characteristic pattern disappeared, and the chromosome complement of the treated subline did not differ significantly from the untreated parent cell strain.