tbuckley/cabot-search huggingface dataset:
The Pathogenesis of Transient Focal Cerebral Ischemia
Authors: CLARK H. MILLIKAN
Journal: Circulation (1965)

The pathogenesis of certain types of focal cerebral ischemia, particularly episodes of focal cerebrovascular insufficiency, is not fully understood. Atherosclerosis, a relatively static process, commonly occurs without producing any neurologic phenomena. However, such episodes rarely occur in cerebral vascular systems unaffected by atherosclerosis. Atherosclerosis plus some transitory pathophysiologic event would explain the clinical events. A list of such events includes vasospasm, transitory systemic hypotension, kinking and external compression of vessels, transitory hypoglycemia, temporary shunts, and thrombosis and multiple emboli. The roles of polycythemia and anemia are mentioned. Evidence is presented that incriminates thrombosis or embolus formation (or both) as the process, secondary to atherosclerosis or associated with atherosclerosis, that produces the focal cerebral ischemia.
Reply to Sbaraglia et al.
Authors: Luis Lara, Andrew Ukleja, Ronnie Pimentel, Roger Charles
Journal: Endoscopy (2015)

In response to the letter from Sbaraglia et al., we agree that current endoscopic techniques blur the lines of surgery [1]. These procedures are prolonged, may expose the patient to higher risks of aspiration, hypothermia, fluid and electrolyte imbalances, and pain, and risks associated with any sudden movement. It is time to recognize this for the sake of patient wellbeing and thus approach these with a “patient first” mindset, which in our case now involves general anesthesia not only for antegrade overtube-assisted enteroscopy but also for endoscopic Zenker’s diverticulotomies, endoscopic submucosal dissection, etc. We rarely perform routine endoscopies, including ERCP and endoscopic ultrasound, with general anesthesia.
Twins with incurable progressive disease can be taken off life support, High Court rules
Authors: Clare Dyer
Journal: BMJ (2015)

Identical twin boys with a progressive and incurable neurodegenerative disorder have died at age 14 months, after a High Court judge ruled that they should be taken off life support despite their parents’ objections.

Their Iraqi father represented himself and the boys’ mother in court, arguing through an interpreter that they should be kept alive and that it was against Islamic principles to withdraw life support before the brain had stopped functioning entirely.

But Mr Justice Holman said that it …
Small Victories
Authors: Peter A. Selwyn
Journal: JAMA (2007)

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
PTU-042 Post polypectomy bleeding (PPB) in the english nhs bowel cancer screening programme (NHSBCSP)
Authors: E Derbyshire, C Nickerson, A Hungin, MD Rutter
Journal: Gut (2015)

