tbuckley/cabot-search huggingface dataset:
Does menopausal transition really influence mental health? Findings from the prospective long‐term <scp>Z</scp>urich study
Authors: Wulf Rössler, Vladeta Ajdacic‐Gross, Anita Riecher‐Rössler, Jules Angst, Michael P. Hengartner
Journal: World Psychiatry (2016)

In the prospective long‐term Zurich study, we re‐examined the hypothesized association between mental health problems in women and the transition through menopausal stages. One hundred sixty‐eight women from a population‐based Swiss community cohort were prospectively followed up from age 21 to 50. At age 50, the occurrence of hot flushes/night sweats and sleep disturbances was significantly more frequent in peri‐ and post‐menopausal women. Irritability/nervousness was increased only in peri‐menopausal women, but that association was accounted for by neuroticism trait scores at age 30. Transitions to peri‐ or post‐menopause were not related to changes in either the prevalence rates of DSM major depressive episode or anxiety disorders, or the course of psychopathological syndromes as assessed by the Symptom Checklist 90 ‐ Revised. The null associations held when adjusting for duration of reproductive period or age at menopause. Preceding mental health problems between ages 21 and 41, increased neuroticism trait scores at age 30, and concurrent psychosocial distress were significantly related to mental health problems occurring between ages 41 and 50. Depending upon the cut‐off point that was chosen, the arbitrary dichotomization of a continuous depression outcome produced spurious associations with the menopausal transition. We conclude that mental health problems between ages 41 and 50 are probably not directly related to the menopausal transition, and that previously reported associations could be false positives due to inadequate dichotomizations, reporting bias, undisclosed multiple adjustments or overfitting.
PTH-186 Accuracy of standard 7.5–10 mhz endoscopic ultrasound for loco-regional staging of oesophageal malignancy – a retrospective analysis: Abstract PTH-186 Table 1
Authors: S Nayeemuddin, V Mahesh, S Murugesan
Journal: Gut (2015)

<h3>Introduction</h3> Systematic reviews have reported wide variations in locoregional – ‘T’ and ‘N’ staging – accuracy of EUS<sup>1</sup>for oesophageal cancer. This is attributed to multiple factors including the frequency of the echoendoscope (5–20 MHz), operator technique, non-traversibility of tumour and use of miniprobes. <h3>Method</h3> Retrospective review of oesophageal cancer cases registered in the local upper GI cancer database and Somerset Cancer registry for the Lancashire and South Cumbria cancer network (January 2008–December 2013). Staging EUS was performed at a single centre (Blackpool Teaching Hospitals) by four operators using Olympus prosound alpha 5 radial (13.8 mm outer diameter) and linear (14.6 mm outer diameter) echoendoscopes. Demographic, endoscopic and histopathological data were analysed and EUS staging was compared with final histopathological (p) staging of tumours. <h3>Results</h3> 405 patients with oesophageal cancer identifed, 141 had EUS staging. 47 [39 male, mean age 70 (age range 45–85)] had final pathological staging available – surgical resection in 42 (89%) and endoscopic mucosal resection (EMR) in 5 (11%). The remaining 94 patients were unfit for resection or had palliative treatment only. Final ‘p’ staging confirmed adenocarcinoma in 38 (81%), sqaumous cell carcinoma in 7 (15%) and poorly differentiated in 2 patients (4%). 30 (64%) patients had neoadjuvant chemotherapy. 10 patients (21%) had endoscopically non-traversible tumours. Overall sensitivity and diagnostic accuracy of EUS for ‘T’ staging was 87% and 70% respectively, which falls to 67% and 49% respectively following neoadjuvant chemotherapy. Overall sensitivity and diagnostic accuracy of EUS for ‘N’ staging was 61% and 49% respectively, which falls to 40% and 38% respectively following neoadjuvant chemotherapy. None of the patients had FNA of local lymph nodes. <h3>Conclusion</h3> These results confirm that EUS has an acceptable overall accuracy for locoregional staging. Accuracy for T4 is diminished, often due to non-traversable tumours (no dilatation pre-EUS or use of mini-probes). Overall accuracy of ‘N’ staging is less than that of published literature as routine FNA of suspicious nodes were not performed. Limitations of study include time lag (mean 16.4 weeks) between EUS and resection and neo-adjuvant chemotherapy down staging of tumours. <h3>Disclosure of interest</h3> None Declared. <h3>Reference</h3> Puli SR, Reddy JBK, Bechtold ML, Antillon D, Ibdah JA, Antillon MR. Staging accuracy of esophageal cancer by endoscopic ultrasound: A meta-analysis and systematic review. World J Gastroenterol. 2008;14(10):1479–1490
Diagnostic decision making in psychiatry
Authors: D A Zarin, F Earls
Journal: American Journal of Psychiatry (1993)

