tbuckley/cabot-search huggingface dataset:
S97 Long Term Survival In Patients Who Undergo Oesophagectomy Is Lower In Patients Who Develop Post-operative Acute Respiratory Distress Syndrome
Authors: R. Dancer, D. Parekh, G. Perkins, D. Thickett
Journal: Thorax (2014)

<h3></h3> Oesophagectomy is a complicated procedure with high risk of complications in the immediate post-operative period. We have previously shown that patients undergoing oesophagectomy have ~ 25% risk of Acute Respiratory Distress Syndrome (ARDS) post op. Post-operative complications have been shown to decrease long term post-operative survival following major surgery.<sup>1</sup>We hypothesised that long term survival would be reduced in patients who develop ARDS post oesophagectomy. We analysed data from 55 patients recruited to the translational sub-study of the BALTI prevention trial. 26 of the 55 patients (47%) died within 2 years of their operation. Patients who died within two years of their oesophagectomy were more likely to have required ventilation for ARDS during their hospital admission. In addition, patients who survived less than two years were more likely to have developed a surgical complication (e.g. anastomotic leak, wound infection, chyle leak) post-op. There was no difference in age, lung function, BMI or cancer staging. Patients who did not survive more than 2 years post-op were more likely to be smoking at the time of the operation, but there was no difference in pack year smoking history between the two groups. Perioperative markers of alveolar epithelial damage (PICCO EVLWI and PVPI), and the severity of both local (BAL CRP) and systemic inflammation (IL-17, ICAM-1, and TNFR-1/2) were associated with outcome. In conclusion, complications during recovery from oesophagectomy have an adverse effect on the chances of long term survival. Development of strategies to reduce post-operative morbidity may improve long term outcomes. <h3>References</h3> Khuri <i>et al</i>. Determinants of Long-Term Survival After Major Surgery and the Adverse Effect of Postoperative Complications. <i>Ann Surg</i>. 2005 Sep;242(3):326–41
Treatment of Chyluria and Chylothorax with Medium-Chain Triglyceride
Authors: Sami A. Hashim, Hartvig B. Roholt, V. K. Babayan, Theodore B. Van Itallie
Journal: New England Journal of Medicine (1964)

THE patient with chyluria offers an unusual opportunity for the study of fat absorption. Within a few hours after ingestion of a meal in which fat is present such a person often will pass milkyappearing urine containing a portion of the chyle that normally would have entered the systemic circulation via the thoracic duct.Apart from the underlying process, chyluria per se can cause serious difficulties for the patient such as dysuria, hematuria and proteinuria. These complications may result in prolonged suffering, anemia and hypoproteinemia. Sometimes, chyluria is amenable to surgical or pharmacologic treatment, or the use of an abdominal . . .
Surgery of the Biliary Tract
Authors: Marshall K. Bartlett, William C. Quinby
Journal: New England Journal of Medicine (1956)

SURGERY for chronic cholecystitis and cholelithiasis has become safer for the patient in recent years chiefly because of a better understanding of blood, fluid and electrolyte replacement, the use of antibiotics and improvements in anesthesia. In spite of these advances, definite risks remain, and continuing efforts must be made to reduce them to a minimum. The purpose of this study was to evaluate the experience with cholecystectomy and choledochostomy for chronic cholecystitis at the Massachusetts General Hospital for the eleven-year period 1943–1953, with particular reference to mortality and complications. It was hoped that a critical study of these factors would . . .
Long-term outcomes of end-stage kidney disease for patients with lupus nephritis
Authors: Lei Zhang, Gavin Lee, Xusheng Liu, Elaine M. Pascoe, Sunil V. Badve, Neil C. Boudville, Philip A. Clayton, Carmel M. Hawley, John Kanellis, Stephen P. McDonald, Chen Au Peh, Kevan R. Polkinghorne, David W. Johnson
Journal: Kidney International (2016)
Abstract 42: Differential Contribution Of The N- And C-terminal Domains To The Folding And Function Of Tandem Calponin-homology Domains
Authors: Krishna Mallela, Swati Bandi, Surinder Singh, Geoffrey Armstrong
Journal: Circulation Research (2014)

