tbuckley/cabot-search huggingface dataset:
THE TREATMENT OF ANGINA PECTORIS WITH KHELLIN*
Authors: JAMES J. CONN
Journal: Annals of Internal Medicine (1953)

Article1 January 1953THE TREATMENT OF ANGINA PECTORIS WITH KHELLINPART IIJAMES J. CONN, M.D., R. W. KISSANE, M.D., F.A.C.P., RUTH A. KOON, M.D., F.A.C.P., THOMAS E. CLARK, M.D.JAMES J. CONN, M.D.Search for more papers by this author, R. W. KISSANE, M.D., F.A.C.P.Search for more papers by this author, RUTH A. KOON, M.D., F.A.C.P.Search for more papers by this author, THOMAS E. CLARK, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-38-1-23 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptIn Part I of this paper1 we reported the results of treating a series of 42 patients afflicted with the anginal syndrome with khellin (visammin) in the form of Ammivin®. The present communication is concerned with a similar series of 42 patients with angina pectoris who were treated with a brand of khellin known as Khelloyd®.† We discussed previously the history, pharmacology and clinical aspects of the drug, and this material will not be repeated.METHODForty-two patients with the anginal syndrome due to arteriosclerotic heart disease were selected to receive khellin orally and/or parenterally. These patients constituted a different...Bibliography1. ConnKissaneKoonsClark JJRWRATE: The treatment of angina pectoris with khellin, Part I, Ann. Int. Med. 36: 1173, 1952. LinkGoogle Scholar2. SchoenbergSina AA: Xanthotoxin from the fruits of Ammi majus , Nature, London 161: 481, 1948. CrossrefGoogle Scholar3. ScottSeiwert RCVJ: The treatment of angina pectoris with pure crystalline khellin, Ann. Int. Med. 36: 1190, 1952. LinkGoogle Scholar4. Kleiber EE: Parenteral administration of Ammivin (khellin) in the treatment of coronary disease, Ann. Int. Med. 36: 1179, 1952. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: JAMES J. CONN, M.D.; R. W. KISSANE, M.D., F.A.C.P.; RUTH A. KOON, M.D., F.A.C.P.; THOMAS E. CLARK, M.D.Affiliations: Columbus, Ohio*Received for publication June 20, 1952.From the Cardiological Departments of the College of Medicine of the Ohio State University and White Cross Hospital, Columbus, Ohio.†50 mg. uncoated tablets of khellin supplied by Lloyd Brothers, Cincinnati, Ohio. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byIntegrated Approach to Coronary Artery DiseaseDie Coronarerkrankungen. Coronarinsuffizienz, Angina pectoris und HerzinfarktGlucagon and the Regulation of Carbohydrate MetabolismDrug evaluation in angina pectoris: Khellin, heparin, PeritratePURIFICATION AND CRYSTALLIZATION OF GLUCAGON 1 January 1953Volume 38, Issue 1Page: 23-27KeywordsAnginaCardiovascular therapyClinical pharmacologyDrugsHospital medicine ePublished: 1 December 2008 Issue Published: 1 January 1953 PDF downloadLoading ...
OP0089 Big Data Sjögren Project (Eular-SS Task Force International Network): Characterization at Diagnosis of 5027 Patients with Primary Sjögren Syndrome
Authors: P. Brito Zeron, B.A. Kostov, M. Zeher, E. Theander, J.-E. Gottenberg, C. Baldini, L. Quartuccio, R. Priori, M. Kvarnstrom, A. Kruize, G. Hernández Molina, S. Praprotnik, D. Isenberg, E. Bartoloni, A. Rasmussen, R. Solans, V. Valim, R. Giacomelli, S. Carsons, D. Hammenfors, C. Vollenweider, F. Atzeni, T. Mandl, S. De Vita, M. Wahren-Herlenius, J. Sanchez-Guerrero, R. Gerli, K. Sivils, S. Mowa, J.G. Brun, X. Mariette, M. Ramos-Casals
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Objectives</h3> To analyse the epidemiological, clinical and immunological characteristics of an international cohort of patients diagnosed with primary Sjögren syndrome (SS) according to the 2002 AE criteria. <h3>Methods</h3> The Big Data Sjögren Project is an international, multicentre registry formed in 2014 to take a "high-definition" picture of the main features of primary SS at diagnosis by merging international SS databases. By January 2015, 5027 consecutive patients fulfilling the 2002 classification criteria for primary SS were included from 9 European and 4 American countries. <h3>Results</h3> The cohort included 4714 (94%) women (female:male ratio, 15:1), with a mean age at diagnosis of primary SS of 54 years (range, 10-97), of which 94% were Caucasian and 88% lived in European countries. The frequency of fulfilment of the 2002 criteria was: 94.4% for dry eye, 92.9% for dry mouth, 88.5% for positive salivary gland biopsy, 85.9% for positive ocular tests, 74.8% for positive oral tests and 70.9% for positive Ro/La autoantibodies. As a minimum of 4 of the 6 criteria are required for fulfilment, the percentage of diagnostic tests performed varied: Ro/La autoantibodies were tested in 99.5% of patients, ocular diagnostic tests (Schirmer9s test and/or corneal stainings) were made in 90.2%, oral tests in 76.7% and salivary gland biopsy in 72% of patients. Systemic involvement at diagnosis was retrospectively measured using ESSDAI definitions in 3314 patients and included articular involvement (35.2%), glandular involvement (19.3%), lymphadenopathy (10.7%), cutaneous involvement (9%), constitutional involvement (8.4%), respiratory involvement (7.3%), peripheral nervous system involvement (5.2%), renal involvement (2.2%), central nervous system involvement (1.7%) and muscular involvement (1.2%). With respect to laboratory abnormalities, 43.3% of patients showed biological abnormalities and 24.7% haematological abnormalities according to ESSDAI definitions. <h3>Conclusions</h3> In this international cohort of 5027 patients with primary SS, most non-sicca clinical features and laboratory abnormalities present at diagnosis are not included in the current criteria; their inclusion in future proposed classification criteria should be evaluated. <h3>Disclosure of Interest</h3> None declared
PTU-302 The ‘jaundice hotline’ service: a large district general hospital experience
Authors: EA Selvaraj, N Chandra, J Booth
Journal: Gut (2015)

