tbuckley/cabot-search huggingface dataset:
FRI0231 Association of systemic sclerosis with pulmonary sarcoidosis in two cases
Authors: G Szucs, E Szolnoki, M Alexa, G Szegedi
Journal: Annals of the Rheumatic Diseases (2001)

<h3>Background</h3> <h3>Objectives</h3> <h3>Methods</h3> A 42-year-old man has been followed up due to mediastinal lymphadeopathy and pleural effusion parallel with Raynaud syndrome, sclerodactylia and bibasal pulmonary fibrosis. He was diagnosed as having systemic sclerosis by the clinical symptoms and skin biopsy and sarcoidosis which was confirmed by the biopsy of mediastinal lymph nodes. A 24-year-old woman has been followed up due to sarcoidosis proved by the biopsy of mediastinal lymph nodes, too) for 3 years before the development of the clinical symptoms of systemic sclerosis. <h3>Results</h3> In both patients sarcoidosis were successfully treated with corticosteroids (in the second case corticosteroid treatment was completed with cyclophosphamid becasue of fibrotising alveolitis). We analysed the clinical symptoms, organ manifestation, prognosis in both cases together with the examination of cytokine profile (interferon-g, IL-1, IL-2, IL-4, IL-6, TNF-a) of CD4 positive lymphocytes from periferal blood. <h3>Conclusion</h3> Our results showed Th1 dominancy in both cases, which may play an important role in the coexistence of sarcoidosis and systemic sclerosis.
Effect of tocilizumab on clinical outcomes at 15 days in patients with severe or critical coronavirus disease 2019: randomised controlled trial
Authors: Viviane C Veiga, João A G G Prats, Danielle L C Farias, Regis G Rosa, Leticia K Dourado, Fernando G Zampieri, Flávia R Machado, Renato D Lopes, Otavio Berwanger, Luciano C P Azevedo, Álvaro Avezum, Thiago C Lisboa, Salomón S O Rojas, Juliana C Coelho, Rodrigo T Leite, Júlio C Carvalho, Luis E C Andrade, Alex F Sandes, Maria C T Pintão, Claudio G Castro, Sueli V Santos, Thiago M L de Almeida, André N Costa, Otávio C E Gebara, Flávio G Rezende de Freitas, Eduardo S Pacheco, David J B Machado, Josiane Martin, Fábio G Conceição, Suellen R R Siqueira, Lucas P Damiani, Luciana M Ishihara, Daniel Schneider, Denise de Souza, Alexandre B Cavalcanti, Phillip Scheinberg
Journal: BMJ (2021)

Abstract Objective To determine whether tocilizumab improves clinical outcomes for patients with severe or critical coronavirus disease 2019 (covid-19). Design Randomised, open label trial. Setting Nine hospitals in Brazil, 8 May to 17 July 2020. Participants Adults with confirmed covid-19 who were receiving supplemental oxygen or mechanical ventilation and had abnormal levels of at least two serum biomarkers (C reactive protein, D dimer, lactate dehydrogenase, or ferritin). The data monitoring committee recommended stopping the trial early, after 129 patients had been enrolled, because of an increased number of deaths at 15 days in the tocilizumab group. Interventions Tocilizumab (single intravenous infusion of 8 mg/kg) plus standard care (n=65) versus standard care alone (n=64). Main outcome measure The primary outcome, clinical status measured at 15 days using a seven level ordinal scale, was analysed as a composite of death or mechanical ventilation because the assumption of odds proportionality was not met. Results A total of 129 patients were enrolled (mean age 57 (SD 14) years; 68% men) and all completed follow-up. All patients in the tocilizumab group and two in the standard care group received tocilizumab. 18 of 65 (28%) patients in the tocilizumab group and 13 of 64 (20%) in the standard care group were receiving mechanical ventilation or died at day 15 (odds ratio 1.54, 95% confidence interval 0.66 to 3.66; P=0.32). Death at 15 days occurred in 11 (17%) patients in the tocilizumab group compared with 2 (3%) in the standard care group (odds ratio 6.42, 95% confidence interval 1.59 to 43.2). Adverse events were reported in 29 of 67 (43%) patients who received tocilizumab and 21 of 62 (34%) who did not receive tocilizumab. Conclusions In patients with severe or critical covid-19, tocilizumab plus standard care was not superior to standard care alone in improving clinical outcomes at 15 days, and it might increase mortality. Trial registration ClinicalTrials.gov NCT04403685 .
Perioperative chemotherapy with gemcitabine plus cisplatin followed by radical liver resection versus immediate radical liver resection alone in gallbladder carcinoma or in front of radical resection in BTC: The phase III GAIN trial.
Authors: Thorsten Oliver Goetze, Sylvie Lorenzen, Ulli Simone Bankstahl, Sven A. Lang, Uwe A Wittel, Steffen Heeg, Wolf Otto Bechstein, Andreas Schnitzbauer, Ursula Pession, Daniel Reim, Tobias Keck, Alfred Königsrainer, Pompiliu Piso, Arndt Vogel, Thomas Wirth, Nuh N. Rahbari, Christoph Reissfelder, Sebastian Belle, Claudia Pauligk, Salah-Eddin Al-Batran
Journal: Journal of Clinical Oncology (2021)

