tbuckley/cabot-search huggingface dataset:
Centrally Assisted Collaborative Telecare for Posttraumatic Stress Disorder and Depression Among Military Personnel Attending Primary Care
Authors: Charles C. Engel, Lisa H. Jaycox, Michael C. Freed, Robert M. Bray, Donald Brambilla, Douglas Zatzick, Brett Litz, Terri Tanielian, Laura A. Novak, Marian E. Lane, Bradley E. Belsher, Kristine L. Rae Olmsted, Daniel P. Evatt, Russ Vandermaas-Peeler, Jürgen Unützer, Wayne J. Katon
Journal: JAMA Internal Medicine (2016)

It is often difficult for members of the US military to access high-quality care for posttraumatic stress disorder (PTSD) and depression.To determine effectiveness of a centrally assisted collaborative telecare (CACT) intervention for PTSD and depression in military primary care.The STEPS-UP study (Stepped Enhancement of PTSD Services Using Primary Care) is a randomized trial comparing CACT with usual integrated mental health care for PTSD or depression. Patients, mostly men in their 20s, were enrolled from 18 primary care clinics at 6 military installations from February 2012 to August 2013 with 12-month follow-up completed in October 2014.Randomization was to CACT (n = 332) or usual care (n = 334). The CACT patients received 12 months of stepped psychosocial and pharmacologic treatment with nurse telecare management of caseloads, symptoms, and treatment.Primary outcomes were severity scores on the PTSD Diagnostic Scale (PDS; scored 0-51) and Symptom Checklist depression items (SCL-20; scored 0-4). Secondary outcomes were somatic symptoms, pain severity, health-related function, and mental health service use.Of 666 patients, 81% were male and the mean (SD) age was 31.1 (7.7) years. The CACT and usual care patients had similar baseline mean (SD) PDS PTSD (29.4 [9.4] vs 28.9 [8.9]) and SCL-20 depression (2.1 [0.6] vs 2.0 [0.7]) scores. Compared with usual care, CACT patients reported significantly greater mean (SE) 12-month decrease in PDS PTSD scores (-6.07 [0.68] vs -3.54 [0.72]) and SCL-20 depression scores -0.56 [0.05] vs -0.31 [0.05]). In the CACT group, significantly more participants had 50% improvement at 12 months compared with usual care for both PTSD (73 [25%] vs 49 [17%]; relative risk, 1.6 [95% CI, 1.1-2.4]) and depression (86 [30%] vs 59 [21%]; relative risk, 1.7 [95% CI, 1.1-2.4]), with a number needed to treat for a 50% improvement of 12.5 (95% CI, 6.9-71.9) and 11.1 (95% CI, 6.2-50.5), respectively. The CACT patients had significant improvements in somatic symptoms (difference between mean 12-month Patient Health Questionnaire 15 changes, -1.37 [95% CI, -2.26 to -0.47]) and mental health-related functioning (difference between mean 12-month Short Form-12 Mental Component Summary changes, 3.17 [95% CI, 0.91 to 5.42]), as well as increases in telephone health contacts and appropriate medication use.Central assistance for collaborative telecare with stepped psychosocial management modestly improved outcomes of PTSD and depression among military personnel attending primary care.clinicaltrials.gov Identifier: NCT01492348.
Leprosy and its Problems
Authors: J. B. Davey
Journal: BMJ (1947)

