tbuckley/cabot-search huggingface dataset:
PWE-400 The effect of periodic feedback on screening colonoscopy for colorectal polyp and adenoma detection rate in gastroenterology fellow
Authors: EH Jin, JP Im, JY Seo, JS Kim
Journal: Gut (2015)

<h3>Introduction</h3> Adenoma detection rate is important quality indicator in screening colonoscopy. The aim of this study was to measure the change in the colorectal polyp and adenoma detection rate before and after monitoring and feedback in first-year gastroenterology fellow. <h3>Method</h3> We prospectively analysed a total of 3312 screening colonoscopy data including successful cecal intubation rate, cecal intubation time, withdrawal time, polyp and adenoma detection at the Seoul National University Hospital between March 2013 and September 2014. 1959 colonoscopies performed by 7 first-year gastroenterology fellows without feedback (group A). And 1353 screening colonoscopies performed by another 6 first-year fellows who were informed the periodic monitoring and feedback (group B). We sent the results of polyp and adenoma detection rate to all fellows and professor in charge every month by E-mail. Then we compared before and after feedback group outcomes. <h3>Results</h3> The average age of patients was 59.4 years, and 55.8% were male. The successful cecal intubation rate was improved after 150 cases both group A (90.0%) and group B (91.3%). Before feedback, overall polyp detection rate was 0.51 ± 0.08, adenoma detection rate was 0.36 ± 0.05. After feedback, the overall polyp detection rate was 0.50 ± 0.05, adenoma detection rate was 0.36 ± 0.03. Compared with before and after feedback group, there was not a significant difference in overall polyp and adenoma detection rate (p = 0.901, p = 0.846). After 150 cases, polyp detection rate was 0.50 for group A, whereas 0.56 for group B (p = 0.041). And adenoma detection rate was significantly higher in group A than group B (0.37 vs. 0.42; p = 0.038). <h3>Conclusion</h3> The minimum threshold number of technical competence in colonoscopy is more than 150 colonoscopies for trainee who initially started learning colonoscopy. The monitoring and feedback program is associated with an increase in polyp and adenoma detection rate after 150 cases. The periodic monitoring and feedback can be effective for trainees who achieved technical competence. <h3>Disclosure of interest</h3> None Declared.
Heterotopic gastric mucosa of the ileum
Authors: Chi-Ming Tai, I-Wei Chang, Hsiu-Po Wang
Journal: Endoscopy (2015)

A 70-year-old woman with a history of breast cancer underwent colonoscopy because of a positive fecal blood test. Her physical examination was unremarkable, but her hemoglobin level was 9.9 g/dL (normal range 13.5 – 17.5 g/dL). The colonoscope reached to 8 cm above the ileocecal valve. In addition to internal and external hemorrhoids, several polypoid lesions measuring 0.3 – 0.8 cm, with surface ulceration, were found in the terminal ileum ( [Fig.1]). Histopathological examination of the biopsy specimens taken from these polypoid lesions revealed mucinous glands in the lamina propria that resembled the pyloric glands of the stomach ([Fig. 2]). A diagnosis of heterotopic gastric mucosa (HGM) of the ileum was made on the basis of the histological findings. Because of the patient’s poor overall condition and the fact that she had no major complications from the HGM, further observation alone was recommended.
Risk stratification for high-dose chemotherapy in metastatic breast cancer.
Authors: M Subar
Journal: Journal of Clinical Oncology (1996)

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.1996.14.2.686 Journal of Clinical Oncology - published online before print September 21, 2016 PMID: 8636796 Risk stratification for high-dose chemotherapy in metastatic breast cancer. M SubarxM SubarSearch for articles by this author https://doi.org/10.1200/JCO.1996.14.2.686 PDF "Risk stratification for high-dose chemotherapy in metastatic breast cancer.." Journal of Clinical Oncology, 14(2), pp. 686–687© 1996 by American Society of Clinical Oncology
Low prevalence of mitral valve prolapse in patients with panic disorder
Authors: M K Shear, R B Devereux, R Kramer-Fox, J J Mann, A Frances
Journal: American Journal of Psychiatry (1984)

