tbuckley/cabot-search huggingface dataset:
AB0934 Cervical Infectious Spondylodiscitis: About Three Cases
Authors: G. Imane, G. Imen, S. Jemmali, R. Abid, R. Dhahri, F. Laajili, L. Bassem, B. Riadh, N. Ben Abdelhafidh, S. Othmani
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Cervical spondylodiscitis diseases are rare. They represent 3 to 15% of spine infections. Moreover, they present some slight epidemiological and clinical differences.It can endanger the patient either locally because of severe destruction, often with concomitant neurological deficits <h3>Objectives</h3> To report some cases of cervical spondylodiscitis and presenting its characteristics <h3>Methods</h3> We report 3 cases (two women and one man) with a mean age of 44 years. <h3>Results</h3> Causative agents were a mycobacterium tuberculosis (MT) in two cases and a staphylococcus in one case. Infection of the upper cervical spine (C1-C2) was noted in one case. Disco vertebral needle biopsy permitted, in one case, to make a bacteriological diagnosis (MT). Spondylodiscitis is associated with paravertebral abscess (one case), epiduritis (2 cases), spinal cord compression (2 cases), vertebral instability (2 cases). Medical management with A combined broad-spectrum antibiotic therapy was performed associated with orthopedic immobilization of the spine and was successful in all cases. <h3>Conclusions</h3> Risk of spine instability and frequency of neurological complications (observed in 20 to 40% of cases) make of cervical spondylodiscitis a serious disease. Urgent and multidisciplinary management is necessary, based on adapted antibiotherapy and orthopedic and surgical immobilization of the cervical spine.Surgery is indicated if a neurological deficit, symptoms of sepsis, epidural abscess formation with consecutive stenosis, instability or severe deformity were present <h3>Disclosure of Interest</h3> None declared
Soundings: Alphabet soups
Authors: George Dunea
Journal: BMJ (2001)

In June, regulatory authorities warned consumers against using colloidal silver, now widely advertised on the internet as a powerful antimicrobial medication. By now this agent has internet chat groups, user sites, accounts of how silver has an honourable history going back to the middle ages, and sites selling devices for making one's own colloidal silver inexpensively at home. Prospective buyers are told to use silver at the first sign of a cold by rubbing it on to the oral and nasal mucosae. Other uses are listed in the form of an alphabet soup which includes acne, allergies, arthritis, athlete's foot, burns, cancer, candida, chronic diarrhoea, cold, cuts, ear infections, emphysema, eye infections, flu, fungal infections, giardiasis, head lice, herpes, hepatitis B and C, hypertension, lyme disease, osteomyelitis, psoriasis, ringworm, sinusitis, skin infections, sores, surgery, throat infections, ulcerative colitis, urinary infections, warts, wounds, and yeast infections.

Space does not allow me to list the many other alphabet soups that may be found on the internet. We find, for example, that sufferers of the common cold may be helped by Asian ginseng, astragalus, blackberry, boneset, coltsfoot, elderberry, eleuthero, eucalyptus, goldenseal, horseradish, marshmallow, meadowsweet, mullein, myrrh, red raspberry, sage, schisandra, slippery elm, usnea, wild indigo, and yarrow.

Also on the internet, we find advertised the many disorders helped by local or systemic administration of St John's wort. There are similar alphabet soups for garlic, for vitamin E, for zinc, and for glutamine.

But the best medicine is the redoubtable Life Extending Preparation. It is effective in allergies, Alzheimer's disease, amyotrophic lateral sclerosis, anaesthesia precautions, atherosclerosis, attention deficit, autoimmune disorder, cancer, catabolic wasting, depression, Down's syndrome, emphysema, gingivitis, HIV, hypertension, immune enhancement, influenza, macular degeneration, menstrual disorders, multiple sclerosis, muscle building, nails, neuropathy, oesophageal reflux, osteoporosis, parkinsonism, retinopathy, thrombosis, and wounds.

