tbuckley/cabot-search huggingface dataset:
FRI0636-HPR Does New Pharmacological Treatment Change Functioning and Psychosocial Adjustment in Persons with Juvenile Idiopatic Arthritis (JIA). Follow-Up of Two Patient Populations Before and After New Medication Strategy
Authors: C. Bengtsson, A. Öjehagen
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> When a child is diagnosed with JIA the following question arise: "How will the future be? Could I have a work, get a family". One patient group, treated in 1982 at 15 yrs of age at the only specialized clinic in Sweden, Lund University Hospital, was followed up after 10 yrs. Later new kinds of pharmacological treatment were available, the question arise whether these affected psychosocial adjustment. <h3>Objectives</h3> Could the new pharmalogical treatments affect adult functioning and psychosocial adjustment? <h3>Methods</h3> Fifty-three patients (group 1) treated as inpatients at the Department for Pediatric Rheumatology, University Hospital in Lund 1982, 15 years of age, were followed up 1993-94. They were compared with a new group of patients (group 2) treated as inpatients 1996, and followed up 2010-2011. The same follow-up methods were used in both; semi-structured telephone-interviews including self-ratings questionnaires; HAQ, ISSI, SAS-SR and SCL-90-R. Both groups were similar in age and sex. <h3>Results</h3> Group 2 had better functioning than group 1 according to HAQ (0.7±0.8 vs 1,2±0,8) and joint replacement was less common, (35% vs 60%). Further more full-time work was more common (53% vs 30%), and they were more often married (55% vs 34%), p &lt;.05. The need of disability allowance has decreased, 28% vs 68%, as well as the need of support from significant others, 42% vs 64%. Both groups had few psychiatric symptoms (SCL-90-R) and a satisfying social network (ISSI). <h3>Conclusions</h3> Patients in group 1 were almost adult before Methotrexate was used and biological treatment had not yet started when they were interviewed 1993-94. In group 2 many patients had been treated with Methotrexate almost from start and 38% were treated with biological drugs when they were interviewed. The financial costs for drugs are high but patients with early treatment cost less in healthcare and disability allowance, and they pay more tax to society, since they are more often working full-time. We consider the patient groups to be comparable at their initial treatment in Lund. The improved functioning and adjustment at follow-up could not be explained by differences in availability of support from society or educational possibilities. <h3>Disclosure of Interest</h3> None declared
Too Much To Read
Authors: J. R. E.
Journal: Annals of Internal Medicine (1965)

Editorials1 October 1965Too Much To ReadJ. R. E.J. R. E.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-63-4-721 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptPOLONIUS: What do you read, my lord?HAMLET: Words, words, words.Too many words. It is no news to the physician that he is steadily losing ground against the rising tide of medical reading matter that threatens to engulf him. Quite aside from the enormous floods of advertising material, commercial "throw-away" publications, and pharmaceutical brochures that pour in on him daily, the conscientious physician is faced with an ever-increasing number of bona-fide medical journals and newsmagazines that by sheer numbers overwhelm his capacity to keep informed of new developments in his chosen fields of interest. Week by week and month...References1. FOX T: Crisis in Communication in The Functions and Future of Medical Journals. University of London Athlone Press, London, 1965. Google Scholar2. ANNOTATION: Reading, writing, and writhing. Lancet 1: 693, 1965. MedlineGoogle Scholar3. EDITORIAL: Too many words. Brit. Med. J. 1: 1264, 1965. CrossrefMedlineGoogle Scholar4. EDITORIAL: Medical journals: recorders or newspapers? Med. J. Austral. 1: 771, 1965. CrossrefMedlineGoogle Scholar5. EDITORIAL: Medical journalism. VII: Sludging in the arteries of communication. Canad. Med. Ass. J. 92: 1132, 1965. MedlineGoogle Scholar6. EDITORIAL: "Crisis in communication." New Eng. J. Med. 272: 1350, 1965. CrossrefGoogle Scholar7. ABELSON PH: An editor's view of publication problems. Fed. Proc. 22: 980, 1963. MedlineGoogle Scholar8. PRICE DJ: Little Science, Big Science. Columbia University Press, New York, 1963. CrossrefGoogle Scholar9. PLATT JR: The step to Man. Science 149: 607, 1965. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byThe sigmoidal curve"Where Did I See That Paper?"J. R. E. 1 October 1965Volume 63, Issue 4Page: 721-723 ePublished: 1 December 2008 Issue Published: 1 October 1965 PDF downloadLoading ...
