tbuckley/cabot-search huggingface dataset:
A Prospective Randomized Comparison of Unsedated Ultrathin Versus Standard Esophagogastroduodenoscopy in Routine Outpatient Gastroenterology Practice: Does It Work Better through the Nose?
Authors: B Birkner, N Fritz, W Schatke, J Hasford
Journal: Endoscopy (2003)

Background and Study Aims: In an outpatient gastroenterological practice setting, highly effective diagnostic procedures and patient satisfaction play an important role. Ultrathin endoscopy in unsedated patients has been shown to be more cost-effective and time-efficient in comparison with standard endoscopy. A prospective randomized study was carried out in unsedated patients to compare performance, feasibility, safety, and patient tolerance between ultrathin transnasal (UT), ultrathin oral (UO), and standard (SO) esophagogastroduodenoscopy (EGD). Patients and Methods: A total of 200 of 600 eligible patients consented to participate in the study, and were randomly assigned to undergo UT, UO, or SO. Patients reported their tolerance of the procedure (anxiety, pain, gagging, and overall satisfaction; Likert scale 1-10), and the endoscopists reported the effectiveness of the procedure (handling, picture quality, and overall performance; Likert scale 1-10). Statistics were calculated using the Kruskal-Wallis test. Results: After randomization, 65, 67, and 68 patients were allocated to the UT, UO, and SO groups, respectively. Failure to achieve complete EGD by the intended route occurred in 14 patients (22 %) in the UT group. Compared to the SO group, patients in the UT and UO groups rated anxiety before the procedure as being more intense - median score (10 % quantile estimate; 90 % quantile estimate): UT, 2.0 (1.0; 4.0); UO, 2.0 (1.0; 4.0); SO, 0.0 (0.0; 2.0); p < 0.0001), whereas SO patients experienced a higher level of anxiety during the procedure (P < 0.0001). Pain during insertion of the endoscope was the least intense in the UO group: UT, 2.0 (1.0; 5.0); UO, 1.0 (1.0; 3.0); SO, 2.0 (1.0; 4.0); P < 0.001). Gagging during insertion was more pronounced in the UO group: UT, 2.0 (1.0; 4.0); UO, 3.0 (1.0; 7.0); SO, 2.0 (1.0; 5.0); P < 0.01). The patients' score for the overall assessment was better in the SO group (P < 0.0001). The endoscopists' overall assessment for ultrathin EGD was poorer than for standard EGD: UT, 3.0 (2.0; 5.0); UO, 3.0 (2.0; 5.0); SO, 2.0 (1.0; 3.0); P < 0.0001). Conclusions: Ultrathin endoscopy through both the transnasal and oral routes has limited use in routine outpatient practice. Techniques for reducing pain and gagging may improve patient tolerance. Further technical improvements are needed to allow routine implementation.
Appendicitis and Pregnancy
Authors: R M KING, G V ANDERSON
Journal: JAMA (1963)

In 74,000 obstetrical patients at Los Angeles County Hospital the incidence of acute appendicitis in pregnancy was 0.05 per cent. In a study of 36 cases of clinically diagnosed appendicitis in pregnancy between 1956 and 1960, it was shown that the fetal and maternal morbidity and mortality were decreased when a definite operative procedure was done early. The difficulty in diagnosis is increased by the necessary consideration of pyelonephritis and twisted ovarian cyst. Rupture of the appendix increased hazards to maternal and fetal survival. It was noted also that threatened premature labor may indicate a ruptured appendix. Emergency operation with the use of antibiotics in such cases was effective therapy. The incidence of premature delivery was proportionate to the delay in operating. If operation was performed in less than eight hours after admission to the hospital, there was no maternal or fetal loss. A delay greater than eight hours resulted in a 17 per cent fetal loss in premature delivery and 4 per cent fetal loss of infants at term.
Network-Based Analysis of Exome Sequencing Mutations Identifies Molecular Subtypes of Myelodysplastic Syndromes
Authors: Aziz Nazha, Bartlomiej Przychodzen, Hideki Makishima, Hetty E. Carraway, Bhumika J. Patel, Cassandra M Hirsch, Michael Clemente, Srinivasa R. Sanikommu, Aaron T. Gerds, Jennifer S. Carew, Satoru Miyano, Matt Kalaycio, Seishi Ogawa, Jaroslaw P. Maciejewski, Mikkael A. Sekeres
Journal: Blood (2015)
Soundings: Remember them?
Authors: Colin Douglas
Journal: BMJ (1998)