<h3>Introduction</h3> The ‘Jaundice Hotline’ was introduced in our hospital in 2013 to facilitate prompt referral of patients with acute onset jaundice in the community via a dedicated ambulatory pathway to expedite appropriate management of biliary obstruction. The faxed referrals are reviewed by a consultant gastroenterologist who requests appropriate imaging or intervention. The results are tracked by a designated secretary and actioned by the consultant. In 2014, we negotiated with our radiology department for once a week dedicated ultrasound and MRCP slots for patients on this pathway. We present data from our experience of developing this service over a 2-year period. <h3>Method</h3> All referrals from the database in 2013 and 2014 were analysed retrospectively. We calculated the time intervals from referral to first consultant decision and time intervals between subsequent investigations before biliary intervention. We divided the data into three groups: all pathology, choledocholithiasis and hepatobiliary cancers. The effect of introducing dedicated ultrasound and MRCP slots were analysed by comparing the mean times between the two years. <h3>Results</h3> A total of 203 referrals (n = 109 in 2013, n = 94 in 2014) were analysed: choledocholithiasis (n = 72), hepatobiliary cancers (n = 32), cholelithiasis (n = 36), liver disease (n = 23) and others (n = 40). For all pathology, we managed to half the average time from referral to first decision by a consultant in 2014. The mean waiting time for ultrasound as the first choice of investigation improved by 3.2 days and for MRCP by 3.1 days in 2014. It took on average 3.2 days longer to obtain a CT in 2014. For choledocholithiasis, the time interval from referral to ERCP in 2013 (2–49 days, mean = 18.1) were similar to 2014 (2–47 days, mean = 17.0) despite mean improvement of 2.2 days and 2.8 days in the waiting times for ultrasound and MRCP respectively. This was due to selected cases where CT was also required as it took on average 5.8 days longer to obtain a CT in 2014 in this group. For cancers, the time from referral to biliary decompression (ERCP/PTC) improved by 3.5 days from 2013 (9–34 days, mean = 20.9) to 2014 (4–29 days, mean = 17.4). The mean time from imaging to MDT was 5.9 days in 2013 and from MDT to biliary intervention was 3.1 days. This trend was similarly observed in 2014 at 5.1 days to MDT and 3.4 days to intervention in 2014. The majority of the time was spent waiting for CT scan. <h3>Conclusion</h3> The positive impact of having dedicated ultrasound and MRCP slots to reduce waiting times for biliary intervention has overall been dampened by the increasing pressures on cross-sectional imaging in hospital medicine. We aim to conduct subanalysis of cholangitis and admission rates for this cohort to negotiate dedicated CT scan slots for this pathway to improve the efficiency of outpatient management of biliary obstruction. <h3>Disclosure of interest</h3> None Declared.
PTU-327 An evaluation of the effect of using an acetic acid protocol for the detection of dysplasia in barrett’s oesophagus in a district general hospital setting: Abstract PTU-327 Table 1
Authors: S Ghuman, K Asghar, J Evans, S Kakhi, N Hawkes
Journal: Gut (2015)

