tbuckley/cabot-search huggingface dataset:
PTU-229 Time to appendicectomy; is it predictive of morbidity?
Authors: Dfn Fung, R Mclean, I Mccallum
Journal: Gut (2015)

<h3>Introduction</h3> Prompt appendicectomy is advocated in the management of acute appendicitis as risks of perforation and its morbidity increases with time. This study aims to examine the morbidity of appendicectomy in relation to the time to surgery at our institution. Significant complications include surgical site infection and intraabdominal abscess. <h3>Method</h3> This is a retrospective study of all appendicectomies performed in two major surgical units (Newcastle Upon Tyne and Gateshead Foundation Trust) between 2000 and 2014. Trust information department were contacted for access to data from administrative records on all emergency surgical admissions in the fourteen year period. All appendicectomies were identified using OPCS-4 procedure codes. Data was collected on patient demographic, time to appendicectomy, length of hospital stay, inpatient mortality and complications. The outcomes of appendicectomy were compared for patients who had surgery on day 0,1,2, &gt;3 following admission. <h3>Results</h3> A total of 2946 appendicectomies were performed for 1557 males and 1389 females with a mean age of 34 years. There were 1566 cases of open appendicectomy (53%), 1262 cases of laparoscopic appendicectomies (42.8%) and 118 cases required open conversion (open conversion rate 8.5%). There was no difference for surgical site infection (1.4% vs 1.1% vs 1.7% vs 0.9%, p = 0.65), intraabdominal abscess (0.1% vs 0.3% vs 0% vs 0% p = 0.99), open conversion (3.6% vs 4.4% vs 5.5% vs 0%, p = 0.75) and complications requiring intervention (0.1% vs 0.3% vs 0% vs 0%, p = 0.99). The median length of hospital stay was 3 days and the overall inpatient mortality 0.1%. <h3>Conclusion</h3> An early decision for appendicectomy has been mainstream practice although there is no evidence in this study to suggest the time to surgery is an independent factor predictive of the morbidity of appendicectomy. <h3>Disclosure of interest</h3> None Declared.
AB0524 Immunosuppressive Treatment in Patients with Primary SjÖgren Syndrome (PSS)
Authors: G. Crespo Amaya, A. Secco, V. Martire, L. Marino, L. Carlevaris, G. Bennasar, M. Mamani, M. Mayer, F. Zazzetti, S. Velez, J.C. Barreira, A. Nitsche, C. Asnal, C. Crow, P. Pucci, F. Caeiro, N. Benzaquen, J.P. Pirola, M. Colazo, O. Rillo, S. Papasidero, J. Demarchi, N. Tamborenea, L. Santiago, L. Raiti, C. Gobbi, E. Albiero, G. Salvatierra, A. Catalán Pellet
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> There is not enough evidence either to support the use of immunosuppressive drugs in pSS or for which specific clinical features they would be indicated. <h3>Objectives</h3> To evaluate the most frequently immunosuppressive drugs prescribed in pSS and to describe the clinical features that determined the indication,in a multicentric cohort of Argentinean patients with pSS. To analyze the clinical characteristics of patients with immunosuppressive therapy in comparison to patients that had not received it. <h3>Methods</h3> We analyzed subjects with pSS included in the data-base of the Argentine study group for SS (GESSAR). We considered the use of methotrexate, azathioprine, cyclophosphamide, leflunomide, mycophenolate, rituximab, belimumab and/or prednisone (&gt;20mg/day). <h3>Results</h3> From 431 patients, 72 (16.7%) had received immunosuppressive therapy. Female: 92%; mean age: 59 years; mean time of the disease: 5 years. Immunomodulatory treatment with hydroxychloroquine in 60%. The drugs most frequently used were:prednisone (40.3%), methotrexate (34.7%), azathioprine (23.6%), cyclophosphamide (9.7%), rituximab (5.6%), mycophenolate (4,2%), leflunomide (2.8%), more than one drug (6.9%). The clinical features that determined the indication of therapy were arthritis (50.8%), parotid swelling (28%), purpura (19.7%), peripheral neuropathy (18.3%), pulmonary involvement (13.9%), autoimmune hepatitis (8.33%) and glomerulonephritis (5.1%). When we compared the clinical characteristics of patients with immunosuppressive treatment against patients without treatment, we found differences in age [59.4 vs 53.8; <i>(p</i>&lt;0.01)], disease duration [5 vs 3; (<i>p</i>&lt;0.01)]; low C3 level [27 vs 12,3;(<i>p</i>&lt;0.01)]; arthritis [50,8 vs 29,4;(<i>p</i>&lt;0.01)]; purpura [19.7 vs 5.5;(<i>p</i>&lt;0.01)], pulmonary disease [13.9 vs 6.3;(<i>p:</i>0.02)] and autoimmune hepatitis [62.5 vs 37.5;(<i>p</i>&lt;0.01)]. Multivariate analysis (adjusted for age and years of disease), with immunosuppressive treatment (dependent variable), showed that arthritis (OR:2.8;95%CI:1.5-5; <i>p</i>&lt;0.01), purpura (OR: 4.4; 95%CI: 1.9-10.3; <i>p</i>&lt;0.01) and autoimmune hepatitis (OR: 8.7; 95%CI: 1.9-40.4; <i>p</i>&lt;0.01)] were independently associated with this indication. <h3>Conclusions</h3> A low number of our patients received treatment with immunosuppressive drugs. The most frequently prescribed drugs were methotrexate and azathioprine. The main clinical features in the immunosuppressant treated group were arthritis, purpura and autoimmune hepatitis. <h3>Disclosure of Interest</h3> None declared
Validation Study Of The Composite Score To Identify Von Willebrand Disease in Children
Authors: Lynn M. Malec, Charity G. Moore, Carolyn M. Bennett, Donald L Yee, Bryce A. Kerlin, Char Witmer, Sriya Gunawardena, Roshni Kulkarni, Sweta Gupta, Peter A. Kouides, Deborah Brown, Heather L. Bujnicki, Margaret V. Ragni
Journal: Blood (2013)
Quality of optical diagnosis of diminutive polyps and associated factors
Authors: Heiko Pohl, Steve Bensen, Arifa Toor, Stuart Gordon, L. Levy, Peter Anderson, Joseph Anderson, Richard Rothstein, Douglas Robertson
Journal: Endoscopy (2016)

