tbuckley/cabot-search huggingface dataset:
Association Between Acute Care and Critical Illness Hospitalization and Cognitive Function in Older Adults
Authors: William J. Ehlenbach, Catherine L. Hough, Paul K. Crane, Sebastien J. P. A. Haneuse, Shannon S. Carson, J. Randall Curtis, Eric B. Larson
Journal: JAMA (2010)

<h3>Context</h3>Studies suggest that many survivors of critical illness experience long-term cognitive impairment but have not included premorbid measures of cognitive functioning and have not evaluated risk for dementia associated with critical illness.<h3>Objectives</h3>To determine whether decline in cognitive function was greater among older individuals who experienced acute care or critical illness hospitalizations relative to those not hospitalized and to determine whether the risk for incident dementia differed by these exposures.<h3>Design, Setting, and Participants</h3>Analysis of data from a prospective cohort study from 1994 through 2007 comprising 2929 individuals 65 years old and older without dementia at baseline residing in the community in the Seattle area and belonging to the Group Health Cooperative. Participants with 2 or more study visits were included, and those who had a hospitalization for a diagnosis of primary brain injury were censored at the time of hospitalization. Individuals were screened with the Cognitive Abilities Screening Instrument (CASI) (score range, 0-100) every 2 years at follow-up visits, and those with a score less than 86 underwent a clinical examination for dementia.<h3>Main Outcome Measures</h3>Score on the CASI at follow-up study visits and incident dementia diagnosed in study participants, adjusted for baseline cognitive scores, age, and other risk factors.<h3>Results</h3>During a mean (SD) follow-up of 6.1 (3.2) years, 1601 participants had no hospitalization, 1287 had 1 or more noncritical illness hospitalizations, and 41 had 1 or more critical illness hospitalizations. The CASI score was assessed more than 45 days after discharge for 94.3% of participants. Adjusted CASI scores averaged 1.01 points lower for visits following acute care illness hospitalization compared with follow-up visits not following any hospitalization (95% confidence interval [CI], −1.33 to −0.70; P &lt; .001) and 2.14 points lower on average for visits following critical illness hospitalization (95% CI, −4.24 to −0.03; P = .047). There were 146 cases of dementia among those not hospitalized, 228 cases of dementia among those with 1 or more noncritical illness hospitalizations, and 5 cases of dementia among those with 1 or more critical illness hospitalizations. The adjusted hazard ratio for incident dementia was 1.4 following a noncritical illness hospitalization (95% CI, 1.1 to 1.7; P = .001) and 2.3 following a critical illness hospitalization (95% CI, 0.9 to 5.7; P = .09).<h3>Conclusions</h3>Among a cohort of older adults without dementia at baseline, those who experienced acute care hospitalization and critical illness hospitalization had a greater likelihood of cognitive decline compared with those who had no hospitalization. Noncritical illness hospitalization was significantly associated with the development of dementia.
Too much of a good thing: immunodeficiency due to hyperactive PI3K signaling
Authors: Craig M. Walsh, David A. Fruman
Journal: Journal of Clinical Investigation (2014)

Primary immune deficiency diseases arise due to heritable defects that often involve signaling molecules required for immune cell function. Typically, these genetic defects cause loss of gene function, resulting in primary immune deficiencies such as severe combined immune deficiency (SCID) and X-linked agammaglobulinemia (XLA); however, gain-of-function mutations may also promote immune deficiency. In this issue of the JCI, Deau et al. establish that gain-of-function mutations in PIK3R1, which encodes the p85α regulatory subunit of class IA PI3Ks, lead to immunodeficiency. These observations are consistent with previous reports that hyperactivating mutations in PIK3CD, which encodes the p110δ catalytic subunit, are capable of promoting immune deficiency. Mutations that reduce PI3K activity also result in defective lymphocyte development and function; therefore, these findings support the notion that too little or too much PI3K activity leads to immunodeficiency.
Reforming the Health Insurance Market for Small Businesses
Authors: M A Hall
Journal: New England Journal of Medicine (1992)

