tbuckley/cabot-search huggingface dataset:
PWE-192 Helicobacter eradication aspirin trial (Heat): side effects analysis of mid-trial data: Abstract PWE-192 Table 1
Authors: K Wright, WH Ho, CJ Hawkey, MD Smith, JS Dumbleton
Journal: Gut (2015)

<h3>Introduction</h3> HEAT is a large multicentre trial involving patients aged 60+ years, on low dose aspirin, breath-tested positive to H.pylori and randomised either to 1-week triple therapy H. pylori eradication or placebo. Triple therapy consists of lansoprazole 30mg, clarithromycin 500mg and metronidazole 400mg, twice daily. We conducted a side effects analysis of mid-trial HEAT data, gathered over an approximate 2.5 year period. <h3>Method</h3> A HEAT side effect report includes 3 pieces of information – name, severity (1=mild, 2=moderate, 3=severe), duration in days – with patient’s allowed to report up to 6 side effect episodes. We analyse these data using descriptive statistics. In addition, for the subgroup experiencing a side effect, we score each episode, formed as the product of severity by duration. Then, for each patient, we aggregate episode scores to generate a total side effect score; a measure that is increasing in both severity and duration. We model the total score using regression methods, controlling for patient characteristics. <h3>Results</h3> Of all 1213 patients, 45.34% (550) reported at least one treatment side effect. As we are currently blind to randomisation, assuming all who report a side effect are in the active treatment arm, the incident rate of 90.7% (550 of 1213/2) differs considerably from the 19.7% rate reported in Bazzoli <i>et al</i>.<sup>1</sup>for a trial arm with a similar dosage triple therapy regimen, although their cohort, with an average age of 52 years, is considerably younger than that of HEAT (average 73 years). The Table 1gives the count of patient’s reporting multiple episodes categorised by severity: Diarrhoea is the most frequently reported side effect with a total of 205 episodes reported by 102 patients, with multiple reports recorded by 24 patients; 30 episodes were reported to be severe. Diarrhoea episode duration averages 3.9 days (range 1–14 days). Linear regression of the total side effects score (n = 543, mean = 18.7, stddev = 22.3, min = 1, max = 180) found no statistically significant systematic dependence of the score on patient characteristics, apart from gender (beta=3.4, p = 0.005), in which women are more likely than men to return a higher score. <h3>Conclusion</h3> To mid-trial, the side effects profile experienced by HEAT participants spans the list of those that are expected, with diarrhoea the most common. It is encouraging that there appears to be no systematic pattern of patient characteristics affecting side effects, although women experience significantly greater impacts than do men. <h3>Disclosure of interest</h3> None Declared. <h3>Reference</h3> Bazzoli F, <i>et al</i>. Aliment Pharmacol Ther. 2002;16:153–158.
The agony of choice in dermatophyte diagnostics—performance of different molecular tests and culture in the detection of Trichophyton rubrum and Trichophyton interdigitale
Authors: C. Kupsch, T. Ohst, F. Pankewitz, P. Nenoff, S. Uhrlaß, I. Winter, Y. Gräser
Journal: Clinical Microbiology and Infection (2016)
PTH-079 Vitamin d deficiency in active crohn’s disease: cause or consequence?
Authors: SL Grainger, SL Jones
Journal: Gut (2015)

