tbuckley/cabot-search huggingface dataset:
Case 28-1965
Authors: Franz J. Ingelfinger, Wallace H. Clark
Journal: New England Journal of Medicine (1965)

Presentation of Case First admission. A fifty-eight-year-old woman was admitted to the hospital because of abdominal pain and vomiting.Eighteen years previously the signs of Raynaud's phenomenon appeared, progressing during the next two years to gangrene of the fingertips. A bilateral thoracodorsal sympathectomy was performed at another hospital. Subsequently, anorexia and mild dysphagia developed, and she lost 20 pounds in weight during the next eight years. Eight years before admission there was the onset of chronic crampy abdominal pain and flatulence as well as psoriasis. Three years later a laparotomy at another hospital was performed because intestinal obstruction was . . .
IV. An Unmet Community Health Need
Authors: John W. Ferree
Journal: JAMA (1962)

LETUS TURN from general considerations of j community health to a specific unmet community public health need—a community problem that has been skirted, consigned to the already too-busy eye specialist, or given a public health lick and a promise for too many years. There are many agencies dealing with care and welfare of the blind, most of them doing excellent and much-needed work. But with rare exceptions, none are geared to prevention of blindness. Most remain essentially social-welfare groups oriented to the problems of the blind. Public health departments are medically oriented units, and prevention and restoration are essentially medical problems rather than responsibilities of social welfare agencies. Visual disorders cost America a staggering $4.5 billion in care and loss of national productivity every year. That's more than 10 times what it cost to put an astronaut into orbit around the world. I'd like to discuss the 4 most
Alarming results
Authors: Douglas Kamerow
Journal: BMJ (2007)

<b>Background:</b> Lung cancer is the leading cause of cancer-related mortality worldwide. Malnutrition is a common problem among patients with cancer, affecting up to 85% of patients with certain cancers and represents a risk factor for poor prognosis. <b>Aim:</b> evaluate nutritional status in patients with lung cancer before and during treatment using nutritional risk index. <b>Patients and Methods</b>: it9s a prospective study conducted in pneumology IV department in Abderahman Mami hospital, from January to May 2011. 30 male patients with a lung cancer were included. Nutritional status was assessed before and during treatment based on anthropometric measures, biological markers and nutritional risk index (NRI). <b>Results:</b> Mean age of patients was 58 ± 12 years, ranging from 19 to 82 years. 29 patients had non small cell lung cancer and one patient had small cell cancer. Malnutrition was noted in 14 patients (47%) before treatment according to the NRI. It was noted in 23 patients (77%) after three cycles of chemotherapy with severe malnutrition in 8 patients. Relationship between body mass index (BMI) and the NRI was linear, but NRI tends to evaluate more objectively risk of malnutrition in patients with lung cancer. <b>Conclusion:</b> Nutritional assessment in patient with lung cancer should be performed systematically, early and repeatedly. Several markers can be used such as BMI and NRI. Nutritional support will reduce morbidity and improve quality of life in patients with lung cancer. <b>Key-words:</b>Lung cancer, malnutrition, treatment, Nutritional risk index.
AB0066 Uric Acid Mediates Murine Acid-Induced Acute Lung Injury
Authors: H. Kataoka
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Acute lung injury (ALI) is a clinical syndrome characterized by acute hypoxic respiratory failure and massive pulmonary infiltrate. Strong acid-containing gastric juice stimulates pulmonary epithelial cells and raises airway permeability, and this suggests that acid can be a trigger of ALI. However, little is known about underlying mechanism of neutrophilic infiltration in response to gastric acid aspiration. Uric acid, one of damage-associated molecular patterns (DAMPs), is released from injured cells and mediates neutrophilic response, and it possibly triggers acute response in ALI. <h3>Objectives</h3> To test whether uric acid mediates murine acid-induced acute lung inflammation. <h3>Methods</h3> To see whether uric acid participates in acute lung inflammation, hydrochloric acid was injected into lungs of mice 3 days after commencement of continuous oral xanthine oxidase inhibitor febuxostat (FBX) treatment or of untreated C57BL/6 mice. Uric acid levels in serum and lung tissues were measured and neutrophilic response was assessed by quantification of inflammatory cells and measurement of tissue myeloperoxidase (MPO) activity. <h3>Results</h3> Acid challenge raised uric acid levels in lung tissue (Figure) and induced neutrophil recruitment. FBX reduced uric acid levels in serum before acid challenge (1.18±0.13 (with FBX treatment, mg/dl), 2.6±0.30 (without FBX, mg/dl), p&lt;0.05) and during inflammation (1.06±0.44 (with FBX, mg/dl), 2.8±0.68 (without FBX, mg/dl), p&lt;0.05). There was a significant reduction in uric acid levels in acid-injured lung tissue by FBX treatment (13.5±6.4 (with FBX, μg/g lung), 30.3±11.8 (without FBX, μg/g lung), p&lt;0.05). FBX blocked acute neutrophilic response to acid injection (neutrophil numbers; 4.42×10<sup>4</sup> (with FBX), 1.16×10<sup>5</sup> (without FBX), p&lt;0.05). In mice treated with FBX, there was a significant reduction of MPO activity in lung tissue (36.77±29.80 (FBX), 68.64±43.06 (without FBX)). <h3>Conclusions</h3> Our results point to the contribution of uric acid in murine acid-induced lung inflammation. <h3>References</h3> Kono H, Chen CJ, Ontiveros F, Rock KL. Uric acid promotes an acute inflammatory response to sterile cell death in mice. The Journal of clinical investigation 2010;120: 1939-49. Rock KL, Kataoka H, Lai JJ. Uric acid as a danger signal in gout and its comorbidities. Nature reviews Rheumatology 2013;9: 13-23. <h3>Disclosure of Interest</h3> None declared
Differential bonding: toward a psychophysiological theory of stereotyping
Authors: C A Pinderhughes
Journal: American Journal of Psychiatry (1979)