FACED with possible extinction, the private health insurance industry has emerged as a vocal advocate of reforming the way it does business. Since January 1990, the Health Insurance Association of America (HIAA) has proposed extensive regulation of the pricing, marketing, underwriting, and design of policies sold to small-business groups.1 Similar proposals for reform have been made by the Blue Cross and Blue Shield Association and by the National Association of Insurance Commissioners (NAIC). It is remarkable to see a reform proposal coming from the industry most likely to oppose it. It is also surprising that, with the rest of the . . .
Cancer in an ileoanal reservoir.
Authors: H D Appelman
Journal: Gut (1990)

Palliation of malignant dysphagia SIR,-Dr Barr et al are to be congratulated on their work examining the role of laser and laser + intubation in the palliation of malignant dysphagia.'We would agree with their conclu- sion that laser therapy should be restricted to specialist centres, and others have highlighted that, apart from operator expertise, high capital cost is another reason for restricting its availability to designated centres.2So what happens to these patients elsewhere?Dissat- isfaction with intubation as a palliative tech- nique prompted us to examine the role of endoscopic tumour destruction using ethanol injections.This technique of ethanol-induced tumour necrosis (ETN) has recently been described,3 and fulfils the criteria suggested by Cox and Bennett for an ideal palliative technique.4It is quick, safe, painless, needs only a short inpatient stay, and has a low complication rate.The results achieved compared favour- ably with all published results of laser palliation.As with laser, apparent complete occlusion of the lumen does not prevent this technique being used.The cost of ETN is considerably less than that of either laser or intubation as there is no initial capital cost and no maintenance cost.The only treatment cost (apart from that of endoscopy) is that of the ethanol for injection.The technique can be quickly learnt by experienced therapeutic endoscopists.We believe that there is an imperative need to institute a prospective randomised trial of laser therapy v ETN.If results were comparable, one would have to conclude not as Barr et al have stated that 'both techniques [laser and intubation] should be available for the management of patients with malignant dysphagia' but 'first line treatment for palliation of malignant dysphagia is ETN.If this treatment fails treatment by laser or intubation should be considered.'
Lynch Syndrome (Hereditary Nonpolyposis Colorectal Cancer) Diagnostics
Authors: K. Lagerstedt Robinson, T. Liu, J. Vandrovcova, B. Halvarsson, M. Clendenning, T. Frebourg, N. Papadopoulos, K. W. Kinzler, B. Vogelstein, P. Peltomaki, R. D. Kolodner, M. Nilbert, A. Lindblom
Journal: JNCI Journal of the National Cancer Institute (2007)

Preventive programs for individuals who have high lifetime risks of colorectal cancer may reduce disease morbidity and mortality. Thus, it is important to identify the factors that are associated with hereditary colorectal cancer and to monitor the effects of tailored surveillance. In particular, patients with Lynch syndrome, hereditary nonpolyposis colorectal cancer (HNPCC), have an increased risk to develop colorectal cancer at an early age. The syndrome is explained by germline mutations in DNA mismatch repair (MMR) genes, and there is a need for diagnostic tools to preselect patients for genetic testing to diagnose those with HNPCC. Patients (n = 112) from 285 families who were counseled between 1990 and 2005 at a clinic for patients at high risk for HNPCC were selected for screening to detect mutations in MMR genes MLH1, MSH2, MSH6, and PMS2 based on family history, microsatellite instability (MSI), and immunohistochemical analysis of MMR protein expression. Tumors were also screened for BRAF V600E mutations; patients with the mutation were considered as non-HNPCC. Among the 112 patients who were selected for screening, 69 had germline MMR mutations (58 pathogenic and 11 of unknown biologic relevance). Sixteen of the 69 mutations (23%) were missense mutations. Among patients with MSI-positive tumors, pathogenic MMR mutations were found in 38 of 43 (88%) of patients in families who met Amsterdam criteria and in 13 of 22 (59%) of patients in families who did not. Among patients with MSI-negative tumors, pathogenic MMR mutations were found in 5 of 17 (29%) of families meeting Amsterdam criteria and in 1 of 30 (3%) of non-Amsterdam families with one patient younger than age 50 years. In three patients with MSI-negative tumors who had pathogenic mutations in MLH1 or MSH6, immunohistochemistry showed loss of the mutated protein. Our findings suggest that missense MMR gene mutations are common in HNPCC and that germline MMR mutations are also found in patients with MSI-negative tumors.
Comparison of health problems related to work and environmental measurements in two office buildings with different ventilation systems.
Authors: A S Robertson, P S Burge, A Hedge, J Sims, F S Gill, M Finnegan, C A Pickering, G Dalton
Journal: BMJ (1985)

