tbuckley/cabot-search huggingface dataset:
PTH-080 Informing ulcerative colitis pathophysiology and outcomes through metabolic profiling
Authors: SCM Fong, CI Le Roy, SP Claus, JD Sanderson
Journal: Gut (2015)

<h3>Introduction</h3> Ulcerative colitis (UC) is a chronic gastrointestinal disorder involving a complex interplay between host genetics, mucosal immunology, gut microbiome and the environment. A complete understanding of aetiology and biomarkers predicting outcome are lacking. We used High-Resolution Magic Angle Spinning Nuclear Magnetic Resonance (HR MAS NMR) spectroscopy to generate metabolic profiles from intact colonic biopsies from UC patients and controls, to inform us about disease pathophysiology and severity. <h3>Method</h3> Colonic tissue biopsies were acquired from 20 individuals (10 UC patients, and 10 controls who had normal mucosa on colonoscopy) at the time of routine colonoscopy. Metabolic signatures were obtained by HR-MAS NMR followed by multivariate pattern-recognition analysis to investigate differences between cohorts. 2 dimensional correlation spectroscopy (COSY) was performed to identify metabolites. <h3>Results</h3> Principal component analysis (PCA) identified one outlier which was excluded from further analysis. Orthogonal projection to latent structures analysis (OPLS) was applied to remaining cases and distinguished UC and control cohorts with significant predictive accuracy. The OPLS model supported good fit (R2Y 0.8362) and predictability (Q2Y 0.5026) parameters. The data analysis showed that colonic biopsies from UC patients contained relatively higher levels of antioxidants (ascorbate) and ethanolamine compared to those obtained from controls. A novel finding was that the model was capable of stratifying the samples based on severity (quiescent, mild, moderate or severe), which has not been demonstrated in previous metabonomic studies on colonic samples of ulcerative colitis. <h3>Conclusion</h3> HR-MAS NMR based metabolic profiling has identified distinct differences in UC patients and controls, in particular increased levels of antioxidants and amino acid which may be required in greater quantities during catabolic conditions such as UC. This study shows the utility of HR-MAS NMR in exploring diagnostic possibilities, disease severity stratification and generating a better understanding of UC pathophysiology. <h3>Disclosure of interest</h3> None Declared. <h3>Reference</h3> Bjerrum JT, Nielsen OH, Hao F <i>et al</i>. Metabonomics in ulcerative colitis: diagnostics, biomarker identification, and insight into the pathophysiology. Journal of Proteome Research 2010;9(2):954–962
Intra-abdominal Infections
Authors: B Risti, C Meyenberger, T Weinrich
Journal: Annals of Internal Medicine (1991)

We present 3 patients with intraabdominal infections. The diagnostic difficulties are caused by the atypical presentation of many of these infections. Fever, deterioration of general condition and loss of appetite and weight are uncharacteristic signs that lead to a delay in correct diagnosis and the beginning of therapy. In the following paper we discuss septic pylephlebitis, spontaneous bacterial peritonitis and renal abscesses as important representatives of intraabdominal infections.
Cytological Studies of Tumors. IX. Characteristic Chromosome Individuality in Tumor Strain-Cells in Ascites Tumors of Rats&lt;xref ref-type="fn" rid="fn1"&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/xref&gt;
Authors: Makino, Sajiro, Kanô, Kyoko
Journal: JNCI Journal of the National Cancer Institute (1953)