The author uses the concept of affiliative-affectionate bonding and the concept of differentiative-aggressive bonding to answer questions regarding the human tendency to stereotype. He states that the human processes of affiliation, introjection, identification, and affection appear to be psychophysiological elaborations of approach-seeking physiology and that differentiation, projection, and aggression appear to be psychophysiological elaborations of withdrawal-avoidance physiology. He also points out that some measure of stereotyping and paranoia may be necessary because differential bonding appears to be essential for adaptation.
Acute Myeloid Leukemia
Authors: Carolyn J. Hildreth
Journal: JAMA (2009)

Acute Myeloid LeukemiaL eukemia is a cancer of the white blood cells that spreads throughout the bloodstream and may affect many organs.It originates in the bone marrow (spongy center of bones), which is where all blood cells are developed before being released into the bloodstream.Leukemia is classified based on the type of abnormal white blood cell and by how rapidly these cells leave the bone marrow and enter the bloodstream.Acute myeloid leukemia (AML) is the most common type of leukemia that affects adults.The June 10, 2009, issue of JAMA contains an article on allogeneic (from a healthy donor other than an identical twin) stem cell transplantation as a treatment for AML.
OC-011 Exhaled volatile organic compound breath analysis in inflammatory bowel disease
Authors: L Hicks, J Huang, S Kumar, S Powles, T Orchard, GB Hanna, H Williams
Journal: Gut (2015)

