tbuckley/cabot-search huggingface dataset:
BCG vaccination programmes may provide useful guidance
Authors: D. Chappel, V. Fernandes
Journal: BMJ (1995)

0Io io io 40 O 10 20 30 40 5o Week Weekly measles notifications in 1987-8 (when last measles epidemic occurred) and 1994, England and Wales their stage of development, to break chains of transmission.When the campaign was planned different methods of delivering services were costed.The cost of preventing an epidemic was estimated at around C20m for the vaccine,
A MEDICAL POET LAUREATE, ROBERT BRIDGES, M.D., POET LAUREATE OF ENGLAND 1913 TO 1930
Authors: Louis H. Roddis
Journal: Annals of Internal Medicine (1937)

ExcerptThe Poet Laureate of England holds an official position of peculiar dignity and honor, even though the duties are nominal and the salary somewhat remarkable—a barrel of wine and one hundred and twenty pounds a year. The title is obtained from the laurel or bay, in classical times the crown of the hero and poet, the lover being crowned with myrtle. In 1921, Professor Broadus published a study of the office of the Poet Laureate, almost the first investigation of the subject made, and there still remains for some minor poet or literary historian, the pleasant task of writing the...
Comparison of US Birth Weight References and the International Fetal and Newborn Growth Consortium for the 21st Century Standard
Authors: Naoko Kozuki, Joanne Katz, Parul Christian, Anne CC Lee, Li Liu, Mariangela F. Silveira, Fernando Barros, James M. Tielsch, Christentze Schmiegelow, Ayesha Sania, Dominique Roberfroid, Richard Ndyomugyenyi, Luke C. Mullany, Aroonsri Mongkolchati, Lieven Huybregts, Jean Humphrey, Wafaie Fawzi, Abdullah H. Baqui, Linda Adair, Vanessa M. Oddo, Robert E. Black
Journal: JAMA Pediatrics (2015)

<h3>Importance</h3> This study introduces how the International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH-21st) international birth weight standards alter our previous understanding and interpretations of fetal growth restriction as represented by small for gestational age (SGA) status. <h3>Objectives</h3> To compare the birth weight distributions of the INTERGROWTH-21st international standard to commonly used US references and examine the differences in the prevalence and neonatal mortality risk of SGA status (below the 10th percentile of a population reference). <h3>Design, Setting, and Participants</h3> We analyzed data from 16 prospective cohorts of newborns on gestational age, birth weight, and systematic mortality follow-up through 28 days from 10 low- and middle-income countries. The studies included were conducted between 1983 and 2008. The analysis was conducted in 2014. Infants were categorized as SGA using the 1991 US birth weight reference, the 1999-2000 US birth weight reference, and the new INTERGROWTH-21st standard. For each study, we compared the SGA prevalence and the risk ratio between SGA status and neonatal mortality, calculated using Poisson regression with robust error variance. <h3>Main Outcomes and Measures</h3> We examine neonatal mortality (death within the first 28 days after birth) as the main outcome measure. <h3>Results</h3> The pooled SGA prevalence was 23.7% (95% CI, 16.5%-31.0%) using the INTERGROWTH-21st standard compared with 36.0% (95% CI, 27.0%-45.0%) with the US 2000 reference. The relative decrease in prevalence was larger among infants born at 33 to less than 37 weeks' gestation compared with term infants. The pooled neonatal mortality risk did not differ significantly; the adjusted risk ratios were 2.13 (95% CI, 1.78-2.54;<i>P</i> &lt; .001) for the INTERGROWTH-21st standard and 2.12 (95% CI, 1.81-2.48;<i>P</i> &lt; .001) for the US 2000 reference. <h3>Conclusions and Relevance</h3> To our knowledge, INTERGROWTH-21st is the first international newborn standard for size for gestational age for healthy fetal growth. We observed a greater-than-one-quarter reduction in SGA prevalence and no significant change in the associated neonatal mortality risk, resulting in a decrease in the percentage of neonatal death attributable to SGA. Our study sheds light on how previously published studies on SGA status may be reinterpreted with the introduction of this new birth weight standard.
Science commentary: Th1 and Th2 responses: what are they?
Authors: A. Berger
Journal: BMJ (2000)

Cytokines are the hormonal messengers responsible for most of the biological effects in the immune system, such as cell mediated immunity and allergic type responses. Although they are numerous, cytokines can be functionally divided into two groups: those that are proinflammatory and those that are essentially anti-inflammatory but that promote allergic responses.

