tbuckley/cabot-search huggingface dataset:
SAT0142 Comparison of the Patient's Assessment Measure (RADAI) and the Physician's Assessment Measure (DAS 28-ESR AND CDAI) of Disease Activity in Rheumatoid Arthritis (RA) in an Open Label Clinical Study
Authors: E. Alvarez-Hernandez, S.R. Marin, S. Alvarez-Etchegaray
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> rheumatoid arthritis (RA) is a chronic inflammatory disease that can lead to join destruction, deformity and loss of function. The measurement of the disease activity is very important in the patient9s follow-up. In RA there are several composite indices for assess this parameter; the DAS 28-ESR and the CDAI are qualified by the physician and the Rheumatoid arthritis disease activity index (RADAI) is qualified by the patient. It is unknown which of the two approaches is most appropriate. <h3>Objectives</h3> To compare the measurement of the activity of the RA from the perspective of the physician and the patient through RADAI and DAS 28-ESR. <h3>Methods</h3> Population: patients with RA who participated in an open label clinical study with the use of methotrexate and anti-TNF alpha. Subjects and methods: demographic, clinical, and treatment data were obtained. DAS28-ESR, CDAI, RADAI, HAQ-DI, EuroQoL 5D were assessed every 4 weeks for 6 months. <h3>Results</h3> We included 190 patients, 179 (94.2%) were women, mean age 43.9±11.9 years, educational level of 8.9±3.9 years. The RADAI had a high internal consistency (Cronbach9s alpha =0.89). The baseline score was 6.04±1.6 and at six months of 2.52±1.7. The baseline score of DAS28-ESR was 5.36±0.74 and at six months of 2.95±0.89. The baseline score of CDAI was 28.05±8.5 and at six months of 7.01±5.3. The HAQ baseline was 1.49±0.64 and at six months of 0.70±0.63 and EuroQoL baseline was of 0.4156±0.20 and at six months of 0.6733±0.17 (p=0.000 for all comparisons) There was moderate to good correlations of RADAI with the DAS28, CDAI, HAQ-DI and EuroQoL5D. The three indexes had a good ability to discriminate between groups of patients for degree of activity. In the final assessment had activity of RA by DAS28-ESR in 31.6%, by CDAI in 26.3% and by RADAI in 35.8% of the patients. The area under the curve of the CDAI was 0.88, the DAS28-ESR of 0.72 and 0.71 of the RADAI with similar sensitivity and specificity. <h3>Conclusions</h3> a comparison of activity from the perspective of the patient and the doctor are equivalent with the use of specific indexes. DAS28-ESR, RADAI, and CDAI are a valid measure of disease activity. <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.6080
Who is at Low Risk after Head or Neck Trauma?
Authors: John A. Marx, Michelle H. Biros
Journal: New England Journal of Medicine (2000)

