tbuckley/cabot-search huggingface dataset:
Early estimates of the effectiveness of the 2011/12 influenza vaccine in the population targeted for vaccination in Spain, 25 December 2011 to 19 February 2012
Authors: S Jiménez-Jorge, S de Mateo, F Pozo, I Casas, M García Cenoz, J Castilla, V Gallardo, E Pérez, T Vega, C Rodriguez, C Quiñones, E Martínez, J Giménez, J M Vanrell, D Castrillejo, M C Serrano, J M Ramos, A Larrauri
Journal: Eurosurveillance (2012)

We present early estimates of influenza vaccine effectiveness (VE) in the population targeted for vaccination, during 25 December 2011 to 19 February 2012. The adjusted VE was 55% (95% CI: 3 to 79) against any type of influenza virus and 54% (95% CI: 1 to 79) against influenza A(H3N2) virus. This suggests a moderate protective effect of the vaccine in the targeted population in a late influenza epidemic with limited match between vaccine and circulating strains.
European network cooperation to identify hotel as source for pneumonia caused by Legionella pneumophila serogroup 2
Authors: PC Lück, F Hahn, M Senger, SA Boers, P Brandsema
Journal: Eurosurveillance (2008)

Here we describe a case of hotel-associated legionellosis in an immuno-competent man caused byLegionella pneumophila serogroup 2, sequence type (ST) 39 that was identified through European cooperation.
TUMORS INVOLVING THE GASSERIAN GANGLION
Authors: A B KING
Journal: JAMA (1921)

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PWE-184 Eosinophilic esophagitis; presentation, diagnosis and response to therapy in a tertiary referral centre in london
Authors: I Parisi, C Bailey, H Saravanapavan, R Sweis
Journal: Gut (2015)

<h3>Introduction</h3> Eosinophilic esophagitis (EoE) is a chronic immune-mediated disorder characterised by an increased eosinophil infiltrate combined with typical symptoms of dysphagia/food bolus obstruction although those with refractory-reflux symptoms without inflammation are not commonly suspected. Recent guidance has improved clinical awareness, endoscopic vigilance and biopsy protocols. This study captures recent trends in endoscopy, histology and subsequent response to therapy of patients with EoE in a London tertiary referral centre. <h3>Method</h3> Between February 2013 and January 2015, reports were collected for all patients who underwent high definition endoscopy and biopsies at University College London Hospital. Patients with oesophageal cancer or surgery were excluded. Demographics, clinical characteristics, eosinophil concentration and response to therapy were collected for all those with &gt;15 eosinophils/high power field (eos/hpf). Mann-Whitney and Kruskal-Wallis tests were used to analyse non-parametric variables. <h3>Results</h3> Of the 848 patients with dysphagia who had biopsies, 39 (4.6%) had &gt;15 eos/hpf; however a total of 46 patients were found to have &gt;15 eos/hpf (30M; mean age 39.5 ± 14.5 years). Patients with eosinophilia presented mostly with dysphagia (25; 54%) and food impaction (22; 48%) while another 7 (15%) also presented with refractory-reflux symptoms (only 2 with Grade A esophagitis but with &gt;80 eos/hpf in the proximal oesophagus). 22% had a history of atopy/asthma. 26/46 (57%) exhibited EoE-specific endoscopic findings; corrugated rings (18), strictures (5), furrows (6) and Schatzki ring (4). 7/46 (17%) had esophagitis Grade A (4), B (2) and C (1) esophagitis. The remaining 13 (28%) had a normal endoscopy. There was no difference in the mean eos/hpf between patients with EoE-specific endoscopic changes (47 ± 24), esophagitis (46.5 ± 21.2) and normal endoscopy (47.5 ± 24.9) (p = 0.915). Furthermore the mean eos/hpf between those who presented with dysphagia, food bolus obstruction or refractory-reflux was similar (p = 0.804). 37 patients were treated with either proton pump inhibitors (PPI; 19) or topical steroids (18). Of the 26 patients whose outcomes were reported, 10 responded to steroids and 9 to PPIs. Response to PPIs was more likely in those with reflux-predominant symptoms vs. dysphagia (p = 0.027). The maximum number of eos/hpf did not predict response to therapy as a whole (p = 0.586) nor in those treated with steroids versus PPI (p = 0.188). Furthermore, there was no association of response to treatment when compared to age, endoscopic appearance or atopy (p = NS). <h3>Conclusion</h3> It is increasingly recognised that EoE does not only present with dysphagia. Therapy targeted towards the predominant symptom can improve outcome in patients with EoE. <h3>Disclosure of interest</h3> None Declared.
The 2015 guidelines for idiopathic pulmonary fibrosis: an important chapter in the evolution of the management of patients with IPF
Authors: Kevin C. Wilson, Ganesh Raghu
Journal: European Respiratory Journal (2015)

