tbuckley/cabot-search huggingface dataset:
Self-regard: a new measure
Authors: M Horowitz, D Sonneborn, C Sugahara, A Maercker
Journal: American Journal of Psychiatry (1996)

The status of patients and research subjects is usually considered in terms of self-reported symptoms. Measures seldom include disturbances in a conscious sense of the self. An additional brief measure of the sense of current self-regard is desirable, since a conscious lapse in an integrated self-concept may occur under stressful circumstances. The authors constructed and tested such a measure.Clinical interviews had indicated five common experiences that occurred more frequently as complaints during stress-induced regressions in the sense of the self as a functioning mind-body agency. An anchored five-item scale, the Self-Regard Questionnaire, was constructed and tested with 79 subjects who were in the midst of grief from the death of a spouse. Data analyses included checks on the internal coherence of questionnaire scale scores and their association with symptom, personality, and social desirability measures.The five-item Self-Regard Questionnaire was completed quickly, in less than a minute, and led to internally consistent and unique data. Low levels of overall self-regard were correlated with higher levels of distress and predicted prolonged distress.These results suggest that the questionnaire is a useful, quick, and easy-to-score self-report tool for assessing, and reassessing over time, current experiences of the self. The five questions may also be useful to clinicians who evaluate patients in contexts other than research.
FRI0284 Influence of Vertebral Fractures Severity and Pelvic Parameters on Global Spinal Balance in Osteoporotic Patients
Authors: J. Fechtenbaum, K. Briot, A. Etcheto, S. Kolta, A. Feydy, C. Roux
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Thoracic kyphosis and other postural parameters related to the postural adjustment strategy affect the biomechanical environment of the spine. These parameters can be influenced by vertebral fractures in elderly osteoporotic patients. <h3>Objectives</h3> This study aims to compare the spine curvatures, the pelvic parameters and the global spinal balance of patients aged above 50 years with and without osteoporotic vertebral fractures. <h3>Methods</h3> Two hundred patients (95% women) aged 66.5±13.6 years underwent a standardised lateral and antero-posterior full skeleton radiographs in the standing position, by EOS® (a low dose biplanar imaging system) in an upright weight-bearing position. VFs were evaluated according to Genant9s classification and the spinal deformity index (SDI). Spinal (thoracic and lumbar Cobb9s indices, thoracic tilt (T9 tilt) and lumbar tilt (L1 tilt)) and pelvic (pelvic tilt, sacral slope, and pelvic incidence) parameters were measured. Sagittal global spinal balance was measured using 3 parameters: the C7 plumb line (mm), the vertical line through the external auditory canal, and the spinosacral angle (SSA in degrees).We compared these parameters in patients with and without vertebral fracture, according to the location and the severity of VFs (SDI). We assessed the discriminative value of the global spinal parameters in patients with at least one vertebral fracture using Area Under the Curve (AUC). <h3>Results</h3> Sixty-nine patients had at least 1 VF, with a mean number of VF of 2.3±1.7 and a mean SDI of 4.2±4.5. In patients with only lumbar VFs (N=11), only lumbar parameters (lower lumbar Cobb9s angle and sacral slope and higher lumbar tilt) were modified. In contrast, in patients having only thoracic VFs (N=58), both thoracic, lumbar and pelvic parameters were different than those in patients without VFs. The greater the SDI, the greater were the thoracic Cobb9s angle and pelvic tilt and the lesser the lumbar Cobb9s angle. Thoracic and lumbar tilts and sacral slope were not affected by SDI increase. The global spine balance assessed by C7 plumbline and SSA was significantly altered in patients with at least one VF, and there was a dose effect of the number and severity of VFs on global spinal balance, significant for all parameters for a SDI value &gt;2. Global spinal balance was significantly altered in patients with at least one FV and low sacral slope (113.4° vs 120.0, p=0.0012). SSA was the postural spinal parameter which better discriminates patients with at least one VF (AUC=0.706) <h3>Conclusions</h3> Global spinal balance is significantly altered in patients with at least one vertebral fracture with a dose-effect of the number and severities of VFs. Pelvic parameters are relevant in the assessment of global spinal balance. <h3>Disclosure of Interest</h3> None declared
AB0929 Elevation of Creatine Kinase in Gout Subjects. A Systematic Evaluation:
Authors: Y.-J. Choi, A. Steinberg, P. Boudes
