tbuckley/cabot-search huggingface dataset:
OP0087 Use of Moist Snuff and the Risk of Developing Rheumatoid Arthritis; Results from the Swedish Epidemiological Investigation of Rheumatoid Arthritis Study
Authors: L. Alfredsson, L. Klareskog, C. Bengtsson
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Smoking is the major known environmental risk factor for RA, and notably this risk factor is exclusively seen in ACPA-positive RA. Whether this increased risk is due to nicotine or other substances of inhaled tobacco smoke is unclear. Smokeless tobacco contains nicotine and is often used as an alternative to smoking. The role of smokeless tobaccoin the etiology of RA has to date only been reported from a Swedish study based on male construction workers, where no association was observed between the use of moist snuff and the risk of RA. However, whether smokeless tobacco is related to the ACPA-positive or ACPA-negative RA remains to be elucidated. <h3>Objectives</h3> In this report we aimed at investigating the association between the use of moist snuff and the risk of RA, and if this exposure has different impact on ACPA-positive and ACPA-negative disease. <h3>Methods</h3> Data from EIRA (Epidemiological Investigation of Rheumatoid Arthritis), a population-based case-control study from Sweden, was used. In total, information from1962 incident cases and 2247 randomly selected controls (matched on age, sex and residency), aged 18-70 years, was analysed. Ever, current and past moist snuff users were compared with never users. We calculated odds ratios (OR) with 95% confidence intervals (CI) for RA overall and the ACPA-positive and ACPA-negative subsets, by means of unconditional logistic regression models. All analyses were adjusted for age, sex, residency, pack-years of cigarette smoking and alcohol consumption. <h3>Results</h3> In total, 254 (13%) cases were ever moist snuff users compared with 290 (13%) controls, resulting in an odds ratio of 1.0 (95% CI 0.8-1.2). When exposure to moist snuff was analysed in relation to the incidence of ACPA-positive and ACPA-negative disease, no associations were observed. Furthermore, neither current nor past moist snuff use was related to the risk of RA, or the two sub-groups of the disease. <h3>Conclusions</h3> The use of moist snuff was not associated with RA risk, neither with regard to ACPA-positive nor ACPA-negative RA. The increased risk of RA associated with smoking may thus not be due to nicotine. <h3>References</h3> Carlens C, et al: Smoking, Use of Moist Snuff, and risk of chronic inflammatory diseases. <i>Am J Respir Crit Care Med.</i> 2010;181:1217-22 <h3>Disclosure of Interest</h3> None Declared
Tackling Rising Health Care Costs in Massachusetts
Authors: John Z. Ayanian, Philip J. Van der Wees
Journal: New England Journal of Medicine (2012)

Interview with Dr. Paul Ginsburg on recent Massachusetts legislation aimed at containing increases in statewide health care spending. (10:20)Download Massachusetts has been a leader in health care reform, but it has also had the highest personal health care spending per capita of any state in recent years. A new law seeking to control that spending may provide lessons for other states and the federal government.
Paraneoplastic Autoimmune Multiorgan Syndrome in a Patient With Li Fraumeni Syndrome
Authors: Susan Margaret O'Gorman, Rochelle Torgerson
Journal: JAMA Dermatology (2013)

Discussion | Khaitan et al, 3 in 1998, were the first to describe a patient with Becker nevus of the lower limb.Subsequently, 11 more cases of Becker nevus of the leg have been reported. 4In 2 patients, the reports explicitly noted the absence of hypertrichosis.In 2 female patients, Becker nevus was associated with localized lipoatrophy: a 14-year-old girl with a softtissue defect on the ventral aspect of her thigh and a 45-yearold woman with lipoatrophy on the right thigh. 5 The case presented herein is unusual because the Becker nevus extended below the knee and involved almost the entire leg.
Lamivudine-induced pure red cell aplasia
Authors: Abraham Majluf-Cruz, Germ�n Luna-Casta�os, Sandra Trevi�o-P�rez, Mario Santoscoy, Leopoldo Nieto-Cisneros
Journal: American Journal of Hematology (2000)