<h3>Introduction</h3> Distinguishing between Crohn’s disease (CD) and ulcerative colitis (UC) is important for determining management and prognosis. Selected ion flow tube mass spectrometry (SIFT-MS) may be used to analyse volatile organic compounds (VOCs) in exhaled breath: these may be altered in disease states, and distinguishing breath VOC profiles can be identified.<sup>1</sup>A recent paediatric study used SIFT-MS to distinguish IBD patients from healthy controls (HC).<sup>2</sup>The aim of this pilot study was to identify, quantify and analyse VOCs present in the breath of adult IBD patients and controls, potentially providing insights into disease pathogenesis and complementing current diagnostic algorithms. <h3>Method</h3> SIFT-MS breath profiling of 56 individuals (20 UC, 18 CD and 18 healthy controls) was undertaken. Multivariate analysis included principal components analysis (PCA) and partial least squares discriminant analysis with orthogonal signal correction (OSC-PLS-DA). Receiver Operator Characteristic (ROC) analysis was performed for each comparative analysis using statistically significant VOCs. <h3>Results</h3> OSC-PLS-DA modelling was able to distinguish both CD and UC from healthy controls and from one other with good sensitivity and specificity. ROC analysis using combinations of statistically significant VOCs (dimethyl sulphide, hydrogen sulphide, hydrogen cyanide, ammonia, butanal and nonanal) gave integrated areas under the curve (AUC) of 0.86 (CD vs HC), 0.74 (UC vs HC) and 0.83 (CD vs UC). <h3>Conclusion</h3> SIFT-MS breath profiling was able to distinguish IBD patients from controls, as well as separate UC from CD, using both multivariate and univariate statistical techniques. The specific VOCs characterising the breath in IBD relate to bacterial dysbiosis (sulphur compounds and ammonia) and oxidative stress (aldehydes)<sup>3</sup>– both mechanisms implicated in disease pathogenesis. <h3>Disclosure of interest</h3> None Declared. <h3>References</h3> Popov TA. Human exhaled breath analysis. Ann Allergy Asthma Immunol. 2011;106(6):451–6 Patel N, Alkhouri N, Eng K, <i>et al</i>. Metabolomic analysis of breath volatile organic compounds reveals unique breathprints in children with inflammatory bowel disease: a pilot study. Aliment Pharmacol Ther. 2014;40(5):498–507 Bos LD, Sterk PJ, Schultz MJ. Volatile metabolites of pathogens: a systematic review. PLoS Pathog. 2013;9(5):e1003311
Preliminary data on the dexamethasone suppression test in children with major depressive disorder
Authors: B Geller, A D Rogol, E F Knitter
Journal: American Journal of Psychiatry (1983)

The authors administered the dexamethasone suppression test to 14 children aged 5-12 years who met the Research Diagnostic Criteria and DSM-III criteria for major depressive disorder. The dexamethasone dose used was 20 micrograms/kg; 2 subjects were nonsuppressors.
PTH-236 An audit of feeding times in paediatric patients undergoing emergency appendicectomy
Authors: T Noone, M Nixon, Adam Revill, Gandrapu Srinivas
Journal: Gut (2015)

<h3>Introduction</h3> Children, like adults, are required to fast before general anaesthesia to reduce the volume and acidity of stomach contents. Prolonged fasting can have significant physiological and psychological effects on children. Current guidelines suggest children should fast preoperatively for 6 and 2 h with regard to food and clear fluids respectively.<sup>1</sup>Control over operative and therefore fasting times for emergency surgery can be challenging. This audit aimed to compare local practice to fasting guidelines with respect to paediatric emergency appendicectomy. <h3>Method</h3> This audit is a retrospective review of children between 5–16 years of age undergoing emergency appendicectomy from April 2013 to April 2014 in our District General Hospital. A standard was set for fasting of 6–7 h for food and 2–2.5 h for clear fluids. <h3>Results</h3> 46 paediatric patients underwent an emergency appendicectomy in the audit period, one of which had to be excluded due to poor documentation. Patients ranged from 5–15 years, with an average age of 11 years. The average starvation for food was 11 h 49 min, with 29% of patients reaching the target (6–7 h). The average time for starvation for clear fluids was 8 h 48 min, with only 2% of patients reaching the target (2–2.5 h). The documentation around the administration of IV fluids was so poor that it had to be excluded. <h3>Conclusion</h3> Patients were inappropriately starved preoperatively, with only 29% and 2% of patients meeting current guidelines with regards to food and clear fluids. This is unlikely to be specific to our hospital and so should prompt a review of the delivery of emergency services. Both our general surgical and anaesthetic departments are currently looking into educating all members of the team regarding feeding times and the introduction of preoperative drinks. <h3>Disclosure of interest</h3> None Declared. <h3>Reference</h3> Brady MC, Kinn S, Ness V, O’Rourke, Randhawa N, Stuart P. Preoperative fasting for preventing perioperative complications in children (Review). <i>Cochrane Database Syst. Rev</i>. 2009;(4)
Survival of Patients With Cancer of the Stomach, Connecticut, 1935–54&lt;xref ref-type="fn" rid="FN1"&gt;2&lt;/xref&gt;
Authors: Fred Ederer, Sidney J. Cutler, Henry Eisenberg, M.D., John R. Keogh
Journal: JNCI Journal of the National Cancer Institute (1960)