<h3>Introduction</h3> Colonoscopies in the English NHSBCSP are offered to 60–74 year olds with an abnormal Faecal Occult Blood Test. Polypectomy breaks the adenoma-carcinoma sequence but carries a risk of adverse events such as Post Polypectomy Bleeding (PPB). The NHSBCSP has a longstanding robust mechanism for capturing and reviewing adverse events. Adverse Events are graded by severity using the NHSBCSP framework, based on the American Society of Gastrointestinal Endoscopy grading system.<sup>1,2</sup> We aimed to (1) determine the rate of PPB, broken down by severity grading, in one region of the NHSBCSP and (2) describe PPB management and outcomes. <h3>Method</h3> This prospectively collected observational case series identified patients with PPB at 5 Bowel Cancer Screening Centres within the North East Region of the English NHSBCSP from the 06/12/2010 to 15/07/2014. Patient co-morbidity, use of anticoagulation, polyp location, morphology, size, polypectomy method, time to presentation, subsequent patient management and outcome were all recorded. PPB was graded as major, intermediate or minor as per the NHSBCSP grading system. <h3>Results</h3> From a total population of 4,191,507, 15,285 colonoscopies were subsequently performed on 11,564 patients leading to 23,766 polypectomies. 68 colonoscopies with PPB were identified; a PPB rate of 0.44% per colonoscopy and 0.29% per polypectomy. 2.9% of cases were major due to need for surgery or admission to the Intensive Care Unit for &gt; 1 night; median time to presentation was 3.5 days (range 1–6 days), median hospital stay was 3 days (range 2–4 days). 41.2% of cases were intermediate, the majority due to need for repeat endoscopy or in patient admission &gt; 4 nights; median time to presentation was 5 days (range 0–19 days), median hospital stay was 2 days (range 0–6 days). Overall, 8.8% of patients presented with symptoms or signs of haemodynamic compromise. 19.1% of patients required intravascular resuscitation with intravenous fluids and/or Red Blood Cells. Repeat endoscopy was performed in 27.9% with repeat endoscopic therapy in 10.3%. Surgery was performed in 1.47% of cases. 1.47% of patients required a second admission and were managed radiologically. <h3>Conclusion</h3> We believe this detailed, robustly collected and prospectively categorised dataset gives a true reflection of PPB rate among experienced colonoscopists. A PPB rate of 0.44% is therefore excellent when compared with other similar series. 2.9% of PPB cases were major, 41.2% were intermediate and 55.9% were minor; therefore clinically significant bleeding occurred in only 44.1% of cases. <h3>Disclosure of interest</h3> None Declared. <h3>References</h3> Chilton A, Rutter M. NHS BCSP Publ<i>. No </i>6, 2011 Cotton PB, <i>et al</i>. Gastrointest Endosc. 2010;71:446–54
PTU-310 Ibd patient satisfaction survey results
Authors: LJ Rook, ML Rawle, A Phillips
Journal: Gut (2015)

<h3>Introduction</h3> Long term follow up is required for patients with inflammatory bowel disease (IBD). In line with the IBD Standards,<sup>1</sup>an important element of providing a quality service to IBD patients is that mechanisms are in place to ‘obtain and respond to patient feedback’ <h3>Method</h3> A questionnaire was developed asking questions about patients’ opinion on their outpatient care, consultation and access to IBD services, in a ‘tick box’ format. There was also the opportunity to write further comments at the end of the questionnaire. It consisted of 5 sections and was 10 pages long. The questionnaires were handed out to the first 100 patients attending an IBD nurse or doctor appointment at York Hospital over a two week period at the beginning of July 2014. <h3>Results</h3> Of the 100 questionnaires that were handed out, 93 were returned. Only 14 were fully completed. There was an even split between male and females completing it (51.6% female). Just over half the patients (50.5%) had Crohn’s disease, 44.1% stated they had ulcerative or indeterminate colitis, with the rest stating they were not sure. Broadly speaking, patients were happy with the services that they were receiving. Overall, 84 of the 87 patients (97%) who completed section 3 were either ‘very satisfied’ or ‘satisfied’ with the IBD treatment they had received. Patients unanimously considered that staff to be friendly and courteous with the vast majority feeling that they were listened to. Section 3 also asked about their emotional support and understanding they had received; 24% of patients were neutral or dissatisfied. 78 out of 84 patients (93%) were ‘very satisfied’ or ‘satisfied’ with the information they had received about their illness from the IBD team, but just under a half of patients were unsatisfied with their GP’s level of knowledge about their illness. <h3>Conclusion</h3> Patients attending IBD clinics in York Hospital are, broadly speaking, satisfied with the care they receive. Work needs to be done to educate local GPs about IBD and more could be done to provide emotional support to patients. Future questionnaires need to be much shorter and focus on these areas. As yet none of the National IBD audits have evaluated patients’ outpatient experience but with some of the recent changes outlined in the NHS England 5, year plan<sup>2</sup>we need to remain vigilant and ensure our services reflect the changing NHS whilst continuing to meet our patient’s individual needs and safe guarding high quality care. <h3>Disclosure of interest</h3> None Declared. <h3>References</h3> Arnott I, Bloom S, Edwards C, Hawkey C. <i>Standards for the healthcare of people who have Inflammatory Bowel Disease (IBD)</i>. London: Oyster healthcare Communications, 2013 NHS England. <i>Five year forward view</i>. London: NHS England, 2014
2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 2: recommended physical interventions (exercise, taping, bracing, foot orthoses and combined interventions)
Authors: Kay M Crossley, Marienke van Middelkoop, Michael J Callaghan, Natalie J Collins, Michael Skovdal Rathleff, Christian J Barton
Journal: British Journal of Sports Medicine (2016)

