tbuckley/cabot-search huggingface dataset:
Clostridium difficile Colitis
Authors: Ciaran P. Kelly, Charalabos Pothoulakis, J. Thomas LaMont
Journal: New England Journal of Medicine (1994)

Clostridium difficile has become one of the commonest pathogens of the lower intestinal tract. This organism appears unique in that infection almost always occurs during or after antibiotic therapy, suggesting that some component of the normal microflora prevents colonization by C. difficile. Once it has overgrown in the colon, C. difficile releases several toxins which cause tissue damage and diarrhea. Infection can range from a simple self-limited diarrheal illness to fulminant colitis with perforation and megacolon. Assay of stool filtrates reveals the presence of cytotoxin in nearly all patients with antibiotic-associated pseudomembranous colitis, and in approximately one third to one half of those with less severe infections. Effective therapy is available in the form of oral vancomycin, although the expense of this antibiotic has led to the use of oral metronidazole or bacitracin, which appear to be equally efficacious and considerably cheaper. Although we have learned a great deal about C. difficile in the past decade, a number of fascinating puzzles remain. We know very little about the immune response to this organism or its toxin, or whether a vaccine might someday be feasible. Similarly, we have very little insight into what effects antibodies exert on the normal colonic flora and how these effects allow C. difficile infection in a small percentage of patients. Studies of this pathogen will undoubtedly lead to a fuller understanding of the enormously complex and still mysterious microbial ferment which lives within our gastrointestinal tract.
Current diagnostic concepts in schizophrenia
Authors: W T Carpenter
Journal: American Journal of Psychiatry (1976)

The diagnosis of psychiatric disorders currently relies primarily on clinical observation and evaluation of manifest psychopathology. Symptom-based diagnosis of schizophrenia defines a highly variable patient population and thus makes replication of research results difficult. However, this diagnostic approach is useful because it has established communicative value, encourages clinicians to rely on the diagnostic data most readily available (i.e., the patient's behavior), and relates directly to treatment plans. The author describes a 12-point symptom-based diagnostic system for schizophrenia that enhances the reliability and (presumably) validity of the diagnostic process. He then illustrates methods that can be used to select homogeneous schizophrenic populations for specialized research purposes.
Ibandronate Shows Marked Pain Relief and a Favorable Renal Safety Profile – Updated Results of a Non Interventional Study in Breast Cancer Patients with Metastatic Bone Disease.
Authors: M. Schmidt, T. Hesse, H. Kuehnle, C. Lerchenmueller, R. Schlag
Journal: Cancer Research (2009)

