tbuckley/cabot-search huggingface dataset:
Panic disorder in cardiac outpatients
Authors: J M Chignon, J P Lepine, J Ades
Journal: American Journal of Psychiatry (1993)

Continuing the long history of interest in the relation of anxiety disorders to cardiovascular function and symptoms, this study investigated the level of anxiety and prevalence of panic disorder in cardiac patients and the possible associations between specific abnormal ECG results and a diagnosis of panic disorder.Consecutive patients referred for ambulatory ECG recordings were assessed with the seven anxiety items of the Hospital Anxiety and Depression Scale. Then, 50 patients with scores higher than 8 (the anxious group) were interviewed with the Schedule for Affective Disorders and Schizophrenia--Lifetime Version Modified for the Study of Anxiety Disorders (SADS-LA).Of the 50 anxious patients (26 male and 24 female) interviewed with the SADS-LA, 62% (N = 31) met the DSM-III-R criteria for panic disorder. Patients with panic disorder had a higher mean maximal heart rate and a shorter P-R interval than patients without panic disorder. Unlike the patients without panic disorder, the patients with panic disorder showed no correlation between maximal heart rate and minimal P-R interval.The rate of panic disorder was high in the patients referred for ECG. Moreover, the prevalence of panic disorder was similar in the patients with and without ECG abnormalities, indicating that in anxious patients the presence of panic disorder does not rule out organic cardiac disease. On the other hand, the higher maximal heart rate and shorter P-R interval of the panic patients may be attributable to hypersensitivity of beta-adrenergic receptors in panic disorder.
SP0159 What is EMA Doing for Patients with Rheumatic Diseases
Authors: R. Veselý
Journal: Annals of the Rheumatic Diseases (2015)

The European Medicines Agency is a decentralised agency of the European Union, located in London. The Agency is responsible for the scientific evaluation of medicines developed by pharmaceutical companies for use in the European Union. It began operating in 1995. The mission of the European Medicines Agency is to foster scientific excellence in the evaluation and supervision of medicines, for the benefit of public and animal health. The Agency is responsible for the scientific evaluation of applications for European Union (EU) marketing authorisations for human and veterinary medicines in the centralised procedure. Among other tasks the Agency plays a role in stimulating innovation and research in the pharmaceutical sector: –it gives scientific advice to companies on the development of new medicines; –it publishes guidelines on the requirements for the quality, safety and efficacy testing of medicines; –it provides special assistance to micro, small and medium-sized enterprises (SMEs) through its SME office; –it issues opinions on orphan designation for medicines for rare diseases; –it manages the Innovation Task Force, a group that provides a forum for early dialogue with applicants. Important achievements during 20 years of history of EMA will be reviewed with focus on the most recent initiatives: –Authorisation of new medicinal products for treatment of rheumatic diseases in adults and in children –Development of scientific guidelines (RA, JIA, SLE, SpA, gout, osteoporosis) –Paediatric investigation plans –Scientific advice –Fostering of research –Patients9 involvement in evaluation activities –International collaboration –Collaboration with academia <h3>Disclosure of Interest</h3> None declared
The Histochemical Demonstration of Esterase&lt;xref ref-type="fn" rid="fn1"&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/xref&gt;
Authors: Marvin M. Nachlas, Arnold M. Seligman
Journal: JNCI Journal of the National Cancer Institute (1949)

