tbuckley/cabot-search huggingface dataset:
THU0552 Ability of Tocilizumab to Inhibit Recurrence and Enable Discontinuation of Steroids in Adult-Onset Still's Disease
Authors: H. Yamashita, Y. Takahashi, H. Kaneko, A. Mimori
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> We previously reported on treatment of refractory Adult-onset Still9s disease (AOSD) with tocilizumab (TCZ) and how it enables rapid reduction of steroid dose. <h3>Objectives</h3> The present study focuses on a new aspect, namely, how TCZ inhibits recurrence and enables discontinuation of steroids in AOSD. <h3>Methods</h3> In 15 subjects, including 7 who received TCZ combination therapy, treatment outcomes of steroid monotherapy and therapy with TCZ were compared. Rates of recurrence were compared using the Kaplan-Meier method. <h3>Results</h3> The mean age of onset was 46.7±23.4 years and the mean disease duration was 10.0±6.5 years. Mean CRP at onset and ferritin levels were higher when patients were receiving TCZ (CRP: 20.79±8.10 mg/dl, ferritin: 17872.2±12158.9 ng/ml) relative to when patients were not receiving TCZ (CRP: 10.79±8.48 mg/dl, ferritin: 7352.3±6837.5 ng/ml). In all patients, with the exception of one patient receiving infliximab, TCZ was administered after their condition was calmed down using a high dose of steroid (60-120 mg prednisolone [PSL]). After TCZ was started, CRP decreased from 0.88±1.14 mg/dl to 0.02±0.02 mg/dl and ferritin decreased from 3153.0±6865.0 ng/dl to 21.16±25.4 ng/dl (P=0.02). The steroid dose was rapidly reduced after TCZ was started, and reduction to a 20 mg dose of PSL was achieved an average of 65.8±26.9 (range: 31-109) days after the start of the maximum dose. The average final steroid (PSL) dose during remission maintenance after initiation of TCZ was 1.2±1.6 mg/day, and 4 patients were able to discontinue steroid use. In addition, it was possible to extend the interval of TCZ administration to an average of 6.1±2.1 weeks. Recurrence was not noted in 6 patients, and there was a total of 17 recurrent episodes. The rate of non-recurrence was significantly higher after initiation of TCZ (n=7) than during the overall period including the time before initiation (n=17) (100% vs 49.9%)(P=0.04). <h3>Conclusions</h3> TCZ is useful in treatment to induce and maintain remission in patients who have AOSD with strong disease activity. TCZ enables discontinuation of steroid use and extension of the interval of TCZ administration during remission maintenance and also inhibits recurrence. <h3>Disclosure of Interest</h3> None declared
Pulmonary Artery Sarcoma Detected on 18F-FDG PET/CT With Unusual Findings
Authors: Yuehong Guo, Tie Wang, Minfu Yang
Journal: Clinical Nuclear Medicine (2015)

A 32-year-old woman, who presented with "sharp pain" in the right chest for more than 1 month and worsening dyspnea and fever for 10 days, was initially thought to have a pulmonary embolism. Cardiac ultrasound showed an ill-defined echogenic mass within the pulmonary trunk. 18F-FDG PET/CT was performed for further evaluation. PET/CT showed an intense hypermetabolism in the main, bilateral proximal, and the right main pulmonary arteries, suggesting the presence of a malignant lesion. Biopsy confirmed the lesion as a primary pulmonary artery sarcoma.
Delayed massive bleeding caused by an ingested fish bone
Authors: Yuyong Tan, Yi Chu, Deliang Liu, Jirong Huo
Journal: Endoscopy (2015)

