tbuckley/cabot-search huggingface dataset:
Tympanocentesis in Children with Acute Otitis Media
Authors: Nader Shaikh, Alejandro Hoberman, Diana H Kearney, Robert Yellon
Journal: New England Journal of Medicine (2011)

This is a Video in Clinical Medicine from the New England Journal of Medicine. Tympanocentesis in Children with Acute Otitis Media Overview Tympanocentesis is defined as needle aspiration of fluid from the middle ear. In children with acute otitis media, drainage of pus from the middle ear results in a rapid and marked improvement in symptoms and enables the clinician to prescribe tailored antimicrobial therapy. This video will demonstrate the technique of tympanocentesis. Indications Tympanocentesis is recommended in children with refractory acute otitis media, in immunocompromised children with otitis media, and in children with suppurative complications of acute otitis media, . . . .
Increased Incidence of Acute Leukemia in Polycythemia Vera Associated with Chlorambucil Therapy
Authors: Paul D. Berk, Judith D. Goldberg, Murray N. Silverstein, Aleksander Weinfeld, Paul B. Donovan, John T. Ellis, Stephen A. Landaw, John Laszlo, Yves Najean, Anthony V. Pisciotta, Louis R. Wasserman
Journal: New England Journal of Medicine (1981)

In studies to determine the optimal treatment for polycythemia vera, 431 previously untreated patients whose disease met established diagnostic criteria were entered into a prospective, randomized controlled trial between 1967 and 1974. Three treatment regimens were used: phlebotomy alone, chlorambucil supplemented by phlebotomy, or radioactive phosphorus supplemented by phlebotomy. Despite minor differences in age and sex, the three groups were comparable in initial hematocrit, white-cell and platelet counts, and disease-related symptoms. The median duration of follow-up is now more than 6 1/2 years. As of February 15, 1980, there were no statistically significant differences in survival among the groups. However, the risk of acute leukemia in patients given chlorambucil was 2.3 times that in patients given radioactive phosphorus and 13 times that in patients treated with phlebotomy alone. The increased incidence of leukemia during chlorambucil treatment is statistically significant (P less than or equal to 0.002); accordingly, the Polycythemia Vera Study Group has discontinued the use of chlorambucil in the treatment of polycythemia vera.
Severe Adverse Cutaneous Reactions to Drugs
Authors: Jean Claude Roujeau, Robert S. Stern
Journal: New England Journal of Medicine (1994)

Although the rate of acute severe adverse cutaneous reactions to medications is low, these reactions can affect anyone who takes medications and can result in death or disability1. Even a small number of cases associated with a particular drug may alter the recommendations for its use24. Prompt differentiation of severe adverse cutaneous reactions from less serious skin disorders may be difficult. Rapid recognition of severe reactions is essential. Prompt withdrawal of the offending drug is often the most important action to minimize morbidity.Adverse cutaneous reactions to drugs are frequent, affecting 2 to 3 percent of hospitalized . . .
Interference with Cardiac Pacemakers by Cellular Telephones
Authors: David L. Hayes, Paul J. Wang, Dwight W. Reynolds, N.A. Mark Estes, John L. Griffith, Rebecca A. Steffens, George L. Carlo, Gretchen K. Findlay, Claudine M. Johnson
Journal: New England Journal of Medicine (1997)

A growing body of evidence suggests that electromagnetic interference may occur between cardiac pacemakers and wireless hand-held (cellular) telephones, posing a potential public health problem. Electromagnetic interference may occur when the pacemaker is exposed to an electromagnetic field generated by the cellular telephone.
SP0087 Immune driven muscle disease: From the thymus to myocytes
Authors: R. Lane
Journal: Annals of the Rheumatic Diseases (2013)

