tbuckley/cabot-search huggingface dataset:
FRI0550 Tumor Necrosis Factor-Alpha Blockade in Recurrent and Disabling Chronic Sciatica Associated with Post-Operative Peridural Lumbar Fibrosis: Results of a Two-Year Double-Blind, Randomized, Controlled Study
Authors: C. Nguyen, K. Sanchez, C. Palazzo, N. Zee, A. Feydy, L. Quinquis, S. Grabar, M. Revel, M.-M. Lefèvre-Colau, S. Poiraudeau, F. Rannou
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> The prevalence of persistent or recurrent post-operative back or lower limb pain in patients who underwent discectomy or laminectomy is up to 15% and its management remains challenging. Post-operative peridural fibrosis secondary to scar formation is one of the major cause of recurrent pain symptoms in the legs after back surgery. We hypothesized that drugs targetting inflammatory-associated fibrotic processes may be of interest in this condition. <h3>Objectives</h3> To assess the efficacy of tumor necrosis factor (TNF)-α inhibition with infliximab (IFX), as an anti-inflammatory and anti-fibrotic agent, in the treatment of post-operative peridural lumbar fibrosis-associated disabling chronic sciatica. <h3>Methods</h3> A two-year double-blind, randomized, controlled study was conducted in a French tertiary care unit. Thirty-five patients presenting with post-operative peridural lumbar fibrosis-associated sciatica were randomized in two groups. The IFX group (N=17) was treated with a single intravenous infusion of 3 mg/kg IFX, and the placebo group (N=18) with a single saline serum infusion. The primary outcome was a 50% reduction in sciatica on visual analog scale (VAS) at day 10. Secondary outcomes were radicular and lumbar pain at day 0, 2 hours after infusion, and radicular and lumbar pain, Québec disability score, drug sparing effect, and tolerance, at days 10, 30, 90, and 180. <h3>Results</h3> The two groups did not differ for baseline characteristics, except for radicular pain and neuropathic pain (VAS scores=55.0[50.0-70.0] in the placebo group <i>vs</i> 70[65.0-85.0] in the IFX group, and 45.0[41.0-73.0] <i>vs</i> 62.5[40.0-75.0], respectively). At day 10, no significant difference was found between placebo and IFX groups for the primary outcome (50% reduction in sciatica was observed in 3[17.6%] patients <i>vs</i> 5[27.8%], p=0.69, respectively). The frequency of patients reaching the Patient Acceptable Symptom State for radicular pain was significantly higher in the placebo than in the IFX group, 2 hours after infusion (12[70.6%] <i>vs</i> 5[27.8%], p=0.01, respectively). The two groups were comparable for all other secondary outcome measures. <h3>Conclusions</h3> Treatment with a single 3 mg/kg IFX infusion for recurrent sciatica pain associated with post-operative peridural lumbar fibrosis does not significantly reduce radicular symptoms at day 10. <h3>Disclosure of Interest</h3> None declared
Neoadjuvant Therapy
Authors: Howard (Jack) West, Jill Jin
Journal: JAMA Oncology (2015)

Neoadjuvant therapy refers to any treatment that is given for cancer before the main treatment, with the goal of making the main treatment more likely to be successful. What Is Neoadjuvant Therapy?In most cancers, the primary, definitive treatment is either surgery to remove the tumor or radiation therapy to kill the tumor cells.Sometimes, extra treatment, such as chemotherapy or hormone therapy, is used either before or after the primary therapy.Extra treatment given after primary therapy is referred to as adjuvant (meaning "helper") therapy, whereas extra treatment given before primary therapy is referred to as neoadjuvant therapy.This general concept of multimodality treatment (the use of more than 1 method to treat cancer) is often used in cancers such as breast, colon, or lung cancers.Using adjuvant or neoadjuvant therapy may improve the probability of cure.
High soluble IL-7 receptor expression in Sjögren's syndrome identifies patients with increased immunopathology and dryness
Authors: M R Hillen, S L M Blokland, A P Risselada, A Bikker, B R Lauwerys, A A Kruize, T R D J Radstake, J A G van Roon
Journal: Annals of the Rheumatic Diseases (2016)

