tbuckley/cabot-search huggingface dataset:
AB0681 Clinical Profile of Myositis Patients with Myositis-Specific Antibodies
Authors: A. Faten, L. Laadhar, I. Ben Ghorbel, M. Kallel-Sellami, H. Houman
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Over the last few years, the discovery of myositis-specific antibodies (MSAs) has allowed the characterization, besides the three main entities: polymyositis (PM), dermatomyositis (DM) and inclusions body myositis, of new clinical entities such as the antisynthetase syndrome (ASS) and autoimmune necrotizing myopathy. <h3>Objectives</h3> The objective of this study was to determine the clinical profile of myositis patients with MSAs. <h3>Methods</h3> From January 2006 to February 2014, we collected the myositis patients with positive MSAs followed in Internal Medicine Department of “La Rabta” Hospital. Autoantibodies were detected by immunodot (Euroimmun®), to identify anti-Mi-2, anti-SRP and anti-synthetase antibodies (anti-Jo-1, anti-PL-7, anti-PL-12, anti -EJ and anti-OJ). <h3>Results</h3> We identified 26 patients (22 women) with one or more MSAs. The average age was 44 years. Eleven patients had two MSAs and only one patient had three MSAs. The anti-Mi-2 autoantibodies were positive in 11 cases: 8 cases of DM, 2 cases of PM and one case of ASS. The myopathy was benign in all cases, the oesopharyngeal and respiratory disease was observed in 5 cases and cardiac involvement in one case. The anti-SRP antibodies were positive in 16 cases: 13 cases of DM, 2 cases of PM and one case of ASS. The myopathy was acute onset in 2 cases, the oesopharyngeal disease was observed in 11 cases and the respiratory disease in 9 cases. Cardiac involvement was observed in 2 cases. Anti-Jo-1 antibodies were positive in 9 cases, 7 cases of ASS and 2 cases of DM, the anti-PL-7 antibodies were positive in a case of PM and the anti-PL-12 antibodies were positive in two cases of DM. Anti-EJ and anti-OJ antibodies were negative in all cases. <h3>Conclusions</h3> Usually, anti-Mi-2, anti-synthetases and anti-SRP antibodies are associated with benign DM, ASS, autoimmune necrotizing myopathy and cardiac involvement respectively. These associations were not confirmed in our study which reflects an atypical profile of MSAs in Tunisian patients. <h3>Disclosure of Interest</h3> None declared
History of incest in girls admitted to a psychiatric hospital
Authors: A Husain, J L Chapel
Journal: American Journal of Psychiatry (1983)

Of 437 adolescent girls admitted to a psychiatric hospital for emotional problems, 61 reported an incestuous involvement. Their mean age at the time of their first experience was 11.9 years. The liaisons occurred as often with fathers as with stepfathers; other, less frequent perpetrators of incest included brothers, brothers-in-law, uncles, a grandfather, an adoptive father, and a half-brother. The authors note that the victim of incest is almost always a preadolescent and that the occurrence of incest is probably not accurately reported nationally.
RNA Sequencing Reveals Novel and Rare Fusion Transcripts in Acute Myeloid Leukemia
Authors: Antonella Padella, Giorgia Simonetti, Giulia Paciello, Anna Ferrari, Elisa Zago, Carmen Baldazzi, Viviana Guadagnuolo, Cristina Papayannidis, Valentina Robustelli, Enrica Imbrogno, Nicoletta Testoni, Gerardo Musuraca, Simona Soverini, Massimo Delledonne, Ilaria Iacobucci, Clelia Tiziana Storlazzi, Elisa Ficarra, Giovanni Martinelli
Journal: Blood (2015)
PTH-124 Liver transplant outcomes in patients with care devolved to a non-transplanting centre: south west liver unit experience
Authors: BC Norton, D Adebayo, K Ramos, A Smith, M Cramp
Journal: Gut (2015)