In the sunlit harbour a dozen warships lie neatly alongside. Ashore, hundreds of sailors relax as they always do: sightseeing, keeping fit, buying gifts, or just drinking lots of beer in a faded little garrison town that looks south across Morocco and north into Spain. In a few days the ships will put to sea, take the first right past Cape Trafalgar, and go home.

The previous year, after a similar annual fleet exercise and at very short notice, something different happened. They put to sea, turned left, and steamed thousands of miles into the South Atlantic: not for exercise but against real bombs, missiles, and torpedoes. They fought a war and won. Some—Antelope, Ardent, Coventry, and Sheffield—never came home.

This year, for the last evening ashore, there is a concert. In a vast limestone cavern hundreds sing along to a Royal Marine band. Then a supply officer who really can sing obliges the company with “Your tiny hand is frozen” from La Boheme, complete with an introduction for new listeners. “Right then. Imagine you’re up home, first time, with a girl .... She’s sitting there. You reach out ....” After three notes they are spellbound.

The second half is a briskly naval version of the Last Night of the Proms, complete with welterweight local contralto and possibly the best “Rule Britannia!” ever done in a cave. Hairy senior ratings roar the chorus, tears rolling down their cheeks.

After the concert, as most walk the mile or so down to the ships, the heavens open. We offer three junior ratings a lift in our officers’ mini. Large and damp, they cram themselves into the back seat. “Great concert, sir,” is the verdict. Dripping hundreds stroll amiably on down.

I have seen ships in the harbour bearing scars of war—patches of new plating here and there—as do the aircraft on the carrier’s deck. Real bombs and bullets do real damage. So how were the sailors?

That night they were fine: proud of the navy, their ships, and themselves. But how are they now, 15 years on? In a stone sentry box, a remnant of Gibraltar’s historic defences, an anonymous hand many years ago carved a chilling couplet: “God and the soldier all men adore, in time of trouble—and then no more.”
Prevention of Systemic Infections, Especially Meningitis, Caused by Haemophilus influenzae Type b
Authors: John B. obbins
Journal: JAMA (1996)

The development of<i>Haemophilus influenzae</i>type b((Hib)gate vaccines has led to the virtual elimination of systemic infections caused by that pathogen, has provided insights into the pathogenesis of and immunity to other capsulated bacteria, and has contributed to the development of new vaccines. Meningitis, a common and serious infection of children, and other infections caused by Hib have been virtually eliminated in countries that have achieved widespread vaccination with Hib conjugates, including the United States, Canada, the United Kingdom, Iceland, Scandinavia, France, and Germany. Hib conjugates have also been shown to be highly effective in developing countries. The principles derived from use of these vaccines, along with studies of other capsulated pathogens, should allow the rapid inclusion of new polysaccharide-based conjugates into routine vaccination schedules of infants, and should help to realize further reductions in serious systemic infectious diseases.
Inhibition Patterns the Whisking Rhythm
Authors: Varun Sreenivasan, Carl C.H. Petersen
Journal: Neuron (2016)

In this issue of Neuron, Deschênes et al. (2016) propose that rhythmic inhibition of whisker motor neurons is a key pattern generator underlying exploratory whisking. The inhibitory premotor neurons located in the brainstem reticular formation are synchronized by breathing-related oscillators.
PWE-218 Risk factors predicting recurrent hospital admission acute pancreatitis
Authors: A Ahmad, Y Khatun, S Dharmayan, M Barua, N Bostan, AA Ayantunde
Journal: Gut (2015)