A 48-year-old man came to our hospital after having ingested a fish bone 2 days earlier; he was experiencing chest pain without hematemesis or melena. Esophagogastroduodenoscopy revealed a fish bone embedded in the esophagus at approximately 27 cm from the incisors ([Fig. 1]). Endoscopic removal of the bone was successful ([Fig. 2]), and oozing bleeding at the wound was noticed ([Fig. 3]). The patient was asked to remain in the hospital for at least 2 days while on a liquid diet, but he refused and went back home.
Establishment of an Ebola Treatment Unit and Laboratory — Bombali District, Sierra Leone, July 2014–January 2015
Authors: Brigette Gleason, John Redd, Peter Kilmarx, Tom Sesay, Francis Bayor, Antons Mozalevskis, Allison Connolly, James Akpablie, Dimitri Prybylski, Daphne Moffett, Michael King, Micah Bass, Kristy Joseph, Jefferson Jones, Francis Ocen
Journal: MMWR Morbidity and Mortality Weekly Report (2015)

The first confirmed case of Ebola virus disease (Ebola) in Sierra Leone related to the ongoing epidemic in West Africa occurred in May 2014, and the outbreak quickly spread. To date, 8,704 Ebola cases and 3,955 Ebola deaths have been confirmed in Sierra Leone. The first Ebola treatment units (ETUs) in Sierra Leone were established in the eastern districts of Kenema and Kailahun, where the first Ebola cases were detected, and these districts were also the first to control the epidemic. By September and October 2014, districts in the western and northern provinces, including Bombali, had the highest case counts, but additional ETUs outside of the eastern province were not operational for weeks to months. Bombali became one of the most heavily affected districts in Sierra Leone, with 873 confirmed patients with Ebola during July-November 2014. The first ETU and laboratory in Bombali District were established in late November and early December 2014, respectively. T- evaluate the impact of the first ETU and laboratory becoming operational in Bombali on outbreak control, the Bombali Ebola surveillance team assessed epidemiologic indicators before and after the establishment of the first ETU and laboratory in Bombali. After the establishment of the ETU and laboratory, the interval from symptom onset to laboratory result and from specimen collection to laboratory result decreased. By providing treatment to Ebola patients and isolating contagious persons to halt ongoing community transmission, ETUs play a critical role in breaking chains of transmission and preventing uncontrolled spread of Ebola (4). Prioritizing and expediting the establishment of an ETU and laboratory by pre-positioning resources needed to provide capacity for isolation, testing, and treatment of Ebola are essential aspects of pre-outbreak planning.
Elimination of Ebola Virus Transmission in Liberia — September 3, 2015
Authors: Luke Bawo, Mosoka Fallah, Francis Kateh, Thomas Nagbe, Peter Clement, Alex Gasasira, Nuha Mahmoud, Emmanuel Musa, Terrence Q. Lo, Satish K Pillai, Sara Seeman, Brittany J Sunshine, Paul J Weidle, Tolbert Nyensweh, CDC Ebola Response Teams
Journal: MMWR Morbidity and Mortality Weekly Report (2015)

Following 42 days since the last Ebola virus disease (Ebola) patient was discharged from a Liberian Ebola treatment unit (ETU), September 3, 2015, marks the second time in a 4-month period that the World Health Organization (WHO) has declared Liberia free of Ebola virus transmission (1). The first confirmed Ebola cases in West Africa were identified in southeastern Guinea on March 23, 2014, and within 1 week, cases were identified and confirmed in Liberia (1). Since then, Liberia has reported 5,036 confirmed and probable Ebola cases and 4,808 Ebola-related deaths. The epidemic in Liberia peaked in late summer and early fall of 2014, when more than 200 confirmed and probable cases were reported each week .
Development of the lymphedema symptoms intensity and distress survey arm.
Authors: S. H. Ridner, M. S. Dietrich
Journal: Journal of Clinical Oncology (2010)