Journal Article Cytological Studies of Tumors. IX. Characteristic Chromosome Individuality in Tumor Strain-Cells in Ascites Tumors of Rats Get access Sajiro Makino, Sajiro Makino Search for other works by this author on: Oxford Academic PubMed Google Scholar Kyoko Kanô Kyoko Kanô Zoological Institute, Hokkaido University, Sapporo, Japan Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 13, Issue 5, April 1953, Pages 1213–1235, https://doi.org/10.1093/jnci/13.5.1213 Published: 01 April 1953 Article history Received: 23 October 1952 Published: 01 April 1953
OP0011 Rheumatology Training Experience – European Survey Among Rheumatology Trainees &amp; Newly Qualified Specialists
Authors: F. Sivera, S. Ramiro, N. Cikes, M. Dougados, L. Gossec, T.K. Kvien, I.E. Lundberg, P. Mandl, A. Moorthy, S. Panchal, J.A. da Silva, J.W. Bijlsma
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Objectives</h3> To describe the confidence and training experience acquired during rheumatology training in 21 core competences across the different European countries. <h3>Methods</h3> As part of a European project to evaluate the differences and similarities in training in rheumatology across Europe, we developed an online survey to assess the training experience. The target population was trainees in rheumatology and rheumatologists certified in the past 5 years. We selected 21 competences, core to rheumatology clinical practice, from the UEMS European curriculum framework (1). For each competence, respondents were asked to assess the confidence in their abilities (0-10 numerical rating scale), the existence of formal education (yes/no), the exposure to patients (0; 1-10; 11-50; 51-100; 101-150; &gt;150) and the existence of an assessment (yes/no) where appropriate. All questions referred to the training period. The survey (June-December 2014) was disseminated in each country by a national PI. <h3>Results</h3> We gathered 1433 answers to the survey of which 1243 could be included in the analysis (28% of overall target population). Respondents came from the 41 EULAR countries with rheumatology training (30% male, 58% trainees). A summary of the results is presented in Table 1. For any given competence, mean confidence was higher in respondents who had received formal education than in those who had not. Similarly, for all clinical competences and rheumatologic techniques, mean confidence was also higher amongst those who had a higher patient exposure during their training that in those who managed ≤10 patients with that given disease. Mean acquired confidence was also higher in respondents who had a longer training period (internal medicine plus rheumatology) than in those with a shorter training period for all competences except osteoporosis and hand Xray interpretation. The level of confidence was also higher for specialists (vs trainees). <h3>Conclusions</h3> The acquired confidence in competences during the rheumatology training program considered core for rheumatology practice is variable, but overall reasonably high. Most of the trainees seem to receive formal education and have some patient exposure in all competences, though only around half are assessed in each competence. <h3>References</h3> European Board of Rheumatology (a section of UEMS). The European Rheumatology Curriculum Framework. www://dgrh.de/fileadmin/media/Praxis_Klinik/european_curriculum_uems_april_2008.pdf <h3>Disclosure of Interest</h3> None declared
THU0204 Correlation Between Serum Level of Infliximab or Adalimumab and Clinical Response in Spondyloarthritis Seems too Strong to Give the Opportunity of an Interest on Dosage for Therapeutic Adaptation
Authors: T. Grange, E. Solau-Gervais
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Anti-TNF are the only biologics available in spondyloarthritis. Although in rheumatoid arthritis, there are several studies on anti-TNF serum level and efficacy, few data concern spondyloarthritis <h3>Objectives</h3> To analyse the clinical relevance of serum levels of infliximab (INF) and adalimumab (ADA) of patients with spondyloarthritis on therapeutic adaptation. <h3>Methods</h3> 69 patients were included in a retrospective study on a cohort of SA followed in an university hospital who got at least on dosage of serum level of INF or ADA (ELISA done in Tours, laboratory CNRS, UMR 6239). The results were expressed as weak, target or increased concentration compared to expected modeled concentration. Two groups of patients were defined: patients in remission and patients with treatment failure. Impact of level of IFN or ADA on therapeutic adaptation and continued therapy at 1 year has been analyzed in each patient. <h3>Results</h3> 109 dosages have been done in 69 patients. 55.1% of the dosages have been used finally by the clinician for therapeutic adaptation. In remission group, 25 dosages have been analyzed. Treatment reduction was done more frequently when the dosage results was unknown (60% versus 40% p=0.3). 78.6% of patients in who treatment dose has been decreased had targeted or increased level of IFN or ADA. Whatever the level of dosage and even if weak, 100% of patients have maintained the decreased dose of treatment at 1 year. There was no influence of dosage of serum level INF or ADA and continued of low dose anti-TNF at 1 year in SA. In the group with treatment failure, 71 dosages have been analyzed. There was no difference between our decision on therapy (increased dose or switch) whatever clinician knew the level of dosage (increased dose 52.9% versus 56.2% and switching 47.1% versus 43.8%).72% of patients with treatment failure had weak level of IFN or ADA. So there is a significant correlation between serum level and clinical response (p=0.012). But only 22.2% of the patients have maintained the therapeutic adaptation at one year with no influence of serum level of IFX or ADA. <h3>Conclusions</h3> Our study show a significant correlation between serum level of IFX or ADA and clinical response in SA and this correlation seems too strong to give the opportunity of an interest on dosage for therapeutic adaptation. <h3>Disclosure of Interest</h3> None declared
Eosinophil‐derived proteins in nasal lavage fluid of neonates of allergic parents and the development of respiratory symptoms during the first 6 months of life
Authors: T Frischer, G Halmerbauer, C Gartner, R Rath, E Tauber, M Schierl, D Y Koller, R Urbanek, J Förster, J Kühr
Journal: Allergy (2000)