Tandem calponin-homology (CH) domains constitute a major class of actin-binding domains that include dystrophin and utrophin, the two key proteins involved in muscular dystrophy. Despite their importance, how their structure controls their function is not understood. Here, we study the contribution of individual CH domains to the actin-binding function and thermodynamic stability of utrophin’s tandem CH domain. Traditional actin co-sedimentation assays indicate that the isolated C-terminal CH2 domain binds weakly to F-actin when compared with the full-length tandem CH domain. In contrast, isolated CH1 binds to F-actin with a similar efficiency as that of the full-length tandem CH domain. Thus, the obvious question that arises is why tandem CH domains require CH2, when their actin-binding efficiency is originating primarily from CH1. To answer, we probed the thermodynamic stabilities of individual CH domains. Isolated CH1 domain is unstable and is prone to serious aggregation. Isolated CH2 is very stable, even appears to be more stable than the full-length tandem CH domain. In addition, the CH2 domain, which is more stable, is less functional. These results indicate that the main function of CH2 is to stabilize CH1. Consistently, the proposed structure of utrophin’s tandem CH domain based on earlier X-ray studies indicates a close proximity between the C-terminal helix of CH2 and the N-terminal helix of CH1, and this helix in CH2 is more dynamic in the full-length protein when compared with that in the absence of CH1, suggesting the mechanism by which CH2 stabilizes CH1. These observations indicate that the two CH domains contribute differentially to the folding and function of tandem CH domains, although both domains essentially have the same native structure in the tandem CH domain. The N-terminal domain determines the function, whereas the C-terminal domain determines the stability. This work was funded by the AHA Grant 11SDG4880046.
DYNAMIC RIGHT VENTRICULAR SHAPE ANALYSIS IN THE NORMAL HEART USING 3D ECHOCARDIOGRAPHY-DERIVED CURVATURE INDICES
Authors: K. Addetia, Francesco Maffessanti, Denisa Muraru, Amita Singh, Megan Yamat, Lynn Weinert, Victor Mor-Avi, Luigi Badano, Roberto Lang
Journal: Journal of the American College of Cardiology (2016)
FRI0218 Validation of the consensus methodology algorithm for the classification of systemic necrotizing vasculitis:
Authors: A. Sharma, T. Mittal, M. Rathi, R. Minz, S. Singh
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> The current classification of systemic necrotizing vasculitis (SNV) is confusing as many patients satisfy criteria for different diseases in different classification systems. Recently, a new classification algorithm was proposed by Watts et al<sup>1</sup> by using the American College of Rheumatology (ACR), Chapel Hill Consensus Criteria (CHCC) and Sorensen surrogate markers (So) for a more uniform classification of patients suffering from these rare disorders. <h3>Objectives</h3> The algorithm uses a stepwise approach for individual patient diagnosis and prioritizes individual criteria as per previous validation. In the present study, we have attempted to re-analyze patients of SNV seen at our center using the consensus methodology algorithm. <h3>Methods</h3> All patients of primary systemic necrotizing vasculitis who presented to the rheumatology clinic at our center between Jan 2007 and Jun 2011 were included in the study. <h3>Results</h3> Seventy nine patients of SNV were studied (see Table 1). One patient diagnosed as MPA had to be excluded from analysis as she had previously been diagnosed to have Behcet's disease. All patients of CSS, WG and MPA were reclassified to the same diagnostic subcategory after application of the algorithm. Four (22%) of 18 PAN patients were unclassifiable after application of the consensus algorithm while 1 was reclassified as MPA. All previously unclassifiable patients could be classified either as MPA or WG after application of the new algorithm. <h3>Conclusions</h3> We conclude that the new classification algorithm is a reliable method for classification of SNV for epidemiological purposes <h3>References</h3> Watts R, Lane S, Hanslik T et al. Ann Rheum Dis 2007;66:222-227 <h3>Disclosure of Interest</h3> None Declared
AB0431 Anti-centromere antibody positive sjögren’s syndrome: a distinct clinical subgroup?
Authors: S.-S. Lee, K.-E. Lee, D.-J. Park
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Objectives</h3> To investigate whether patients with Sjögren's syndrome(SS) can be distinguished based on the positivity of anti-centromere antibody (ACA) and if so, whether the subgroups differ in their clinical and laboratory features. <h3>Methods</h3> Eighty two consecutive patients with SS were included, with a median age of 43 years (range 15 - 71). All patients had minor salivary gland biopsy and sociodemographic, glandular, and extraglandular manifestations, and laboratory findings including autoantibodies, complement, and immunoglobulin levels, were analyzed. EULAR SS disease activity index (ESSDAI) and SS disease damage index (SSDDI) were also measured. <h3>Results</h3> The prevalence of ACA among SS patients was 13.4%. ACA positive SS patients had higher age at diagnosis (p=0.023), shorter disease duration (p=0.014), higher prevalence of Raynaud's phenomenon (p&lt;0.001), sclerodactyly (p=0.017) and Hashimoto's thyroiditis (p=0.005) compared to ACA negative patients. The prevalence of anti-SSA/Ro and anti-SSB/La antibodies were significantly lower in ACA positive patients than ACA negative patients (p=0.002, both). Although SSDDI were not different between the two groups, ESSDAI was significantly lower in ACA positive patients than ACA negative patients (p=0.008). None of patients originally having ACA didn't evolve to full blown systemic sclerosis. <h3>Conclusions</h3> These findings suggest that patients with SS who have ACA differ from classic SS patients in several clinical and laboratory parameters. ACA should be considered as one of the pathogenically relevant autoantibodies for SS. <h3>Disclosure of Interest</h3> None Declared
Pancreatitis Associated With Ondansetron
Authors: J. J. ALBERTI-FLOR
Journal: JNCI Journal of the National Cancer Institute (1995)