The aim of this report is to describe five patients with lamivudine-induced pure red cell aplasia, an association not previously described. We describe patients with unresponsive anemia in whom a complete study including blood cell counts, reticulocyte counts, hemolysis tests, and bone marrow aspiration was performed. Pure red cell aplasia was considered when anemia was associated with normal leukocyte and platelet counts with a corrected reticulocyte count below 1% and less than 5% bone marrow erythroid progenitors in the absence of positive hemolysis tests. Complete remission was considered when bone marrow erythroid progenitors were at least 16%. Five male patients had pure red cell aplasia with a median age of 32 years (range 29 to 37 years). Before lamivudine, they had hemoglobin >11.8 g/dl without transfusion requirements. After receiving the drug, hemoglobin dropped to 5.2 g/dl (4.3 to 6.1 g/dl) with high transfusion requirements and mean bone marrow erythroid progenitors of 1.84% (0 to 4%). Withdrawal of lamivudine was attempted to confirm the diagnosis. Seven weeks after stopping lamivudine, hemoglobin rose up to 12.8 g/dl (11 .3 to 13.8 g/dl) and bone marrow erythroid progenitors increased up to 25.6% (21 to 40%) without transfusion requirements. Lamivudine-induced pure red cell aplasia may be a cause of anemia unresponsive to conventional treatment in AIDS. Since lamivudine use in Mexico has been relatively short, we expect more cases to appear in the future.
In vitro and in vivo genotoxicity of 1,3-butadiene and metabolites.
Authors: G T Arce, D R Vincent, M J Cunningham, W N Choy, A M Sarrif
Journal: Environmental Health Perspectives (1990)

1,3-Butadiene and two major genotoxic metabolites 3,4-epoxybutene (EB) and 1,2:3,4-diepoxybutane (DEB) were used as model compounds to determine if genetic toxicity findings in animal and human cells can aid in extrapolating animal toxicity data to man. Sister chromatid exchange (SCE) and micronucleus induction results indicated 1,3-butadiene was genotoxic in the bone marrow of the mouse but not the rat. This paralleled the chronic bioassays which showed mice to be more susceptible than rats to 1,3-butadiene carcinogenicity. However, 1,3-butadiene did not induce unscheduled DNA synthesis (UDS) in the rat or mouse hepatocytes following in vivo exposure. Likewise, UDS in rat and mouse hepatocytes in vitro was not induced by EB or DEB. Salmonella typhimurium gene mutation (Ames) tests of 1,3-butadiene using strains TA1535, TA97, TA98, and TA100 and employing rat, mouse, and human liver S9 metabolic systems were barely 2-fold above background only in strain TA1535 at 30% 1,3-butadiene in air with induced and uninduced rat S9 and mouse S9 (uninduced). 1,3-Butadiene was negative in in vitro SCE studies in human whole blood lymphocytes cultures treated in the presence of rat, mouse, or human liver S9 metabolic activation. In general, 1,3-butadiene is genotoxic in vivo but is a weak in vitro genotoxin.
Atrial natriuretic peptide concentrations in hypoxic secondary pulmonary hypertension: relation to haemodynamic and blood gas variables and response to supplemental oxygen.
Authors: R J Winter, A C Davidson, D Treacher, R M Rudd, J V Anderson, L Meleagros, S R Bloom
Journal: Thorax (1989)

Plasma atrial natriuretic peptide concentrations, measured in samples drawn from the pulmonary artery, were raised in nine of 17 patients with hypoxic pulmonary hypertension but normal right atrial pressures at rest. No relationship was seen between atrial natriuretic peptide concentrations and mean pulmonary artery or right atrial pressure, or calculated pulmonary or systemic vascular resistance. Patients with the most severe hypoxaemia tended to have higher plasma atrial natriuretic peptide concentrations; three patients with no past history of oedema had concentrations more than twice the upper limit of normal. Treatment with supplementary oxygen for 30 minutes reduced pulmonary vascular resistance in all patients but had no significant effect on plasma atrial natriuretic peptide concentration. These findings suggest that atrial natriuretic peptide may be a factor in the control of sodium and water balance in hypoxic cor pulmonale, where the determinants of individual susceptibility to peripheral oedema are not well understood.
Wanted: patients with mental illness in role of teacher
Authors: S. Nil
Journal: BMJ (2002)

