tbuckley/cabot-search huggingface dataset:
SAT0393 Health Related Quality of Life in Rheumatoid Arthritis and Systemic Lupus Erythematosus Patients in Switzerland: Not the Same Impact!
Authors: B. Chaigne, A. Finckh, D. Neto, D. Alpizar Rodriguez, C. Ribi, C. Chizzolini
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) are chronic systemic autoimmune diseases with different pathogenesis, that share susceptibility genes and both diseases can alter patients9 quality of life (1,2). Quality of life has imposed itself as an important outcome measure and the assessment of health related quality of life (HRQoL) is included in therapeutic goals and evaluation of novel treatments (3,4). <h3>Objectives</h3> To compare health-related quality of life (HRQoL) in systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) in Switzerland. <h3>Methods</h3> The primary outcome of this study was to assess and compare HRQoL in patients with SLE and RA. In this analysis, we included patients from the multicenter Swiss SLE cohort study (SSCS) and age and sex matched patients from the multicenter Swiss Clinical Quality Management Program for Rheumatoid Arthritis (SCQM) databases that were assessed for HRQoL using the SF-36 physical component scale (PCS) and mental component scale (MCS). Marginal longitudinal regression was used to identify and test predictive factors of HRQoL in the two diseases. Finally, analysis of variance was used to test HRQoL difference between both groups. <h3>Results</h3> A total of 267 patients with SLE and 267 matched patients with RA were analysed. The median [Interquartile range (IQR)] MCS and PCS scores were 46.9 [35.5-54.3] and 40.8 [33.5-47.1] in SLE and 48.8 [37.6-56.7] and 34.7 [26.8-43.0] in RA, respectively. Thus, the MCS was significantly lower in SLE patients (p=0.04), while the PCS was significantly lower in RA patients (p&lt;0.001). Such differences were confirmed in the longitudinal model that showed a significant improvement on PCS in RA patients during the time of follow-up. <h3>Conclusions</h3> While SLE and RA both affect HRQoL, patients with SLE have lower MCS whereas patients with RA have lower PCS. These alterations persist after one year of follow-up and indicate fundamental differences in the impact of disease in these two populations. <h3>References</h3> Lisnevskaia L, Murphy G, Isenberg D. Systemic lupus erythematosus. Lancet. 2014 May 29; Scott DL, Wolfe F, Huizinga TWJ. Rheumatoid arthritis. Lancet. 2010 Sep 25;376(9746):1094–108. Strand V, Levy RA, Cervera R, Petri MA, Birch H, Freimuth WW, et al. Improvements in health-related quality of life with belimumab, a B-lymphocyte stimulator-specific inhibitor, in patients with autoantibody-positive systemic lupus erythematosus from the randomised controlled BLISS trials. Ann Rheum Dis. 2014 May;73(5):838–44. Bingham CO, Weinblatt M, Han C, Gathany TA, Kim L, Lo KH, et al. The effect of intravenous golimumab on health-related quality of life in rheumatoid arthritis: 24-week results of the phase III GO-FURTHER trial. J Rheumatol. 2014 Jun;41(6):1067–76 <h3>Disclosure of Interest</h3> None declared
PTH-190 Optimisation of the peptest diagnostic test for detection of gord using pepsin as a marker: an ideal primary care tool: Abstract PTH-190 Table 1
Authors: V Strugala, PW Dettmar, KD Bardhan
Journal: Gut (2015)