welcomed by those able to afford it, but with present living conditions I do not think much of it has been peeled or washed before consumption.Many of these fruits were picked and packed in countries where the British population would not dream of eating them without previous washing in a weak solution of some oxidizing agent.It-is known that the virus of poliomyelitis is easily destroyed by oxidizing agents (Jos.Stokes, jun., in 'Textbook of Pediatrics (edit.W. E. Nelson), Philadelphia, 1946, p. 479).I feel that a more vigorous campaign among the public, in- cluding those serving meals and uncooked food, for more care in handling and in washing up all utensils is called for urgently.-I am, etc., Winchester.MYRTLE M. HUTCHINS.SIR,-In an article on acute poliomyelitis by Dr. W. H. Kelleher (Aug.23, p. 291) the opinion of American observers is quoted that "perhaps 98% of poliomyelitis is a mild, wide- spread, highly communicable disease, mainly of young children, leaving no residual paralysis . .." Tis opinion is valid for the present outbreak of the disease in this country, and the presence of the specific virus is not the only factor necessary for producing the disease in a clinically recognizable form.It is very important to discover what it is that has been added to the virus in 2% of people to produce serious disease of the nervous system.To solve this problem a study of clinical and environmental factors must be made of the patients and their, known contacts, using the knowledge of the virus as an indi- cator of the people at risk.Recent outbreaks of smallpox4 enteric fever, and of other acute diseases, as well as chronic infections such as tuberculosis and chronic pyogenic disease, show how large is the unknown factor in the equation: specific organism plus x equals disease.A revival of epidemiology is needed, with knowledge of bacteria and viruses as an aid instead of the insufficient substitute which it has been for many years.Clinicians must take a bold part in this revival.-I am, etc.,
PWE-215 An isolated abnormal chromogranin B is associated with pancreato-duodenal nets and the presence of liver metastases
Authors: R Basuroy, R Sherwood, R Srirajaskanthan, J Ramage
Journal: Gut (2015)

<h3>Introduction</h3> Chromogranin B (CgB) is a soluble secretory protein like chromogranin A (CgA) that has been reported to be elevated in patients with neuroendocrine tumours (NETs) but is not routinely assessed. This study explores whether an abnormal CgB paired with a normal CgA provides any useful clinical information in NET patients. <h3>Method</h3> A prospective NET database (01/2007–11/2014) was interrogated for paired radioimmunoassay CgA (two assays; normal &lt;6 nmol/L and 60 pmol/L) and CgB (two assays, normal &lt;3 nmol/L, &lt;150 pmol/L) results. <h3>Results</h3> 1161 paired CgA and CgB results (479 patients) were retrieved. 51 patients had an isolated abnormal paired CgB (79 results; mean CgB result=2.68xULN); 2 patients were excluded as coding error. Primary sites were 24 pancreas, 9 small bowel, 4 rectal, 3 duodenal, 3 unknown, 2 duodenal-jejunal, 2 pre-sacral, 1 caecal and 1 lung. In 8/9 small bowel NETs, the CgB was raised in isolation on only one occasion on longitudinal testing. The tumour grades were 24 G1, 18 G2, 4 G3 and 3 unknown. Liver metastases were present in 38/49 patients. <h3>Conclusion</h3> An isolated abnormal paired CgB was observed in 11% of NET patients. In 59% of patients it was associated with a pancreatic or duodenal primary NET. In 78% liver metastases were present. Further assessment is required to establish the role of CgB when paired with CgA as a biomarker of clinical utility in the diagnosis, prognosis and therapeutic monitoring of NETs. <h3>Disclosure of interest</h3> None Declared.
Results of a Europe-wide investigation to assess the presence of a new variant of Chlamydia trachomatis
Authors: E J Savage, C Ison, M JW Van de Laar
Journal: Eurosurveillance (2007)

In 2006, a new variant of Chlamydia trachomatis was reported in Sweden. Three countries – Ireland, Norway, and Denmark – have detected the variant to date, but very few cases in total have occurred. The European network for STI surveillance (ESSTI) and the European Centre for Disease Prevention and Control (ECDC) assessed the potential spread of the variant in other European countries, and concluded that there is currently no evidence that the variant has spread widely across Europe. However, the variant strain has been reported in between 10% and 65% of infected patients in Sweden. It is too early to tell whether the variant will remain confined to Sweden or whether the number of cases will significantly increase. Enhanced surveillance will need to be continued to address these concerns.
Organ preservation in bladder carcinoma: a matter of selection.
Authors: C J Logothetis
Journal: Journal of Clinical Oncology (1991)