<h3>Introduction</h3> Studies have suggested that mucosal enhancement techniques, such as acetic acid (AA) spray may increase detection of advanced dysplasia during surveillance of Barrett’s oesophagus. A standardised AA protocol was adopted by 3 consultants and a nurse endoscopist (NE) from 2011, other endoscopists continued a conventional methodology for surveillance. We aimed to investigate the impact of the use of a standard protocol (HD image in WL, FICE assessment and use of 3% AA dye spray, with targeted biopsies and Seattle protocol biopsies) on the detection of all dysplasia and advanced dysplasia (HGD, or in-situ adenocarcinoma). <h3>Method</h3> We searched the HICCS Endoscopic Reporting System for all endoscopies where Barrett’s oesophagus was detected between October 2010 and October 2014 (n = 587). Only specific surveillance cases were included (index and specific recall cases excluded). Endoscopy reports were checked and histology results retrieved from the Welsh Clinical Portal system. Differences in dysplasia detection rates for the AA Protocol (AA) or ‘standard’ white light endoscopy (WLE) were tested using the Chi-squared test, with significance level set at p &lt; 0.05. <h3>Results</h3> In the 4 year study period, 367 Barrett’s surveillance procedures were performed in 220 patients. The AA protocol was applied during 86 procedures, standard WLE in 269 procedures. The dysplasia rates are shown in the Table 1. There was a significant increase in the detection rate of all types of dysplasia (p &lt; 0.00001), and advanced dysplasia (p = 0.007) in the AA protocol group. Dysplasia detection rates achieved by the trained NE were comparable with consultants using AA protocol and higher than consultant and NE colleagues not using AA protocol. <h3>Conclusion</h3> Introduction of a Standard AA Protocol in our Health Board was associated with higher detection of dysplasia compared with white light endoscopies performed during the same time interval. The training of a nurse endoscopist to provide this service has proved both feasible and effective. All surveillance patients now attend pre-booked lists where AA protocol is used. <h3>Disclosure of interest</h3> None Declared.
Training police officers to distinguish mental illness
Authors: S S Janus, B E Bess, J J Cadden, H Greenwald
Journal: American Journal of Psychiatry (1980)

The authors evaluated the impact of short-term intensive instruction by mental health professionals on police officers' attitudes toward the mentally ill and on their ability to distinguish between mental illness and other behavior. Compared with a control group who did not receive the special training the 80 officers showed increased interest in and sympathy for psychiatric problems.
Treatment of lysosomal storage disorders
Authors: A. B Mehta
Journal: BMJ (2003)

Increased awareness and diagnosis are important as treatment is now feasible 

The lysosomal storage disorders have hitherto justifiably been consigned to the small print sections of textbooks of biochemistry and internal medicine and optional modules of the undergraduate medical curriculum. However, new treatments may halt–or even reverse–progressive organ damage. The substantial morbidity and premature mortality of these disorders may be preventable.

The lysosomal storage disorders are a group of 40 or so rare disorders, due to inherited deficiency of individual enzymes. Organ damage arises from progressive accumulation of the substrates for the missing enzyme. The commonest lysosomal storage disorders, with an incidence of 1 in 60 000-120 000,1–3 are Gaucher's disease (glucocerebrosidase deficiency), Anderson-Fabry disease (α galactosidase deficiency), and mucopolysaccharidosis I (α l-iduronidase deficiency). Enzyme replacement therapy for each of these three conditions is licensed and available in Europe.