9125 Background: Breast cancer survivors with lymphedema report a poorer QOL than those without lymphedema, and experience multiple health-related symptoms. A self-report tool is needed to: 1) promote rapid identification of lymphedema and related symptoms; 2) identify and target areas where intervention or education is needed; 3) monitor treatment outcomes; and 4) improve communication among healthcare providers and patients with lymphedema. The purpose of this project was to design a self-report tool to evaluate arm lymphedema and its related symptoms. Methods: The LSIDS-A was developed and tested in over 300 patients in three phases at Vanderbilt University School of Nursing. Results: Phase One: Via literature review and an expert panel survey, common symptoms experienced by breast cancer survivors with lymphedema were identified. A 52-item scale was developed with a look-back period of one-week. Each symptom in the survey required a yes/no response. If yes was selected then a rating from 1 (slight) to 10 (severe) was selected for “Intensity” and “Distress.” Phase Two: 128 community-dwelling breast cancer survivors (64 with lymphedema and 64 without) completed the LSIDS-A. The format was “clear” and “made sense”, thus response structure was left intact. One item was reworded and sixteen items were deleted leaving a 36-item revised instrument. Phase Three: The 36-item LSIDS-A was subsequently tested in two studies of breast cancer survivors with lymphedema comprising a total sample of 185 additional individuals. Symptoms with highest prevalence included: swelling (86%), fatigue (76%), heaviness (69%), tightness (62%), sleep loss (61%), aching (57%), and appearance concerns (55%).The weighted global index of symptom burden (average of symptom Intensity*Distress ratings) was internally reliable (Cronbach's alpha = 0.95). Within the overall 36-symptoms burden index, six clusters of types of symptom burden were manifested: psychosocial (13 probes), swelling/pressure (5 probes), insurance (2 probes), arm pain (4 probes), neurological (8 probes), skin (2 probes), and sex (2 probes). Conclusions: The 36-item LSIDS-A is a valid and reliable tool. Breast cancer survivors with lymphedema experience both local and systemic symptoms. No significant financial relationships to disclose.
New BMJ policy on economic evaluations
Authors: D. Craig
Journal: BMJ (2003)

Editor—We, the NHS Economic Evaluation Database Research Team, agree with Smith that economic evaluations should contain comprehensive reporting of both clinical effectiveness and economic analysis and that the BMJ is right to implement this new policy.1 How the clinical trial results (which inform the economic evaluation) are obtained is often paramount to the understanding and quality of the economic analysis conducted.2


Research reports are included and abstracted in full on the NHS Economic Evaluation Database (www.york.ac.uk/inst/crd)—if they explicitly report costs and clinical outcomes for an intervention and at least one comparator.3 However, to critique the method adopted in the effectiveness study underpinning the economic evaluation appropriately, our template requires information that is often omitted in the report of the economic evaluation. When the parent clinical study has been previously published elsewhere, we obtain the study and use that alongside the economic research when writing the abstract. The abstract on the database then provides information on sample selection, study design, method of analysis, and so on, with the fact that the relevant information is cited from the parent study. 






Adhering to published guidelines, such as those provided by the BMJ,4 should produce publications of the highest quality, but authors are still likely to feel the need to be selective in their reporting, given word limits. If authors are required to report more effectiveness data other crucial aspects of the economic evaluation might receive less attention. The focus for BMJ editors should be to ensure that reporting of both important components of economic evaluations receives appropriate attention from the authors.

If the policy results in full reporting of both clinical and economic results in one place—for example, two papers in one issue of the journal—this will constitute an improvement. If, however, the new policy results in the combination of clinical and economic results in one short paper, this may be a step backwards.
Tomorrow
Authors: Robert L McRoberts
Journal: JAMA (2004)

