tbuckley/cabot-search huggingface dataset:
SAT0345 Patient Perceptions, Attitudes and Concerns about Anti-TNF Drugs:
Authors: C. Saygin, D. Uzunaslan, G. Hatemi, V. Hamuryudan
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> Patients9 perceptions about the side effects of drugs can have major impact on compliance to treatment. This becomes especially important with newer therapies. <h3>Objectives</h3> To evaluate the frequency of patient concerns about drug-related side effects among anti-TNF users and to delineate the factors predicting an increase in concerns aboutanti-TNF drugs. <h3>Methods</h3> Rheumatoid arthritis (RA), ankylosing spondylitis (AS), and psoriatic arthritis (PsA)patients who were using TNF-alpha antagonists and who attended our outpatient clinic for their routine visits were included. We questioned whether the subjects were satisfied with their drugs (rated from 0 to 3), concerned with the side effects at the beginning of treatment and at present (rated from 0 to 3), and if concerned, we asked them to specify the particular side effects that they had concerns on. In addition, disease activity in the preceding one week was assessed with "Rapid Assessment of Patient Index Data" (RAPID3). Perceptions and attitudes towards the drugs were assessed with "Beliefs about Medicines Questionnaire" (BMQ). Data regarding demographic features, disease duration, duration of drug therapy, and side effects that had been experienced during follow-up were collected from patient records.Having a score of ≥2 points in drug satisfaction or concern were tabulated as the presence of satisfaction or concern. Multivariate linear regression analysis was used to determine the factors associated with increased concerns about anti-TNF drugs. <h3>Results</h3> We surveyed 100 patients (75 with AS, 21 with RA, 4 with PsA) who were currently using anti-TNF drugs (56infliximab; 26etanercept; 13adalimumab; and 5 golimumab). Demographic and clinical features as well as the number of patients with at least 2 points of concern scores, RAPID3 and BMQ scores are given in the table. Ninety percent of patients reported that they were satisfied with their anti-TNF medication.The most commonly feared side effects were neoplasms (52%), tuberculosis (42%), and damage to liver and kidneys (32%). Univariate analysis revealed that having AS was associated with a lower rate of concerns (p=0.006, β=0.278, 95%CI=0.072-0.408) and having concerns at the beginning of anti-TNF treatment was associated with higher rate of concerns at the time of interview (p=0.001, β=0.335, 95%CI=0.124-0.490). The presence of concerns at the onset of treatment predicted higher concern scores at the time of interview in multiple regression (p=0.01, β=0.279, 95%CI=0.064-0.458). <h3>Conclusions</h3> Around one half of our patients reported that they were concerned about drug related adverse events at the initiation of anti-TNF drugs and this continued in one third after a mean duration of 44.19 months of treatment. The risk of cancer and tuberculosis were two major side effects that the patients were most concerned. <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.4131
DISECCIÓN SUBMUCOSA ENDOSCÓPICA (DSE): FASE INICIAL DE LA CURVA DE APRENDIZAJE TRAS ENTRENAMIENTO EN MODELO PORCINO. EVOLUCIÓN Y COMPLICACIONES
Authors: JC Marín-Gabriel, P Hernán-Ocaña, A González-Blanco, S Rodríguez-Muñoz, J Díaz-Tasende, AJ Del Pozo-García, M Pérez-Carreras, Y Rodríguez-Gil, F Colina-Ruizdelgado, G Castellano-Tortajada
Journal: Endoscopy (2011)

