tbuckley/cabot-search huggingface dataset:
PTU-283 Usefulness of short-term post-operative lft monitoring after laparoscopic common bile duct exploration
Authors: CC Wewelwala, P Cashin, D Croagh, G Jones
Journal: Gut (2015)

<h3>Introduction</h3> This study examines the usefulness of postoperative LFT monitoring in diagnosing incomplete clearance of bile ducts after laparoscopic common bile duct exploration (LCBDE) performed during laparoscopic cholecystectomy (LC). <h3>Method</h3> Data on all patients who had LCBDE over a period of three years were collected retrospectively. Patients who had unsuccessful LCBDE were considered for the test group and remaining patients were considered for the control group. Pre-operative, 12–24 h post-operative and 24–48 h post-operative alkaline phosphotase (ALP), gamma-glutamyl transferase (GGT), alanine transaminase (ALT) and bilirubin levels were recorded. <h3>Results</h3> 20 patients in the test group and 52 patients in the control group were identified. 12–24 h postoperative blood tests compared to pre-operative blood tests revealed worsening or no improvements of LFTs in 10 of 10 in test group and 19 of 52 in control group (p = 0.30). After excluding patients who had intervention within 24 h, 24–48 h postoperative blood tests compared to 12–24 h postoperative blood tests revealed worsening or no improvements of LFTs in 7 of 16 in test group and 11 of 37 in control group (p = 0.322). 10 patients with a normal final intra-operative cholangiogram free of filling defects needed re-intervention due to retained choledocholithiasis subsequently. 6 of these 10 patients (60%) were discharged home on second post-operative day after observing improved LFTs but re-admitted for subsequent intervention. <h3>Conclusion</h3> There is NO difference in post-operative LFT patterns between patients who had successful LCBDE and unsuccessful LCBDE. Therefore post-operative LFT monitoring is not reliable. <h3>Disclosure of interest</h3> None Declared.
Polyanionic Macromolecular Prodrugs of Ribavirin: Antiviral Agents with a Broad Spectrum of Activity
Authors: Tracey M. Hinton, Kaja Zuwala, Celine Deffrasnes, Shawn Todd, Shuning Shi, Glenn A. Marsh, Megan Dearnley, Benjamin M. Wohl, Martin Tolstrup, Alexander N. Zelikin
Journal: Advanced Healthcare Materials (2016)

Macromolecular prodrugs are developed as multiarmed agents against diverse viral pathogens. Lead candidates inhibit infectivity and replication of HIV, Ebola, influenza, measles, RSV, etc—thus being broad-spectrum antiviral agents. As a service to our authors and readers, this journal provides supporting information supplied by the authors. Such materials are peer reviewed and may be re-organized for online delivery, but are not copy-edited or typeset. Technical support issues arising from supporting information (other than missing files) should be addressed to the authors. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
Analysis of VH Genes in Follicular and Diffuse Lymphoma Shows Ongoing Somatic Mutation and Multiple Isotype Transcripts in Early Disease With Changes During Disease Progression
Authors: Christian H. Ottensmeier, Andrew R. Thompsett, Delin Zhu, Bridget S. Wilkins, John W. Sweetenham, Freda K. Stevenson
Journal: Blood (1998)
339TiP Phase III study of afatinib vs placebo as adjuvant therapy after chemo-radiotherapy (CRT) in primary unresected patients with locoregionally advanced (LA) head and neck squamous cell carcinoma (HNSCC) in Asia: LUX-Head &amp; Neck 4 (LUX-H&amp;N4)
Authors: C.S. Hu, A. Chan, L. Gao, M.-J. Ahn, E. Cohen, M.-K. Ang, Y. Cheng, Q. Hu, S.-B. Kim, P. Li, Y. Sun, B. Fan, G. Cheng, E. Ehrnrooth, C.-H. Wang
Journal: Annals of Oncology (2015)
Abdominal Aortic Aneurysm
Authors: M Pasic, M Turina
Journal: New England Journal of Medicine (1996)