<h3>Introduction</h3> The diagnostic test Peptest™ detects pepsin, which is exclusively produced by the stomach, in expectorated saliva and is a quick and easy unique marker of the reflux of gastric contents responsible for gastro-oesophageal reflux disease (GORD).<sup>1</sup> A study into the ability of Peptest to detect patients with GORD was performed. The optimal sampling strategy to give the highest diagnostic yield was investigated. <h3>Method</h3> Patients attending routine endoscopy clinic at Rotherham General Hospital with symptoms of GORD with erosive oesophagitis (EO) or if the score of the GERDQ<sup>2</sup>was ≥8. The patients provided 1–10 saliva samples with randomised strategies thats were blindly analysed for the presence of pepsin using Peptest™ and conc<sup>n</sup>of pepsin determined (≥16ng/ml). <h3>Results</h3> 59 GORD subjects (30M:27F; mean age 57; 83% on PPI) provided 283 expectorated saliva samples of which 149 samples (53%) were Peptest positive representing 47 GORD subjects with at least 1 Peptest positive sample (80%) [significantly greater than a control group<sup>1</sup>38%, p &lt; 0.0001 Fisher's exact test]. Pepsin conc<sup>n</sup>ranged from 0–500 ng/ml with median 30 ng/ml (IQR 0–164) and mean 94 ng/ml (SD 133) [significantly greater than a control group<sup>1</sup>p &lt; 0.0001, Mann Whitney U test]. There were 22 patients with EO, 35 patients with non-erosive reflux disease (NERD) and 2 patients with Barrett's Oesophagus (BO) with at least 1 sample pepsin positive: 68% for EO (mean 68 ng/ml), 86% for NERD (mean 105 ng/ml) and 100% (mean 152 ng/ml) for BO. Peptest results based on timing of the sample is given in Table 1. <h3>Conclusion</h3> Optimal sampling time for diagnosis of GORD by Peptest is 60 min after a meal or within 15 min of a symptomatic episode. The ease of the test allows for saliva samples to be taken before commencing treatment, but even amongst pre-treated EO patients (where gastroscopy is often negative) Peptest can still recognise the underlying reflux. Peptest, therefore, has the potential to be used as the first line investigation in patients suspected of reflux. Those without 'alarm' symptoms and who test 'positive' could therefore be managed in general practice. Referral for gastroscopy or for other invasive investigations can be reserved for those for whom there is separate need (e.g. to check BO, if reflux symptoms are refractory, or for opportunistic cancer screening). <h3>Disclosure of interest</h3> V. Strugala Employee of: RD Biomed Ltd, P. Dettmar Shareholder of: RD Biomed Ltd, Conflict with: RD Biomed Ltd, K. Bardhan: None Declared. Study was part funded by Technology Strategy Board <h3>References</h3> Hayat JO, <i>et al</i>. Gut 2015;64:373–380 Jones R, <i>et al</i>. APT 2009;30(10):1030–1038
Katayama Fever
Authors: Carl A J Puylaert, Pieter-Paul van Thiel
Journal: New England Journal of Medicine (2016)

During an elective in Uganda, a 24-year-old Dutch medical student swam in the Nile River. Two months after his return, he presented with a nonproductive cough and malaise, as well as diarrhea and nonpruritic rash. Examination revealed multiple small papules on the trunk.
FDG PET in Intracranial Carcinomatous Meningitis
Authors: Céline Heimburger, Caroline Bund, Izzie Jacques Namer
Journal: Clinical Nuclear Medicine (2015)