During the past 15 years, clinical practice guidelines have evolved from the consensus-based opinions of experts to evidence-based documents developed using a rigorous systematic approach. In 2000, a selected panel of international experts in the field of interstitial lung diseases developed a guideline for the diagnosis and management of idiopathic pulmonary fibrosis (IPF) [1]. The guideline was based upon the consensus opinions of the few expert panel members; the panel members' decisions were not informed by a systematic review of the literature, meaning that there was no formal synthesis of the evidence or appraisal of the quality of the evidence. Despite these limitations, the guideline was considered state of the art for the time. It provided important direction to clinicians, including the first concrete definition for IPF, and provoked new studies. During the following decade, abundant evidence accumulated at a rapid rate, making it difficult for the average clinician to synthesise, interpret, and apply the evidence to their clinical practice. To address this, and to improve upon the previous document, the IPF guideline was updated in 2011 using an evidence-based approach for the first time [2]. The updated guideline redefined IPF using precise diagnostic criteria based on the clinical, radiological and histopathological features of IPF; it also it provided evidence-based treatment recommendations for the first time in the field of IPF. 2015 guidelines for treatment of IPF empowers the clinician and patient to make individualised treatment decisions <http://ow.ly/R37nz>
Solid Pseudopapillary Tumor of the Pancreas: Diagnosis by EUS-Guided Fine-Needle Aspiration
Authors: K. Mergener, S. Detweiler, L. Traverso
Journal: Endoscopy (2003)

A partially calcified cystic lesion in the area of the pancreatic tail was incidentally detected when a 57-year-old woman underwent chest computed tomography (CT) for evaluation of chronic cough (Figure [1 a]). She had no history of pancreatitis, but reported severe abdominal trauma approximately 20 years earlier. A thrombosed pseudoaneurysm was therefore considered in the differential diagnosis. Endoscopic ultrasound (EUS) showed a calcified lesion 3.5 × 2.3 cm in size in the pancreatic tail, with an obvious hypoechoic solid component as well as cystic areas (Figure [1b]). Fine-needle aspiration (FNA) revealed cells arranged in distinct papillary-like structures. Immunohistochemistry was negative for synaptophysin and positive for low-molecular-weight cytokeratin and vimentin. The patient underwent distal pancreatectomy. Histological examination of the resected specimen confirmed a solid pseudopapillary tumor (SPT) (Figure [2]).
Differentiation of depression from chronic pain with the dexamethasone suppression test and DSM-III
Authors: R D France, K R Krishnan, J L Houpt, A A Maltbie
Journal: American Journal of Psychiatry (1984)

The concept of chronic pain has become enmeshed with depression. In an attempt to unravel this complex relationship, the authors studied a uniform group of 42 patients with chronic pain, i.e., patients who had chronic low back pain with defined organic pathology, in relation to the dexamethasone suppression test (DST). The results were analyzed in relation to the presence or absence of major depression and cortisol suppression. Forty-one percent of the patients with major depression had abnormal cortisol responses to dexamethasone administration; all patients without major depression had normal responses. These results suggest that chronic pain patients differ from patients with major depression and a positive DST.
Final results of a phase II study of cyclophosphamide, etoposide, and estramustine in patients with castration-resistant prostate cancer.
Authors: W. Zhang, M. Shams, P. Moffett, G. Rabinowits, C. Salvador, G. H. Kloecker, D. A. Laber
Journal: Journal of Clinical Oncology (2011)