Article Tools Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.1991.9.9.1525 Journal of Clinical Oncology - published online before print September 22, 2016 PMID: 1875215 Organ preservation in bladder carcinoma: a matter of selection. C J LogothetisxC J LogothetisSearch for articles by this author https://doi.org/10.1200/JCO.1991.9.9.1525 PDF "Organ preservation in bladder carcinoma: a matter of selection.." Journal of Clinical Oncology, 9(9), pp. 1525–1526© 1991 by American Society of Clinical Oncology
THU0435 Treatment Persistence with Subcutaneous Biologic Therapies in Patients with Psoriatic Arthritis (PSA)
Authors: R. Lyu, Q. Ding, M. Govoni, C. Makin, J. Korn, T. Fan, A. Ogbonnaya, C.M. Black, S. Kachroo
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> The treatment landscape of psoriatic arthritis has evolved in recent years, with the introduction of subcutaneous TNF-alpha blockers in the EU. These changes in the treatment landscape could affect how patients are managed with psoriatic arthritis. <h3>Objectives</h3> The objective of this study was to describe persistence with subcutaneous biologic over 12 months for newly treated PsA patients and evaluate the impact of prior DMARD use <h3>Methods</h3> This was a retrospective analysis using IMS Disease Analyzer-Germany, an electronic medical records database. Adult (≥18 years of age) PsA patients who initiated therapy with subcutaneous biologics between January 1, 2009 and June 30, 2012 were included in the analysis. The first subcutaneous biologic prescription date served as their index date. Continuous observation of at least 12 months pre- and post-index date was required. Patients who were prescribed any biologic during the pre-index period or diagnosed with rheumatoid arthritis, ankylosing spondylitis, Crohn9s disease, or ulcerative colitis during the study period were excluded from the study population. A chi-square test was used to measure differences between patients with and without use of pre-index DMARD. A multivariate logistic regression was created to assess the impact of DMARD use on persistence, controlling for baseline characteristics <h3>Results</h3> A total of 197 biologic-naïve PsA patients were selected. Of these, 89 were free of PsO. The mean (SD) age of the patients was 49 (11) years, with 50% being female. The majority of patients (61%) indexed on adalimumab, while the remainder indexed on etanercept (35%) and golimumab (4%). In the overall PsA population, the persistence rate with the index subcutaneous biologic was 54.3%, with similar results among those with and without DMARD uses (53% vs 56%, respectively). Multivariate analysis did not identify any significant predictors for persistence, including DMARD use (OR: 1.05; 95% CI: 0.53-2.07) and psoriasis (OR: 1.07; 95% CI: 0.56- 2.03 <h3>Conclusions</h3> More than half of the PsA patients were persistent with the index subcutaneous biologic over a 12-month period with similar persistence rates observed among those with and without psoriasis and DMARD use <h3>Disclosure of Interest</h3> R. Lyu Employee of: Merck, Q. Ding Employee of: Merck, M. Govoni Employee of: Merck, C. Makin: None declared, J. Korn: None declared, T. Fan Employee of: Merck, A. Ogbonnaya: None declared, C. Black Employee of: Merck, S. Kachroo Employee of: Merck
Post-vaccine measles in a child with concomitant influenza, Sicily, Italy, March 2015
Authors: F Tramuto, P Dones, C D’Angelo, N Casuccio, F Vitale
Journal: Eurosurveillance (2015)

