tbuckley/cabot-search huggingface dataset:
AB0281 Characteristics of the Rheumatoid Arthritis in a Five-Year Follow-Up of 300 Tunisian Patients
Authors: K. Baccouche, L. Mani, S. Belghali, Z. Alaya, N. Elamri, N. Amara, H. Zeglaoui, E. Bouajina
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Objectives</h3> The objective of this study is to analyze epidemiologic, clinical, biological, radiological characteristics in the RA. <h3>Methods</h3> A total of 300 patients were included with the diagnosis of rheumatoid arthritis meeting ACR 1987 criteria, in a retrospective study, between 2007 and 2012. <h3>Results</h3> The average age was 53 years [17- 94]. The predominance was for woman with a sex ratio 8/10. The mean number of years from the onset of RA symptoms until diagnosis was 5 years. The average disease duration was 9 years. The mean value of the DAS 28 was 6.04 [1.2 to 8.5], 96% of patients had an active RA (DAS 28 &gt;3.2). Extra-articular manifestations were reported in 54.25% of patients: secondary Sjögrens syndrome in 22.3%, osteoporosis in 32.6%, rheumatoid nodule in 4.6%, pulmonary fibrosis in 8.4%, cardiac manifestations in 2.3%, medullar compression in 1.3% and carpal tunnel syndrome in 0.6% of cases. Rheumatoid factor was reported in 68.8% of cases and the mean value of IGA, IGG, IGM was respectively 219, 190 and 246 UI/ml. Anti-citrullinated peptide Antibodies and anti nuclear antibody was reported in 69.6% and 15% of the cases, there mean value were respectively 114 RU/ml and 1/464. Radiological destruction was observed in 91.6% of cases. The mean value of Sharp score was 43.27 [0-180]. There was a positive correlation between DAS 28 and RF (p=0.028) but no significant relation was observed with ACPA and ANA. <h3>Conclusions</h3> Rheumatoid arthritis in our study is characterized by its severity, higher disease activity and a later diagnosis; this is why we need a better management of RA, to alter the course of this progressive disease. <h3>Disclosure of Interest</h3> None declared
This is the AMA
Authors: R. B. Roth
Journal: JAMA (1973)

Thirty-four years ago, during my senior year in medical school, one of my professors published a book. It was called<i>Medicine at the Crossroads</i>.<sup>1</sup>One needs to read only to the second page of the "Foreword" to learn that it concerns the "crisis" in medical care, and that if the profession does not voluntarily mend its ways the government will take over. Apparently, in the view of some, my contemporaries and I have lived our entire professional careers, either stalled at the same crossroads, or impaled on the sharp point of a crisis, depending on one's choice of metaphors. Somehow or other, it hasn't really seemed that way. A 34-year-old volume on the socioeconomics of medicine is scarcely a source for currently valid statistics. How quaint it may seem is apparent from the fact that the high cost of medical care is equated to $4-a-day hospital rooms and to
Surveillance of occupational exposure to bloodborne pathogens in health care workers: the Italian national programme
Authors: G Ippolito, V Puro, N Petrosillo, G De Carli
Journal: Eurosurveillance (1999)

Health care workers (HCWs) face a serious risk of acquiring bloodborne infections, in particular hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV), all of which are associated with significant morbidity and mortality
Airway Microbiota Determines Innate Cell Inflammatory or Tissue Remodeling Profiles in Lung Transplantation
Authors: Eric Bernasconi, Céline Pattaroni, Angela Koutsokera, Christophe Pison, Romain Kessler, Christian Benden, Paola M. Soccal, Antoine Magnan, John-David Aubert, Benjamin J. Marsland, Laurent P. Nicod
Journal: American Journal of Respiratory and Critical Care Medicine (2016)

In lung transplant recipients, long-term graft survival relies on the control of inflammation and tissue remodeling to maintain graft functionality and avoid chronic lung allograft dysfunction. Although advances in clinical practice have improved transplant success, the mechanisms by which the balance between inflammation and remodeling is maintained are largely unknown.To assess whether host-microbe interactions in the transplanted lung determine the immunologic tone of the airways, and consequently could impact graft survival.Microbiota DNA and host total RNA were isolated from 203 bronchoalveolar lavages obtained from 112 patients post-lung transplantation. Microbiota composition was determined using 16S ribosomal RNA analysis, and expression of a set of genes involved in prototypic macrophage functions was quantified using real-time quantitative polymerase chain reaction.We show that the characteristics of the pulmonary microbiota aligned with distinct innate cell gene expression profiles. Although a nonpolarized activation was associated with bacterial communities consisting of a balance between proinflammatory (e.g., Staphylococcus and Pseudomonas) and low stimulatory (e.g., Prevotella and Streptococcus) bacteria, "inflammatory" and "remodeling" profiles were linked to bacterial dysbiosis. Mechanistic assays provided direct evidence that bacterial dysbiosis could lead to inflammatory or remodeling profiles in macrophages, whereas a balanced microbial community maintained homeostasis.The crosstalk between bacterial communities and innate immune cells potentially determines the function of the transplanted lung offering novel pathways for intervention strategies.
PTH-351 Cytoreductive surgery and heated intraperitoneal chemotherapy: safety and feasibility of a newly established uk peritoneal malignancy unit
Authors: U Shariff, C Seretis, A Ali, S Veerabadran, T Raju, D Browse, H Youssef
Journal: Gut (2015)