e15084 Background: Combination chemotherapy for castration-resistant prostate cancer (CRPC) has response rates between 20-67% as measured by PSA decline, and most importantly, it demonstrated improvement in symptom control and quality of life. Oral therapy offers the tremendous advantage of independence and avoids catheter-related complications. Cyclophosphamide (C), etoposide (E) and estramustine (E) are active against CRPC. Methods: Objectives are to evaluate the efficacy and safety of this triple drug oral regimen (CEE). Each treatment cycle consists of cyclophosphamide 50 mg/m2, etoposide 50 mg/m2 and estramustine 280 mg, administered on days 1-14, every 28 days. Response was assessed by changes in size of measurable and non-measurable lesions as per RECIST criteria and PSA level. Results:Forty-six patients, who completed at least 2 cycles, were evaluated for toxicity and response. Median baseline characteristics: age 69 years (50-86); ECOG performance status 1 (0-3); PSA 105.5 ng/ml (11.4-2270); 32.7% had prior chemotherapy. Total number of cycles administered: 295, median of 5cycles/patient. PSA decline: 16 (34.8%) had 0-50% decrease, 19 (41.3 %) had > 50-80% decrease, 5 (10.7%) had >80% decrease, with an overall PSA response rate of 52.0%. Only 6 (13%) patients had increased PSA. Response per RECIST criteria: of the thirty patients with measurable lesions, one patient had a CR (3.3%), two had PR (6.7%), twenty-two had SD (73.3%) and five had PD (16.7%). Four out of five patients who relapsed after chemoholiday achieved 2nd response with CEE treatment. 67.4% of the subjects experienced an improvement in their ECOG performance status and 73.9% reported improvement in their level of pain. Toxicity: Grade 3-4: 21.7% neutropenia, 10.8% thrombocytopenia, 6.5% anemia, 7.7% fatigue. Four patients (8.6%) developed grade 1-2 neutropenic fever. Six patients (13.0%) developed a thrombotic event, five (10.9%) grade 1 DVTs and one (2.2%) grade 5 myocardial infarction. Conclusions:CEE is a well-tolerated, all oral, easy to administer and effective triple drug therapy for patients with metastatic castration-resistant prostate cancer.
Expression patterns of human epidermal growth factor receptor proteins in early gastric cancer
Authors: A. Mohamed, M. Gandy, A. Butt, V. Sehgal, I. Puccio, R. Hamoudi, R. Haidry, M. Novelli, M. Banks, L. Lovat, M. Rodriguez-Justo
Journal: International Journal of Surgery (2015)

Introduction  Stomach cancer is the 3rd commonest cause of death by cancer worldwide. As many as 60% of these gastric tumours express the Human Epidermal Growth Factor receptor (HER 1–4), which play a role in cell proliferation and survival. Endoscopic submucosal dissection (ESD) is a minimally invasive surgical technique used to resect early gastric neoplasias. The purpose of this study was to establish a relationship between HER family expression in early gastric cancers, their clinical utility as a diagnostic or prognostic adjunct and how over-expression of the HER receptor affects the curative rate of ESD.  Method  Formalin fixed paraffin embedded tissue from 22 early gastric ESD resection specimens were sectioned. Normal gastric resections were used as a control. Immunohistochemical staining for the HER family receptors were optimised and staining performed against EGFR external (ED) and internal domain (ID), HER2 (ED and ID), HER3 (ID) and HER4 (ID). Scoring was performed by two independent observers and confirmed by diagnostic software.  Results  2/22 (9%), 2/22 (9%) and 3/22 (13%) of cases were positive for EGFR ID, HER2 ID and HER2 ED respectively. 1/22 (4.5%) of cases showed co-expression of EGFR ID, HER2 ID and HER2 ED. 1 showed HER2 ED and ID co-expression. EGFR ED, HER3 and HER4 were all negative for overexpression. Over-expression of HER2 ID (p = 0.047) and HER2 ED (p = 0.0045) correlated positively with cancer aggressiveness. 10/20 (50%) cases showing no over-expression treated with ESD had reoccurrence of dysplasia, compared to 3/3 (100%) in the over-expressed group (p = 0.21).  Conclusion  Though small, our study showed a positive relationship between EGFR and HER2 expression, a potential target for therapeutic treatment. HER3 and HER4 expression did not correlate with any other antibody, in contrast to reported relationships. Repeats with different antibody clones would confirm the reliability of these results. The prognostic utility EGFR and HER2 co-expression to predict an aggressive early gastric cancer phenotype warrants further investigation. Although insignificant, the negative correlation between HER over-expression and ESD curative rates should be followed up with a larger cohort.  Disclosure of interest  None Declared.
NCCN Guidelines Insights: Survivorship, Version 1.2016
Authors: Crystal S. Denlinger, Jennifer A. Ligibel, Madhuri Are, K. Scott Baker, Gregory Broderick, Wendy Demark-Wahnefried, Debra L. Friedman, Mindy Goldman, Lee W. Jones, Allison King, Grace H. Ku, Elizabeth Kvale, Terry S. Langbaum, Mary S. McCabe, Michelle Melisko, Jose G. Montoya, Kathi Mooney, Mary Ann Morgan, Javid J. Moslehi, Tracey O'Connor, Linda Overholser, Electra D. Paskett, Jeffrey Peppercorn, M. Alma Rodriguez, Kathryn J. Ruddy, Tara Sanft, Paula Silverman, Sophia Smith, Karen L. Syrjala, Susan G. Urba, Mark T. Wakabayashi, Phyllis Zee, Nicole R. McMillian, Deborah A. Freedman-Cass
Journal: Journal of the National Comprehensive Cancer Network (2016)