need for postoperative radiotherapy in such settings in a randomized trial.Furthermore, we agree with Dr. Levin that we need a better discussion of treatment costs.There is clearly a need to calculate the cost of reducing the risk of local recurrence by the use of radiotherapy.Such an assessment can best be done in randomized clinical trials, such as ours, where the effectiveness of radiotherapy has been specifically investigated.This would provide a solid basis to compare the cost of radiation therapy following breast conservation with that of other treatment modalities.Within our study, we have ongoing projects in which we are seeking to define risk factors for local recurrence and to calculate cost-effectiveness.
SAT0123 Reactivation of latent tuberculosis infection and new infection of tuberculosis in patients with anti-tumor necrosis factor therapy for tuberculosis-endemic area
Authors: B.S. Koo, M.W. So, W.J. Seo, Y.-G. Kim, C.-K. Lee, B. Yoo
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Prophylaxis of tuberculosis in patients treated with anti-tumor necrosis factor (Anti-TNF) prevents the latent tuberculosis infections (LTBI). But incidence rate of tuberculosis with anti-TNF therapy in tuberculosis-endemic area is higher than in other areas despite strict prophylaxis. <h3>Objectives</h3> We analyzed incidences and characteristics of patients with reactivation of LTBI and new tuberculosis infection. <h3>Methods</h3> We identified 548 patients treated with anti-TNF in tertiary care center from June 2003 through June 2010. The number of patients with ankylosing spondylitis, rheumatoid arthritis, psoariatic arthritis, spondyloarthropathy and behcet's disease were 316, 215, 11, 3 and 3 respectively. Their medical records including history of tuberculosis infection were reviewed. <h3>Results</h3> Among 548 patients, 508 patients took tuberculosis screening test and 266 patients had LTBI prophylaxis. Nevertheless, we observed 11 cases of tuberculosis (2.0%) and the incidence rate of tuberculosis was 969.66 per 100,000 person-years. Patients infected by tuberculosis were 6 non-LTBI, 4 LTBI received prophylaxis and 1 without screening test. The mean duration of anti-TNF therapy was 20.75±18.61 months and patients of extrapulmonary tuberculosis were 9. Among 11 tuberculosis patients, 3 non-LTBI patients and 2 LTBI patients who received prophylaxis were infected by tuberculosis after anti-TNF therapy of 12 months and their mean duration of anti-TNF therapy was 40.8 months. In addition, three non-LTBI patients treated with anti-TNF therapy for less than 12 months were infected by new tuberculosis or reactivated LTBI with false-negative screening test. <h3>Conclusions</h3> The incidence of tuberculosis in patients treated with anti-TNF was higher than other previous reports. This result show that the reactivation of LTBI and development of new tuberculosis infection as a long period of anti-TNF therapy for the endemic area. Screening and prophylaxis of LTBI are important but we also have to be concerned about new tuberculosis infection during anti-TNF therapy. <h3>References</h3> Dixon WG, Hyrich KL, Watson KD, Lunt M, Galloway J, Ustianowski A, et al. Drug-specific risk of tuberculosis in patients with rheumatoid arthritis treated with anti-TNF therapy: results from the British Society for Rheumatology Biologics Register (BSRBR). Annals of the rheumatic diseases. 2010 Mar; 69(3):522-528. Tubach F, Salmon D, Ravaud P, Allanore Y, Goupille P, Breban M, et al. Risk of tuberculosis is higher with anti-tumor necrosis factor monoclonal antibody therapy than with soluble tumor necrosis factor receptor therapy: The three-year prospective French Research Axed on Tolerance of Biotherapies registry. Arthritis and rheumatism. 2009 Jul; 60(7):1884-1894. <h3>Disclosure of Interest</h3> None Declared
Simultaneous Human Granulocytic Ehrlichiosis and Lyme Borreliosis
Authors: Robert B. Nadelman, Harold W. Horowitz, Tze-chen Hsieh, Joseph M. Wu, Maria E. Aguero-Rosenfeld, Ira Schwartz, John Nowakowski, Shobha Varde, Gary P. Wormser
Journal: New England Journal of Medicine (1997)

