tbuckley/cabot-search huggingface dataset:
AB0385 Clinical and Subclinical Neuropsychiatric Abnormalities in Rheumatoid Arthritis Patients
Authors: E. M Khedr, N. Abo El Fetoh, O. Herdan, D.H. El-Hammady, R. M Gamal, H. Khalifa, A. M Ali
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Rheumatoid arthritis (RA) is a chronic, systemic, inflammatory disease with probable autoimmune aetiology. RA has many secondary complications and a variety of neuropsychological consequences <h3>Objectives</h3> To estimate the frequencies of neuropsychiatric disorders in RA patients and their relation with the duration and activity of disease. <h3>Methods</h3> Seventy four consecutive female, RA patients were recruited and compared with 25 age and educational status-matched female healthy volunteers. All eligible participants underwent clinical, laboratory and electrophysiological examinations (motor and sensory nerve conduction study, F-wave of four Limbs, P300 Event related Potential (ERP) and electroencephalography (EEG). Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders 3rd edition, Revised (DSM-III-R) Axis I Disorders (SCID-I) for diagnosis of psychiatric illness and Wechsler Adult Intelligence scale 3rd edition (WAIS-III) with assessment of total scale, verbal and performance intelligence quotients (IQ)were administered to all participants. <h3>Results</h3> Fourteen patients (18.9%) had evidence of symptomatic peripheral neuropathy and radiculopathy, while 60.8% had psychiatric disorders. Depression was the most prevalent psychiatric disorder (45%), followed by anxiety (27%) and comorbid anxiety with depression (21.6%). low IQ score was recorded in 54%. P300 latency was significantly prolonged (p=0.0001) and seven (9.5%) RA patients recorded abnormal P300 latency (&gt;mean ± 2SD) compared to control values. Abnormal electroencephalography (EEG) findings were observed in 48.6%. VAS pain score was significantly higher among patients with psychiatric disorders versus patients without psychiatric disorders (p=0.0001). Significant negative correlation was recorded between disease activity score and total IQ (p=0.01), while no significant association between with the disease activity score with the presence of neuropathy or psychiatric disorders. <h3>Conclusions</h3> Cognitive impairment, depression, anxiety and peripheral neuropathy are common in RA patients. Early diagnosis and management of neuropsychiatric disorders in RA patients may greatly improve the patients9 health related quality of life. <h3>Disclosure of Interest</h3> None declared
SAT0405 Risk of Status Epilepticus and Intractable Epilepsy in Systemic Lupus Erythematosus Patients with Antiphospholipid Antibodies
Authors: K. Sheth, T. Mehta, V. Sheth, R. Soni, S. Puri, A.L. Parke
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Antiphospholipid antibodies are present in 33% of patients with Systemic Lupus Erythematosus (SLE). Studies have shown that presence of antiphospholipid antibody independently increases seizure risk in SLE patients. In this nation-wide study, we tried to determine if antiphospholipid antibodies are independent predictors of intractable epilepsy and status epilepticus (general and partial). <h3>Objectives</h3> To determine if antiphospholipid antibody is an independent predictor of status epilepticus, grand mal status epilepticus or epilepsia partialis continua in patients with SLE. <h3>Methods</h3> We queried the Healthcare Cost and Utilization Project9s (HCUP) Nationwide Inpatient Sample (NIS) between 2002 and 2011 and separated the hospitalizations due to or with SLE using ICD 9 diagnostic codes previously established by HCUP. Among this population, we examined the patients with antiphospholipid antibodies (APLA) and compared their risk of seizures compared to the patients without APLA using the logistic regression model. The model was controlled for variables which included age, sex, race, ischemic stroke, intracranial bleed, hypertension, chronic kidney disease, uremia, lupus nephritis, lupus encephalitis, craniotomy, head trauma, hyponatremia, psychosis, intracranial infections, brain neoplasms, use of immunosuppression, alcohol use, abnormal electroencephalogram and use of antiepileptics. Using SAS 9.2, survey procedures were used to identify multivariate predictors of intractable epilepsy, grand mal status and epilepsia partialis continua. <h3>Results</h3> A total of 1,631,680 hospitalizations with SLE were available for analysis of which 907 (0.06%) had intractable epilepsy, 2092 (0.13%) had grand mal status and 146 (0.01%) patients had epilpesia partialis continua. The odds ratio (OR) of intractable epilepsy in SLE patients with APLA was 1.157 (Confidence Interval (CI)=0.500-2.673, p value=0.7336); OR for grand mal status was 1.094 (CI=0.671-1.786, p value=0.7183); and OR for epilepsia partialis continua was 2.813 (CI=0.768-10.295, p value=0.1183). <h3>Conclusions</h3> SLE and antiphospholipid antibody syndrome overlap significantly, and antiphospholipid antibodies are independently associated with increased risk of seizures. In our analysis, patients with SLE who have antiphospholipid antibodies were not at increased risk of having status epilepticus (partial or generalized). We also found that antiphospholipid antibodies are not an independent predictor for refractory epilepsy in patients with SLE. <h3>References</h3> Herranz MT, Rivier G, Khamashta MA, Blaser, K U, Hughes GR (1994). Association between antiphospholipid antibodies and epilepsy in patients with systemic lupus erythematosus. Arthritis and Rheumatism, 37(4), 568-571. <h3>Disclosure of Interest</h3> None declared
OC-054 Living with the cure; an exploration of patient’s experience following surgical resection for oesophageal cancer
Authors: E Jones
Journal: Gut (2015)