We are presenting a detailed 10-year survival analysis by stage, age, calendar period of diagnosis, and type of treatment for patients with cancer of the stomach diagnosed in the State of Connecticut between 1935 and 1954. Observed survival is measured relative to expected survival in the general population. Among patients diagnosed 1935–44, about 1 out of 5 who were expected to survive the 1st year after diagnosis, in fact survived; of those expected to live from the end of the 1st year through the 5th year, 1 out of 3 survived. Mortality among the 5-year survivors was far greater than that of persons in the general population of similar age. Patients diagnosed 1945–54 experienced slightly higher 5-year survival than those diagnosed 1935–44; this improvement in length of survival was associated with an increase in the percent of patients treated by surgical intervention and an increase in the survival time of the surgically treated patients. The data suggest that the delay from onset of symptoms to treatment was not shortened, but that mortality from operations was reduced. Five-year survival rates for stomach cancer in Connecticut are similar to the average obtained at 8 treatment centers in the United States.
Comparison of sunitinib (su) versus temsirolimus (tem) in patients (pts) with poor-risk metastatic renal cell carcinoma (prmRCC).
Authors: Daniel Keizman, Victoria Neiman, Avishay Sella, Eli Rosenbaum, Maya Gottfried, David Sarid, Eliahu Gez, Natalie Maimon, Michael Anthony Carducci, Hans J. Hammers, Mario A. Eisenberger, Victoria J. Sinibaldi, Avivit Peer, Avivit Neumann, Svetlana Kovel, Wilmosh Mermershtain, Keren Rouvinov, Ilan Feldhamer, Raanan Berger, Ariel Hammerman
Journal: Journal of Clinical Oncology (2016)

539 Background: Based on a single phase 3 study, the mTOR inhibitor tem was approved as 1 st line therapy for prmRCC. However, in daily practice, prmRCC pts are often treated with the VEGFR and PDGFR inhibitor su. We aimed to compare the clinical effectiveness of su vs tem in prmRCC pts. Methods: We performed an international multicenter retrospective study of pts with prmRCC (HENG criteria), who were treated in 8 centers across 2 different countries. 31 pts were treated with 1 st line tem. Each tem treated pt was individually matched with a 1 st line su treated pt, by clinicopathologic factors. The effect of tx type (tem vs su) on clinical benefit, progression free survival (PFS) and overall survival (OS), was tested using a chi-square test and partial likelihood test from cox model. Furthermore, univariate and multivariate analyses of association between clinicopathologic factors and tx type (tem vs su), and outcome were performed using the entire pt cohort (n=62). Results: The groups were matched by age (median 65), gender (male 68%), prior nephrectomy (58%), renal cell carcinoma histology (clear cell 81%), smoking status (active in 35%), use of angiotensin system inhibitors (42%), and pre-tx neutrophil to lymphocyte ratio &gt;3 (58%). In tem vs su treated pts, clinical benefit (partial response + stable disease) was 61% (n=19) (partial response 6%, n=2) vs 71% (n=22) (partial response 29%, n=9) (p=0.62). Median PFS was 5 vs 8 mos (p=0.08), and median OS 9 vs 17 mos (p=0.03). In multivariate analyses of the entire pt cohort (n=62), su tx was independently associated with OS (HR 0.6, p=0.001). Conclusions: In prmRCC patient, the VEGFR inhibitor su may be associated with an improved outcome vs the mTOR inhibitor tem.
The role of social support in the functioning of patients with unipolar depression
Authors: J A Flaherty, F M Gaviria, E M Black, E Altman, T Mitchell
Journal: American Journal of Psychiatry (1983)