Figure 1. A cross-sectional computed tomographic scan of the abdomen of an 85-year-old man shows an aneurysm (arrow) of the infrarenal aorta measuring 10 cm in diameter. The initial diagnosis was made on physical examination by palpation of a pulsatile abdominal mass and was confirmed by computed tomography. The infrarenal aorta was replaced by a tube graft, and the remaining aneurysmal wall was trimmed and sutured back around the graft as a reinforcement. L denotes lumen, T mural thrombus lining the aneurysm, and IVC inferior vena cava.
SAT0521 Juvenile Onset Connective Tissue Diseases in Norway – a Hospital Based Registry
Authors: T.M. Ingebrigtsen, T. Garen, B. Flatø, H. Sanner
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> In 1999 a registry of patients with juvenile idiopathic arthritis and juvenile onset connective tissue diseases was established at Oslo University Hospital, Rikshospitalet. <h3>Objectives</h3> To evaluate clinical characteristics in patients with juvenile onset connective tissue diseases registered in the hospital based registry. <h3>Methods</h3> The registry is based on written informed consent. Patients with juvenile onset connective tissue diseases were classified using ICD-10 codes and data was registered at one time point. Gender, date of registration, disease onset, Childhood Health Assessment Questionnaire (CHAQ) and self-reported assessment of pain and wellbeing (VAS 0-10cm, where 0 indicates no pain and excellent wellbeing) was recorded, in addition to disease-specific variables. CHAQ score (range 0-3) was calculated without corrections for helping aids. For patients under the age of 16 years, both VAS and CHAQ were reported by the parent. Data is shown as n (%) or median (IQR). <h3>Results</h3> A total of 137 patients with juvenile onset connective tissue diseases were registered. Median age at disease onset was 12 years and median age at inclusion was 14 years, and 77% were female. The distributions in various ICD-10 subgroups are shown in table 1. The most frequent subgroups were systemic lupus erythematosus (SLE), juvenile dermatomyositis (JDM), mixed connective tissue disease (MCTD) and Wegener9s granulamatosis. Assessment of wellbeing was worse in girls (n=89) than in boys (n=26) in the group as whole; median 23 (10-49) versus median 7 (1-41); p=0.050. When comparing levels of wellbeing between different diagnoses, no differences were found. Pain intensity was higher in patients with MCTD than in those with Wegener9s (p=0.016). No difference was found when comparing assessment of pain between genders. Median CHAQ score was 0.0 for all diagnoses, except for JDM and MCTD (0.6, 0.3, respectively). A higher CHAQ score was found in patients with JDM compared to SLE (p=0.001) and Wegener9s patients (p=0.006), and in patients with MCTD compared to SLE patients (p=0.05). <h3>Conclusions</h3> The age at onset and gender distribution is as expected. MCTD patients seemed to have a worse experience of pain than the other patients. Girls had lower sense of wellbeing than boys. Limited physical functioning was more frequent in patients with JDM and MCTD than in other patient groups. The registry is an important database for further studies concerning juvenile onset connective tissue diseases. <h3>Disclosure of Interest</h3> None declared
PWE-387 Role of technique of abdomino-perineal excision of rectum on perineal complications and interventions - our experience
Authors: HD Thirkettle, PC Munipalle, DFN Fung, DW Borowski, DK Garg, MA Tabaqchali, TS Gill, AK Agarwal
Journal: Gut (2015)