The purpose of this article is to examine the consequences of and possible responses to uncertainty in psychiatric diagnosis. Uncertainty is inevitable because of the overlap in characteristics, or test results, between populations with and without a psychiatric disorder. As a result, there is never one correct method of identifying cases and noncases (i.e., case definition). In this paper principles of decision analysis and clinical epidemiology are used to develop a framework for thinking about the consequences of different diagnostic schema and for choosing among them. The framework illustrated here involves choosing an external validator, choosing a separator, and choosing a cutoff. This framework is applied to the problems facing three hypothetical researchers, and the consequences for their research of different diagnostic choices are explored. It is demonstrated how the relevance of research to clinicians and policy makers rests on the choice of the case definition process. The prevalent use of structured psychiatric interviews has not been accompanied by adequate attention to the problem of determining a diagnosis once the information is obtained. It is argued that more attention must be given to this process if we are to make optimal use of available resources for research and treatment.
High frequency of cross-reacting antibodies against 2009 pandemic influenza A(H1N1) virus among the elderly in Finland
Authors: N Ikonen, M Strengell, L Kinnunen, P Österlund, J Pirhonen, M Broman, I Davidkin, T Ziegler, I Julkunen
Journal: Eurosurveillance (2010)

Since May 2009, the pandemic influenza A(H1N1) virus has been spreading throughout the world. Epidemiological data indicate that the elderly are underrepresented among the ill individuals. Approximately 1,000 serum specimens collected in Finland in 2004 and 2005 from individuals born between 1909 and 2005, were analysed by haemagglutination-inhibition test for the presence of antibodies against the 2009 pandemic influenza A(H1N1) and recently circulating seasonal influenza A viruses. Ninety-six per cent of individuals born between 1909 and 1919 had antibodies against the 2009 pandemic influenza virus, while in age groups born between 1920 and 1944, the prevalence varied from 77% to 14%. Most individuals born after 1944 lacked antibodies to the pandemic virus. In sequence comparisons the haemagglutinin (HA) gene of the 2009 pandemic influenza A(H1N1) virus was closely related to that of the Spanish influenza and 1976 swine influenza viruses. Based on the three-dimensional structure of the HA molecule, the antigenic epitopes of the pandemic virus HA are more closely related to those of the Spanish influenza HA than to those of recent seasonal influenza A(H1N1) viruses. Among the elderly, cross-reactive antibodies against the 2009 pandemic influenza virus, which likely originate from infections caused by the Spanish influenza virus and its immediate descendants, may provide protective immunity against the present pandemic virus.
Outbreak of listerosis due to imported cooked ham, Switzerland 2011
Authors: H Hächler, G Marti, P Giannini, A Lehner, M Jost, J Beck, F Weiss, B Bally, M Jermini, R Stephan, A Baumgartner
Journal: Eurosurveillance (2013)

From 24 April to 31 July 2011, nine cases of listeriosis were registered in the cantons of Aargau, Basel-Land and Zurich, Switzerland. In six of the cases, infection with Listeria monocytogenes was laboratory confirmed, while three remained suspected cases. The suspected cases were family members of confirmed cases with identical or similar symptoms. All confirmed cases were infected with a L. monocytogenes strain belonging to serovar 1/2a: all had an indistinguishable pulsotype by pulsed-field gel electrophoresis (PFGE). The same strain was detected in samples of cooked ham that were on sale from a particular retailer. Two samples of ham tested contained 470 and 4,800 colony-forming units (CFU) L. monocytogenes per gram respectively. Data of shopper cards from two confirmed cases could be evaluated: both cases had purchased the contaminated ham. The outbreak initiated a product recall and alert actions at national and European level, through the Rapid Alert System for Food and Feed (RASFF). Following the RASFF alert, the company producing the contaminated ham was inspected by the responsible authorities. Their investigations showed that the ham was not contaminated in the production plant, but in the premises of a company to which slicing and packing was outsourced.
Website of the week: Error in medicine
Authors: Douglas Carnall
Journal: BMJ (2000)

The consensus this week is that medicine lags behind other industries that are safety critical. The principal remedy will be to change from a culture of blame to a learning culture, in which the focus of inquiry shifts from the individual to the system in which errors were made. In other words, make the system work, and the individuals will take care of themselves.