<h3>Introduction</h3> It is widely acknowledged by healthcare professionals, that patient’s health-related quality of life is significantly reduced for some time after resection of the oesophagus for cancer.<sup>1</sup>This includes physical, psychological and social functioning, and the factors examined are often physician-led. What is less well understood is the lived experience of these patients on a daily basis.<sup>2</sup> <h3>Method</h3> This was designed as a phenomenological study, to examine a group of 10 people, purposively sampled, who have lived through a named experience; oesophagectomy for cancer. They were selected from a trust-held database between the dates of January 2006 and January 2009. There was a 90% response rate. There were specific exclusion criteria for patients with active or recurrent cancer. In-depth interviews were arranged and audio-recorded. The interviews were subsequently analysed and themes were identified. <h3>Results</h3> Patients identified an overall phenomenon of tiredness, eating problems and loss of pleasure in life which was multi-factorial. The factors could be separated into the following themes; experience of receiving a cancer diagnosis, accessing information, in-patient experience, physiological post-operative symptoms, perceptions of health professionals, psycho-social post-operative effects and positive framing and spirituality. Other experiences of significance were dumping syndrome, social and identity changes and problems related to flashbacks to intensive care. <h3>Conclusion</h3> Implications for practice were identified. A need for increased access to Upper GI Clinical Nurse Specialists and specialist dieticians along with more tailored information-giving was highlighted. Patients experiencing distress related to intensive care flashbacks may need specialist psychological assessment. Both post-operative complications and perception of in-patient experiences appeared to affect quality of life during the first year after surgery. Acknowledgements to Dr Rob Monks, academic supervisor at University of Central Lancashire. <h3>Disclosure of interest</h3> None Declared. <h3>References</h3> Viklund P, Wengstrom Y, Rouvelas I, Lindblad M, Lagergren J. Quality of life and persisting symptoms after oesophageal surgery. Eur J Cancer 2006;42:1407–14 Wainright D, Donovan JL, Kavadas V, Cramer H, Blazeby JM. Remapping the body: learning to eat again after surgery for esophageal cancer. Qual Health Res. 2007;17(6):759–771
In Vitro Lymphocyte Immunization to Cultured Human Tumor Cells: Parameters for Generation of Cytotoxic Lymphocytes2
Authors: Brahma S. Sharma
Journal: JNCI Journal of the National Cancer Institute (1976)

Journal Article In Vitro Lymphocyte Immunization to Cultured Human Tumor Cells: Parameters for Generation of Cytotoxic Lymphocytes Get access Brahma S. Sharma Brahma S. Sharma Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 57, Issue 4, October 1976, Pages 743–748, https://doi.org/10.1093/jnci/57.4.743 Published: 01 October 1976 Article history Received: 09 June 1975 Revision received: 17 December 1975 Accepted: 05 March 1976 Published: 01 October 1976
PWE-110 Breathomics – distinguishing minimal from overt hepatic encephalopathy using volatile organic compound analysis: a pilot study
Authors: J Covington, M Mcfarlane, L Kho, S Wurie, N O'Connell, R Savage, C Nwokolo, KD Bardhan, R Arasaradnam
Journal: Gut (2015)