A cross sectional survey investigating "building sickness" was carried out in two buildings with similar populations of office workers but differing ventilation systems, one being fully air conditioned with humidification and the other naturally ventilated. The prevalence of symptoms related to work was assessed by a questionnaire administered by a doctor. A stratified, randomly selected sample of workers was seen (84% response). Building sickness includes several distinct syndromes related to work, most of which were significantly more common in the air conditioned building than the naturally ventilated building--namely, rhinitis (28% v 5%), nasal blockage and dry throat (35% v 9%), lethargy (36% v 13%), and headache (31% v 15%). The prevalence of work related asthma and humidifier fever was low and did not differ significantly between the two buildings. An environmental assessment of the offices was performed to attempt to identify possible factors responsible for the differences in the prevalence of disease. Globe temperature, dry bulb temperature, relative humidity, moisture content, air velocity, positive and negative ions, and carbon monoxide, ozone, and formaldehyde concentrations were all measured. None of these factors differed between the buildings, suggesting that building sickness is caused by other factors.
Cytokine immunoreactivity in seasonal rhinitis: regulation by a topical corticosteroid.
Authors: P Bradding, I H Feather, S Wilson, S T Holgate, P H Howarth
Journal: American Journal of Respiratory and Critical Care Medicine (1995)

Seasonal allergic rhinitis is characterized by the development of nasal mucosal inflammation in response to natural allergen exposure, and is prevented by the administration of topical corticosteroids. Interleukin-4 (IL-4), IL-5, and IL-6 may have important roles in this process, and in vitro the gene transcription for each of these cytokines is inhibited by corticosteroids. In this study we have therefore investigated the effect of seasonal allergen exposure on the expression of immunoreactivity for IL-4, IL-5, and IL-6 in nasal mucosal biopsies, and the effect of regular prophylactic treatment with the topical corticosteroid, fluticasone propionate. Following a nasal mucosal biopsy out of season, patients were randomized double-blind to receive 6 wk of treatment during the pollen season with either topical fluticasone nasal spray (200 micrograms daily) or matching placebo. Each subject underwent a repeat nasal biopsy at the end of the 6-wk treatment period. Seasonal increases in epithelial eosinophils (p = 0.046), submucosal eosinophils (p = 0.001), and epithelial mast cells (p = 0.055) occurred in the placebo--but not the fluticasone-treated patients. Submucosal mast cell numbers did not change in either group. Immunoreactivity for IL-4 and IL-6 was localized predominantly to mast cells while IL-5 was found in both mast cells and eosinophils. Numbers of IL-4+ cells in the nasal submucosa were significantly suppressed by treatment with fluticasone (p = 0.0003 for monoclonal antibody [mAb] 3H4, p = 0.041 for mAb 4D9). In contrast, fluticasone treatment failed to influence the number of IL-5 and IL-6 immunoreactive cells.(ABSTRACT TRUNCATED AT 250 WORDS)
Banking of human tissue for biomonitoring and exposure assessment: utility for environmental epidemiology and surveillance.
Authors: L R Goldman, H Anton-Culver, M Kharrazi, E Blake
Journal: Environmental Health Perspectives (1995)

Human tissue banking could provide a tool to address a number of public health concerns. We can potentially use it to monitor trends in human exposures, serve as an early warning system for new environmental exposures, assess low-level exposures around hazardous waste and other point sources of pollutants, evaluate the effectiveness of regulatory programs, and study etiologies of diseases (e.g., childhood cancer and birth defects) that are likely to be related to the environment. This article discusses opportunities to establish human tissue banks in connection with pre-existing public health surveillance programs for cancer and adverse reproductive outcomes. This is a cost-effective way to conduct surveillance and enhances the ability to carry out epidemiologic studies. The article also discusses ethical issues that are particularly important for public health practice. One is the issue of risk communication and the need to explain risks in a way that provides people with the information they need to determine appropriate action on the individual and community levels. Second is the issue of environmental justice. We recommend early involvement of communities that are likely to be involved in tissue-banking projects and full explanation of individual and group social risks from their participation.
IMPROVED AEROPLANE SPLINT FOR TREATMENT OF CERTAIN FRACTURES
Authors: Seth M. Fitchet
Journal: JAMA (1924)