<h3>Introduction</h3> Cytoreductive Surgery (CRS) and Heated Intraperitoneal Chemotherapy (HIPEC) is a radical strategy for the treatment of disseminated intra-abdominal cancers.<sup>1</sup>Complete cytoreduction combines multiple visceral and peritoneal resections to achieve macroscopic intra-abdominal tumour clearance. Combined with HIPEC, this aims to destroy residual microscopic tumour. We report the results of this technique and early survival data in a newly established UK Peritoneal Malignancy Unit, by a team trained to deliver the service. <h3>Method</h3> For all patients undergoing peritoneal surgery (November 2011–February 2015) data was prospectively collected on demographics, severity of disease (Peritoneal Carcinomatosis Index-PCI), surgery undertaken, pathology, operating time, intra-operative blood loss, intensive care unit (ITU) stay, length of stay (LOS), completeness of cytoreduction (CC) and postoperative morbidity/mortality. <h3>Results</h3> Of 49 patients operated on, Complete Cytoreduction was achieved in 41 patients (84%) (CC0–37: CC1–4: CC2–8) (median age 56 years, range 29–79). The pathology included were: 29 colorectal cancers (7 primary, 22 recurrent), 8 appendiceal adenocarcinoma, 3 ovarian tumours, 9 others. Of the 41/49 CC0/1 patients, median PCI was 9 (0–29); median intra-operative time 9 h (4–12), median blood loss 1L (0–2.5L); median ITU stay: 4 days (1–11); median LOS: 16 days (5–75). Grade 3/4 (CTCAEv3) complications occurred in 15 patients (34%). 1 patient (2.2%) returned to theatre and there was no post-operative mortality. Median follow-up was 11.4 months (range 1.5–36.4). Kaplan-Meier predicted 1-year survival was 81% and 2-year survival was 68%. <h3>Conclusion</h3> Results from our unit demonstrate that CRS/HIPEC can be performed safely by a team trained to deliver the service. Medium-term survival rates are acceptable, in patients who would have traditionally been considered as terminal, with 68% surviving 2 years. Morbidity rates are high, but with careful case selection and aggressive treatment of post-operative complications, there was no postoperative mortality in this series. <h3>Disclosure of interest</h3> None Declared. <h3>Reference</h3> Esquivel J, Sticca R, Sugarbaker P, <i>et al</i>. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in the management of peritoneal surface malignancies of colonic origin: A consensus statement. Ann SurgOncol. 2007;14:128–133
Frequent expression of the cell death-inducing gene Bax in Reed- Sternberg cells of Hodgkin's disease
Authors: F Rigal-Huguet, J Gopas, I Prinsloo, J Pris, G Delsol, JC Reed, D Schlaifer, P Brousset, D Benharroch, S Krajewski, G Laurent, F Meggetto
Journal: Blood (1996)
Clozapine-induced weight gain: prevalence and clinical relevance
Authors: R Leadbetter, M Shutty, D Pavalonis, V Vieweg, P Higgins, M Downs
Journal: American Journal of Psychiatry (1992)

