tbuckley/cabot-search huggingface dataset:
PTH-246 Can we trust reports of stool consistency? the validity and reliability of the bristol stool form scale
Authors: JM Raker, MR Blake, K Whelan
Journal: Gut (2015)

<h3>Introduction</h3> Stool form is frequently used as a proxy measure of stool consistency, which is a central component in the description of normal or altered bowel habit. The Bristol Stool Form Scale (BSFS) is in widespread use in clinical practice and research and yet has undergone incomplete assessment of validity and reliability. The aim of this study was to determine concurrent validity and intra-rater reliability of the BSFS. <h3>Method</h3> Healthy adults provided a single real stool that was independently categorised using the BSFS by both themselves and by an expert in gastroenterological research, following which stool water was measured using lyophilisation. Participants also used the BSFS to categorise 26 stool models, 7 representing the BSFS types (reference types) and 6 intermediate types, all covertly provided in duplicate. Concurrent validity (comparison with gold standard) was determined by measuring (i) agreement between participants and experts categorisation; (ii) comparison with stool water content; and (iii) the accuracy of categorisation of reference stool models. Intra-rater reliability was measured by the accuracy of categorisation of covert duplicate stool models. <h3>Results</h3> 86 healthy adults categorised the stool models, of which 59 provided a real stool. Stool water content was significantly different between stools categorised to different stool types (P &lt; 0.05) and water content correlated with BSFS type (rs = 0.320, p &lt; 0.05). Participants and experts agreed on 36% of real stool categorisations, representing only fair agreement (κ = 0.25). Stools categorised as Type 2 and 5 by participants (both at the border of normal consistency) were actually assigned a wide range of types by the experts. Participants correctly categorised reference stool models on 81% of occasions, representing substantial accuracy. However, the Type 2, 3 and 6 reference models were categorised correctly on less than 75% of occasions. Familiarity with the scale improved accuracy of model categorisation (p &lt; 0.05). Overall substantial intra-rater reliability was demonstrated (κ = 0.72), although low exact agreement was seen with the Type 2 and 3 models. <h3>Conclusion</h3> Overall, the BSFS has good concurrent validity and intra-rater reliability. However, categorisation of real stools proves difficult for some. In both categorisation of real stools and stool models issues arise around the borders of stool types representing normal and abnormal bowel habit (Types 2 and 3 and Types 5 and 6) and this should be taken into consideration when using the scale. Familiarity with the scale and education in its use may improve accuracy of stool categorisation. This study should be repeated in patients with abnormal bowel habit to determine its utility in clinical practice. <h3>Disclosure of interest</h3> None Declared.
Tricyclic Antidepressants
Authors: Jan Koch-Weser, Leo E. Hollister
Journal: New England Journal of Medicine (1978)

ABOUT 70 per cent of prescriptions for tricyclic antidepressants are written by non-psychiatrists, largely physicians in family practice or internal medicine. Depressions seem to be a common problem in medical practice. Despite this widespread recognition of depression and prescription of antidepressant drugs, many believe that depressed patients either are frequently not recognized or that they are inadequately treated.1 2 3 Depression is readily diagnosed when that is the patient's chief complaint; unfortunately, it rarely is. A host of complaints may mask the true underlying disorder. Patients with many vague complaints, most or all of which defy explanation, and those who may be . . .
Case 49-1972
Authors: Richard C. Cabot, Benjamin Castleman, Robert E. Scully, Betty U. McNeely, S. Jan Behrman, Robert E. Scully
Journal: New England Journal of Medicine (1972)

Presentation of CaseA 27-year-old woman was admitted to the hospital because of infertility.She had been married for nine years and had been unable to conceive. The menarche had occurred at the age of 13 years. The menstrual periods were subsequently irregular and very infrequent except for a 20-month interval preceding and following her marriage, during which they were regular, lasting five to seven days. In the nine years before admission she was seen on numerous occasions in the Out-Patient Department because of obesity, infertility and infrequent menstrual periods. Physical examination on those visits revealed an obese woman, 164 . . .
PTU-019 Pain, perception and reality – comparison of comfort scores of south asian and white british patients undergoing bowel cancer screening colonoscopy:
Authors: AM Verma, MS Hanna, V Lewin, B Robinson, RJ Robinson
Journal: Gut (2015)