The rarity of these disorders makes the potential market for therapeutic products very small while the costs of research, development, clinical trials, and marketing are comparable to those for drugs with a much larger potential market. Furthermore, it is not enough simply to treat patients with recombinant enzymes– modifications must be made so that the infused enzyme is targeted to lysosomes in relevant cells and tissues.

Glucocerebrosidase (Cerezyme, Genzyme Corporation, Massachusetts, United States) has been available for over 10 years and …
Methysergide Alopecia
Authors: Kamal Sadjadpour
Journal: JAMA (1974)

<h3>To the Editor.—</h3> May I call the attention of your readers to an uncommon side effect of methysergide, which is used in the prophylaxis of migraine and related headaches? A woman, aged 30, subject to frequent migraine attacks, was given methysergide, 2 mg twice daily. After two months she began losing scalp hair, although the migraine attacks remained in abeyance. Methysergide dosage was reduced to 2 mg daily. On this regimen, she had a few headaches, but hair loss continued, requiring a wig. After one month, methysergide therapy was discontinued and hair loss was reversed. This is a highly uncommon side effect of methysergide and has been reported only rarely. The hair loss may be self-limiting, despite the use of the drug. Spontaneous hair loss in patients with migraine or other disorders is also reported, but in this case seems unlikely.
Upsurge of hepatitis A in the Netherlands – early 1998
Authors: F Termorshuizen, M  J W van de Laar
Journal: Eurosurveillance (1998)

Far more cases of hepatitis A were identified in the Netherlands in the first five months of 1998 than in the same period of 1997. In order to investigate the reasons for this upsurge we compared the notified cases of hepatitis A in the first five months
PTH-154 Changes in incidence and management of upper gi perforation over 14 years
Authors: R Mclean, M Jones, D Fung, S Dixon, I McCallum
Journal: Gut (2015)

