tbuckley/cabot-search huggingface dataset:
Low prevalence of serrated polyposis syndrome in screening populations: a systematic review
Authors: Yasmijn van Herwaarden, Moniek Verstegen, Polat Dura, Wietske Kievit, Joost Drenth, Evelien Dekker, Joep IJspeert, Nicoline Hoogerbrugge, Fokko Nagengast, Iris Nagtegaal, Tanya Bisseling
Journal: Endoscopy (2015)

<b>Background and study aims:</b> The most frequently cited prevalence for serrated polyposis syndrome (SPS) is 1 in every 3000 people screened, but this value is debated. Additionally, changes in 2010 in the World Health Organization (WHO) diagnostic criteria for SPS might affect reported prevalence. An updated estimate of SPS prevalence is necessary to predict the number of cases in screening programs. <b>Patients and methods:</b> A systematic literature search was conducted in the PubMed, EMBASE, and Web of Science databases up to February 2014. Studies reporting the prevalence of SPS, as defined by WHO criteria, in screening populations were selected. <b>Results:</b> Six studies reported prevalence of SPS in screening populations, varying from 0 to 0.66 %. The highest prevalences (0.34 % and 0.66 %) were seen in studies from screening programs with patients pre-selected by fecal blood test. Primary colonoscopy-based screening programs, that have the lowest risk of bias, reported SPS prevalences ranging from 0 to 0.09 %. Across studies, 56 patients were diagnosed with SPS of whom 3 presented with synchronous colorectal cancer at index endoscopy. <b>Conclusion: </b>The true prevalence of SPS is unclear because of the risk of bias across studies, but is likely to be below 0.09 % as derived from primary colonoscopy screening programs. The prevalence in pre-selected screening populations after positive fecal testing is higher, with reported values of 0.34 % and 0.66 %. Large and high quality primary colonoscopy screening studies, reporting SPS prevalence in adequately described populations, are necessary for better estimation of the true prevalence of SPS in average-risk patients.
FRI0448 PAH Risk Calculator (Detect), Besides SSC-PAH, Reveals SSC Patients with Borderline and Exercise-Induced PH
Authors: A. Volkov, N. Yudkina, I. Kurmukov, E. Nikolaeva
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Early diagnostics PAH, associated with SSc is very important, due to devastating nature of the disease. Borderline and exercise-induced PH is a condition thought to represent early-stage pulmonary arterial vasculopathy. <h3>Methods</h3> We selected 21 patients with SSc (age 52+10 years, all female) with normal resting mean PAP (17 (14;21) mm Hg) who underwent graded bicycle supine exercise right heart catheterization (RHC). Patients were included in this study if they had 1) a pulmonary artery wedge pressure (PAWP) ≤15 mmHg by RHC; 2) no significant interstitial lung disease; 3) no left heart diseases like systemic hypertension, ischemic heart disease etc. Mean pulmonary artery pressure (mPAP), cardiac output (CO), and others were estimated invasively. Cut-off values of mean PAP ≥30 mm Hg at peak exercise were considered exercise-induced pulmonary hypertension (EI-PH), mean PAP 21-24 mm Hg so-called borderline pulmonary hypertension (Bo-PH). The risk of PAH development was calculated by DETECT PAH risk calculator. <h3>Results</h3> 11 of 21 pts had risk factors by DETECT calculator. We didn9t find PH at rest RHC in none of 21 pts. 6 SSc pts had mPAP level between 21-24 mm.Hg. 10 (48%) patients showed EI-PH (median level of mPAP =36 (32; 42) mm Hg), 7 hadn9t changes in pressure follow exercises. 4 pts were excluded due to low exercise tolerance. We revealed significant correlation between the level of mPAP and DETECT total risk score (r=0,55, p&lt;0,01). We found that patients with EI-PH had significantly higher DETECT PAH risk score than patients without EI-PH (38 (27; 42) vs 25 (16; 35), p&lt;0,05). Calculated level of PAH risk in both DETECT steps were also different depending on existence Bo-PH (41 (34; 43) vs 28 (25; 36), p&lt;0,02). <h3>Conclusions</h3> Our small study assume that DETECT PAH risk calculator also may help to recognize SSc patients who have preclinical stage of PAH. <h3>References</h3> Coghlan JC, Denton CP, Grünig E, et al. Evidence-based detection of pulmonary arterial hypertension in systemic sclerosis: the DETECT study. Ann Rheum Dis 2014;73:1340–1349. Saggar R. et al. Exercise-Induced Pulmonary Hypertension Associated With Systemic Sclerosis. Arthritis &amp; Rheumatism, 2010, v.62(12), pp.3741-3750. <h3>Disclosure of Interest</h3> None declared
Esophageal Stenting in Unusual Situations
Authors: C S Shim
Journal: Endoscopy (2003)