How much shorter is the list given by the great Paracelsus (1493-1541) for his Tincture of Philosophers: it merely cured cancer, colic, dropsy, falling sickness, fistulas, and noli-me-tangere.
SAT0097 Predicting Cardiovascular Risk in Patients with Rheumatoid Arthritis
Authors: R. Agca, A.M. van Sijl, A.E. Voskuyl, M.T. Nurmohamed
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Rheumatoid arthritis (RA) is a chronic inflammatory disease with an enhanced cardiovascular (CV) risk. Classical risk factors for cardiovascular disease (CVD) do not fully explain this elevated risk. Existing risk prediction models generally either underestimate or overestimate this CV risk in RA patients. Accurate tools for predicting the development of CVD in an RA population still lack. <h3>Objectives</h3> To investigate the predictive value of several clinical and soluble markers of CVD in a prospective observational cohort of longstanding RA patients. <h3>Methods</h3> Baseline sera and blood were collected and stored for 353 RA patients participating in an ongoing prospective cohort study to assess cardiovascular morbidity and mortality (CARRΈ study). Cardiovascular end points were defined as a verified medical history of coronary, cerebral or peripheral arterial disease. A backward selection model was used to identify predictor variables for incident CVD. Variables with a p-value above 0.1 were excluded. <h3>Results</h3> During 10 years of follow up 58 patients had developed CVD. The majority of the patients were female (65.7%) with a mean age of 63±6 years and a mean RA duration of 8±4 years. Male gender (OR 2.30, 95%CI 1.19 – 4.42; P=0.013), older age (OR 1.05, 95%CI 1.00 – 1.09; P=0.047) a higher systolic blood pressure (OR 1.02, 95%CI 1.01 – 1.04; P=0.005), an elevated serum creatinin level (OR 1.02, 95%CI 1.00 – 1.03; P=0.094) and a serum high density lipoprotein (HDL) below 1.0 mmol/l (OR 2.00, 95% CI 0.97 – 4.12; P=0.059) predicted CVD development in a multivariable model with an area under the receiver operating characteristics curve (AUC) of 0.75 (95%CI 0.69 – 0.81), indicating a moderate to good discriminatory capacity for CVD development within this population. RA duration, disease activity score (DAS28), rheumatoid factor (RF), anti-cyclic citrulline peptide antibody (anti-CCP), diabetes, smoking, body mass index (BMI), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), total cholesterol (TC), low density lipoprotein (LDL), triglycerides, apolipoprotein A-I (Apo A-I), apolipoprotein B (Apo-B) and serum uric acid didn9t predict CVD development (data not shown). <h3>Conclusions</h3> CV risk can be predicted by gender, age, systolic blood pressure, serum creatinine and serum HDL in patients with longstanding RA. Additional studies are needed to investigate whether adding other biomarkers related to CVD will improve the predictive capacity of this model. <h3>Disclosure of Interest</h3> None declared
The Production of Hepatic Tumors in Rats Ingesting Various Concentrations of &lt;italic&gt;p&lt;/italic&gt;-Dimethylaminoazo-Benzene&lt;xref ref-type="fn" rid="fn1"&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/xref&gt;
Authors: Julius White, Rosemary R. Hein
Journal: JNCI Journal of the National Cancer Institute (1951)

The Production of Hepatic Tumors in Rats Ingesting Various Concentrations of p-Dimethylaminoazo-Benzene Get access Julius White, Julius White National Cancer Institute3Bethesda, Md. Search for other works by this author on: Oxford Academic PubMed Google Scholar Rosemary R. Hein Rosemary R. Hein National Cancer Institute3Bethesda, Md. Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 12, Issue 1, August 1951, Pages 23–26, https://doi.org/10.1093/jnci/12.1.23 Published: 01 August 1951 Article history Received: 16 March 1951 Published: 01 August 1951
AB0712 Development of a “Renal Crisis Prevention Card” as an Education Tool to Improve Outcomes in High Risk Patients with Systemic Sclerosis (SSC)
Authors: L. Shapiro, L.A. Saketkoo, J. Farrell, K. Fligelstone
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Scleroderma renal crisis (SRC) is a devastating complication of SSc. The introduction of effective treatment with ACE inhibition (ACE-I) in 1979 dramatically reduced death as a near-immediate consequence of SRC. However, poor outcomes still occur with great frequency including chronic or temporary dialysis or death. Individuals with early, rapidly progressive diffuse disease and RNA polymerase III antibody positivity are at high risk for SRC. Prophylactic use of ACE-I in high risk patients has not demonstrated improved outcomes and may have negative consequences. Our goals were to identify associative causes of poor outcome and develop a targeted preventive intervention to address in accordance with findings. <h3>Methods</h3> A retrospective chart review at Royal Free Hospital scleroderma clinic between 1994-1999 identified and stratified 44 cases of SRC for long term outcomes (death, long-term dialysis, short-term dialysis, and no dialysis). Cases were then assessed for factors potentially related to outcomes: onset of symptoms, time to medical attention, and therapeutic management. Results directed development of SRC preventive intervention. <h3>Results</h3> Death or long-term dialysis was the outcome in approximately 50% of the cases reviewed. Three subgroups emerged as associative with poor outcomes: SSc patients with no previously established SSc diagnosis presenting as "malignant hypertension" SSc patients with an established SSc diagnosis but uninformed about SRC and misinterpreted symptoms or failed to recognize the urgency of seeking medical attention SSc patients who presented promptly for urgent outpatient medical care informing physician of SSc diagnosis, but were incorrectly treated with therapies other than ACE-I or initiation of ACE-I was without sufficiently rapid dose adjustment to achieve blood pressure control. Poor outcomes were correlated to delayed therapy, rather than drug failure. All patients in the "no dialysis/death" group were treated with ACE-I according to protocol. From these findings, a "scleroderma renal crisis prevention card" was developed. The card is dual-sided with one side for patients and the other for physicians unfamiliar with patient. <h3>Conclusions</h3> Despite availability of effective therapy, SRC is associated with poor outcomes often consequential to treatment delay and lack of knowledge of initial treating physicians. A "renal crisis prevention card" may improve health outcomes of high-risk patients as a method of educating patients and health care providers. <h3>Disclosure of Interest</h3> L. Shapiro: None declared, L. A. Saketkoo Grant/research support from: ACR/EULAR Exchange Awardee, J. Farrell: None declared, K. Fligelstone: None declared
Structural Determinants of Phenoxazine Type Compounds Required to Modulate the Accumulation of Vinblastine and Vincristine in Multidrug-Resistant Cell Lines
Authors: K N Thimmaiah, J K Horton, X D Qian, W T Beck, J A Houghton, P J Houghton
Journal: Cancer Communications (1990)