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Creatine kinase (CK) elevation is occasionally encountered in gout subjects without any clinical manifestation of a neuromuscular disorder. To our knowledge no data have been published to systematically describe the extent of this association. <h3>Objectives</h3> The objective of this work is to report on the frequency of isolated CK elevation in a gout population, to compare it with a reference population, namely non gouty subjects with type-2 diabetes mellitus, and to formulate recommendations for clinical practice and subjects9 monitoring during clinical studies. <h3>Methods</h3> CK values from subjects screened in four gout clinical studies and two type-2 diabetes studies were collected. Descriptive statistics mean, median, and dispersion were reported. The frequency and level of abnormal values (based on central laboratory determination) were further described and compared between groups. For abnormal values clinical correlation were sought. <h3>Results</h3> CK values were available for 1,059 gout subjects and 1,963 diabetes subjects. Means, including comparison between gout and diabetes, standard deviations, medians and ranges are provided in the following table. Using normal laboratory values of 24-195 UI/L, 276/1,059 (26%) subjects with suspected gout and 207/1,963 (10.5%) subject with diabetes had abnormally elevated CK values. The frequency of subject with &gt;3 times the upper limit of normal was 28/1059 (2.6%) in gout subjects and 13/1963 (0.7%) in diabetes subjects. <h3>Conclusions</h3> Overall, CK are significantly higher in a gout population when compared to a diabetic population. A clinically significant proportion of gout patients have abnormally elevated CK when screened for participating in a clinical study. Abnormally elevated CK in a gout subject could be due to concomitant medications frequently prescribed in this group (such as colchicine or statins) or recreational (exercise-induced). The possibility that CK elevation could be due to tendinous/muscular deposition of uric acid, while suggested by some case-reports in the literature, remains a hypothesis that need to be further tested. <h3>Disclosure of Interest</h3> Y.-J. Choi Shareholder of: cymabay therapeutics, Employee of: cymabay therapeutics, A. Steinberg Shareholder of: cymabay therapeutics, Employee of: cymabay therapeutics, P. Boudes Shareholder of: cymabay therapeutics, Employee of: cymabay therapeutics
SAT0060 Orthopaedic Surgery in an Asian Rheumatoid Arthritis Cohort: Predictors and Impact on Quality of Life
Authors: L.W. Koh, E.T. Koh, J.W.L. Tan, T.Y. Lian, W.Q. See, L. Liu, K.P. Leong
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Objectives</h3> To identify predictors of orthopaedic surgery and its impact on quality of life in a South-East Asian rheumatoid arthritis registry cohort. <h3>Methods</h3> Data was collected from patients enrolled in the Tan Tock Seng Hospital Rheumatoid Arthritis Registry. All patients fulfilled the 1987 ACR criteria for RA. The clinical, extraarticular features (EAF), disease activity score (DAS 28), functional status (Health Assessment Questionnaire, HAQ) and health- related quality of life measures (SF-36) were prospectively collected since 2001. Comparison between those with and without orthopaedic surgical procedures (groups I and II respectively) at entry to the registry till 2013 or death was done. Risk factors for surgery at study entry were determined using logistic regression (STATA SE 10), adjusted for age and disease duration. <h3>Results</h3> The study comprised of 1049 patients, predominately Chinese (77.9%); 190 patients (18.1%) had surgery (synovectomy 6.4%, arthroplasty 17.5%, arthodesis 1.1%). The mean age of groups I and II were similar (49.2 vs 48.2 years, p=0.35), mean duration from onset of RA to 1st joint surgery was 136.2 months. Group I had significantly longer symptoms before seeking rheumatologists (mean 63.5 vs 32.0 months, p&lt;0.0001), duration from onset of RA to 1st disease modifying drug (74.2 vs 39.3 months, P&lt;0.0001) and disease duration (243.1 vs 151.6 months, p&lt;0.0001). Higher deformed joint count (mean 4.8 vs 1.7, OR 1.13, p&lt;0.001), presence of radiographic erosions (70.4 vs 52.3%, OR 1.46, p&lt;0.05), EAF (36.3 vs 24.1%, OR 1.67, p=0.004), HAQ score &gt;1.5 (15.4 vs 7.5%, OR 3.08, p&lt;0.001 and not DAS 28 or RF positivity were predictive of orthopaedic surgery. Lower scores were seen for the physical functioning domains of the SF36 in the group that had orthopaedic surgery, but there was no significant difference in the mental component between the two groups. <h3>Conclusions</h3> Delayed diagnosis and delay in initiation of disease modifying therapy were positive predictors of orthopaedic surgery in our cohort of RA patients, independent of disease activity scores and rheumatoid factor positivity. RA patients in this cohort who required orthopaedic intervention report significantly poorer scores on physical quality of life measures. <h3>Acknowledgements</h3> This study is supported by the Centre Grant, National Medical Research Council, Ministry of Health, Singapore. (CG12Aug17) <h3>Disclosure of Interest</h3> None declared
Primary Tracheal and Bronchial Lymphoma Displayed on 18F-FDG PET/CT Imaging
Authors: Lei Jiang, Shuguang Chen, Yanli Li, Gang Chen, Hongcheng Shi
Journal: Clinical Nuclear Medicine (2015)