Esophageal cancer is frequently unresectable at the time of diagnosis because of local invasion or metastatic disease. Therapy is therefore usually palliative in nature, with the major aims being relief of dysphagia, maintenance of nutrition and occlusion of tracheoesophageal fistula. Palliative surgery eventually offers the best palliation for esophageal obstruction symptoms and signs such as dysphagia and vomiting. However because of the very poor prognosis, the short median survival time and the considerable morbidity and mortality rate of surgery, this approach cannot be justified in preference to less invasive nonsurgical techniques.
Body-Mass Index and Risk of Death in Asians
Authors: Alpana P Shukla
Journal: New England Journal of Medicine (2011)

To the Editor: The study by Zheng et al. (Feb. 24 issue) 1 seeks to fill a major gap in the under - standing of the relationship between body-mass index (BMI) and mortality in Asians, who repre - sent more than 60% of the global population. The results of the study suggest that the effect of BMI on cardiovascular mortality differs between East Asian and Indian-Bangladeshi subjects. In their analysis of BMI and cancer mortality, the authors report that leanness is associated with greater risk. Although the study has controlled for the effect of smoking, tobacco chewing, a com - mon practice in the Indian population, is not con - sidered. Smokeless tobacco is associated with an increased risk of cancer, particularly oral cancer. 2
Phase II trial of chronic daily VP-16 administration in unresectable hepatocellular carcinoma (HCC)
Authors: R Wierzbicki, A Ezzat, A Abdel-Warith, A Ayoub, I Kagevi, M Fadda, J Sieck, M Abdulkareem, T Amin, A Yazigi
Journal: Annals of Oncology (1994)
Priorities in psychiatric residency training
Authors: C L Bowden, F J Humphrey, M G Thompson
Journal: American Journal of Psychiatry (1980)

The authors surveyed 22 psychiatric educators to determine their views of the basic knowledge and skills that should be required for all psychiatric residents. A comprehensive document of educational objectives facilitated practical differentiation of responses. Diagnostic, problem-solving, and treatment-dispositional skills were particularly highly ranked. Such data may be useful in defining the profession of psychiatry as well as in curriculum planning.
Multicentric carcinoid tumor of the ileum localized by radioguided laparotomy.
Authors: MARGARITA DE LA OSSA, WILLIAM SMOAK, IRWIN WILLIS, MORTON ROBINSON
Journal: Clinical Nuclear Medicine (2001)

DE LA OSSA, MARGARITA M.D.; SMOAK, WILLIAM M.D.; WILLIS, IRWIN M.D.; ROBINSON, MORTON J. M.D. Author Information
Overview: public health issues in tardive dyskinesia
Authors: G Gardos, J O Cole
Journal: American Journal of Psychiatry (1980)

