tbuckley/cabot-search huggingface dataset:
SAT0569 Utility of a Self Administered Questionnaire as a Tool for Screening Joint Involvement Underway Psoriasis
Authors: G. Sandri, V. Cestelli, M.T. Mascia, C. Lasagni, G. Pellacani
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> The psoriatic arthropathy (AP) is a chronic inflammatory disease of skeletal muscle associated with psoriasis that can involve the synovium, cartilage, bone, tendons and entheses. The identification of individuals with AP can be difficult due to both the wide variability of the clinical manifestations, and the lack of bio-specific markers of the disease. The dermatologist is not always able to recognize the clinical manifestations of this disease and therefore a multidisciplinary approach between the dermatologist and rheumatologist in this context is of considerable importance in order to make an early diagnosis and target treatment. <h3>Methods</h3> We have developed a questionnaire that can be self-administered to psoriasis patients to identify those who are more likely to be affected by rheumatology. There are 11 questions with the answers:, "no", "I don9t know", "I don9t understand", that patients can compile themselves in the waiting room before their visit. <h3>Results</h3> 106 questionnaires were collected as part of the surgery "psoriasis" of the Dermatology Clinic of the Hospital. All patients who reported joint symptoms and who did not have a diagnosis of psoriatic arthritis (49) were subsequently evaluated by the rheumatologist. The survey showed a diagnosis of AP in 7 cases and suspected AP in another 5 cases. Among the 7 patients with ascertained AP: 86% reported back pain, 71% reported the presence of "sausage fingers" and another 71% reported waking up with joint or muscle pain which resolved after at least half an hour of movement. <h3>Conclusions</h3> Having identified in a simple way arthropathic complications in a group of patients who were already followed for only psoriasis, the self-administered questionnaire is, therefore, a simple and economical tool to help identify patients affected by psoriasis to be sent to the rheumatologist to confirm the diagnosis of psoriatic arthritis. <h3>Disclosure of Interest</h3> None declared
Multimedia: Rationing—Talk and Action in Health Care
Authors: Graham Winyard
Journal: BMJ (1999)

Ed Bill New


King’s Fund and BMJ Books, £25, pp 261 




ISBN 0 7279 1180 5

———————

Rating: ★★

This is a book from a group with a mission. The members of the Rationing Agenda Group wish to promote “a continuing, broad and deep debate about rationing in the NHS.” Their book shows, sometimes unintentionally, how difficult this may be to achieve.

The topic could not be more topical, and, by bringing together many of the “big names” in the rationing debate to explore key issues and dilemmas, the book provides a single volume that covers as much of the ground as most readers can possibly need. There is a range of standard articles on theory and on practice (“talk” and “action”), and Chris Heginbotham, in making the case that rationing is inevitable, reminds us of the scope and scale of the rationing that is taken for granted and not even featuring in current debates.

Some issues are debated from chosen opposing viewpoints, with each protagonist having the right of reply. Sometimes the results are impressive. Klein and New crisply dissect the problem, and indeed the wisdom, of attempting to define the package of health care that the NHS should provide. The clash of intellectual antlers as Williams and Grimley-Evans debate the rationing of health care on the basis of age was, for me, the highlight of the book.

The six accounts in the “action” section cover a broad range of initiatives, while demonstrating the gulf that currently exists between theorists and practice. It was only in this last section that the book felt slightly dated: an analysis of the potential role of the courts in rationing seems important in the light of recent events.

For all these reasons, the book should command a place on the shelves of healthcare libraries and the rationing cognoscenti. But it will not, I fear, succeed in its mission to stimulate widespread debate. It is often heavy going. Perhaps this is inevitable, as many of the concepts are complex and precision is correspondingly important, but it does not capture the casual reader with little time to spare.