<h3>Introduction</h3> Patients with Crohn’s disease (CD) often have low levels of vitamin D (Vit D). Initially considered to be secondary to active disease, there is growing evidence that Vit D has a role in immune regulation and that deficiency might contribute to flares of disease. If this hypothesis is correct, CD should exhibit discernible seasonal fluctuations in activity, associated with changing Vit D levels, but studies over three decades have produced conflicting results. <h3>Method</h3> Severely active CD requires hospitalisation. We retrospectively analysed consecutive admissions over 44 months (Feb 2010-Sept 2013) to our two district general hospitals in outer North East London, where the primary diagnosis was CD. Admissions lasting less than two days were excluded, to avoid counting patients attending for elective investigations or treatment. Variation in Vit D levels in our locality was modelled from the proportion of primary care patients deficient in Vit D (serum total 25(OH)D &lt;25 nmolL) each month from Oct 2012 to Sept 2013. 31,000 requests for Vit D levels were made by GPs during this period. Seasonal variations in and associations between Vit D levels and admissions for CD were assessed by Hewitt’s test<sup>1</sup>and Spearman rank correlation, respectively. <h3>Results</h3> 385 admissions for CD were recorded in the 44 month period. 40% more admissions occurred December–May than June–November (p &lt; 0.05). We observed the expected seasonal variation in Vit D levels (p &lt; 0.01). The curves for monthly admissions plotted alongside percentage of Vit D deficiency coincide, with a correlation coefficient of 0.65, p &lt; 0.05, see Figure 1. <h3>Conclusion</h3> Our study confirms seasonal variation in admissions to hospital for CD in outer NE London and suggests for the first time in the UK that more than 40% of this fluctuation might be accounted for by changes in Vit D levels. Since we used community levels as a surrogate for the Vit D levels of our patients, the influence of active disease secondarily lowering Vit D can be discounted. Our results justify the systematic assessment of Vit D levels in patients with CD and give further impetus to evaluation of Vit D supplementation. <h3>Disclosure of interest</h3> None Declared. <h3>Reference</h3> Walter SD. Exact significance levels for Hewitt’s test for seasonality. J Epidemiol Community Health 1980;34:147–149
Spontaneous Flow of Bile Through the Human Pancreatic Duct in the Absence of Pancreatitis: Nature’s Human Experiment
Authors: T. Pohle, J. Konturek, W. Domschke, M. Lerch
Journal: Endoscopy (2003)

One hundred years ago E. L. Opie proposed two distinct hypotheses to address the pathogenesis of gallstone-induced pancreatitis. These hypotheses appear mutually exclusive. The first predicts that impediment to the flow of pancreatic juice causes pancreatitis (the pancreatic duct obstruction hypothesis), whereas the second predicts that bile flow into the pancreatic duct behind an impacted gallstone would trigger the onset of acute pancreatitis (the common-channel hypothesis). One of the more convincing arguments against the latter hypothesis is the observation that bile, when experimentally perfused through the pancreatic duct of dogs, does not induce pancreatitis. This experimental situation had spontaneously developed in the patient we describe here: a biliopancreatic fistula had permitted the continuous flow of bile through a large portion of the pancreas, which was associated with cholangitis but had apparently never led to pancreatitis. This patient's case would suggest that in humans, just as in experimental animals, bile flow through the pancreatic duct is not necessarily involved in the onset of gallstone-induced pancreatitis and lends further support to Opie's pancreatic duct obstruction hypothesis.
On the Etiology of Esophageal Carcinoma&lt;xref ref-type="fn" rid="fn1"&gt;2&lt;/xref&gt;
Authors: J MOSBECH, A VIDEBAEK
Journal: JNCI Journal of the National Cancer Institute (1955)

On the Etiology of Esophageal Carcinoma Get access Johannes Mosbech, Johannes Mosbech The University Institute of Human Genetics (Professor Tage Kemp, M.D.) and the Radium Centre (Chief: Jens Nielsen, M.D.), Copenhagen, Denmark Search for other works by this author on: Oxford Academic PubMed Google Scholar Aage Videbæk Aage Videbæk The University Institute of Human Genetics (Professor Tage Kemp, M.D.) and the Radium Centre (Chief: Jens Nielsen, M.D.), Copenhagen, Denmark Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 15, Issue 6, June 1955, Pages 1665–1673, https://doi.org/10.1093/jnci/15.6.1665 Published: 01 June 1955 Article history Received: 17 November 1954 Published: 01 June 1955
Case 10-1967
Authors: George S. Richardson, Robert E. Scully
Journal: New England Journal of Medicine (1967)