SAT0243 Clinical Features of Patients with Early Axial Spondyloarthritis Depending on the Presence of Sacroiliitis and the Visualization Method Used: Table 1
Authors: E. Gubar, T. Dubinina, A. Dyomina, A. Godzenko, O. Rumyantseva, S. Shubin, A. Smirnov, S. Glukhova, S. Erdes
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Objectives</h3> To analyze clinical features of patients (pts) with early axial spondyloarthritis (axSpA) and the possible interrelation of non-radiographic axSpA (nr-axSPA) and ankylosing spondylitis (AS) <h3>Methods</h3> 150 pts with axSpA and &lt;5 years duration of inflammatory back pain (ASAS criteria) were examined following ASAS guidelines. While the axSPA diagnosis was determined by ASAS 2009 criteria, the AC – by mNY 1984 criteria <h3>Results</h3> At the first examination, 77 (51.3%) pts had X-ray identified sacroiliitis (xSI) and their AS was determined by the mNY criteria (Group 1). 88 (58.7%) pts had sacroiliitis according to MRI (MRI-SI), while 42 of them also had xSI. 46 (30.7%) pts who had active MRI-SI and had no xSI were graded as pts with nr-aSPA (Group 2). In 27 (18.1%) pts, SI was not determined by any of the visualization methods (they were HLA-B27 positive and additionally they had ≥2 other axSPA symptoms (Group 3). Clinical features of pts from all groups are summarized in the Table. Pts of Groups 1 and 2 were comparable by demographic and clinical characteristics. Psoriasis was more common among pts of Group 2 (13.0%) vs Group 1 (1.3%; p=0.007). In Group 1, there were significantly more males than in Group 3 (49.4% and 18.5%, respectively (p=0.004). Among the SI pts (Groups 1 and 2) acute inflammation phase reactants (ESR and CRP) were significantly higher, than in pts without SI. MRI inflammation of the lumbar spine (LS) was more common among the pts with xSI (Group 1 – 25.7%, Group 3 – 7.4%, p=0.04), as well as low BMD (Z≤-2SD) in the LS (Group 1 – 22.4%., Group 3. – 3.9%, p=0.03). Dactylitis was more common among Group 3 pts as compared to the SI cohort (Groups 1 and 2) (p<sub>1-3</sub>=0.05, p<sub>2-3</sub>=0.03), as well as enthesitis (p<sub>1-3</sub>=0.02, p<sub>2-3</sub>=0.04) <h3>Conclusions</h3> Patients with nr-aSPA but active MRI-SI should be most probably considered as early AS cases, when they did not yet develop destructive changes in sacroiliac joints. Dactylitis and enthesitis are more common in axSpA patients without signs of SI (both by MRI or X-ray). <h3>Disclosure of Interest</h3> None declared
THE TREATMENT OF CANCER OF THE UTERUS
Authors: E MAURIZIO
Journal: JAMA (1921)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
PTU-333 Clostridium difficile infection rate of recurrence is lower, and mortality is higher, in a large teaching hospital trust than in clinical trials: a prospective observational study
Authors: V Wilkinson-Smith, L Koay, T Hills, M Diggle, G Major, R Spiller
Journal: Gut (2015)

<h3>Introduction</h3> Clostridium difficile infection (CDI) is the most common nosocomial infection in the United Kingdom. New treatments have shown reduction in CDI recurrence in clinical trials. Their high cost has been justified by savings on treatment of recurrence and reduction in financial penalties. However, in such a sick group of patients with multiple comorbidities recruitment rates to clinical trials are typically very low. A service development project was initiated to assess the current local burden of CDI and rates of recurrence. <h3>Method</h3> For one year, between 30<sup>th</sup>October 2013 and 2014, all samples tested positive for <i>C. difficile</i>toxin production (Techlab Toxin AB Quikcheck) in the Microbiology department of Nottingham University Hospitals NHS Trust (NUH) were identified. Baseline age, leukocyte count, CRP, albumin and creatinine were recorded as well as use of proton pump inhibitors or other antibiotics if treatment was initiated by NUH. The main outcome measure was CDI recurrence within 6 months, with a particular focus on those treated by, and re-presenting to, NUH. At time of submission 6-month data is available for most cases with 3-month data available for all. In April 2014 the Trust adopted the use of Fidaxomicin for recurrent cases of CDI and for those receiving concomitant antibiotic treatment. <h3>Results</h3> After exclusion of samples sent during the same episode (&lt;20 days apart), the study identified 188 episodes of CDI in 164 individuals, mean age 71 ± 14. In 121 episodes this was the first presentation of CDI and there was a decision to treat medically (1 colectomy, 15 end-of-life). Of those 121, 16 patients had toxin (+) recurrence (13%). 