The so-called aeroplane splint has been found of value in the treatment of certain fractures involving the humerus near the shoulder, such as unimpacted fracture of the anatomic and surgical neck of the humerus, fracture dislocation at the anatomic or surgical neck of the humerus, and fracture of the greater tuberosity of the humerus. There are various models and variations of the aeroplane splint, but all of them, so far as we know, have the same, and a serious objectionable feature; that is, difficulty in adjusting, and a more marked difficulty in maintaining adjustment. To overcome this objection on an otherwise excellent piece of useful apparatus, we developed the splint here described. It has been used in the successful treatment of several patients who had fractures that were susceptible of being held by it, but could not be maintained in proper reduction with other types of aeroplane splint with which
Relapse of leukemia with loss of mismatched HLA resulting from uniparental disomy after haploidentical hematopoietic stem cell transplantation
Authors: Itzel Bustos Villalobos, Yoshiyuki Takahashi, Yoshiki Akatsuka, Hideki Muramatsu, Nobuhiro Nishio, Asahito Hama, Hiroshi Yagasaki, Hiroh Saji, Motohiro Kato, Seishi Ogawa, Seiji Kojima
Journal: Blood (2010)
Skin’s Antibacterial Proteins
Authors: Tracy Hampton
Journal: JAMA (2007)

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
Hypertension in the Papago Indians
Authors: CHARLES R. STROTZ, GREGORY I. SHORR
Journal: Circulation (1973)

A study of blood pressure in Papago Indians was undertaken utilizing a computerized health information system. Hypertension was present in close to 20% of the study population. The prevalence of hypertension in the Papago tended to peak during young adulthood and showed very little increase in older age groups. The rates of cardiac, cardiovascular and renal complications were analyzed for the hypertensive and nonhypertensive Papago. Hypertension was associated with increased morbidity from target organ damage despite a low rate of arteriosclerosis. This increased morbidity appeared to be independent of the morbidity associated with diabetes which is also common in the Papago Indians.
Occupational allergic rhinitis and contact urticaria caused by bishop's weed (<i>Ammi majus</i>)
Authors: R Kiistala, S Mäkinen‐kiljunen, K Heikkinen, J Rinne, T Haahtela
Journal: Allergy (1999)

Bishop's weed ( Ammi majus ) has been known to induce toxic phytophotodermatitis. We now describe IgE‐mediated rhinitis and contact urticaria caused by exposure to bishop's weed in a 31‐year‐old atopic female florist. A skin prick‐prick test with bishop's weed flowers gave an 8‐mm wheal, and the bishop's weed‐specific IgE level in the patient's serum was 9.7 PRU/ml (RAST class 3). In an immunoblotting experiment with the patient's serum, nine IgE‐binding protein bands with the molecular weights 19, 34, 39–41 (doublet), 52–61 (doublet), and &gt;67 (triplet) kDa were detected in bishop's weed extract. The patient became symptomless after she had ceased to work as a florist.
Isolation and Characterization of Active LINE and SINEs from the Eel
Authors: Masaki Kajikawa, Kenji Ichiyanagi, Nozomu Tanaka, Norihiro Okada
Journal: Molecular Biology and Evolution (2004)