Abstract Background: Bisphosphonates (BP), the current standard of care for patients with metastatic bone disease (MBD) due to breast cancer (BC), effectively reduce the incidence of skeletal related events (SRE) and the severity of bone pain. However, BP treatment may adversely affect kidney function and thus renal safety is a key determinant of BP risk/benefit assessment. In randomized clinical trials (RCT), Ibandronate (IBA), a third generation amino-BP available in IV and oral formulations, has demonstrated sustained effects on SRE and bone pain with a low incidence of renal adverse events. To verify those results under real life conditions, a large-scale non interventional study (NIS) is currently being conducted in Germany.Patients and methods: In accordance with the terms of the marketing authorization, BC patients with MBD receive 6 mg IBA IV every 3–4 weeks or 50 mg of oral IBA once daily (at the physician's discretion) for up to 24 weeks. Pain severity (VAS), analgesic use (WHO analgesic ladder), SRE, and renal function (serum creatinine levels and estimated creatinine clearance, eCrCl; Cockcroft-Gault formula) are recorded in 4-week-intervals.Results: For this interim analysis, data for 2676 patients, mean age 63.6 ±11.8 years, were evaluated. 1735 (65%) were BP-naïve; 317 (12%) had received prior treatment with IBA, 614 (23%) with other BPs, including zoledronic acid (ZOL) (393; 15%) and pamidronate (PAM) (210; 8%). At baseline, mean pain severity (VAS) was lower for patients pretreated with IBA (2.7 ± 2.2) compared to BP-naïve patients (3.3 ± 2.4; p &amp;lt; 0.0001) or patients pretreated with other BPs (3.2 ± 2.4; p= 0.0041) and analgesic use was less frequent (38% vs 49% and 47%, respectively).In patients reporting pain at baseline, mean pain severity decreased on IBA treatment throughout the observation period (VAS: 3.2 ± 2.4 to 2.4 ± 2; p &amp;lt; 0.0001). In parallel, there was an overall reduction of analgesic use with 57% of patients not requiring analgesics at the end of the observation period. SRE were rare (7%), irrespective of prior treatment. For patients evaluable for renal function throughout the observation period, mean eCrCl at baseline was significantly lower in patients pretreated with ZOL (70.7 ml/min) than in BP-naïve (78.9 ± 30.9 ml/min; p &amp;lt; 0.0001) or IBA-pretreated patients (78 ± 29.1 ml/min; p=0.00386). Changes in renal function during IBA treatment were small and balanced across all subgroups. Overall tolerability of IBA treatment was rated as very good or good by 96% of physicians and patients alike.Conclusion: In this interim analysis of a large scale NIS in BC patients with MBD, IV and oral IBA showed marked and sustained pain relief with an overall reduction of analgesic use and a renal safety profile comparable to results of RCTs. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 1108.
EFFECTS OF AEROBIC AND RESISTANCE EXERCISE ON VASCULAR FUNCTION
Authors: Gerasimos Siasos, Dimitrios Athanasiou, Gerasimos Terzis, Aggeliki Stasinaki, Panagiotis Tourikis, Efstathios Dimitropoulos, Stamatis Tsouroulas, Nikolaos Gouliopoulos, Evangelos Oikonomou, Marina Zaromitidou, Konstantinos Mourouzis, Sotirios Tsalamandris, Eleni Kokkou, Christodoulos I Stefanadis, Dimitris Tousoulis
Journal: Journal of the American College of Cardiology (2015)
Genetic Drift during Systemic Arbovirus Infection of Mosquito Vectors Leads to Decreased Relative Fitness during Host Switching
Authors: Nathan D. Grubaugh, James Weger-Lucarelli, Reyes A. Murrieta, Joseph R. Fauver, Selene M. Garcia-Luna, Abhishek N. Prasad, William C. Black, Gregory D. Ebel
Journal: Cell Host & Microbe (2016)
AB0154 Pathogenic Role of Irhom2 in Seropositive Rheumatoid Arthritis
Authors: Y.J. Kim, E.-J. Lee, S. Hong, B.S. Koo, W.J. Seo, J. Oh, Y.-G. Kim, C.-K. Lee, B. Yoo
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> Tumor necrosis factor (TNF)-α is a major pathologic cytokine in rheumatoid arthritis (RA) and the current target of RA treatment has been on blocking the TNF-α. iRHOM2 is a regulator of TNF-α convertase that mediate the release of TNF-α from immune cells. Moreover, immune complexes (ICs) are known to induce expression of iRHOM2 via Fc receptors (FcλRIIIa/CD16) in monocytes, regulating the production of TNF-α. <h3>Objectives</h3> We hypothesized that the expression of iRHOM2 and Fc receptors are up regulated in seropositive RA patients, that is mediated by immune complex. <h3>Methods</h3> The level of TNF-α was measured in the serum of seropositive (+) and seronegative (−) RA patients by ELISA. Messenger RNA expression of iRHOM2 and CD16 was evaluated on peripheral blood mononuclear cells of (+) RA, (−) RA patients, and healthy controls. ICs were extracted from serum of RA patients by adding polyethylene glycol. Isolated ICs were added to THP1-cell cultures to examine the induction of iRHOM2 and CD16. <h3>Results</h3> Serum level of TNF-α was similar between (+) RA patients and (−) RA patients (3.23±(5.97) pg/ml vs. 1.99±(1.93) pg/ml). Increased iRHOM2 and CD16 mRNA expression was found on PBMC in (+) RA patients compared to those in (−) RA patients (figure). IC isolated from (+) RA patient could enhance the expression of iRHOM2 as well as CD16 from THP-1 cells. <h3>Conclusions</h3> iRHOM2, highly expressed in (+) RA monocytes, might be regulated by immune complex containing anti-cyclic citrullinated peptides antibody, although serum TNF-α level was not different in (+) and (−) RA patient. <h3>References</h3> Lichtenthaler SF. iRHOM2 takes control of rheumatoid arthritis. J Clin Invest 2013;123:560-2. Issuree PD, Maretzky T, McIlwain DR et al. iRHOM2 is a critical pathogenic mediator of inflammatory arthritis. J Clin Invest 2013;123:928-32. Cooper DL, Martin SG, Robinson JI et al. FcgammaRIIIa expression on monocytes in rheumatoid arthritis: role in immune-complex stimulated TNF production and non-response to methotrexate therapy. PLoS One 2012;7:e28918. <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.3199
Severe case of intestinal vasculitis: knife's edge diagnosis and treatment
Authors: P. Lenz, J. Dominick, P. Barth, M. Köhler, D. Domagk, K. Hengst, H. Ullerich
Journal: Endoscopy (2012)