Patellofemoral pain affects physically active and sedentary individuals, accounting for 11–17% of knee pain presentations to general practice1 ,2 and 25–40% of all knee problems seen in a sports injury clinic.3 ,4 Patellofemoral pain is characterised by anterior knee pain associated with activities such as squatting, rising from sitting and stair ambulation. While traditionally viewed as self-limiting, increasing research data suggest that patellofemoral pain is often recalcitrant and can persist for many years,5–8 and may cause a decline in sports participation.8 ,9

Despite its high prevalence among active individuals9–12 and frequent presentations for treatment, there are few published guidelines to help clinicians choose the appropriate evidence-based treatment for patellofemoral pain. The most recent and relevant paper from Barton and colleagues13 combined systematic review findings with qualitative interviews from expert clinicians to provide a clinically relevant synthesis, covering the literature up to September 2013. At the International Patellofemoral Pain Research Retreat in Manchester 2015, we held a consensus meeting to update the current evidence base and produce consensus-based recommendations regarding treatment for patellofemoral pain. All retreat registrants were active researchers in patellofemoral pain and presented their research findings. Many of the world leading researchers (eg, 8 out of the top 10 researchers with the highest number of publications, when the term ‘patellofemoral pain’ was searched in Scopus, February 2016) were in attendance and contributed to the consensus meeting.

The consensus meeting during the retreat resulted in recommendations, based on evidence published between January 2010 and June 2015. These recommendations should be combined with information gathered from individual patients, regarding their preferences, experiences, presentation and values, along with the values, expertise and skills of individual practitioners to create a patient-centred treatment approach.

### Literature review

CJB searched EMBASE, MEDLINE, CINAHL and Current Contents for systematic reviews …
Malaria incidence and mortality in Italy in 1999-2000
Authors: R Romi, D Boccolini, G Majori
Journal: Eurosurveillance (2001)

In 1999-2000, a total of 2060 malaria cases were reported by the ISS. Most of the patients took inappropriate treatments or did not have any prophylaxis. Ninety-three per cent became infected in African malarious countries, 4% in Asian countries, and 3% in Latin America. P. falciparum accounted for 84% of the cases, followed by P. vivax (8%), P. ovale (5%), and P. malariae (2%). Deaths corresponded to an annual case fatality rate of 0.3% in 1999 and 0.5% in 2000. In general, imported malaria cases reflect the number of Italian travellers who underestimate the infection risk in Asian and Latin American malarious countries and permanent residents of African origin who visit their relatives in their native countries.
AB0671 Vitamine D Serum Level Correlates with Quadriceps Muscle Strength in Inflammatory Myositis
Authors: A. Meyer, G. Laverny, R.-M. Javier, J.-E. Gottenberg, B. Geny, J. Sibilia
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Vitamin D has been involved in both inflammation and muscle strength. Inflammatory myopathies are characterized by muscle inflammation and weakness. <h3>Objectives</h3> We assessed whether vitamin D serum level is linked to muscle strength during inflammatory myopathies. <h3>Methods</h3> Fourteen consecutive patients with inflammatory myopathies (with the exclusion of inclusion boy myositis) were prospectively included. Muscle strength was recorded on dominant quadriceps using hand held dynamometer. 25-OH-vitamin D3 level was measured on a blood sample at the same time. <h3>Results</h3> <i>Characteristic of the patients:</i> 9 women and 5 men with a median age of 53.5 (13-71) were included. Duration of mysoitis at the time of muscle strength was 29 months (3-68). 11 patients were treated at the time of quadriceps strength measurements (corticosteroids n=11, methotrexate n=9, mycophenolate mofetil n=2, intraveinous immunoglobulin n=5). <i>Vitamine D levels and quadriceps muscle strength:</i> Median 25-OH-vitamine D3 level was 17.80μg/L (10.2-38.3) and median quadriceps strength (expressed as the percentage of the mean value recorded in healthy volunteers of the same age and sex) was 65% (14-107). 25-OH-vitamine D3 correlated with quadriceps muscle strength (figure: Spearman R =0.68, 95%CI: 0.22-0.89, p&lt;0.01). <h3>Conclusions</h3> Our data suggests that vitamin D is involved in muscle strength during inflammatory myopathies. 25-OH-vitamin D3 might be monitored in these patients not only with the aim of protecting bone during corticosteroids treatments but also with the objective of improving muscle strength. <h3>Disclosure of Interest</h3> None declared
Epilepsy, Psychiatry
Authors: J ROUBICEK
Journal: JAMA (2001)