Increased expression of interleukin (IL)-7 and its receptor is suggested to play a critical role in immunopathology of primary Sjogren's syndrome (pSS).1–3 Data from humans and mice demonstrate that IL-7 drives a range of processes involved in pSS immunopathology, including epithelial cell apoptosis, lymphocyte infiltration and reduction of salivary output.3 The IL-7/IL-7R axis is involved in the formation of (ectopic) lymphoid structures in salivary glands (SGs),3 ,4 which is a predictor for lymphoma development in pSS.5 ,6 IL-7 activity is potentiated by the soluble form of its receptor (sIL-7R), which is produced in inflamed tissues by activated stromal cells.7 As sIL-7R is a possible biomarker for IL-7-driven immune activation and lymphoid neogenesis, we studied the expression of sIL-7R in pSS in relation to markers of inflammation and saliva production.

Ninety-five patients with pSS were diagnosed according to the 2002 criteria (table 1).8 sIL-7R was measured in serum of 68 patients with pSS using ELISA as previously described9 and compared with 51 healthy individuals (HC). Labial SG biopsy tissues were taken from 27 patients and, after thorough rinsing, were incubated in 200 µL of sterile saline for 1 hour at room temperature. In these tissue supernatants, sIL-7R was measured …
Protamine insulin in children.
Authors: G. L. Boyd
Journal: JAMA Pediatrics (1936)

Summary   The discovery of protamine insulin is a distinct advance in diabetic therapy. It offers as good or better control of the disease with fewer doses in the day.  Reactions are fewer and, at least for the child, usually occur at more convenient periods when the child is at home, and not during his sleep.  There is a wider margin of safety in errors either in the dose of insulin given or in the food taken.
Soundings: Power to the paperwork
Authors: Colin Douglas
Journal: BMJ (2000)

The class stood in line along the edge of the swimming pool: two dozen of us, dressed in time-expired flying suits and burdened with survival gear. An instructor grinned. “Fall in,” he said. We fell in.

Over a couple of hours of chilly, chlorine flavoured discomfort we practised a series of drills that might come in handy if one of the navy's ageing helicopters failed to make it home. Some of it I found quite taxing.

For most of the class it was routine stuff, a regular update that they—young, fit aircrew—took for granted. Less fit and a lot older, I had to pay more attention, and as the drills progressed I became aware that wherever I was in the pool I was never far from one or more crop headed, superfit survival instructors, the petty officers who ruled our morning.

How kind, I thought at first, but later on, as we formed eights and floundered in and out of inflatable orange igloos, I made more sense of it. They had spotted in their morning's flock an unknown quantity, a middle aged reservist of dubious fitness and swimming ability, and clearly did not wish to spend the afternoon on tedious and avoidable paperwork.

I have no precise idea of what forms are involved in writing off a surgeon lieutenant commander Royal Naval Reserve, but the navy has forms for every contingency so they must exist and, to judge from the care taken to ensure my survival, they are probably quite detailed.

I worked it out because 10 years before that I'd been there myself. In the naval hospital in Malta an old woman on holiday from Devon—someone's mother in law—was desperately unwell. Of course I wanted her to get better, but not having a clue about what to do if a civilian died in a service hospital added much to my motivation. Intravenous digoxin—given far faster than is now recommended—achieved a small miracle. She shook her jowls, opened her eyes, and said, “That's better”: a relief for both of us.