A 63-year-old white man, diagnosed with pT3N2 squamous cell lung carcinoma, underwent right upper lobectomy with adjuvant radiochemotherapy. After a partial epileptic seizure, MRI revealed a solitary right frontal metastasis that was treated with surgical resection followed by stereotaxic radiotherapy. Three months later, the patient presented weight loss, weakness, and headache. He underwent a whole-body FDG PET/CT for restaging. It showed intense FDG uptakes on the brain periphery corresponding to nodular meningeal contrast enhancement on MRI leading to the diagnosis of carcinomatous meningitis, despite negative cerebrospinal fluid cytology.
THU0331 Increased Incidence of Tuberculosis Among Systemic Lupus Erythematosus Patients – Should Tuberculosis Screening at Diagnosis be the Next Step?
Authors: A.M. Gherghe, A. Matei, H. Györfi, A. Soare, R. Dobrota, M. Sasu, L. Macovei, I. Ancuta, C. Ciofu, M. Milicescu, M. Bojinca, V. Stoica, C. Mihai
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> World Health Organization (WHO) declared tuberculosis (TB) the most common infectious disease in the world. TB has a higher incidence among patients with systemic rheumatic diseases than in the general population; in such patients, it frequently presents as extrapulmonary or disseminated disease. According to WHO surveillance reports, although steadily decreasing during the last years, the incidence of TB in Romania in 2005-2014 was by far the highest among all EU countries. <h3>Objectives</h3> To assess the characteristics and risk factors of active TB infection in a cohort of patients with systemic lupus erythematosus (SLE). <h3>Methods</h3> Data of all SLE patients followed up in our clinic in 2005 – 2014 were retrospectively analyzed. Clinical and demographic characteristics and treatment before diagnosis of TB were recorded. The incidence of active TB infection was compared to data from the general population. Univariable logistic regression was used to assess the influence of various factors on the risk of developing TB. <h3>Results</h3> Four hundred SLE patients were evaluated in our clinic during the 10-year interval; of them, 18 cases of active TB per 4291 patient-years (time of exposure, PY) were identified, accounting for an incidence of 419.5/100.000 PY, which is 4.43 times the incidence of TB in our region in the period 2005-2014. Ten of the 18 cases had extrapulmonary or disseminated TB; delayed diagnosis and more severe forms were observed in them. Two patients repeatedly had active TB infection after 2, respectively 3 years from the first TB diagnosis. High-dose glucocorticoids (hd-GC) and cyclophosphamide (CYC) treatment were significantly associated with TB: OR (95% CI) 9.6 (1.2-77.5), p=0.03 for hd-GC and 3.3 (1.2-9.1), p=0.02 for CYC. Fever was the most important red-flag for the diagnosis of TB, OR (95% CI) 73.1 (15.2-352.7), p&lt;0.001. Other frequent manifestations were weight loss and cough. No association was found between TB and age, disease duration or socio-economic status. <h3>Conclusions</h3> We found an increased incidence of active TB infection with a majority of extrapulmonary TB in a large cohort of Romanian SLE patients. Cyclophosphamide treatment and high daily dose of glucocorticoids before the diagnosis of TB were important determinants for the increased risk of TB in SLE patients. These results suggest that in a country with high TB burden, TB screening and treatment of latent TB would be useful before initiation of immunosuppressive treatment. <h3>Disclosure of Interest</h3> None declared
PTU-218 Prophylactic mesh repair for the prevention of parastomal herniation: a case controlled comparative study between the prophylactic mesh and non-mesh group
Authors: S Anwar, A Bilkhu
Journal: Gut (2015)