A 75-year-old Caucasian woman was referred to our department due to severe enteritis of unknown origin. Peroral gastrointestinal endoscopy with a long enteroscope (SIF-Q180, Olympus Optical, Tokyo, Japan) revealed severe, segmented, partially stenotic, ulcerative duodenitis/jejunitis ([Video 1]). Peranal single-balloon enteroscopy (210 cm) showed no pathologic processes, and cytomegalovirus infection [1] and nonsteroidal anti-inflammatory drug (NSAID)-induced enteropathy [2] were ruled out. Digital subtraction angiography was carried out to detect any ischemic cause of the intestinal alterations. Irregularities were noted in the caliber of the superior mesenteric artery and inferior mesenteric artery ([Fig. 1]), both in the central and peripheral branches, typical for intestinal vasculitis. The diagnosis was confirmed by histological examination ([Fig. 2]), and immunosuppressive treatment with steroid and azathioprine was instituted. Initially, the patient responded well, but on follow-up the intestinal vasculitis showed only slight macroscopic improvement. At 6 months after the initial diagnosis, the patient was referred to our neurological department with dysphasia and suspected cerebral infarction. Magnetic resonance angiography revealed ischemic regions, probably because of cerebral involvement in the systemic vasculitis [3]. The treatment was changed to cyclophosphamide and the patient recovered well without any neurological sequelae. At the latest (12-month) follow-up, the intestinal vasculitis was controlled with the cyclophosphamide treatment, with a satisfactory clinical outcome, although mucosal alterations persisted endoscopically.
Abstract 3130: Dependency on c-MYC in multiple myeloma.
Authors: Toril Holien, Thea K. Våtsveen, Hanne Hella, Anders Waage, Anders Sundan
Journal: Cancer Research (2013)

Abstract The oncogene c-MYC is deregulated in multiple myeloma. Importantly, the activity of c-MYC is elevated in plasma cells in patients with myeloma compared to the premalignant state monoclonal gammopathy of undetermined significance, indicating a prominent role for c-MYC in myeloma pathogenesis. We earlier found the bone morphogenetic proteins induce apoptosis in myeloma cell lines and primary cells by SMAD-dependent downregulation of c-MYC. Repression of c-MYC by short hairpin RNA in myeloma cell lines has by others also been shown to induce apoptosis. We wanted to go one step further and study the role of c-MYC in primary myeloma cells. Transcriptional regulation by c-MYC requires heterodimerization of c-MYC and its obligate partner MAX. The small molecular inhibitor 10058-F4 disrupts the formation of such heterodimers and was used in vitro to test the dependency on c-MYC activity in primary myeloma cells and myeloma cell lines. The inhibitor induced apoptosis in a dose-dependent manner in the 22 primary samples tested. Apoptosis was induced in five of six cell lines tested. The sixth cell line, U266, does not express c-MYC, and was not sensitive to the inhibitor. Using the INA-6 myeloma cell line, we found that apoptosis induced by 10058-F4 correlated with downregulation of the anti-apoptotic protein Bcl-xL. We also found that apoptosis was induced by the inhibitor even in the presence of bone marrow stromal cells derived from myeloma patients. Our results further support that c-MYC is a potential target for therapy in multiple myeloma. Citation Format: Toril Holien, Thea K. Våtsveen, Hanne Hella, Anders Waage, Anders Sundan. Dependency on c-MYC in multiple myeloma. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 3130. doi:10.1158/1538-7445.AM2013-3130
Depression and anxiety in Babylon
Authors: Edward H Reynolds, James V Kinnier Wilson
Journal: Journal of the Royal Society of Medicine (2013)

Over the last 25 years, we have drawn attention to Babylonian descriptions, understanding and treatment of neurological and psychiatric disorders.1–5