<h3>Introduction</h3> Acute pancreatitis is a relatively common condition and is associated with significant morbidity and mortality. Patients with acute pancreatitis do experience repeated hospital visits and admission due to recurrent symptoms. The aim of the study was to evaluate the factors that may predispose to recurrent pancreatitis requiring repeated hospital admission. <h3>Method</h3> Demographic and clinical data of all patients admitted to our hospital with acute pancreatitis between January 2011 and December 2014 were retrospectively reviewed. We collected data relating to the severity using modified Glasgow scoring tool, length of hospital stay and outcomes including intensive care admission, presence of complications and acute pancreatitis specific mortality. Patients with recurrent hospital admission were identified and factors predicting repeat presentation were evaluated. <h3>Results</h3> 569 patients with acute pancreatitis were admitted during the 4 year study period. There were 264 males and 305 females with the mean age of 60 (13–100) years. The aetiology factors included 290 gallstones, 91 alcohol induced, 142 idiopathic, 12 drug related, 9 hyperlipidaemia, 8 post ERCP, 8 pancreatic malignancy, 4 pancreatic divisum, 3 hypercalcaemia, 1 trauma and 1 autoimmune disease. 44.5% of the patients had at least one associated co-morbidity. There were 449, 44 and 76 patients with mild, moderate and severe pancreatitis according to the modified Glasgow criteria. Majority of the patients (83%) were managed on the ward while 71 and 35 were admitted to the high dependency and intensive care units respectively. 105/569 (18.5%) patients developed complications and we recorded pancreatitis specific mortality rate of 4.7%. 35% (199/569) of the patients required repeated admissions ranging from 2–4 episodes. Factors such as the aetiology of pancreatitis and the presence of comorbidity are predictors of recurrent symptoms and repeated hospital admission. Patients with gallstone pancreatitis (p-value 0.002) and comorbidity (p-value 0.008) have more likelihood of representation. Patients older than 70 years were more likely to present with recurrent symptoms but the difference did not reach a statistically significant level (p-value (0.060). Factors such as gender, severity of pancreatitis and the presence of complications at the first presentation have no significant influence on recurrent presentation. <h3>Conclusion</h3> Significant proportion of the patients with acute pancreatitis present with recurrent symptoms particularly those with gallstone induced with associated comorbidity. Early surgical and endoscopic treatment of the gallstones may prevent recurrent presentation. <h3>Disclosure of interest</h3> None Declared.
Patient Satisfaction with Self-Administration of Subcutaneous (Sc) Trastuzumab Via Single-Use Injection Device (Sid) in the International, Randomised Prefher Study
Authors: S. Verma, P.J. Barrett-Lee, G. Curigliano, L. Fallowfield, A. Knoop, V. Müller, E. Brewczynska, R. El-Maraghi, G. López-Vivanco, S. Sehdev, Z. Machackova, S. Osborne, X. Pivot
Journal: Annals of Oncology (2014)
Steroid-Induced Fractures and Bone Loss in Patients with Asthma
Authors: Allen D. Adinoff, J. Roger Hollister
Journal: New England Journal of Medicine (1983)