The Histochemical Demonstration of Esterase Marvin M. Nachlas, Marvin M. Nachlas research associate Search for other works by this author on: Oxford Academic PubMed Google Scholar Arnold M. Seligman Arnold M. Seligman assistant professor of surgery Kirstein Laboratory for Surgical Research, Beth Israel Hospital, Boston, and the Department of Surgery, Harvard Medical School Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 9, Issue 5-6, April-June, Pages 415–425, https://doi.org/10.1093/jnci/9.5-6.415 Published: 01 April 1949 Article history Received: 29 October 1948 Published: 01 April 1949
SAT0422 Impact of Symptoms and Disease Activity on Quality of Life in Primary SjÖgren's Syndrome: Table 1.
Authors: L.H. Dias, S.T. Miyamoto, V. Valim, R. Altoé
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Health-related quality of life (HRQOL) is considerably compromised in primary Sjögren9s syndrome (pSS) patients. Symptoms and disease activity are different components of the disease, but they are not necessarily associated and both might affect quality of life. <h3>Objectives</h3> To investigate the impact of pSS9s symptoms and disease activity on HRQOL in patients with pSS. <h3>Methods</h3> In a case-control study, 77 pSS (AECG) patients were evaluated through the questionnaires Functional Assessment of Chronic Illness Therapy Fatigue Subscale (FACIT-Fatigue), EULAR Sjögren9s Syndrome Patient Reported Index (ESSPRI), EULAR Sjögren9s Syndrome Disease Activity Index (ESSDAI), Short Form 36 Health Survey (SF-36) and World Health Organization Quality of Life Assessment - Abbreviated Version (WHOQOL-BREF). Seventy seven healthy controls answered SF-36 and WHOQOL-BREF. Mann-Whitney, t-test and Spearman9s correlation were used for statistical analysis. <h3>Results</h3> pSS patients and healthy controls were matched for age [52.3 (±9.03) and 52.2 (±8.91), respectively] and sex (all women). Patients had lower employment rate (36.4% vs 62.3%, p=0.00) and higher work disability (10.4% vs 1.3%; p=0.04). The mean scores of ESSDAI, ESSPRI and FACIT-fatigue were 3.34 (±4.61), 6.58 (±2.29) and 26.17 (±11.02), respectively. SF-36 and WHOQOL-BREF scores were significantly lower in patients with pSS (p&lt;0.001) except WHOQOL-BREF Environment domain (p&lt;0.07). There was no correlation between disease activity and HRQOL. FACIT-fatigue and ESSPRI total showed significant correlation with all domains of SF-36 and WHOQOL-BREF, while ESSPRI pain domain showed the highest correlations (table 1). <h3>Conclusions</h3> Fatigue, dryness and mainly pain, but not disease activity, are associated with low quality of life in pSS patients. These findings suggest that management strategies to reduce symptoms, especially pain are important to improve quality of life in pSS. <h3>Disclosure of Interest</h3> None declared
Preparing for imported Ebola cases in Israel, 2014 to 2015
Authors: Tal Brosh-Nissimov, Lion Poles, Micha Kassirer, Roee Singer, Ehud Kaliner, Dikla Dahan Shriki, Emilia Anis, Itay Fogel, Dan Engelhard, Itamar Grotto
Journal: Eurosurveillance (2015)

During the current outbreak of Ebola virus disease (EVD) in West Africa, preventing exportation of the disease posed many challenges for economically more developed countries. In Israel, although the risk of importing single cases was assumed to be low, the implications of local transmission were great. This article describes the EVD preparedness plan of the Israeli Ministry of Health. Key elements were a sensitive case definition, designation of a single treatment centre for suspected and confirmed cases, construction of a mobile unit using customised negative-pressure tents and a vigorous national training programme. There were no patients with EVD in Israel, but a few suspected cases were assessed. The Israeli plan may provide a template for emergency infectious disease response in other geographically small countries.
Epstein-Barr Virus and Burkitt's Lymphoma
Authors: I Joab
Journal: New England Journal of Medicine (1978)

Burkitt's lymphoma has the highest incidence of any childhood cancer in equatorial Africa. Geographic distribution appears to be related to climatic conditions and coincides with areas of endemic malaria. These tumors are characterized by reciprocal translocation from chromosome 8 at or near the c-myc locus to either the immunoglobulin chain locus on chromosome 14 (80 p. 100 of cases) or one of the light chain loci on chromosome 2 or 22. As a result of this translocation, transcription of the protooncogene c-myc is activated. Deregulation of c-myc could play a major role in onset and development of the tumor. Study of Burkitt's lymphoma led to the discovery of the first association between viral infection and tumor development in humans. The Epstein-Barr virus is contained in all endemic Burkitt's lymphoma cells, thus implicating it as a likely etiologic factor. Viral expression is reduced essentially to small non-coding RNA, non-polyadenilates, and EBERs (10(6) copies per cell) and a nuclear protein EBNA1 which is indispensable for maintenance of the Epstein-Barr virus genome in infected cells. Expression of EBNA in transgenes leads to lymphoma in mice and could play a role in the expression of the c-myc gene involved in translocations.
Early brain trauma and schizophrenia in Nigerian patients
Authors: O Gureje, R Bamidele, O Raji
Journal: American Journal of Psychiatry (1994)