Although the Babylonians had no understanding of brain or psychological function, they were remarkably observant describers of many medical disorders and behaviours which we see today and for which they had their own interpretations and treatments. We began with the neurological disorders of epilepsy1 and stroke, including so-called Bell's Palsy,2,3 and more recently we discussed psychiatric disorders, including psychoses of epilepsy4 and obsessive compulsive disorder, phobias and psychopathic behaviour.5 We turn our attention now to depression and anxiety in Babylon.
Endoscopic management of a migrated biliary T-tube
Authors: A. Krishnan, R. Ramakrishnan
Journal: Endoscopy (2011)

The accidental migration of a biliary T-tube is a rare complication. A 38-year-old man presented with jaundice and abdominal pain. He had undergone open cholecystectomy and common bile duct (CBD) exploration 1 month previously for cholelithiasis and choledocholithiasis, with a T-tube placed in the CBD during surgery for subsequent biliary decompression. On examination, he was markedly icteric and had right upper quadrant tenderness. It was noted that the external end of the T-tube had accidentally migrated into peritoneal cavity. Laboratory investigations were as follows: total bilirubin 6.4 mg/dL, aspartate transaminase (AST) 62 U/L, alanine transaminase (ALT) 110 U/L, serum alkaline phosphatase (ALP) 224 U/L. Plain radiographs and ultrasound examination of the abdomen revealed that the whole of the T-tube was within the peritoneal cavity.
Randomized Trial of Longer-Term Therapy for Symptoms Attributed to Lyme Disease
Authors: Anneleen Berende, Hadewych J.M. ter Hofstede, Fidel J. Vos, Henriët van Middendorp, Michiel L. Vogelaar, Mirjam Tromp, Frank H. van den Hoogen, A. Rogier T. Donders, Andrea W.M. Evers, Bart Jan Kullberg
Journal: New England Journal of Medicine (2016)