To study the association between bone disease and long-term steroid administration in asthmatics, we reviewed the hospital records of 128 patients over 40 years of age who had taken daily or alternate-day adrenal corticosteroids for at least a year and compared them with the records of 54 other asthmatics of similar age who had not required long-term administration of steroids. We found evidence in the records of a total of 58 fractures of the ribs or vertebrae in 14 of the patients who had received long-term steroid treatment (11 per cent) and no evidence of fractures in the patients who had not received long-term treatment. We also prospectively studied 30 hospitalized asthmatic patients between 20 and 70 years of age who had been screened for medications (other than steroids) or complieating diseases known to affect bone mineralization. Eight of 19 asthmatic patients receiving long-term steroid therapy had rib or vertebral fractures, whereas none of 11 matched patients not receiving such therapy had fractures. Furthermore, bone-density measurements of the distal and proximal radius by photon absorptiometry revealed that the trabecular, but not the cortical, bone mass was below normal in the former group of patients but not in the latter. Within the long-term steroid group, there was no significant correlation between bone density and dose or duration of steroid treatment. We conclude that long-term steroid therapy in asthmatic patients is associated with decreased trabecular bone density and an increased prevalence of rib and vertebral fractures. (N Engl J Med 1983; 309:265–8.)
Complement-Mediated Demyelination in Patients with IgM Monoclonal Gammopathy and Polyneuropathy
Authors: Salvatore Monaco, Bruno Bonetti, Sergio Ferrari, Giuseppe Moretto, Ettore Nardelli, Francesco Tedesco, Tom Eirik Mollnes, Eduardo Nobile-Orazio, Emanuela Manfredini, Luisa Bonazzi, Nicola Rizzuto
Journal: New England Journal of Medicine (1990)

We investigated the role of complement in the pathogenesis of the demyelinating polyneuropathy that occurs in some patients with IgM monoclonal gammopathy. Seven patients with chronic sensorimotor polyneuropathy and IgM monoclonal gammopathy were examined. In six patients, the monoclonal protein recognized an epitope shared by myelin-associated glycoprotein and two peripheral-nerve glycolipids, whereas in one patient, IgM bound to an unidentified myelin antigen. Direct and indirect immunofluorescence and immunoperoxidase assays showed colocalization along the myelin sheaths of peripheral-nerve fibers of monoclonal protein with complement components C1q, C3d, and C5. In addition, terminal-complement complex that was not associated with S protein was detected in myelin sheaths. It appeared that alterations in myelin geometry caused by the separation of myelin lamellae corresponded to sites at which terminal-complement complex was deposited. We conclude that demyelination in polyneuropathy associated with IgM monoclonal gammopathy may be mediated by complement.
Of What Value Is Uracil/Tegafur Plus Leucovorin to Colorectal Cancer Patients?
Authors: Michael Friedman
Journal: Journal of Clinical Oncology (2002)

Article Tools EDITORIALS Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.2002.20.17.3574 Journal of Clinical Oncology - published online before print September 21, 2016 PMID: 12202655 Of What Value Is Uracil/Tegafur Plus Leucovorin to Colorectal Cancer Patients? Michael FriedmanxMichael FriedmanSearch for articles by this author Show More Pharmacia Corp, Peapack, NJ https://doi.org/10.1200/JCO.2002.20.17.3574 Full Text PDF Figures and Tables "Of What Value Is Uracil/Tegafur Plus Leucovorin to Colorectal Cancer Patients?." Journal of Clinical Oncology, 20(17), pp. 3574–3575© 2002 by American Society of Clinical Oncology
Retrograde Arterial Catheterization of the Left Ventricle in 388 Patients
Authors: Sergio Aguilar, Maximiliaan G. Kaulbach, Paul G. Hugenholtz
Journal: New England Journal of Medicine (1966)

DURING the past decade there has been increasing interest in direct catheterization of the left ventricle. Different surgical approaches have been advocated and have found a varying degree of popularity. Brockenbrough and his associates1 reported that the trans-septal technic permitted entry into the left ventricle in 95 per cent of 450 patients, but the safety of this method has been questioned by reports of occasional, serious complications.2 3 4 The left ventricle can also be entered directly through the anterior chest wall. A recent study suggested that this percutaneous method was quite useful and in aortic stenosis should be considered the method . . .
Isolated Deficiency of Follicle-Stimulating Hormone Re-Revisited
Authors: Clare Matthews, V. Krishna Chatterjee
Journal: New England Journal of Medicine (1997)