Public health concern over tardive dyskinesia has been rising, but the magnitude of the problem has been undetermined. The incidence of tardive dyskinesia is unknown, and prevalence rates yield conflicting and possibly misleading estimates. The natural course of tardive dyskinesia is highly variable: in some patients (probably many fewer than previously believed) it is irreversible. No currently available therapeutic agent satisfies the criteria of safety, marked effectiveness, and prolonged efficacy in the treatment of tardive dyskinesia. Primary prevention involves reducing antipsychotic drug exposure, secondary prevention involves early diagnosis and prompt intervention, and tertiary prevention involves clinical measures to reduce disability and to treat severe cases vigorously. Educational methods that disseminate knowledge and influence prescribing habits need to be identified and used more widely.
Ultrastructure of the Rabbit Papilloma Virus&lt;xref ref-type="fn" rid="FN1"&gt;2&lt;/xref&gt;
Authors: F. Haguenau, R. A. Bonar, Dorothy Beard, J. W. Beard
Journal: JNCI Journal of the National Cancer Institute (1960)

The ultrastructure of the rabbit papilloma virus particle has been studied by electron micrography of thin sections of the purified agent, obtained from 7 different batches of warts occurring naturally in cottontail rabbits. In preparations treated by procedures including fixation with osmic acid and staining with uranyl acetate and lead hydroxide, there were observed essentially circular images, 26 to 29 mµ diameter, exhibiting a densely stained internal structure. This was distributed in a thick threadlike or granular form and filled most of the demonstrable substance of the particle. There were also numerous images of low contrast resembling “ghost” forms seen in preparations of other filterable agents. The appearance of the images differed greatly from that of other viruses associated with tumors. The results are discussed in relation to the constitution of purified tumor viruses and its bearing on the demonstration of structure with the stains employed.
Private psychiatry and accountability: a response to the APA task force report on private practice
Authors: S S Sharfstein, C A Taube, I D Goldberg
Journal: American Journal of Psychiatry (1975)

The authors note that the imminence of national health insurance makes it very important to determine the roles, efficiency, and effectiveness of both the private and the public sectors of mental health care. The difficulties in distinguishing public from private care are examined. The authors present estimated distributions of care by type of provider that differ from those of an APA task force report on private practice. They point out the need for objective research on the quality of care in both sectors and on the effectiveness of alternative mental health systems, suggesting that public choices should be made on the basis of correct interpretations of reliable data and accountability to those being served.
PTU-315 Coeliac – supported, self help and management programme (c-sshamp); uk’s first remote web-based management system for stable coeliac patients
Authors: MW Johnson, K Rostami, M Marsh, P Ciclitira
Journal: Gut (2015)

<h3>Introduction</h3> The 1:150 prevalence of coeliac patients in UK carries an economic burden and has created a dilemma for the NHS in how best to deal with the increasing numbers. The 2010 BSG guidelines on the “Management of coeliac disease in UK”,<sup>1</sup>advocates that all coeliac patients should receive longterm review with someone experienced in coeliac management. Many Clinical Commissioning Groups have therefore recommended discharging these patients for community review. Unfortunately, we often find that these patients have not received the appropriate care and support they need, and are being re-referred back to the hospital once potentially avoidable long-term complications have already occurred. We set out to try and prevent this by developing a alternative, cost efficient, safe and effective method of managing our stable coeliac patients. <h3>Method</h3> A 7 year retrospective analysis of all serology, duodenal histology and dietetic referrals requested through the Luton and Dunstable University Hospital was used to create a database of all local coeliac patients. With the support of Coeliac UK and our own local Coeliac Forum Group, we have developed personalised web-sites, using Patient Knows Best (PKB), to assist with the remote management of community based coeliac patients, whilst still providing hospital based specialist over-view. <h3>Results</h3> We now have a database of 1264 coeliac patients. Since January 2014 we have steadily started moving our more stable patients on to our Coeliac – Supported, Self Help And Management Programme (C-SSHAMP). Presently this offers a personalised websites with a novel coeliac symptomatic monitoring system, an alert system if a patient score badly, a library of self help advice sheets and a record of their virtual consultations. The system provides a direct portal of access between patients and their specialists, can be converted into 14 different languages and has both iPhone or Android apps developed. Annually blood tests are reviewed through a virtual (telephone) clinic to monitor and support patients. <h3>Conclusion</h3> C-SSHAMP is the first remote web-based management system in UK for stable coeliac disease patients. We believe we can automate much of the BSG guidance about annual review, whilst providing a “remote” presence which will act as a gentle reminder to improve compliance with acceptance and adjustment to a strict gluten free diet. By empowering our patients with the confidence and knowledge to monitor and manage their condition more effectively themselves, we aim to reduce the long term complication rate. <h3>Disclosure of interest</h3> None Declared. <h3>Reference</h3> Ciclitira P, Dewar DH, McLaughlin SD, <i>et al</i>. The management of adults with COELIAC disease. <i>Br Soc Gastroenterol</i>2010
Intravenous versus intramuscular atropine in ECT
Authors: B A Kramer, A Afrasiabi, V E Pollock
Journal: American Journal of Psychiatry (1992)