Introducción: La DSE permite la extirpación de neoplasias precoces del tracto digestivo, en bloque y sin límite de tamaño.
AB0588 Prevalence of conventional cardiovascular risk factors in patients with psoriasis alone and in patients with psoriatic arthritis
Authors: R. Queiro-Silva, P. Tejón, P. Coto, S. Alonso, M. Alperi, S. Rodríguez, B. Acasuso, J. L. Riestra, L. Arboleya, J. Ballina
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Patients with psoriasis and psoriatic arthritis (PsA) are at increased risk of cardiovascular disease. It has been suggested that this elevated risk reflects an increased prevalence of conventional cardiovascular risk factors in psoriatic patients. However, PsA may act as a confounder in this type of studies. Very few papers have studied the prevalence of such comorbidities in patients with psoriasis alone compared to those with PsA. <h3>Objectives</h3> The main purpose of this study was to compare the profile of conventional cardiovascular risk factors in patients with psoriasis alone and in patients with PsA in order to analyze whether the presence of arthritis was associated with greater cardiovascular comorbidity. <h3>Methods</h3> we analyzed the conventional cardiovascular risk profile (smoking, obesity, hypertension, diabetes mellitus and dyslipidemia) in 310 psoriatics (mean age 46 ± 15.6 years) and 86 PsA patients (mean age 49 ± 12.5 years). The study population was stratified according to sex, age at psoriasis onset, psoriasis severity, and HLA-Cw6. Uni and multivariate analyses were done in order to compare these factors with disease subtypes. <h3>Results</h3> The global prevalence of cardiovascular risk factors was as follows: hypertension 20%, dyslipidemia 15.15%, obesity 30%, smoking 33.8%, DM II 9.3%. A total of 24 patients developed angor and/or myocardial infarction (6%). Compared to patients with psoriasis alone, those with PsA had a greater prevalence of DM II (11.8% vs. 8.8%, p=0.022) and a tendency towards higher levels of dyslipidemia (21.2% vs. 13.7%, p=0.08). Men had lower levels of HDL (49 ± 12.5 mg/dl vs. 59 ± 15.6 mg/dl, p&lt; 0.05), higher levels of triglycerides (142 ± 86.4 mg/dl vs. 107 ± 67.8 mg/dl, p&lt; 0.05), a higher abdominal circumference (101 ± 11.4 cm vs. 91 ± 14.12 cm, p&lt; 0.05), and a higher BMI (29 ± 4.17 vs. 27 ± 5.09, p&lt; 0.05). Subjects with disease onset over 40 years had a higher risk of developing DM II (OR 2.6, CI 95%: 1.14-5.93, p= 0.022). However, after adjusting for other factors this risk was higher among PsA subjects (OR 14, CI 95%: 1.73-112.5, p= 0.013). Patients carrying the HLA-Cw6 antigen showed less hypertension compared to those without this antigen (13.7% vs. 23.2%, p= 0.025). Similarly, patients with PASI &lt; 10 showed more frequently hypertension than those with PASI &gt;10 (22.3% vs. 15.5%, p=0.08). <h3>Conclusions</h3> The profile of conventional cardiovascular risk factors differs between patients with psoriasis and PsA. Subjects with PsA had a higher risk of developing DM II, especially those with psoriasis onset above 40 years. <h3>Disclosure of Interest</h3> None Declared
Use of Serum Transaminase Levels in the Differentiation of Pulmonary Embolism and Myocardial Infarction
Authors: Franz Goldstein, Harold L. Israel, David Seligson
Journal: New England Journal of Medicine (1956)

THE diagnosis of pulmonary embolism continues to present a challenge to the clinician. Massive pulmonary embolism is often diagnosed correctly ante mortem and is identified with relative ease by the pathologist at autopsy. However, it is in nonfatal cases that the diagnosis is frequently missed or is in doubt. The correct diagnosis of nonfatal pulmonary embolism is of utmost importance because early recognition and treatment of thromboembolic disease and the correction of frequently present mild unrecognized congestive heart failure provide a means of prevention of fatal embolism, and, secondly, because when thromboembolism is overlooked, treatment may be inappropriately instituted for . . .
SP0164 Good Prognostic Value of Tertiary Lymphoid Structures in Human Lung Cancer
Authors: M.-C. Dieu-Nosjean
Journal: Annals of the Rheumatic Diseases (2013)

