tbuckley/cabot-search huggingface dataset:
SAT0170 Work-Related Disability in Behcet’S Syndrome: A British Series
Authors: P. Mehta, N. Ambrose, D. Haskard
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Behcet's syndrome (BS) is a rare, heterogenous inflammatory disorder which is most active during working years, thus affecting productivity. <h3>Objectives</h3> We aim to survey the frequency of and reasons for work-related disability among patients attending our tertiary referral BS centre and also how work may affect patients' health with respect to their Behcet's syndrome. <h3>Methods</h3> The proposal was discussed with the Behcet's syndrome society patient group and approval was obtained from the Research Ethics committee. A postal questionnaire survey was sent to 200 patients attending our BS clinic. Consent was implied, by return of questionnaires. <h3>Results</h3> 70 responses were received. 46% were male. The median age was 47 years. 78% were White British. 42% had high-school education, 31% university degrees and 16% vocational qualifications. 7% considered themselves to have significant co-morbidities. 19% were taking no medication, 49% steroids, 61% immunosuppressants and 17% TNF-blockers. 13% were homemakers, 21% retired (73% medically retired), 3% students, 54% employed and 9% unemployed. 81% of the 32 patients currently not working, had been working before BS was diagnosed. 84% of these patients stated they were not working because of BS. The most common reasons for this oral ulceration and the effects on speech (42%) and fatigue (29%). 31% patients felt their BS had improved after stopping work. Of the 54% working, 61% were full-time and 39% part-time. 53% had made changes to their work because of BS – reduced hours (43%), part-time work (32%) and changed job (25%). 65% felt their BS had improved after these changes. The mean number of sick days was 18, with 13 days attributed to BS. The mean visual analogue scale assessments for the effect of BS on productivity at work was 7, the effect of BS on regular activities was 4 and the effect of work on BS was 6. <h3>Conclusions</h3> Work-related disability in BS is high and underappreciated. A large number of patients give up work or change their work practice because of BS, particularly the effects of oral ulceration on speech. The perceived effects of BS on productivity at work and the effects of work on patients' health are considerable. <h3>Disclosure of Interest</h3> None Declared
A Clinical Lecture ON CHRONIC INTESTINAL STASIS; OR, OUR MECHANICAL RELATIONSHIP TO OUR SURROUNDINGS
Authors: W. A. Lane
Journal: BMJ (1924)

MOST of uts are unaware of the extraordinary and remark- able evolutionarv changes in the structure of the body wlichl develop very riapidly during a portion of the life- tinse of tlhe inidividual.Somile changes may be in progress manyyears before tie-y become recognizable, while others mzay appear in a few yeasrs or even in a few months or weeks.I'Whlile in the dissectinig room I studied the-chainges whiclh thse miecha'nics of-the labourer undergo in consequence of the heavy anid continuous woork he performs, and I soon fotunld that it was usually quite easy from the examination of the body to tell the occupation the labourer lhad followed d'uring life.I formiiulated three simple laws:* Kaolin, which is recommended to prevent (lecomposition in the intes- tines, niay be disp,ensed bv rul%bing tip with water atnd then (iradiually adding muicilage of tragacanth.It canl be flavouredl to taste.Details werei given by Dr. Pirie in the.JOURNAL of Novemiiber 24th, 1923 (p. 1011).lfeJ recommen(ds abotut 3 oz. of kaolin to 9 oz. of water, with 1 oz. of mucilage, and that a port wineglass be taken six times a day.
PWE-209 Endoscopy increases the risk of venous thromboembolism—case control study: Abstract PWE-209 Table 1
Authors: S V Venkatachalapathy, P Kiwanuka-musoke, G Evans, P Bassett, A F Muller
Journal: Gut (2012)