<h3>Introduction</h3> Oncological outcome from Extra-Levator Abdomino-Perineal Excision of low rectal cancers (ELAPE) have been shown to be superior to those achieved by conventional APER. However, it usually requires some form of pelvic floor repair due to the larger defect, and it has been suggested that ELAPE carries a higher morbidity particularly in view to pelvic floor complications. We examined results and outcomes from ELAPE and APER in our institution. <h3>Method</h3> All non-restorative excisions of primary low rectal cancers in a single colorectal unit between 2009 and 2014 were retrospectively examined, using data from healthcare records, pathology records and administrative databases. End points for analysis included duration of hospital stay following index surgery, rates of immediate (≤ 30 days) and late post-operative complications, re-admission rates, re-interventions and perineal hernia rates. <h3>Results</h3> A total of 44 patients underwent non-restorative excision of a rectal cancer (26 ELAPE and 18 APER), with a median follow up period of 30 months. There was no difference between the groups for age, gender, BMI, and rates of pre-operative neo-adjuvant treatment. However, there were more UICC stage III cancers in the ELAPE group compared to APER (5/26 [19.2%] vs. 11/18 [61.1%], p = 0.035). The median length of stay was similar in both groups (7.5 days, p = 0.44), and there was no difference between ELAPE and APER for early complication (12/26 [46.2%] vs. 7/18 [38.9%], p = 0.632), re-intervention (12/26 [46.2%] vs. 3/18 [16.7], p = 0.078), readmission (8/26 [30.8%] vs. 1/18 [5.6%], p = 0.071), and perineal hernia rates (1/26 [3.8%] vs. 1/18 [5.6%], p = 0.474). However, late perineal complications were more common in ELAPE (17/26 [65.4%] vs. 2/18 [11.1%], p &lt; 0.001) and required intervention (11/26 [42.3%] vs. 1/18 {[5.6%], p = 0.007). Other factors associated with late complications included neo-adjuvant treatment (18/34 [52.9%] vs. 1/10 (10.0%], p = 0.016), CRM positivity (5/6 [83.3%] vs. 13/36 [36.1%], p = 0.095) and use of mesh for perineal repair (17/29 [58.6%] vs. 2/13 [15.4%], p = 0.009). Within ELAPE, there was no difference in complications between biological and synthetic mesh groups. <h3>Conclusion</h3> ELAPE appears to have no increased short-term morbidity compared to conventional APER, but late complication rates are higher. This may be, in part, explained by tumour factors, use of neo-adjuvant treatment and the use of mesh for reconstruction in this group. Selective use of ELAPE for non-restorative excision of a rectal cancer is advised, and the role of flap reconstruction may need to be considered in more patients. <h3>Disclosure of interest</h3> None Declared.
The impact of the 2009 influenza A(H1N1) pandemic on attitudes of healthcare workers toward seasonal influenza vaccination 2010/11
Authors: C Brandt, H F Rabenau, S Bornmann, R Gottschalk, S Wicker
Journal: Eurosurveillance (2011)

The emergence of the influenza A(H1N1)2009 virus provided a major challenge to health services around the world. However, vaccination rates for the public and for healthcare workers (HCWs) have remained low. We performed a study to review the reasons put forward by HCWs to refuse immunisation with the pandemic vaccine in 2009/10 and characterise attitudes in the influenza season 2010/11 due to the emergence of influenza A(H1N1)2009. A survey among HCWs and medical students in the clinical phase of their studies was conducted, using an anonymous questionnaire, at a German university hospital during an influenza vaccination campaign. 1,366 of 3,900 HCWs (35.0%) were vaccinated in the 2010/11 influenza season. Of the vaccinated HCWs, 1,323 (96.9%) completed the questionnaire in addition to 322 vaccinated medical students. Of the 1,645 vaccinees who completed the questionnaire, 712 had not been vaccinated against the influenza A(H1N1)2009 virus in the 2009/10 season. The main reason put forward was the objection to the AS03 adjuvants (239/712, 33.6%). Of the HCWs and students surveyed, 270 of 1,645 (16.4%) stated that the pandemic had influenced their attitude towards vaccination in general. Many German HCWs remained unconvinced of the safety of the pandemic (adjuvanted) influenza vaccine. For this reason, effective risk communication should focus on educating the public and HCWs about influenza vaccine safety and the benefits of vaccination.
PTU-100 Should we screen the antenatal population for hepatitis C in the UK? a snapshot of seroprevalence from a single london centre:
Authors: E Dannhorn, R Davis, C Koshy, P Kooner
Journal: Gut (2015)