Emergency response to 999 calls Alternatives to the emergency 999 response can be seen in EuropeEditor-Snooks et al point out that the current 999 emergency response system has problems: increasing demand from the public and ever shorter response time targets. 1 They find a lack of evidence on alternative systems and responses in the English medical literature.By restricting their search, they overlook live examples only a few miles from these shores.France, since the mid-1960s, has had a system which incorporates many of the alternatives quoted by the authors: the Service d'Aide Medical Urgente (SAMU). 2 Calls to the control room are logged by trained telephone operators and then passed on to a "medical dispatcher": a doctor in emergency medicine, trained by the service.Medical dispatchers may simply provide medical advice to the caller, or they may decide to use one of a range of other responses to a call.These are referral to, or the dispatch of, a primary care doctor; arranging nonurgent transport by a private ambulance; urgent transport by pompiers (emergency technicians working through the fire service); or sending out a mobile intensive care unit with a doctor trained in emergency medicine.Medical dispatchers also coordinate the deployment of additional resources and decide on the most appropriate destination for a patient.In 2001 the service covering Paris received 300 000 calls (about 820 calls per day).Only 6% of the calls (50 per day) resulted in the dispatch of a mobile intensive care unit.In 16% of cases (130 per day) a primary care doctor was called.Altogether 205 calls per day were managed by the pompiers, by a private ambulance, or by giving medical advice.The remainder were
Tobacco Addiction and Tobacco Mortality
Authors: William Pollin
Journal: JAMA (1984)

Addictive disorders now cause more than one fourth of all deaths in the United States—more than a half million deaths in 1982. But this essential fact is obscured in the nation's vital records and statistics by the general practice of certifying addictive disease deaths to their innumerable anatomic manifestations. However, this situation need not continue indefinitely. Physicians have both an opportunity and a responsibility to state their knowledge of the underlying causes of deaths occurring under their care, and the diagnostic category "Tobacco Use Disorder/Tobacco Dependence," listed in the ninth revision of the<i>International Classification of Diseases</i>is available for their use. By routinely ascertaining the lifetime smoking experience of each patient and stating on each death certificate the role of tobacco, physicians can contribute substantially to improvement of vital statistics, epidemiology, and public health. (<i>JAMA</i>1984;252:2849-2854)
Illegal Internet Drug Sales
Authors: Joan Stephenson
Journal: JAMA (2008)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
The Role of Aldosterone in Man
Authors: John H. Laragh
Journal: JAMA (1960)

FOLLOWING demonstration of the remarkable biological effects of hydrocortisone, many investigators were willing to recognize this steroid as the major and totipotent hormone secreted by the adrenal cortex. However, in 1950 it was found<sup>1</sup>that steroidal extracts of urine from patients forming edema contained a material which was potent in promoting sodium retention and potassium excretion in adrenalectomized rats. This finding was perhaps a stimulus to the important work which led to the isolation and characterization<sup>2</sup>of the adrenal cortical hormone aldosterone. Aldosterone is present in relatively minute amounts in plasma (one one-hundredth of the concentration of hydrocortisone), but its great potency indicates that it plays a major role in regulating the amount of sodium and potassium in the body; through its direct effect on the renal tubule it accelerates renal retention of sodium chloride and the elimination of potassium ions. In normal individuals aldosterone secretion may
NEW ORAL ANTICOAGULANTS ARE NOT SUPERIOR TO WARFARIN IN SECONDARY PREVENTION OF STROKE: INSIGHTS FROM A META-ANALYSIS OF RANDOMIZED TRIALS AND INDIRECT TREATMENT COMPARISONS
Authors: Partha Sardar, Saurav Chatterjee, Wen-Chih Wu, Edgar Lichstein, Joydeep Ghosh, Shamik Aikat, Debabrata Mukherjee
Journal: Journal of the American College of Cardiology (2013)
Fiberendoscopy of the Gastrointestinal Tract in Children-Experience with Newly Designed Fiberscopes
Authors: M. Cremer, J. Peeters, P. Emonts, P. Rodesch, S. Cadranel
Journal: Endoscopy (1974)

Fiberendoscopy in children has classical indications: gastrointestinal bleeding, mucosal lesions and doubtful radiological pictures, foreign body removal, etc. – Utilization of small caliber fiberscopes is a necessity in endoscopy of children; when these fiberscopes are provided with almost all the technical achievements of bigger instruments, it is a great progress and allows further investigations in the underdevelopped field of pediatric endoscopy.
The Landmark Identical Twin Case
Authors: Thomas E. Starzl
Journal: JAMA (1984)