In 25 patients with panic attacks the prevalence of mitral valve prolapse was 8%, close to that in the general population. The higher rates in previous reports may be due to differences in prolapse criteria, sampling techniques, or the samples' sex ratios.
High Throughput Sequencing-Based Pathogen Discovery In Multiple Myeloma
Authors: Akinyemi I. Ojesina, Chandra Sekhar Pedamallu, Aleksandar Kostic, Joonil Jung, Daniel Auclair, Jens Lohr, John Carpten, Gad Getz, Jonathan J Keats, Matthew Meyerson
Journal: Blood (2013)
PTH-184 Superior patient preference and high diagnostic accuracy for the detection of barrett’s oesophagus using a novel, portable, probe-based transnasal endoscope
Authors: SS Sami, M di Pietro, J Ortiz-Fernández-Sordo’, J White, IN Guha, RC Fitzgerald, K Ragunath
Journal: Gut (2015)

<h3>Introduction</h3> Barrett’s Oesophagus (BO) is the only recognised precursor to oesophageal adenocarcinoma. The second generation EG Scan™ system is portable with a disposable, ultrathin, probe-based imaging capsule; therefore it may be used in the community setting closer to the patient’s home. We aimed to compare the performance of unsedated transnasal endoscopy (TNE) using the EG Scan™ with conventional oesophagogastroduodenoscopy (C-OGD) for the detection of BO. <h3>Method</h3> This was a prospective, two-centre, diagnostic study with tandem design. Consecutive adult patients with histologically confirmed BO and those referred for assessment of reflux or dyspepsia were invited to participate. We excluded patients with recurrent epistaxis; nasal obstruction; and disease of the nasal cavity. All subjects underwent unsedated TNE (index test) followed by C-OGD (reference standard) on the same day, by two different operators blinded to the findings of each other. The primary outcome measure was the diagnostic accuracy for BO. In addition, procedure preference; tolerability (10-point visual analogue scale (VAS), 0 = worst and 10 = best); and adverse events questionnaires were administered on day 0 and day 14 after the procedures. <h3>Results</h3> 100 patients agreed to participate out of 439 subjects who were invited (22.8%). The mean age was 59.5 years (+/-13.7) and 63% were males. Prevalence of BO was 50%. 89 patients (89%) completed both procedures (11% failed TNE due to the inability to intubate the nasopharynx). Sensitivity, specificity and area under the receiver operating characteristic of TNE for the diagnosis of BO were 0.96 (95%confidence interval (CI) 0.85–0.99), 0.91 (95% CI 0.78–0.97), and 0.93 (95% CI 0.88–0.99), respectively. Patients reported higher preference for TNE compared to C-OGD on both day 0 (73.0% vs. 18.0%%, p &lt; 0.001) and day 14 (64.2% vs. 16.0%, p &lt; 0.001). Preference for TNE remained significantly higher in patients who had C-OGD under sedation (57.1% vs. 31.4%, p &lt; 0.001). Subjects also reported significantly better experience (mean VAS) with TNE compared to C-OGD on day 0 (7.5 vs. 5.6, p &lt; 0.001) and day 14 (7.3 vs. 5.1, p &lt; 0.001). Two patients (2.2%) experienced transient pre-syncopal episodes. No serious adverse events occurred. <h3>Conclusion</h3> TNE using the EG Scan™ device was highly accurate for the detection of BO. More importantly, a significant majority of patients preferred TNE over C-OGD regardless of sedation use. The low test uptake could be due to the requirement for patients to undergo 2 procedures on the same visit. The EG Scan™ could potentially provide a true community-based screening tool for BO and oesophageal adenocarcinoma. <h3>Disclosure of interest</h3> None Declared.
Brief Report: Proatherogenic Cytokine Microenvironment in the Aortic Adventitia of Patients With Rheumatoid Arthritis
Authors: Ammad Ahmed, Ivana Hollan, Samuel A. Curran, Susan M. Kitson, Marcello P. Riggio, Knut Mikkelsen, Sven M. Almdahl, Pål Aukrust, Iain B. McInnes, Carl S. Goodyear
Journal: Arthritis & Rheumatology (2016)