Emergency physicians have traditionally relied heavily on diagnostic imaging in the evaluation of patients with head or neck trauma. This conservative approach is intended to reduce the risk of missing intracranial lesions or cervical-spine fractures to virtually zero, since the morbidity associated with these injuries can be great and the medicolegal consequences severe. Each year in the United States more than 2 million adults present on an emergency basis after trauma to the head. Of the 80 percent with apparently minor injury,1 between 6 percent and 9 percent harbor unexpected, traumatic intracranial lesions, although fewer than 1 percent require neurosurgical . . .
AB0563 Attitude of patients with ankylosing spondylitis to physical exercises
Authors: T. Dubinina, E. Volnuchin, S. Erdes
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> According to ASAS recommendations regular physical exercises are the basic non-pharmacological therapy method for ankylosing spondylitis (AS). Nevertheless, there is the lack of data on fulfilling recommendations on physical exercises by pts in real life. <h3>Objectives</h3> To study the attitude of AS pts to physical exercises. <h3>Methods</h3> To clarify actual fulfilling physical exercises by AS pts a special questionnaire was developed. To assess fulfilling physical exercises "Exercise Benefits" and "Barriers Scale" (EBBS) were used. EBBS subscales were analyzed to determine expected benefits and impediments for physical exercises. 32 pts were questioned (average age 34.4±10.0 years) diagnosed AS (New York criteria), admitted to clinical department of FSBI "RIR" RAMS: 21 (65.6%) men and 11 (34.4%) women. Median disease duration at the moment of admission was 11.6±7.8 years (min.-1, max.-27 years), disease activity according to BASDAI – 4.9±2.1, functional disturbances according BASFI – 4.8±2.8. <h3>Results</h3> 26 pts out of 32 do physical exercises (81.3%). 34.6% do this every day, 26.9% - from 3 to 5 times a week, 38.5% - less than 3 times a week. Half of pts use exercises from different sites of Internet, 29.2% - according physician's recommendations, 16.7% - according booklets for pts, 4.1% - exercises seen in other pts. Three out of 6 pts who do not do exercises consider that exercises will aggravate their health; the rest would like to begin exercising. Regarding 29 pts with positive opinion to exercises 65.5% would like to have individual course, and 34.5% - in groups. 69.9% of pts expect that exercises will retard the developing of the disease and improve spinal mobility, 20.7% expect pain and stiffness subsiding, 10.3% - improvement of physical form. The mean benefits EBBS score was57.6±12.5. The most frequently reported benefits of exercise were that it «exercise decreases feelings of stress and tension for me» (90.6%) and «exercise increases my muscle strength» (93/7%). The mean barriers EBBS score was42.8±6.7. Most frequentДн reported barriers of exercise were that it «I am fatigued by exercise». <h3>Conclusions</h3> On the whole, despite positive attitude to physical exercises, only 34.6% of AS pts do them every day. Lack of information about exercises, frequency of them, their influence on disease activity and functional improvements restrict AS pts in using them. <h3>Disclosure of Interest</h3> None Declared
Native Kidney Recovery After a Failed Renal Transplant
Authors: ROBERT MANSBERG, ILIAS DRIVAS, JOHN M. ROBERTS
Journal: Clinical Nuclear Medicine (2003)

MANSBERG, ROBERT M.B.B.S., F.R.A.C.P.; DRIVAS, ILIAS M.B.B.S.; ROBERTS, JOHN M. M.B.B.S., F.R.A.C.P. Author Information
Erythrocyte Pyruvate Kinase Deficiency Resulting in Congenital Nonspherocytic Hemolytic Anemia
Authors: Frank A. Oski, Louis K. Diamond
Journal: New England Journal of Medicine (1963)

HEREDITARY spherocytosis with its associated congenital hemolytic anemia is generally easily recognized and satisfactorily treated with splenectomy. A rarer group of congenital hemolytic anemias, however, is sometimes confused with hereditary spherocytosis because of the occasional presence of small numbers of spherocytes in association with varying degrees of abnormality in the incubated osmotic fragility test. In this later group of "congenital nonspherocytic hemolytic anemias" splenectomy has often been performed but usually does not produce a clinical cure. Because splenectomy is generally of inconsistent value, this type of anemia must be accurately differentiated for the sake of proper treatment and accurate prognosis. . . .
OC-006 Setting up a centralised decontamination service: lessons learnt
Authors: V Jackson, J Mitchell, D Jones
Journal: Gut (2012)