A number of reports have suggested that early brain trauma, especially obstetric complications, may be associated with schizophrenia. This observation seems at variance with the similar rates of schizophrenia reported for advanced and developing countries when viewed against the high rate of perinatal morbidity in developing countries. Using patients with mania as comparison subjects, the authors investigated the association of early brain trauma with schizophrenia in adult life among Nigerian patients.The manic (N = 12) and schizophrenic (N = 26) groups, both diagnosed according to the Research Diagnostic Criteria, were compared in respect to the prevalence of events commonly regarded as definite obstetric complications and the prevalence of childhood brain injury for which hospitalization was required.A history of early brain trauma was associated with an adult diagnosis of schizophrenia. Schizophrenic patients with a history of early brain trauma were more likely than those without early brain trauma to have shown poor scholastic performance in childhood. They also showed mixed cerebral laterality in adulthood.Early brain trauma may be a specific risk factor for the later development of schizophrenia. Patients with such a history may evidence other features of neurodevelopmental deviance.
Can a Shift in Fuel Energetics Explain the Beneficial Cardiorenal Outcomes in the EMPA-REG OUTCOME Study? A Unifying Hypothesis
Authors: Sunder Mudaliar, Sindura Alloju, Robert R. Henry
Journal: Diabetes Care (2016)

Type 2 diabetes mellitus causes excessive morbidity and premature cardiovascular (CV) mortality. Although tight glycemic control improves microvascular complications, its effects on macrovascular complications are unclear. The recent publication of the EMPA-REG OUTCOME study documenting impressive benefits with empagliflozin (a sodium-glucose cotransporter 2 [SGLT2] inhibitor) on CV and all-cause mortality and hospitalization for heart failure without any effects on classic atherothrombotic events is puzzling. More puzzling is that the curves for heart failure hospitalization, renal outcomes, and CV mortality begin to separate widely within 3 months and are maintained for >3 years. Modest improvements in glycemic, lipid, or blood pressure control unlikely contributed significantly to the beneficial cardiorenal outcomes within 3 months. Other known effects of SGLT2 inhibitors on visceral adiposity, vascular endothelium, natriuresis, and neurohormonal mechanisms are also unlikely major contributors to the CV/renal benefits. We postulate that the cardiorenal benefits of empagliflozin are due to a shift in myocardial and renal fuel metabolism away from fat and glucose oxidation, which are energy inefficient in the setting of the type 2 diabetic heart and kidney, toward an energy-efficient super fuel like ketone bodies, which improve myocardial/renal work efficiency and function. Even small beneficial changes in energetics minute to minute translate into large differences in efficiency, and improved cardiorenal outcomes over weeks to months continue to be sustained. Well-planned physiologic and imaging studies need to be done to characterize fuel energetics-based mechanisms for the CV/renal benefits.
Spasticity
Authors: Jan Koch-Weser, Robert R. Young, Paul J. Delwaide
Journal: New England Journal of Medicine (1981)

SPASTICITY has been defined in strictly physiologic terms as "a motor disorder characterized by a velocity-dependent increase in tonic stretch reflexes ('muscle tone') with exaggerated tendon jerks, resulting from hyperexcitability of the stretch reflex, as one component of the upper motor neuron syndrome." 1 Whereas this definition refers to the minimum positive symptom in patients with "spasticity," it does not refer at all to the other components of the upper-motor-neuron syndrome2 that are usually most troubling to patients. These components include positive symptoms, such as flexor spasms, and a multitude of negative symptoms designated somewhat inadequately as weakness and loss of . . .
Selective internal radiation therapy (SIRT) for liver metastases with concomitant systemic oxaliplatin, 5-fluorouracil and folinic acid: A phase I/II dose escalation study
Authors: G. A. van Hazel, D. Price, G. Bower, R. A. Sharma, K. Blanshard, W. P. Steward
Journal: Journal of Clinical Oncology (2005)