TPS353 Background: Radical surgical resection represents the only potentially curative treatment option for Biliary Tract Cancer (BTC) and Gallbladder Carcinoma (GBC). Nevertheless, 5-year OS is only 20–40% after curatively intended resection. GBC is the fifth most common neoplasm of the digestive tract and even the most frequent cancer of the biliary system. The majority of gallbladder carcinoma cases are discovered incidentally by the pathologist after cholecystectomy for a benign indication, so called incidental gallbladder carcinomas. For improving curative rates in BTC and GBC, early systemic therapy combined with radical resection seems to be a promising approach. The earliest moment to apply chemotherapy would be in front of radical surgery. Encouraging results of neoadjuvant/perioperative concepts in other malignancies provide an additional rationale to use this treatment in the early phase management of GBC and intrahepatic as well extrahepatic cholangiocarcinoma, especially because data regarding pure adjuvant chemotherapy in BTC`s are currently conflicting. Methods: GAIN is a multicenter, randomized, controlled, open-label phase III trial, including pts with GBCs in front of radical liver resection and pts with resectable/borderline resectable intra- and extrahepatic cholangiocarcinomas (ICC/ECC). Pts. are randomized to either neoadjuvant systemic chemotherapy (Gemcitabine + Cisplatin 3 cycles pre- and post-surgery) followed by radical surgery or to direct surgery without neoadjuvant treatment. Primary endpoint is OS; secondary endpoints are PFS, R0-resection rate, toxicity, perioperative morbidity, mortality and QoL. A total of N = 333 patients with GBC or BTC will be included. Recruitment has just started; first patient in was on December 6th, 2019. Clinical trial information: NCT03673072.
Liver injury in coronavirus infected patients: the experience of a COVID-19 dedicated hospital in lombardia, italy
Authors: M. Triolo, M. Tacelli, B. Magro, L. Pasulo
Journal: Hepatology (2020)

Background: In December 2019, a new contagious disease, named COVID-19 and caused by a novel coronavirus (SARSCov- 2), emerged in Wuhan City, China, and is now spreading across international borders Although the disease mainly causes respiratory symptoms, it can also cause impairmentof other organs Interestingly, in many cohorts of patients infected with SARS-Cov-2 it has been noted a more or less significant increase of transaminases, however the real impact of such alteration on liver function is currently unknown This study aimed at evaluating the impact of COVID-19 on the liver function and the clinical outcome of these patients Methods: In this monocentric retrospective study, patients admitted at the ASST-Papa Giovanni XXIII-Bergamo with diagnosis of COVID-19 between 1stMarch and 30thApril 2020 were enrolled A significant increase of hepatic cytolysis was defined as ALT ≥5xULN  Impairment of liver function was defined as association of ALT ≥5xULN with bilirubin ≥1 5 mg/dL and/or INR ≥ 1 7  Results: One thousand two hundred sixty three patients with confirmed SARS-Cov-2 infection were enrolled (mean age 66 years, 76% males)  A significant increase of ALT was present in 47 (4%) of patients and among these 8 (17%) and 3 (6%) presented bilirubin ≥1 5 mg/dL and/or INR ≥ 1 7, respectively Eleven/forty seven patients (23%) died after a median of 5 (1-21) days since COVID-19 diagnosis, with 30-day-mortality rate of 19%, nobody for liver-related causes Age and creatinin were the only independent predictors of mortality  Moreover, mortality rate was no significantly increased in patients with ALT ≥5xULNcompared to patients with ALT <5xULN (p=0 94) Conclusion: Infection for SARSCov- 2 may result in increase of transaminases however it is not associated with significant impairment of liver function and increase of mortality
Metastatic Adamantinoma of the Femur on FDG PET/CT
Authors: Patrick Martineau, Ingrid Bloise, Claire Gowdy, Daniel Worsley
Journal: Clinical Nuclear Medicine (2021)