Long interspersed elements (LINEs) and short interspersed elements (SINEs) are retrotransposons. These elements can mobilize by the “copy-and-paste” mechanism, in which their own RNA is reverse-transcribed into complementary DNA (cDNA). LINEs and SINEs not only are components of eukaryotic genomes but also drivers of genomic evolution. Thus, studies of the amplification mechanism of LINEs and SINEs are important for understanding eukaryotic genome evolution. Here we report the characterization of one LINE family (UnaL2) and two SINE families (UnaSINE1 and UnaSINE2) from the eel (Anguilla japonica) genome. UnaL2 is ∼3.6 kilobases (kb) and encodes only one open reading frame (ORF). UnaL2 belongs to the stringent type—thought to be a major group of LINEs—and can mobilize in HeLa cells. We also show that UnaL2 and the two UnaSINEs have similar 3′ tails, and that both UnaSINE1 and UnaSINE2 can be mobilized by UnaL2 in HeLa cells. These elements are thus useful for delineating the amplification mechanism of stringent type LINEs as well as that of SINEs.
A History of Neurophysiology in the 17th and 18th Centuries: From Concept to Experiment
Authors: Frank R. Freemon
Journal: JAMA (1985)

Mary Brazier, a well-known neuroscientist, has produced an excellent review of the scientific developments between 1600 and 1800 that led to the formation of the discipline of neurophysiology in the 19th century. She uses the lives of major scientific figures to build a narrative of scientific progress. For each scientist, Dr Brazier lists a few pertinent facts such as place of birth, education, vocation, and scientific honors, but restricts evaluation of the person's scientific investigations to those aspects that bear on the nervous system. For example, Dr Brazier bypasses the philosophical and mathematical accomplishments of Descartes to concentrate on his view of how the pineal gland might control the flow of animal spirits (CSF) from the brain ventricles through brain and nerves to inflate contracting muscles. The reader of the book will soon realize that Dr Brazier has examined a prodigious amount of original material in Latin, English, German, French,
FRI0283 Quality Indicators for Use of Biologic Agents in Rheumatic Diseases
Authors: Y. Suyama, M. Kishimoto, R. Rokutanda, C. Min, Y. Haji, Y. Ohara, H. Shimizu, K.-I. Yamaguchi, Y. Matsui, M. Okada
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> Biologics are widely used for the treatment of rheumatic diseases because of the efficacy, but careful surveillance and prophylactic measures are necessary to reduce the incidence of adverse events, especially infections. Quality indicator (QI) has been received an increasing attention in rheumatology field and several guidelines for the prevention of biologic agents-related infections have been published. However, few studies have reported the status of the implementation as well as interventions to improve its adherence in clinical settings. <h3>Objectives</h3> Herein, we repot the efficacy of QI monitoring for hepatitis, latent tuberculosis infection (LTBI), and pneumocystis pneumonia (PCP) in the use of biologic agents in the treatment of rheumatic diseases. <h3>Methods</h3> We retrospectively studied all patients who had received biologic agents (TNF and non-TNF agents) from January 2007 to December 2013 in our department. To evaluate the adherence of a minimal standard of care for the pre-administration screening, we monitored 3 QI bundles as LTBI bundle: chest image, tuberculosis skin test (TST) or prophylaxis, and interferon-gamma-release assays (IGRAs), de novo hepatitis B and C infection bundle: HBs-Ag, HBs-Ab, HBc-Ab, and HCV-Ab, and PCP bundle: chest image, IgG, and β-D glucan. QI bundles were implemented in 2010 and data were compared before and after QI monitoring investigation. In addition, we also evaluated the results of follow-up IGRA tests for detection of latent and newly developing tuberculosis. <h3>Results</h3> We identified 328 eligible patients (mean age 52.5 years; 73.8% female), and improved adherence to pre-administration screening was shown after QI implementation in 2010. The rates of following the QIs improved from 82% to 99% in LTBI bundle, from 74% to 84% in PCP bundle, and from 65% to 78% in hepatitis B and C infection bundle, respectively (Table 1). We also assessed 168 patients with a negative or indeterminant IGRA results in the initial LTBI screening and evaluated by follow-up IGRA test after starting biologic agents, which showed 7% of IGRA positive conversion (Table 2). Neither active tuberculosis, PCP, nor de novo hepatitis were reported in our study. <h3>Conclusions</h3> Implementation of monitoring of quality indicators based on guidelines lead to the safety for the use of biologic agents in the treatment of rheumatic disease.Our results also indicate the importance of follow-up IGRA test for the patients with previous negative results to prevent the activation of newly acquired LTBI, especially in relatively endemic countries. <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.4841