<h3>Introduction</h3> With only seven transplant centres currently commissioned in the UK, many patients travel long distances for specialist care. A hepatology network was established with the support of King’s College Hospital in the South West Peninsula 13 years ago. Over time a devolved model of assessment and care for liver transplant patients, involving a large regional centre and referring hospitals, has been developed with post-transplant care delivered close to the patients’ home. Our aim is to establish whether patients receiving care at the South West Liver Unit have similar outcomes to current transplant centres. <h3>Method</h3> We retrospectively analysed data of all potential liver transplant patients cared for at the South West Liver Unit between 2000–2015. We created a patient database by reviewing clinical documents, which included all 361 patients formally assessed for liver transplant at the South West Liver Unit, and 174 patients who have undergone transplantation to date. Of the cases transplanted since the network was established, 21 received a transplant since 1<sup>st</sup>March 2014 and 153 over 1 year ago. Where a patient was re-transplanted the most recent transplant date was used. We undertook a survival analysis using a Kaplan-Meier survival plot on SPSS V.20 to determine percentage survival at 1, 3, and 5 years post-transplantation. <h3>Results</h3> The median survival time post-transplantation in our patient group was 12.6 years (95% confidence intervals 11.6–13.5). In total, 23 of the 174 patients died during follow up. Survival analysis (Figure 1)demonstrated non-risk adjusted survival rates of 93.4%, 92.7%, and 85.4% at 1, 3, and 5 years, respectively. These results are concordant with those currently reported by the seven transplant units within the UK. <h3>Conclusion</h3> The 1, 3, and 5 year survival outcomes for liver transplant recipients whose post-transplant care was provided by a non-transplanting centre and its network, are good and comparable to those of all current transplant centres. With increasing numbers of patients being transplanted and surviving, provision of accessible specialist care is becoming increasingly important. This data provides reassurance that devolution of care of liver transplant recipients, to appropriately staffed and trained regional centres, is a viable model for service delivery. Centres demonstrating good post-transplant outcomes will be well placed to develop into transplant units in the future. <h3>Disclosure of interest</h3> None Declared.
EXOME SEQUENCING IN A FAMILY IDENTIFIES RECQL5 MUTATION RESULTING IN EARLY MYOCARDIAL INFARCTION
Authors: Yi Tong Ma, Xiang Xie, Ying-Ying Zheng, Yi-Ning Yang, Xiao-Mei Li, Zhen-Yan Fu, Ma Xiang, Zhen-Ye Gan, Bang-Dang Chen, Fen Liu, Ying Huang
Journal: Journal of the American College of Cardiology (2015)
Tardive dyskinesia in an adolescent
Authors: P McLean, D E Casey
Journal: American Journal of Psychiatry (1978)

The frequent use of neuroleptic drugs in the treatment of disturbed children and adolescents demands that clinicians be aware of the danger of tardive dyskinesia in this age group. A case history of a 15-year-old boy who developed incapacitating tardive dyskinesia that resolved during treatment with deanol is presented. The recognition, differential diagnosis, and management of this syndrome in children are discussed. Lithium carbonate was a useful alternative to neuroleptics in managing the adolescent's disturbed behavior.
PTU-206 Downstaging by further chemotherapy for poor responders to chemoradiotherapy in inoperable rectal cancers – prospective study
Authors: R Engineer, V Ostwal, P Gupta, S Chopra, P Patil, A Saklani, S Arya, SK Shrivastava
Journal: Gut (2015)

<h3>Introduction</h3> The patients with locally advanced unresectable rectal cancers who were still inoperable on MRI imaging were further treated with 4 to 6 cycles of chemotherapy and reassessed for resectability. <h3>Method</h3> Patients with locally advanced carcinoma rectum assessed to have unresectable disease on MRI at presentation received neoadjuvant radiation to a dose of 50 Gy in 1.8 to 2 Gy daily fractions with concurrent capecitabine chemotherapy 825 mg/m<sup>2 </sup>daily. A follow up MRI was done 6 weeks after completion of NACRT and assessed in a joint multidisciplinary meeting. Those with persisting unresectable local disease on MRI were planned for 4 cycles of chemotherapy followed by reassessment imaging for resectability. We present the results of the patients with poor response to NACTRT having further treated by the chemotherapy. <h3>Results</h3> From Jan 2013 till December 2014, 50 patients with unresectable rectal cancer recieving NACRT were still found to have unresectable disease on MRI. They were planned for further chemotherapy with FOLFIRINOX or FOLFOX based regimens. Thirty three (67%) patients had radiological evidence of partial regression and one patient died of neutropenic sepsis. Of these 22 (37%) patients underwent R0 resection and another 10 are scheduled for surgery. Eight patients were still inoperable and 5 were detected to have peritoneal metastasis during surgery were given further palliative chemotherapy. One patient was lost to follow-up and 1 died due to sepsis. Four patients had complete pathological response. <h3>Conclusion</h3> Achieving margin negative resection in these patients is an encouraging starting point for further research in this subset. Whether this continued decrease in primary tumour volume can be attributed to delayed response to radiotherapy or addition of further chemotherapy, or both, is yet to be ascertained. Hence for patients with advanced local disease not yet in palliative stage, further intensive chemotherapy with clinicoradiological follow-up should be done to facilitate successful surgical resection. <h3>Disclosure of interest</h3> None Declared.
PTU-334 Setting up a paediatric nurse-led inflammatory bowel disease (ibd) clinic – a tertiary centre experience: Abstract PTU-334 Table 1
Authors: V Garrick, L Curtis, K Fraser, P McGrogan, A Barclay, RK Russell, R Hansen
Journal: Gut (2015)