Presentation of CaseA seventy-one-year-old woman, gravida 3, para 3, entered the hospital because of vaginal bleeding of three weeks' duration.She had been well until one year previously, when she was admitted to the hospital because of crampy abdominal pain, nausea and vomiting. An x-ray film of the abdomen showed fluid levels in the small intestine and cecum. At laparotomy an annular obstructing mass, 7.5 by 3.5 cm., was found in the ascending colon just above the cecum; a right hemieolectomy and ileotransverse colostomy were performed. The liver appeared normal; the ovaries and fallopian tubes were atrophie. Pathological examination . . .
Clinicopathogenetic Significance of Chromosomal Abnormalities in Patients With Blastic Peripheral B-Cell Lymphoma
Authors: Brigitte Schlegelberger, Thomas Zwingers, Lana Harder, Hadwiga Nowotny, Reiner Siebert, Michael Vesely, Heinrich Bartels, Ruth Sonnen, Georg Hopfinger, Alexander Nader, German Ott, Konrad Müller-Hermelink, Alfred Feller, Renate Heinz
Journal: Blood (1999)
Low toxicity profile of the combination of bendamustine plus rituximab in elderly frail patients with newly Diagnosed Diffuse Large B-Cell Lymphoma (DLBCL)
Authors: M. Spina, S. Luminari, F. Salvi, F. Passamonti, A. Fabbri, U. Vitolo, G. Cabras, M. Miglino, F. Merli, P.P. Fattori, A.M. Liberati, A. Zaccaria, T. Patrizia, R. Ciancia, E.A. Pesce, S. Storti
Journal: Annals of Oncology (2015)
18F-FDG PET/CT for Early Postradiotherapy Assessment in Solitary Bone Plasmacytomas
Authors: Pierpaolo Alongi, Lucia Zanoni, Elena Incerti, Federico Fallanca, Paola Mapelli, Nikolaos Papathanasiou, Luigi Gianolli, Maria Picchio, Jamshed Bomanji
Journal: Clinical Nuclear Medicine (2015)

Purpose The purpose of this study was to evaluate the performance and possible prognostic value of early 18F-FDG PET/CT (FDG PET/CT) assessment after radiotherapy (RT) in patients with solitary bone plasmacytoma (SBP). Methods Twenty-one patients affected by SBP who underwent FDG PET/CT scan for early restaging (≤6 months) postradiotherapy assessment were selected from the PET databases of University College London Hospital of London and San Raffaele Hospital of Milan. Patients with no abnormal uptake were classified as having no pathologic uptake (NPU). A SUVmax cutoff value of 4 was chosen to discriminate minimal residual uptake (MRU; SUVmax ≤ 4) from pathologic uptake (PU, SUVmax >4). Progression-free survival (PFS) rate was estimated using Kaplan-Meier curves and Cox regression analysis. Results In 10 of 21 patients restaged by FDG PET/CT, further previous baseline scan was available also at staging, and results showed positive findings at the level of all biopsy-proven disease areas. Considering MRU as PU, FDG PET/CT showed a sensitivity and specificity of 86% and 29%, respectively. Using SUVmax >4 as the cutoff, sensitivity and specificity were 86% and 93%, respectively. Kaplan-Meier curves revealed a significant difference in PFS probability between patients classified as positive on FDG PET/CT using a cutoff of SUVmax >4 (PU) and those classified as negative (NPU + MRU) (log-rank, Mantel-Cox, P = 0.009; χ2 = 6.85). Cox regression analysis of PFS using SUVmax >4 as cutoff revealed an interesting relation in prediction of progression (HR, 9.458). Conclusion 18F-FDG PET/CT for early restaging after RT in patients with SBP should be considered carefully in view of the lack of specificity of a low SUVmax value. The good correlation between a high SUVmax value and follow-up suggests a possible prognostic role for FDG PET/CT in disease progression at early restaging after RT.
THU0006 Validation of Differential Methylation in Maternally Versus Paternally Transmitted Psoriatic Disease
Authors: R.A. Pollock, D.D. O'Rielly, A. Dohey, D. Codner, V. Chandran, D. Gladman, P. Rahman
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Several studies have demonstrated excessive paternal transmission of psoriasis and psoriatic arthritis (PsA). This phenomenon is thought to be mediated by genomic imprinting. We previously compared whole blood methylation patterns among PsA patients from Newfoundland, Canada and identified 90 significant CpG sites that differentiate patients with paternally and maternally-transmitted disease. <h3>Objectives</h3> To validate previously-identified CpG sites in an independent sample of PsA patients with paternally and maternally-transmitted disease from Toronto, Canada. <h3>Methods</h3> All PsA patients included in the study satisfied the CASPAR criteria and had a parent with either psoriasis or PsA. Forty-six (46) PsA patients with paternally-transmitted disease were compared to 48 PsA patients with maternally-transmitted disease at 136 CpG sites on 10 different chromosomes. Percent methylation was measured at each CpG site by Sequenom EpiTyper technology, which involves bisulfite conversion followed by mass spectrometric analysis. Generated β values ranging from 0% (fully unmethylated) to 100% (fully methylated) were compared between groups using the nonparametric Mann-Whitney U test. Logistic regression models adjusting for age and sex were run to confirm the unadjusted results. <h3>Results</h3> PsA patients with paternally-transmitted disease were 52% female, and at the time of sample collection had a mean (SD) age of 47.7 (12.6) years, psoriasis duration of 23.7 (13.3) years, PsA duration of 14.1 (9.7) years, PASI score of 5.3 (7.2) and tender joint count of 4.9 (7.8). Patients with maternally-transmitted disease were 53% female, and had a mean age of 50.3 (11.1) years, psoriasis duration of 23.1 (12.2) years, PsA duration of 14.9 (12.0) years, PASI score of 4.5 (5.3) and tender joint count of 6.8 (8.5). Three CpG sites were significantly differentially methylated in the Toronto patients with paternally and maternally-transmitted disease. The most significant site was located within an intron of the CROCC (rootelin) gene on 1p36.13 and was hypomethylated in paternally-transmitted disease (p=0.014). Two sites within the 59 UTR of the PACSIN1 gene on chromosome 6p21.3 were also significantly hypomethylated in paternally-transmitted disease (p=0.040 and p=0.047). After adjustment for age and sex, CpG methylation at CROCC remained significantly associated with paternally-transmitted disease (OR=0.77, 95% CI 0.60-0.99, p=0.04). <h3>Conclusions</h3> CpG methylation at the CROCC locus on chromosome 1p36.13 differentiates PsA patients with paternally and maternally-transmitted disease. Although CROCC is not known to be imprinted in humans, these data suggest it may play some role in the excessive paternal transmission of psoriatic disease. Further validation of these results in somatic and germ line cells are necessary. <h3>Disclosure of Interest</h3> None declared
Soundings: Goodbye Vesalius
Authors: Colin Douglas
Journal: BMJ (2001)