There are a number of primary immune mediated neuromuscular diseases. Careful clinical examination, detailed neurophysiological studies and muscle immunohistochemistry are key to accurate diagnosis and effective therapy. The archetypical disease, myasthenia gravis, is most often caused by autoantibodies to nicotinic acetylcholine receptors (AChR-abs) and is clearly initiated in the thymus. However, the antigens and antigen presenting cells that determine the immunopathogenesis of other immune myopathies is unclear. “Myositis specific antibodies” are found in the great majority of patients with “overlap myositis” and in dermatomyositis, but their antigenic targets are not muscle-specific and their specificity is related more closely to involvement of tissues other than muscle. Muscle-specific autoantibodies have been found in only two immune myopathies to date: anti-decorin myopathy (antibodies to chondroitin sulphate, a component of the muscle extracellular matrix) and in myositis with antibodies to γ/δ sarcoglyan. Muscle inflammation is a common histopathological finding in a wide variety of muscle diseases in addition to immune myopathies. It is probable that such inflammation plays a part in the pathogenesis of genetic myopathies which, in turn, can be associated with autoantibodies such as AChR-ab that contribute to the muscle dysfunction. Increasingly, efforts are being made to identify muscle-specific autoantibodies using muscle specific antigen sources in a variety of conditions. <h3>Disclosure of Interest</h3> None Declared
OP0010 Reduced Sick Leave in Today’s Early RA Patients Compared to 10 Years Ago, the Swedish Tira Project
Authors: M. Björk, T. Skogh, M. Husberg, I. Thyberg
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Ten years ago rheumatoid arthritis (RA) was associated to extensive sick leave during the years after diagnosis despite early instituted disease modifying anti rheumatic drugs (DMARD:s) (1). Since then the treatment strategies have undergone big changes and biological agents have been introduced. <h3>Objectives</h3> To compare sick leave in early RA today compared to10 years ago. <h3>Methods</h3> 320 patients were included in the Swedish early RA cohort (TIRA1) during 1996-1998 and 522 patients were included 2005-2008 in the TIRA2 cohort. The prescription of traditional DMARD:s was more frequent in TIRA2 already at inclusion but there were no differences in DAS28 between two cohorts that timepoint. The 120 patients (76% women) that were still participating in TIRA1 at 2-year follow-up and that were ≤ 64 years were included in the present study together with the corresponding 275 patients (74% women) in TIRA2. Sick leave data (sickness benefit and disability pension) were obtained for patients one year before until two years after inclusion (diagnosis). <h3>Results</h3> One year before diagnosis 20% in TIRA1 and 18% in TIRA2 were on sick leave. Until time for inclusion this number increased to 50% in TIRA1 and 39% in TIRA2. At one year after inclusion much fewer were on sick leave in TIRA2 (30%) than in TIRA-1 (51%). After two years, sick leave in TIRA2 was further reduced to 28% which differs vastly from TIRA1, where the sick leave increased to 54%. The mean days of sickness benefit and disability pension during the year before diagnosis were 42 and 24 respectively in TIRA1 compared to 31 and 35 in TIRA2. During the year after diagnosis, the mean days of sickness benefit and disability pension were 93 and 33 in TIRA1, and 59 and 36 in TIRA2. During the second year the corresponding figures were 72 and 66 days in TIRA 1 versus 35 and 41 days in TIRA2. <h3>Conclusions</h3> The far lower sick leave rate seen today after a diagnosis of RA, compared to the situation 10 years ago, cannot be explained by differences in sick leave during the year before diagnosis. Although sick leave is lower today, the sick leave rate in TIRA2 is still high compared to the general population. This highlights a need to develop efficient multiprofessional intervention strategies in addition to modern anti-rheumatic pharmacotherapy regimens. <h3>References</h3> Björk M, Thyberg I, Rikner K, Balogh I, Gerdle B. (2009). Sick leave before and after diagnosis of rheumatoid arthritis: a report from the Swedish TIRA project. J Rheumatol; 36:1170-1179. <h3>Disclosure of Interest</h3> None Declared
AB0589 Steroid-sparing effect of tocilizumab in the treatment of rheumatoid arthritis
Authors: Y. Maeda, S. Ohshima, M. Yoshimura, A. Watanabe, E. Tanaka, S. Tsuji, Y. Harada, M. Matsushita, Y. Katada, J. Hashimoto, Y. Saeki
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Long-term use of corticosteroid is often required in rheumatoid arthritis(RA), but it is suggested that dose dependent relationship between prednisone treatment and the risk of pneumonia in RA patients<sup>1</sup>. Therefore, reducing corticosteroid use may improve the safety profile. Moreover, because long term use of corticosteroid increases adverse events such as osteoporosis, diabetes mellitus, hyperlipidemia, it is better to taper corticosteroid dose as rapidly as clinically feasible. <h3>Objectives</h3> To evaluate the steroid-sparing efficacy of tocilizumab(TCZ) compared with infliximab(IFX) in RA. <h3>Methods</h3> Ninety-five RA patients (TCZ n=55; IFX n=40) were enrolled this study from our medical center between 2005 and 2011.The disease activity assessed by DAS28ESR, and prednisolone(PSL) dose were monitored at baseline and after 26, 54weeks. In addition, we evaluated total cholesterol, several bone biochemical markers such as serum crosslinked N-telopeptide of type I collagen (NTx), urinary NTx, and serum osteocalcin(OC) at the same time. <h3>Results</h3> Baseline characteristics were similar in the 2 groups. Mean age was 59.9±13.5, 58.2±12.5 y, and the mean duration of disease was 11.4±10.1, 9.8±10.0 y in the TCZ and IFX groups, respectively. Disease activity was significantly reduced at week26, week54 compared with baseline in both groups (P&lt;0.001). The mean DAS28ESR at week26 in TCZ-group was significantly decreased compared with that in IFX-group(Fig. 1). Steroid utilization in TCZ-group could be significantly more reduced compared with that in IFX-group (Fig. 2). Moreover, 24 patients (43.6%) in TCZ-group and 10 patients (25.0%) in IFX-group could discontinued PSL at week54. On the other hand, TCZ treatment significantly decreased the level of urinary Ntx than IFX at week26 and week54 (Fig. 3). There were no statistically differences in the levels of T-cho, and serum Ntx, serum OC at 26, 54weeks between 2 groups. <h3>Conclusions</h3> Both TCZ and IFX were effective steroid-sparing agent for patients with RA. In addition, TCZ might have superior steroid-sparing efficacy compared to IFX. Furthermore, the mean level of urinary Ntx significantly decreased by TCZ treatment at week26 and week54. Taken together, this steroid-sparing efficacy might improve systemic bone metabolism. <h3>References</h3> Frederick Wolfe, et al. Treatment for Rheumatoid Arthritis and the Risk of Hospitalization for Pneumonia. Arthritis and Rhumatism 2006;54:628-634. <h3>Disclosure of Interest</h3> None Declared
Abstract P5-10-21: Maternal and Neonatal Outcomes of Dose Dense Chemotherapy for Breast Cancer in Pregnancy
Authors: EH Cardonick, D Gilmandyr
Journal: Cancer Research (2010)