Abstract Adamantinomas are rare malignant primary bone tumors, which typically arise in young patients, are generally low-grade tumors, and classically arise from the anterior tibial diaphysis. We present the case of a 70-year-old woman who underwent repeat imaging with FDG PET for a pathologically proven case of femoral adamantinoma who experienced a relatively rapid development of metastatic disease with an atypical distribution of lesions.
Abstract 324: Effect of Prehospital Use of Plasma and Erythrocytes on Crystalloid and Blood Product Requirements in Trauma
Authors: Anatolij Truhlar, Jana Berkova, Jaromir Koci, Libor Seneta, Vit Rehacek
Journal: Circulation (2019)

Introduction: Recent studies demonstrated positive effects of blood products (BP) administration by helicopter emergency medical services (HEMS) to trauma patients but most of them were limited to specific cohorts (e.g. mixture of primary and secondary transports, long prehospital times, high prevalence of penetrating injuries, military use). This study aimed to assess implementation of prehospital use of BP into a regional trauma system treating predominantly blunt injuries (&gt;95 %) and achieving short prehospital times (first emergency call to handover at trauma center ~60 min). Methods: A prospective observational study in patients treated with prehospital plasma (1 unit) followed by erythrocytes (1 unit) during the initial 7 months of the RABBIT trial (Rapid Administration of Blood by HEMS in Trauma, ClinicalTrials NCT03522636). The treatment group was compared to a historical cohort treated with massive transfusion protocol but no BP available prehospitally. It was hypothesized that early transfusion was associated with lower severity of coagulopathy and lower requirements for crystalloids and BP within 24 hours. Data analysis was performed using Prism 6.0 (GraphPad, La Jolla, USA). Results: Twenty patients treated with prehospital BP (Jun-Dec 2018) were compared to 24 patients in a control group (Jun-Dec 2017). There were no secondary transports. No differences were found between groups in age (47.0 ± 4.1 vs. 46.1 ± 3.7 years, p=0.87), ISS (33.5 ± 3.7 vs. 35.8 ± 3.4, p=0.65), prehospital time (60.9 ± 3.8 vs. 63.8 ± 3.6 min, p=0.59), fibrinogen (2.6 ± 0.2 vs. 2.5 ± 0.2 g/L, p=0.74) and lactate on admission to trauma center (4.5 ± 0.7 vs. 4.4 ± 0.7 mmol/L, p=0.94). The treated patients had better INR (1.1 ± 0.1 vs. 1.4 ± 0.1, p=0.028), and required 14.5 ± 1.7 units of BP in 24 hours compared to 21.42 ± 4.0 units in a control group (p=0,15). Prehospital and emergency department (ED) dose of crystalloids was reduced from 1696 ± 161 mL to 1088 ± 137 mL (p=0.006). No colloids were given at any time. There were no transfusion related complications. Conclusion: Prehospital use of plasma and erythrocytes in a setting with short prehospital times was associated with lower need for crystalloids, better INR at admission, and a trend towards lower consumption of BP in a trauma center.
SP0129 Pharmaceutical pain control in rheumatoid arthritis
Authors: K Viktil
Journal: Annals of the Rheumatic Diseases (2001)