The tone is faintly evangelical: the Rationing Agenda Group has seen the light and wants us all to do so too, while remaining completely undecided about what this would entail. Faced with tight budgets and soaring demand, we turn to the experts for help. Their answer seems to be that more discussion is needed, led perhaps by a Swedish style central committee of experts. This is the book’s central weakness. Debate is valuable to busy people only if it helps them to solve practical problems. Perhaps the politicians have been right with their pragmatic approach.
AB0095 Efficacy of Celecoxib for the Formation of Joint Contracture Followed by Immobilization in a Rat
Authors: J. Ozawa, A. Kaneguchi, H. Moriyama, N. Kito, R. Tanaka
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Concomitant with joint contracture, the inflammatory reactions have been shown in immobilized joint. Several investigators reported the effect of anti-inflammatory drugs on joint contracture formation followed by immobilization, however, the exact effect remains uncertain. <h3>Objectives</h3> We aimed to investigate a favorable effect of selective cyclooxygenase (COX)-2 inhibitor celecoxib (CBX) treatment on immobilization-induced contracture in a rat model. <h3>Methods</h3> Thirteen-week-old male Wistar rats (n=30) were used in this study. Rats were divided into three groups; control, immobilization (Im), and Im+CBX groups (n=10 each). In IM and Im + CBX groups, the right knee was immobilized by external fixation at 140° of flexion for 3 weeks. In Im+CBX group, CBX (50 mg/kg orally once a day) were treated during immobilization periods. Age-matched untreated animals were used as control group. At the end of intervention period, knee joint passive range of motion (ROM) were measured with14.6 Nmm extension moments before and after transection of knee flexor muscles (the former mainly indicates myogenic-, and the latter indicates arthrogenic contracture). In addition, the knee flexor semitendinosus muscles and knee joints were histologically analyzed to investigate the involvement of morphological alterations on joint contracture formation. For all data, one-way analysis of variance were used for statistically analysis, and the Tukey9s post-hoc test were applied. P-value of &lt;0.05 was considered statistically significant. <h3>Results</h3> Before myotomy, knee extension ROMs significantly decreased in IM group (61%) and IM+CBX group (70%) than those in control group. In comparison between IM and IM+CBX groups, ROM limitations were alleviated in IM+CBX group compared with those in IM group (<i>P</i> &lt;0.05). After myotomy, ROMs also decreased in IM group (83%) and IM + CBX group (86%) compared with those in control and there was no difference between IM and IM+CBX groups. The semitendinosus muscle lengths and the serial sarcomere numbers were both decreased by immobilization, but CBX treatment could partially inhibit these changes (<i>P</i> &lt;0.05). Intra-articular hemorrhages, which is shown to accelerate immobilization- induced joint contracture, were observed in both IM and IM+CBX groups, and were not inhibited by CBX administration. <h3>Conclusions</h3> Our results demonstrate the existence of COX-2-mediated pathway as a trigger for the formation of joint contracture, despite the immobilization-induced model. CBX treatment can partially prevent the progression of contracture acting on muscular components. Arthrogenic contracture may be regulated by infiltrated blood cells in joint cavity. These results suggest that anti-inflammatory therapies (ie., drugs or physical agents) may be useful for alleviation of immobilization-induced joint contracture. <h3>Disclosure of Interest</h3> None declared
It is now the age to define the appropriate follow-up of primary breast cancer patients.
Authors: M Rosselli Del Turco, D Palli, A Cariddi
Journal: Journal of Clinical Oncology (1994)

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.1994.12.9.1996 Journal of Clinical Oncology - published online before print September 21, 2016 PMID: 8083724 It is now the age to define the appropriate follow-up of primary breast cancer patients. M Rosselli Del TurcoxM Rosselli Del TurcoSearch for articles by this author , D PallixD PalliSearch for articles by this author , A CariddixA CariddiSearch for articles by this author https://doi.org/10.1200/JCO.1994.12.9.1996 PDF "It is now the age to define the appropriate follow-up of primary breast cancer patients.." Journal of Clinical Oncology, 12(9), pp. 1996–1997© 1994 by American Society of Clinical Oncology
Introduction: overview of the clinical studies program
Authors: M M Katz, G L Klerman
Journal: American Journal of Psychiatry (1979)