<h3>Introduction</h3> There have been several studies suggesting South Asian patients have differing pain perception to White British patients.<sup>1 </sup>Watson <i><i>et al</i>.</i>compared hot and cold pain perception in 20 age-matched South Asian and White British volunteers, with significantly increased heat pain scores and reduced pain threshold.<sup>2</sup> Recently, Al-Hashimi <i><i>et al</i></i>showed no significant differences in post-operative pain scores and analgesia consumption in 60 South Asian patients undergoing total abdominal hysterectomy versus 60 age-matched White British controls.<sup>3</sup> Sedation and analgesia administration is well regulated in colonoscopy practice and comparing comfort scores in similar aged South Asian and White British screening patients is of interest to bowel cancer screening programme (BCSP) centres in ethnically diverse areas. <h3>Method</h3> In 2014, colonoscopy screened individuals (BCSP) in Leicester and Kettering had their self-selected ethnic origin recorded. Comfort scores of 713 patients recorded in the Exeter online database was correlated to ethnic origin data and analysed. <h3>Results</h3> Total number of patients: 713 Difference between means: 0.26 (95% CI: 0.05–0.47) <h3>Conclusion</h3> This analysis shows mean comfort scores are significantly <i>lower</i>in South Asian patients (p = &lt;0.02). This is counter to what published literature might suggest. We reported in 2014 that South Asian patients undergoing BCSP colonoscopy have significantly lower adenoma detection rates when compared to White British patients (31.68% vs 48.09% p = &lt;0.02). <sup>4</sup>Perhaps fewer adenomas requiring polypectomy lead to more straightforward colonoscopy and lower comfort scores. Whatever the explanation, this analysis shows that pain perception is complex. The interaction of patient ethnicity factors (behavioural, cultural, social and psychological) are not easily predicted and requires further study. <h3>Disclosure of interest</h3> None Declared. <h3>References</h3> Edwards CL, Fillingim RB, Keefe F. Race, ethnicity and pain. Pain 2001; 94: 133–137 Watson PJ, Latif RK, Rowbotham DJ. Ethnic differences in thermal pain responses: a comparison of South Asian and White British healthy males. Pain 2005;118:194–200 Al-Hashimi M, Scott S, Griffin-Teall N, Thompson J. Influence of ethnicity on the perception and treatment of early post-operative pain. Pain 2014. doi: 10.1177/2049463714559254 Verma AM, Lewin V, Chilton AP, de Caestecker J, Dixon A, Jameson J, Wurm P, Robinson RJ. Variations in adenoma detection rate and cancer detection rate in individuals from different ethnic groups undergoing bowel cancer screening colonoscopy. Gut 2014;<b>63</b>(Suppl 1):A122
On the Enzymic Nature of Mitochondrial Characterization by Janus Green B and the Detection of Krebs-cycle Dehydrogenases with Janus Green B
Authors: J L SHOWACRE, H G DUBUY
Journal: JNCI Journal of the National Cancer Institute (1955)

Journal Article On the Enzymic Nature of Mitochondrial Characterization by Janus Green B and the Detection of Krebs-cycle Dehydrogenases with Janus Green B Get access Jane L. Showacre, Jane L. Showacre National Microbiological Institute,2Bethesda, Md. Search for other works by this author on: Oxford Academic PubMed Google Scholar H. G. DuBuy H. G. DuBuy National Microbiological Institute,2Bethesda, Md. Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 16, Issue 1, August 1955, Pages 173–194, https://doi.org/10.1093/jnci/16.1.173 Published: 01 August 1955 Article history Received: 21 February 1955 Published: 01 August 1955
Clinical benefit of docetaxel or enzalutamide after progression on first-line abiraterone acetate and prednisone in men with metastatic castration resistant prostate cancer (mCRPC).
Authors: Tian Zhang, Mallika S. Dhawan, Patrick Healy, Daniel J. George, Jorge Oldan, Bennett Chin, Andrew J. Armstrong
Journal: Journal of Clinical Oncology (2014)