<h3>Introduction</h3> Paediatric Nurse-led IBD patient reviews often occur in an unscheduled manner and without defined resources resulting in inefficient use of nurse time. We describe the process of the first year of a Paediatric Nurse-led IBD clinc. <h3>Method</h3> The clinic was designed as a quality initiative to dedicate a weekly session for consecutive patient review and facilitate more effective use of resources. Appropriate post graduate study was undertaken by the Paediatric IBD Nurse Specialist prior to the clinic being set up which included history taking, clinical examination, prescribing, requesting tests or further investigation, referral to other services and venepuncture. A nurse-led clinic proforma and patient pathway was designed to facilitate an auditable pathway for patients coming through clinic. Clinical governance and supervision was provided at the IBD multi-disciplinary team (MDT) meeting where each patient was discussed in an MDT forum. <h3>Results</h3> 344 patient episodes involving 124 patients took place between Feb 2013 – Dec 2014. 68 male. 93 Crohn’s disease (CD), 17 Ulcerative Colitis (UC) and 14 IBD Unclassified (IBDU). Median number of patients seen per clinic was 4. 87% of reviews were routine; 13% were rapid review (booked &lt; 48 hrs before clinic). Reasons for review were diverse. Co-ordination of care (eg: referral to surgeons; ordering further investigations) was the most common outcome (33%). Optimisation of therapy (eg: increasing medication doses; adding other medications such as rectal therapy) was the next most common outcome (27%). Thirty four percent of patients were planned for review at the MDT clinic, 32% were planned for further nurse-led clinic review and 20% had a nurse vigilance call booked. <h3>Conclusion</h3> The Paediatric Nurse-led IBD clinic has provided a robust and auditable addition to the IBD patient service. Co-ordination of care requiring cross boundary working with surgeons, physicians, dietitians and other members of the MDT was part of the outcome in over 1/3 of all patient reviews. This demonstrates the pivotal role of the IBD nurse within the MDT. <h3>Disclosure of interest</h3> None Declared. <h3>References</h3> Jelness-Jorgenson LP, <i>et al</i>. Is patient reported outcome (PRO) affected by different follow-up regimens in inflammatory bowel disease (IBD)? A one year prospective, longitudinal comparison of nurse-led versus conventional follow-up. J Crohn’s Colitis 2012;6(9):887–894 Whayman K, <i>et al</i>. Developing the role of the clinical nurse specialist in inflammatory bowel disease. Part 2: scope of practice. Gastrointest Nurs. 2012;10(9):22–29
Soundings: I couldn't believe my eyes
Authors: Liam Farrell
Journal: BMJ (2004)

I have advice for prospective patients—if you get sick, your word on its own may not be enough, so make sure that you have some concrete evidence of infirmity, or that your symptoms conform to an accepted pattern. The word “atypical” is pejorative in the medical world, implying one of three things: imagining it, deliberately making it up, or expensive and time consuming investigations will prove it to be benign. We doctors are scientifically trained; we believe that there is an order out there, and if something doesn't fit a scientifically validated pattern, we tend not to believe in it; if the bloods come back normal, it is even harder to persuade us. We're usually right, of course, but not always.

Joe had a new and exotic symptom to add to his catalogue: a feeling of impending doom.