To the Editor: In 1972, Rabin et al. described the case of an Israeli woman with primary amenorrhea due to an isolated deficiency of follicle-stimulating hormone.1 They “revisited” the case in 1979...
Intra-Articular Injection of Cortisone in the Treatment of Rheumatoid and Hypertrophic Arthritis
Authors: Abraham Cohen, Isadore Rose, Marvin J. Seven
Journal: New England Journal of Medicine (1954)

THE intra-articular use of cortisone in the treatment of rheumatoid and hypertrophic arthritis has not been investigated as widely as the use of hydrocortisone. In 1951 Duff and his co-workers1 found that intra-articular injection of cortisone reduced the number of white cells in the synovial fluid in cases of rheumatoid arthritis and improved the viscosity and quality of mucin. Similar effects of hydrocortisone were found to be more lasting. The investigators interpreted these findings as support for the belief that both cortisone and hydrocortisone act directly on connective tissue. Early clinical reports2 3 4 showed intra-articular injection of cortisone to have transient . . .
THU0297 Serum CXCL8, 10 and 12 are Increased in Patients with Behcet's Disease and CXCL10 Levels are Correlated with Number of Erythematous Nodosum
Authors: S.J. Lee, J.Y. Choi, B.Y. Choi, D.J. Ko, H.M. Kwon, J.Y. Moon, E.H. Kang, J.K. Park, E.Y. Lee, E.B. Lee, Y.W. Song
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Chemokines are multifunctional mediators that control leukocyte recruitment into the inflammatory sites and enhance immune responses. It remains to be investigated which chemokines are important in Behcet9s disease (BD). <h3>Objectives</h3> The objective of this study was to investigate serum levels of neutrophil and lymphocyte chemoattractants in BD patients and its association with disease activity and symptoms. <h3>Methods</h3> We collected sera from patients with BD (n=64) and age-, sex matched healthy controls (n=21). Serum levels of chemokines were assayed for the neutrophil chemoattractants (CXCL1 and CXCL8) and lymphocyte chemoattractants (CXCL9, CXCL10, CXCL12, CXCL13 and CXCL16) by using a multiplex assay. Behcet9s disease current activity form (BDCAF) and symptoms were evaluated at the time of blood collection. <h3>Results</h3> Serum levels of CXCL8, CXCL10 and CXCL12 were significantly higher in the BD patients than in healthy controls (p&lt;0.001, p=0.050 and p=0.002, respectively). Serum chemokine levels were not associated with BDCAF in BD patients. But CXCL10 levels were significantly higher in patients with erythematous nodosum (EN) than in patients without EN (p=0.008). AdditionaIly, CXCL10 levels were significantly correlated with number of EN (r=0.338, p=0.006). There was no difference of serum level of CXCL1, CXCL9, CXCL13 and CXCL16 between BD and healthy controls <h3>Conclusions</h3> Serum levels of CXCL8, CXCL10 and CXCL12 were significantly higher in the BD patients than in healthy controls. CXCL10 levels were correlated with number of EN in BD patients. <h3>Disclosure of Interest</h3> None declared
Myeloma with Xanthoderma Due to an IgG<sub>λ</sub>Monoclonal Anti-Flavin Antibody
Authors: Mehdi Farhangi, Elliott F. Osserman
Journal: New England Journal of Medicine (1976)

When yellow skin and yellow hair developed in an elderly patient with multiple myeloma, we ruled out the usual causes of such pigmentation but identified a monoclonal IgGlambda (lgGGar) with anti-flavin antibody activity. Purified IgGGar was bright yellow, and the acid-dissociated chromophore was identified as riboflavin by chromatography and absorption spectroscopy. Native IgGGar contained 1.45 moles of flavin per mole of IgG, and increased to 2 moles with addition of riboflavin to saturation. The flavin was localized to the Fab fragment and was bound to IgGGar with high affinity. IgGGar showed strongest affinities for riboflavin, flavin mononucleotide and flavin adenine dinucleotide, and lower affinities for dinitrophenyl derivatives and naphthoquinone. The demonstration of hapten bound to the circulating monoclonal immunoglobulin in this case suggests the possibility of bound but colorless haptens on other myeloma proteins as well as on normal immunoglobulins.
Case 38-1997
Authors: John G. Krikorian, Darryl E. Palmer-Toy
Journal: New England Journal of Medicine (1997)