<h3>Introduction</h3> The paradigm of hepatitis C (HCV) treatment has shifted, with the introduction of revolutionary regimens offering sustained virological response rates of &gt;90%. However, only 3% of HCV patients receive treatment each year, and 50% with chronic HCV are undiagnosed.<sup>1</sup> There are significant differences in HCV prevalence within minority groups. Infection rates in South Asian and Eastern European groups are as high as 2.7%<sup>2</sup>and 5.1%, respectively.<sup>3</sup>The area served by Barking, Havering and Redbridge NHS Trust (BHRUT) reflects huge population ethnic diversity. Screening at antenatal (AN) booking allows testing of women not included in current guidelines. Data for AN populations has not been determined. We postulated that AN testing for HCV antibody (HCV Ab) would identify significant seroprevalence. <h3>Method</h3> 1000 sequential AN samples, each representing serum collected from one women at AN booking, were anonymously tested for anti-HCV Ab, hepatitis B surface antigen (HBsAg), and HIV, using ARCHITECT (Abbott). Positive results were confirmed with VIDAS (bioMérieux). Equivocal results were ARCHITECT positive/VIDAS negative. <h3>Results</h3> <h3>Conclusion</h3> Our results demonstrate a snapshot of the seroprevalence of HCV, HBV and HIV in the AN population served by BHRUT. HCV prevalence was in keeping with national statistics. AN HBsAg and HIV Ab positivity was higher than national data.<sup>4</sup> Limitations include small sample size, reflecting 1 month of AN samples collected. Serum was only tested for HCV Ab; viraemia should be confirmed by PCR. Anonymous testing prevented identification of known cases. We argue that AN testing represents opportunity for early diagnosis. AN testing for HBV and HIV were introduced as diagnosis allowed early treatment, which can now be provided for HCV. It is interesting that prevalence within our AN cohort is similar to that of the general population. AN populations represent well patients, motivated to engage with health care, with high uptake of screening. HCV testing can be added safely and reliably to existing panels. With the revolution in HCV treatment, there must now be an emphasis placed on early identification. <h3>Disclosure of interest</h3> E. Dannhorn Grant/ Research Support from: Research support granted by Abbott, R. Davis: None Declared, C. Koshy: None Declared, P. Kooner: None Declared. <h3>References</h3> Public Health Englang (PHE). HCV in the UK: 2013 report Uddin, <i><i>et al</i></i>. Prevalence of chronic viral hepatitis in people of south Asian ethnicity living in England: the prevalence cannot necessarily be predicted from the prevalence in the country of origin. <i>J Viral Hepat</i>. 2010;<b>17</b>(5):327–35 PHE; HCV in the UK: 2014 PHE; Annual report from the sentinel surveillance study of blood borne virus testing in England: data for Jan-Dec 2013
THU0450 Ultrasound-Detected Osteophytes Predict Incident Radiographic Hand Osteoarthritis and Pain Five Years Later:
Authors: A. Mathiessen, H.B. Hammer, B. Slatkowsky-Christensen, T.K. Kvien, I.K. Haugen
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> A cross-sectional study has shown that ultrasound (US) is more sensitive than conventional radiography (CR) in detecting small osteophytes in joints with hand osteoarthritis (OA). Osteophytes can be seen prior to joint space narrowing (JSN), may be an early risk factor for OA progression, and is associated with pain. However, previous studies on the predictive value of osteophytes on disease progression and pain is limited in number, have shown inconsistent results, and none of these have included US. <h3>Objectives</h3> To examine whether US-detected osteophytes in joints with concurrent normal CR and no joint tenderness at baseline could predict incident radiographic hand OA and joint tenderness five years later. <h3>Methods</h3> We included 78 participants (71 women, mean (SD) age 67.8 (5.2) years) from the Oslo hand OA cohort with US examination at baseline, and CR and clinical examination (tenderness upon palpation) at baseline and 5-year follow-up. US was performed on the first carpometacarpal and the interphalangeal joints. The radiographs was scored according to the Kellgren-Lawrence (KL) scale and the OARSI atlas for osteophytes (0-3) and joint space narrowing (JSN; 0-3). Associations between baseline US-detected osteophytes (independent variable) and incident radiographic OA features five years later (dependent variables) were explored only in joints without radiographic OA (i.e. KL grade=0, no osteophytes and no JSN) at baseline by use of Generalized Estimating Equations, expressed as odds ratio (OR) with 95% confidence intervals (CI) and adjusted for age, sex, body mass index and follow-up time. In addition, in radiographic normal joints with no tenderness at baseline, we explored whether US-detected osteophytes could predict incident joint tenderness. <h3>Results</h3> Mean (SD) follow-up time was 4.7 (0.4) years. At baseline, 1218/1643 (74.1%) of the total number of assessed joints had US-detected osteophytes. In total 301 joints were assessed as being normal on CR, of which 86 had concurrent osteophytes detected by US. Most of these osteophytes (79.1%) were small (score 1). US-detected osteophytes at baseline was a strong predictor for incident radiographic OA during follow-up (table). The strongest association was seen for incident JSN (OR=5.3, 95% CI 2.1-13.4). In addition, a significant association was found between US-detected osteophytes at baseline and the occurrence of tenderness by joint palpation at follow-up (OR=1.9, 95% CI 1.1-3.3). <h3>Conclusions</h3> For the first time, we were able to show that US-detected osteophytes were a strong predictor for the development of radiographic OA as well as tenderness at joint level after 5-years follow-up. These results support the use of US as a promising tool for early detection of hand OA. <h3>Disclosure of Interest</h3> None declared
Antonio Egas Moniz (1874-1955), Portuguese neurologist
Authors: J Kenéz
Journal: JAMA (1968)