We describe the occurrence of measles in an 18 month-old patient in Sicily, Italy, in March 2015, who received the first dose of a measles-containing vaccine seven days before onset of prodromal symptoms. Measles virus infection was confirmed by PCR and detection of specific immunoglobulin; viral genotyping permitted the confirmation of a vaccine-associated illness. The patient had a concurrent influenza virus infection, during a seasonal epidemic outbreak of influenza.
SAT0217 Long Term Effects of Glucocorticoid Therapy on Radiological Progression of Joint Damage in Rheumatoid Arthritis: An Individual Patient Meta-Analysis: Table 1
Authors: M.C. van der Goes, J.W. Jacobs, M. Boers, J.R. Kirwan, I. Hafström, B. Svensson, J.W. Bijlsma
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Objectives</h3> To determine the long term effects of initial glucocorticoid therapy on joint damage in patients with early rheumatoid arthritis (RA). <h3>Methods</h3> Randomised controlled trials assessing the efficacy of glucocorticoid treatment during one or two years in RA including follow up measurements after the original study duration were identified. Lead authors of these studies were invited to provide data on patient characteristics, disease activity, co treatment, and (erosive) joint damage. A comprehensive dataset with individual patient data was created and used for analyses, and data up to five years after the start of trials was analysed. <h3>Results</h3> Original study data and follow up measurements after the trial duration were shared by authors from five studies. Of the 838 patients entering these studies, 413 had been allocated to a treatment strategy including glucocorticoids. In total, 79% percent of the patients had at least one follow up radiograph scored between 3 and 5 years follow up after start of the original trial. Radiological progression over five years was significantly lower in glucocorticoid users (p=0.001). When analysing exclusively the time period after trials, initial glucocorticoid users and controls showed similar radiological progression rates. <h3>Conclusions</h3> Addition of glucocorticoid therapy to treatment in early RA is effective in decreasing radiological damage. This beneficial effect can still be identified after five years of follow up, mainly reflecting the initially obtained advantage. <h3>Disclosure of Interest</h3> None declared
Counterpoint: The Argument for Combination Chemotherapy in the Treatment of Metastatic Breast Cancer
Authors: Mary Cianfrocca, William J. Gradishar
Journal: Journal of the National Comprehensive Cancer Network (2007)

The question of combination versus single-agent chemotherapy in the setting of metastatic breast cancer (MBC) is an often-debated issue. Many single agents have activity in this setting and the potential for significant synergism between chemotherapy agents has led to many combination chemotherapy trials. This article defends the position that combination chemotherapy is the optimal approach for patients with MBC.
Vital Signs: Deficiencies in Environmental Control Identified in Outbreaks of Legionnaires’ Disease — North America, 2000–2014
Authors: Laurel E. Garrison, Jasen M. Kunz, Laura A. Cooley, Matthew R. Moore, Claressa Lucas, Stephanie Schrag, John Sarisky, Cynthia G. Whitney
Journal: MMWR Morbidity and Mortality Weekly Report (2016)