Eosinophilic airways inflammation forms the pathophysiologic basis for a proportion of children at risk of developing recurrent wheezing. Early preventive measures and/or anti-inflammatory treatment may be guided by the identification of such children.We studied upper-airways inflammation by nasal lavage in a cohort of 397 infants within the first 4 weeks of life. They participated in an international multicenter study on the prevention of allergy in Europe (SPACE-Biomed II Program). A volume of 2 ml of prewarmed 0.9% saline was instilled into each nasal cavity and immediately re-collected by a suction device. The average recovery was 502 microl (SD: 311 microl). The concentrations of eosinophil cationic protein (ECP) and eosinophil protein X (EPX) were determined by RIA analysis.ECP was detectable (>2 microg/l) in 47% of samples (173/365) and EPX (>3 microg/l) in 54.7% (197/360). Children with a doctor's diagnosis of a wheezy bronchitis within the first 6 months of life (n = 40) had significantly higher ECP and EPX concentrations in the nasal lavage at 4 weeks of age (median ECP: 14 microg/l; 5-95th percentile: 0-122.4 microg/l) than children without such diagnosis (median ECP: 0 microg/l; 5-95th percentile: 0-86.6 microg/l; P<0.05). Corresponding figures for EPX were 12.14 microg/l (0-148.98 microg/l) vs 7.5 microg/l (0-81.46 microg/l; P<0.05). No associations between nasal ECP/EPX and the development of food allergy or eczema were observed.Increased nasal ECP and EPX in the first 4 weeks of life are associated with wheezing in 6-month-old infants at increased risk of atopic disease. We suggest that this might be related to a general tendency for a Th2 cytokine pattern in these young infants and subsequent trafficking of eosinophils into the nasal mucosa, or it might be a consequence of intrauterine allergen exposure.
Mechanism of Experimental Tumorigenesis. VIII. Ultrastructural Alterations in Mouse Epidermis Caused by Carcinogen Administered Orally&lt;xref ref-type="fn" rid="FN1"&gt;2&lt;/xref&gt;&lt;xref ref-type="fn" rid="FN2"&gt;3&lt;/xref&gt;&lt;xref ref-type="fn" rid="FN3"&gt;4&lt;/xref&gt;
Authors: Kai Setälä, Eino Erkki Niskanen, Lauri Merenmies, Mauri Nyholm, Leo Stjernvall
Journal: JNCI Journal of the National Cancer Institute (1961)