e16031 Background: Abiraterone acetate (AA) has demonstrated survival benefit in the pre-chemotherapy setting for patients (pts) with mCRPC, now with widespread clinical use. However, there is a lack of data on how the impact of prior therapy with AA affects efficacy of enzalutamide (enza) or docetaxel. Methods: All pts with mCRPC at Duke Cancer Institute who received AA prior to chemotherapy, either on trial or as standard practice, who had complete follow up on response to subsequent therapy as of the cutoff date, August 12, 2013, were included in this study. Clinical and demographic information, laboratory values, response, and progression and overall survival-based outcomes were abstracted. The pts were separated into two main groups: group A, who were treated with AA followed by enza, and group B, who were treated with AA followed by docetaxel-based chemotherapy. The primary objective was to describe response and progression free survival to subsequent therapy after progression on AA. Results: Group A (AA -> enza, n=8), and group B (AA -> docetaxel, n=12) had similar clinical characteristics at AA progression, including pain and patterns of spread. However, group A pts had higher baseline circulating tumor cell (CTC) and prostate specific antigen (PSA) levels, while group B pts were younger (mean 65 vs 73 yrs). Median PFS for group A was 3.6 months, and median OS was 8.5 months. Median PFS for group B was 5.1 months, and median OS was not reached. A ≥50% PSA decline was achieved in 12.5% of group A pts vs 50% of group B patients. Radiographic or clinical progression as best response was noted in 62.5% of pts in group A vs 33% of pts in group B. Conclusions: This chart review details the first experience of enza after AA in the pre-docetaxel setting, and suggests clear cross-resistance in the majority of men with mCRPC, while docetaxel provided a greater probability of PSA decline and radiographic/clinical benefit. These data may help to inform on the complex treatment decisions facing men with mCRPC progressing on first line AA and should be explored in larger multicenter registries and controlled trials.
Evidence of enzootic circulation of West Nile virus (Nea Santa-Greece-2010, lineage 2), Greece, May to July 2011
Authors: A Chaskopoulou, C I Dovas, S C Chaintoutis, I Bouzalas, G Ara, M Papanastassopoulou
Journal: Eurosurveillance (2011)

A West Nile virus (WNV) surveillance network including sentinel chickens was deployed in Thessaloniki county, Greece, from May to July 2011. For the first time in summer 2011, a chicken WNV isolate from 6 July was molecularly identified. The partial NS3 sequence was identical to that of the Nea Santa-Greece-2010 WNV lineage 2, detected in central Macedonia in 2010. This suggests that WNV is actively circulating in central Macedonia and that it may have overwintered in northern Greece.
Tumor-Specific, Cell-Mediated Immunity in Guinea Pigs With Tumors
Authors: Bruce H. Littman, Monte S. Meltzer, Ronald P. Cleveland, Berton Zbar, Herbert J. Rapp
Journal: JNCI Journal of the National Cancer Institute (1973)

Journal Article Tumor-Specific, Cell-Mediated Immunity in Guinea Pigs With Tumors Get access Bruce H. Littman, Bruce H. Littman Search for other works by this author on: Oxford Academic PubMed Google Scholar Monte S. Meltzer, Monte S. Meltzer Search for other works by this author on: Oxford Academic PubMed Google Scholar Ronald P. Cleveland, Ronald P. Cleveland Search for other works by this author on: Oxford Academic PubMed Google Scholar Berton Zbar, Berton Zbar Search for other works by this author on: Oxford Academic PubMed Google Scholar Herbert J. Rapp Herbert J. Rapp Biology Branch, National Cancer Institute, National Institutes of Health, Public Health Service, U.S. Department of Health, Education, and Welfare, Bethesda, Md. 20014 Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 51, Issue 5, November 1973, Pages 1627–1635, https://doi.org/10.1093/jnci/51.5.1627 Published: 01 November 1973 Article history Received: 18 May 1973 Accepted: 09 July 1973 Published: 01 November 1973
Interview: NCI's Klausner on Challenges, Solutions
Authors: H. McIntosh, None Klausner
Journal: JNCI Journal of the National Cancer Institute (1996)

In an interview, he describes his first months in office and his hopes for NCI.News: What are the major issues facing the Institute?R.K.: When I inherited the NCI, there was a tremendous amount of uncertainty.The institute needed to articulate what it was and where it was going.It also needed to open up so that it was no longer a mysterious bureaucracy but, in fact, a very open, accessible, and interactive environment driven by scientific opportunity and the principles and behaviors of science -not politics.It needed to be freed from internal boundaries and to become much more dynamically connected to all the communities it serves.My initial challenge was to make structural, but also cultural, changes so that all of the communities that have a stake in our struggle against cancer feel that they have a place where their advice is sought and listened to.News: You mentioned cultural changes.What are they?R.K.: They include creating governance structures where there is a voice given to individuals at all levels of the institution.So we have created two internal advisory boards -the Intramural Advisory Board and the Extramural Advisory Board.These boards are learning to find their own voice.They understand that they have direct access to me and that the governing structures of this institution listen to their input.
A psychiatric study of patients referred with a diagnosis of hypoglycemia
Authors: C V Ford, G A Bray, R S Swerdloff
Journal: American Journal of Psychiatry (1976)