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
AB1232-HPR The Relationship Between Kinesiophobia and Quality of Life, Functional Status, Disease Activity and Depression in Patients with Ankylosing Spondylitis
Authors: D. Oskay, I. Düzgün, Z. Tuna, S. Bağlan, B. Elbasan, Y. Yakut, A. Tufan
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Ankylosing spondylitis (AS) is a chronic, inflammatory disorder characterized by pain and stiffness especially on back and sacroiliac joint. Pain, reduced spine mobility, and decreased physical functioning are the major manifestations of AS. In the literature, the role of kinesiophobia in musculoskeletal pain disorders has been examined in studies of acute and chronic back pain, osteoarthritis and fibromyalgia. The results of these studies tend to support the important contribution of fear of movement in the evaluation of pain, disability, function and QoL and treatment of musculoskeletal disorders. <h3>Objectives</h3> To investigate the effects of kinesiophobia on quality of life (QoL), functional ftatus, disease activity and depression of AS patients. <h3>Methods</h3> 163 participants (18 men, 18 women) who were under a regular follow-up protocol in Gazi University Rheumatology Clinic and Rheumatologic Rehabilitation Unit with the diagnosis of AS. Primary outcome measure was kinesiophobia. Evaluation was done using the The Tampa Scale of Kinesiophobia (TSK). Exploratory measures were Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), BECK Depression Inventory (BDI) and AS quality of life questionnaire (ASQOL). Pearson9s correlation test was used to verify correlations. <h3>Results</h3> Kinesiophobia was found to be very common in AS affecting 66.6% of patients. There were correlation found between TSK and BASDAI pain, BASFI, ASQOL, BDI scores (Respectively, r=.259, r=.294, r=.392, r=.398; p&lt;.05). There were no correlations found between TSK and BASDAI total and BASMI scores (Respectively, r=.142, r=.198; p&gt;.05). <h3>Conclusions</h3> Our study is the first clinical study designed to investigate the relationship of kinesiophobia with the other clinical measurements in AS patients. Their pain levels and psychological states have an impact on fear of movement. In relation, functional status and quality of life of them affected negatively. <h3>References</h3> Burwinkle T, Robinson JP, Turk DC. Fear of Movement:FactorStructure of the Tampa Scale of Kinesiophobia in Patients With Fibromyalgia Syndrome. The Journal of Pain, Vol 6, No 6 (June), 2005: pp 384-391. Vlaeyen JW, Kole-Snijders AM, Boeren RG, et al. Fear of movement/(re)injury in chronic low back pain and its relation to behavioral performance. Pain. 1995; 62: 363-372. Dagfinrud H, Kvien TK, Hagen KB, Nghien FT, Donohue JT. Physiotherapy interventions for ankylosing spondylitis. Dochrana Databased System Reviews. 2008; 23(1): CD002822. <h3>Disclosure of Interest</h3> None declared
Junior doctors need to have time for their lives outside medicine
Authors: M. Cant
Journal: BMJ (1996)

EDITOR,—It clearly needs saying again: the pay was not the problem for junior doctors.1 Junior doctors have lives outside medicine. Increasingly, doctors are women, and some are women with children. I trained under the “old system” but not very long ago, often working 120 hours a week during my three years in hospital, and I was constantly frustrated …
Treatment of the Guillain-Barré Syndrome
Authors: M Zagar
Journal: JAMA (1963)