<h3></h3> It is now well established that immune responses can take place at distance of secondary lymphoid organs, in tertiary lymphoid structures (TLS). We have previously shown that such structures can develop in human lung cancer (LC), and may represent an activation site for tumor-specific T cells. The aim of this study was to determine whether a protective adaptive immunity can take place within TLS. We showed that the density of TLS is associated with a specific immune signature. Some genes related to chemotaxis (adhesion molecules, chemokines and integrins) are overexpressed in TLS, and correlated with T cell density. Intra-tumoral PNAd+ high endothelial venules were exclusively associated with TLS, and colocolized with CD62L+ T cells in TLS. Moreover, the density of TLS is associated with the coordination of T-cell immune response. Tumors with high density of TLS present a specific immune contexture characterized by a strong T-cell infiltration, T-cell activation with a Th1 polarization and cytotoxic effector function. Regarding the humoral immunity, we have observed that B-cell follicles of TLS present the same cellular composition and organization as in lymph nodes, with all B-cell differentiation stages. The somatic mutation and isotype switching machineries were activated in these B-cell follicles. The PNAd+ ligand CD62L, was selectively detected on TLS B cells except by germinal center B-cells, as reported for lymph nodes. CXCR5 expression decreased on fully differentiated B cells, a known key regulatory process that allows effector cells to leave CXCL13+ germinal centres. In a retrospective study, the density of TLS B cells was associated with a favorable clinical outcome in patients with early-stage LC. More interestingly, combination of both markers of APC (mature dendritic and B cells of TLS), indicated that they are strongly correlated with long-term survival for patients with early-stage LC and patients with advanced-stage of LC treated by neo-adjuvant-chemotherapy. Preliminary data on the specificity of antibodies secreted locally by intra-tumoral B cells will be discussed in the physiopathology of human LC. Altogether, these data bring new insights into the lymphocyte recruitment to intra-tumoral TLS, and suggest that peripheral blood T and B cells enter into TLS via high endothelial venules, which represent a new gateway for lymphocytes to the tumor. TLS may represent an active site for the initiation of a protective cellular and humoral immunity. In this immunosuppressive situation, TLS may play a major role in the shaping of the intra-tumoral immune contexture. <h3>Disclosure of Interest</h3> None Declared
Abstract 1358: Are physician recommendations for BRCA 1/2 testing among breast cancer patients appropriate? A population based study.
Authors: Anne Marie McCarthy, Mirar Bristol Demeter, Tracey Fredricks, Kaijun Liao, Judy A. Shea, Peter Groeneveld, Susan M. Domchek, Katrina Armstrong
Journal: Cancer Research (2013)

Abstract Purpose: To evaluate the rates and predictors of physician recommendation for BRCA 1/2 testing in breast cancer patients. Patients and Methods: Women aged 18-64 diagnosed with invasive breast cancer in 2007 in Pennsylvania completed a survey on family history of cancer, physician treatment recommendations, and BRCA 1/2 testing (N=2258). Based on age at diagnosis and family history, women were categorized as high, moderate, or low risk for BRCA 1/2 mutations. Multivariate logistic regression was used to assess the odds of physician recommendation for BRCA 1/2 testing by risk group, age at diagnosis, demographics, and tumor characteristics. Results: Nearly 25% of participants were at high risk for carrying a BRCA 1/2 mutation based on age at breast cancer diagnosis and family history of breast and/or ovarian cancer. Physician recommendations for BRCA 1/2 testing were strongly associated with risk of carrying a BRCA 1/2 mutation, with 53% of women at high risk reporting a testing recommendation compared to 9% of women at low risk. In addition, physician recommendations were strongly correlated with use of testing in all risk groups. Among women at high risk of mutation, lack of a recommendation for BRCA 1/2 testing was more common among women who were older, had lower income, and were employed. Conclusion: Although BRCA 1/2 testing recommendations appear to be appropriately correlated with mutation risk among women with breast cancer, a significant proportion of breast cancer patients who meet criteria for BRCA 1/2 testing may not be receiving recommendations for such testing from their providers. Citation Format: Anne Marie McCarthy, Mirar Bristol Demeter, Tracey Fredricks, Kaijun Liao, Judy A. Shea, Peter Groeneveld, Susan M. Domchek, Katrina Armstrong. Are physician recommendations for BRCA 1/2 testing among breast cancer patients appropriate? A population based study. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 1358. doi:10.1158/1538-7445.AM2013-1358
A case of intraductal tubular neoplasm of the pancreas which we could detect by endoscopic ultrasonography at first time
Authors: Sugimori Satoshi
Journal: Endoscopy (2011)