THE IMPETUS for the NIMH-Clinical Research Branch Collaborative Program on the Psychobiology of Depression stemmed from the growing concern with depression as a U.S. public health problem and the growing awareness that there had been some striking changes over the past 20 years in our conception of the nature and etiology of the affective disorders. New findings in the area of genetics and biochemistry inspired hypotheses implicating the chemistry of the endocrine and central nervous systems in ways quite different than had been thought in the past. There was reason to believe that we were on the verge of linking physiology, psychosocial factors, and behavior in these disorders, which would eventually make possible the development of a coherent and valid psychobiologic theory ofdepression. However, serious methodologic problems and the practical difficulties intrinsic to clinical research had seriously retarded progress toward this objective. Because of these developments and the perceived
Endoscopic introduction of an over-the-scope clip through an overtube to close a gastrocutaneous fistula in a patient with a complex upper esophageal stenosis
Authors: Marco D’Assuncao, Paul Kröner, Sandhya Mudumbi, Klaus Mönkemüller
Journal: Endoscopy (2015)

A 51-year-old man with a history of laryngeal cancer requiring total laryngectomy and placement of a forearm skin graft into the hypopharynx developed a nonhealing gastrocutaneous fistula after removal of a gastrostomy tube ([Fig. 1 a]). The injection of indigo carmine through the skin made it possible to determine the precise location of the 3- to 4-mm-diameter gastrocutaneous fistula within thickened gastric folds ([Fig. 1 b]). A gastroscope could be passed into the stomach after an esophageal stenosis between the hypopharynx and upper esophageal sphincter, induced by radiation fibrosis and the presence of a forearm skin graft, had been dilated sequentially with 9-, 10-, and 12-mm Savary bougies; however, it was still not possible to pass the fistula-closing device, an over-the-scope clip (OTSC System; Ovesco Endoscopy, Tübingen, Germany), through the hypopharynx.
Seasonal Variation in Fatal Thromboembolism and Its High Incidence in the Surgical Patient
Authors: J G SHARNOFF, M ROSENBERG, B A MISTICA
Journal: JAMA (1963)

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 Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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) 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
Breast Cancer
Authors: Jay R. Harris, Marc E. Lippman, Umberto Veronesi, Walter Willett
Journal: New England Journal of Medicine (1992)

Adjuvant Therapy of Breast CancerThe demonstration that adjuvant systemic therapy (i.e., systemic therapy given at the time of primary local treatment in the absence of demonstrated metastases) can prolong the disease-free interval and improve overall survival has been a major advance in the management of breast cancer. Randomized clinical trials of systemic adjuvant therapy were pioneered by the Istituto Nazionale per lo Studio e la Cura dei Tumori176 and the National Surgical Adjuvant Breast and Bowel Project177 and provided the first evidence of the benefit of cytotoxic chemotherapy in women with involvement of axillary lymph nodes, particularly younger women. . . .
Pulmonary Clinicopathological Correlation In Long Term Survivors Following Allogeneic Hematopoietic Stem Cell Transplantation: An Autopsy Series
Authors: Laura Spring, Lee Gazourian, Lynette Sholl, Jyothi Jagannathan, Emily Meserve, Ami S. Bhatt, Gerald L. Weinhouse, Victor Pinto-Plata, Robert J. Soiffer, Joseph H. Antin, Vincent T. Ho, Rebecca M. Baron, George R. Washko
Journal: Blood (2013)
Injuries in world junior ice hockey championships between 2006 and 2015
Authors: Markku Tuominen, Michael J Stuart, Mark Aubry, Pekka Kannus, Jari Parkkari
Journal: British Journal of Sports Medicine (2016)