Abstract Background: Fear of neutropenia requiring the use of pegfilgrastim has prevented the use of dose dense chemotherapy (dd) during pregnancy. Some physicians/patients may be concerned as well about the ability of the pregnant patient and her neonate to tolerate dose dense chemotherapy during pregnancy. The objective of this study is to compare the outcome of women and their neonates when dose dense chemotherapy is used in pregnancy compared to treatment at least 3 weeks apart. Materials and Methods: A retrospective cohort study of pregnant women receiving chemotherapy for breast cancer were identified from the Cancer and Pregnancy Registry. The timing of chemotherapy in pregnancy was decided by the patient's oncologist in consultation with their patient. Fisher's Exact test comparing patient and neonatal outcome was performed. Results: 109 pregnant women diagnosed with breast cancer participated. Ten women received dose dense (dd) and 99 conventional chemotherapy (cc). The mean gestational age at delivery for dd group was 35.8 (SD 3.1) weeks and 36.3 (SD 2.7) weeks in the cc group, p=.60. Mean birth weight was 2560 (SD 579)grams in the dd group, 2634 (SD 599) grams in the cc group, p=.642]There were no fetuses with growth restriction in the dd group, compared to 7.0% in the cc group, p=1.0. Of the 10 neonates in the dd group, 10% (1/10) experienced transient neutropenia, none did so in the cc group, p=0.09. Neonatal Outcomes GA=gestational age at delivery;IUGR=fetal growth restriction. No significant differences in GA at delivery, Birthweight or neutropenia was found. There was an 10% (1/10) incidence of maternal neutropenia in the dd group, 5.1% in the cc group, p=.45. Maternal mean follow up was 3.5 (2.6) years. The mean time to recurrence was 17.6 months for dd versus 19.7 months in the conventional group, p=0.84. Overall survival in the dd group was 90%, in the cc group, 86%, p=1.0. Maternal Outcomes No significant difference in neutropenia, time to recurrence or survival was found. Discussion: The small number of women receiving dose dense treatment is a limitation of this study. We found that maternal neutropenia, time to recurrence as well as overall survival was comparable between groups. Neonatal birth weight, gestational age at delivery and incidence of neonatal neutropenia was comparable between groups. Dose dense chemotherapy should be considered in pregnant women if the benefits are demonstrated in the nonpregnant population. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P5-10-21.
Changes in Circulating Transcobalamin II after Injection of Cyanocobalamin
Authors: Robert M. Donaldson, Myron Brand, Delchi Serfilippi
Journal: New England Journal of Medicine (1977)