Case: 57 years old, female. Chief complaint: Epigastralgia. Past History: 31 years old & 37 years old: Uterine myoma surgery. Present illness: On January 2010 she consulted the hospital about epigastralgia. She was pointed out main pancreatic duct dilatation at the pancreatic tail on abdominal US. She received enhanced CT and MRI. But there were no tumor in the pancreas. So she came our institute in order to examine pancreas in detail. Physical examination conscious level: clear, There is no abnormal findings in physical examination. (Laboratory Data) CBC and serum biochemical levels were almost normal without Total cholesterol (282mg/dl). CEA, CA 19–9 and SPan-1 were normal range. Diagnostic imaging:
1048 MEASUREMENT FOR IMPROVING TRANSIENT ELASTOGRAPHY PERFORMANCE OF DETECTING ADVANCED FIBROSIS IN PATIENTS WITH CHRONIC HEPATITIS B
Authors: Y.P. Chen, X.E. Liang, Q. Zhang, Y.W. Lu, J. Peng, Y.F. Zhu, W.Q. Wen, J.L. Hou
Journal: Journal of Hepatology (2012)
COMPLICACIONES ENDOSCOPICAS DE UNA SERIE DE 800 ENTEROSCOPIAS DE DOBLE BALÓN. MANEJO Y FACTORES RELACCIONADOS
Authors: E Fuentes García, MI Lopez Espín, P Bebia Conesa, E Perez-Cuadrado Robles, P Esteban Delgado, S Chacón Martinez, J Rodrigo Agudo, J Shanabo, E Perez-Cuadrado Martinez
Journal: Endoscopy (2012)

Objetivos: La enteroscopia de doble balón (EDB) es una técnica ya consolidada, que permite el abordaje diagnostico terapéutico de Intestino Delgado. No se conocen las complicaciones de la técnica en nuestro medio. Presentamos las complicaciones de una serie de 800 EDB surgidas dentro de una Unidad de Intestino Delgado con amplia experiencia en esta técnica. Material y método: se realiza un análisis retrospectivo de 800 EDB realizadas desde 2006 hasta Julio 2012, registrando las complicaciones derivadas de la técnica. Resultados: Se registraron 10 complicaciones mayores (1,25%) debidas a la técnica de EDB: 3 perforaciones, 1 dehiscencia de sutura de ID, 4 complicaciones hemorrágicas, 1 incarceración y 1 caso de Pancreatitis. Conclusiones: Las complicaciones de la EDB son superponibles a la de la endoscopia convencional, aumentando estas para los procedimientos terapéuticos. Pacientes con anastomosis quirúrgicas en intestino delgado, realización de dilataciones y polipectomías múltiples presentaron especialmente mayor riesgo de complicaciones. Ninguna de las complicaciones implicaron mortalidad y la mayoría se resolvieron con tratamiento conservador. Por otra parte, solo hemos detectado un caso de Pancreatitis aguda leve a diferencia de la mayoría de las series de EDB, probablemente debido a nuestra sistemática inicial de no hinchar los balones ni retraer sobretubo y enteroscopio hasta pasadas varias asas yeyunales. La experiencia en nuestra Unidad de ID muestra unas complicaciones similares a otras series de EDB publicadas.
Abstract 1435: Myeloid TGF-β signaling regulates Platelet factor 4 expression that is important in host immune suppression and tumor metastasis.
Authors: Yanli Pang, Guiquan Zhu, Li Yang
Journal: Cancer Research (2013)

Abstract Myeloid cells are the most abundant hematopoietic cells in the human body and play a crucial role in tumor angiogenesis, invasion, and metastasis. Here we found that deletion of the gene encoding TGFβ receptor 2 (Tgfbr2) specifically in myeloid cells reduced the level of platelet factor-4 (PF4) in the myeloid cells of 4T1 tumor bearing mice. This is accompanied by decreased lung metastasis of 4T1 mammary carcinoma. Interestingly, deletion of Cxcr3, encoding the receptor for PF4, significantly decreased the lung metastasis of 4T1 mammary carcinoma. The decreased metastasis may attribute to augmented anti-immunity. First, myeloid cells with Cxcr3 deletion showed decreased expression of IL-10, IL-4, iNOs, and arginase. In addition, there was an increased number of both CD4+ and CD8+ T cell in Cxcr3-/- mice compared to the wilt type controls. Our results suggest that TGFβ regulation of PF4 may modulate cancer metastasis through suppressing host anti-tumor immunity. Citation Format: Yanli Pang, Guiquan Zhu, Li Yang. Myeloid TGF-β signaling regulates Platelet factor 4 expression that is important in host immune suppression and tumor metastasis. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 1435. doi:10.1158/1538-7445.AM2013-1435
TCT-366 Short and Long-Term Outcomes After Retrograde Coronary Intervention for Chronic Total Occlusion: Comparison With the Anterograde Approach
Authors: Yusuke Watanabe, Yves Louvard, Francesca Sanguineti, Stephen O'Connor, Thomas Hovasse, Philippe Garot, Marie-Claude Morice, Thierry Lefevre
Journal: Journal of the American College of Cardiology (2013)
The Billroth Lecture
Authors: D. O'Neill
Journal: BMJ (2012)