The number of reported cases of Legionnaires' disease, a severe pneumonia caused by the bacterium Legionella, is increasing in the United States. During 2000-2014, the rate of reported legionellosis cases increased from 0.42 to 1.62 per 100,000 persons; 4% of reported cases were outbreak-associated. Legionella is transmitted through aerosolization of contaminated water. A new industry standard for prevention of Legionella growth and transmission in water systems in buildings was published in 2015. CDC investigated outbreaks of Legionnaires' disease to identify gaps in building water system maintenance and guide prevention efforts.Information from summaries of CDC Legionnaires' disease outbreak investigations during 2000-2014 was systematically abstracted, and water system maintenance deficiencies from land-based investigations were categorized as process failures, human errors, equipment failures, or unmanaged external changes.During 2000-2014, CDC participated in 38 field investigations of Legionnaires' disease. Among 27 land-based outbreaks, the median number of cases was 10 (range = 3-82) and median outbreak case fatality rate was 7% (range = 0%-80%). Sufficient information to evaluate maintenance deficiencies was available for 23 (85%) investigations. Of these, all had at least one deficiency; 11 (48%) had deficiencies in ≥2 categories. Fifteen cases (65%) were linked to process failures, 12 (52%) to human errors, eight (35%) to equipment failures, and eight (35%) to unmanaged external changes.Multiple common preventable maintenance deficiencies were identified in association with disease outbreaks, highlighting the importance of comprehensive water management programs for water systems in buildings. Properly implemented programs, as described in the new industry standard, could reduce Legionella growth and transmission, preventing Legionnaires' disease outbreaks and reducing disease.
SAT0314 Impact of Urate-Lowering Therapy in the Risk of Acute Inflammation Episodes During Hospital Admissions in Patients with Gout: Table 1
Authors: F. Perez-Ruiz, S.P. Chinchilla, I. Urionagüena
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> An increased risk (OR 4.1, 95% CI 1.8-9.2) of acute inflammation episodes during hospital admission in patients with gout, has been reported in an online survey (1). Less than half of the patients were on urate lowering therapy (ULT); in those treated the levels of uricaemia and adequacy of the treatment are unknown. The authors9 advice was to administer preventive treatment during admissions. <h3>Objectives</h3> To evaluate the time-associated impact of ULT, in gout patients with and without hospital admissions. <h3>Methods</h3> Case-control study within a nested cohort of patients with prospective follow-up, during 6 months (June-December 2014). The appearance of at least one inflammation episode during admission was analyzed. The ratio of inflammation episodes in patients with and without hospital admissions was compared; as well as treatment, basal data prior to treatment and during follow-ups, and uricaemia prior to the inflammation episode during admission. <h3>Results</h3> 274 patients, all of them with ULT (91.6% men, age 61±13 years, basal serum urate levels 9.1±1.4 mg/dL, time of disease evolution 7.7±8.1 years, 37% with tophi, 40% with poliarticular distribution). Twenty-eight patients (10.2%, 20.4/100 patient/years) had an admission and ten an episode of arthritis: 2 of them due to calcium pyrophosphate, 8 due to monosodium urate. The admitted patients were elder, compared to the not admitted (67.0±10 vs 61±13, p=0.03), but showed similarity in the rest of the data. Amongst the admitted patients, no statistically significant differences were observed between those with gout and those asymptomatic, regarding age (71±7 vs 64±10), serum urate basal levels (9.0±1.1 vs 9.2±1.0), or previous to the episode (5.2±1.7 vs 5.1±1.1), the rate of uricaemia in therapeutic level &lt;6mg/dL (75% vs 89%, p=0.32), presence of tophi, poliarticular distribution or episodes during the year prior to treatment.The analysis per year of follow-up showed that 7/8 episodes were observed during the first two years and no episodes after 3 or more years of treatment (rates, ORs &amp; CI limits are shown in the table). <h3>Conclusions</h3> There is a clear tendency for risk reduction of acute inflammation episodes during hospital admission, in patients treated with ULT who have an acceptable uricaemia control and within therapeutic levels. The risk of suffering an acute inflammation episode is similar to that previously reported; nonetheless, the risk is striking only during the first year of treatment, plausible during the second, but not observed afterwards. <h3>References</h3> Dubreuil M, et al. Am J Med 2013;126:1138-1141. <h3>Disclosure of Interest</h3> F. Perez-Ruiz Consultant for: AstraZeneca, Menarini, Pfizer, Speakers bureau: AstraZeneca, Menarini, S. Chinchilla: None declared, I. Urionagüena: None declared
Antiproliferative Activity of Liposome-Encapsulated Transforming Growth Factor-β against MDA-MB-435 Human Breast Carcinoma Cells
Authors: Dominic Fan, Janet Price, Hans Schackert, Christopher Seid, Christoph Wilmanns, Subhas Chakrabarty, Isaiah J. Fidler
Journal: Cancer Communications (1989)

We determined whether transforming growth factor-beta (TGF-beta) could be encapsulated in phospholipid liposomes and then would mediate antiproliferative activity against the sensitive, human breast cancer cell line, MDA-MB-435. TGF-beta was encapsulated in multilamellar liposomes consisting of phosphatidylcholine (PC) or PC and phosphatidylserine (PS) at a 7:3 molar ratio. It was captured in both the aqueous phase and the bilayer lipid (hydrophilic and lipophilic association) and was stable for at least 24 hr of incubation at 37 degrees C in medium that contained 5% fetal bovine serum. In calcium- and magnesium-free Hanks' balanced salt solution, TGF-beta in the internal aqueous compartment was stable for at least five days, even in the presence of trypsin and ethylenediamine tetraacetic acid. TGF-beta (type 1 or 2) in liposomes was active as free-form TGF-beta in mediation of antiproliferative effects. The lipophilic nature of TGF-beta, which resulted in a high capture ratio in liposomes, coupled with exceptional stability, suggested that liposomes could be a carrier for the in vivo use of TGF-beta.