Background Detailed injury data are not available for international ice hockey tournaments played by junior athletes. We report the incidence, type, mechanism and severity of injuries in males under ages 18 and 20 at junior ice hockey World Championships during 2006–2015. Methods All injuries in the International Ice Hockey Federation World Junior under-20 (WJ U20) Championship and under-18 (WJ U18) Championship were collected over a 9-year period using a strict injury definition, a standardised injury reporting system and diagnoses made by a team physician. Results 633 injuries were recorded in 1326 games over a 9-year period, resulting in an injury rate (IR) of 11.0 per 1000 player-games and 39.8/1000 player-game hours. The IRs in all tournaments were 4.3/1000 player-games for the head and face, 3.2 for the upper body, 2.6 for the lower body and 1.0 for the spine and trunk. A laceration was the most common injury type followed by a sprain. Lacerations accounted for 80% (IR 3.6) of facial injuries in WJ U20 tournaments. The shoulder was the most common injury site (IR 2.0) in WJ U18 tournaments. Board contact was the mechanism for 59% of these shoulder injuries. Concussion was the most common head and face injury (46%; IR 1.2) in WJ U18 tournaments. Conclusions and recommendations The risk of injury among male junior ice hockey players was lower than the reported rates in adult men but higher than that in women. Facial lacerations were common in U20 junior players (WJ U20) since most wear only partial facial protection (visor). The IR for shoulder injuries was high in U18 junior players (WJ U18). Suggested strategies for injury prevention include full facial protection for all players and flexible board and glass for all junior tournaments.
The Health Care Response to Pandemic Influenza
Journal: Annals of Internal Medicine (2006)

The threat of an H5N1 influenza virus (avian flu) pandemic is substantial. The success of the current U.S. influenza pandemic response plan depends on effective coordination among state and local public health authorities and individual health care providers. This article is a summary of a public policy paper developed by the American College of Physicians to address issues in the U.S. Department of Health and Human Services Pandemic Influenza Plan that involve physicians. The College's positions call for the following: 1) development of local public health task forces that include physicians representing all specialties and practice settings; 2) physician access to 2-way communication with public health authorities and to information technology tools for diagnosis and syndrome surveillance; 3) clear identification and authorization of agencies to process licensing and registration of volunteer physicians; 4) clear guidelines for overriding standard procedures for confidentiality and consent in the interest of the public's health; 5) clear and fair infection control measures that do not create barriers to care; 6) analysis of and solutions to current problems with seasonal influenza vaccination programs as a way of developing a maximally efficient pandemic flu vaccine program; 7) federal funding to provide pandemic flu vaccine for the entire U.S. population and antiviral drugs for 25% of the population; and 8) planning for health care in alternative, nonhospital settings to prevent a surge in demand for hospital care that exceeds supply. *This paper is an abridged version of a full-text position paper (available at www.acponline.org/college/pressroom/as06/pandemic_policy.pdf) written by Laura Barnitz, BJ, MA, and updated and adapted for publication in Annals of Internal Medicine by Michael Berkwits, MD, MSCE. The original position paper was developed for the Health and Public Policy Committee of the American College of Physicians: Jeffrey P. Harris, MD (Chair); David L. Bronson, MD (Vice Chair); CPT Julie Ake, MD; Patricia P. Barry, MD; Molly Cooke, MD; Herbert S. Diamond, MD; Joel S. Levine, MD; Mark E. Mayer, MD; Thomas McGinn, MD; Robert M. McLean, MD; Ashley E. Starkweather; and Frederick E. Turton, MD. It was approved by the Board of Regents on 3 April 2006.
AB0611 Cardiovascular Disease Associated with Systemic Lupus Erythematosus – a Must for Better Prevention
Authors: S. Ioana, D. Opris, L. Groseanu, A. Borangiu, R. Ionescu
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune condition with multi-organ involvement. Although atherosclerotic vascular involvement is not the most common, in time this is related to increasing mortality. <h3>Objectives</h3> To characterize a SLE cohort from the cardiovascular events perspective, in order to improve our prevention strategies. <h3>Methods</h3> We enroled 65 patients with SLE admitted in SF Maria Hospital in 2014. All patients gave informed consent for all procedures. We performed a complete evaluation of all patients both clinical and paraclinical, including disease activity score – SELENA-SLEDAI, damage score – SLICC damage index (SDI), history of the disease and medication, association with atherosclerotic cardiovascular disease. The statistic analysis was made with <i>SPSS</i> 20.0. <h3>Results</h3> Almost half of the patients – 49% had at least one cardiovascular events, most of them being younger then 50 years. Ischemic events found in our cohort were: ischemic heart disease like acute myocardial infarction or angina pectoris, aortic abdominal aneurism, peripheral ischemic arterial disease and ischmic cerebrovascular disease. Established atherosclerotic risk factors with significant correlation (p&lt;0.05) in this group of patients were: high blood pressure (p 0.011), menopause (p 0.0001), heredo-collateral vascular disease (p 0.029), high Body Mass Index (p 0.035), sedentary life style (p 0.035). We also found predictive factors that are related to the SLE itself: 83.33% from sub-group of patients with atherosclerotic cardiovascular involvement had positive antiphospholipidic Ab (p&lt;0.001), 87,5% from this patients had a disease longer then 5 years (p 0,010) and 66% had a SDI greater or equal to one (p 0.035). Older age at SLE diagnosis was significant associated with vascular involvement (p 0.001). <h3>Conclusions</h3> Routine assessment for this vascular pathology should be implemented in evaluation of SLE patients. Presence of correctable risk factors like hypertension, obesity or sedentary life style must be checked regularly. Special attention for prompt identification of this co-morbiditie is especially important in long standing disease that already accumulated damage. <h3>References</h3> Knight JS, Kaplan MJ. Cardiovascular disease in lupus: insights and updates. Curr Opin Rheumatol. 2013;25(5):597-605. <h3>Disclosure of Interest</h3> None declared
PTH-217 Spinal infections among patients with long term central venous catheters for home parenteral nutrition: a descriptive case series
Authors: R Topan, E Lightman, M Small, T Ambrose, JM Nightingale, SM Gabe
Journal: Gut (2015)