The purpose of this article is to review the most up-to-date information on the treatment of Guillain-Barré syndrome-acute polyradiculoneuritis. Several different treatments for GBS are currently under investigation-plasmapheresis (plasma exchange), high-dosed intravenous gammaglobulin and intravenous corticosteroids. Controlled trials have shown that treatment with plasmapheresis reduced the time spent on a ventilator, in the intensive care unit, and the time needed to regain independent walking. It is generally accepted that plasmapheresis is indicated in severe GBS and for patients who are still in the first two weeks of the disease. High-dosed intravenous immunoglobulins showed their efficacy, at a dosage of 0.4 g/kg/daily for five days. The treatment is easier and morbidity is lower, but both therapies are very expensive. Corticosteroids cannot be considered useful therapy for GBS after two randomized controlled trials, one using conventional doses and the other high doses--500 mg methylprednisolone daily for five days. One pilot study on 25 patients has shown that combined treatment with high dose methylprednisolone and immunoglobulins was more effective than immunoglobulins alone. In the treatment of chronic polyradiculoneuritis corticosteroids do have a place. General medical care and supportive therapy in the intensive care unit are of the greatest importance.
SAT0131 Uric Acid is Associated with Metabolic Syndrome in Longstanding Rheumatoid Arthritis: Table 1.
Authors: R. Agca, A.M. van Sijl, A.E. Voskuyl, M.T. Nurmohamed
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Cardiovascular (CV) risk is enhanced in patients with rheumatoid arthritis (RA). Metabolic syndrome, a cluster of several classic CV risk factors, has been shown to be more prevalent in patients with RA. Previous studies have associated metabolic syndrome with hyperuricemia, a potential marker for cardiovascular morbidity and mortality. <h3>Objectives</h3> To investigate the relationship between uric acid and metabolic syndrome in a prospective observational cohort of longstanding RA patients. <h3>Methods</h3> Uric acid was measured in baseline samples of 353 RA patients participating in an ongoing prospective cohort study to assess cardiovascular morbidity and mortality (CARRΈ study). Metabolic syndrome was defined according to the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III, ATP III) (1). <h3>Results</h3> 23.8% of the patient in this cohort fulfilled the criteria of metabolic syndrome according to the NCEP ATP III guidelines (1). Patients were predominantly females (65.7%) with a mean age of 63±6 years and a mean RA duration of 8±4 years. Elevated uric acid levels in serum were significantly associated with metabolic syndrome in a univariate analysis (table 1). After correction for gender, age, CVD prevalence, RA duration and disease activity in a multivariable model, uric acid remained significantly associated with metabolic syndrome (table 1). <h3>Conclusions</h3> Elevated serum uric acid levels were significantly associated with metabolic syndrome in patients with longstanding RA. <h3>References</h3> Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation 2002; 106(25):3143-3421. <h3>Disclosure of Interest</h3> None declared
Electronic Cigarette Use Among Working Adults — United States, 2014
Authors: Girija Syamlal, Ahmed Jamal, Brian A. King, Jacek M. Mazurek
Journal: MMWR Morbidity and Mortality Weekly Report (2016)

Electronic cigarettes (e-cigarettes) are battery-powered devices that deliver a heated aerosol, which typically contains nicotine, flavorings, and other additives, to the user. The e-cigarette marketplace is rapidly evolving, but the long-term health effects of these products are not known. Carcinogens and toxins such as diacetyl, acetaldehyde, and other harmful chemicals have been documented in the aerosol from some e-cigarettes (1-3). On May 5, 2016, the Food and Drug Administration (FDA) finalized a rule extending its authority to all tobacco products, including e-cigarettes.* The prevalence of e-cigarette use among U.S. adults has increased in recent years, particularly among current and former conventional cigarette smokers (4); in 2014, 3.7% of all U.S. adults, including 15.9% of current cigarette smokers, and 22.0% of former cigarette smokers, used e-cigarettes every day or some days (5). The extent of current e-cigarette use among U.S. working adults has not been assessed. Therefore, CDC analyzed 2014 National Health Interview Survey (NHIS) data for adults aged ≥18 years who were working during the week before the interview, to provide national estimates of current e-cigarette use among U.S. working adults by industry and occupation. Among the estimated 146 million working adults, 3.8% (5.5 million) were current (every day or some days) e-cigarette users; the highest prevalences were among males, non-Hispanic whites, persons aged 18-24 years, persons with annual household income <$35,000, persons with no health insurance, cigarette smokers, other combustible tobacco users, and smokeless tobacco users. By industry and occupation, workers in the accommodation and food services industry and in the food preparation and serving-related occupations had the highest prevalence of current e-cigarette use. Higher prevalences of e-cigarette use among specific groups and the effect of e-cigarette use on patterns of conventional tobacco use underscore the importance of continued surveillance of e-cigarette use among U.S. working adults to inform public health policy, planning, and practice.