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
Soundings: Emerging infections
Authors: Imre Loefler
Journal: BMJ (2006)

Perhaps there are still a few species of rats and mice more numerous than man, but there are certainly more humans than any other large mammals. If the propagation of one's species is a measure of evolutionary success, Homo sapiens is undoubtedly successful.

As space and energy are limited, the proliferation of one species is always at the expense of others. Not only have humans and their domestic stock displaced wildlife, their need for food and shelter is to blame for the disappearance of forests.

The large scale environmental dislocations in the tropics over the past 100 years have triggered a new wave of extinctions and new evolutionary processes: threatened by the disappearance of their traditional hosts, microorganisms ranging from viruses to protozoans have responded to the evolutionary pressure by leaping over host species boundaries to accumulate in humans and their domestic animals.

The simian immune deficiency virus mutated to become HIV and has, in the process, acquired a larger and more promising niche; once limited to the tropical forests of Africa and transported slowly from tree to tree, now it travels from continent to continent by jet. When HIV begins to weaken the immune competence of the host, that host will serve as a training ground for microorganisms hitherto limited to animal or plants hosts to adapt themselves to humans and, at the same time, allow various human pathogens to gain virulence.

Ebola, Lassa, Marburg, SARS (severe acute respiratory syndrome), and other viruses have tried to follow HIV, but their success has so far been limited, for they are too quickly lethal to establish themselves.

Not so influenza; originating in now decimated wild bird species, it has learnt to use poultry and pigs as agents of amplification before it attacks humans.

The killing of civets, pigs, poultry, cattle, and bats, and the attempted eradication of numerous species presumed to be vectors is a predictable, if crude and largely ineffective response.

The conquest of nature is human destiny. As Marx recognised, the world is continuously transformed by human activity—there is no pristine nature. What we are learning now is that however much we manipulate nature, the laws of ecology are universal and supreme.
SP0111 Calcinosis, Lipodystrophy and Other Pediatric Features
Authors: B.M. Feldman
Journal: Annals of the Rheumatic Diseases (2015)