Phenoxazine and seven other structurally related compounds were investigated to determine whether they would increase accumulation of Vinca alkaloids in multidrug-resistant (MDR) GC3/C1 (human colon adenocarcinoma) and KB-ChR-8-5 (HeLa variant) cell lines. Among eight compounds examined, phenoxazine caused greater accumulations of vincristine (VCR) and vinblastine (VLB) than the other chemosensitizers. The structure-activity relationship of these compounds for anti-MDR activity suggested an ideal tricyclic ring structure with a basic nitrogen atom at position 10 for modulating the accumulation of Vinca alkaloids. Addition of oxygen to position 5 of the tricyclic ring system further increased the activity, implying that a highly electronegative element with one, or more, lone pair of electrons in the nucleus opposite to heterocyclic nitrogen was a requirement for better anti-MDR activity. The relationship between the concentration of phenoxazine and the potentiation of Vinca alkaloid accumulation in comparison to verapamil was examined. For VCR in GC3/C1 cells, maximal modulation indices were: for verapamil, 1.8; phenoxazine, 8.6; and for VLB, 1.3 for verapamil compared to 3.3 for phenoxazine. In KB-ChR-8-5 cells, for VCR the maximal modulating index values were 9.0 and 4.3, respectively, and for phenoxazine and verapamil and for VLB were 5.0 and 3.7, respectively. Accumulations of VLB in GC3/C1 cells were similar in the presence of 1 microM phenoxazine or 10 mM sodium azide plus 10 mM 2-deoxyglucose. The effects of verapamil and phenoxazine on the accumulation of Vinca alkaloid were additive. Further, phenoxazine decreased the efflux of VLB by 30% in KB-ChR-8-5 cell line and 10% in GC3/C1 cells. In addition to enhancing the cytotoxicities of VCR and VLB, phenoxazine competed relatively weakly for binding to P-glycoprotein with [3H]azidopine and moderately with [3H]azidoverapamil, at equal concentrations, suggesting that the multidrug transporter may be the primary target for phenoxazine.
Psychiatric disorders in patients with cerebrotendinous xanthomatosis
Authors: V M Berginer, N L Foster, M Sadowsky, J A Townsend, G J Siegel, G Salen
Journal: American Journal of Psychiatry (1988)

Cerebrotendinous xanthomatosis is a familial recessive disorder. Patients with the disorder present with tendon xanthomas, juvenile cataracts, dementia, and pyramidal and cerebellar abnormalities but have normal plasma cholesterol. High plasma cholestanol concentrations and abnormal bile acid metabolism are specific for this disease. The authors describe four patients with cerebrotendinous xanthomatosis and prominent psychiatric symptoms. In three of these patients appropriate diagnosis and treatment were delayed for years because the presence of cerebrotendinous xanthomatosis was not recognized. Early recognition of this potentially lethal disease is important because both the psychiatric and neurological symptoms respond to treatment with chenodeoxycholic acid.
Steady-state protriptyline levels in an outpatient population
Authors: J T Biggs, W H Holland, W R Sherman
Journal: American Journal of Psychiatry (1975)