The NCCN Guidelines for Survivorship provide screening, evaluation, and treatment recommendations for common consequences of cancer and cancer treatment. They are intended to aid health care professionals who work with survivors of adult-onset cancer in the posttreatment period, including those in general oncology, specialty cancer survivor clinics, and primary care practices. Guidance is also provided to help promote physical activity, weight management, and proper immunizations in survivors. This article summarizes the NCCN Survivorship panel's discussions for the 2016 update of the guidelines regarding the management of anxiety, depression, posttraumatic stress disorder–related symptoms, and emotional distress in survivors.
FRI0094 Kidney Function and Effectiveness of Methotrexate Treatment in Rheumatoid Arthritis Patients
Authors: P. Studenic, F. Alasti, J.S. Smolen, H. Haslacher, D. Aletaha
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Treatment options for rheumatoid arthritis (RA) patients are manifold, but methotrexate (MTX) and leflunomide categorized as DMARDs of first choice in treating rheumatoid arthritis patients. Methotrexate accumulates in patients with impaired kidney function and should therefore be used cautiously. At the same time, such accumulation may also lead to an increased effectiveness. <h3>Objectives</h3> To investigate the effects of methotrexate dose and kidney function on effectiveness, using patients treated with leflunomide as the control group. <h3>Methods</h3> We identified patients starting either MTX or leflunomide treatment, who had clinical and laboratory follow up for at least 6 month out of a longitudinal observational database. By using multivariable regression analyses, we tested whether creatinine or glomerular filtration rate (GFR) besides baseline SDAI were associated with observed Simplified Disease Activity (SDAI) response. <h3>Results</h3> 200 patients receiving MTX (74% female, Median (IQR): GFR=77 (67-90), SDAI=14 (7-23.1), 59% rheumatoid factor positive) and 46 receiving Leflunomide (89% female, Median (IQR): GFR=67 (61-81), SDAI=12 (6-18.6), 59% rheumatoid factor positive) were identified in our longitudinal observational database for analyses. Regression analyses in the MTX cohort showed that after adjusting for MTX dose higher creatinine was associated with higher SDAI response after 6 month of treatment (p=0.002). Analogously, in a separate analysis lower GFR was also significantly associated with larger clinical improvement (p=0.013) (Figure). In patients treated with leflunomide creatinine as well as GFR was not associated with SDAI change after 6 month of treatment (p=0.254). <h3>Conclusions</h3> Impaired kidney function is a risk factor for MTX accumulation and associated toxicity, at the same time, higher treatment responses in these patients indicate increased clinical benefit in these patients. This could also indicate room for higher doses in patients with normal kidney function, which is historically limited to 25mg/week. <h3>Disclosure of Interest</h3> None declared
Homologous and Heterologous Skin Transplantation in Patients With Lymphomatous Disease
Authors: Daniel G. Miller, M.D., Jesus G. Lizardo, M.D., Reuven K. Snyderman, M.D.
Journal: JNCI Journal of the National Cancer Institute (1961)

Forty-three patients with lymphomatous disease received homologous skin transplants. In 19, survival of the graft was prolonged. Nine patients who had received human skin grafts also received pigskin transplants. In 2, survival was prolonged. There was no consistent correlation between ability to accept or reject homografts and type of therapy administered, the titer of isohemagglutinins, response to typhoid-paratyphoid vaccination, skin testing with tuberculin, mumps, and Candida albicans antigens or properdin titers. Graft survival was not prolonged in the 4 patients with hypogammaglobulinemia. There were patients with chronic lymphatic leukemia, Hodgkin's disease, lymphosarcoma, reticulum-cell sarcoma, and multiple myeloma in both the typical-rejection and prolonged-survival groups. Two patients with chronic myelogenous leukemia and 1 with acute leukemia had typical homograft rejections.
Description of the early stage of pandemic (H1N1) 2009 in Germany, 27 April-16 June 2009
Authors: None Novel influenza A(H1N1) investigation team
Journal: Eurosurveillance (2009)