In the autumn of 1979, the 25th anniversary was observed in Boston of the kidney transplantation that was the subject of the LANDMARK ARTICLE by Merrill and co-workers<sup>1</sup>that is reproduced in this issue. All of the authors of the article were members of the Harvard Medical School Faculty serving at the Peter Bent Brigham Hospital, where research in renal transplantation had been an important activity for several preceding years and where such work has continued to the present time. The decision at these institutions to focus for a historical celebration on the first identical twin transplantation rather than some earlier or subsequent event revealed an in-house perception of the importance of the case that has been shared by outside students of medical history such as Groth<sup>2</sup>of Stockholm. Of the four authors, Merrill and Guild were internists. The specialty of nephrology was somewhere between nonexistent and fledgling.
Effect of UVB therapy and a coal tar bath on short contact dithranol treatment for psoriasis
Authors: Y. PARAMSOTHY, M. COLLINS, C.M. LAWRENCE
Journal: British Journal of Dermatology (1988)

Journal Article Effect of UVB therapy and a coal tar bath on short contact dithranol treatment for psoriasis Get access Y. PARAMSOTHY, Y. PARAMSOTHY Department of Dermatology, North Staffordshire Hospital Centre, Stoke‐on‐Trent, U.K. Search for other works by this author on: Oxford Academic Google Scholar M. COLLINS, M. COLLINS Department of Community Medicine, North Staffordshire Hospital Centre, Stoke‐on‐Trent, U.K. Search for other works by this author on: Oxford Academic Google Scholar C.M. LAWRENCE C.M. LAWRENCE Department of Dermatology, North Staffordshire Hospital Centre, Stoke‐on‐Trent, U.K. Dr C.M.Lawrence, Department of Dermatology, The Royal Victoria Infirmary, Newcastle upon TyneNE1 4LP, U.K. Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 118, Issue 6, 1 June 1988, Pages 783–789, https://doi.org/10.1111/j.1365-2133.1988.tb02596.x Published: 01 June 1988
FDG PET/CT Incidental Diagnosis of a Synchronous Bladder Cancer as a Fourth Malignancy in a Patient With Head and Neck Cancer
Authors: Medhat M. Osman, Mustafa E. Altinyay, Amir G. Abdelmalik, Todd M. Brickman, Mark A. Varvares, Nghi C. Nguyen
Journal: Clinical Nuclear Medicine (2011)

A 74-year-old man with 40-year history of smoking and known history of chronic lymphocytic leukemia and cutaneous T-cell lymphoma underwent FDG PET/CT examination for a recent diagnosis of squamous cell carcinoma diagnosed from right frontal crown and left posterior ear skin biopsy. PET images revealed multiple FDG-avid lesions in the head and neck, highly suspicious for nodal metastases. Reviewing CT portion of PET/CT examination revealed a hyperattenuating density in the posterior bladder wall. This lesion was not noticed initially due to the intense physiologic bladder uptake. On lowering the intensity, this lesion showed intense FDG avidity on the PET portion of the examination. Cytoscopic biopsy revealed low-grade papillary urothelial cell carcinoma.
Insulin signaling is required for insulin’s direct and indirect action on hepatic glucose production
Authors: Simon J. Fisher, C. Ronald Kahn
Journal: Journal of Clinical Investigation (2003)

We and others have suggested that insulin predominantly acts indirectly to inhibit hepatic glucose production (HGP) via suppression of gluconeogenic precursors, FFAs, and glucagon. To test that hypothesis, we performed high-dose hyperinsulinemic-euglycemic clamps using [3-3H]-glucose in liver-specific insulin receptor knockout (LIRKO) mice, LIRKO mice treated with streptozotocin (LIRKO+STZ), and controls. In LIRKO mice, fasted glucose was normal, but insulin levels were elevated tenfold. STZ treatment reduced insulinemia by 60% with resulting hyperglycemia. Interestingly, basal HGP was similar in all three groups. During the clamp, HGP was suppressed by 82 ± 17% in controls, but was not suppressed in either LIRKO or LIRKO+STZ mice. Glucose infusion and utilization were impaired (∼50%) in LIRKO and LIRKO+STZ mice versus controls. Insulin suppressed FFAs similarly in all groups (∼46%). Glucagon was not significantly suppressed during the clamp. Thus, in LIRKO mice, (a) high-dose insulin fails to suppress HGP indicating that both direct and indirect effects of insulin require an intact insulin-signaling pathway in the liver; (b) primary hepatic insulin resistance leads to hyperinsulinemia and secondary extrahepatic insulin resistance; and (c) lowering insulin levels with STZ tended to improve extrahepatic insulin sensitivity but failed to reveal the previously postulated indirect role of insulin in suppressing HGP.
Success of Mass Vaccination of Infants Against Hepatitis B-Reply
Authors: Huey-Ling Chen
Journal: JAMA (1996)