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-099 Low risk of lamivudine resistance in hbv, hbeag negative patients. time to reconsider?
Authors: E Kouroumalis, D Samonakis, M Koulentaki, A Voumvouraki
Journal: Gut (2015)

<h3>Introduction</h3> Lamivudine has been largely replaced for the treatment of chronic HBV infection by new (and more expensive) antivirals with a high viral resistance barrier. It has been reported that lamivudine resistance can be as high as 20% after one year and up to 80% at five years. We therefore assessed a cohort of our patients for the development of Lamivudine resistance over time. <h3>Method</h3> 100 chronic HBV hepatitis patients, histologically diagnosed (male 67, female 33), median age 59 years (range 20–75), initially received lamivudine and were followed up for at least 5 years. All were HBeAg negative, HbeAb positive. Genotype D was found in all 23 patients genotyped. All were non-cirrhotic on liver biopsy before treatment (66% Ishak fibrosis stage 2–3, 34% Ishak stage 4–5). Median HBV DNA at the commencement of treatment was 450000 IU/ml. Only 12 patients had a viral load over 1000000 IU/ml. Lamivudine resistance was considered when an increase of 2 logs in the viral load, followed by an aminotransferase increase after an initial response was noted on follow up. <h3>Results</h3> All patients responded to lamivudine with normalisation of aminotransferases and subsequent reduction of HBV DNA to less than 100 IU/ml within 6 months from treatment initiation. Lamivudine resistance was 5% at one year, 10% at 2 years, 17% at 4 years and 21% at 5 years <h3>Conclusion</h3> The risk for lamivudine resistance development in our chronic HBV hepatitis patients is well below the reported in the literature. Whether this is due to the relative lower levels of viral load or to the lack of cirrhotics in our cohort remains to be further examined. Nonetheless we believe that in view of the low cost, lamivudine use should possibly be reconsidered as a first line treatment In HBV infection for non-cirrhotic patients with a viral DNA below 1000000 IU/ml. <h3>Disclosure of interest</h3> None Declared.
AN UNUSUAL CASE OF ECTOPIC PREGNANCY
Authors: G ROLFINI
Journal: JAMA (1922)

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