<h3>Introduction</h3> Decontamination is moving towards a centralised service within secondary care. The aim of such is to maximise expertise and maintain quality standards. The development of centralised decontamination will minimise risk and assist the audit process. Within the authors workplace the decision was taken to house this service within the endoscopy department. <h3>Methods</h3> An analysis of current services that used flexible endoscopes was undertaken including workforce, equipment and current usage of decontamination within the area it was undertaken. This included endoscopy, ENT &amp; MFU outpatient and inpatient, ITU, Theatres. This led to a business case to request appropriate resource to enable implementation and deliver of required service for all users. <h3>Results</h3> There was a difference in perceptions of a centralised decontamination service from all stakeholders. Each department had a tunnel vision with little regard for others. This led to a conflict due to all users having different priorities with little understanding of other pressures. Out of hours decontamination was an expectation from management with no acknowledgement of the impact this would have on the workforce. It was understood that all capital equipment would be pooled, however this was not accepted by some departments and led to shortages of endoscopes as services were reluctant to “share”. The development of a band 4 decontamination supervisor helped the implementation of the service by offering expertise and leadership to all user groups. Management expectations of the service were often unrealistic due to lack of expertise in the area. The band 4 role offered a realistic solution using the knowledge and skills from their own experience in the field. Savings were delivered by the reduction of reprocessors required for maintenance contracts. <h3>Conclusion</h3> Clear understanding of objectives is required prior to the development of any service. It is vital that a stakeholders group is formed and gives all involved the time to voice any concerns at any stage. Workforce requirements must be analysed to ensure the right skill mix is available to deliver the required knowledge and skills for implementation and sustainability. There needs to be greater emphasis on business continuity plans when cenralising any service. <h3>Competing interests</h3> None declared.
AB0360 Comparative study of the characteristics of spanish and european patients in a local registry of patients with rheumatoid arthritis
Authors: C. Santos-Ramírez, J. Rosas, J. Senabre, G. Santos-Soler, X. Barber, E. Salas, M. Sánchez-Barrioluengo, N. Llahí, C. Cano
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Objectives</h3> To evaluate the characteristics of patients in a local registry of patients with rheumatoid arthritis, according to their nationality. <h3>Methods</h3> We analyzed data from 303 patients from a local registry of patients with rheumatoid arthritis (RA) diagnosed from January 2006 to December 2011, in the Rheumatology department, Hospital Marina Baixa. Epidemiological data, analytical, clinical, disease activity, presence of erosions, duration, treatment, complications and quality of life questionnaires were collected. An analysis of clinical characteristics of patients by establishing two main comparison groups: Spanish and non-Spanish European was done. <h3>Results</h3> We included 303 patients: 225 (74%) are Spanish, 51 are non-Spanish Europeans (17%) of which about half are of British origin, 15 (5%) are American, four (1.5%) Asian and 6 (2%) from Africa. We compared the following characteristics of the Spanish population front to the European: women 66.6% vs 66.6%. Mean age: 63.8 vs 61 years. Mean age at diagnosis: 57 vs. 52 years. Alcohol 6% vs 13%. Smokers 19% vs. 40% (p&lt;0.05). Mantoux positive in 24% vs 9% (p=0.2). Active workers 32% vs 56%. Mean body mass index 29 vs 22 (p&lt;0.05). Rheumatoid factor positive in 40% vs 58% (p&lt;0.05). Citrullinated peptide antibodies positive in 40% vs 55%. Mean time of evolution: 2.3 vs 2.8 years. Inflammatory activity levels in 2011 are similar in both groups presenting a mean DAS28-ESR 2.6 in the Spanish group and 2.9 in the European group. Regarding the time from diagnosis to initiation of a disease modifying medication, the mean in the Spanish group is 3.9 months vs 5.5 months in the group of Europeans. From diagnosis to the start of a biological treatment, the mean time is 23 months vs 33 months. The use of biological drugs is similar between both groups: 21% vs 23%. <h3>Conclusions</h3> 1. 17% of the patients in our local registry of patientswith rheumatoid arthritis is European (not Spanish). 2. The Mantoux test is positive in a higher percentage in the Spanish patients (24% vs 9%). 3. There are no differences in RA activity in both groups. 4. Europeans take an average of 1 year more from diagnosis to the beginning of a biological agent. <h3>Disclosure of Interest</h3> C. Santos-Ramírez Grant/Research support from: Asociaciόn para la Investigaciόn en Reumatología de la Marina Baixa (AIRE-MB), J. Rosas: None Declared, J. Senabre: None Declared, G. Santos-Soler: None Declared, X. Barber: None Declared, E. Salas: None Declared, M. Sánchez-Barrioluengo: None Declared, N. Llahí: None Declared, C. Cano: None Declared
Cancer in the Parents of Children with Cancer
Authors: Jørgen H. Olsen, John D. Boice, Niels Seersholm, Andrea Bautz, Joseph F. Fraumeni
Journal: New England Journal of Medicine (1995)

Certain types of cancer in children and young adults have been linked with an increased risk of cancer in close relatives. However, the relation between childhood cancer and familial risk remains to be fully assessed in population-based studies.
Hormone-Producing Tumor of Adrenal Cortex, with Congenital Absence of Contralateral Adrenal Gland
Authors: Harry M. Spence, F. Gregg Thompson
Journal: New England Journal of Medicine (1947)