Presentation of CaseA 41-year-old man was admitted to the hospital because of fever of three weeks' duration.Twenty-one years earlier, the patient had had Hodgkin's disease, with cervical, axillary, mediastinal, and perihilar lymphadenopathy. A staging laparotomy with splenectomy showed minimal splenic involvement and multiple negative retroperitoneal lymph nodes. Stage IIIB was assigned. He was treated with MOPP (mechlorethamine, vincristine, procarbazine, and prednisone), which was ineffective and was replaced by ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine). Subsequently, he received mantle irradiation, followed by cycles of chemotherapy that included lomustine and vinblastine.The patient was asymptomatic thereafter except for the development . . .
P127 Superiority of glycopyrronium versus tiotropium in early onset of bronchodilation in patients with moderate to severe COPD – the FAST study
Authors: H Watz, C Mailaender, A-M Kirsten
Journal: Thorax (2015)

<h3>Background</h3> Glycopyrronium (GLY) has demonstrated efficacy similar to open-label and single-blinded tiotropium (TIO) in the treatment of COPD and fast onset of bronchodilation action.<sup>1,2</sup> The double-blinded FAST study compared the efficacy of GLY with TIO in serial spirometry and bodyplethysmography measurements to allow for a more intensified characterisation of the earlier onset of action. <h3>Methods</h3> In this multicenter, randomised, double-blinded, double-dummy, cross-over study patients (pts) with moderate-to-severe COPD received single-dose of both once- daily GLY 44 μg and TIO 18 μg via the Breezhaler® and Handihaler® devices respectively. Primary endpoint was the forced expiratory volume in one second (FEV<sub>1</sub>) AUC<sub> –2h</sub>. Other endpoints included inspiratory capacity (IC), residual volume (RV), functional residual capacity (FRC) and specific airway resistance (sRaw), all measured by bodyplethysmography. <h3>Results</h3> Of 152 pts randomised (mean age: 61.8 yr, mean post-bronchodilator FEV<sub>1</sub>: 52.1%) 99.3% completed the study. After inhalation of the single dose, GLY demonstrated superiority to TIO in early bronchodilation i.e. FEV<sub>1</sub> AUC<sub> –2h</sub> (least squares mean (LSM) = 0.037 L, p = 0.0006). Both treatments showed similar improvements in IC, RV, and FRCpleth. Over the first 90 min after dosing, GLY also showed statistically significant improvement in sRaw compared to TIO with a difference of 0,184 kPa*s at the time point 90 min (LSM, p = 0.006). <h3>Conclusion</h3> GLY showed effective bronchodilation and was superior to double-blinded TIO in terms of early onset of bronchodilation. Both GLY and TIO showed similar improvements in static lung volume parameters; however GLY was superior in reduction of sRaw early after inhalation. <h3>References</h3> 1 Kerwin E, <i>et al</i>.<i> Eur Resp J</i> 2012;<b>40</b>:1106–1114 2 Chapman, <i>et al</i>. <i>BMC Pulm Med</i>. <b>2014</b>;14:4
Drug users’ families demand end to “war on drugs”
Authors: Richard Hurley
Journal: BMJ (2016)

UNGASS

The families of dead users of illicit drugs protested outside the United Nations headquarters in New York City on Monday 18 April, the day before the start of an emergency three day special meeting of the UN general assembly (UNGASS2016) to discuss the global drug problem, the first since 1998.

“There is a hollow ring to this UN meeting’s slogan, ‘A better tomorrow for today’s youth,’ for these are families whose lives have been wrecked by the global drug war,” said Jane …