<h3>Introduction</h3> Venous thromboembolism (VTE) is a major cause of mortality contributing up to 25 000 deaths per year. There are no published studies that have linked the risk of VTE to endoscopic procedures. The current study was designed to assess whether endoscopic procedures increase the risk of venous thrombosis. <h3>Methods</h3> A retrospective case-control study of cases of patients (pts) with VTE from the Trust9s Haemophilia department database over a 3-year period from 1 January 2009 to 31 December 2011. Each case was age and sex matched to one control patient, who attended an outpatient appointment during the same period. The notes and endoscopy reports of cases and controls were reviewed to identify those patients, who had undergone endoscopy in the preceding 3 months of the VTE diagnosis. All adult patients were included in the study. Pts undergoing OGD, flexible sigmoidoscopy, colonoscopy and ERCP were included. Endoscopic US and bronchoscopy pts were excluded. Study sample size was calculated from a literature review of an approximate 2% occurrence of endoscopy in the population and our internal pilot study suggesting a 5% incidence of endoscopy in patients with VTE. With a 5% significance level and 80% power we calculated that 425 subjects per group were required to confirm a difference in endoscopy between pts with VTE and controls. The difference in occurrence of endoscopy between cases and controls was examined using the Mc Nemar test. The risk of VTE occurring following endoscopy was quantified using ORs. <h3>Results</h3> 45/445 (10.1%) patients had endoscopy in the VTE group compared to controls (14/445, 3.2%; p&lt;0.001) of which, 21 had OGD, 17 colonoscopy, one had ERCP and six Sigmoidoscopy. The number of pts in each endoscopy procedure category was insufficient to confirm whether the risk of VTE was dependent on the type of procedure performed. The OR for developing a VTE after an endoscopic procedure was 3.58 (95% CI 1.86 to 7.46). <h3>Conclusion</h3> 10% of patients with confirmed VTE had an endoscopy in the preceding 3 months of the diagnosis compared to 3% in the control group (p&lt;0.001). Pts undergoing endoscopy have a 3.6-fold increased risk of VTE compared to controls. Larger studies may highlight whether the type of endoscopic procedure or diagnosis may alter this risk. <h3>Competing interests</h3> None declared. <h3>Reference</h3> 1. Nice guidelines CG-92.
Endoscopic vs. laparoscopic gastrojejunostomy for duodenal obstruction: a randomized study in a porcine model
Authors: D. von Renteln, M. Vassiliou, D. McKenna, A. Suriawinata, C. Swain, R. Rothstein
Journal: Endoscopy (2011)

<b>Background and study aims:</b> Open or laparoscopic gastrojejunostomy is an established treatment for malignant duodenal obstruction but may be associated with significant morbidity and mortality. The purpose of this study was to develop a model for an entirely endoscopic gastrojejunostomy to treat duodenal obstruction, and to compare this with the laparoscopic technique. <b>Methods:</b> During the first part of the study the endoscopic technique was developed and tested in porcine nonsurvival and survival experiments (n = 12). During the second part of the study (n = 10), endoscopic gastrojejunostomy for duodenal occlusion was compared with laparoscopic gastrojejunostomy in a survival randomized controlled trial (RCT). For both groups duodenal occlusion was achieved by the laparoscopic approach. <b>Results:</b> In the RCT, the median times for laparoscopic vs. endoscopic gastrojejunostomy were 70 minutes (interquartile range [IQR] 65 – 75) vs. 210 minutes (IQR 197 – 220; <i>P</i> = 0.01). There was a trend toward increased anastomotic diameter at necropsy in the laparoscopic group (2 cm, IQR 2 – 3) compared to the endoscopic group (1.8 cm, IQR 1.6 – 1.8; <i>P</i> = 0.06). One animal in the endoscopic group died secondarily to bowel ischemia from volvulus of the jejunal loop. One animal in the laparoscopic group was prematurely sacrificed due to extensive pulmonary congestion and edema. All anastomoses were intact and patent. <b>Conclusions:</b> Purely endoscopic gastrojejunostomy using the developed technique and devices is feasible and can result in adequate relief of duodenal obstruction. Endoscopic anastomoses tend to be smaller than laparoscopic anastomoses, with the procedures being more time-consuming and associated with higher complication rates.
Pulmonary Hemorrhage in a Patient with Fibrillary Glomerulonephritis
Authors: Richard G. Masson, Helmut G. Rennke, Michael N. Gottlieb
Journal: New England Journal of Medicine (1992)