ALTHOUGH hyperfunctioning tumors of the adrenal cortex are rare, they are the subject of an increasing number of reports in the current literature owing both to improved diagnostic procedures, such as perirenal air insufflation and assay of the sex hormones excreted in the urine, and to increasing knowledge of the physiology of the adrenal cortex, especially in its interlocking relation with the function of the pituitary gland and the gonads.The purpose of this communication is to present a case of a hormone-producing tumor of the adrenal cortex characterized by the symptomatology of Cushing's syndrome and associated with complete absence . . .
SAT0394 Patients with Rheumatoid Arthritis in Comparison to Other Connective Tissue Diseases are Mostly Influenced by Concomitant Fibromyalgia
Authors: J. Toms, M. Dankova, Z. Hrncir
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> A number of clinical studies documented that fibromyalgia (FM) can frequently accompany connective tissue diseases (CTD) as a concomitant syndrome. There is a lack of data about differencies in FM impact on individual CTD. <h3>Objectives</h3> To compare the impact of concomitant FM on CTD in terms of pain intensity, disease activity, function disability and quality of life (QOL) in a regional, monocentric, cross-sectional study. <h3>Methods</h3> 120 consecutive adult patients (pts) with rheumatoid arthritis (RA), 91 pts with systemic lupus (SLE), 30 pts with polymyositis/dermatomyositis (PM/DM) and 30 pts with systemic sclerosis (SSc) were examined in our outpatient rheumatology department on the presence of FM (ACR criteria,1990). Standard Manual Tender Point Survey was used for the examination of FM tender points. The following data were recorded: demographic data, tender point count (TPC), pain, fatigue and stiffness intensity on a 100 mm visual analog scale (VAS), Fibromyalgia Impact Questionnarie (FIQ) score and disease activity indices according to individual CTD representatives (DAS-28, SLEDAI, serum muscle enzymes). Health Assessment Questionnarie (HAQ) and Short Form 36 items (SF-36) were used for evaluation of functional disability and QOL, respectively. Statistical analysis was based on Kruskal-Wallis nonparametric tests comparing mutually all the CTD cohorts with and without FM. Patient file with SSc and FM was not included into the analysis due to small quantity. <h3>Results</h3> FM diagnosis was established in 25 (20.8%) pts with RA, 10 (11.0%) pts with SLE, 4 (13.3%) pts with PM/DM and 1 patient with SSc (3.6%). CTD groups with concomitant FM were shown to have significantly higher levels of pain, fatigue, stiffness, TPC and FIQ (p &lt;0.05). RA/FM pts reached the highest average intensity of pain (VAS pain 63.7 mm), the worst disability level (HAQ 1.832) and the most reduced QOL nearly in all domains of SF-36. Disease activity assessment was significantly influenced only in RA pts (DAS-28 in RA with and without FM 5.35 ± 1.1 vs. 3.67 ± 1.4; p &lt; 0.0001). <h3>Conclusions</h3> Concomitant FM appears most frequently in pts with RA in comparison to other CTD. RA patients are also mostly influenced by FM at the level of pain perception, disability and QOL. This impact of FM contributes to significant difficulties in RA disease activity assessment unlike other CTD. <h3>Disclosure of Interest</h3> None Declared
Developmental Exposure to a Commercial PBDE Mixture: Effects on Protein Networks in the Cerebellum and Hippocampus of Rats
Authors: Prasada Rao S. Kodavanti, Joyce E. Royland, Cristina Osorio, Witold M. Winnik, Pedro Ortiz, Lei Lei, Ram Ramabhadran, Oscar Alzate
Journal: Environmental Health Perspectives (2014)