The aim of this study was to determine the prevalence and clinical relevance of weight gain during clozapine treatment. Previous reports indicated clinically significant weight gain in 13% to 85% of patients and an average gain of 9.0 to 24.7 lb.Twenty-one state hospital patients with treatment-resistant schizophrenia or schizoaffective disorder were weighed weekly for 12 weeks before clozapine treatment and during the first 16 weeks of treatment. Psychiatric symptoms were rated with a modified version of the Brief Psychiatric Rating Scale (BPRS).The mean weight gain for the entire group was 13.9 lb, or 8.9% of body weight. During the 16 weeks of clozapine treatment, 38% of the patients experienced marked weight gains and 29% had moderate weight gains. The improvements in BPRS total score and composite negative symptom score were significantly greater for the eight patients with marked weight gains than for the other 13 patients.Clozapine's propensity to induce weight gain may relate to the drug's efficacy and/or its unique neuropharmacologic effects. Increased attention to this phenomenon is important because of the morbidity associated with obesity.
GTL001, A Therapeutic Vaccine for Women Infected with Human Papillomavirus 16 or 18 and Normal Cervical Cytology: Results of a Phase I Clinical Trial
Authors: Pierre Van Damme, Myriam Bouillette-Marussig, Annick Hens, Ilse De Coster, Christophe Depuydt, Anne Goubier, Viggo Van Tendeloo, Nathalie Cools, Herman Goossens, Thierry Hercend, Benedikt Timmerman, Marie-Christine Bissery
Journal: Clinical Cancer Research (2016)

Abstract Purpose: Women infected with human papillomavirus (HPV) with normal cytology to mild abnormalities currently have no treatment options other than watchful waiting or surgery if high-grade cervical lesions or cancer develop. A therapeutic vaccine would offer the possibility of preventing high-grade lesions in HPV-infected women. GTL001 is a therapeutic vaccine composed of recombinant HPV16 and HPV18 E7 proteins fused to catalytically inactive Bordetella pertussis CyaA. This study examined the tolerability and immunogenicity of GTL001 in women infected with HPV16 or HPV18 with normal cytology. Experimental Design: This was a phase I trial (EudraCT No. 2010-018629-21). In an open-label part, subjects received two intradermal vaccinations 6 weeks apart of 100 or 600 μg GTL001 + topical 5% imiquimod cream at the injection site. In a double-blind part, subjects were randomized 2:1:1 to two vaccinations 6 weeks apart of 600 μg GTL001 + imiquimod, 600 μg GTL001 + placebo cream, or placebo + imiquimod. Results: Forty-seven women were included. No dropouts, treatment-related serious adverse events, or dose-limiting toxicities occurred. Local reactions were transient and mostly mild or moderate. HPV16/18 viral load decreased the most in the 600 μg GTL001 + imiquimod group. In post hoc analyses, the 600 μg GTL001 + imiquimod group had the highest rates of initial and sustained HPV16/18 clearance. Imiquimod increased antigen-specific T-cell response rates but not rates of solicited reactions. All subjects seroconverted to CyaA. Conclusions: For women infected with HPV16 or HPV18 with normal cervical cytology, GTL001 was immunogenic and had acceptable safety profile. Clin Cancer Res; 22(13); 3238–48. ©2016 AACR.
Depression in the Wives of Nuclear Submarine Personnel
Authors: Karen Beckman, Anthony J. Marsella, Ruth Finney
Journal: American Journal of Psychiatry (1979)

The authors compared levels of depression among 24 wives of nuclear submarine personnel under conditions of husband-presence and husband-absence in a crossover research design. The wives had significantly higher depression scores under conditions of husband-absence on both the Zung Depression Scale and the Multiple Affect Adjective Checklist. The results are discussed in terms of the tremendous stresses imposed on the wives as a result of the nuclear submarine deployment schedule and the failure of the Navy and the spouses to recognize and reward the wives for their efforts.
Effect of a Chemically Defined Diet in Liquid Form on Colon Carcinogenesis in Rats
Authors: M R Lewin
Journal: JNCI Journal of the National Cancer Institute (1986)

Journal Article Effect of a Chemically Defined Diet in Liquid Form on Colon Carcinogenesis in Rats Get access M. R. Lewin, Ph.D. M. R. Lewin, Ph.D. Department of Surgery, School of Medicine, The Rayne Institute, University College London, University Street, London WC1E 6JJ, England Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 77, Issue 2, August 1986, Page 590, https://doi.org/10.1093/jnci/77.2.590 Published: 01 August 1986
Diagnosing schizophrenia: Professor Kraepelin and the research diagnostic criteria
Authors: R L James, P R May
Journal: American Journal of Psychiatry (1981)

The authors applied current diagnostic criteria (the Research Diagnostic Criteria developed by Spitzer and associates and DSM-III) to Kraepelin's descriptions of his own patients and compared Kraepelin's diagnoses of "functional" psychoses related to schizophrenia with those of today. Thirty-two case histories were selected from Kraepelin's textbook of psychiatry. Two psychiatrists screened out any comments from the case histories that might have revealed Kraepelin's original diagnoses.The screened case histories were then diagnosed by one of the authors. A high degree of agreement was found between Kraepelin's diagnoses and the diagnoses of present-day systems.
Immunoglobulin levels in psychiatric patients
Authors: M Strahilevitz, J B Fleischman, G W Fischer, R Harris, N Narasimhachari
Journal: American Journal of Psychiatry (1976)