Twelve patients receiving ECT consented to random assignment to either intravenous or intramuscular administration of atropine for a total of 48 ECTs. There were no statistically significant differences between routes of administration in heart rate, blood pressures, or sialorrhea, but intravenous administration eliminated one injection per treatment and the development of dry mouth and tachycardia between the intramuscular injection and ECT. The authors recommend that atropine for ECT be administered intravenously.
A multilevel approach to understanding the resurgence and evolution of infectious syphilis in Western Europe
Authors: K Fenton
Journal: Eurosurveillance (2004)

Nearly eight years after an outbreak of infectious syphilis was first reported in Bristol, England, successive outbreaks have occurred in most western European countries. In this issue of Eurosurveillance we take a look at the recent resurgence and evolution of infectious syphilis in seven European countries in order to critically review our understanding of its epidemiology, and to examine opportunities for directing interventions in the near future. The papers also provide some insight into the multilevel, multifactorial causation of syphilis epidemics, and how this may be changing over time in the presence of preventive interventions.
PTU-242 Diagnostic accuracy of serial complement protein analysis in acute appendicitis: c3, c4, ic3b and tcc
Authors: MJ Marshall, AM Shaw, NJ Smart, IR Daniels
Journal: Gut (2015)

<h3>Introduction</h3> White cell count (WCC) and C-reactive protein (CRP) use in the diagnosis of acute appendicitis (AA) lacks sufficient sensitivity and specificity. The aim of this study was to assess the diagnostic accuracy of admission and serial plasma Complement proteins C3, C4, iC3b and TCC in AA. <h3>Method</h3> A prospective observational study was undertaken between February 2012 and December 2013. Patients aged ≥18 years presenting with right iliac fossa pain with suspected AA were recruited. AA was defined histologically in operatively managed patients or on CT in conservatively managed cases. Plasma C3, C4, iC3b and TCC were measured on admission and at 4 and 8 h. The change (∆) in biomarker over 4 and 8 h was calculated by subtracting the concentration at admission from that at each time point to give ∆<sub>4</sub>and ∆<sub>8</sub>, respectively. Admission and ∆ values were compared in AA and all other conditions (non-AA) and the diagnostic efficacy was assessed using Receiver Operating Characteristic (ROC) curves. <h3>Results</h3> 74 patients were recruited to the study, 26 participants were male (35%) with a median age of 33 years (range 18–84). Blood samples were obtained at 4 h and 8 h after admission in 43 and 28 patients, respectively. 31 patients underwent appendicectomy. AA was diagnosed in 22 cases (one case being diagnosed by CT and treated conservatively). Isolated admission C3, C4, iC3b and TCC did not discriminate between AA and non-AA. TCC∆<sub>4</sub>was diagnostic with a ROC Area Under Curve (AUC) of 0.84 (95% C. I 0.69–0.99). Admission WCC, Absoulte Neutrophil Count (ANC) and CRP demonstrated ROC AUCs of 0.75 (0.62–0.88), 0.76 (0.63–0.89) and 0.78 (0.67–0.88), respectively. <h3>Conclusion</h3> TCC∆<sub>4 </sub>demonstrates good diagnostic accuracy in AA superior to admission conventional biomarkers WCC, ANC and CRP. TCC∆<sub>4</sub>could be used as a four hourly blood test in the Emergency Department to stratify patient risk for admission or further investigation. Further validation in a prospective observational study is required. <h3>Disclosure of interest</h3> None Declared.
Soundings: Postcard from Sussex
Authors: Trisha Greenhalgh
Journal: BMJ (1999)

The children recently developed some romantic notion of going camping for the weekend. Their vision (acquired from I know not where) includes hot sausages on demand, clear starry skies, crackling campfires, and jolly sing songs. My own memories of camping (from the none too distant era when our holiday venues were dictated by financial necessity) are not quite thus, but I have agreed to give it another go. 