The treatment of persistent symptoms attributed to Lyme disease remains controversial. We assessed whether longer-term antibiotic treatment of persistent symptoms attributed to Lyme disease leads to better outcomes than does shorter-term treatment.
AB0399 Eular recommendations for the management of rheumatoid arthritis: Do we all agree?:
Authors: L. Cunha-Miranda, C. Rodrigues, S. Fernandes
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Over the past 15 years, rheumatologists have developed and witnessed many paradigmatic changes in the treatment of rheumatoid arthritis (RA). In RA, joint damage and physical disability are the major adverse outcomes associated with reduction in quality of life and premature mortality. Some inconsistencies in therapeutic targets and strategies among rheumatologists have been recognised. EULAR published the "EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs". But what is the real impact on clinician's daily practice of these guidelines. <h3>Objectives</h3> To assess Portuguese Rheumatologists' opinion on the "EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs" published in May 2010. The opinion from 52 experts regarding the 15 recommendations published this year by the EULAR, is presented at table 1. When assessing the potential impact of these recommendations, 62% of the experts considered these recommendations important to their practice, nevertheless 61% of the present rheumatologists said that they wouldn't change their common daily practice <h3>Conclusions</h3> Although there is an overall agreement in most of the recommendations, there are some that are not so consensual. Although the Portuguese rheumatologists considered them important, they wouldn't change their clinical practice after this publication. This may reflect the gap between EULAR recommendations and real life practice. A greater involvement of all countries that constitute the EULAR is needed, so that different sensibilities and expertises are covered. <h3>References</h3> Smolen JS et al. Ann Rheum Dis 2010;69:631-7. Smolen JS et al. Ann Rheum Dis 2010;69:964-75. <h3>Disclosure of Interest</h3> None Declared
THE INFLUENCE OF AGING IN LA SIZE AND FUNCTION IN THE ELDERLY POPULATION: THE ARIC STUDY
Authors: Alexandra Goncalves, Chung-Lieh Hung, Brian Claggett, Kotaro Nochioka, Susan Cheng, Suma Konety, Dalane Kitzman, Amil Shah, Scott Solomon
Journal: Journal of the American College of Cardiology (2016)
FRI0244 Prevalence of MRI Spinal Lesions Typical for Axial Spondyloarthritis in Patients with Inflammatory Back Pain
Authors: M. De Hooge, J. Pialat, A. Feydy, M. Reijnierse, P. Claudepierre, A. Saraux, M. Dougados, D. van der Heijde
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> Since 2012, a cut-off value of ≥3 inflammatory lesions was suggested by the ASAS/OMERACT group, as positive MRI of the spine (MRI-spine). Moreover, fatty lesions on MRI-spine are associated with axial Spondyloarthritis (axSpA). <h3>Objectives</h3> To determine the prevalence of inflammatory (BME) and fatty lesions on MRI of the spine in patients (pts) with and without axSpA <h3>Methods</h3> Pts aged 18-50 with inflammatory back pain (≥3 months, ≤3 years) from 25 participating centers in France were included in the DESIR-cohort (n=708). All available baseline MRIs were independently scored by 2 well-calibrated readers, blinded to any other data. In case of disagreement, an experienced radiologist served as adjudicator. BME and fatty lesions typical for axSpA were scored when visible on ≥2 consecutive slices. Prevalence of MRI lesions was calculated based on several cut-offs and lesions were considered present if 2/3 readers agreed <h3>Results</h3> All pts with symptom onset &lt;45 yrs with MRI-spine (n=549) were included in the analyses. Pts fulfilling the ASAS criteria could either fulfill both arms, only the imaging arm or only the clinical arm. The first 2 groups were subdivided; pts with radiographic sacroiliitis (mNY+) &amp; sacroiliitis on MRI (MRI+), pts with mNY+ &amp; no sacroiliitis on MRI (MRI-), pts without radiographic sacroiliitis (mNY-) &amp; MRI+. BME lesions occur in all different subgroups of the ASAS criteria and in pts without axSpA (table). The prevalence in no SpA group (which can be seen as false positives) is only 6.1%. With a cut-off ≥2 BME lesions false positives drop below 5% while the prevalence in the ASAS axSpA groups is still reasonable. Especially prevalence in pts with mNY+ &amp; MRI+ is very high; 61.9% (both arms positive) and 43.8% (imaging arm only positive). Fatty lesions are seen slightly less often seen in all patient groups. However the same trend is seen as with BME lesions; Even with cut-off ≥1 the prevalence in no SpA group is low (5.5%), with cut-off ≥2 false positives drop below 5% and again pts with mNY+ &amp; MRI+ have the highest percentage of spinal fatty lesions <h3>Conclusions</h3> In a low percentage of pts without axSpA BME and fatty lesions is found indicating that spinal BME and fatty lesions are specific for patients with axSpA. These lesions are especially prevalent in pts with sacroiliitis on imaging. In this cohort, a cut-off ≥2 or ≥3 BME lesions and similarly ≥2 or ≥3 fatty lesions discriminate best between pts with and without axSpA <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.1986
Discordant Findings Between Tc-99m HMPAO Mixed Leukocytes and Tc-99m–Labeled Monoclonal Antibody Fragments (via LeukoScan) in a Patient with Pulmonary Aspergillosis
Authors: Ingeborg Goethals, Olivier De Winter, Lorena D'Ignazio, Alberto Signore, Rudi Dierckx, Christophe Van De Wiele
Journal: Clinical Nuclear Medicine (2002)

GOETHALS, INGEBORG M.D.; DE WINTER, OLIVIER M.D.; D’IGNAZIO, LORENA M.D.; SIGNORE, ALBERTO M.D.; DIERCKX, RUDI M.D., Ph.D.; VAN DE WIELE, CHRISTOPHE M.D., Ph.D. Author Information
Squamous Cell Carcinoma Arising From Pulmonary Hamartoma
Authors: Byoung Jun Lee, Hye-Ryoun Kim, Gi Jeong Cheon, Jae Soo Koh, Cheol Hyeon Kim, Jae Cheol Lee
Journal: Clinical Nuclear Medicine (2011)

A 62-year-old woman was admitted for evaluation of a recently increased lung mass which had been regarded as benign for several years. Interestingly, hypermetabolism was noted in only half of the mass while standardized uptake value of the other half was very low on ¹⁸FDG PET/CT suggesting the difference in their nature. Finally, squamous cell carcinoma with hamartoma was found by pathologic examination of surgically removed tumor specimen. As a few reports have suggested that malignant transformation of hamartoma into adenocarcinoma or sarcoma could be possible, this is the first reported case showing that squamous cell carcinoma could also develop from hamartoma. Physicians should be aware of the malignant potential of pulmonary hamartoma.