In a study of 19 schizophrenic patients, 7 nonschizophrenic patients, and 31 controls, the authors found significantly higher mean serum levels of 1) immunoglobulin A in schizophrenic women then in control women and in schizophrenic blacks than in either schizophrenic whites or black controls. 2) immunoglobulin D in schizophrenic blacks than in schizophrenic whites, 3) immunoglobulin M in controls than in nonschizophrenic patients, and 4) immunoglobulin G (IgG) in schizophrenics whose urine was positive for phenothiazines than in schizophrenics whose urine was negative for phenothiazines. High serum levels of IgG were associated with no or mild hallucinations and low levels with moderate or severe hallucinations. Black female patients had significantly more severe hallucinaions than white female patients. The authors discuss the possible implications of these findings.
Challenges to academic psychiatry
Authors: H Pardes, H A Pincus
Journal: American Journal of Psychiatry (1983)

Economic constraints, effects of retrenchments in federal health policy, and increased competition for resources are challenging all sectors of academic medicine. Departments of psychiatry are at particular risk during this era for reasons including the lack of a sound research and research training base in many psychiatry departments; the small number of students entering the field and implications therein for the availability of residency slots in psychiatry; and patterns of allocating resources within academic medical centers which, combined with biases in reimbursement policy toward cognitively based specialties, threaten the economic strength of psychiatric departments. A conceptual model based on marketing principles is proposed to aid in identifying and capitalizing on the unique strengths of the field.
PTU-127 Ivor-lewis oesophagectomy for oesophageal cancer: data from a university hospital surgical department
Authors: A Harper, S Klimach, K Hamdan
Journal: Gut (2015)

<h3>Introduction</h3> The aim of this study was to ascertain recurrence and survival following Ivor-Lewis oesophagectomy for oesophageal cancer at our hospital. <h3>Method</h3> Ivor-Lewis oesophagectomy resections performed by three consultant surgeons from 2007 to present at an English university hospital were recorded on a prospectively maintained database. The Somerset Cancer database and our hospitals own electronic record system (Integrated Clinical Environment) were used to retrieve data on treatment protocols, tumour histology, staging and survival. <h3>Results</h3> Between March 2007 and February 2014 159 patients underwent oesophagectomy at the Royal Sussex County Hospital, Brighton, UK. M:F 130:29. Average age at surgery was 64 years. Pre-operative histology identified 87% adenocarcinomas, 11% squamous cell carcinoma and 2% high grade dysplasia. Barrett’s was identified on histology in 49% of patients with adenocarcinoma. Neo-adjuvant chemotherapy (predominantly ECX) was received by 84% of the cohort however 11% of these cases did not complete treatment due to complications. Of those receiving neo-adjuvant chemotherapy 16% had stable disease based on final staging, 53% achieved down staging and 31% had progressive disease. Final staging (using TNM 7<sup>th</sup>Edition) found: 9% stage 0, 23% stage I, 29% stage II, 24% stage III and 15% stage IV. R0 resection was achieved in 59% of cases. A &gt;5 cm distal resection margin was achieved in 57% of cases compared to only 24% of proximal resection margins. Adjuvant chemotherapy was received in only 13% of cases. Recurrence occurred in 37% of cases and the average time to recurrence was 494 days. Of the R1 resections 45% had recurrence compared to 32% of R0 cases. For this cohort 1 year survival was 79.2%, 2 year survival was 64.2% and 3 year survival was 45%. Laparoscopic gastric mobilisation (LGM) was practiced by one of three surgeons from July 2010 and accounted for 36% of cases over this time period. Average lymph node (LN) harvest in LGM cases was 19.6 and 13 for totally open (TO) cases over the same time period. The recurrence rate was higher in TO compared to LGM (RR = 1.7) despite a greater proportion of higher stage cancers in the LGM group (stage III and IV 56% vs 29%) however there was no statistically significant difference in mortality between the two groups. <h3>Conclusion</h3> Despite achieving R0 resection on final histology nearly a third of these patients experienced recurrence suggesting the need for more aggressive adjuvant therapy. Neo-adjuvant down staging in 53% of cases is comparable to previous published data.<sup>1</sup>Despite a greater LN harvest and reduced recurrence rate observed in the LGM group this did not impact on overall survival. <h3>Disclosure of interest</h3> None Declared. <h3>Reference</h3> Bamias. Cancer 1996;<b>77</b>:1978–1985
Hypnotizability and psychopathology
Authors: D Spiegel, D Detrick, E Frischholz
Journal: American Journal of Psychiatry (1982)