<h3>Introduction</h3> Long-term central venous catheters for home parenteral nutrition (HPN) carry a risk of recurrent bacterial colonisation and catheter related sepsis (CRS).<sup>1</sup>Spinal infections following an episode of CRS are uncommon but may be underreported or overlooked due to the high incidence of osteoporotic fractures in this cohort.<sup>2</sup>We aimed to determine the frequency and describe cases of spinal infections in HPN patients at our institution. <h3>Method</h3> We performed a retrospective review of all spinal infections presenting in our HPN patients between January 2010 and October 2013, a cohort of approximately 270 patients. Data were extracted on basic demographics, indication for and duration of HPN, means of venous access, history of presentation and management. <h3>Results</h3> The CRS rate was 0.9 per 1000 catheter days. Six patients were identified (mean age 65 years, 5 male) with spinal infection, a rate of 0.02 per 1000 catheter days. Duration with current CVC ranged from 5 months to 2 years. All patients presented with spinal pain; 5/6 cervical, 1/6 thoracic. All patients had a normal white cell count and differential, and in only 1 case was the CRP elevated. In 4 cases an organism was isolated at the time of presentation from blood cultures taken centrally and/or peripherally – commonly staphylococcal species. All patients had contrast-enhanced magnetic resonance imaging (MRI) with features compatible with spinal infection and in two patients a repeat MRI demonstrated resolution of changes. In three patients a disc biopsy was performed yielding one negative culture, one microbiological correlation with blood cultures and a single positive culture (unknown isolate). All patients received three months of intravenous antibiotic therapy augmented with surgery or conservative management on a case-by-case basis. The CVC was removed in 4/6 patients at presentation, with salvage in the remaining two. <h3>Conclusion</h3> Spinal infections associated with long-term CVC for HPN should be considered in patients presenting with spinal pain. They are often of insidious onset and may present with normal inflammatory markers which may contribute to delayed or missed diagnoses that together with differences in the definition of CRS<sup>1</sup>may partially explain the poor representation in the current HPN-related literature.<sup>3</sup>Gold-standard imaging is with contrast-enhanced MRI with formal biopsy decided on an individual basis. Management should involve prolonged antibiotics and liaison with microbiology and neurosurgery. Multidisciplinary discussion on CVC salvage is important especially in cases of difficult vascular access. <h3>Disclosure of interest</h3> None Declared. <h3>References</h3> Reimund JM, <i>et al.</i><i>Clin Nutr.</i>2002;21(2):33–38 Haderslev KV, <i>et al.</i><i>JPEN</i>2004;28(5):289–294 Huard G, <i>et al.</i><i>J Clin Med Res.</i>2014;6(4):272–277