We report characteristics of the early stage of the pandemic (H1N1) 2009 in Germany. Until 16 June 2009, 198 confirmed cases were notified. Almost half of the cases (47%) were imported, mostly from Mexico and the United States. About two third of indigenous cases were outbreak-related (with two large school-associated outbreaks, n=74). According to our results Germany is still in the early stage of the pandemic with limited domestic transmission.
Identification of base substitutions in the promoter regions of the A gamma- and G gamma-globin genes in A gamma- (or G gamma-) beta+-HPFH heterozygotes using the DNA-amplification-synthetic oligonucleotide procedure
Authors: KG Yang, TA Stoming, YJ Fei, S Liang, SC Wong, B Masala, RB Huang, ZP Wei, TH Huisman
Journal: Blood (1988)
Secretion of radioactivity in breast milk after Tc-99m DTPA aerosol and Tc-99m MAA lung imaging.
Authors: MERYEM KAYA, FUNDA USTUN, AZIZ GULTEKIN, TEVFIK FIKRET CERMIK, MAHMUT AHMUT YUKSEL, OMER NECMI YIGITBASI
Journal: Clinical Nuclear Medicine (2001)

KAYA, MERYEM M.D.; ÜSTÜN, FUNDA M.D.; GÜLTEKIN, AZIZ M.D.; FIKRET ÇERMIK, TEVFIK M.D.; AHMUT YÜKSEL, MAHMUT M.D.; NECMI YIGITBAŞI, ÖMER Ph.D.¯ Author Information
AB0924 Echocardiography Findings in Asymptomatic Hyperuricemic Patients with Silent Deposit of MSU Crystals:
Authors: M. Andrés, M.A. Quintanilla, F. Sivera, P. Vela, J.M. Ruiz-Nodar
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Both asymptomatic hyperuricemia (AH) and gout have been reported to associate with abnormal echocardiography findings, such as left ventricle hypertrophy (LVH) [1] or dyastolic dysfunction (DD) [2]. However, to date no study has focused on the echocardiography findings in AH patients with silent monosodium urate (MSU) crystal deposits. <h3>Objectives</h3> To describe the echocardiography findings of a subgroup of AH patients with demonstrated MSU crystals deposit, and to compare with subgroups with normouricemia (NU) and AH without crystals. <h3>Methods</h3> Cross-sectional study. Consecutive patients admitted due to an acute coronary event were screened for enrolment. Patients were classified according to the serum uric acid (SUA) level at admission as: AH (SUA&gt;7.0 mg/dL and no history suggestive of gout) or NU (sustained SUA&lt;7.0mg/dL on lab records). Those with current urate-lowering treatment were excluded. AH patients underwent US of both knees and 1st MTP joints in order to detect signs of crystal deposition; when present, arthrocentesis was performed to confirm MSU crystals by polarised light microscopy. These findings were confirmed by a blinded rheumatologist. All patients underwent transthoracic echocardiography during the admission, by an independent observer. The presence of the following echocardiography variables was assessed: a) moderate-severe LVH; b) moderate-severely decreased left ventricle ejection fraction (LVEF); c) grade II DD; d) moderate-severe aortic stenosis (AS); and e) moderate-severe mitral regurgitation (MR). Comparison between subgroups was performed. Regression was used to analyze the association between echocardiography variables and crystal deposits, adjusting for potential confounders. <h3>Results</h3> 140 patients were enrolled, median (p25-75) age 71.5 years (61.0-79.8), 76.4% males. Sixty-six were NU and 74 AH; 13 (17.5%) of these were later classified as AH with crystals after US and arthrocentesis. Traditional CV risk factors distributed similarly between groups, except for hypertension and BMI, increased in both AH subgroups (but not differing between them). The Table shows the echocardiographic findings. Both AH subgroups showed higher prevalence of LVH and AS, but no significant differences were noted regarding the crystal status. No differences in the other echocardiography variables were found. In the regression analysis, the presence of MSU crystals did not associate with any of the echocardiographic variables evaluated. <h3>Conclusions</h3> This is the first study assessing the echocardiographic findings of AH patients with demonstrated MSU crystals. The results suggest no apparent impact of these crystals on this outcome. <h3>References</h3> Eur J Clin Invest. 44:972. PLoS One. 9:e108357. <h3>Disclosure of Interest</h3> None declared