“A frightful fiend doth close behind me tread,” he intoned morbidly, but there were no objective signs whatever.

“All right,” I said, “I'll run a few tests,” knowing I was only postponing things for a few days, but you never know, a few therapeutic bloods might help, and there is always the one-in-a-kajillion chance that something actually might turn up.

Joe returned a few days later. No change, he said; surprise, surprise, I said. Then suddenly he collapsed on to the floor, screaming (in agony, I think, but possibly delight). His abdomen became acutely distended, gouts of blood and acid flew everywhere, quite ruining my new shell suit, and an alien head with the now traditional slavering jaws burst out.

In 20 years of general practice, I've seen everything, so I tapped the key code for “parasitic infestation,” tempted the alien with a few convenient small children, sedated it with intravenous diazepam (finding a vein was a bit tricky), and stuffed it in the surgery fridge, from which nothing ever comes out.

Just then my receptionist arrived, with a sheet of paper. She has seen everything too. “I'll get the mop,” she said.

Joe was still lying on the floor, pale and exsanguinating, but with an annoyingly satisfied I-told-you-I-was-sick look on his face.

“There you are Joe,” I said, waving the sheet of paper at him, “Your tests are completely normal; there's nothing wrong with you.”
Prospects for the BCG vaccination programme in France
Authors: D Lévy-Bruhl
Journal: Eurosurveillance (2006)

Until recently, the French BCG vaccination programme consisted of a mandatory BCG vaccination before children started at daycare centres, and of re-vaccination of tuberculin-negative children. A re-assessment of this programme has been undertaken in recent years. It has led to the discontinuation of all revaccinations and post-vaccination tuberculin tests except those post-vaccination tuberculin tests performed as part of a diagnosis of tuberculosis infection or disease or of the follow-up of health or social workers for whom BCG vaccination remains mandatory. Based on an estimate of the epidemiological impact of either selective vaccination of high risk children or discontinuation of BCG vaccination, and taking into account the risk-benefit balance that can be made of the two options, the Conseil Supérieur d’Hygiène Publique de France (CSHPF, national high council of public hygiene) has recommended a change to selective vaccination. However, the committee has proposed the strengthening of other control measures aimed at decreasing the risk of infection for children, as a pre-requisite to the implementation of this strategy. This position is made more complex by the withdrawal of the multipuncture technique in early 2006, previously used in France in more than 90% of BCG primary vaccinations.
Emergence of extensively drug-resistant and pandrug-resistant Gram-negative bacilli in Europe
Authors: M Souli, I Galani, H Giamarellou
Journal: Eurosurveillance (2008)

International and local surveillance networks as well as numerous reports in the biomedical literature provide evidence that the prevalence of antibiotic resistant Gram-negative bacteria is escalating in many European countries. Furthermore, isolates characterised as multidrug-resistant (i.e. resistant to three or more classes of antimicrobials), extensively drug resistant (i.e. resistant to all but one or two classes) or pandrug-resistant (i.e. resistant to all available classes) are increasingly frequently isolated in hospitalised patients causing infections for which no adequate therapeutic options exist. Acinetobacter baumannii, Pseudomonas aeruginosa and Klebsiella pneumoniae are specifically addressed in this review as the most problematic and often extensively or pandrug-resistant pathogens. According to the available multicentre surveillance studies, the proportion of imipenem-resistant A. baumannii strains is reported to be as high as 85% in bloodstream isolates from intensive care unit patients in Greece and 48% in clinical isolates from hospitalised patients in Spain and Turkey. Among 33 European countries participating in the European Antimicrobial Resistance Surveillance System (EARSS) in 2007, six countries reported carbapenem resistance rates of more than 25% among P. aeruginosa isolates, the highest rate reported from Greece (51%). According to EARSS, Greece has also the highest resistance rates among K. pneumoniae; 46% to carbapenems, 58% to quinolones and 63% to third generation cephalosporins. This review describes the magnitude of antimicrobial resistance in Gram-negative bacteria in Europe highlighting where the efforts of the scientific communities, the academia, the industry and the government should focus in order to confront this threat.
Short-Term Dynamic Psychotherapy
Authors: Ragnhild Husby, Alv A. Dahl, Carl-Ivar Dahl, Astrid Nøklebye Heiberg, Ola M. Olafsen, Lars Weisœth
Journal: Psychotherapy and Psychosomatics (1985)