The English campsite is not so much a microcosm of society as its mirror image. The west end of this site sports a terrace of super pitches separated by high hedges, on each of which stands an impossibly large touring caravan sprouting high tech appendices, and—more often than not—a very old Cortina. Through the double glazed windows we dimly see clusters of satisfied faces watching satellite television and eating three course dinners prepared in a scaled down version of an Ideal Home kitchen.

Down market of these lies row upon row of cottage style tents, each positioned three metres from its neighbour with a neat little lawn and a secondhand Golf out front. Most seem to have modest home improvements in the form of windbreaks or awnings, behind which dad is enthusiastically preparing the nightly barbecue with a beer in his hand and the radio set to easy listening.

As self declared “basic” campers, we are sent downtown to the walkers’ enclosure. We pick our space among back to back terraces of olive green pup tents in which off duty executives stuff their hiking boots with broadsheets and brew China tea very slowly on temperamental primus stoves. Later, they will eat tinned stew and join us in the self satisfied conversations of those who have successfully freed up a weekend to get away from it all.

Football is the great leveller. Our lads line up shyly on the sideline, and within seconds are absorbed into a game. Someone from the posh end of town asks them how we all fit into our “poxy” home at night.

Fortunately, a goal is scored, and class differences forgotten in the urgent plan to equalise. With the equinox upon us, we adults can rest assured that the game will continue for hours yet.

We pull out the Friday comics, unroll our bedding, and begin to relax. “Snap,” says a voice. Someone in the tent opposite is already reading the BMJ.
Negative Haemoccult<sup>®</sup>Test in Malignant and Premalignant Lesions of the Colon
Authors: J M Kimmig, M Strauch, M Hallen
Journal: Endoscopy (1989)

To date, no published report on a trial has provided sufficiently strong evidence of the accuracy of the Haemoccult Test assessed by false-negative error, and validated on the basis of a complete colonoscopy of all patients. Total colonoscopy (up to the cecum) was performed on 534 patients whose stools had been tested for occult blood. The results of the colonoscopy were classified as follows: --expected continual bleeding (target lesions: carcinoma, polyps greater than or equal to 10 mm) --intermittant bleeding (polyps less than 10 mm, colitis, etc.), and --no source of bleeding. Results were regarded as false-negative in patients who were found to have a target lesion (carcinoma, polyp greater than or equal to 10 mm) following a negative Haemoccult test. Apart from positive and negative prognostic values, sensitivity and specificity were taken into account as characteristics for the quality of the test. Following a positive Haemoccult test result 46 of the 534 patients were found to have polyps greater than or equal to 10 mm and 22 carcinomas; following negative Haemoccult test results 31 patients were found to have polyps measuring greater than or equal to 10 mm in diameter and 2 carcinomas. On the basis of the chosen classification a false-negative Haemoccult result was established in 8.6% and a false-positive result in 4.3%. The Haemoccult test showed a sensitivity of 67% and a specificity of 93% in patients with target lesions or patients without a source of bleeding.
JAK2 exon 12 mutant mice display isolated erythrocytosis and changes in iron metabolism favoring increased erythropoiesis
Authors: Jean Grisouard, Sai Li, Lucia Kubovcakova, Tata Nageswara Rao, Sara C. Meyer, Pontus Lundberg, Hui Hao-Shen, Vincent Romanet, Masato Murakami, Thomas Radimerski, Stephan Dirnhofer, Radek C. Skoda
Journal: Blood (2016)