tbuckley/cabot-search huggingface dataset:
Culdocentesis and ectopic pregnancy.
Authors: P S Cartwright, B Vaughn, D Tuttle
Journal: BMJ (1970)

Seventy-seven patients with ectopic pregnancy underwent culdocentesis; the tap was positive in 70%, negative in 10% and inadequate in 20%. A positive tap was significantly associated with a low hematocrit but was often obtained in patients without hypotension, tachycardia, peritoneal irritation or tubal rupture. While patients with peritoneal irritation were significantly more likely to have a large hemoperitoneum, many with 500 ml or more of hemoperitoneum did not have peritoneal irritation, hypotension, tachycardia, low hematocrit or tubal rupture. Culdocentesis is valuable for evaluating the patient suspected of having an ectopic pregnancy, and the absence of tachycardia, hypotension, low hematocrit or peritoneal irritation should not dissuade one from performing the test. A positive tap does not indicate tubal rupture, and a large hemoperitoneum may accumulate in its absence.
AB0954 Local Steroid Injection Versus Wrist Splinting for Carpal Tunnel Syndrome: A Randomized Clinical Trial and a Qualitative Exploration
Authors: H. So, V. Chung
Journal: Annals of the Rheumatic Diseases (2015)

Cancer-associated microangiopathic haemolytic anaemia (CA-MAHA) is a syndrome characterised by Coombs-negative haemolytic anaemia and thrombocytopenia. It is primarily seen in advanced solid tumours and is distinct from thrombotic thrombocytopenic purpura/haemolytic uraemic syndrome. Diagnosis is often delayed and patients have a high mortality. We present the case of CA-MAHA in a patient with metastatic breast cancer treated successfully with early initiation of chemotherapy. In addition, we report longitudinal laboratory evaluation of circulating tumour cells and microparticles and suggest a hypothesis for the mechanism behind CA-MAHA.
Congenital Adrenal Hyperplasia
Authors: Perrin C. White, Maria I. New, Bo Dupont
Journal: New England Journal of Medicine (1987)

(Second of Two Parts)Molecular Genetics of 21-Hydroxylase DeficiencyIt has been demonstrated that the HLA-linked defect in 21-hydroxylase deficiency involves a structural gene for the corresponding cytochrome P450 (P450c21). A bovine cDNA clone was isolated that encoded part of this enzyme (i.e., "complementary DNA," corresponding to the messenger RNA for P450c21, linked to sequences that allowed this DNA to replicate autonomously in bacteria).52 DNA samples were extracted from leukocytes obtained from normal persons and from patients with 21-hydroxylase deficiency who carried the characteristic HLA haplotype A3;Bw47:DR7. These samples were analyzed with use of Southern blot hybridization.4, 53 For this analysis, . . .
Psychiatric services in Soviet general outpatient clinics
Authors: B M Segal
Journal: American Journal of Psychiatry (1979)

The author believes that the first level of psychiatric care in the U.S.S.R.--the general polyclinics (outpatient clinics) and the medical-sanitary units--have not been adequately studied. He describes this level of care, which is considered useful and progressive in that the clinics are supposed to make psychiatric care available to the population, lighten the load placed on psychiatric facilities, and improve follow-up therapy. However, he also points out the shortcomings in this first level of psychiatric care in the U.S.S.R., including the bureaucratic nature of the system and the uneven quality of service the clinics render to various social groups in urban and rural areas.
Lack of Infectivity of Bovine Leukemia (C-Type) Virus to Rats 2
Authors: Stephen W. Barthold, Lois E. Baumgartener, Carl Olson
Journal: JNCI Journal of the National Cancer Institute (1976)

Sprague-Dawley rats were given ip injections of bovine culture and sheep cultures of bovine leukemia virus (BLV) and Gross passage-A leukemia virus [MuLV(G)]. Sera were tested for precipitin antibodies to BLV antigens, but none had antibodies to BLV antigens. BLV did not induce tumors in Sprague-Dawley rats, but the rats were susceptible to MuLV(G) at low doses.
Coping with adversaries in elective public office
Authors: E Messner
Journal: American Journal of Psychiatry (1981)