The authors measured steady-state protriptylive levels in 12 outpatients undergoing treatment for depression. The steady-state level of protriptyline was surprisingly high compared with levels obtained when other tricyclic antidepressants were prescribed. This finding probably accounts for the effectiveness of protriptyline at low doses and its frequent side effects.
Massive splenomegaly in hairy cell leukemia.
Authors: M S Tallman, D Hakimian, L Peterson
Journal: Journal of Clinical Oncology (1998)

Article Tools Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.1998.16.3.1232 Journal of Clinical Oncology - published online before print September 21, 2016 PMID: 9508212 Massive splenomegaly in hairy cell leukemia. M S TallmanxM S TallmanSearch for articles by this author , D HakimianxD HakimianSearch for articles by this author , L PetersonxL PetersonSearch for articles by this author Show More Northwestern University Medical School, Chicago, IL, USA. https://doi.org/10.1200/JCO.1998.16.3.1232 PDF "Massive splenomegaly in hairy cell leukemia.." Journal of Clinical Oncology, 16(3), pp. 1232–1233© 1998 by American Society of Clinical Oncology
DNA Methylation in Cancer and Aging
Authors: Michael Klutstein, Deborah Nejman, Razi Greenfield, Howard Cedar
Journal: Cancer Research (2016)

Abstract DNA methylation is known to be abnormal in all forms of cancer, but it is not really understood how this occurs and what is its role in tumorigenesis. In this review, we take a wide view of this problem by analyzing the strategies involved in setting up normal DNA methylation patterns and understanding how this stable epigenetic mark works to prevent gene activation during development. Aberrant DNA methylation in cancer can be generated either prior to or following cell transformation through mutations. Increasing evidence suggests, however, that most methylation changes are generated in a programmed manner and occur in a subpopulation of tissue cells during normal aging, probably predisposing them for tumorigenesis. It is likely that this methylation contributes to the tumor state by inhibiting the plasticity of cell differentiation processes. Cancer Res; 76(12); 3446–50. ©2016 AACR.
Seroprevalence of Hepatitis B and C Virus in Two Institutions Caring for Mentally Handicapped Adults
Authors: M E Cramp, H C Grundy, R M Perinpanayagam, D E Barnado
Journal: Journal of the Royal Society of Medicine (1996)

Hepatitis B virus infection is common in institutions caring for the mentally handicapped. Hepatitis B virus and hepatitis C virus share routes of transmission but the prevalence of hepatitis C virus infection in this population is unknown. We have tested 101 patients from two institutions in South-East England caring for adults with mental handicap for the presence of hepatitis C antibody, hepatitis B core antibody, and if necessary hepatitis B surface antigen. None tested positive for hepatitis C antibody, but 43 had hepatitis B core antibody of whom 14 were chronic carriers positive for hepatitis B surface antigen. Unlike hepatitis B virus, hepatitis C virus infection appears to be uncommon in UK institutions.
PWE-107 Bone disease in primary biliary cirrhosis – is the risk higher than previously thought?
Authors: L Corless, F Majeed, G Abouda
Journal: Gut (2015)