They were not humble. Their subject, they told us, was by far the most ancient of medical sciences yet still the foundation of all modern clinical practice.

They were not, however, all-powerful. Their curricular time had just been cut from 900 to 500 hours: a setback they bore with fortitude, simply teaching the same stuff almost twice as fast. But they were still, they told us quietly as exams loomed, the gatekeepers of medicine. No one could proceed without knowing vast amounts of minute detail about the bedraggled, reeking corpses over which they presided.

Fresh from a year in sub-Saharan Africa, I thought I detected, as might any modest 19 year old amateur anthropologist in the circumstances, a rite of passage. That helped. Our cohort would be stressed, mystified, bullied, degraded, and eventually—with a few exceptions—found worthy.

Meanwhile, we trooped to practicals and lectures. A sad woman with a prosthetic right upper limb explained the mitral valve. “Just like a bishop's mitre . . .” She held up a normal hand and a metal claw. “. . . as those of you with two hands can easily demonstrate.” A retired surgeon confided to small groups the convoluted secrets of the greater omentum, using folds in the lapels of the lab coat of the nearest student—somehow always female—to make his point.

A smiling junior answered all questions by quoting verbatim whole chunks of the official textbook in response to the stimulus of key words—anticipating the principles of the CD ROM by some 25 years. And daily the star lecturer launched upon his late morning peroration via sentences that lengthened steadily, the approaching release signalled by the most breathtakingly audacious grammatical construction of all—encrusted with ornately worked parentheses and featuring not only serried flying buttresses of subordinate clauses but echoing transepts of noun phrases in apposition too—which led at last to a dying fall, mass exit to the Men's Union and lunch: pie, beans, and chips.