The authors studied 44 outpatients with unipolar depression to determine the association among social support systems, life events, social adjustment, and depressive symptoms. Social support had a reasonably high correlation with outcome measures. Patients with high social support had significantly better scores than those with low social support on the Hamilton Rating Scale for Depression and the Social Adjustment Rating Scale Self-Report. These data corroborate the hypothesis that social support systems play a critical role in the ongoing functioning of a defined group of depressed patients.
AB0787 Evaluation of Longitudinal Association Between Changes in Facet Joints and Administration of Tumor Necrosis Factor Inhibitors in Ankylosing Spondylitis Using CT
Authors: S.W. Chung, R. Song, Y.-A. Lee, S.-J. Hong, H.-I. Yang, S.-H. Lee
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Ankylosing spondylitis (AS) is a chronic inflammatory arthropathy, which primarily affects the sacroiliac joints and axial skeleton. In AS, involvement of the facet joints results in both back pain, and limitation of spinal mobility. Involvement of facet joint in AS have been reported in several articles. Improvements in spinal mobility in AS after treatment with tumor necrosis factor (TNF) inhibitors have been reported. However, TNF inhibitors were reported to increase or to not inhibit structural damage progression in AS, as assessed using plain radiography. It seems logical that improvement in spinal mobility by TNF inhibitors would result from their effects on facet joint. <h3>Objectives</h3> To study the effect of TNF inhibitors on progressive facet joint damage in AS patients. <h3>Methods</h3> AS patients who were treated with TNF inhibitors and had 2 sets of spinal computed tomography (CT) scans, a median of 50.96±5.47 months apart, were included (n=25). Radiographic severity of facet joints was assessed by a new scoring system using CT. Total facet joints from C2-C3 to L5-S1 were scored: erosions 1, subchondral sclerosis 2, partial ankyloses 3, and total ankyloses 4. We compared the longitudinal effects of TNF inhibitors with non-TNF inhibitor treatment by scoring of facet joint of 25 AS patients who were not treated by TNF inhibitors. <h3>Results</h3> The mean age were 30.9±6.7 years and no significant differences in gender distribution (male, 84% vs. 88%). The only significant difference between two groups was that TNF inhibitor treated group had longer disease duration (years, 4.15±4.02 vs. 2.13±1.73, <i>p</i>=0.001). Significant increases in CT score in the total spine and T-spine were observed in both groups at follow-up time points (Table 1). The rates of increase in CT score of the total spine were similar in both groups, whereas, the rates of increase in CT score of the T-spine was lower in the TNF inhibitor treated group than in the non-TNF group. However, the difference was not statistically significant (<i>p</i>=0.387; Fig. 1). <h3>Conclusions</h3> Treatment with TNF inhibitors did not prevent the radiographic progression of facet joints damage in AS patients <h3>References</h3> Wilkinson M, Bywaters EG. Clinical features and course of ankylosing spondylitis; as seen in a follow-up of 222 hospital referred cases. Ann Rheum Dis. 1958;17:209-28. 2Machado MA, Barbosa MM, Almeida AM et al. Treatment of ankylosing spondylitis with TNF blockers: a meta-analysis. Rheumatol Int. 2013;33:2199-213. <h3>Disclosure of Interest</h3> None declared
Research priorities in bronchiectasis: a consensus statement from the EMBARC Clinical Research Collaboration
Authors: Stefano Aliberti, Sarah Masefield, Eva Polverino, Anthony De Soyza, Michael R. Loebinger, Rosario Menendez, Felix C. Ringshausen, Montserrat Vendrell, Pippa Powell, James D. Chalmers
Journal: European Respiratory Journal (2016)

Bronchiectasis is a disease of renewed interest in light of an increase in prevalence and increasing burden on international healthcare systems. There are no licensed therapies, and large gaps in knowledge in terms of epidemiology, pathophysiology and therapy. The European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC) is a European Respiratory Society (ERS) Clinical Research Collaboration, funded by ERS to promote high-quality research in bronchiectasis. The objective of this consensus statement was to define research priorities in bronchiectasis. From 2014 to 2015, EMBARC used a modified Delphi process among European bronchiectasis experts to reach a consensus on 55 key research priorities in this field. During the same period, the European Lung Foundation collected 711 questionnaires from adult patients with bronchiectasis and their carers from 22 European countries reporting important research priorities from their perspective. This consensus statement reports recommendations for bronchiectasis research after integrating both physicians and patients priorities, as well as those uniquely identified by the two groups. Priorities identified in this consensus statement provide the clearest possible roadmap towards improving our understanding of the disease and the quality of care for patients with bronchiectasis.