3657 Background: SIR-Spheres (Sirtex Medical Limited, Sydney, Australia) contain the pure β-emitter, yttrium-90, used to selectively irradiate liver metastases from colorectal cancer. The combination of SIRT with systemic 5-fluorouracil (5-FU) and folinic acid (LV) has been shown to improve survival when compared to systemic chemotherapy alone (Van Hazel et al JSO 2004;88:78). The administration of oxaliplatin in combination with 5-FU/LV improves response rates and it is a radiosensitiser. The goal of this study was to evaluate the safety and efficacy of combining oxaliplatin and 5-FU/LV chemotherapy with SIRT Methods: Seventeen patients with liver metastases from colorectal cancer, who had not received previous chemotherapy for metastatic disease, were entered into the study. Chemotherapy consisted of the FOLFOX4 regimen, modified with an oxaliplatin dose escalated from 30 mg/m2 to 85 mg/m2 in order to assess safety and tolerability. SIR-Spheres were implanted by injection into the hepatic arterial system on days 3 or 4 of the first chemotherapy cycle. Results: Most patients experienced nausea or abdominal pain within 48 hours of SIRT. Mild peripheral neuropathy was evident in 6 of the first 11 patients, appearing between cycles 10–12. Grade 3/4 transient neutropenia was seen in 5 of 11 patients. Three NCI Grade 3 events were documented in 2 of 3 patients at the 30 mg/m2 tier (diarrhea, nausea/vomiting, fever). Six grade 3 events were seen in 4 of 8 patients in the 60 mg/m2 tier (diarrhea, nausea/vomiting, abdominal pain, fever, leukopenia, anaemia). Only one grade 3 event has been exhibited to date in 1 of 6 patients in the 85 mg/m2 tier (nausea/vomiting). Partial responses (RECIST) were seen in all of the first 11 patients. Median time to liver progression is currently 11+ months. Conclusions: The administration of SIRT in combination with oxaliplatin appears to possess an acceptable toxicity profile. The maximum tolerated dose has not been defined, but it is expected to be at least 85 mg/m2. We plan to proceed to phase III trials of chemoradiation using FOLFOX4 with or without SIRT. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Sirtex
Amoxicillin
Authors: HAROLD C. NEU
Journal: Annals of Internal Medicine (1979)

Amoxicillin is an aminopenicillin available in the United States only for oral use. It has an antibacterial activity and spectrum similar to that of ampicillin and is destroyed by gram-positive and gram-negative beta-lactamases. It is more active against enterococci and salmonellae than ampicillin, but less active against Shigella. It is better absorbed than ampicillin from the gastrointestinal tract with blood levels two to two and one half times those of ampicillin. Amoxicillin is an excellent agent to treat otitis media, bacterial sinusitis, bacterial exacerbations of bronchitis, acute lower-urinary-tract infections, gonorrhea, and typhoid. In special settings it may be useful as oral therapy of endocarditis, septic arthritis, and osteomyelitis and as prophylaxis to prevent endocarditis. When the cost of amoxicillin approaches that of ampicillin, it should replace that agent as the oral aminopenicillin of first choice.
Continuing in treatment as a form of selection bias
Authors: M J Edlund, A C Swann
Journal: American Journal of Psychiatry (1989)

Panic patients who continued treatment (N = 12) did not have symptom scores significantly different from those of patients who declined or discontinued treatment (N = 12) but they did have lower pretreatment MHPG levels. Continuing in treatment may itself cause selection bias for biochemical variables under study.
Newer antidepressants and the cytochrome P450 system
Authors: C B Nemeroff, C L DeVane, B G Pollock
Journal: American Journal of Psychiatry (1996)

This review evaluates the in vitro and in vivo evidence for inhibition of cytochrome P450 enzymes by the newer antidepressants and provides clinical recommendations for avoiding and managing drug interactions.The international literature on the cytochrome P450 system and related drug interactions from 1966 to 1995 was reviewed. In vitro studies, pharmacokinetic trials in human subjects, and case reports were assessed.The newer antidepressants each inhibit a different cluster of cytochrome P450 enzymes, which are of relevance to the potential for drug interactions. Cytochrome P450 1A2 is inhibited by fluvoxamine and is implicated in drug interactions with theophylline, clozapine, and others. Fluoxetine, norfluoxetine, sertraline, and paroxetine are potent in vitro inhibitors of cytochrome P450 2D6 and are capable of causing marked elevations in plasma desipramine and nortriptyline concentrations. Fluoxetine, sertraline, and fluvoxamine are believed to inhibit cytochrome P450 2C because of observed interactions with phenytoin, diazepam, and other drugs metabolized by these enzymes. Cytochrome P450 3A4 metabolizes terfenadine, astemizole, carbamazepine, alprazolam, triazolam, and other benzodiazepines. Plasma concentrations of these drugs have increased when they are administered with fluvoxamine, nefazodone, fluoxetine, and sertraline.The majority of the newer antidepressants are associated with a risk for clinically significant drug interactions. A rapidly growing body of literature provides evidence for a distinct profile of cytochrome P450 inhibition and drug interaction risks by individual antidepressants. These findings underscore the need for definitive in vivo interaction studies of plasma from phenotyped patients treated with clinically effective antidepressant doses of medication, for direct comparative clinical studies, and for studies assessing the utility of phenotyping in clinical practice.
Case 37-1988
Authors: Richard C. Cabot, Robert E. Scully, Eugene J. Mark, William F. McNeely, Betty U. McNeely, David F. Giansiracusa, Frances Stafford-Brady
Journal: New England Journal of Medicine (1988)