FIBRILLARY glomerulonephritis is an unusual kidney disease characterized by infiltration of the mesangium and glomerular basement membrane by fibrillary deposits that are negative on Congo-red staining but are reactive for polyclonal immunoglobulins.1 2 3 4 5 The disorder is thought to be mediated by the local production or deposition of abnormal paraproteins.6 , 7 In the approximately 50 cases of this disorder that have been reported previously, there have been no instances of pulmonary or other extrarenal manifestations. We describe a patient with fibrillary glomerulonephritis who died of pulmonary hemorrhage and fibrosis. The finding of fibrillary deposits in the interstitium of the lung in this patient . . .
AB0717 Frequency of cervical dysplasia in patients with systemic lupus erythematosus
Authors: A. Lopez Rodriguez, S. Cerpa Cruz, S. Gutierrez Ureña, G.E. Martinez Bonilla, A.G. Bernard Medina, V. Rodriguez Orozco, M. Ayala Arzola, M. Castañeda Ureña, M.P. Martinez Vazquez, M.D.L.M. Ayala Castellanos
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Systemic Lupus Erythematosus (SLE) is a prototype of autoimmune disease that is characterized by multisystem involvement and production of multiple auto-antibodies that underwent tissue deposition and cause chronic inflammation. Some studies have suggested that the lupus patients have and increased risk of malignancies such as lymphoma, sarcoma and breast cancer. The risk of cervical dysplasia or an abnormal pap smear in women with SLE seems to be increased but in our country there is scanty data about the frequency of cervical abnormalities. <h3>Objectives</h3> The purpose of this study was to determine the occurrence of cervical dysplasia and Pap smear abnormalities in patients with systemic lupus erythematosus. <h3>Methods</h3> Cross-sectional study was performed, 30 women with SLE, according to ACR criteria, were included and we compared them with eighty-three historical controls from de data base of gynecological department. The clinical activity of SLE was measured with MEX-SLEDAI. Pap smear was done in the two groups and the patients with suspicious lesions on the cervix underwent colposcopy and cervical biopsy. Statistics analysis was done by using arithmetic mean, standard deviation, Mann-Whitney U test for comparison of groups and multivariate logistic regression for correlation, chi-square and Exact Fisher test for categorical variables, the program we used was SPSS (v 12.0). <h3>Results</h3> The frequency of cervical dysplasia in the SLE group was 23% versus 10% in the control group; the risk of intraepithelial dysplasia for SLE patients was OR 2.85 (IC 95% 1.93 to 8.71). When we did adjusted multivariate analysis, no association was found between cervical dysplasia and age of beginning the sexual life, the number of sex partners, the time of evolution of the disease, the use of corticosteroids or the immunosuppressive drug therapy. No correlation with clinical activity of SLE and cervical dysplasia. In a sub-analysis the infection by human papillomavirus was more frequent in the SLE group, 30% vs 4%, but we did not identified more risk of cervical dysplasia in the former patients OR 0.88 (IC 95% 0.22 to 0.352) <h3>Conclusions</h3> This work demonstrated that patients with SLE have more risk of cervical dysplasia than general population; we suggest that the epidemiological surveillance of this group of patients should be more careful, with pap smear more early in life and probably every 6 months apart. <h3>References</h3> Klumb EM, Araujo ML Jr, Jesus GR, Santos DB, Oliveira AV, Albuquerque EM, Macedo JM. Is higher prevalence of cervical intraepithelial neoplasia in women with lupus due to immunossuppresion? J Clin rheumatol 2010 oct; 16 (7): 355. <h3>Disclosure of Interest</h3> None Declared
Relation Between Coronary Blood Flow and Myocairdial Oxygen Consumption
Authors: S. J. Sarnoff, J. P. Gilmore, N. S. Skinner, A. G. Wallace, J. H. Mitchell
Journal: Circulation Research (1963)

Experiments were done in the isolated supported heart preparation to ascertain whether a change in coronary blood flow would induce a change in myocardial O 2 consumption if the activity of the heart (aortic pressure, heart rate and stroke volume) was controlled. Over a wide range of coronary blood flows, the O 2 consumption did not vary under such circumstances. If the coronary flow was restricted to levels which produced an unequivocal deteriration of ventricular performance, a modest decrease in O 2 consumption was sometimes observed. Reciprocal type experiments were also performed. In these, coronary flow was held constant or nearly so while varying the activity of the heart markedly. Under these circumstances the myocardial O 2 consumption did vary directionally with the amount of ventricular myocardial tension developed insofar as this was indicated by the tension-time index. Data were also obtained suggesting that ventricular end diastolic fiber length is not of itself a major determinant of myocardial O 2 consumption.
Effect of Octreotide on Intestinal Motility and Bacterial Overgrowth in Scleroderma
Authors: Hani C. Soudah, William L. Hasler, Chung Owyang
Journal: New England Journal of Medicine (1991)