Computer programmers make errors too, and the systems that programmers use to deal with them are interesting because the tools that they use today will be ours tomorrow. In the open source model of development (www.opensource.org) databases of software bugs are maintained on the internet: users can contribute to them freely, and as the software is modified and fixed, so the bugs fall off the end of the database (www.chiark.greenend.org.uk/debian/Bugs/).

Setting up a similar system for medical errors would be a radical notion but would cut down on the number of intermediaries involved in communicating sources of error that the present systems require. Of course, the great difference between software and humans is that once the software is “stable” it requires no further effort. Back in the real world, the best place to start looking for material specifically oriented to the medical domain on the web seems to be www.smi.stanford.edu/people/felciano/research/humanerror/.

Over on the east coast of the United States a team of managers and accident and emergency doctors has devised a scheme for looking at error in their own workplaces and minimising it (http://teams.drc.com/powerpoints/Jim/ACEP_1207_site/index.htm). They've made use of Powerpoint's natty feature for converting proprietary files to HTML, which makes turning a talk into a website very easy indeed. The downside of the approach is that the resultant files of text plus graphics are comparatively large—downloading the whole talk (94 Powerpoint slides) takes 2 Mb. Alternatively, for a case study from a British intensive care unit, download www.dcs.gla.ac.uk/∼bussed/HECS/HECS.html.
Interleukin-9 stimulates the proliferation of human myeloid leukemic cells
Authors: RM Lemoli, A Fortuna, A Tafuri, M Fogli, M Amabile, A Grande, MR Ricciardi, MT Petrucci, L Bonsi, G Bagnara, G Visani, G Martinelli, S Ferrari, S Tura
Journal: Blood (1996)
Measles resurges in Italy: preliminary data from September 2007 to May 2008
Authors: A Filia, M De Crescenzo, T Seyler, A Bella, M L Ciofi Degli Atti, L Nicoletti, F Magurano, S Salmaso
Journal: Eurosurveillance (2008)

Following an incidence rate of 1/100,000 inhabitants in 2006 [1], Italy has been facing an upsurge of measles cases since September 2007, with outbreaks being reported in various regions. In Italy, measles vaccination is currently offered free of charge as combined measles-mumps-rubella (MMR) vaccine. The current national vaccination schedule recommends two doses of MMR vaccine, given respectively at 11-12 months and 5-6 years of age. Although childhood vaccination coverage has increased in recent years, reaching the national average of 88% in 2006 (source: Ministry of Health), with some regional variability (Figure 1), it is still below the target of 95% set by the National Measles Elimination Plan (MEP) launched in 2003 [2], and outbreaks continue to occur.
APC/CCdh1 As a Mediator Of Hematopoietic Differentiation, Self-Renewal and Malignant Transformation
Authors: Andrea Schmidts, Daniel Ewerth, Dominik Schnerch, Arunas Kvainickas, Dagmar Wider, Birgit Kügelgen, Heike L. Pahl, Monika Engelhardt, Ralph Wäsch
Journal: Blood (2013)
On the Mechanism of Cancer Induction by Ultraviolet Radiation. III. The Growth Curve&lt;xref ref-type="fn" rid="FN1"&gt;2&lt;/xref&gt;
Authors: Harold F. Blum
Journal: JNCI Journal of the National Cancer Institute (1959)

The equations describing the experiments on the induction of cancer by ultraviolet light are examined in terms of the concept that the tumor consists of an increasing number of clones whose rate of proliferation is accelerated by repeated doses of ultraviolet light. Accord with this concept is found.
Complete heart block following a single dose of trazodone
Authors: J L Rausch, D M Pavlinac, P E Newman
Journal: American Journal of Psychiatry (1984)