Infection with the agent of human granulocytic ehrlichiosis occurs in areas in which Borrelia burgdorferi and Babesia microti are endemic.1–4 The most likely vector of human granulocytic ehrlichiosis is the deer tick, Ixodes scapularis, which is also the vector of Lyme disease and babesiosis.3,4 Coinfection in humans with both the agent of human granulocytic ehrlichiosis and B. burgdorferi can be anticipated because ixodes ticks infected with the two organisms have been identified in several locales.3–5 The diagnosis of simultaneous infection with B. burgdorferi and the agent of human granulocytic ehrlichiosis is important because the natural history of . . .
Diabetes prevention counseling is cost effective, US study finds
Authors: Michael McCarthy
Journal: BMJ (2016)

Medicare, the US insurance program for elderly people and people with disabilities, announced plans on 23 March to cover diabetes prevention programs that focus on lifestyle counseling, after an independent evaluation found that a pilot program had successfully reduced participants’ risk of developing type 2 diabetes while creating savings that more than covered the program’s cost.

The US Centers for Disease Control and Prevention estimated that 29.1 million adults in the United States (nearly one in 10 of the US population) have diabetes, and 86 million US adults (more than one in three) have pre-diabetes. Of these, 22 million are 65 or older and eligible for Medicare coverage.

Earlier this week, …
Failure to Launch? The Independent Payment Advisory Board's Uncertain Prospects
Authors: Jonathan Oberlander, Marisa Morrison
Journal: New England Journal of Medicine (2013)

Interview with Prof. Jonathan Oberlander on the future of Medicare's Independent Payment Advisory Board and the implementation of the Affordable Care Act (09:44)Download Because the growth in Medicare spending has moderated, the Independent Payment Advisory Board will not be as important as either its supporters or its detractors have claimed. Indeed, the IPAB's ability to move forward at all is in doubt.
PWE-069 Vascular complications of pancreatitis managed with transcatheter embolisation—a district general hospital experience
Authors: S Chatterjee, R Raza, S Hall, F P Perez, D Dwarakanath, C Wells, J Hancock, J Latimer
Journal: Gut (2012)

<h3>Introduction</h3> Life threatening haemorrhage from vascular complications of pancreatitis are rare but, need to be effectively managed even in a district general hospital (DGH) setting. We report our experience of gastrointestinal bleeding due to local complications of pancreatitis which were effectively managed by radiological intervention. <h3>Methods</h3> All mesenteric angiograms done in our hospital over a period of 7 years were reviewed retrospectively along with their case notes. All such procedures in our hospital were performed by a single interventional radiologist. <h3>Results</h3> Out of 31 patients identified in this period 28 patients had bleeding secondary to peptic ulcers. Three patients had bleeding due to vascular complications of pancreatitis. Patient I: A 58-year-old lady had developed pancreatic pseudocyst secondary to azathioprine induced pancreatitis. He presented with hematochezia but, gastroscopy was normal. Urgent mesenteric angiogram revealed beaded pancreatico-duodenal artery in spasm adjacent to the pseudocyst. This was embolised with control of upper GI haemorrhage. Patient II: A 59-year-old man with alcohol induced pancreatitis and pseudocyst presented with UGI bleeding. OGD revealed blood in the stomach and duodenum but, no source of bleeding was identified. Mesenteric angiogram revealed pseudoaneurysm of the gastroduodenal artery adjacent to the pseudocyst which was embolised with control of haemostasis. Patient III: A 64-year-old man with a known pseudocyst presented with UGI bleeding. CT angiogram revealed bleeding into the pseudocyst secondary to a pseudoaneurysm of the gastroduodenal artery. This was treated with mesenteric emobolisation. <h3>Conclusion</h3> Haemorrhage due to vascular complications of pancreatitis usually present as a life threatening emergency and associated haemodynamic compromise. Surgery is often difficult due to the lack of trained pancreatico-biliary surgeons in most DGHs. Radiological embolisation is an effective treatment which should be readily available in hospitals admitting such patients. Foundation trusts ought to invest in such resources to prevent unwarranted mortality. <h3>Competing interests</h3> None declared.
The Bone Density of Female Twins Discordant for Tobacco Use
Authors: John Llewelyn Hopper, Ego Seeman
Journal: New England Journal of Medicine (1994)