The aim of short-term dynamic psychotherapy is, through working with a central conflict and transference reactions, to obtain lasting changes based on cognitive and emotional understanding of the main dynamics of the central conflict, called insight. The aim of the present study was to construct a follow-up form that was easy to handle, could score different outcome of short-term dynamic psychotherapy, as for instance symptom relief, change in social functioning and better insight, and was reliable. Sufficient reliability was established with a reliability coefficient between 0.756 and 0.564 for eight result variables. Percentage agreement was estimated in addition. As a total only 10% of the scores differed more than +/- 1 from a consensus score on a scale from zero, no change, to 7, recovered. The therapist was a reliable observer of his/her own patients. The sex of the observer did not influence percentage agreement. High-formal training in psychotherapy tended to give higher percentage of agreement compared to low-formal training.
Psychogenic factors in kidney transplant rejection: a case study
Authors: M Viederman
Journal: American Journal of Psychiatry (1975)

The author examines the influence of psychic factors on kidney transplant rejection in a patient who suffered emotional trauma. As an adolescent, this man had reacted to the death of his father with an incomplete mourning response and had coped with the loss through identification and a search for surrogates. The death of a paternal surrogate immediately preceded the transplant rejection. The author emphasizes that the establishment of a causal relationship between a somatic event and a psychic antecedent is facilitated by demonstrating that a latent conflict has been evoked symbolically by an external event. Further research into such correlations could significantly enhance our understanding of disease processes.
EPID-29DURAL PRIMARY MARGINAL ZONE LYMPHOMA WITH LARGE B-CELLS PRESENT: A CASE REPORT AND REVIEW OF THE LITERATURE
Authors: Christopher Trevino, Suzanne Tucker
Journal: Neuro-Oncology (2015)

A 64-year-old female presented with personality changes, acalculia, falls, headache and nausea. CT and MR imaging of the head revealed a homogeneously contrast-enhancing 7 cm x 4.4 cm x 4.4 cm right frontal dural-based mass, concerning for a meningioma. She underwent a right frontal craniotomy with complete resection. Post-operative pathology demonstrated sheets of lymphocytes and plasma cells with small numbers of germinal cells present. The infiltrate was limited to the dura and leptomeninges. Immunophenotype as demonstrated by immunohistochemistry and flow cytometry was diagnostic of an extranodal marginal zone lymphoma with extensive plasmacytic differentiation. Given the normal bone marrow biopsy and absence of disease on CT chest, abdomen, and pelvis, she was diagnosed with an extranodal primary dural-based marginal zone B-cell lymphoma (MZL) with plasmacytic differentiation. Primary dural lymphomas are a well-described subset of primary central nervous system (CNS) lymphomas that most commonly present as low grade lymphomas. MZLs generally carry a much better prognosis than typical diffuse large B-cell lymphomas. This case illustrates that hematopoietic malignancies should be considered in the differential diagnosis of dural based masses in addition to meningiomas or less common dural metastases, solitary fibrous tumors, leiomyosarcomas, and hemangiopericytomas. Typically dural based lymphomas have increased vasogenic edema compared to meningiomas. Unlike other extranodal MZLs, dural based MZLs have no strong association with chronic inflammatory conditions, infections, or immunosuppression. The literature supports that MLZs are very radiosensitive; with excision and low dose-localized radiation therapy, patients may remain disease free locally. However, systemic recurrence may occur, possibly because the dura is outside the blood brain barrier. Appropriate diagnosis is important as it has both prognostic and treatment implications.
MAGE-A3 Recombinant Protein (recMAGE-A3) Immunotherapy and Autologous Peripheral Blood Lymphocyte (PBL) Infusion Is Safe and Induces Robust Humoral Immune Responses In Multiple Myeloma (MM) Patients Undergoing Autologous Stem Cell Transplantation (autoSCT)
Authors: Nikoletta Lendvai, Sacha Gnjatic, Achim A Jungbluth, Stephane Bertolini, Linda Pan, Ralph Venhaus, Ioanna Tsakos, Katarzyna Garcia, Linda Thibodeau, Katherine Alpaugh, Nailah Cummings, Rafik Fellague-Chebra, Olivier Gruselle, Hearn J. Cho
Journal: Blood (2013)