Too much paperwork in the NHS? Just wait and see. As I write this, someone, or some committee, in the Department of Health is working on the fifth or 50th draft of a long new form we may not like much, but which might have saved the lives of a lot of old ladies in some of Harold Shipman's patients.
A memorable patient: Auntie Joan
Authors: Richard Ashford
Journal: BMJ (2004)

I never met Joan, but she was the favourite aunt of one of my close friends, and she died recently. My friend will miss her; he told me she was young at heart, had a wicked sense of humour, and always had a twinkle in her eye. She was loved by all her family—everyone's favourite aunt. She had lived by the seaside and had a happy life—but she grew old, as we all must, and, finally, she was admitted to one of the local district hospitals ill and anaemic.

It was clear she had some form of advanced malignancy, and an oncology opinion was needed. As is often the way, however, it was Friday afternoon and the oncologist was not on site. He therefore arranged to see her on Monday. The inevitable happened over the weekend, and Auntie Joan died with no definite diagnosis, though it was undoubtedly cancer. Despite her age, her family was left distressed, missing that crucial reassurance from an expert that everything possible had been done.

Of course, nothing could have been done. What was humbling was that my friend was sure that, had the oncologist been me, I would have gone to see her. Regrettably, I am quite sure that, after a busy week, had I been on another site, I would not have made a special trip either. My friend was also sure that a few skilful and kind words would have made his cherished aunt's sudden death more bearable. Surely not a lot to ask.

I wonder if I might have gone10 years ago, but I am probably fooling myself. Certainly now it is not possible to provide this level of service, and maybe it never was. Today, departmental guidelines do not permit us to admit anyone to a cancer centre for assessment; a plan to treat actively is required. Under any protocol, an elderly anaemic lady with advanced malignancy is not an oncological emergency requiring urgent assessment, especially if she is 20 miles away in another hospital. This is particularly so on a Friday afternoon, after a week of busy clinics, correcting press and internet misinformation, attending governance meetings, and travelling to multidisciplinary team meetings. Even if anyone had gone, there was clearly no effective treatment that could have been offered.

Yet, despite all our protocols and guidelines, this was still an opportunity to show compassion that was missed. Why else, after all, are we doctors? Auntie Joan was not just an elderly patient with incurable malignancy, she was a key family member, too ill by then to show much of the sparkle that endeared her so much to her family.

Will I go the next time I am contacted in similar circumstances? I don't know. Would you? If we do, Auntie Joan will certainly have been a memorable patient.
Treatment strategy for video capsule retention by double-balloon enteroscopy
Authors: Yuxin Wang, Zhuan Liao, Peng Wang, Jie Chen, Jiefang Guo, Hongyu Fu, Yuanhang Dong, Zhaoshen Li, Yiqi Du
Journal: Gut (2016)

We read with great interest the recent endoscopy news reported by Gluck et al ,1 presenting a novel prepless X-ray imaging capsule for colon cancer screening. The capsule emits low-dose X-rays that can penetrate the colon contents and identify polyps without the need for bowel preparation. However, one capsule retention occurred in 46 asymptomatic volunteers in a pilot study and it was retrieved by colonoscopy. Actually, capsule endoscopy retention is not rare even in patient without suspected Crohn's disease or bowel obstruction, with a retention rate of around 1.0%.2 ,3 Most retained capsules remain harmless but some can cause bowel obstruction, perforation or even capsule fragmentation.4 Several case reports described the use of double-balloon enteroscopy (DBE) for capsule extraction.5 ,6

In this investigation, we aimed to evaluate the use of DBE for retrieval of endoscopic capsules and identify …
Increasing rates in Clostridium difficile infection (CDI) among hospitalised patients, Spain 1999-2007
Authors: A Asensio, J Vaque-Rafart, F Calbo-Torrecillas, J J Gestal-Otero, F López-Fernández, A Trilla-Garcia, R Cantón
Journal: Eurosurveillance (2008)