Five-hour oral glucose tolerance tests (GTTs) differentiated 30 volunteer patients who considered themselves hypoglycemic into three major groups: those who had reactive hypoglycemia, those who were normal, and those who had diabetes. Clinical psychiatric evaluation and Minnesota Multiphasic Personality Inventory testing revealed that half of the 30 patients were experiencing a current psychiatric disorder, usually depression. Hysterical personality traits were also noted in many of the patients. The idea that reactive hypoglycemic patients have specific personality characteristics was not substantiated by the authors' data. They hypothesize that some patients with psychiatric illness may have their symptoms erroneously attributed to incidental GTT findings.
Treatment of T2/T3 bladder carcinoma: total cystectomy with and without preoperative irradiation.
Authors: Sophie D. Fosså, Sigurd Ous, Kjell Tveter, Brynjulf Otnes, Asbjørn Igesund, Eigil Dingsør, Odd Aunan, Sigbjørn Taksadahl, Ole Scott-Knudsen, Eiliv Lund
Journal: European Urology (1986)
Visualization of the Genitalia in Renal Transplant Evaluation
Authors: KOTTEKKATTU BALAN, NICK BIRD, RAAJ KUMAR PRASEEDOM
Journal: Clinical Nuclear Medicine (2001)

BALAN, KOTTEKKATTU M.B.B.S., M.D., F.R.C.P.I.; BIRD, NICK M.Sc.; PRASEEDOM, RAAJ KUMAR F.R.C.S. Author Information
Surveillance of haemolytic uraemic syndrome in children under 15 years of age in France in 1998
Authors: S Haeghebaert, V Vaillant, B Decludt
Journal: Eurosurveillance (2000)

Data from a national network of paediatric nephrology departments in France suggest that the incidence of haemolytic uraemic syndrome (HUS) in 1998 was 0.7 cases per 100 000 children aged under 15 years and that cases occur sporadically. Six out of 85 cas
PWE-165 A single institute experience of surgical treatment for achalasia of cardia institute of minimal access surgery – royal gwent hospital
Authors: M Uppara, O Rutka, A Rasheed
Journal: Gut (2015)

<h3>Introduction</h3> Achalasia of Cardia of is rare motility disorder characterised by inadequate oesophageal peristaltic activity combined with a non-relaxing lower oesophageal sphincter. Non-surgical therapy help to palliate symptoms in the early stages but cardiomytomy achieves a better outcome in advanced achalasia. <h3>Method</h3> A prospective data base of all patients surgically treated for achalasia is electronically maintained including the chief symptomatology, pre-operative investigations, treatment and outcomes. Statistical analysis was conducted using STATA 13.1 software. <h3>Results</h3> 17 patients underwent laparoscopic cardiomyotomy with addition of antireflux procedure in 12 patients. Pre-operative investigations showed sigmoid type morphology on barium swallow in 15 patients and rest were non-sigmoid type. Pearson Chi square test of measure of association between S1 and S2 morphology and symptomatology such as regurgitation, nausea/vomiting, weight loss and haematemesis showed significant association between S1 type morphology and regurgitation, heartburn and weight loss (p = 0.0001). Addition of anti-reflux procedure to cardiomyotomy improved the symptomatic outcome significantly. <h3>Conclusion</h3> Our interim results suggest that the addition of anti-reflux procedure to cardiomyotomy enhance the symptomatic surgical outcome. <h3>Disclosure of interest</h3> None Declared.
Serotonergic sensitivity in borderline personality disorder: preliminary findings
Authors: E Hollander, D J Stein, C M DeCaria, L Cohen, J B Saoud, A E Skodol, D Kellman, L Rosnick, J M Oldham
Journal: American Journal of Psychiatry (1994)

Twelve patients with borderline personality disorder and 15 healthy comparison subjects were challenged with single doses of oral m-chlorophenylpiperazine (m-CPP) and placebo. Following m-CPP, the patients experienced decreased anger and fear. Seven of the 12 patients reported a "spacy," "high," depersonalized/derealized experience following m-CPP, which was confirmed by clinicians' ratings. Compared with the normal male subjects, the male patients with borderline personality disorder had higher cortisol levels and marginally blunted prolactin responses after receiving m-CPP. These results suggest serotonergic dysfunction in borderline personality disorder.
Chronic Traumatic Encephalopathy in a 25-Year-Old Athlete—Distribution of Lesions
Authors: Graham Martin
Journal: JAMA Neurology (2016)