A 46-year-old woman presented with cough for over 20 days, unrelieved by anti-inflammation treatment. Diffuse wall thickening and mildly luminal stenosis of the lower trachea and both main bronchi were observed on chest CT examination. The pathology after bronchoscopy confirmed non-Hodgkin lymphoma (mucosa-associated lymphatic tissue, MALT). FDG PET/CT was performed to evaluate the extent of the disease, which demonstrated the abnormal FDG accumulation in the diffusely thicken wall of trachea and bronchi, without lymph nodes and other extranodal tissue involvement.
FRI0517 Cross-Cultural Adaptation and Validation of the Screen for Child Anxiety Related Disorders Test (SCARED) in Juvenile Idiopathic Arthritis
Authors: H. Tazi Lachhab, S. Rostom, B. Amine, N. Bensaoud, D. Khnaba, L. Bouhouche, R. Bahiri, N. Hajjaj-Hassouni
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Children and adolescents with juvenile idiopathic arthritis are at high risk of developing some particularly anxious psychological disorders. Although it is a common mental health problem in children with chronic rheumatic diseases in our country, it is not sufficiently studied. <h3>Objectives</h3> The purpose of this study was to translate an assessment questionnaire of an anxiety disorders in children (SCARED) into classical Arabic and to measure its reliability and psychometric validity. <h3>Methods</h3> A classic Arabic version of SCARED was developed and evaluated using a sample of 47 children suffering from juvenile idiopathic arthritis. A questionnaire of 41 items (5 areas) was completed by our patients at two different moments in time with a 48 hours interval. Studies on test-retest reliability and internal consistency were performed using the intra-class correlation coefficient (ICC) and the Cronbach9s coefficient α. The validity of the Arabic version of the SCARED was assessed using a sample of 47 children matched for age and sex. Criteria of judgment: The primary outcome was the reliability and psychometric validity of the SCARED. <h3>Results</h3> A total of 47 children with juvenile idiopathic arthritis (according to the criteria of the ILAR 2001) were tested along with 47 other children without JIA who formed the control group. The first group had a mean age of 11.5±3.3 years, with a male predominance (59.6%), 31% had joint Oligo form, the median duration of disease was 4 years [2–6]. The median Jadas of our patients was 8 [3; 14], indicating moderate disease activity. We demonstrated high test-retest reliability (ICC &gt;0.994) and high internal consistency (Cronbach9s α of 0.997). We have shown that the overall coefficients of test-retest reliability were high for the total score and for each SCARED domain. In terms visible validity, the questionnaire was understandable and was able to accurately measure the various aspects of anxiety within children. We found a strong correlation with measures of depression, sleep disorders and quality of life assessed by CDRS (r =0.096 and p=0.04), the CSHQ (r =0.304/p=0.03) and PedsQL4, 0 (r =0.252/p=0.04). We found significant differences in the total scores and domains between the JIA group and the control group, denoting a good discriminate validity of the SCARED. <h3>Conclusions</h3> The results provided evidence of the validity and reliability of the Arabic version of the SCARED for Moroccan children with juvenile idiopathic arthritis. The questionnaire is an appropriate instrument to detect anxiety within children and could be useful in clinical practice, research and teaching. <h3>Disclosure of Interest</h3> None declared
Responding to a Request for Physician-Assisted Death—Reply
Authors: Timothy E. Quill, Anthony L. Back, Susan D. Block
Journal: JAMA (2016)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Radiology of the Small Intestine
Authors: Alexander R. Margulis
Journal: JAMA (1970)