Patients with scleroderma may have abnormal motility of the small intestine, with pseudoobstruction and bacterial overgrowth. Standard stimulatory agents are often ineffective in such patients. Because the somatostatin analogue octreotide evokes intestinal motor activity in normal subjects, we hypothesized that it might increase motility in patients with scleroderma.
OP0249 Effect of Exercise for Patient with Osteoporotic Vertebral Fractures
Authors: L. Evstigneyeva, E. Kozhemyakina, O. Lesnyak, E. Negodaeva, G. Guselnikova, A. Belkin, E. Leskovetc
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Effect of exercise for patient with osteoporotic vertebral fractures. <h3>Objectives</h3> Severe osteoporosis, with compression fractures of the vertebrae leads to a decrease in the quality of life and functional activity of patients. The effectiveness of exercise could affect improvement in functional status and quality of life of patients. <h3>Methods</h3> Seventy-eight postmenopausal women with vertebral fractures were randomized into the exercise group (n=40) and control group (n=38). The mean age was 70.7 ±8.1 SD years in the exercisers and 67.6 ± 7.0 SD years in the control (p=0.07). All women had at least one osteoporotic vertebral fracture and suffered from chronic back pain. Baseline variables in QUALEFFO score were not significantly different between groups. Exercise program included stretching, strength training and weight-bearing exercises. The program was conducted two times per week 60 minute a day for 12 months. Participants in the control group were instructed to continue with their usual daily activities. Participants were assessed at baseline and 12 months using the Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO-41) and the “Timed Up and Go” test. Dynamic balance was assessedusing ofstabilometrics- computer posturographicsystem of diagnostics of balance, skills movements Balance-Master, NeuroCom. <h3>Results</h3> There was improvement in total QUALEFFO score over 12 months in the exercise group (44.2) in compared to control group (56.6), p&lt;0.0000, improvements were observed as in total QUALEFFO score, so and in all domains. According to the results of stabilometrics received significant difference in the assessment of functional capacity, skills movements and sways of the centre of gravity in the exercise group. There was improvement in test «SIT-TO-STAND - WT Transfer» in the exercise group (0,9) compared with the control (1.5) p=0,001, «Body WT Rising Index» - 9.8 and 12.2 (p=0,03) and «Tandem Walk end Sway» - 6,8 and 9.1 (p=0,02), respectively. A small decrease of the time of performance «Timed Up and Go» test observed in the exercise group from 11.5 to 10.8 (p&lt;0.05) and there were no significant change in the control group (from 10.8 to 11.1, p=0.37). <h3>Conclusions</h3> Exercise therapy reliably improves the quality of life of patients with osteoporotic fractures of the vertebrae, as well as improves the functional mobility and balanceof patients. <h3>Disclosure of Interest</h3> None Declared
Policies need to restrain growth in healthcare spending, say experts
Authors: B. Roehr
Journal: BMJ (2013)

The debate on US healthcare policy must focus on overall cost containment, not on shifting costs within the silos of public, employer, and private sector payers, experts told a congressional briefing on 28 January.

Fuelling the renewed policy debate are a report earlier this month from the Centers for Medicare and Medicaid Services saying that aggregate healthcare spending rose at a relatively low 3.9% for the last three years for which information was available1 and broad recommendations from the Commonwealth Fund on how an additional $2 trillion might be shaved from increased healthcare spending over the next decade.2

“We are not talking about fighting over …
Tips for a Physician in Getting the Right Job, Part XI
Authors: Jay A. Harolds
Journal: Clinical Nuclear Medicine (2014)

There are many important things for the applicant to remember to do during an interview. It is important for the job seeker to be well rested for the interview and to arrive on time. The candidate should be positive, show enthusiasm and high energy, be respectful and friendly, smile, be brief and to the point in answers, not embellish his/her qualifications, and be candid in all responses. The answers should be delivered in a clearly heard voice, with reasonable speed, and in varying tone.
Abstract 5130: Integrative approaches for the identification of therapeutic targets in basal like breast cancer from multi-level molecular data
Authors: Bruno M. Tesson, Guillem Rigaill, Anne Vincent-Salomon, David Gentien, Sergio Roman-Roman, Alain Pierré, Francisco Cruzalegui, Stéphane Depil, Gordon Tucker, Thierry Dubois, Emmanuel Barillot
Journal: Cancer Research (2012)