<h3>Introduction</h3> To ascertain whether prophylactic mesh reinforcement at the time of stoma formation with a composite synthetic mesh reduces the incidence of parastomal herniation. <h3>Method</h3> Data was prospectively collected over 5 years from 1<sup>st</sup>January 2009 to 31<sup>st</sup>December 2013 for patients undergoing a prophylactic re-enforcement of the para-stomal abdominal wall with a Dynamesh-IPOM mesh, using a laparoscopic intra-peritoneal onlay technique. A case controlled comparison was carried out with a cohort of matched patients undergoing stoma-forming procedures in the same time duration, without the use of a prophylactic mesh. The primary outcome was the development of a parastomal hernia on clinical or radiological examination. Statistical analysis was carried out on IBM SPSS v21 in order to compare age, gender, BMI, ASA, operative time, length of stay, length of follow-up and incidence of hernias in between groups using a single-centre, single-surgeon case-control study design. <h3>Results</h3> Eleven patients underwent prophylactic mesh reinforcement of their colostomy using a keyhole mesh configuration (mean age 67 ± 11.9, M:F 8:3, median BMI 29 [95% CI 23–34]. Median operative time was 300 mins [95% CI 205–337]. This group included 8 APER and 3 Hartmann’s procedures; there was one conversion to an open procedure. After a median follow-up of 20 months [95% CI 6–27] none developed a parastomal hernia. There were 19 patients in the control group (Mean age 72.4 ± 14.0, M:F 12:7, median BMI 27.1 [95% CI 21.8–37.3]. The median operative time was 300 [95% CI 230–435]. This group included 13 APER, 5 Hartmann’s and one left hemicolectomy with end colostomy. There was one conversion to an open procedure. After a median follow-up 15 months [95% CI 6–29] six patients (31.6%) developed a parastomal hernia (two detected on CT scanning and 4 evident on clinical examinations). Two of these went on to have subsequent repair of the hernia (one elective, one emergency). There were no significant differences in between groups for age, gender, ASA, BMI, operative time, rate of conversion and length of follow-up. The likelihood ratio for developing a parastomal hernia was 6.33 (<i>p &lt; 0</i>.05) and a Chi-square test demonstrated a significant association of herniation without mesh reinforcement; x<sup>2</sup>(1) = 4.34, <i>p &lt; 0</i>.05. <h3>Conclusion</h3> Prophylactic mesh reinforcement of stomas with a composite synthetic mesh using an intraperitoneal onlay technique caused a significant reduction in the risk of parastomal herniation. Furthermore, the use of this particular synthetic mesh does not confer any additional infective complications. <h3>Disclosure of interest</h3> None Declared.
Laparoscopic Findings in Serosal Eosinophilic Gastroenteritis
Authors: J A Solis-Herruzo, B de Cuenca, M T Muñoz-Yagüe
Journal: Endoscopy (1988)

This report describes the laparoscopic features of two patients with serosal eosinophilic gastroenteritis. In one case only hyperemia of the peritoneal serosa was found. In the other the laparoscopic picture resembled peritoneal carcinomatosis. We show that laparoscopy and peritoneal biopsy may permit diagnosis of the disease without the need for laparotomy.
The private versus the public psychiatric interview
Authors: N E Zinberg
Journal: American Journal of Psychiatry (1985)

As videotaping, one-way screens, and other audiovisual aids are used more frequently for teaching and research purposes in psychiatry, it becomes increasingly important to define how the fact of observation changes the traditionally private psychiatric interview. The author defines the difference between the public and private interview, reviews the pertinent literature, and describes personal experiences with a variety of observational situations. He focuses on how observation affects the concentration of the therapist, how it changes the social uniqueness of the therapy situation, and how, with the addition of a potential audience, the one-to-one situation may become more like a group situation, in which different psychological mechanisms may be employed.
Outcomes of sutureless total thyroidectomy in elderly
Authors: Salvatore Tolone, Mariachiara Bondanese, Roberto Ruggiero, Simona Gili, Raffaele Pirozzi, Simona Parisi, Nunziomattia Buonomo, Vincenzo Napolitano, Ludovico Docimo, Giovanni Docimo
Journal: International Journal of Surgery (2016)
Anaerobic Infections
Authors: Sherwood L. Gorbach, John G. Bartlett
Journal: New England Journal of Medicine (1974)

A BASIC fact of our tenuous coexistence with our environment is that "life on man" is predominantly anaerobic. The micro-organisms that reside on our skins populate our mouths and proliferate in the deeper recesses of our gastrointestinal tracts have an obligatory requirement to avoid atmospheric oxygen. Indeed, their necessity to live without oxygen is as great as their host's necessity to live with it.Since anaerobic bacteria are the major residents of our skins and mucous-membrane surfaces, it is reasonable to suspect that these organisms play a part in pathologic processes associated with disturbances of these sites. In the past, . . .
Alcohol consumption, ACTH level, and family history of alcoholism
Authors: M A Schuckit, S C Risch, E O Gold
Journal: American Journal of Psychiatry (1988)