Forty minutes after receiving a single starting dose of trazodone, a patient developed complete heart block. The case illustrates that, despite the results of earlier studies, trazodone's effect on cardiac conduction may be severe in individuals at risk for conduction delay.
Intermittent medication for stable schizophrenic outpatients: an alternative to maintenance medication
Authors: M I Herz, H V Szymanski, J C Simon
Journal: American Journal of Psychiatry (1982)

Because of neuroleptics' potential long-term side effects, the authors conducted a pilot study of an alternative to maintenance medication for stable schizophrenic outpatients. The doses of 19 patients were gradually reduced to zero over 8 weeks, and medication was then given only when a patient experienced early signs of relapse. The patients attended weekly group therapy and were closely monitored for prodromal signs, especially at times of stress; significant others helped observe patients. Five patients experienced increased symptoms during the drug washout period and were dropped from the study; of the remaining 14, 10 remained stable on the intermittent medication protocol.
Psychiatric needs in local jails: emergency issues
Authors: H R Lamb, R Schock, P W Chen, B Gross
Journal: American Journal of Psychiatry (1984)

There is an urgent need for psychiatric services for mentally ill inmates in local jails. The authors recommend that a psychiatric team be established inside the jail to provide short-term crisis evaluation, disposition, and treatment; that special training be provided for jail booking personnel in the recognition of psychiatric problems during the initial jail screening and classification process; that special modules be developed for mentally ill inmates; and that inmates in need of hospitalization have easy access to hospital beds. They describe a psychiatric ward actually located within a county jail to treat mentally ill inmates who are considered security risks.
A European survey on public health policies for managing cases of meningococcal disease and their contacts
Authors: M Hoek, G Hanquet, S Heuberger, P Stefanoff, P Zucs, M Ramsay, J Stuart, None on behalf of the European Union Inv
Journal: Eurosurveillance (2008)

In 2007, a European survey was conducted to compare national policies on public health management of cases of meningococcal disease and their contacts. The results revealed differences in definitions of close contacts and prophylactic regimens between countries. These differences can be attributed to a lack of evidence on optimal prevention and treatment strategies. The development of guidance for best practice in priority areas, based on evidence or consensus, is therefore recommended.
Postoperative urinary retention.
Authors: Leiv Arne Rosseland, Audun Stubhaug, Harald Breivik, Per Christian Medby, Helge Holst Larsen
Journal: BMJ (1991)

Retention of urine is a common postoperative problem.We present two patients with postoperative urinary retention. Current opinions on monitoring and treatment are reviewed.One male postoperative patient was transferred from the postanaesthesia care unit after orthopaedic surgery under spinal anaesthesia. Shortly thereafter he collapsed. Hypotension and bradycardia were treated with intravenous ephedrine and atropine. Urinary retention was suspected and the bladder catheterised for 1,000 ml urine. A follow-up examination revealed no sequelae. A female patient was operated for haemorrhoids under epidural anaesthesia. The second postoperative day she was catheterised for 1,500 ml of urine. Two years later she had an ovarian cyst removed under general anaesthesia. Postoperative urinary retention developed with bladder overdistension (volume > 1,000 ml). A follow-up examination showed rest urine of 25 to 75 ml, and a chronic bladder dysfunction. The incidence of postoperative urinary retention varies depending upon type of surgery, gender, age, and preoperative history of urinary tract dysfunction. Method of anaesthesia or postoperative pain treatment is not correlated to incidence of urinary retention, but excessive intravenous volume load during the operation is.Postoperative urinary retention should be monitored in all patients after surgery. All patients with history of difficulties with micturition need close supervision to avoid urinary bladder overdistention.
Physical Activity and Plasma Cyclic Adenosine Monophosphate Levels in Manic-Depressive Patients and Healthy Adults
Authors: Eleftherios Lykouras, Evangelos Garelis, Eleftheria Varsou, Costas N. Stefanis
Journal: American Journal of Psychiatry (1979)

Intense exercise for one hour induced a significant increase in plasma cyclic adenosine monophosphate (cAMP) in 5 healthy volunteers. In 44 manic-depressive patients, cAMP levels correlated more strongly with mood ratings than with activity scores. The authors conclude that physical activity is one of the factors which contribute to changes of cAMP levels in affective illness.
The Real Gap between Bench and Bedside
Authors: Stewart Wolf
Journal: New England Journal of Medicine (1974)