<h3>Introduction</h3> Procedures and admissions for upper GI perforation are common in acute general surgical practice. This study aimed to describe changes in incidence and outcomes of such patients over the last 14 years. <h3>Method</h3> Trust information departments at Newcastle upon Tyne and Gateshead Health foundation trusts were contacted to request data for all emergency admissions under a general surgeon from 2000–2014 after necessary approvals. Cases were identified using ICD-10 codes: K25, K26, K27, and K28, with subdivisions 0.1, 0.2, 0.6, and 0.7. Data on demographics, co-morbidities, interventions and outcomes were also collected and analysed. <h3>Results</h3> Upper gastrointestinal perforation (gastric and duodenal) accounted for 310/80,814 admissions (0.38%). The mean age was 56.9 years (95% CI: 54.9 to 58.9 years) and 62.6% of patients were male. The overall mean LOS was 17.9 days (95% CI: 14.7 to 21.2 days). 68 patients were managed conservatively (mean LOS 21.0 days), 227 patients were managed by open repair (LOS 17.7 days) and 15 by laparoscopic repair (LOS 6.6 days). There were 50 inpatient deaths (16.1%), 37/225 (16.4%) following an open repair, and 13/68 (19.1%) with conservative management. A laparoscopic approach was used in 9.6% of perforation repairs in the 2005–09 period and 8.1% in 2010–14 with no inpatient mortality. Operative management occurred in 81.3% (74/91) in 2000–04, 83.2% (94/113) in 2005–09, and 69.8% (74/106) in 2010–14. The inpatient mortality rate from UGI perforation has fallen from 28.6% to 15.9% and 5.7% over the respective time periods. <h3>Conclusion</h3> Mortality from upper GI perforation has fallen significantly over the last 14 years. There is a trend towards increased conservative management although this is unlikely to account for all improvements and optimisation of ‘adjuvant’ medical therapy may be important. Laparoscopic repair has impressive results though case selection may be an important factor. <h3>Disclosure of interest</h3> None Declared.
THU0096 Correlation Between Ultrasound Doppler Imaging and Circulating Vascular Endothelial Growth Factor in Rheumatoid Arthritis Patients Following Anti-TNF-α Treatment
Authors: E.M. Bartels, H. Bliddal, B. Danneskiold-Samsøe, K. Ellegaard
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Successful anti-TNF-α treatment of rheumatoid arthritis (RA) causes a decrease in inflammation with reduced blood flow in the synovial tissue of the affected joints. Ultrasound Doppler (USD) is used as an estimate of the amount of blood flow in a tissue and is sensitive to measurements of small blood vessels. USD is used as a marker of disease activity in RA, where inflammation causes forming of new small blood vessels. Vascular Endothelial Growth Factor (VEGF) is suspected to be a main player in angiogenesis during inflammation. A role of VEGF in the pathogenesis of RA is supported by elevated serum levels in RA patients compared to healthy controls. <h3>Objectives</h3> In a cohort of anti-TNF-α treated RA patients, to investigate if a change in USD signal following treatment over a year is associated with change in VEGF, and if VEGF is correlated to disease activity. <h3>Methods</h3> 73 out of a cohort of 109 RA patients in anti-TNF-α treatment (adalimumab, etanercept or infliximab), 53 women and 20 men, age 57±13 years, with inflammation of wrist joints were assessed prior to starting anti-TNF-α therapy, and following treatment. USD examination was carried out on the most affected wrist, and fasting blood samples were collected, with no prior strenuous physical activity, at baseline, and after 180 days and 1 year of treatment. USD was measured as colour fraction (CF<sub>Mean</sub>), and VEGF was measured by ELISA (Platinum, Bioscience) in EDTA-plasma at each time point. DAS28<sub>CRP</sub> was determined. Linear regression was applied, using Pearson9s correlation coefficient and a significance level at 0.05. The study was approved by the local ethics committee (KF01-045/03). <h3>Results</h3> Full data set was available for 64 patients at 180 days and for 58 patients at 1 year. DAS28<sub>CRP</sub> at baseline was 5.1±1.3. VEGF was in the range earlier reported for RA patients. No correlation was found between CF<sub>Mean</sub> and VEGF at baseline (R<sup>2</sup>=0.006; P&gt;0.05), or in change in CF<sub>Mean</sub> and change in VEGF at 180 days (R<sup>2</sup>=0.0016; P&gt;0.05) and 1 year (R<sup>CRP</sup> and VEGF at baseline (R<sup>2</sup>=0.05; P&gt;0.05). <h3>Conclusions</h3> In our cohort of RA patients, no correlation was seen between VEGF plasma level and USD activity in an affected wrist joint prior to start of an anti-TNF-α of treatment, or between changes in USD and changes in VEGF following 180 and 365 days of treatment. At baseline VEGF level did not correlate to DAS28<sub>CRP</sub> either. These results do not support a role of VEGF, although important for angiogenesis, as a determinant for the increased perfusion in RA. <h3>Acknowledgements</h3> The study was supported by the Danish Rheumatism Association and the OAK Foundation <h3>Disclosure of Interest</h3> None declared
The St. Louis Community Homes Program: graduated support for long-term care
Authors: H Sandall, T T Hawley, G C Gordon
Journal: American Journal of Psychiatry (1975)

The authors describe a group-home program that has been operating successfully for three years in St. Louis, Mo. The program offers ex-mental hospital patients the opportunity to gradually acquire experience in living independently in the community. The success of a living arrangement in which an apartment is shared by a group of patients demonstrates long-term chronic patients can often adjust to minimally supervised living arrangements and that many ex-mental hospital patients can use this experience as a springboard to personal growth and eventual autonomy.
Differences in nocturnal melatonin secretion between melancholic depressed patients and control subjects
Authors: R Brown, J H Kocsis, S Caroff, J Amsterdam, A Winokur, P E Stokes, A Frazer
Journal: American Journal of Psychiatry (1985)

The authors took multiple serum samples for measurement of melatonin between 4:30 p.m. and 7:30 a.m. in seven male depressed patients with melancholia and five healthy male control subjects and found that melancholic patients had a significantly lower rise of melatonin. They also compared a second, separate group of 14 women and five men suffering from melancholic depression with seven healthy male control subjects and nine depressed women without melancholia. The melancholic patients had a significantly lower concentration of serum melatonin at 11:00 p.m. than either the control subjects or the nonmelancholic depressed patients. These findings support the possibility that the functioning of the pineal gland is altered in these patients.
PERIODIC PHYSICAL EXAMINATION
Authors: R S ten Cate
Journal: JAMA (1924)

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