The aim of the study was to identify endoscopist-related and procedural factors that may be associated with the quality of optical diagnosis of diminutive polyps using narrow-band imaging (NBI).All subjects who participated in a randomized trial on cap-assisted colonoscopy were eligible for the current study. Optical polyp diagnosis was an a priori outcome of the initial trial. Ten participating endoscopists used NBI to assess all of the diagnosed polyps as adenomatous or non-adenomatous in real-time and provided a degree of diagnostic certainty. The main outcome measures were quality benchmarks of optical diagnosis (negative predictive value [NPV] for diminutive rectosigmoid adenomas, agreement with pathology-based surveillance interval) and assessment of endoscopist-related and procedural factors potentially associated with the quality of optical diagnosis.A total of 1650 polyps were found in 607 patients, with 1311 polyps (79 %) being diminutive, of which 672 (53 %) were adenomatous. The NPV of optical diagnosis for rectosigmoid adenomas was 95 %. The optical diagnosis-based surveillance interval agreed with the pathology-based recommendation in 93 % of patients. Prior experience with image-enhanced endoscopy had no effect on optical diagnosis. Low and high adenoma detectors were not different in achieving the quality benchmarks. Cap-assisted colonoscopy was not associated with quality of optical diagnosis. Quality metrics of optical diagnosis remained similar during the first and second half of the study period.High quality optical diagnosis of diminutive polyps can be achieved and sustained by endoscopists previously inexperienced in this practice with minimal training. None of the examined factors appear to affect the quality of optical diagnosis; particularly, endoscopists' adenoma detection was not associated with optical diagnosis.
SP0188 Adverse Effects of Exercise in Rheumatic and Musculoskeletal Diseases
Authors: M.D. Iversen
Journal: Annals of the Rheumatic Diseases (2015)