Patients with juvenile idiopathic inflammatory arthritis (JIIM) usually have the dermatomyositis phenotype (JDM). As such, children present much like adults with dermatomyositis with some notable differences. This talk will focus on similarities and differences between adult and childhood dermatomyositis, with a special focus on the absence of malignancy as an etiological factor, as well as the course, prognosis, autoantibodies, and clinical features of JDM such as lipodystrophy and calcinosis. <h3>Disclosure of Interest</h3> None declared
AB0144 The Distinct and Overlapping Functions of Hypoxia Inducible Factors in the Adaption Process of Human Microvascular Endothelial Cells to Hypoxia
Authors: P. Kunath, M. Hahne, M. Mursell, C. Strehl, G.-R. Burmester, F. Buttgereit, T. Gaber
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> During the Pathogenesis of rheumatoid arthritis (RA), the chronic inflammatory process in the arthritic joint leads to degradation of articular cartilage and subchondral bone. Local hypoxic regions result from massive infiltration and proliferation of immune cells, leading to angiogenesis which facilitates cell survival and progressive chronicity. A key regulator of the hypoxia induced cell adaption processes is the transcription factor HIF (hypoxia-inducible factor). HIF consists of a β-subunit, which needs to heterodimerize with the oxygen sensitive HIF-1α or HIF-2α subunit in order to be transcriptionally active. <h3>Objectives</h3> However, the distinct functions of HIF-1α and HIF-2α in the hypoxia induced endothelial cell adaption processes are unknown. <h3>Methods</h3> For this purpose we investigated the adaption of Human Microvascular Endothelial Cell (HMEC)-1 to hypoxic conditions by angiogenesis and the bioenergetic switch to glycolysis with regard to 2D angiogenesis, ATP/ADP-ratio gene and protein expression. We further established specific knockdown cells for HIF-1α, HIF-2α, and the HIF-1α/HIF-2α in order to identify distinct functions of both transcription factors. <h3>Results</h3> We showed that HMEC-1 cells are suitable for our study aim and that HIF-1α and HIF-2α knockdown resulted in impaired angiogenesis. Transcriptome analysis and evaluation of pro-angiogenic factors indicated major impact on angiogenesis by HIF-2α. Overlapping functions of both transcription factors were found regarding bioenergetics adaption with priority for HIF-1α. However, a respectful amount of solely regulated HIF-1α genes were identified and indicate a distinct function of HIF-1α in the bioenergetic adaption process. Data were supported by the results of HIF-1α/HIF-2α combined knockdown. <h3>Conclusions</h3> Our results indicate distinct functions of HIF-1α and HIF-2α and demonstrate a major impact of HIF-2α on angiogenesis. This is of high interest regarding intervention of the chronicity of the inflammatory process in RA and opens new possibilities for therapeutic approaches by targeting the specific hypoxia induced transcription factors. <h3>Disclosure of Interest</h3> None declared
Preventing Adverse Events
Authors: Rueben Granich
Journal: Annals of Internal Medicine (1995)

Letters15 June 1995Preventing Adverse EventsRueben Granich and Amerish BeraRueben GranichSearch for more papers by this author and Amerish BeraSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-122-12-199506150-00023 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The study of adverse events by Petersen and colleagues [1] raises some important issues. The authors conclude that the care of patients by cross-covering housestaff increases the likelihood of preventable adverse events. Few adverse events occurred, however, when patients were covered by an experienced night float resident. Thus, factors other than discontinuity of care were clearly responsible for negative events. Intern mistakes during cross-coverage may have been related to fatigue, excessive patient load, inexperience, or a lack of adequate “sign out” by coresidents. Fatigued residents make an excessive number of errors [2, 3]. Thirty percent of interns ...References1. Petersen LA, Brennan TA, O'Neill AC, Cook EF, Lee TH. Does housestaff discontinuity of care increase the risk for preventable adverse events? Ann Intern Med. 1994; 121:866-72. Google Scholar2. Friedman RC, Bigger JT, Kornfeld DS. The intern and sleep loss. N Engl J Med. 1971; 285:201-3. Google Scholar3. Hart RP, Buchsbaum DG, Wade JB, Hamer RM, Kwentus JA. Effect of sleep deprivation on first-year residents' response times, memory, and mood. J Med Educ. 1987; 62:940-2. Google Scholar4. Valko, RJ, Clayton PJ. Depression in the internship. Dis Nervous System. 1975; 36:26-9. Google Scholar Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 June 1995Volume 122, Issue 12Page: 962-964KeywordsAdverse eventsComputersFatigueHealth care qualityPatients ePublished: 15 August 2000 Issue Published: 15 June 1995 Copyright & PermissionsCopyright © 1995 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...