To the Editor In the article by Mez et al,1 half (5 of 10) of the lesions in the thin section specimen (panel B in the article’s Figure) stained for AT8, are in the sulcal depths of gyri. Is this characteristic of chronic traumatic encephalopathy?
Screening for Syphilis
Authors: Amy G. Cantor, Miranda Pappas, Monica Daeges, Heidi D. Nelson
Journal: JAMA (2016)

<h3>Importance</h3> Screening for syphilis infection is currently recommended for high-risk individuals, including those with previous syphilis infection, an infected sexual partner, HIV infection, or more than 4 sex partners in the preceding year. <h3>Objective</h3> To update a 2004 systematic review of studies of syphilis screening effectiveness, test accuracy, and screening harms in nonpregnant adults and adolescents. <h3>Data Sources</h3> Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews through October 2015 and Ovid MEDLINE (January 2004 to October 2015), with updated search through March 2016. <h3>Study Selection</h3> English-language trials and observational studies of screening effectiveness, test accuracy, and screening harms in nonpregnant adults and adolescents. <h3>Data Extraction and Synthesis</h3> One investigator abstracted data, a second checked data for accuracy, and 2 investigators independently assessed study quality using predefined criteria. <h3>Main Outcomes and Measures</h3> Transmission of disease, including HIV; complications of syphilis; diagnostic accuracy; and harms of screening. <h3>Results</h3> No evidence was identified regarding the effectiveness of screening on clinical outcomes or the effectiveness of risk assessment instruments; the harms of screening; or the effectiveness of screening in average-risk, nonpregnant adolescents or adults or high-risk individuals other than men who have sex with men (MSM) or men who are HIV positive. Four non-US studies indicated higher rates of syphilis detection with screening every 3 months vs 6 or 12 months for early syphilis in HIV-positive men or MSM. For example, there was an increased proportion of asymptomatic, higher-risk MSM in Australia (n = 6789 consultations) receiving a diagnosis of early syphilis when tested every 3 months vs annually (53% vs 16%,<i>P</i> = .001), but no difference among low-risk MSM. Treponemal and nontreponemal tests were accurate in asymptomatic individuals (sensitivity &gt;85%, specificity &gt;91%) in 3 studies but required confirmatory testing. Reverse sequence testing with an initial automated treponemal test yielded more false reactive test results than with rapid plasma reagin in 2 studies, one with a low-prevalence US population (0.6% vs 0.0%,<i>P</i> = .03) and another in a higher-prevalence Canadian population (0.26% vs 0.13%). <h3>Conclusions and Relevance</h3> Screening HIV-positive men or MSM for syphilis every 3 months is associated with improved syphilis detection. Treponemal or nontreponemal tests are accurate screening tests but require confirmation. Research is needed on the effect of screening on clinical outcomes; effective screening strategies, including reverse sequence screening, in various patient populations; and harms of screening.
The Emergence of Environmental Health Literacy—From Its Roots to Its Future Potential
Authors: Symma Finn, Liam O’Fallon
Journal: Environmental Health Perspectives (2015)

Environmental health literacy (EHL) is coalescing into a new subdiscipline that combines key principles and procedural elements from the fields of risk communication, health literacy, environmental health sciences (EHS), communications research, and safety culture. These disciplines have contributed unique expertise and perspectives to the development of EHL. Since 1992, the National Institute of Environmental Health Sciences (NIEHS) has contributed to the evolution of EHL and now seeks to stimulate its scientific advancement and rigor.The principal objective of this article is to stimulate a conversation on, and advance research in, EHL.In this article, we propose a definition of and conceptual framework for EHL, describe EHL in its social and historical context, identify the complementary fields and domains where EHL is being defined and implemented, and outline a research agenda. Extensive reviews of web and literature searches indicate that the concept of EHL is evolving rapidly, as are the definitions of its scope and inquiry. Although several authors have outlined different frameworks, we believe that a more nuanced model based on Bloom's taxonomy is better suited to EHL and to future research in this area.We posit that EHL can potentially benefit the conduct and outcomes of community-engaged and health disparities EHS research and can ensure that the translation of research findings will lead to greater understanding of specific risks, reduction of exposures, and improvement of health outcomes for individuals and communities. We provide four recommendations to advance work in EHL.