Presentation of CaseA 35-year-old woman was admitted to the hospital because of headaches and episodes of right-sided numbness.She was well until seven years earlier, when she noticed the rapid onset of bilateral visual loss, which gradually improved. She went to another hospital, where a computed tomographic (CT) scan of the brain was reported to show a left occipital density of uncertain cause. Subsequent medical evaluation at a second hospital revealed a persistent right homonymous hemianopia. The erythrocyte sedimentation rate was 49 mm per hour; tests for rheumatoid factor and for antinuclear antibodies were negative. An echocardiographic examination, a . . .
THU0368 Work Ability and Work Disability Evaluation in Patients with Rheumatoid Arthritis – from the Tomorrow Study: Table 1.
Authors: S. Anno, K. Inui, K. Mamoto, T. Okano, Y. Sugioka, M. Tada, T. Koike, H. Nakamura
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Rheumatoid arthritis (RA) may impair work productivity and daily activity due to effects on joint function. <h3>Objectives</h3> The objective of this study was to evaluate work disability and the main associated factors in patients with RA who participated in the TOMORROW study (registration number: UMIN000003876) started in 2010. <h3>Methods</h3> Participants in the study comprised 192 RA patients (mean age, 58.4 years; females, 83.9%) and 192 age- and sex-matched healthy volunteers (Vo: mean age, 57.7 years; females, 84.9%). Work-related outcomes were measured using the Work Productivity and Activity Impairment questionnaire (WPAI) by employment status (paid worker (PW), employed for ≥35 h/week; part-time worker (PTW), employed for &lt;35 h/week; or home worker (HW), non-employed). Health status and daily activities were assessed using the EuroQol-5 Dimensions (EQ-5D) and Health Assessment Questionnaire (HAQ). Disease Activity Score 28 based on CRP (DAS28) was used to assess disease severity. <h3>Results</h3> No significant differences in percentages of participants in each employment status were evident between groups (PW/PTW/HW: RA, 18/17/65 [%]; Vo, 18/25/58 [%], p=0.105). No significant differences in percentages of absenteeism, presenteeism, overall work impairment (OWI) or percentage of activity impairment (AI) were evident between groups (Table 1). However, in the HW group, percentage of AI was higher in RA patients than in Vo (Table 1). Among RA patients, HW showed lower EQ-5D (p&lt;0.001) and higher HAQ (p&lt;0.001) than PW (Table 1). Higher DAS28 scores were observed in HW (3.05) than in PW (2.09) or PTW (2.37) (p&lt;0.001 each). <h3>Conclusions</h3> Surprisingly, no significant differences in employment status or work impairment were seen between RA and Vo groups among paid workers. HW with RA showed impaired daily activity and high disease activity compared to working RA patients. <h3>Disclosure of Interest</h3> None declared
Risk Factors for Cataracts Treated Surgically in Postmenopausal Women
Authors: Sarah Floud, Hannah Kuper, Gillian K. Reeves, Valerie Beral, Jane Green
Journal: Ophthalmology (2016)

PurposeTo identify risk factors for cataracts treated surgically in postmenopausal women.DesignPopulation-based, prospective cohort study.ParticipantsA total of 1 312 051 postmenopausal women in the UK Million Women Study, aged 56 years on average (standard deviation [SD], 4.8), without previous cataract surgery, hospital admission with cataracts, or cancer at baseline, were followed for cataracts treated surgically.MethodsCox regression was used to calculate adjusted relative risks (RRs) for cataract surgery by lifestyle factors, treatment for diabetes, reproductive history, and use of hormonal therapies.Main Outcome MeasuresCataract surgery identified by linkage to central National Health Service (NHS) records for inpatient and day-patient admissions (Hospital Episode Statistics for England and Scottish Morbidity Records in Scotland).ResultsOverall, 89 343 women underwent cataract surgery during an average of 11 (SD, 3) years of follow-up. Women with diabetes were at greatest risk (diabetes vs. no diabetes RR, 2.90; 95% confidence interval [CI], 2.82–2.97). Other factors associated with an increased risk of cataract surgery were current smoking (current smokers of ≥15 cigarettes/day vs. never smokers RR, 1.26; 95% CI, 1.23–1.30) and obesity (body mass index [BMI] ≥30 vs. <25 kg/m2; RR, 1.12; 95% CI, 1.10–1.14).ConclusionsDiabetes, smoking, and obesity were risk factors for cataract surgery. Alcohol use, physical activity, reproductive history, and use of hormonal therapies had little, if any, association with cataract surgery risk.