The authors compared the hypnotic responsivity of 115 chronically ill psychiatric patients with that of 83 nonpatient volunteers. The Hypnotic Induction Profile was administered to all subjects, and diagnoses were established for the patients according to Research Diagnostic Criteria. All of the diagnosed patients (those with thought disorder, affective disorder, generalized anxiety, and miscellaneous disorders) were significantly less hypnotizable than the nonpatient comparison group. This effect was unrelated to age or medication differences. The authors discuss the implication of these findings in relation to a new model of hypnotic responsivity that takes into account the moderating effects of severe psychopathology.
OP0260 Adipokines Alter the Interaction of Rheumatoid Arthritis Synovial Fibroblasts with Endothelial Cells
Authors: R. Hasseli, K.W. Frommer, B. Zimmermann, M. Schönburg, S. Rehart, U. Müller-Ladner, E. Neumann
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> As an endocrine organ, adipose tissue plays a crucial role in inflammatory processes. These can be mediated by adipokines, important factors secreted by adipose tissue, displaying pro- or anti-inflammatory effects. Rheumatoid arthritis (RA) is a chronic inflammatory joint disease, in which joints are consecutively affected. We previously showed that within the murine organism RA synovial fibroblasts (SF) are able to migrate from one site to another. This may contribute to the spreading of the disease <i>in vivo</i>. Due to the observation that in this model RASF migrate through the vasculature, the interaction between RASF and endothelial cells appears to be critical in this process. <h3>Objectives</h3> To assess whether adipokines affect the adhesion of RASF to endothelial cells (EC) or surface molecules expressed by EC (here: E-selectin) and to identify relevant adhesion molecules whose expression is altered by adipokines. <h3>Methods</h3> RASF and EC were stimulated with the adipokines adiponectin (Ad) (10 μg/ml), visfatin (Vis) (100 ng/ml) and resistin (Res) (20 ng/ml), and “therapeutically” with methotrexate (MTX) (1.5 μM) and the glucocorticoids prednisolone (PNL) (1 μM) and dexamethasone (DXM) (1 μM). The expression of selected adhesion molecules from RASF and EC was analyzed by real-time PCR. RASF adhesion to EC was studied under static conditions using a cell-to-cell binding assay, while RASF adhesion to E-selectin was studied under flow conditions (flow rates: 18.4/30.5/60.5 ml/h) in a dynamic adhesion assay as flow conditions are required for selectins to be obtain their active conformation. <h3>Results</h3> Under static conditions, the adipokines caused an increased adhesion of RASF to EC (Ad: 37%, Vis: 23%, Res: 32%; n=6), while PNL and MTX caused a minor decrease (-7% for both; n=4). DXM did not change RASF adhesion to EC under static conditions. Under flow conditions, visfatin increased RASF adhesion to E-selectin (28%/87%/29%; n=3 for each flow rate), while DXM decreased their adhesion ability (-33%/-35%/-41%; n=3 for each flow rate). mRNA expression of VCAM-1 in RASF (n=3) was reduced by stimulation with PLN (-3.3-fold) and DXM (-8.3-fold), respectively. TNF increased ICAM-1 mRNA expression (46.5 fold) and decreased P-selectin mRNA expression (-7.7-fold) in EC (n=3). <h3>Conclusions</h3> Adipokines increase the cellular expression of adhesion molecules on RASF as well as EC and strengthen their interaction. This increased adhesion of RASF to endothelial cells mediated by adipokines could therefore influence the migration of RASF and thus the spreading of RA <i>in vivo</i>. As glucocorticoids and MTX antagonized these effects, our experiments can also explain some of the clinical effects observed in patients. <h3>Disclosure of Interest</h3> None declared
Oral Contraceptives and Ovarian Cancer
Authors: J T Casagrande, M C Pike, B E Henderson
Journal: New England Journal of Medicine (1983)

Cramer et al. reported the results of a case control study of ovarian cancer in women under age 60, indicating that oral contraceptive (OC) use was associated with a decreased risk of the disease. Yet, according to Cramer et al. the decreased risk was evident only in women over age 40 and that below this age OC use was actually associated with an increased risk of ovarian cancer. As other workers had not broken down the data in this manner, Cramer et al. were unable to compare this result with the results from other studies. This group of researchers has reanalyzed their data to allow such a comparison. In contrast to the results of Cramer et al. it was found that only in the young cases was their any possible negative association between OC use and ovarian cancer. The data for both women under and over 40 showed a steady decrease in ovarian cancer with increasing duration of OC use.