<h3>Introduction</h3> Hepatic encephalopathy (HE) is a neurological manifestation of decompensated liver disease which develops in approximately 50% of patients with cirrhosis. The current diagnostic challenge presented by Hepatic encephalopathy is the detection of minimal HE, as opposed to the more clinically apparent overt HE. Rifaximin, licensed for overt HE, is an effective therapy for these patients, but earlier identification and treatment of HE could prevent liver disease progression and hospitalisation. We conducted a pilot study to analyse the breath samples of patients with different HE grades, alongside the breath of healthy controls, using a portable type electronic nose (uvFAIMS). <h3>Method</h3> 42 patients were enrolled; 22 with HE and 20 healthy controls. Breath samples were captured at the bedside using a Warwick designed breath capture device. The samples were then analysed using an ultra violet FAIMS machine. This uses ultra violet light to energise electrons rather than ionising radiation in the traditional FAIMS devices. West Haven criteria were applied and MELD scores calculated. Data was analysed using a previously developed pipeline based on a 2D wavelet transform and threshold, removing background noise. Sensitivity, specificity, and Area Under Receiver Operator Curve (AUROC) were calculated in 10-fold cross validation and reported using sparse logistic regression. <h3>Results</h3> 12 patients had minimal HE and 10 had covert/overt HE. Classification of HE vs controls showed a sensitivity of 0.88 (0.73 – 0.95) and specificity of 0.68 (0.51 – 0.81), AUROC 0.84 (0.75–0.93). Minimal HE was distinguished from covert/overt HE with a sensitivity of 0.79 (0.49 – 0.95) and specificity of 0.50 (0.37 – 0.63), AUROC 0.71 (0.57–0.84). There was no statistically significant differences between differing HE grades; AUROC 0.61 (0.43 – 0.79). <h3>Conclusion</h3> This pilot study has confirmed the potential of detection and diagnosis of HE via breath analysis identification of VOCs signatures. Importantly this was performed utilising a non-invasive, portable bedside device and holds potential for future early diagnosis of minimal or covert HE. <h3>Disclosure of interest</h3> None Declared.
Off-Pump Coronary Bypass Surgery
Authors: Jeff Healey, Elisabeth Fenwick, Bernie O'Brien
Journal: New England Journal of Medicine (2003)

tory response syndrome and microembolization, which leads to multiorgan dysfunction. 4 It seems rational that all patients, both those at high risk and those at low risk, would benefit from a technique that avoids the use of cardiopulmonary bypass.The study by Nathoe et al. did not show a significant difference in cardiac outcomes between coronaryartery bypass grafting with cardiopulmonary bypass and off-pump coronary-artery bypass in low-risk patients.Coronary-artery bypass grafting was 14.1 percent more expensive at one year.A similar article, by Abu-Omar and Taggart, 4 adds to the strong evidence that low-risk populations are the best candidates for off-pump coronary-artery bypass.Those authors rightly highlight two randomized trials, both of which showed reductions in postoperative morbidity and the length of the hospital stay in lowrisk patients who underwent off-pump coronaryartery bypass.These articles are refreshing because they remind cardiologists and cardiac surgeons that off-pump coronary-artery bypass is beneficial in both high-risk and low-risk patients and that it is more cost-effective in low-risk patients.
Sulfasalazine
Authors: Peter Goldman, Mark A. Peppercorn
Journal: New England Journal of Medicine (1975)