Plasma levels of ACTH were evaluated in 18 sons of alcoholics and 18 sons of nonalcoholics before and after they consumed placebo, 0.75 ml/kg of ethanol, and 1.1 ml/kg of ethanol. The analyses revealed significant changes in ACTH levels over time, an effect of ethanol on ACTH overall, and significantly lower ACTH levels in the sons of alcoholics than in the control subjects following the high-dose ethanol challenge. The data corroborate the earlier finding that sons of alcoholics have less intense responses to ethanol and are consistent with the conclusion that changes in cortisol level associated with drinking include a pituitary response as well as effects on the adrenal glands.
Endoscopic ultrasound-guided biliary drainage with a novel fine-gauge balloon catheter: one-step placement technique
Authors: Takeshi Ogura, Tatsushi Sano, Saori Onda, Daisuke Masuda, Akira Imoto, Kazuh de Higuchi
Journal: Endoscopy (2015)

During endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS), it is necessary to dilate the fistula [1]. Graded dilation with a 4-Fr cannula and 6- and 7-Fr bougie dilators is relatively easily performed, and this stepwise procedure appears to be safe [2]. On the other hand, the use of a needle knife for fistula dilation in endoscopic ultrasound-guided biliary drainage (EUS-BD) may be associated with post-procedural adverse events [3]. These procedures have the potential to cause bile leakage because only the guidewire is placed between the bile duct and intestine across the abdominal cavity during the exchange of devices.
International consensus statement on injury surveillance in cricket: a 2016 update
Authors: John W Orchard, Craig Ranson, Benita Olivier, Mandeep Dhillon, Janine Gray, Ben Langley, Akshai Mansingh, Isabel S Moore, Ian Murphy, Jon Patricios, Thiagarajan Alwar, Christopher J Clark, Brett Harrop, Hussain I Khan, Alex Kountouris, Mairi Macphail, Stephen Mount, Anesu Mupotaringa, David Newman, Kieran O'Reilly, Nicholas Peirce, Sohail Saleem, Dayle Shackel, Richard Stretch, Caroline F Finch
Journal: British Journal of Sports Medicine (2016)

Cricket was the first sport to publish recommended methods for injury surveillance in 2005. Since then, there have been changes to the nature of both cricket and injury surveillance. Researchers representing the major cricket playing nations met to propose changes to the previous recommendations, with an agreed voting block of 14. It was decided that 10 of 14 votes (70%) were required to add a new definition element and 11 of 14 (80%) were required to amend a previous definition. In addition to the previously agreed 'Match time-loss' injury, definitions of 'General time-loss', 'Medical presentation', 'Player-reported' and 'Imaging-abnormality' injuries are now provided. Further, new injury incidence units of match injuries per 1000 player days, and annual injuries per 100 players per year are recommended. There was a shift towards recommending a greater number of possible definitions, due to differing contexts and foci of cricket research (eg, professional vs amateur; injury surveillance systems vs specific injury category studies). It is recommended that researchers use and report as many of the definitions as possible to assist both comparisons between studies within cricket and with those from other sports.
OC-065 Mechanisms underlying fodmap-induced symptoms in patients with irritable bowel syndrome: a double-blind crossover trial using magnetic resonance imaging
Authors: G Major, S Pritchard, K Murray, C Hoad, L Marciani, P Gowland, R Spiller
Journal: Gut (2015)