In Reply.  —We are glad to know that the work of Dr Durand and colleagues confirms our results of hepatitis B seroepidemiology after a mass immunization program on populationbased samples of children 3 to 4 years of age. A hepatitis B vaccination program without administration of HBIG may yield good results in an area of lower maternal hepatitis B virus e antigen (HBeAg) seropositivity rate in HBsAg-carrier mothers. In a previous study, the efficacy of hepatitis B immunization increased from 75% with vaccination alone to 94% with addition of HBIG in infants born to HBeAg-seropositive, HBsAg carrier mothers. 1 The strategy of maternal screening and administration of HBIG may differ with consideration of HBeAg seropositivity rate and financial issues in different areas. However, a universal hepatitis B immunization program is recommended for all newborns in both high-rate and low-rate endemic areas to prevent HBV infection and its related diseases.
Quality control in postgraduate training
Authors: K. Sharif, M. Afnan
Journal: BMJ (1998)

Measuring the pass rates of candidates in each training programme would sharpen the sensibilities of all involved say Khaldoun Sharif and Masoud Afnan

Membership or fellowship of a royal college is an essential qualification for a specialist medical career in the United Kingdom. One of the main aims of postgraduate medical training is to prepare trainees for a specialist career. This inherently includes training for the relevant membership or fellowship examination. But how good are individual training programmes in doing this job? We simply do not know.

You might reasonably expect that professional pride would ensure that postgraduate deans (who pay for the training), the royal colleges (which recognise particular hospitals' suitability to do the training), and the training organisations publicly demonstrated the effectiveness of the training. However, none do: pass rates for trainees in each training programme are not published and probably not even collected. This is despite a clear recommendation by the standing committee on postgraduate medical and dental education (SCOPME) to monitor postgraduate medical education by all organisations involved in order to evaluate its effectiveness.(1)

SCOPME also recommends that this monitoring should be an integral part of the educational process and should include (among other things) examination pass rates.1 This information would definitely be possible to collect. Directors of training programmes know (or should know) which candidates are sitting …
Suppression of interferon-α signaling by hepatitis E virus
Authors: Chen Dong, Mohammad Zafrullah, Tonya Mixson-Hayden, Xing Dai, Jiuhong Liang, Jihong Meng, Saleem Kamili
Journal: Hepatology (2011)

The interferon (IFN) system is integral to the host response against viruses, and many viruses have developed strategies to overcome its antiviral effects. The effects of hepatitis E virus (HEV), the causative agent of hepatitis E, on IFN signaling have not been investigated primarily because of the nonavailability of an efficient in vitro culture system or small animal models of infection. We report here the generation of A549 cell lines persistently infected with genotype 3 HEV, designated as HEV-A549 cells and the effects HEV has on IFN-α-mediated Janus kinase-signal transducer and activator of transcription (JAK-STAT) signaling. Treatment of HEV-A549 cells with 250, 500, and 1000 U/mL of IFN-α for 72 hours showed a dose-dependent reduction in HEV RNA levels by 10%, 20%, and 50%, respectively. IFN-α-stimulated genes coding for the antiviral proteins dsRNA-activated protein kinase (PKR) and 2',5'-oligoadenylate synthetase (2',5'-OAS) were down-regulated in IFN-α-treated HEV-A549 cells. HEV infection also prevented IFN-α-induced phosphorylation of STAT1. Regulation of STAT1 by HEV was specific, as phosphorylation of STAT2, tyrosine kinase (Tyk) 2, and Jak1 by IFN-α was unaltered. Additionally, STAT1 levels were markedly increased in HEV-A549 cells compared with naive A549 cells. Furthermore, binding of HEV open reading frame (ORF)3 protein to STAT1 in HEV-A549 cells was observed. HEV ORF3 protein alone inhibited IFN-α-induced phosphorylation of STAT1 and down-regulated the IFN-α-stimulated genes encoding PKR, 2',5'-OAS, and myxovirus resistance A.HEV inhibits IFN-α signaling through the regulation of STAT1 phosphorylation in A549 cells. These findings have implications for the development of new strategies against hepatitis E.