The author, a psychoanalyst who has served as an elected public official, has observed and participated in many adversary relationships in that they provide explicit procedures for expression and resolution of disputes. These cognitive features can neutralize some of the emotional impact of the conflicts, but their frequency, intensity, and pervasiveness can still be stressful to elected officials. The author describes his own strategies for coping with that stress as well as some strategies used by other elected officials.
PTU-030 Eus-guided insertion of self-expandable metal stents facilitates access for endoscopic necrosectomy in walled-off necrosis
Authors: A Koutsoumpas, R Palmer, S Ket, S Reddy, M Silva, Z Soonawalla, B Braden
Journal: Gut (2015)

<h3>Introduction</h3> Wide flange fully covered self-expandable metallic stents (FCSEMS) have recently been developed for EUS-guided transmural drainage of pancreatic fluid collections. We used these wide calibre stents for transgastric access for endoscopic necrosectomy in patients requiring necrotic debridement. <h3>Method</h3> Patients referred with large, symptomatic walled off-necrosis for endoscopic therapy were included. Under EUS guidance, the necrotic cavity was accessed using the needle knife of a cystotome. After securing the access with a guidewire the new tract was enlarged to 10 F using the ring diathermy of the cystotome. This allowed a 2 or 3 cm long 14 mm diameter FCSEMS to be placed transmurally. If clinically required, endoscopic necrosectomy sessions were performed through the FCSEMS in weekly intervals. <h3>Results</h3> Six patients (5 men, median age 50 years) had a walled off-necrosis with a median size of 16 cm (range 12–17 cm) causing gastric outlet obstruction (5) or biliary compression (1). One patient with an endosonographically visible artery transversing the necrotic cavity was declined due to bleeding risk. In the other five patients, the insertion of a transgastric FCSEMS under EUS guidance was successful without immediate complications. In all five patients, the cavity reduced to &lt;3 cm after a mean of 3 (range 2–5) endoscopic necrosectomy sessions. There were no major complications. One stent migration occurred after the cavity had reduced to less than 3 cm. <h3>Conclusion</h3> EUS-guided insertion of FCSEMS into walled-off necrosis appears safe and results in effective drainage. Endoscopic necrosectomy can be performed through the transmural FCSEMS which provides endoscopic access for repeated debridement and flushing of the necrotic cavity. <h3>Disclosure of interest</h3> None Declared. <h3>References</h3> Seifert H, Wehrmann T, Schmitt T, Zeuzem S, Caspary WF. Retroperitoneal endoscopic debridement for infected peripancreatic necrosis. Lancet 2000;356(9230):653–5 Braden B, Dietrich CF. Endoscopic ultrasonography-guided endoscopic treatment of pancreatic pseudocysts and walled-off necrosis: new technical developments. World J Gastroenterol. 2014;20(43):16191–6. doi: 10.3748/wjg.v20.i43.16191
Biological Studies on the Rous Sarcoma Virus. V. Preparation of Improved Standard Lots of the Virus for Use in Quantitative Investigations
Authors: John B. Moloney
Journal: JNCI Journal of the National Cancer Institute (1956)

Journal Article Biological Studies on the Rous Sarcoma Virus. V. Preparation of Improved Standard Lots of the Virus for Use in Quantitative Investigations Get access John B. Moloney John B. Moloney 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 4, February 1956, Pages 877–888, https://doi.org/10.1093/jnci/16.4.877 Published: 01 February 1956 Article history Received: 15 August 1955 Published: 01 February 1956
PWE-425 Does the presence of a trainee compromise biliary cannulation rates at ercp :results from a prospective audit
Authors: AK Kurup, S Shetty, NC Fisher
Journal: Gut (2015)