A casualty of the hegemony of the English language is our distancing from the primacy of Austro-Germanic leadership in medical research, practice, and education for the latter half of the 19th and the early 20th centuries. Virtually every field of medical practice continues to benefit from the imagination, energy, and systematic inquiry of giants such as Koch, Kraepelin, Virchow, Rokitansky, Semmelweiss, Freud, and countless others. 

We may also underestimate their impact on education, in particular through the 1910 Flexner report in the US, which profoundly influenced teaching in medical schools both in the US and further afield. Flexner drew heavily on the scientific and innovative …
Task of primary care is to grade depression
Authors: Petre T C Jones
Journal: BMJ (2007)

Sadness is normal because life can be difficult.1 2 Sadness in bereavement, for example, is appropriate and healthy—I hope my children will be sad after I've gone. However, sadness is not depression: when it is combined with cognitive, emotional, somative, and behavioural features it becomes the syndrome of depression, with its multifactorial aetiology, so common in primary care. But diagnosis does not mean …
P51 Barriers And Facilitators To Effective Self-management Of Asthma - A Systematic Review And Thematic Synthesis
Authors: S. Kirby, C. Miles, E. Arden-Close, L. Yardley, A. Bruton, M. Hankins, D. Thomas
Journal: Thorax (2014)

<h3>Introduction and objectives</h3> Self-management is an established approach to controlling asthma, recommended in guidelines. Despite the reported effectiveness of self-management, its promotion, uptake and use among patients, carers, and health-care professionals remain low. We conducted a systematic review and thematic synthesis of qualitative research into self-management in adults, children and adolescents with asthma. Our objective was to identify the perceived barriers and facilitators associated with reduced or improved effectiveness of asthma self-management. <h3>Method</h3> Electronic databases (Medline, EMBASE, AMED, CINAHL, and PsycINFO; 1996 – August 2013) and British Thoracic Society guidelines were searched for qualitative literature that explored factors relevant to facilitators and barriers to uptake, adherence, or outcomes of self-management in adults, children and adolescents with asthma. We assessed the methodological strengths of the studies using the Critical Appraisal Skills Programme (CASP) tool for qualitative studies, and conducted a thematic synthesis of included studies. <h3>Results</h3> Of the 1532 studies initially identified, 34 papers were included in the review. Thematic synthesis identified 10 overarching themes (Figure 1) which suggest that barriers and facilitators of self-management included the perceived quality of the relationship between health-care professionals and patients, the perceived adequacy of education around self-management and medications, and positive and negative beliefs about asthma with regards to self-management and existing interventions. Self-management could also be helped or hindered by the amount and type of social support and perceived ease of access to healthcare. In addition, having a co-morbidity, mood/anxiety problems, and encountering professional barriers within the health care system (such as consultation time and access to lung function testing), are perceived to hinder successful self-management of asthma. <h3>Conclusion</h3> Perceived barriers and facilitators occur at the level of individuals with asthma (and carers), health-care professionals, and organisations. These findings contribute to our understanding of why existing self-management interventions may not always be effective, and can be used to inform future study into areas where further intervention may improve the adoption of self-management of asthma. For example, future work could include addressing patient and carer beliefs in educational interventions and decisions involving treatment, or greater use of pharmacist educators, patient advocates, and technological interventions.
Seeking an Expert Interpretation
Authors: Michael Berkwits, Stephen J. Gluckman
Journal: New England Journal of Medicine (1997)

A 32-year-old woman had been evaluated one month earlier for low-grade fevers and malaise. Her temperature at that time was 37.9°C (100.2°F), but her history and physical examination were otherwise unremarkable. She was told that she probably had a viral syndrome, and she was treated supportively. She returned one week later with the same symptoms, and on the basis of a distant history of sinus problems, she was given a one-week course of amoxicillin for possible sinusitis. Her fever persisted.This patient has a subacute febrile illness. Initially she was told she had two conditions: a viral syndrome . . .