3 patients had a 2<sup>nd</sup>recurrence, all of whom had been treated with Fidaxomicin on 1<sup>st</sup>recurrence. 15 others received Fidaxomicin, 9 of whom had not responded to other treatment or recurred. There was no clear predictor of likelihood of recurrence. 32/121 patients died within 6 months of CDI (26%), of whom 23 died within 3 months (19%). <h3>Conclusion</h3> CDI recurrence rates in medically treated patients were much lower than that reported for standard therapy in previous clinical trials (25%). Mortality in the medically treated group was much higher than in trials (6–7%) but similar to previous observational studies, reflecting under-representation of very sick patients in clinical trials. Treatment guidelines should recognise this limitation when applying clinical trial results to their patient population. <h3>Disclosure of interest</h3> V. Wilkinson-Smith: None Declared, L. Koay: None Declared, T. Hills: None Declared, M. Diggle: None Declared, G. Major: None Declared, R. Spiller Grant/ Research Support from: Lesaffre, Ironwood, Norgine, Falk Pharma, Consultant for: Almirall, Astellas, Yuhan, Danone.
AB0248 Clinical Significance of Soluble Vascular Endothelial-Cadherin and Anti-Vascular Endothelial-Cadherin Antibody in Rheumatoid Arthritis Treated with Etanercept or Adalimumab
Authors: C. Banse, H. Polena, B. Stidder, A. Khallil-Mgharbel, E. Houivet, T. Lequerré, P. Fardellone, X. Le Loet, P. Philippe, C. Marcelli, I. Vilgrain, O. Vittecoq
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> The extra cellular domain of vascular endothelial-cadherin (sVE) increases in rheumatoid arthritis (RA) through TNF induction. <h3>Objectives</h3> The aim of our study was to investigate the clinical value of sVE and anti-vascular endothelial-cadherin antibody (AAVE) in RA treated with etanercept or adalimumab combined with methotrexate, in terms of disease activity, prediction of structural prognosis and response to treatment. <h3>Methods</h3> This was an 18-month prospective multicenter study in which patients had active RA, refractory to conventional Disease-Modifying Antirheumatic Drug (DMARD) requiring TNF antagonist. Fluctuations of sVE rates and AAVE titers were measured respectively by dot blot and ELISA at different time points over the follow-up period. Their relationship with parameters reflecting articular or systemic disease activity, progression of structural damage defined by ultrasonography (US) erosions, and response or remission to treatment based on EULAR criteria was analyzed. <h3>Results</h3> Forty-eight patients received TNF blocking agents, i.e, etanercept (n=18) and adalimumab (n=30). Variation of sVE rates significantly correlated with that of C-reactive protein (CRP) levels at weeks 6, 12, 26 and 52 (r=0.4869, p=0.0008; r=0.3909, p=0.0087; r=0.3148, p=0.0450 and r=0.5477, p=0.0014 respectively). There was a significant decrease in sVE levels in the group with a decrease in CRP levels compared to the group with unmodified CRP (initial CRP ≤10 mg/l or initial CRP&gt;10 mg/l with a variation of less than 50%). AAVE titers correlated with Erythrocyte Sedimentation Rate (ESR) (r=0.381, p=0.0128), CRP (r=-0.3361, p=0.0317), number of swollen joints (r=0.3102, p=0.0456) and total power doppler score (r=0.3841, p=0.0132). At baseline, AAVE was correlated with rheumatoid factors and a to lesser degree anti-CCP (respectively r=0.5801, p&lt;0.0001 and r=0.3021, p=0.0518). Kinetics of sVE levels as well as AAVE titers were not associated with progression of US erosive score neither with the response to methotrexate/adalimumab or etanercept combination. <h3>Conclusions</h3> sVE seems to be a biomarker associated with systemic RA activity under anti-TNF. AAVE are related to autoantibodies usually associated to RA and had stable titers under TNF blocking agents. <h3>Disclosure of Interest</h3> None declared
Cocci, Not Klebsiella
Authors: P H Edelstein
Journal: New England Journal of Medicine (1997)