Smoking is recognized as a risk factor for vertebral, forearm, and hip fractures. Since bone density is an important determinant of bone strength, we conducted a study to ascertain whether a deficit in bone density is associated with tobacco use and, if so, to identify the responsible mechanisms.
PM-06 * IMPROVED ANATOMICAL MODEL PREDICTION OF GLIOMA GROWTH UTILIZING TISSUE-SPECIFIC BOUNDARY EFFECTS
Authors: J. Jacobs, A. Hawkins-Daarud, S. Johnston, R. Rockne, K. Swanson
Journal: Neuro-Oncology (2014)

PURPOSE: Kinetic parameters for glioblastoma multiforme (GBM), derived from clinical scans, can be used to predict the occurrence of hypoxia, necrosis, response to radiation therapy, and overall survival. The virulence of the disease is related to both the motility (invasiveness) and the rate of cellular division (proliferation) of glioma cells. Improving current volumetric estimates for these kinetic parameters can allow for more effective predictions of the course and extent of the individual patient's disease. METHODS: Utilizing the assumption that glioma cells preferentially migrate through white matter as compared to grey matter, we integrate the constraints of anatomical boundaries into current measurement-derived, volumetric estimates of growth and invasion kinetics for eight GBM patients. We then implement these revised kinetic parameters into a mathematical model of GBM growth, in an anatomical atlas, and compare the results to the volumetric measurements of the clinical scans. The effectiveness of this method in recapitulating growth in-silico is compared with estimates of disease kinetics from purely volumetric estimates derived from clinical scans. RESULTS: We found that taking anatomical boundaries to glioma growth into account improved estimation of invasiveness by up to 50%, whereas estimates of proliferation rate remained stable. This, in turn, allowed mathematical models to volumetrically match a patient's clinical scans for pretreatment time points with greater accuracy. CONCLUSIONS: Improving estimation of patient-specific parameters used in mathematical models of GBM, we more effectively predict the course and extent of the disease. More accurate prediction of GBM extent lays a better foundation for planning treatment and evaluating the success of treatment against what would have occurred without treatment.
Ronald Dennis Hyde
Authors: S. Howson-Green
Journal: BMJ (2013)

Ronald Dennis Hyde had a well deserved reputation as scrupulously meticulous clinician. His colleagues described him as a man who believed that the smallest detail mattered. His research techniques as a clinical pathologist and have been recognised for setting a standard.

He spent most of his working life at St Thomas’ and Southampton General before retiring from the NHS in 1993 to devote his time to planning laboratory techniques to study leukaemia for the Hospital Corporation of America.

Ronald Hyde was born at Thornton Heath, Surrey, and …
L'amaigrissement pré-opératoire obtenu chez les super-supers obèses par la mise en place d'un ballon intragastrique facilite le „gastric by-pass„ ultérieur et tend à minorer sa morbidité mais n'augmente pas la perte de poids à long terme
Authors: V Maunoury, C Zerrweck, P Bulois, L Arnalsteen, J Branche, R Caiazzo, H Verkindt, M Pigeyre, F Pattou
Journal: Endoscopy (2011)

Introduction: La super-super obésité (BMI>60kg/m2) est un facteur pronostique indépendant de morbidité de la chirurgie bariatrique qu'une réduction pondérale pre opératoire pourrait réduire; cette réduction peut être obtenue par la mise en place d'un ballon intragastrique. Nous rapportons l'évaluation de cette méthode avant un „gastric by-pass„ par laparoscopie.