This presentation is part of a series designed to examine how much exercise is beneficial and safe in patients with rheumatic and musculoskeletal diseases. It is well documented that aerobic exercise, strength training and its variants help prevent joint stiffness, soft tissue contracture, diminished muscle force and endurance without apparent increases in joint symptoms or disease activity. Recent studies of exercise in rheumatic and musculoskeletal diseases are attempting to define the dose at which exercise is beneficial and to that end, what adverse outcomes are attributed to exercise. This presentation will synthesize the state-of-the evidence regarding short-term and long-term risk of exercise, particularly activities that involve joint loading (such as running) and provide recommendations for regular sustained exercise in these patients. <h3>Disclosure of Interest</h3> None declared
Family History of Breast Carcinoma in Women Predisposed to Develop Breast Carcinoma&lt;xref ref-type="fn" rid="FN1"&gt;1&lt;/xref&gt;
Authors: C. D. Haagensen, M.D.
Journal: JNCI Journal of the National Cancer Institute (1972)

Family History of Breast Carcinoma in Women Predisposed to Develop Breast Carcinoma Get access C. D. Haagensen, M.D. C. D. Haagensen, M.D. Columbia-Presbyterian Medical Center, New York, New York 10032 Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 48, Issue 4, April 1972, Pages 1025–1027, https://doi.org/10.1093/jnci/48.4.1025 Published: 01 April 1972
Regional cerebral blood flow in childhood autism: a SPECT study
Authors: M Zilbovicius, B Garreau, N Tzourio, B Mazoyer, B Bruck, J L Martinot, C Raynaud, Y Samson, A Syrota, G Lelord
Journal: American Journal of Psychiatry (1992)

The authors investigated a possible cortical brain dysfunction associated with infantile autism.They measured regional cerebral blood flow with single photon emission computed tomography (SPECT) and xenon-133 in 21 children with primary autism (according to DSM-III-R criteria). Five cortical brain areas including frontal, temporal, and sensory association cortices were examined in order to test the recent hypothesis of cerebral dysfunction in primary autism. Anatomical references for each subject were obtained with computerized tomography or magnetic resonance imaging and were used to delimit the regions of interest for SPECT analysis.When the results from the group with primary autism were compared with an age-matched group of nonautistic children with slight to moderate language disorders (N = 14), no cortical regional abnormalities were found.It appears that there is no regional cortical dysfunction in primary autism; however, in light of methodological limitations, one cannot exclude the possibility of more localized or subcortical brain dysfunctions in autism.
Labeled Leukocyte Accumulation Corresponding to an Intestinal Polyp in Inflammatory Bowel Disease
Authors: RAUL MARTINEZ-LAZARO, ANABEL CORTES-BLANCO
Journal: Clinical Nuclear Medicine (2001)

From the Nuclear Medicine Service, Hospital Universitario Miguel Servet, Zaragoza, Spain Received for publication May 17, 2000. Accepted July 31, 2000. Reprint requests: Anabel Cortés Blanco, Domingo Ram 32, 3F, Zaragoza, 50017, Spain. E-mail: [email protected]
Increase in risk of breast cancer is small
Authors: C J Mugglestone
Journal: BMJ (1995)

cancer and for those who took it for more than 10 years the relative risk was virtually neutral (relative risk 1-03).2Furthermore, it seems that, even if the incidence of breast cancer is increased in current long term users, the risk of death is decreased.'Those of us who advocate hormone replacement therapy would agree with McPherson's sentiments that on balance the current evidence continues to suggest that such therapy will probably give rise to a net gain in years of life.The American nurses' study recruited 121 700 female registered nurses aged 30 to 55 in 1976; it will be several years yet before such studies can provide us with conclusive answers.
A marketplace model of consultation psychiatry in the general hospital
Authors: F G Guggenheim
Journal: American Journal of Psychiatry (1978)