<h3></h3> Relief of pain is a problem which is difficult to handle in rheumatic diseases and multidisciplinary approach is necessary. Drugs play an important role in the control of pain. There are different groups of drugs which are relevant: Analgesics. In general – work fast, short duration of relief. However long-lasting formulations are available. 1.1. Non-opioid analgesics – Weak to medium effect. Often as a supplement to stronger analgesics. Give no addiction. 1.2. Opioid analgesics – Strong effect. May give addiction, important to have in mind when treating pain in chronic diseases. Non steroidal antiinflammatory drugs/coxibs. Reduce both pain and stiffness, tenderness and swollen joints. However, interaction problems with other drugs, may affect renal function, platelet function and and give gastrointestinal (GI) problems. The new class coxibs have however reduced the GI-and the platelet-problems. Psychotropic drugs – e.g. antidepressants, antipsychotics, antiepileptica, anxiolytica. Useful among others in neurogenic pain. Strategies of pharmacological treatment of pain: Acute (e.g. postoperative pain) and chronic pain need different strategies.
Covid-19: Gothic sanctuary gives hope for the future
Authors: Alison Shepherd
Journal: BMJ (2021)

To the sound of organ music, hundreds of people aged over 80 receive their Pfizer-BioNTech covid-19 vaccination inside the grandeur of Salisbury Cathedral transept.On Saturday 16 January the cathedral was turned into a pop-up vaccination hub by Sarum South Primary Care Network.Its co-clinical director Dan Henderson said around 1000 patients and staff were vaccinated in one day.Nicholas Papadopulos, the dean of Salisbury, told the Guardian, "This place has stood here for 800 years to give glory to God, and to serve the city and the region.What better way could there be to do that than hosting Salisbury's stage in the vaccination programme.It is absolutely wonderful." 1 Lichfield and Blackburn cathedrals have also opened their doors to help the vaccination drive, along with race courses, sports halls, and other venues closed because of the current lockdown.From the start of this week, across the UK people aged 70 and over and the clinically extremely vulnerable also began to be invited to join the 3.8 million people who have so far received their first vaccine dose.The government has pledged to offer a vaccine to everyone over the age 70, all health and social care workers, and clinically extremely vulnerable people by mid-February.
Trichloroacetic acid peels for the treatment of acanthosis nigricans
Authors: Renato Luiz Baldissera, Eric J. Yang, Juliano Vilaverde Schmitt, Erica Lin, Felipe Emanuel de Jesus, Milvia Maria Simões e Silva Enokihara, Carlos Gustavo Wambier, Edileia Bagatin
Journal: Journal of the American Academy of Dermatology (2021)
Abstract 19610: The Role of Coronary Artery Calcium for Stratifying Cardiovascular Risk in Patients With Hypertension: A Subgroup Analysis of Coronary Artery Calcium Consortium
Authors: Sina Kianoush, Zeina Dardari, Garth Graham, William J McEvoy, Michael D Miedema, Khurram Nasir, John Rumberger, Leslee J Shaw, Daniel S Berman, Matthew Buddof, Michael J Blaha
Journal: Circulation (2017)

Introduction: Risk of coronary heart disease (CHD) and cardiovascular disease (CVD) is heterogeneous among patients with hypertension. The SPRINT trial showed that patients at the highest risk for ...
The Inertia Paradox
Authors: Jessica Frey
Journal: Annals of Internal Medicine (2021)

Ad LibitumJanuary 2021The Inertia ParadoxJessica Frey, MDJessica Frey, MDWest Virginia University, Morgantown, West Virginia (J.F.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M19-3696 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail I remember ice-skating,snow nipping at our noses.You released my hands,unleashing me into the icy unknown.My blade caught on an indentation in the ice,and my shrieks of giddiness stopped shortas my limbs starfished into the airand sprawled into a knotted mess.When I was older,you told me you named it the Inertia Paradox:that feeling you got when you saw me start to fall and you trieddesperatelyto turn around and right me again.But the slickness of the ice and the speed and the windkept pushing you forward.Then the unanswered phone ... Author, Article, and Disclosure InformationAffiliations: West Virginia University, Morgantown, West Virginia (J.F.)Current Author Address: Jessica Frey, MD, 1 Medical Center Drive, Morgantown, WV 26505; e-mail, jessfrey.[email protected]com. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics January 2021Volume 174, Issue 1Page: 121KeywordsEmotionsFalls ePublished: 19 January 2021 Issue Published: January 2021 Copyright & PermissionsCopyright © 2021 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Research progress of heat stroke during 1989–2019: a bibliometric analysis
Authors: De-Meng Xia, Xu-Ren Wang, Pan-Yu Zhou, Tian-Le Ou, Lei Su, Shuo-Gui Xu
Journal: Military Medical Research (2021)