Since transcobalamin II is the plasma binder of vitamin B12(cobalamin) that mediates delivery of cobalamin to tissues, we measured circulating levels of transcobalamin II after intravenous injection unlabeled cyanocobalamin in 12 control subjects and, because the liver is a major source of transcobalamin II, in eight patients with decompensated cirrhosis. Thirty minutes after injection of cyanocobalamin (200 ng per kilogram of body weight), total transcobalamin II (unsaturated plus cobalamin bound) declined in all 20 subjects to levels that averaged (+/- S.E.) 53.5 +/- 4.6 per cent of initial values. Subsequently, unsaturated transcobalamin II rapidly increased so that by eight hours, total transcobalamin II approached preinjection levels. Rates of regeneration of transcobalamin II were similar in control subjects and patients with liver disease. Unlike total transcobalamin II, total transcobalamin I was unaltered by injection of cyanocobalamin. Moreover, addition of cyanocobalamin to plasma in vitro did not alter measurements of total transcobalamin II. The rapid response of circulating transcobalamin II to cyanocobalamin injection strongly supports a dynamic role for this polypeptide during transport of a relatively large load of cobalamin.
Ventilation–Perfusion Mismatch as a Consequence of Vascular Involvement in a Case of Primary Mediastinal B-Cell Lymphoma
Authors: Georgios Arsos, Vasilia Garypidou, Gewan Al-Mousa, Ionnis Iakovou, Constantinos Karakatsanis
Journal: Clinical Nuclear Medicine (2002)