The manner in which internists and surgeons view potential psychiatric consultations is analogous to the way in which consumers evalute a service or product in the marketplace. Factors that determine a purchase or a consultation request include 1) perception of need, 2) prior attitude and experience, 3) projected image, 4) availability, and 5) cost/benefit ratio. The author presents a model of psychiatric consultation, with similarities between research and development, manufacturing and merchandising phases on the one hand, and negotiation, investigation, and implementation phases on the other.
West Nile Virus and Other Nationally Notifiable Arboviral Diseases — United States, 2015
Authors: Elisabeth Krow-Lucal, Nicole P. Lindsey, Jennifer Lehman, Marc Fischer, J. Erin Staples
Journal: MMWR Morbidity and Mortality Weekly Report (2017)

Arthropod-borne viruses (arboviruses) are transmitted to humans primarily through the bites of infected mosquitoes and ticks. The leading cause of domestically acquired arboviral disease in the United States is West Nile virus (WNV) (1). Other arboviruses, including La Crosse, St. Louis encephalitis, Jamestown Canyon, Powassan, and eastern equine encephalitis viruses, also cause sporadic cases and outbreaks. This report summarizes surveillance data reported to CDC in 2015 for nationally notifiable arboviruses. It excludes dengue, chikungunya, and Zika viruses, which are primarily nondomestic viruses typically acquired through travel (and are addressed in other CDC reports). In 2015, 45 states and the District of Columbia (DC) reported 2,282 cases of domestic arboviral disease. Among these cases, 2,175 (95%) were WNV disease and 1,455 (67%) of those were classified as neuroinvasive disease (meningitis, encephalitis, or acute flaccid paralysis). The national incidence of WNV neuroinvasive disease was 0.45 cases per 100,000 population. Because arboviral diseases continue to cause serious illness, maintaining surveillance is important to direct prevention activities such as reduction of vector populations and screening of blood donors.
Anemia
Authors: MICHAEL W. BRANDRISS
Journal: Annals of Internal Medicine (1964)

Clinical Staff Conference1 August 1964AnemiaMICHAEL W. BRANDRISS, M.D.MICHAEL W. BRANDRISS, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-61-2-343 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptAnemia has been noted frequently as a side effect of amphotericin B therapy in our patients. To determine the frequency, type, and possible mechanism of this anemia, we studied 30 patients with systemic fungal disease who received 37 courses of amphotericin B intravenously (1). The total dose of drug in any one course varied from 0.36 to 6.0 g. The mean hematocrit reading of the group prior to treatment was 41% and the mean low reading during therapy was 27%. A decrease in the hematocrit reading of more than 10 units occurred during 76% of the treatment courses and a...Reference1. BRANDRISSWOLFFMOORESSTOHLMAN MSRF: Anemia induced by amphotericin B. JAMA. In press. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Bethesda, Maryland PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByHIV-associated cryptococcal meningitisDas BesteuerungsverfahrenDas BesteuerungsverfahrenAdverse reactions to anti-infective agentsSpontaneous Resolution of Endogenous Candida Endophthalmitis Complicating Intravenous Hyperalimentation 1 August 1964Volume 61, Issue 2Page: 343-344KeywordsAmphotericinAnemiaDrugsFungal diseasesHematocrit Issue Published: 1 August 1964 PDF DownloadLoading ...
Case 33-1966
Authors: John D. Stoeckle, Benjamin Castleman
Journal: New England Journal of Medicine (1966)

Presentation of Case First admission. A thirty-four-year-old woman entered the hospital because of vaginal bleeding.At the age of eighteen years she was referred to the Cardiac Clinic because of a chronic cough and dyspnea; the diagnosis of an interatrial septal defect was made. Two years before admission she returned to the hospital for right-sided cardiac catheterization, which showed a markedly increased pulmonary blood flow and a diagnosis of ostium primum defect was made. Four months before entry there was the onset of vaginal spotting, which became more severe three months later.Physical examination revealed a mildly cyanotic woman. The . . .
PTH-081 Colorectal cancer in inflammatory bowel disease – is surveillance working?
Authors: T Akbar, S Rahmany, R Harris, S Cotton, L-A McCabe, DA Lloyd, JN Gordon
Journal: Gut (2015)