The demand is often expressed today, sometimes with breathless urgency, that the fruits of research be applied more quickly to the treatment and prevention of disease. The implication is that "basic scientists" have turned up quantities of information not available to promote the health of mankind for want of more "applied" research, and more speedy and simplified exchange of biomedical information. Although both need continuing emphasis, neither alone nor in combination can they assure rapid progression of knowledge from bench to bedside. I would propose instead that the delay is due mainly to our inability to understand and to integrate . . .
AB1171 Clinical Significance of Anti-Nuclear Antibodies in IGG4-Related Disease
Authors: S. Hara, H. Nuka, S. Horita, T. Zoshima, K. Ito, M. Aizu, H. Fujii, K. Yamada, M. Kawano
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Anti-nuclear antibodies (ANAs) are autoantibodies binding to various components of the cell nucleus. ANAs are often detected in various systemic autoimmune diseases. IgG4-related disease (IgG4-RD) is a newly recognized systemic fibroinflammatory condition of unknown etiology<sup>1)</sup> involving various organs. ANAs are detected in 15% of IgG4-RD patients<sup>1)</sup> and this fact is the basis of the suggestion that IgG4-RD may be autoimmune in nature. However, disease-specific ANAs such as anti-SS-A antibody and anti-dsDNA antibody remain to be clarified in IgG4-RD. <h3>Objectives</h3> The present study was conducted to clarify the positive rate, titer, and clinical significance of ANAs in IgG4-RD. <h3>Methods</h3> We enrolled 70 IgG4-RD patients (45 males, 25 females; mean age 64.1±1.2 years) diagnosed according to comprehensive diagnostic criteria for IgG4-RD<sup>2)</sup>. The positive rate, titer and staining pattern of ANA in IgG4-RD patients using immunofluorescence method were retrospectively compared to those in 65 patients with systemic lupus erythematosus (SLE), 22 with anti-SS-A antibody positive Sjögren9s syndrome (SjS), and 341 healthy controls (HC) who received medical examination. In addition, we analyzed the relationship between the titer of ANAs and serum IgG level in the IgG4-RD patients. <h3>Results</h3> The ANA titers were as follows (Figure); 21 (30.0%) patients showed ≥1:40 and 7 (10.0%) patients ≥1:160 in IgG4-RD; 65 (100%) patients showed ≥1:40 and 55 (86.4%) ≥1:160 in SLE; 21 (95.5%) patients showed ≥1:40 and 19 (86.4%) ≥1:160 in SjS; 96 (30.9%) HC showed ≥1:40 and 5 (1.5%) ≥1:160. The dominant staining pattern of ANAs was homogenous (79.0%) in IgG4-RD, but speckled with/without homogenous in SLE (speckled 31.7%, speckled + homogenous 31.7%) and SjS (speckled 47.8%, speckled + homogenous 26.1%). Serum IgG level was not different between IgG4-RD patients showing ≤1:80 and ≥1:160 of ANAs (≤1:80, mean 2,084 mg/dL, range 1,078-5,358 mg/dL; ≥1:160, mean 3,068 mg/dL, range 1,765-4,661 mg/dL; <i>p</i> =0.078), although serum IgG levels tended to be high in cases in which ANAs revealed high titers. <h3>Conclusions</h3> The positive rate, titer and staining pattern of ANAs in IgG4-RD were similar to those in HC, and are quite different from those in SLE and SjS. These results indicate that ANA detection is nonspecific in IgG4-RD, appearing according to serum IgG elevation. ANAs are not useful in the diagnosis and do not contribute to the pathogenesis in IgG4-RD. <h3>References</h3> Yamamoto M, Takahashi H, Shinomura Y. Mechanisms and assessment of IgG4-related disease: lessons for the rheumatologist. Nat Rev Rheumatol 2014; 10, 148-159. Umehara H, Okazaki K, Masaki Y, et al. Comprehensive diagnostic criteria for IgG4-related disease (IgG4-RD), 2011. Mod Rheumatol 2012; 22, 21-30. <h3>Disclosure of Interest</h3> None declared