Gone, all gone. A brief note in the university's financial recovery plan indicates that the anatomy department is no more. Elements of the subject will be taught in context as the need arises. But recent advances in anatomy, by Vesalius and others, will all no doubt still be freely available on CD ROM.
PTH-340 Complete pathological tumour response and outcomes in indian patients with rectal cancers
Authors: S Sinukumar, A Saklani, R Engineer, P Patil
Journal: Gut (2015)

<h3>Introduction</h3> Total Mesorectal Excision coupled with neoadjuvant chemoradiotherapy (NACTRT) is currently considered the standard treatment for patients with locally advanced rectal cancers (LARC). Various studies have reported pathological downstaging and a complete pathological response rate of 15% &gt;27% following neoadjuvant chemoradiotherapy which has translated into improved survival. We endeavour to determine the clinical outcome of patients attaining a complete pathological tumour response following neoadjuvant chemoradiotherapy in the Indian setting where most of our patient population is younger and present with aggressive tumour biology. <h3>Method</h3> Four hundred and thirty patients of LARC underwent surgical resection following NACTRT from 2010 to 2013. Of the 430 patients, seventy patients achieved complete pathological response in the primary tumour. Clinicopathological and treatment details were recorded for these 70 patients. Locoregional and systemic recurrence rates were calculated and Disease free survival (DFS), Overall survival (OS), were evaluated using Kaplan-Meier curves. Log-rank test was used to compare survival outcomes between different subgroups of patients. <h3>Results</h3> 16.2% patients had a complete pathological tumour response (ypT0). The median age of presentation was 47 years (Range 18–77 years). The median pretreatment carcinoembryonic (CEA) tumour marker level was 3.2 (Range 1.1–127 ng/ml). The median interval between completion of NACTRT and surgery was 56 days (Range12–206days). Abdominoperineal resection (APR) was the most common surgical procedure perfomed. The commonest histology was classical adenocarcinoma. Signet cell carcinoma and mucinous carcinoma was seen in 12.8% and 7.1% of cases respectively. The median nodes dissected at surgery was 8(range 1–21). Six out of the 70 patients (8.6%) showed residual disease in the nodes. (ypT0N0=64, ypT0N+ =06). After a median follow up of 30.5 months (Range 11–59 months), the 3 year Overall survival was 95.1% and the 3 year Disease free survival was 87.9% for these 70 patients. In patients with complete response in the tumour but residual disease in nodes, i.e. ypT0N+, the 3year DFS was 80% and OS was 100%. As compared to the above, patients with no residual nodal disease enjoyed a 3 year DFS of 88.5% (Log-rank, p = 0.48) and an OS of 94.6% (Log-Rank, p = 0.58). The locoregional and systemic recurrence rates both were 4.2% respectively. <h3>Conclusion</h3> In the Indian scenario, despite younger age and higher proportion of mucinous and signet cell tumours outcome in complete responders is good and is in concordance with world literature. <h3>Disclosure of interest</h3> None Declared.
FRI0543 Does Electrophysiologically Severe Patients Have also Higher Neuropathic Complaints in Carpal Tunnel Syndrome?: Table 1
Authors: M. Karadeniz, T. Dandinoglu
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy, which can be diagnosed by history, physical examinations and electrodiagnosis. Electrodiagnosis is most valuable way in the diagnosis of CTS and the evaluation of its severity. In addition to neuropathic pain mechanisms which play a dominant role in CTS, musculoskeletal structures caused nociceptive stimulus may also contribute to pain formation. LANSS (Leeds Assessment of Neuropathic Symptoms and Signs) is a frequently used scale to determine which mechanism (neuropathic and/or nociceptive) is more dominant. <h3>Objectives</h3> The purpose of this retrospective study was to investigate the relationship between the electrophysiologic severity and neuropathic complaints (LANSS scale scores). <h3>Methods</h3> Fifty patients whom were admitted to our out patient clinic at January 2014 to July 2014, aged 22-68 years and diagnosed with carpal tunnel syndrome by nerve conduction studies were included in the study. All patients were suffering from neuropathic pain and evaluted with LANSS scale. Because of indication of surgery for severe CTS, only mild to modorate CTS patients were included. <h3>Results</h3> When compared to moderate group, LANSS scale scores of mild CTS patients were significantly higher than those of moderate group (Table 1). <h3>Conclusions</h3> We think, in addition to complex pathogenesis of neuropathic pain, higher LANSS scores in mild cases may be related with a low pain and discomfort threshold in the first phase of nerve entrapment, which becomes higher later in CTS. Additional studies are needed to explain this complex findings. <h3>Disclosure of Interest</h3> None declared