Polybrominated diphenyl ethers (PBDEs) are structurally similar to polychlorinated biphenyls (PCBs) and have both central (learning and memory deficits) and peripheral (motor dysfunction) neurotoxic effects at concentrations/doses similar to those of PCBs. The cellular and molecular mechanisms for these neurotoxic effects are not fully understood; however, several studies have shown that PBDEs affect thyroid hormones, cause oxidative stress, and disrupt Ca2+-mediated signal transduction. Changes in these signal transduction pathways can lead to differential gene regulation with subsequent changes in protein expression, which can affect the development and function of the nervous system.In this study, we examined the protein expression profiles in the rat cerebellum and hippocampus following developmental exposure to a commercial PBDE mixture, DE-71.Pregnant Long-Evans rats were dosed perinatally with 0 or 30.6 mg/kg/day of DE-71 from gestation day 6 through sampling on postnatal day 14. Proteins from the cerebellum and hippocampus were extracted, expression differences were detected by two-dimensional difference gel electrophoresis, and proteins were identified by tandem mass spectrometry. Protein network interaction analysis was performed using Ingenuity® Pathway Analysis, and the proteins of interest were validated by Western blotting.Four proteins were significantly differentially expressed in the cerebellum following DE-71 exposure, whereas 70 proteins were significantly differentially expressed in the hippocampus. Of these proteins, 4 from the cerebellum and 47 from the hippocampus, identifiable by mass spectrometry, were found to have roles in mitochondrial energy metabolism, oxidative stress, apoptosis, calcium signaling, and growth of the nervous system.Results suggest that changes in energy metabolism and processes related to neuroplasticity and growth may be involved in the developmental neurotoxicity of PBDEs.
Hypophosphatemic Osteomalacia Demonstrated by Tc-99m MDP Bone Scan
Authors: SUZY KIM, CHAN H. PARK, YOON-SOK CHUNG
Journal: Clinical Nuclear Medicine (2000)

Hypophosphatemic osteomalacia, a familial or rarely acquired disorder, is characterized biochemically by hypophosphatemia, decreased renal tubular reabsorption of phosphate, decreased intestinal absorption of calcium, and normal serum calcium. This report concerns a rare case of hypophosphatemic osteomalacia of unknown cause that was shown on Tc-99m MDP bone scanning.
P2 Trends in lung cancer diagnostics, does the timing of tests matter? Results from the National Lung Cancer Audit 2009–2011: Abstract P2 Table 1.
Authors: IS Woolhouse, R Stanley, M Slade, P Beckett, MD Peake
Journal: Thorax (2013)

<h3>Background</h3> NICE lung cancer guidelines recommend choosing investigations that give the most information about diagnosis and staging with the least risk to the patient. In particular, performing CT scan before bronchoscopy, PET scan before surgery and avoiding tests that give only diagnosis when information on staging is also needed to guide treatment. We report current UK practice for lung cancer patients diagnosed following a GP referral and assess the impact of the timing of diagnostic and staging tests on the number of tests, diagnostic times and survival. <h3>Methods</h3> Data submitted to the National Lung Cancer Audit 2006 to 2011 were analysed. Completeness of the “date CT performed” field was used as a marker of diagnostic data quality. The audit periods 2006–8 were excluded due to CT completeness less than 80%. This study focuses on outpatient pathways and includes GP referrals only. <h3>Results</h3> 43,747 patients were identified. The proportion of patients recorded as having each test is shown in the table. The proportion of patients with two or more tests recorded dropped from 30% in 2009 to 26.5% in 2011 (p &lt; 0.001). Mean diagnostic time was significantly shorter in patients undergoing CT before first appointment (30 days versus 36 days, p &lt; 0.001). The mean number of tests was marginally lower in patients undergoing CT before bronchoscopy (1.5 tests versus 1.6 tests, p &lt; 0.01). This equates to 4375 fewer tests in this study population. Of the 7,340 patients who underwent surgery, mean survival in those with a date of death recorded was higher in those with PET recorded (356 versus 300 days, p &lt; 0.001) but no different in those with pre-operative histology recorded (334 versus 322 days, p = ns). <h3>Conclusion</h3> The data suggest an improvement in practice consistent with current guidance and that diagnostic pathways with early CT are associated with shorter diagnostic times and fewer diagnostic tests. However, a significant proportion of patients undergoing surgery do not have a PET scan recorded which is associated with worse survival. Further study is required to understand this association but it may relate to unrecognised metastatic disease in patients not undergoing PET before surgery.