The authors have succeeded in producing a classic book on radiology of the small bowel. The book consists of 21 chapters dealing with the radiologic appearance of a host of conditions involving the small bowel, including malabsorption, inflammatory diseases, tumors, involvement by systemic diseases, etc. There is a chapter on the small bowel in infants and children by John Moseley and Jack Rabinowitz, and a delightful chapter on some uncommon lesions of the small bowel by Dr. Arthur Clemett. The book is up to date and conveys a great deal of medical as well as radiologic information. The text is concise, lucid, and beautifully written. The illustrations are of superb quality and the entire text is luxuriously illustrated. It is almost unbelievable that such wealth of material can be presented in one book by two authors with the cooperation of three other radiologists. Dr. Marshak and Dr. Lindner have written
Interactions between Diet and Exposure to Secondhand Smoke on the Prevalence of Childhood Obesity: Results from NHANES, 2007–2010
Authors: Brianna F. Moore, Maggie L. Clark, Annette Bachand, Stephen J. Reynolds, Tracy L. Nelson, Jennifer L. Peel
Journal: Environmental Health Perspectives (2015)

Exposure to secondhand smoke (SHS) may increase risk for obesity, but few studies have investigated the joint effects of exposure to SHS and diet.We examined the interaction of exposure to SHS and diet on the prevalence of obesity among 6- to 19-year-olds who participated in the 2007-2010 National Health and Nutrition Examination Survey.We characterized exposure using a novel biomarker [4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL)], an established biomarker (cotinine), and self-report. Multinomial logistic regression models examined the association of SHS exposure on the prevalence of overweight and obesity as separate outcomes (compared with normal/underweight). Interaction by diet was assessed by introducing interaction terms (with SHS) of the individual nutrients [dietary fiber, eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), vitamin C, and vitamin E] into separate models.Approximately half of the children had NNAL and cotinine levels above the limit of detection, indicating exposure to SHS. Interaction results suggest that the prevalence of obesity among children with both high exposure to SHS and low levels of certain nutrients (dietary fiber, DHA, or EPA) is greater than would be expected due to the effects of the individual exposures alone. Little or no evidence suggesting more or less than additive or multiplicative interaction was observed for vitamin C or vitamin E. The association between SHS and obesity did not appear to be modified by dietary vitamin C or vitamin E.Childhood obesity prevention strategies aimed at reducing SHS exposures and improving diets may exceed the expected benefits based on targeting either risk factor alone.Moore BF, Clark ML, Bachand A, Reynolds SJ, Nelson TL, Peel JL. 2016. Interactions between diet and exposure to secondhand smoke on the prevalence of childhood obesity: results from NHANES, 2007-2010. Environ Health Perspect 124:1316-1322; http://dx.doi.org/10.1289/ehp.1510138.
Soundings: Clinical myths
Authors: Kevin Barraclough
Journal: BMJ (2006)

I realise now that much of the teaching I received (and much I have given) has actually been rather dishonest. The true variation of disease presentations and the low predictive value of any one of the clinical features were never explained. We were taught “classical” presentations. The pictures in the books—like rashes in a dermatology textbook—were gross examples (in every sense of the word). The descriptions of disease were often from a world long gone. Nobody could miss the vast goitre, the acromegalic who looked as though he should be in a Bond movie, the gross deformity of the rheumatoid hands. But hypothyroidism doesn't present with a huge goitre and slow reflexes any more. We need to stop teaching myths.