An electron microscopic study of the effect of orally administered 7,12-dimethylbenz[a]anthracene (DMBA) on the epidermis of the back of the mouse was studied on healthy female mice of a tumor-resistant strain. As in previous experiments with locally applied DMBA, the pattern appeared to agree with that seen in light microscopy of the same material, and contained the histologic criteria generally accepted in classical pathology as characteristic of the effect of a carcinogen upon the mouse epidermis. The electron microscopic features were: (a) abnormalities in cell surface-to-cell surface contact, in which combined light, electron, and polarization microscopy indicated disturbances in the detachment of epidermal cells; (b) development of new profiles such as a crown of thornlike pattern in the cytoplasmic periphery, which in polarization microscopy appeared to be composed of brilliant anisotropic material; (c) disturbances in keratinization and the appearance of immature degradation products and cellular remnants in places where they are not seen normally and in nonspecific states; (d) accumulation of globular, electron-dense inclusion bodies intracristally within the internal membranes of the mitochondria even in the basal cells, and (e) a characteristic variability in degree and quality of the changes in various places. The character of the alterations was independent of the dose of DMBA and was not affected by the hair follicular cycle. The results of control experiments, as well as light microscopy studies of serial sections from internal organs, rule out the possibility that these changes might depend on irrelevant external carcinogen contamination or on a hypothetical general toxicity of the carcinogen under the present experimental conditions.
Predicting overall survival for patients with periampullary carcinoma.
Authors: Vincent Yeung, Yutao Gong, Jialu Yu, Yan Yu, Bo Lu, Joshua David Palmer, Rick Burkhart, Benjamin E Leiby, vei Shaun Siow, Harish Lavu, Ernest Rosato, Jordan Michael Winter, Nancy Lewis, Ashwin Reddy Sama, Edith P. Mitchell, Pramila R. Anne, Ying Xiao, Mark Hurwitz, Charles Yeo, Voichita Bar-Ad
Journal: Journal of Clinical Oncology (2015)

376 Background: The purpose of this study was to develop a model predicting the overall survival of patients with peri-ampullary cancer (PAC) following resection, with or without adjuvant therapy. This will help guide physicians in providing optimal post-operative care. Methods: Patients treated between 2006-2012 in our institutional pancreatic tumor registry were analyzed. All patients underwent pancreaticoduodenectomy for PAC. 334 patients had adequate records for analysis and were used to develop a multivariate model based on Cox regression. The variables used in our analysis were age, gender, T-stage, tumor differentiation, positive lymph node ratio (# positive/total), positive resection margins, chemotherapy, radiation therapy (RT), and tumor histology. Multivariate Cox hazards regression tested significance. Model performance was evaluated by the concordance index (c-index). Results: Median age of the cohort was 65 years. 54% of the patients were male. Median follow-up time was 16 months. Median overall survival was 19 months. T-stages were as follows: 7% T1, 9% T2, 77% T3, and 8% T4. 27% of the patients had a positive tumor margin, 68% of patients had positive lymph node spread. 81% of the patients had tubular adenocarcinoma, 9% ampullary adenocarcinoma, 5% cholangiocarcinoma, and 4% duodenal carcinoma. T-stage, tumor differentiation, tumor histology, positive lymph node (PLN) ratio, and adjuvant chemotherapy had a statistically significant association with overall survival (Table 1). The model performance c-index was evaluated as 0.630 with 95% CI as [0.571, 0.690], from a bootstrapping internal validation test on 3-year-survival. Conclusions: This model shows promise in predicting survival following resection for patients with PAC. More patient cases and further analysis of additional factors including specific RT related parameters and specific chemotherapy regimen are needed for development of a more robust model. [Table: see text]
Treatment of persons found incompetent to stand trial
Authors: L Pendleton
Journal: American Journal of Psychiatry (1980)

Persons found incompetent to stand trial comprise the largest group of psychiatric patients committed to mental hospitals through the criminal justice system in the United States. The law dictates that these patients receive short-term treatment aimed specifically at enabling them to stand trial with as little delay as possible. The author describes the treatment and assessment aspects of a program that admits approximately 200 trial-incompetent persons each year. During 1978, 90% of the 205 patients discharged from this program were certified by the treatment staff as competent to stand trial; 97.5% of that group subsequently completed the trial process.
Case 50-1967
Authors: Daniel Deykin, James M. Gibson
Journal: New England Journal of Medicine (1967)

Presentation of Case First admission. A seventy-three-year-old woman entered the hospital because of difficulty in breathing.For many years she had been treated for hypertension with a medication of unknown type. Nine years before entry she had a stroke, resulting in severe left hemiparesis. Six years later the blood pressure was 150 to 170 systolic, 80 to 90 diastolic. During the year before admission she experienced postprandial epigastric distress that was usually accompanied by dyspnea and was relieved by sitting upright. A few months before entry the episodes became more frequent, and during the week before entry she had . . .
OC-112 Nupeg (nasal unsedated seated peg) is safer and better tolerated than rig (radiologically-inserted gastrostomy) in very high risk gastrostomy candidates
Authors: O Roy, J Woodward, S Skerratt, A Datta, N Johnston
Journal: Gut (2015)