Objective Patients with rheumatoid arthritis (RA) are at increased risk of developing cardiovascular disease (CVD) via mechanisms that have not yet been defined. Inflammatory pathways, in particular within the vascular adventitia, are implicated in the pathogenesis of primary CVD but could be amplified in RA at the local tissue level. The aim of this study was to examine the aortic adventitia of coronary artery disease (CAD) patients with or without RA to determine the cytokine profile contained therein. Methods Aortic adventitia and internal thoracic artery biopsy specimens obtained from 19 RA patients and 20 non‐RA patients undergoing coronary artery bypass graft surgery were examined by immunohistochemistry. Results Interleukin‐18 (IL‐18), IL‐33, and tumor necrosis factor (TNF) were expressed in aortic adventitia biopsy specimens from both groups, and expression of these cytokines was significantly higher in RA patients. In RA patients, IL‐33 expression in endothelial cells correlated positively with the number of swollen joints, suggesting a link between the systemic disease state and the local vascular tissue microlesion. Conclusion The presence of the proinflammatory cytokines IL‐18, IL‐33, and TNF may play a role in the inflammatory process within the adventitia that contributes to plaque formation and destabilization. In theory, the amplified expression of these cytokines may contribute to the known increased occurrence and severity of CAD in patients with RA.
A phase I study of RAD1901, an oral selective estrogen receptor degrader, in ER–positive, HER2–negative, postmenopausal advanced breast cancer patients.
Authors: Wael A. Harb, Fiona Garner, Marcie Clarkin, Kathleen A Roberge, Alan G Harris, Gregory Williams, Gary Hattersley
Journal: Journal of Clinical Oncology (2015)

TPS638 Background: RAD1901 is a novel, non-steroidal, orally bioavailable selective estrogen receptor degrader (SERD). Preclinical studies demonstrated a favorable tissue selectivity profile, dose dependent ER degradation and potent inhibition of in vitro breast cancer cell proliferation. In an MCF7 xenograft model, significant tumor regression was consistently observed with RAD1901 treatment, compared to Tamoxifen or Fulvestrant. A phase I clinical study conducted in healthy postmenopausal female volunteers evaluated once daily doses up to 1000mg/day for 7 days. All dose levels were tolerated and pharmacokinetic analysis demonstrated good plasma exposure with dose proportional increases. 18F-estradiol positron emission tomography (FES-PET) was performed at baseline and after 6 days of treatment with RAD1901, to assess estrogen receptor engagement. Standardized uptake values (SUV) pre- and post-treatment demonstrated a complete attenuation of FES-PET signal in ER-rich tissues such as the uterus at both th...
Fox rabies in France
Authors: B Toma
Journal: Eurosurveillance (2005)

Fox rabies was first recorded in France in March 1968, and remained a problem until 1998. In the course of the first two decades and despite the control measures applied, rabies expanded both in terms of the enzootic surface area and number of cases. The measures applied consisted of actions aimed at reducing fox population density, the mandatory vaccination of domestic carnivores in the officially infected areas, and use of human prophylaxis. Following the large scale implementation of oral vaccination of foxes, starting 1989-1990, the rabies front was pushed back and yearly incidence decreased until rabies was eliminated at the end of 1998. The comparison of results obtained during both periods of applying various strategies is spectacular. France remains exposed to the risk from bat rabies on one hand, and from accidental cases of canine rabies imported from enzootic countries, on the other.
Case 1-1974
Authors: Richard C. Cabot, Benjamin Castleman, Robert E. Scully, Betty U. McNeely, Arthur L. Herbst, Stanley J. Robboy
Journal: New England Journal of Medicine (1974)