<h3>Introduction</h3> The burden of colorectal cancer (CRC) in inflammatory bowel disease (IBD) is currently unclear. Recent studies suggest the magnitude of risk may be considerably lower than previous estimates raising questions surrounding current surveillance protocols. However, studies that use IBD surveillance cohorts to identify cases may underestimate the burden of disease with substantial number of cases arising in patients that fall outside current surveillance parameters. Our aim was to identify all cases of CRC arising in patients with IBD in a single geographic locality in a recent timeframe and analyse factors affecting diagnosis with particular reference to current UK surveillance recommendations. <h3>Method</h3> Patients with IBD who developed CRC in a 5-year period from between 2010 and 2015 were identified from a fully maintained database of all CRC cases diagnosed in our locality. This was cross-referenced with histology reports and endoscopy reports from the same period. Case notes were reviewed with data on demographics, disease, presentation, diagnosis, CRC surveillance, cancer stage and outcomes collected and analysed. <h3>Results</h3> 672 cases of CRC were identified in the study period of which 17 (2.5%) arose in patients with IBD (10 UC: 6CD: 1 IBDU). 16 cases were adenocarcinomas with 1 anal squamous cell carcinoma in a patient with longstanding fistulating perianal Crohn’s disease. 6/17 cases (35%) were screen detected in asymptomatic patients undergoing regular surveillance. 4/17 (24%) were interval cancers identified in patients prior to their next scheduled surveillance. The remaining 7/17 (41%) were identified in patients who were not participating in a screening programme. 4 of these cases fell outside current screening parameters with the further 3 cases arising in patients who had ceased surveillance (average age 87; range 84–93). Surveillance in the interval cancers did not adhere to published guidelines in 3 out of 4 cases. 5/6 (83%) screen detected cases were classified as Duke’s A or B, compared with 5/11 (45%) of the non-screen detected cases. <h3>Conclusion</h3> The burden of CRC in patients with IBD is significant accounting for 2.5% of all cancers in the study period. Screen detected cancers were identified at an earlier stage than non-screen detected cancers, though 41% of cases arose in patients that would not currently qualify for screening in the UK. Screening did not adhere to guidelines in 75% of interval cancers. These results support the concept of a surveillance programme though reinforce the importance of meticulous high quality colonoscopy and adherence to guidelines to improve outcomes. <h3>Disclosure of interest</h3> None Declared.
Rate of Aldosterone Secretion in Hypertensive Patients With Demonstrable Renal Artery Stenosis
Authors: M P SAMBHI, B A LEVITAN, J C BECK, E H VENNING
Journal: JAMA (1963)

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De novo renal cell neoplasia after kidney transplantation, according to the International Society of Urological Pathology (ISUP 2013) Vancouver Classification
Authors: F. Massari, C. Ciccarese, M. Brunelli, D. Bimbatti, E. Fantinel, A. Eccher, A. Modena, G. Martignoni, G. Tortora
Journal: Annals of Oncology (2015)
Cyclothymic mood swings in the course of affective disorders and schizophrenia
Authors: C G Fichtner, L S Grossman, M Harrow, J F Goldberg, D N Klein
Journal: American Journal of Psychiatry (1989)

The authors assessed cyclothymic mood swings and psychosocial adjustment in 38 unipolar depressed, 27 bipolar, 35 schizophrenic, and 27 other psychiatric patients 4 years after hospital discharge and in 153 normal control subjects. The patients were significantly more cyclothymic at follow-up than the control subjects, but there were no differences in cyclothymia between the diagnostic groups. Cyclothymic patients showed significantly poorer posthospital functioning than noncyclothymic patients. These findings raise questions concerning the scope of the hypothesized cyclothymic-bipolar spectrum. Minor mood swings in a variety of patients with poor posthospital adjustment may reflect persistent vulnerability to psychopathology.