A PREVALENT view of rheumatoid arthritis in the late 1930's was that the disease had both infectious and inflammatory components, and thus it seemed reasonable that a therapeutic agent might be designed that combined in a single molecule both antibacterial and anti-inflammatory activity. One of the drugs introduced as a result of this reasoning was sulfasalazine (Fig. 1), which combined the recently introduced antibacterial drug sulfapyridine with the anti-inflammatory agent salicylate.1 Although time has failed to justify the original hopes for a drug active against rheumatoid arthritis, sulfasalazine has been demonstrated to be useful in the therapy and prophylaxis of . . .
SAT0297 Prognosis of Vitamin D Insufficiency: A 3-Year Follow-Up of the Road Study
Authors: N. Yoshimura, S. Muraki, H. Oka, S. Tanaka, H. Kawaguchi, K. Nakamura, T. Akune
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Vitamin D (VD) influences bone quality and is important in maintaining bone densityl; however, there are few reports clarifying how VD status changes over time and what factors may affect the prognosis of VD status. <h3>Objectives</h3> To clarify the natural course of subjects with VD insufficiency, factors associated with the prognosis of VD where compared between subjects with VD insufficiency and the general population. <h3>Methods</h3> The Research on Osteoarthritis/Osteoporosis Against Disability study (ROAD), a large-scale population-based cohort study, was performed between 2005 and 2007. Serum 25D levels were measured in 1683 participants. The change of VD status in 1346 individuals (79.6%), who completed a follow-up survey 3 years later, was evaluated. The VD insufficiency group was comprised of 717 individuals (53.3%). Factors associated with VD insufficiency prognosis after 3 years were determined using multinominal logistic regression analysis after adjustment for potential risk factors. <h3>Results</h3> After 3 years, of the 717 subjects with VD insufficiency at baseline, 387 (54.0%) maintained insufficiency, 281 (39.2%) improved to normal VD status, and 49 (6.8%) exhibited worsening of VD status. Multinominal logistic regression analysis indicated that higher serum levels of 25D (p&lt;0.001) and lower intact parathyroid hormone levels (p&lt;0.007), increased alcohol consumption (p=0.017), and lower total daily energy intake were significantly associated with worsening of VD status (p=0.001). <h3>Conclusions</h3> VD insufficiency status altered over a 3-year period with improvement in 40% of patients, and worsening in 7%. The present study revealed that high serum 25D and low serum intact parathyroid hormone at baseline, low alcohol consumption, and higher daily energy intake are factors associated with improved VD status overtime. <h3>Disclosure of Interest</h3> None declared
Ongoing evaluation in psychiatry: the first step toward quality
Authors: J F Borus, J Yager
Journal: American Journal of Psychiatry (1986)

Concern about quality control in psychiatric training has been heightened by the lack of standardized assessment within residencies to ensure that graduates reach a level of competence commensurate with the ability to practice independently and the high failure rate on the American Board of Psychiatry and Neurology examination. An APA task force explored the paucity of evaluation of both training programs and residents and made 10 recommendations for improving the quality of residency training. The authors describe the evaluative components of these recommendations and the political steps taken to gain professional consensus for their requirement in all training programs.
The Hidden Lesion
Authors: Alfred I Lee, Christopher A Tormey
Journal: New England Journal of Medicine (2016)

A 24-year-old woman presented to the ED with pain in the left leg. She had been training for a 5-km race when, 2 days before presentation, she had crampy pain in her left leg, extending to the left lower abdomen and buttock, plus leg swelling and exertional dyspnea.
AB0012 TNF-Alpha and IL-10 Promoter Polymorphisms in Susceptibility To Systemic Lupus Erythematosus in Bulgarian Population
Authors: M. Ivanova Goycheva, S. Stanilova, R. Stoilov, R. Rashkov, I. Manolova
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Cytokine network alterations contribute strongly to the initiation and perpetuation of systemic lupus erythematosus (SLE). The production of IL-10 and TNF-alpha, which are important regulators of inflammation is under genetic control and functional significance of a number of single nucleotide polymorphisms (SNPs) in the regulatory regions of <i>IL10</i> and <i>TNFA</i> genes has been demonstrated <sup>1,2</sup>. <h3>Objectives</h3> In the present study, we analyzed the involvement of two functional SNPs in the promoter region of IL-10 (-1082 A/G; rs1800896) and TNF-alpha (-308 G/A, rs1800629) genes in the susceptibility to SLE in Bulgarian population. <h3>Methods</h3> A case–control study was carried out on 154 SLE patients and 152 sex and age matched healthy subjects. The allele and genotype frequencies of rs1800896 and rs1800629 were determined using allele specific PCR and restriction fragment length RFLP-PCR assays, respectively. <h3>Results</h3> We observed significant differences in the genotype (p=0.001) and allele (p=0.002) frequencies of <i>TNFA</i> -308G/A SNP between SLE patients and controls. There was an increase of the <i>TNFA</i> -308 A allele (21.8% vs 12.5%; OR =1.95) and a higher frequency of heterozygous AG genotype (42.2% vs 22.4%; OR =2.52) in cases compared to controls (p&lt;0.001). Logistic regression analysis revealed that the presence of <i>TNFA</i> -308 A allele in the genotype (AG+AA) was associated with 2.4 times higher risk of developing SLE (OR=2.417; p&lt;0.001). Regarding the distribution of <i>IL10</i> -1082 A/G polymorphism a higher frequency of <i>IL10</i> -1082 G allele (40.9% vs. 33.9%; OR =1.36; p=0.072) and GG genotype (17.5% vs. 9.2%; OR =2.09; p=0.033) was observed in SLE patients compared to controls. When analyzing the influence of combined <i>IL10/TNFA</i> genotypes on SLE appearance, we found that the carriage of both high cytokine producing genotypes of two polymorphisms (<i>IL10</i> -1082 GG and <i>TNFA</i> -308 AA/GA, respectively) significantly increased the risk of developing SLE with OR =7.94; p=0.006. <h3>Conclusions</h3> Our results suggest that combination of <i>IL10</i>-1082A/G and <i>TNFA</i> -308G/A polymorphisms strongly contribute to the SLE susceptibility in Bulgarian population, particularly due to their functional effect on inducible cytokine production. Carriage of each of the genotype associated with high production of IL-10 and TNFA independently lead to 2-fold higher risk of developing SLE, while combining them increases the risk up to 8 times. <h3>References</h3> Wesdendorp RG et al. Lancet 1997;349:170-3. Eskdale J. et al. Immunogenetics 1997; 46:120-128. <h3>Disclosure of Interest</h3> None declared
PWE-285 Total robotic radical rectal resection with da vinci xi system: single docking, single phase technique
Authors: AS Tamhankar, S Jatal, A Saklani
Journal: Gut (2015)