ARSOS, GEORGIOS M.D.*; GARYPIDOU, VASILIA M.D.†; AL-MOUSA, GEWAN M.D.†; IAKOVOU, IOANNIS M.D.*; KARAKATSANIS, CONSTANTINOS M.D.* Author Information
SAT0199 Video-Capillaroscopy Assessment of Peri-Calcinotic Skin Indicates Specific Features of Severe Vasculopathy Associated with Calcium Deposits in Systemic Sclerosis.
Authors: L. Loughrey, L.-A. Bissell, G. Abignano, E. M. Hensor, A. Redmond, M. Buch, F. Del Galdo
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Calcium deposits (calcinosis) in Systemic Sclerosis (SSc) are clinically heterogeneous both for site and severity of involvement. Despite often leading to complications such as digital ulcers and driving poor hand function, little attention has been paid to the pathogenesis of calcinosis and the therapeutic options remain limited. The presence of calcinosis in limited cutaneous SSc as well as in the diffuse form suggests that the condition may be associated with vasculopathy rather than fibrosis, however to date, no formal studies have addressed this hypothesis. <h3>Objectives</h3> We performed video-capillaroscopy of peri-calcinotic skin and unaffected skin in the same but contra-lateral Region of Interest (ROI), to determine whether we could detect any calcinosis – specific change in the capillaroscopic pattern. <h3>Methods</h3> Eighteen calcinotic deposits and contra-lateral ROIs were analysed with an Optilia Digital video-capillaroscopy system equipped with 200x magnification lens. For each calcinotic deposit we captured images in the 4 surrounding quadrants within 3 millimetres of the lesion. Images from each quadrant were captured, indentified and stored and in an electronic database. Analysis of the images was performed by two rheumatologists fully trained in video-capillaroscopy and blinded to the clinical details. Presence of; enlarged capillaries, Giant capillaries, Haemorrhages, Drop-out, disorganisation and capillary ramifications were assessed independently. McNemars tests were employed for statistical analysis. <h3>Results</h3> Twelve of the 18 calcinotic deposits were located at the distal phalanx, 3 at the proximal phalanx, 1 at both the middle and proximal phalanx and two at the palmer metacarpal. Drop out areas were observed in at least 1 quadrant of all 18 calcinotic deposits vs 7 contra-lateral control ROIs (p=0.05). Enlarged capillaries were observed at 17 deposits vs 11 ROIs (p =0.05), giant capillaries, disorganisation and capillary ramifications were observed at 7, 9 and 5 deposits, respectively, while none were observed in any ROIs (P &lt; 0.05 for all). Haemorrhages were observed at 5 deposits and 2 ROIs, (P = 0.05). <h3>Conclusions</h3> This pilot study suggests that specific features of severe vasculopathy such as drop out areas, giant capillaries and disorganisation of the vascular array are observable in plain skin video-capillaroscopy and may be specifically associated with calcinotic deposits in SSc. Further studies are warranted both to unravel the role of vasculopathy in the pathogenesis of calcinosis and to determine potential benefit of therapeutic options targeting peripheral vasculopathy. <h3>Disclosure of Interest</h3> None Declared
Novel phosphatidylethanolamine derivatives accumulate in circulation in hyperlipidemic ApoE−/− mice and activate platelets via TLR2
Authors: Sudipta Biswas, Liang Xin, Soumya Panigrahi, Alejandro Zimman, Hua Wang, Valentin P. Yakubenko, Tatiana V. Byzova, Robert G. Salomon, Eugene A. Podrez
Journal: Blood (2016)
<i>Kcne2</i>deletion attenuates acute post-ischaemia/reperfusion myocardial infarction
Authors: Zhaoyang Hu, Shawn M. Crump, Ping Zhang, Geoffrey W. Abbott
Journal: Cardiovascular Research (2016)