Students still carry out a cardiovascular examination and spend an age staring at the hands for Osler's nodes. Astonishing! The Austin-Flint murmur, pre tibial myxoedema, egophony. Why are we wasting their time with these things? But if we ask the student what the chance is that rectal bleeding in a 60 year old signifies colorectal cancer—is it one in a thousand or one in ten?—they won't know, because we don't.

The dishonesty is the myth that somehow symptoms and signs in medicine are highly predictive of disease—or even that we know how predictive they are. Surely we shouldn't still be teaching medical students about whispering pectoriloque and splinter haemorrhages? We should be teaching them about clinical probability and the truly discriminatory factors in the history and examination.

I see people complaining of breathlessness every day of the week. It is a bit embarrassing that if a student asked me whether a breathless 60 year old presenting to me has a one in a thousand chance of having heart failure or a one in ten chance I wouldn't really know. We rely on a “feel” for clinical probability that accrues with experience. That experience is clearly a potent thing because otherwise there would be a lot more mistakes than there are. But it would be nice if we could quantify it and pass it on a bit more efficiently. More relevant than obscure 19th century physical signs, I think.

In future I am going to be more honest about the depth of our numerical ignorance. And if the students are a bit shocked, then maybe we should be too.
SAT0112 Cardiovascular Risk in Rheumatoid Arthritis Patients: Subclinical Left Ventricular Systolic Dysfunction in Asymptomatic Patients
Authors: G. Orsolini, O. Viapiana, A. Giollo, G. Cioffi, A. Dalbeni, F. Ognibeni, E. Fracassi, R. Zampieri, S. Troplini, D. Gatti, M. Rossini, S. Adami
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Patients with rheumatoid arthritis (RA) have an increased risk for cardiovascular adverse events, favored by the progression of arterial stiffness leading to coronary atherosclerosis and concentric left ventricular (LV) geometry. These conditions can lead to LV systolic dysfunction (LVSD) that can be expressed by different parameters such as stress-corrected midwall shortening (sc-MS), a prognostic of CV events in patients with arterial hypertension and diabetes. <h3>Objectives</h3> To evaluate the prevalence of LVSD in RA patients. <h3>Methods</h3> From January to June 2014, 198 recruited RA patients were investigated and compared with 198 controls matched for age, gender, body mass index, prevalence of hypertension and diabetes. Echocardiography was performed measuring many parameters expressing LV systolic function: sc-MS (impaired if &lt;86,5%) and S9 (impaired if &lt;9.0 cm/sec). Combined circumferential and longitudinal (C&amp;L) function was evaluated by impairment of both sc-MS and S9. LV ejection fraction (LVEF) was considered impaired if &lt;50%. Moreover, we evaluated through E/E9 ratio a diastolic function and the presence of an excess of LV mass (inappropriate if &gt;123% of measured/predicted ratio). This last parameter has been evaluated in a group of 235 patient. <h3>Results</h3> LVSD defined by S9 reduction was found in 45% of RA patient, by sc-MS in 56% of patients vs 15% of controls (p&lt;0.001). LVEF was impaired in 3% of RA patients and in 1% of controls (p=non significant). A combined C&amp;L dysfunction was detected in 28% of patients and associated with ventricular mass (OR 1.03, p=0.04) and concentric LV geometry (OR 2.76, p=0.03). RA was independently associated with impaired sc-MS and C&amp;L dysfunction. Among RA patient, variables associated with LVSD were higher E/E9 ratio and systolic blood pressure. LVM was increased in 64% of patients and in 15% of controls (p&lt;0.001) <h3>Conclusions</h3> In conclusion we demonstrate through different parameters that among RA patients there is a significant prevalence of LVSD that precedes LVEF impairment. RA has turn to be an independent risk factor for LVSD. These data confirm the need for a careful evaluation of CV risk in RA patients. <h3>Disclosure of Interest</h3> None declared