To the Editor: Rubin and colleagues (Nov.7 issue) 1 conclude that advanced epithelial ovarian cancers in patients with germ-line BRCA1 mutations have a better prognosis than their sporadic counterparts.Although this may eventually prove to be correct, the methods used in this study raise several questions.Important prognostic information about the patients with BRCA1 mutations, such as the status of residual disease and the type of chemotherapy used, was said to be unavailable from the patients' charts, although these data are critical in choosing a proper control group.Did the authors attempt to check the original operative reports; to make direct contact with the surgeons, the medical oncologists, or both; and, when possible, to ask the patients?Since many patients and family members know what kind of chemotherapy was administered, I am surprised that this basic information was not available.Histology and disease stage are important prognostic factors in ovarian tumors, yet in only 14 cases were slides reviewed to confirm the diagnosis.Why were slides from the remaining 39 patients unavailable?Is it possible that the distribution of histologic subtypes and grades shown in Table 1 of the article would have differed if the authors had undertaken a centralized review of all available slides?The authors make no direct mention of how rigorously they assessed survival status.Was this done by reviewing the charts, calling patients directly, or examining death certificates?Readers should be given enough information for them to have confidence in the quality of the data presented.In view of these uncertainties in the BRCA1 -mutation group, I am at a loss to know how the authors can confidently choose a representative control group for comparison.It is not enough to select the control group on the basis of age and stage alone, because there are many other influences on outcome that could easily bias the results.The median survival of 29 months in the control group suggests that those patients represent a group at particularly high risk, with suboptimally debulked disease, 2 and this may therefore artifactually magnify any potential survival advantage associated with the presence of a BRCA1 mutation.These concerns lead me to believe that the authors have drawn conclusions about the influence of BRCA1 mutations on prognosis that are not entirely justified by their data.
The Related Adhesion Focal Tyrosine Kinase (RAFTK) Is Tyrosine Phosphorylated and Participates in Colony-Stimulating Factor-1/Macrophage Colony-Stimulating Factor Signaling in Monocyte-Macrophages
Authors: William C. Hatch, Ramesh K. Ganju, Dananagoud Hiregowdara, Shalom Avraham, Jerome E. Groopman
Journal: Blood (1998)
SP0005 Co-Morbidity in Psoriatic Arthritis? Beyond the Skin and Joints
Authors: H. Marzo-Ortega
Journal: Annals of the Rheumatic Diseases (2015)

Psoriatic arthritis (PsA) is a common inflammatory disorder affecting 0.3-1% of the general population, and can be found in 10-40% of the psoriasis (Pso) population. The physical and psychological burden of the musculoskeletal and skin symptoms in affected individuals is substantial, leading to a significant impact on their quality of life. Recent epidemiological studies have shown that beside the joint and skin involvement, PsA and Pso may be associated to multiple systemic comorbidities including metabolic syndrome, other autoimmune diseases and lymphoma. Further, the higher prevalence of metabolic syndrome together with the inflammatory burden associated to both PsA and Pso contribute to an increased cardiovascular risk and mortality. The complexity of this “psoriatic disease” suggests that management should not only be targeted at the skin and joints but should encompass an individualized holistic approach to address by-standing co-morbidities and lifestyle adjustments. <h3>Disclosure of Interest</h3> None declared
AB1013 Pulse of Methylprednisolone May Reduce the Risk of Renal Involvement in Children with Henoch-Schonlein Purpura
Authors: V. Javadi Parvaneh, R. Shiari, K. Rahmani, F.F. Mehregan, L. Mahboubi, S. Salehi, M.H. Yeganeh