Most cardiac arrhythmia-associated genes encode ion channel subunits and regulatory proteins that are also expressed outside the heart, suggesting that diseases linked to their disruption may be multifactorial. KCNE2 is a ubiquitously expressed potassium channel β subunit associated with cardiac arrhythmia, atherosclerosis, and myocardial infarction (MI) in human populations. Here, we tested the hypothesis that Kcne2 disruption in mice would influence the acute outcome of experimentally induced MI. One-year-old male Kcne2+/+ and Kcne2−/− mice were subjected to cardiac ischaemia/reperfusion injury (IRI) by left anterior descending coronary artery ligation. After reperfusion (3 h), infarct size and markers of tissue damage were quantified. Unexpectedly, post-reperfusion, Kcne2−/− mice exhibited 40% lower infarct size, decreased myocardial apoptosis and damage, and more than two-fold lower serum levels of damage markers, lactate dehydrogenase and creatine kinase, than Kcne2+/+ mice. Kcne2 deletion, despite increasing normalized heart weight and prolonging baseline QTc by 70%, helped preserve post-infarct cardiac function (quantified by a Millar catheter), with parameters including left ventricular maximum pressure, max dP/dt (P < 0.01), contractility index, and pressure/time index (P < 0.05) all greater in Kcne2−/− compared with Kcne2+/+ mice. Western blotting indicated two-fold-increased glycogen synthase kinase 3β (GSK-3β) phosphorylation (inactivation) before and after IRI (P < 0.05) in Kcne2−/− mice compared with Kcne2+/+ mice. GSK-3β inhibition by SB216763 mimicked in Kcne2+/+ mice the cardioprotective effects of Kcne2 deletion, but did not further enhance them in Kcne2−/− mice, suggesting that GSK-3β inactivation was a primary cardioprotective mechanism arising from Kcne2 deletion. Kcne2 deletion preconditions the heart, attenuating the acute tissue damage caused by an imposed IRI. The findings contribute further evidence that genetic disruption of arrhythmia-associated ion channel genes has cardiac ramifications beyond abnormal electrical activity.
Abstract 1695: Mechanisms of cytotoxicity of diepoxybutane, epichlorohydrin, and (1-chloroethenyl) oxirane
Authors: Bethany L. Bartley, Vanesa L. Silvestri, Christopher Ng, David C. Hirsch, Julie T. Millard
Journal: Cancer Research (2010)

Abstract The bifunctional alkylating agents are an important class of drugs for the treatment of cancer, psoriasis, and some anemias. These compounds are widely believed to exert their cytotoxic effects through reactions with biological nucleophiles, with DNA interstrand cross-links considered to be the most lethal lesions. Indeed, for many families of bifunctional alkylators, DNA interstrand cross-linking correlates with cytotoxicity. Moreover, apoptotic potential may play a role in antitumor chemotherapeutic utility. We have established previously that diepoxybutane (DEB) and the structurally related compounds epichlorohydrin (ECH) and 1-(chloroethenyl)oxirane (CEO) form DNA interstrand cross-links in vitro. With the goal of elucidating the molecular and cellular mechanisms by which this family of epoxides exerts its cytotoxic effects, we are determining the relationships between interstrand cross-linking, LD50 values, and apoptotic potentials for DEB, ECH, and CEO in chicken 6C2 and human HL-60 cells. Preliminary results in 6C2 cells suggest that cytotoxicity follows the order DEB &amp;gt; CEO &amp;gt; ECH. Furthermore, flow cytometry with Annexin V-FITC/PI dual staining has revealed that the apoptotic potentials follow the order DEB &amp;gt;&amp;gt; ECH &amp;gt; CEO. Reverse-transcriptase real-time PCR analysis of HL-60 cells treated with DEB under conditions known to induce apoptosis suggests up-regulation of several key genes involved in the mitochondrial apoptotic pathway, including BAK1, BAX, DIABLO, and APAF1. Further work is underway to characterize the pathways by which ECH and CEO exert their apoptotic effects. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 1695.
Some Questions about Bronchiogenic Carcinoma
Authors: Evarts A. Graham
Journal: New England Journal of Medicine (1951)

EVER since cancer has been subjected to surgical attack, neoplasms have constituted a problem that has been generally regarded as belonging especially in the province of the surgeon. But his interest in neoplastic disease has not been confined in the past, — nor should it be in the present, — to methods of resection of the growth. Many surgeons have made important contributions to the pathology, the peculiar actions, and even the etiology of some of the neoplasms. Percivall Pott of London, for example, at about the time of your "Boston Tea Party," was the first to call attention to . . .