<h3>Introduction</h3> A trainee endoscopist on the ERCP list prolongs procedure time and may increase risk of technical failure or procedural complications.<sup>1,2</sup>Recent BSG guidance has identified a biliary cannulation rate of 90% as an ERCP performance indicator which may conflict with the need to train juniors. This prospective audit assessed the impact of an endoscopy trainee on the overall biliary cannulation rates. <h3>Method</h3> We prospectively audited sequential ERCPs done on a “virgin” ampulla (no previous ERCP). Procedures were supervised by 2 experienced trainers; trainees were present when possible (trainees were senior SpRs with limited ERCP experience). A short-wire system was used for biliary cannulation and standard techniques used.<sup>1</sup>The trainee would have 6 min to achieve biliary cannulation, failing which the trainer would take over. Predicted ERCP difficulty was graded using accepted criteria.<sup>3</sup>The primary outcome was the biliary cannulation rate. <h3>Results</h3> One hundred and eight sequential ERCPs were prospectively audited over a period of 6 months [July 2014–Dec 2014]. Difficulty was graded as 1 (n = 69] or 2 [n = 39]. One of two trainee endoscopists was present during 61[56%] ERCP cases; remaining cases were done by a consultant alone [n = 47, 44%]. Deep biliary cannulation was successful in 99 cases [91%]. The cannulation rate was 93% [57/61] with a trainee and 89% [42/47] without[p = 0.7229 Fishers exact test] Median cannulation time was 6.6 min (range 1–25). There was no significant difference in cannulation times when a trainee was present[T test, p = 0.890]. Where a trainee was involved, 20/61[32%] cannulations were achieved independently by the trainee. There were no major complications recorded in cases where a trainee was involved. <h3>Conclusion</h3> This audit suggested that acceptable biliary cannulation rates can be achieved on ERCP training lists, with involvement of experienced trainers and defined training parameters. <h3>Disclosure of interest</h3> None Declared. <h3>References</h3> Freeman ML, Nelson DB, Sherman S, Haber GB, Herman ME, Dorsher PJ, <i>et al</i>. Complications of endoscopic biliary sphincterotomy. N Engl J Med. 1996;335:909–18 Shekhar, Shetty, Fisher BSG 2014 (abstract) SchutzSM, AbbottRM. Grading ERCPs by degree of difficulty: a new concept to produce more meaningful outcome data. Gastrointest Endosc. 2000;51(5):535–9
Decline in Circulating Tumor Cell Count and Treatment Outcome in Advanced Prostate Cancer
Authors: David Lorente, David Olmos, Joaquin Mateo, Diletta Bianchini, George Seed, Martin Fleisher, Daniel C. Danila, Penny Flohr, Mateus Crespo, Ines Figueiredo, Susana Miranda, Kurt Baeten, Arturo Molina, Thian Kheoh, Robert McCormack, Leon W.M.M. Terstappen, Howard I. Scher, Johann S. de Bono
Journal: European Urology (2016)

Treatment response biomarkers are urgently needed for castration-resistant prostate cancer (CRPC). Baseline and post-treatment circulating tumor cell (CTC) counts of ≥5 cells/7.5 ml are associated with poor CRPC outcome. To determine the value of a ≥30% CTC decline as a treatment response indicator. We identified patients with a baseline CTC count ≥5 cells/7.5 ml and evaluable post-treatment CTC counts in two prospective trials. Patients were treated in the COU-AA-301 (abiraterone after chemotherapy) and IMMC-38 (chemotherapy) trials. The association between a ≥30% CTC decline after treatment and survival was evaluated using univariable and multivariable Cox regression models at three landmark time points (4, 8, and 12 wk). Model performance was evaluated by calculating the area under the receiver operating characteristic curve (AUC) and c-indices. Overall 486 patients (122 in IMMC-38 and 364 in COU-AA-301) had a CTC count ≥5 cells/7.5 ml at baseline, with 440, 380, and 351 patients evaluable at 4, 8, and 12 wk, respectively. A 30% CTC decline was associated with increased survival at 4 wk (hazard ratio [HR] 0.45, 95% confidence interval [CI] 0.36–0.56; p < 0.001), 8 wk (HR 0.41, 95% CI 0.33–0.53; p < 0.001), and 12 wk (HR 0.39, 95% CI 0.3–0.5; p < 0.001) in univariable and multivariable analyses. Stable CTC count (<30% fall or <30% increase) was not associated with a survival benefit when compared with increased CTC count. The association between a 30% CTC decline after treatment and survival was independent of baseline CTC count. CTC declines significantly improved the AUC at all time-points. Finally, in the COU-AA-301 trial, patients with CTC ≥5 cells/7.5 ml and a 30% CTC decline had similar overall survival in both arms. A 30% CTC decline after treatment from an initial count ≥5 cells/7.5 ml is independently associated with CRPC overall survival following abiraterone and chemotherapy, improving the performance of a multivariable model as early as 4 wk after treatment. This potential surrogate must now be prospectively evaluated. Circulating tumor cells (CTCs) are cancer cells that can be detected in the blood of prostate cancer patients. We analyzed changes in CTCs after treatment with abiraterone and chemotherapy in two large clinical trials, and found that patients who have a decline in CTC count have a better survival outcome.
Stereotactic body radiation therapy for low-, intermediate- and high-risk prostate cancer: Disease control and quality of life at 9 years.
Authors: Alan J. Katz, Josephine Kang
Journal: Journal of Clinical Oncology (2016)