Abstract Basal-like breast cancer is a molecular subtype of breast carcinoma accounting for up to 15% of cases and associated with a poor prognosis. There is no targeted therapy for this disease; since most basal-like breast cancers do not over-express HER2 and are negative for hormone receptors, they cannot be treated with trastuzumab antibody (anti-HER2) or anti-hormonal therapies. Finding therapeutic targets for the treatment of basal-like tumors is therefore a priority in breast cancer research. In this project, biopsies for the different subclasses of breast cancer (46 basal-like, 33 HER2+/ER-, 35 luminal A and 40 luminal B) were obtained from the Biological Center of Institut Curie and characterized by immuno-histochemistry. Using different microarray platforms, genome-wide profiles were obtained at the DNA, messenger RNA, and microRNA levels. Additionally, data were collected for a selection of 150 proteins using Reverse Phase Protein Arrays. We present the results of separate analyses of each of these molecular levels, and we introduce methods that integrate information across multiple layers of data to pinpoint potential drivers of the disease. In particular, we propose an approach to identify genome regions where copy number alterations correlate with transcriptome-wide perturbation of gene expression. Such correlation suggests that these regions may harbor genes playing an important role in carcinogenesis. Using criterions based on co-expression and on prior biological knowledge, the method determines the genes in these regions that are most likely to be cancer drivers and may therefore be relevant as therapeutic targets. Using HER2+ tumors to illustrate the approach, we show that the method is indeed able to designate the HER2 oncogene as a likely driver. With the addition of miRNA and protein data to these integrated studies, we hope that such approaches will suggest putative cancer driving genes as novel potential therapeutic targets. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 5130. doi:1538-7445.AM2012-5130
AB0911 Characteristics of PFAPA Patients Responding to Colchicine Treatment: A Retrospective Study of 21 Children
Authors: P. Dusser, B. Neven, V. Hentgen, I. Koné-Paut
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> Colchicine is an alkaloid that has been used for years in familial Mediterranean fever (FMF), a hereditary autoinflammatory disease associated with excessive IL-1 (interleukine 1) signaling. It has also been used as prophylaxis for patient with frequent PFAPA (periodic fever, aphthous stomatitis, pharyngitis, adenopathy) episodes. PFAPA syndrome is characterized by sudden attacks of fever associated with aphthous stomatitis, pharyngitis and adenopathy occurring every 3-8 weeks and lasting for 3-6 days. It usually begins at the age of 4 years old. The physiopathology of this disease is not well known but a major role of an excessive IL-1 signaling has been suggested by Stojanov in 2011 allowing to think of a potential role of the colchicine in the therapeutic arsenal. <h3>Objectives</h3> To study the characteristics of PFAPA population in which colchicine treatment allows a decrease of the PFAPA attacks recurrences. This could allow us to defining predictive factors of a potential response to colchicine treatment. <h3>Methods</h3> A retrospective and multicentered study was performed on PFAPA patients under colchicine prophylaxis treatment. Two groups were studied depending on their colchicine9s response. A good colchicine response was defined as a rise of 50% or more of the time between two attacks. Subgroup analysis was performed using Mann-Whitney test regarding the family history, the age at onset, the recurrence and the characteristics of the attacks (duration and maximum fever, asthenia, pharyngitis, aphtous stomatitis, lymphadenopathy, abdominal pain) and the genetic background of the patient namely heterozygous for the Familial Mediterranean fever gene. <h3>Results</h3> Twenty one children were studied. Among them, 67% were male. The mean age at onset of PFAPA disease was of 2.1±1.4 years old. The PFAPA attacks in our population was described as a 3.1±1.1 days (mean,standard deviation) (1 to 7 days) of strong fever (mean 39°C) with chills (28%) most frequently associated with pharyngitis (78%), abdominal pain (75%), cervical adenitis (62%), asthenia (50%) and aphtous stomatitis (47%). Looking at genetics, 52% (11/21) of the patients were FMF heterozygous. Twelve patients were defined as responder to colchicine. No significant differences were found between the two groups. <h3>Conclusions</h3> Future prospective studies should be performed using a larger group of patients in order to better define the efficiency of the colchicine and its indications in PFAPA patients. <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.6041