<h3>Introduction</h3> Fermentable carbohydrates can trigger symptoms of irritable bowel syndrome (IBS) but the underlying mechanisms are unclear. Our aim was to test whether fructose or inulin ingestion would cause more symptoms than glucose in IBS patients and to determine which magnetic resonance imaging (MRI) biomarkers could explain the origin of their symptoms. <h3>Method</h3> A 3-period, 3-treatment, randomised, double-blind crossover study. 29 IBS patients meeting Rome III criteria for IBS, who also reported bloating, completed 3 study days at least 1 week apart: median age 34 (IQR 25–48.5), 22 female, 7 male. Procedures: symptom score, breath hydrogen (H<sub>2</sub>) measurement and MRI scan at baseline (fasted) and 0, 60, 120, 180, 240 and 300 min post-prandially. Symptoms and H<sub>2</sub>were also measured at 30 and 90 min. Symptoms of flatulence, bloating, pain and diarrhoea were recorded on a simple 0–3 integer scale and by visual analogue score (VAS). Treatments: ingestion of 40 g of glucose (control), fructose or inulin in 500 ml water. Primary endpoint: a rise from baseline of ≥3 in a composite symptom score of the integer scales (CSS – max total 12). Secondary endpoints: composite symptom intensity (VAS), H<sub>2</sub>and MRI measures of small bowel water content (SBWC), colonic volume and gas. <h3>Results</h3> Table 1[mean (SD) or median (IQR)]. More patients had a rise in CSS ≥3 after inulin than glucose (p &lt; 0.04). Symptoms peaked 50 min after fructose and 240 min after inulin. H<sub>2</sub>rose after both but more so after inulin with a later peak (90 vs. 300 min). While fructose increased SBWC, inulin increased colonic gas and total volume more than fructose or glucose. There were no significant differences between those who reported a rise in symptoms and those who did not. In those with symptoms after inulin there was a correlation between peak rises in symptom intensity and colonic gas (p &lt; 0.05, r<sup>2</sup>= 0.33). H<sub>2</sub>did not correlate with symptoms (r<sup>2</sup>= 0.08). For fructose the best correlate of symptoms was SBWC (p = 0.05, r<sup>2</sup>= 0.26). <h3>Conclusion</h3> Inulin induced more symptoms than glucose probably by distending the colon while any fructose effect appears to be mediated by small bowel distension. The similarity of findings between patients with and without a symptom increase suggests that visceral hypersensitivity is the key to symptoms. <h3>Disclosure of interest</h3> G. Major: None Declared, S. Pritchard: None Declared, K. Murray: None Declared, C. Hoad: None Declared, L. Marciani: None Declared, P. Gowland: None Declared, R. Spiller Grant/ Research Support from: Lesaffre, Ironwood, Norgine, Falk Pharma, Consultant for: Almirall, Astellas, Yuhan, Danone.
Christmas Books
Authors: John Lister
Journal: New England Journal of Medicine (1975)

IT would have been easy, at the end of 1974, to reflect upon the gloomy events of that year and to contemplate the coming year with equally gloomy anticipation. But, instead, I determined to try to look ahead in the light of three unusually interesting books that arrived in my Christmas stocking! Will Pickles of Wensleydale, by John Pemberton1; Aneurin Bevan 1945–1960, by Michael Foot2; and Medical Nemesis, by Ivan Illich.3 The first is a charming story of the man who practiced medicine in a Yorkshire dale from 1911 until 1964 and became famous as . . .
An ongoing multi-state outbreak of measles linked to non-immune anthroposophic communities in Austria, Germany, and Norway, March-April 2008
Authors: D Schmid, H Holzmann, S Abele, S Kasper, S König, S Meusburger, H Hrabcik, A Luckner-Hornischer, E Bechter, A DeMartin, Jana Stirling, A Heißenhuber, A Siedler, H Bernard, G Pfaff, D Schorr, M S Ludwig, HP Zimmerman, Ø Løvoll, P Aavitsland, F Allerberger
Journal: Eurosurveillance (2008)

From the second week of March 2008, public health authorities in the province of Salzburg observed an increased number of measles cases compared to previous years. Twenty cases of measles had been were notified Austria-wide in 2007, 24 in 2006, 10 in 2005, and 14 in 2004. The current outbreak has affected, as of 14 April, 202 people in Austria, 53 in Germany, and four in Norway, bringing the total number of cases related to this outbreak to 259. The initial case series investigation revealed that the common link was attendance of an anthroposophic school and day care centre in Salzburg city. The majority of the pupils were not vaccinated against measles.