Limited information is available on the burden and epidemiology of Clostridium difficile infection (CDI) in Spain. The present report communicates the secular trends in prevalence of CDI among hospitalised patients in Spain from 1999 through 2007. Data were obtained through the EPINE study (Estudio de prevalencia de las infecciones nosocomiales en los hospitales españoles), a point prevalence study series of nosocomial infections among patients admitted to hospital in Spain. A total of 378 cases with CDI were identified. Median age was 74 years. Prevalence rates of CDI increased from 3.9 to 12.2 cases per 10,000 hospitalised patients and showed a significantly increasing secular trend from 1999 through 2007 (prevalence rate ratio per each year increment 1.09; 95% CI 1.05 - 1.14). Percentage of hospitalised patients receiving antimicrobials increased linearly from 36.0% in 1999 to 40.7% in 2007 (p <0.001) and was strongly correlated to CDI prevalence (R square = 0.73; regression coefficient =1.194, 95% CI= 1.192 - 1.196).
Localization of Fibrinolytic Activity in the Eye
Authors: H C KWAAN, T ASTRUP
Journal: JAMA (1963)

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
Gastric and Duodenal Ulcers
Authors: H R CARROLL
Journal: JAMA (1941)

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 Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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) 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
Hair-Metal Binding
Authors: Thomas A. Hinners, Willie J. Terrill, Jane L. Kent, Anthony V. Colucci
Journal: Environmental Health Perspectives (1974)

Extensive ambient extraction of several metals from human hair compromises some assumptions concerning the binding of metals to hair and the biochemical process of metal incorporation into hair. Hair metal concentrations can reveal metal intoxications and metal deficiencies.

The scalp hair selected for investigation included specimens of different colors from both sexes for various donor ages and from different geographic exposure areas. The hair samples were washed by agitation for 30 min with a 1% solution of sodium lauryl sulfate in a pH 7.2 buffer, rinsed repeatedly with deionized water, and oven-dried at 110°C before 2-g portions were taken for extraction and digestion. Extraction involved agitation of the washed hair samples for 21 hr with 40 ml of 1% nitric acid at room temperature (23°C). The extracted hair was digested in order to quantitate the amount of metal that was not extracted. Metal measurements were made by conventional flame atomic absorption spectroscopy. Potential interferences were investigated.

Extraction varied between 82 and 100% for Na, Mg, K, Ca, Mn, Zn, Cd, and Pb. Removal of Fe, Ni, and Cu was 33–54%. Anatomical location, binding chemistry, biochemical incorporation, and mass screening are discussed.
AB0688 Treatment with Rituximab in Systemic Sclerosis Patients: Our Experience in a Pilot Clinical Trial
Authors: D. Giuggioli, F. Lumetti, M. Colaci, G. Cassone, V. Cestelli, C. Ferri
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Systemic sclerosis (SSc) is an immune-mediated disorder characterized by abnormal fibrosis and diffuse microangiopathy with skin and internal organ involvement due to both T- and B-lymphocyte activation. The present study aimed to assess the efficacy of long-term treatment with rituximab (RTX), a chimeric monoclonal antibody that targets B-cell CD20. The rationale for the use of RTX in SSc is based on experimental data suggesting a key role for B cells in regulating the fibrotic process. <h3>Objectives</h3> The present study aimed to assess the efficacy of long-term treatment with rituximab (RTX) in systemic sclerosis patients. <h3>Methods</h3> Eleven SSc patients (M/F 3/8, mean age 43.2±10.5SD years, mean disease duration 3.6±6.2SD years) underwent to RTX cycle (weekly infusion of RTX 375 mg/m<sup>2</sup> of body surface plus 100 mg methylprednisolone for 4 weeks); in 10/11 RTX was repeated every 6 months for a total of 2-6 cycles. Patients9 clinical-serological evaluation, including HAQ assessment and visual analogical scale (VAS), was performed every six months. <h3>Results</h3> At the end of the follow-up period (3.7±2.8 SD years) an improvement of the skin sclerosis involvement was constantly observed; in particular, patients with diffuse SSc cutaneous variant showed a significant decrease of modified Rodnan skin score (from 25±4.1 to 17.2±4.1; p&lt;0.004). Similarly, the articular involvement, melanodermia, and calcinosis ameliorated if compared to baseline; these positive clinical variations were mirrored by a subjective recovery of patients9 well being in all cases (HAQ, VAS). No significant variations were observed with regards to other SSc clinical manifestations; in particular, lung involvement remained stable or showed a moderate progression at the last patients9 evaluation. Finally, in no cases significant side effects were observed. <h3>Conclusions</h3> Our results indicate that treatment of SSc patients with RTX may be particularly effective for severe skin sclerosis, as suggested by other preliminary trials. The scarce efficacy of RTX on some disease manifestations may suggest the use of combined treatment, namely RTX with other antifibrotic/vasoactive drugs. <h3>Disclosure of Interest</h3> None declared
A hotel-based outbreak of Salmonella enterica subsp. Enterica serovar Enteritidis (Salmonella Enteritidis) in the United Kingdom, 2006
Authors: N Calvert, L Murphy, A Smith, D Copeland, M Knowles
Journal: Eurosurveillance (2007)