Heat stroke (HS) is an acute physical disorder that is associated with a high risk of organ dysfunction and even death. HS patients are usually treated symptomatically and conservatively; however, there remains a lack of specific and effective drugs in clinical practice. An analysis of publication contributions from institutions, journals and authors in different countries/regions was used to study research progress and trends regarding HS.We extracted all relevant publications on HS between 1989 and 2019 from Web of Science. Using the Statistical Package for Social Science (SPSS, version 24) and the software GraphPad Prism 8, graphs were generated and statistical analyses were performed, while VOSviewer software was employed to visualize the research trends in HS from the perspectives of co-occurring keywords.As of April 14, 2020, we identified 1443 publications with a citation frequency of 5216. The United States accounted for the largest number of publications (36.2%) and the highest number of citations (14,410), as well as the highest H-index at 74. Although the sum of publications from China ranked second, there was a contradiction between the quantity and quality of publications. Furthermore, Medicine & Science in Sports & Exercise published the most papers related to HS, with Lin MT publishing the most papers in this field (112), while the review by Knochel JP received the highest citation frequency at 969. The keyword heat-stress appeared most recently, with an average appearing year of 2015.5. In the clinical research cluster, exertional heat-stroke was determined to be the hotspot, while ambient-temperature and heat waves were the new trends in the epidemiological research cluster.Corresponding to this important field, while the contributions of the publications from the United States were significant, the mismatch between the quantity and quality of publications from China must be examined. Moreover, it is hypothesized that clinical and epidemiological studies may become hotspots in the near future.
End-of-Life Characteristics Associated With Short Hospice Length of Stay for Patients With Solid Tumors Enrolled in Phase I Clinical Trials
Authors: Ramy Sedhom, Amanda L. Blackford, Arjun Gupta, Kelly Griffiths, Janet Heussner, Michael A. Carducci
Journal: Journal of the National Comprehensive Cancer Network (2021)

Background: Patients participating in phase I trials represent a population with advanced cancer and symptoms, with quality-of-life implications arising from both disease and treatment. Transitions to end-of-life care for these patients have received little attention. Good empirical data are needed to better understand the role of advance care planning and palliative care during phase I trial transitions. We investigated how physician–patient communication at the time of disease progression, patient characteristics, and patterns of care were associated with end-of-life care. Methods: We conducted a retrospective chart review of all patients with solid tumors enrolled in phase I trials at a comprehensive cancer center from January 2015 to December 2017. We captured physician–patient communication during disease progression. Among patients who died, we assessed palliative care referral, advance care planning, place of death, healthcare use in the final month of life, hospice enrollment, and hospice length of stay (LOS). Factors independently associated with a short hospice LOS (defined as ≤3 days) were estimated from a multivariable model building approach. Results: Among 207 participants enrolled in phase I intervention studies at Johns Hopkins Hospital, the median age was 61 years (range, 31–91 years), 48% were women, 21% were members of racial minority groups, and 41.5% were referred from an outside institution. At the time of disease progression, 53% had goals of care documented, 47% were previously referred to palliative care, and 41% discussed hospice with their oncologist. A total of 82% of decedents died within 1 year of study enrollment, and 85% enrolled in hospice. Among the 147 participants who enrolled in hospice, 22 (15%) had a short LOS (≤3 days). Factors independently associated with an increased risk of short hospice LOS in the multivariable model included age &gt;65 years (odds ratio [OR], 1.12; 95% CI, 1.01–1.24; P =.04), whereas remaining at the same institution (OR, 0.72; 95% CI, 0.65–0.80; P &lt;.001) and referral to palliative care before progression (OR, 0.83; 95% CI, 0.75–0.92; P &lt;.001) were associated with a decreased risk of short hospice LOS. Conclusions: Reported data support the benefit of palliative care for patients in phase I trials and the risks associated with healthcare transitions for all patients, particularly older adults, regardless of care received. Leaving a clinical trial is a time when clear communication is paramount. Phase I studies will continue to be vital in advancing cancer treatment. It is equally important to advance the support provided to patients who transition off these trials.