20 Background: Stereotactic body radiation therapy (SBRT) takes advantage of the prostate’s low α/β ratio to deliver a large radiation dose in a few fractions. This prospective study expands upon prior studies to further evaluate SBRT efficacy and QOL for a large patient population that includes low-, intermediate- and high-risk patients with prostate cancer. Methods: 515 patients with organ-confined prostate cancer (471 T1c and 44 T2a, all N0M0) received robotic SBRT. The median age was 69 years and the median PSA was 6.48 ng/ml. By NCCN criteria, 324 patients were low-risk, 139 were intermediate-risk, and 52 were high-risk. Androgen deprivation therapy was administered to 70 patients for up to one year. 158 patients with Gleason scores &lt; 4+3 received 35 Gy delivered in 5 daily fractions. The remaining patients, from all risk groups, received a total dose of 36.25 Gy in 5 daily fractions. The proximal seminal vesicles were treated except in low-risk cases. Biochemical failure was assessed using the Phoenix criterion and QOL was assessed with EPIC scoring. Results: At a median follow-up of 84 months, 74 patients died (72 from unrelated causes). The median PSA at 78 months was 0.11 ng/ml. The actuarial 9 year freedom from biochemical failure was 95%, 89%, and 66% for the low-, intermediate- and high-risk groups (p = 0.01). For patients with Gleason scores &lt; 4+3, there was no difference in terms of median nadir or biochemical control between doses of 35 and 36.25 Gy. Late RTOG toxicity was mild with 4% grade 2 rectal, 9.5% grade 2 urinary, and 1.9% grade 3 urinary. Late grade 2-3 urinary toxicity was 6.9% for 35 Gy vs. 13.2% for 36.25 Gy (p = 0.01). Mean EPIC urinary and bowel QOL declined at 1 month post-treatment and returned to baseline by 2 years where it remains. EPIC sexual QOL declined by 29% at 78 months. Conclusions: SBRT alone produces excellent biochemical control rates at up to 9 years with mild toxicity and minimal impact on quality of life. These long-term results appear superior to standard IMRT with lower cost and are strikingly similar to HDR therapy. These results also strongly suggest that 35 Gy is as effective as 36.25 Gy for patients with Gleason &lt; 4+3, with less urinary toxicity.
SAT0351 Is Illness Perception and Coping Associated with the Patient-Related Treatment Delay in Early Rheumatoid Arthritis? An Explorative Study Within the Carera Trial
Authors: K. Van der Elst, D. De Cock, E. Vecoven, S. Arat, S. Meyfroidt, J. Joly, P. Moons, P. Verschueren, R. Westhovens
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Persons, later on diagnosed with early rheumatoid arthritis (ERA), often delay their first contact with a health professional after symptom onset. Besides initial symptoms, psychosocial characteristics of individuals may influence their help-seeking behavior. <h3>Objectives</h3> To explore the role of disease characteristics, illness perception and coping style on the patient-related delay at treatment initiation in recently diagnosed patients with ERA. <h3>Methods</h3> This explorative, cross-sectional study included 112 patients with ERA from the CareRA trial of whom complete data on patient-related delay, coping and illness perception were available. In addition to baseline socio-demographic and clinical data, we collected information on the patients9 psychosocial profile with the Utrecht Coping List and the Revised Illness Perception Questionnaire. Correlations were measured by Spearman9s rho. By means of a regression analysis, we weighted the association of variables on patient-related delay. <h3>Results</h3> The patient-related delay was positively correlated with perceptions of causality including psychological attributions (r=0.301, p=0.001), risk factors (r=0.189, p=0.045) and immunity (r=0.261, p=0.005), and with passive coping (r=0.222, p=0.018). It was negatively correlated with the 28-Swollen Joint Count (r=-0.194, p=0.040), perceptions of treatment control (r=-0.271, p=0.004) and illness coherence (r=-0.208, p=0.028). Clinical and psychosocial variables explained respectively 15% and 18% of the variability in patient-related delay. <h3>Conclusions</h3> Aside from a lower swollen joint count, a longer patient-related delay was correlated with a passive coping style, a strong conviction of symptom causality, poor expected treatment control and a feeling of limited illness coherence. Psychosocial aspects could influence individuals9 help-seeking behavior and are worthwhile to consider when aiming for a reduction of ERA treatment delay. <h3>Disclosure of Interest</h3> None declared
Predictors and survival for pathologic tumor response grade (TRG) in borderline resectable (BRPC) and locally advanced pancreatic cancer (LAPC) treated with induction chemotherapy and neoadjuvant stereotactic body radiotherapy (SBRT).
Authors: Eric Albert Mellon, Sarah E. Hoffe, Jessica M. Frakes, Tobin Joel Crill Strom, Gregory M. Springett, Ravi Shridhar, Barbara Centeno, Mokenge Peter Malafa, Pamela Joy Hodul
Journal: Journal of Clinical Oncology (2016)