Presentation of CaseA 26-year-old married woman, gravida 1, para 0, was admitted to the hospital because of persistent flank pain.Eighteen months before admission she entered another hospital because of pain in the right lower quadrant of the abdomen. Three months previously a pregnancy test had been positive. Physical examination revealed an abdominal mass that arose 26 cm above the symphysis pubis. Marked tenderness and slight rebound tenderness were elicited over the abdomen, particularly in the right lower quadrant. No fetal heart sounds were audible. An abdominal exploration disclosed a right ovarian tumor, 21 by 15 by 7 cm, . . .
AB0344 Influence of the Choice of Coping Strategies on Pain Intensity in Patients with a High Activity of Rheumatoid Arthritis
Authors: E.V. Muslimova, S.P. Yakupova, E.Z. Yakupov
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Inspite of the large amount of scientific studies investigating the problem of pain in rheumatoid arthritis (RA), the question why patients with equally high indices of disease activity are experiencing different levels of pain, remains unsolved. <h3>Objectives</h3> To identify the influence of the choice of different coping strategies for pain intensity and frequency of NSAID usage in patients with a high activity of RA. <h3>Methods</h3> The cross – sectional survey included 124 patients with RA (male to female ratio 4,4:1), mean age 49,4 [44; 56] years, mean duration of disease ranged from 3 months to 41 years (10,8 [3,5;13]). RA diagnosis based on ACR/EULAR criteria of 2010. Pain was recorded using a visual analog scale (VAS). Chronic pain Coping Questionnaire was used in determing coping strategies. Patients were divided into 2 groups: the 1st group included patients that took NSAID daily, the 2nd group – patients that used NSAID every 2-3 days or less. DAS 28 in both groups corresponded to the high activity of RA (5,65 [5,15; 6,4] vs 5,16 [4,4; 5,64]), p&lt;0,05. The significance of differences was determined by Mann – Whitney test, differences were considered significant at p&lt;0,005. <h3>Results</h3> Opposite coping behaviour was revealed among patients of two groups: patients of the 1st group used maladaptive coping strategies significantly more often than patients from the 2nd group (70% vs 37,7%, p=0,002), and visa versa, patients from the 2nd group were more focused on adaptive coping (18% vs 53,3%, p=0,0005). Patients from the 1st group had higher pain intensity scores than patients from the 2nd group according to the VAS scale (50 [40; 65] vs 40 [30; 50], p=0,002). <h3>Conclusions</h3> The choice of coping strategies that make patients with a high RA activity affects the intensity of pain and the frequency of NSAID usage. Thus, patients that were focused on maladaptive coping, experienced significantly higher levels of pain intensity and took NSAID more often than patients that used adaptive coping strategies (p&lt;0.05). The data suggests the necessity of the cognitive - behavioral therapy implementation, that could help patients in modifying their maladaptive behavior, to the complex treatment of patients with RA. <h3>Disclosure of Interest</h3> None declared
SP0214 The Consultant's Role in Strategic Career Decisions for Rheumatology
Authors: S. Rednic
Journal: Annals of the Rheumatic Diseases (2015)

The role of a doctor is complex and include beside professional attributes, such as being a competent and experienced medical doctor able to cover complex cases, also being a teacher, being able to train and mentor junior doctors, disseminating expertise to the next generation Consultants plays an indispensable role as educators and possess the range of skills that doctors in training need to acquire. The relationship between the trainee and the trainer is crucial in determining job satisfaction, motivation to learn and strategic career decisions. The quality of that relationship can make the difference between a post that is rewarding and one that is demoralizing. Considering of the relationship relatively little is known about it and about how to help both parties to foster a good relationship, given the limited duration of a placement, the pressures inherent in both roles and the fraught environment in which they work. There are few data about what makes an effective educational supervisor. Good supervisors create an educational climate within the team or unit, give constructive feedback, assess the trainees progress and their leaning needs and keep up to date as a teacher. Poor supervisors essentially neglect their role as trainers, overlook the their trainees educational needs and maybe in conflict with others. A consultant competence as a clinician is also important to the trainees, the worst supervisors may be clinically incompetent or eve maltreat their patients. A questionnaire covering a wide range of issues about choosing a specialty and about the relation with the mentors was given to the rheumatology trainees. Most respondents described a positive interaction between themselves and their supervising consultant. They particularly appreciated positive feedback, clinical support, teaching, career advice or a social interaction that made them feel they were recognized as person. Positive interactions were associated with a positive view of medicine as a career and confidence in themselves as doctors. However some respondents described an interaction that was unreasonable demands, criticism or humiliation. These were associated with a more negative view of medicine as a career and of themselves as doctors. In conclusion, a healthy mentoring relationship is likely to provide the mental and moral challenges essential to continue medical career and self improvement <h3>Disclosure of Interest</h3> None declared
AB0120 Hearing Impairment and Tympano-Ossicular Compliance Are Affected by Disease Activity in Rheumatoid Arthritis
Authors: H. Macías Reyes, C. Chavez Martin, J.D.J.E. Gόmez Bañuelos, A.A. Saldaña Millán, B.T. Martin Marquez, R.E. Navarro Hernandez, M. Vázquez del Mercado Espinosa
Journal: Annals of the Rheumatic Diseases (2015)