<h3>Introduction</h3> Primary biliary cirrhosis (PBC) is common in gastroenterology practice. Bone disease is more common and fracture risk higher than the general population, although overall prevalence is unknown and risk generally assumed to be considerably lower in those without cirrhosis/severe cholestasis.<sup>1,2</sup>Since poor bone health can impact both quality of life and mortality, guidelines recommend assessment by bone densitometry (DEXA) for all with PBC, and consideration of calcium and vitamin D (Ca/vitD) supplementation.<sup>2</sup>We measured bone health in our patients and reviewed performance against guidelines. <h3>Method</h3> We performed a retrospective review of all patients (n = 121) with confirmed PBC in our centre. Both prevalence and development of bone disease were measured by including only those with at least 5 years follow up (n = 67). <h3>Results</h3> Our cohort was representative of the PBC population; the majority (92.4%) were female and older, and progression to cirrhosis uncommon (7.5%). 26.8% had evidence of chronic liver disease (CLD), and 2/3 had evidence of disease progression during follow up. 61% were on appropriate weight based dose of ursodeoxycholic acid; 10.4% were on no therapy. DEXA was performed in 66.7% at some time during follow up. Of those, 65.9% had bone disease (17 osteopenia, 12 osteoporosis). Fracture prevalence was 10.4%; most were not on prior bone protection (data not available n = 2). 53% of the cohort were on no bone protection, including 5 with osteopenia. The cohort was divided into those with/without CLD. Of those with CLD, (n = 18), 13 had DEXA of whom 69.2% were osteopenic/osteoporotic; most were on bone protection. Of those with no DEXA, only one was receiving Ca/vitD. Even in those with no evidence of CLD (n = 36), 44.4% were osteopenic/osteoporotic. Again, a notable proportion (33.3%) had no DEXA. We found no significant difference in bilirubin or alkaline phosphatase (AlkP) between those with/without bone disease, although there was a clear trend towards higher AlkP in longer-term, advanced disease. <h3>Conclusion</h3> The majority of the cohort had bone disease, and we found a higher than expected rate of fracture. We found a high prevalence of bone disease even in those with no evidence of advanced liver disease, a group previously considered low risk. This was accompanied by poor adherence to guidelines for DEXA and use of Ca/vit D. This suggests there are many undiagnosed patients with bone disease not receiving appropriate therapy, with subsequent implications for long-term health. We have developed a PBC management policy, highlighting the importance of bone health assessment and management. <h3>Disclosure of interest</h3> None Declared. <h3>References</h3> Collier JD, <i>et al</i>. Guidelines on the management of osteoporosis associated with chronic liver disease. <i>Gut</i>. 2002;<b>50</b>(Suppl I):i1–i9 EASL clinical practice guidelines: management of cholestatic liver diseases. J Hepatol. 2009;51:237–267
PTU-031 Hemospray use for the management of acute bleeding from upper gastrointestinal cancer: the russells hall experience
Authors: BR Disney, AK Kurup, H Muhammad, S Ishaq
Journal: Gut (2015)

<h3>Introduction</h3> Cancer of the upper gastrointestinal tract accounts for approximately 4% of acute upper gastrointestinal bleeding (UGIB) related admissions. The treatment of malignancy related bleeding is challenging due to the diffuse and widespread nature of bleeding. Hemospray (Cook Medical, Winston-Salem, North Carolina, USA), an inorganic haemostatic powder that allows a wide area of therapeutic coverage. To date little is known of its use in tumour related UGIB. The aim of this study was to assess feasibility and effectiveness of Hemospray in the treatment and palliation of malignancy related upper GI bleeding. <h3>Method</h3> Retrospective analysis of all malignancy related UGIB treated with Hemospray at Russells Hall Hospital. Patients were identified from the endoscopy database. Patient demographics, Hemospray use and the use of other therapeutic modalities were collected. Outcomes including primary haemostasis, rebleeding and mortality were obtained. <h3>Results</h3> Hemospray use was identified in 15 patients, on 19 occasions (range 1–3 per patient), with malignancy related UGIB. Mean patient age was 71 years, range 43–96 years; male gender 66.6% (n = 10). Mean haemoglobin on presentation was 72 ± 17 g/L and mean urea 10.9 ± 6.6 mmol/L. The bleeding was diffuse and widespread ooze in all cases. The tumour site was oesophageal 40% (n = 6), gastric 26.7% (n = 4) and duodenal 33.3% (n = 5). Hemospray was used as the primary haemostatic treatment on 89.5% of occasions (n = 17). On 2 occasions adrenaline was used first line. Primary haemostasis was achieved in 95% of cases (n = 18). In 1 patient the Hemospray delivery system failed; in this case Endoclot was used successfully. The median procedure duration was 18 min (range 9–50 min). The 7 day and 30 day rebleeding rate was 10.5% (n = 2) and 15.8% (n = 3) respectively. None of the patients required surgery or radiological intervention to arrest the bleeding. There were no documented complications of Hemospray therapy. Mortality was 5% (n = 1) and 16% (n = 3) at 7 and 30 days respectively. There were no bleeding related deaths; death was due to the underlying condition in all patients. Average length of stay was 19 days (range 3–101 days); excluding the outlier of 101 days the average length of stay was 9 days (range 3–27). One patient with gastric cancer had Hemospray applied on 3 occasions which palliated bleeding for approximately 2 months duration each time. <h3>Conclusion</h3> Overall Hemospray appears to be an effective haemostatic therapy for malignancy related UGIB and should be considered as a primary therapeutic modality in this setting. It may be used as a bridge to more definitive therapies such as radiotherapy or drug therapy (e.g. thalidomide, chemotherapy). <h3>Disclosure of interest</h3> None Declared.