<h3>Introduction</h3> Endoscopic gastrostomy (PEG) placement in patients with severe respiratory or neuromuscular compromise carries a high risk of mortality through aspiration and radiological placement (RIG) is usually preferred in this setting. We have used ‘push-PEG’ placement in high risk patients guided by nasal endoscopy, unsedated and seated at 30–45° and here we report the outcomes of this technique compared to RIG placement in high risk patients. <h3>Method</h3> Records were analysed retrospectively for all ‘push-PEGs’ placed since 2008 and compared with records of RIG placements since 2010. Indications, completion rates and complications were compared. <h3>Results</h3> 296 push-PEGs have been placed since 2008 (mostly for head and neck malignancy). 242 were placed by standard per-oral endoscopic guidance and 54 using transnasal endoscopy using a Pentax transnasal endoscope. Of the 54, 27 (50%) were NuPEGs and the other 50% received intravenous sedation (SenPEG). 53/54 (98%) were placed successfully and without complication. One sedated patient experienced a respiratory arrest that required emergency intubation and led to the development of the NuPEG technique, since when no complications have been reported. From 2010–2014, 46 RIGs have been placed. Of these, 89% were successful and uncomplicated with one colonic perforation identified. In two patients where RIG failed due to anxiety or inability to lie flat, NuPEG was performed uneventfully. As a result, NuPEG has entirely replaced RIG in our institution where no RIGs have been placed since 2013. <h3>Conclusion</h3> NuPEG is safer and better tolerated than RIG in patients with respiratory or neuromuscular compromise and is the technique of choice in high risk patients requiring gastrostomy placement. <h3>Disclosure of interest</h3> None Declared.
Avian and pandemic influenza–Five questions for 2006
Authors: A Nicoll
Journal: Eurosurveillance (2005)

In January this year it was observed that 2005 was going to be the Year of the Rooster in the Chinese calendar, and that perhaps was an ill omen for bird (avian) and pandemic influenza. Certainly, influenza was the infection that then dominated the popular press in 2005, and so in a certain way this was a very ‘good’ year for influenza and those who study it. The infection has been getting the attention it deserves as a human threat.
Conditions not attributable to a mental disorder: an epidemiological study of family problems
Authors: J M de Figueiredo, H Boerstler, L O'Connell
Journal: American Journal of Psychiatry (1991)

The objective of this research was to identify and measure the differences among three groups of psychiatric outpatients: those with family problems but without mental disorders, those with both family problems and mental disorders, and those with a mental disorder but without family problems. DSM-III V code conditions (conditions not attributable to a mental disorder) other than family problems do occur, but family problems were chosen because of their importance.All patients admitted to an outpatient psychiatric clinic during a 2-year period were studied (N = 382). Of these, 92 had V code conditions unrelated to family problems and were excluded. Data are presented on the remaining 290 patients. Sociodemographic variables, DSM-III diagnoses, source of referral, previous and subsequent use of outpatient services, and type of family problem were examined. Patients were from a low-income population and came from three ethnic groups (white, black, and Hispanic).Among whites, more men than women had family problems without mental disorders; among blacks, more women than men had family problems with and without mental disorders. Marital problems occurred most frequently in the group with family problems without mental disorders, and married subjects were more likely to have a V code condition. Professional referrals were more common than other referral sources in all three groups. However, family problems without mental disorders were more likely to occur among those who were referred by their families and had never had psychiatric treatment; patients with family problems and mental disorders were more likely to be self-referred and to have been previously treated; those with a mental disorder but without family problems were usually referred by professionals and almost always had been previously treated. There appeared to be underreporting of family problems among those with family problems and mental disorders and among black men with family problems with and without mental disorders.More research is needed on the patterns of use of outpatient psychiatric services by individuals with family problems and other V code conditions.
Farmer's Lung: Case Report
Authors: L BROWN, H PARROT, E C PORTER
Journal: JAMA (1963)

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