453 Background: Neoadjuvant therapy response correlates with survival in several gastrointestinal malignancies. Thus, we intensified our neoadjuvant approach to pancreas adenocarcinoma in part to induce greater response. Here we analyzed whether pre- and post- therapy CA19-9 or SUVmax correlated with College of American Pathology TRG at pancreatectomy and whether TRG associated with survival. Methods: After IRB approval, we identified BRPC and LAPC patients treated in our standardized pathway who underwent surgical resection with reported TRG (n = 81, median follow-up 30.8 months). Patients had baseline CA19-9, CT, endoscopic ultrasound, and FDG PET/CT then underwent multi-agent chemotherapy (79% with planned 3 cycles of GTX) followed by 5 fraction SBRT. They then underwent restaging CT, PET/CT, and CA19-9 prior to resection. Overall (OS) and progression free survival (PFS) were estimated and compared by Kaplan-Meier and log-rank methods. Univariate ordinal logistic regression correlated TRG with baseline, re-staging, and change in CA19-9 (16% with missing values or CA19-9 &lt; 5 excluded) and SUVmax (14% with missing values or no hypermetabolism excluded). Results: Decrease in CA19-9 before and after neoadjuvant therapy correlated with improved TRG (p = 0.02) as did re-staging SUVmax (p &lt; 0.01), though not decrease in SUVmax (p = 0.08). The TRG groupings had similar OS and PFS except the TRG 0 (complete response) group. Compared to TRG 1-3 patients (median OS 38.4 months, median PFS 17.8 months), the 6 patients with TRG 0 had no deaths (p = 0.05) and only 1 failure (p = 0.03). A group of 10 TRG 1 patients with only isolated tumor cells remaining had similar outcomes to the other TRG 1-3 patients. Conclusions: Pre-operative PET-CT and CA19-9 response correlate with neoadjuvant therapy response by TRG. Patients with complete pathologic response have superior outcomes. This provides rationale for further intensification of neoadjuvant therapy in BRPC and LAPC. Further work seeks to identify techniques to better select which BRPC and LAPC patients should undergo tumor resection.
Sexual practices and transmission of HAV and HCV
Authors: E Bouvet
Journal: Eurosurveillance (2005)

In the current issue of Eurosurveillance, two articles report outbreaks of hepatitis A (Copenhagen) and hepatitis C (Paris) in the male gay community, and it seems likely that specific sexual practices of this community may have been the mode of transmission. For decades, it has been accepted that the hepatitis A virus (HAV) is transmitted through direct contact from person to person either through the oro-faecal route or by contaminated food that is unprepared or contaminated during preparation, whereas the hepatitis C virus (HCV) is transmitted through a parenteral mode (through blood and its components). As far as hepatitis A is concerned, several outbreaks have already been reported in gay men, leading to recommendations for vaccination against hepatitis A by the health authorities in several countries.
Alexithymia and anxiety sensitivity in panic disorder and obsessive- compulsive disorder
Authors: S B Zeitlin, R J McNally
Journal: American Journal of Psychiatry (1993)

The authors compared scores on the Toronto Alexithymia Scale and the Anxiety Sensitivity Index of 27 patients with panic disorder and 31 patients with obsessive-compulsive disorder. Results suggest that patients with panic disorder constrict emotional experience, thereby reducing the likelihood of their experiencing physiological symptoms that accompany affect.
Abstract 15464: Differential Effects of Smoking on Specific Cardiovascular Presentations in Men and Women: Prospective Cohort Study in 900,000 Patients Using CALIBER Linked Electronic Health Records
Authors: Julie George, Emily Herrett, Spiros Denaxas, Owen Nicholas, Anoop Shah, Eleni Rapsomaniki, Jinqi Zhang, Adam Timmis, Liam Smeeth, Harry Hemingway
Journal: Circulation (2012)

Background: It is not known whether the risk of smoking differs across a range of specific cardiovascular presentations because previous studies have been too small or evaluated a limited number of...