OBJECTIVES: To clarify the relation between the prevalence of dry eye syndrome and subjective symptoms of asthenopia in visual display terminal (VDT) operators. METHOD: 722 VDT workers (242 subject workers with symptoms of asthenopia and 480 controls without such symptoms) without obvious organic ocular diseases received an ophthalmological examination consisting of refractometry and a tear function (phenol red thread) test. RESULTS: More than 30% of symptomatic workers were found to meet the criteria of dry eye, and the odds ratio compared with the controls was 4.61 (p &lt; 0.001). This odds ratio was significantly greater than that obtained for refractive errors (2.31). CONCLUSIONS: Although this cross sectional study could not prove that dry eyes are the cause of asthenopia, the profound association of dry eyes with symptoms of asthenopia could be verified. It would be useful to carry out tear function tests in workers with symptoms of asthenopia.
PWE-323 An evaluation of surveillance colonoscopy in the elderly
Authors: HKSI Singh, C Thorn
Journal: Gut (2015)

<h3>Introduction</h3> The BSG guidelines on colorectal cancer (CRC) screening recommend that the minimum age to cease surveillance colonoscopy is 75 years. The decision to continue surveillance should then be based on individual patient factors. Currently, there is an increasing demand on endoscopy services due to the introduction of screening programmes and initiatives to increase accessibility. We aim to evaluate the diagnostic yield and complication rate of surveillance colonoscopy in the over 75-age group. <h3>Method</h3> A prospectively collected database of patients at GWH Swindon was interrogated and a consecutive cohort of patients undergoing surveillance colonoscopy for a history of polyps between 11/7/2011 and 6/7/2014 was identified. Patients &lt;75 years, undergoing flexible sigmoidoscopy or colonoscopy for other indications, and those with a previous history of CRC were excluded. Local databases and the electronic patient record were used to obtain further information, including surveillance period, history of CRC, the number and size of polyps seen on colonoscopy, the number of polyps biopsied/retrieved, histology results, quality of each colonoscopy (degree of pain caused, limited colonoscopy/ poor bowel preparation), complication events, and follow up arrangements after colonoscopy. The final cohort comprised 74 patients. The primary outcome was significant adenoma yield (i.e. &gt;1 cm) per annum surveillance. Secondary outcomes included complication rates, quality of colonoscopies, proportion of polyps investigated and accordance with BSG guidelines. <h3>Results</h3> 1) Polyp, adenoma and significant adenoma yield per annum surveillance was 0.37%, 0.33% and 0.17% respectively. Only 2 patients developed CRC over 225 years of polyp surveillance. 2) 13.5% experienced significant pain. 3) 52.7% of surveillance colonoscopies were incomplete or had poor bowel preparation. 4) 80.6% of polyps were biopsied or retrieved. 5) No patient was found to have post-procedure bleeding or perforation. 6) Of 44 patients analysed, 25 patients (56.8%) had inappropriate surveillance colonoscopy according to BSG guidelines. Eighteen (41%) had surveillance earlier than was appropriate. <h3>Conclusion</h3> Our service evaluation suggests that polyp surveillance in elderly patients does not result in a high adenoma/polyp yield; procedures are often suboptimal due to high rates of incomplete procedures and can cause significant pain. BSG guidelines were not followed accurately. This may expose patients to further harm and waste limited resources. It therefore may be more beneficial for endoscopy departments to reduce the number of elderly individuals to whom they offer surveillance or improve compliance with the BSG guidelines. These strategies may decrease demand without resulting in an increase in the incidence of significant neoplastic disease. <h3>Disclosure of interest</h3> None Declared.
The &lt;italic&gt;p&lt;/italic&gt;H of Rat Tumors Measured &lt;italic&gt;In Vivo&lt;/italic&gt;
Authors: M. Eden, B. Haines, H. Kahler
Journal: JNCI Journal of the National Cancer Institute (1955)

Journal Article The pH of Rat Tumors Measured In Vivo Get access M. Eden, M. Eden National Cancer Institute,3Bethesda, Md. Search for other works by this author on: Oxford Academic PubMed Google Scholar B. Haines, B. Haines National Cancer Institute,3Bethesda, Md. Search for other works by this author on: Oxford Academic PubMed Google Scholar H. Kahler H. Kahler National Cancer Institute,3Bethesda, Md. Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 16, Issue 2, October 1955, Pages 541–556, https://doi.org/10.1093/jnci/16.2.541 Published: 01 October 1955 Article history Received: 12 May 1955 Published: 01 October 1955