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Henoch-Schonlein purpura (HSP) is a disease with small blood vessels inflammation. Although HSP can affect people at any age, most cases occur in children between the ages of 2 and 11. The disease involves skin, intestines, kidneys, and joints. The main symptom is a rash with numerous small bruises, which have a raised appearance, over the legs or buttocks. Almost 30-40% of children with HSP may have renal involvement. In most patients, the kidney impairment is mild and goes away without any long-term damage. However, about 5% of patients may develop progressive kidney disease and 1% may go on to end stage renal disease (ESRD). <h3>Objectives</h3> To date, treatment of HSP remains primarily supportive in most cases. Hematuria at disease onset and persistence of renal manifestations during the occurrence of HSP can be significant predictors of possible development of renal sequelae. These manifestations, along with other features may predict the development of renal sequelae in most patients. Various drugs have been used to prevent renal disease from progressing. The results have been inconsistent. The aim of our study was to evaluate the efficacy of pulsed Methylprednisolone in children with HSP and renal manifestation. <h3>Methods</h3> 69 children with HSP who had HSP and were admitted to Mofid Children9s Hospital were evaluated; Children who had the indication of treatment were received 30mg/kg of Methylprednisolone for three consecutive days instead of traditionally oral prednisolone therapy. All of children were followed for ten years and evaluated for renal involvement. <h3>Results</h3> Of 69 patients with HSP, 55 children full filed the indication of therapy and were received pulsed methylprednisolone. Only 6 patients had the renal manifestation but no ESRD. Only one patient had persistent renal disease that was treated by Cyclophosphamide. <h3>Conclusions</h3> The previous results showed that 30-40% of children with HSP may have renal involvement and about 5% of patients may develop progressive kidney disease. Our 10 years follow up showed that only 10% of children who were admitted to Hospital and were received pulse of Methylprednisolone, had renal involvement. None of 69 patients suffered ESRD. We suggest limiting the indications of steroid therapy for children with HSP. However, if the patients need to receive steroid therapy, pulse of Methylprednisolone may reduce the latent renal complications. <h3>Disclosure of Interest</h3> None declared
Intrapatient Comparison of 111In-PSMA I&amp;T SPECT/CT and Hybrid 68Ga-HBED-CC PSMA PET in Patients With Early Recurrent Prostate Cancer
Authors: Isabel Rauscher, Tobias Maurer, Michael Souvatzoglou, Ambros J. Beer, Tibor Vag, Martina Wirtz, Gregor Weirich, Hans-Jürgen Wester, Jürgen E. Gschwend, Markus Schwaiger, Margret Schottelius, Matthias Eiber
Journal: Clinical Nuclear Medicine (2016)

The aim of this study was to evaluate the detection efficiency of In-PSMA-I&T SPECT/CT in comparison to hybrid Ga-PSMA HBED-CC PET in patients with early recurrent prostate cancer.Twenty-two patients (mean age, 68.2 ± 6.8 years; range, 52-76 years) with rising prostate-specific antigen (PSA; median, 1.03 ng/mL; range, 0.2-7.2ng/mL) and known positive lesions in hybrid Ga-PSMA HBED-CC PET scheduled for salvage surgery were included. Whole-body scintigraphy and SPECT/CT were performed 4 hours after application of 147.0 ± 24.8 MBq (range, 90-183 MBq) In-PSMA I&T. Images were evaluated for suspected lesions, and conspicuity of all lesions was rated using a 4-point-scale (0 = not seen, 1 = retrospectively seen in knowledge of Ga-PSMA HBED-CC PET, 2 = low signal, 3 = high signal). Tumor-to-background ratios were determined for SPECT and PET and compared. Tumor-to-background ratio of SPECT was correlated with lesion size as well as patients' Gleason score and PSA level.In-PSMA I&T SPECT/CT detected 14 of 29 PET-positive lesions (48.3%) with no additional lesions identified with In-PSMA I&T SPECT/CT. There was a significant weak to moderate correlation of PSA level with tumor-to-background ratio of In-PSMA I&T SPECT/CT (correlation coefficient r = 0.6406; 95% confidence interval, 0.1667-0.8741; P = 0.0136). There was no significant difference (P > 0.05), but a weak trend toward a higher detectability in In-PSMA I&T SPECT/CT regarding lesion size and initial PSA level.In a preselected collective of recurrent prostate cancer patients with low PSA values, In-PSMA I&T SPECT/CT showed lower detection rates than hybrid Ga-HBED-CC PSMA PET. However, In-PSMA I&T SPECT/CT showed a patient based detection rate of 59%, making it a potentially valuable imaging tool where PET is not available apart from its proven value as a PSMA-targeted probe for radioguided surgery.