An outbreak of food-borne Salmonella Enteritidis PT4 occurred in Cumbria, in north-west England, in the summer of 2006. Fifteen people, all with positive stool samples, met the case definition; three of these were admitted to hospital, including one patient who died. Preliminary investigations suggested a link to a meal served at a local hotel. A case control study was implemented, together with microbiological and environmental investigations. Fifteen microbiologically confirmed cases and 27 unmatched controls were included in the study, controls being randomly selected from people who had eaten at the hotel on the same day. The epidemiological evidence indicated a very strong association between infection and consumption of tiramisu made with raw shell eggs, although none were available for microbiological investigation. These results are in line with other salmonellosis outbreaks that have been associated with the use of raw shell eggs in food manufacturing and production. This paper highlights the continuing need for a greater awareness by those who work in the food industry of the health risks associated with the consumption of raw shell eggs.
Soundings: The inaugural
Authors: Trisha Greenhalgh
Journal: BMJ (2002)

Planning your inaugural lecture? You need to decide what to say, what to wear, and whom to invite.

Anyone who has been on the payroll for more than 40 years gets to come automatically. Their brief is to occupy the front three rows and stare disapprovingly if you say anything controversial.

For the most part they will feign sleep, but on the stroke of six they will make a swift dash for the refectory via a little known passageway. By the time that you arrive with the main cohort of guests, they will have stationed themselves against the bar, lit smelly cigars, and consumed the lion's share of the claret and canapes.

To redress the balance, you need a good showing of youth, gaiety, and intellectual curiosity. Medical students can be hired for the purpose—the going rate is a tenner each (for £15 they will laugh at your jokes on cue).

What to wear? If you are male and under 45, you need a Marks and Spencer sports jacket and a pair of well cut chinos. Older, and you should go for a mid to dark grey suit, off white shirt, and fading alma mater tie. Have your hair cut Albert Einstein style, and hold your head at an angle of 15 degrees to the vertical so as to appear eccentric and quizzical.

If you are female, your outfit must say four words: sod the glass ceiling. Assuming you lack the credentials to don the national costume of an under-represented ethnic minority, you have three choices. The first is unwashed jeans and a stud through your tongue. But unless you have a first degree relative on the throne or a Nobel prize within your grasp, such behaviour is likely to get you branded a silly girl. The second is full academic regalia (check your cv—you will probably find that you are eligible for a red gown with black and gold epaulettes by now). If you carry this off well—with ample bosom and firm jaw—the faculty might commission an oil painting of you to go in the entrance hall.

The safest option is probably a pair of three inch stilettos and a slinky black dress. This will allow the crusty old dons in the front row to fantasise about you draped over the bonnet of a Ferrari once they have ceased to follow your line of argument.

And what to say? Frankly, as long as you don't offer a faultless critique of the dean's latest publication, no one will give a damn.