<h3>Introduction</h3> Robotic rectal surgery has distinct advantages over laparoscopy. Total robotic resection is coming up after the evolution of hybrid technology. The latest da vinci Xi system (Intuitive Surgical, Sunnyvale, USA) is enabled with newer features to make total robotic resection possible in single docking and single phase. The study aims to assess the advantages of da Vinci Xi system in rectal cancer surgery. It also assesses the initial oncological outcomes after rectal resection with this system from a tertiary cancer centre in India. <h3>Method</h3> Twenty three rectal cancer cases were operated from 06/10/2014 to 25/02/2015 robotically. Total robotic technique was used in all patients. The data was evaluated prospectively. The demographic details, body mass index (BMI), perioperative outcomes, pathology results and post-operative complications were noted. <h3>Results</h3> 17 cases were given pre-operative chemoradiotherapy as they had clinico-radiologically locally advanced disease (Stage III) at initial evaluation. Other cases was operated upfront. One case needed conversion to open approach as it had invaded presacral fascia. Median age of the cohort was 51 years. Male:Female ratio was 1.55:1. Median BMI was 22. Three patients underwent intersphincteric resection (ISR). Twelve patients underwent anterior resection (AR). Eight patients needed abdominoperineal resection (APR). Median distance from anal verge was 4 cm. Median robotic docking time and robotic procedure time were 8 min and 280 min respectively. Median blood loss was 150 ml. One patient died due to pulmonary thrombo-embolism. Circumferential resection margin (CRM) and longitudinal resection margins (LRM) were uninvolved in all patients. Median distances of tumour from proximal and distal resection margins were 14 cm and 3.5 cm respectively. Median lymph node yield was 12. Median post-operative stay was 6 days. <h3>Conclusion</h3> Latest da Vinci Xi system has made total robotic rectal surgery feasible in single docking and single phase. In the wake of new system, four arm total robotic rectal surgery may replace hybrid technique of laparoscopic and robotic surgery for rectal malignancies. The learning curve for the new system appears to be shorter than anticipated. Early perioperative and oncological outcomes of total robotic rectal surgery with the new system are promising. <h3>Disclosure of interest</h3> None Declared.
Post-Traumatic Headache
Authors: G S Barolin
Journal: New England Journal of Medicine (1928)

Acute and increasing headaches after traumatism may be a signal for important complications, namely: subarachnoid hemorrhage, infections from the sinus, subdural hematoma. In chronic posttraumatic headaches we do not see one single clear cut entity of "posttraumatism". The trauma acts mainly (pathophysiologically) via vasolability and via cervical spine. The important role of cervical spine for posttraumatic headaches is greatly underestimated, especially if the cranial trauma is looked at isolated, just by valuing X-rays and duration of unconsciousness. If we look at traumatism as a triggering respectively modifying factor it makes clear that we can not postulate an everlasting causation of headache by traumatism, but have to see posttraumatic headache in a fluent transition from trauma-etiology to a constitionally caused personality-etiology. Difficulties arise in giving a clear cut limit between the two causations. A time span of about two years is a ruff measure. Our multidimensional concept of headache etiology demands a clear analysis of the different factors. On the basis of this we can build up a polypragmatic way of therapy that acts as specific and complex as possible. This creates higher efficacy.