T lymphocytes are a major source of cytokines. These cells bear antigen specific receptors on their cell surface to allow recognition of foreign pathogens. They can also recognise normal tissue during episodes of autoimmune diseases. There are two main subsets of T lymphocytes, distinguished by the presence of cell surface molecules known as CD4 and CD8. T lymphocytes expressing CD4 …
Treatment adherence with CPAP for obstructive sleep apnea is influenced by mask leak
Authors: Miena Meshkat, Julia Ebner, Otto Burghuber, Arschang Valipour
Journal: European Respiratory Journal (2011)

Aims: To investigate the effect of mask leak on adherence with CPAP therapy in patients with obstructive sleep apnea syndrome (OSAS).

Methods: We studied 63 patients (mean Age 55±11yrs, mean BMI 36±7kg/sqm, mean AHI 48±30/hr, ESS 11±5) who received fixed or auto-adjusted CPAP treatment for OSAS at our institution. All patients underwent a standardized educational session and mask fitting by experienced staff. Data on treatment adherence and mask leakage was collected for approximately 6 months after initiation of CPAP.

Results: Mean ± standard deviation days of CPAP use was 176±82 days, percentage of days with CPAP usage 84±18%, and percentage of days with at least 4 hours CPAP use/night 71±24%. There was a significant inverse relationship between CPAP adherence using Kribbs criteria and average time spent with mask leak per night (r =-0.362, p  4 hours per night on at least 5 days per week, were compared with those who used their device less frequently (n = 21). There were no significant differences between baseline characteristics, residual AHI or therapeutic CPAP pressure between groups. Patients with poor CPAP adherence, however, had significantly higher average mask leakage flow (39±8 litres/min vs. 34±6 litres/min, p < 0.01) and higher time spent with mask leakage per night (3.7±6 min/night vs. 7.7±10 min/night, p < 0.05) than those with good adherence.

Conclusion: Mask leakage may influence treatment adherence with CPAP for OSAS.
Abstract 3961: Effectiveness of the combined treatment with hsp90 inhibitor and heavy ion irradiation
Authors: Ryuichi Okayasu, Aya Masaoka, Hirokazu Hirakawa, Hiroshi Fujisawa, Shigeaki Sunada, Ryoichi Hirayama, Miho Noguchi, Huizi Li, Akira Fujimori
Journal: Cancer Research (2014)

Abstract Hsp90 inhibitors have been studied as effective sensitizers for radiation therapy. Some encouraging results have been observed and the mechanism of radio-sensitization has also been investigated mostly with X-or gamma-rays. There has not been any study for Hsp90 inhibitors with heavy ion radiation. In this report we show the data with the combined effect with hsp90 inhibitors including 17AAG and PU-H71 with high linear energy transfer (LET) heavy ion radiation. As in proton radiation treatment, heavy ions can be targeted to tumor tissues due to its physical properties, while significantly lower radiation doses are delivered in surrounding normal tissues. In addition, with heavy ions higher biological effectiveness, i.e, more tumor cell killing, can be attained than with proton or conventional photon radiation. We are finding that if tumor cells were pre-treated with an hsp90 inhibitor and then exposed to heavy ion (carbon) radiation, very effective cell killing were observed using SQ5 human lung tumor cells. Another interesting feature of hsp90 inhibitors is that normal cells are not much influenced by the drug. Our in vivo mouse xenograft studies using nude mice also indicate a better tumor control with the combination of hsp90 inhibitor and local carbon irradiation as compared with carbon irradiation alone. Further studies show that the mechanism behind this radio-sensitization may be attributed to inhibition of DNA double strand breaks (DSBs) by hsp90 inhibitors; particularly homologous recombination pathway of DSB repair might be affected. Our flow cytometry study also reveals some new aspect of tumor cell killing by this combination therapy. Our data suggest that hsp 90 inhibitors are good candidates for the combined cancer therapy using heavy ion irradiation. Citation Format: Ryuichi Okayasu, Aya Masaoka, Hirokazu Hirakawa, Hiroshi Fujisawa, Shigeaki Sunada, Ryoichi Hirayama, Miho Noguchi, Huizi Li, Akira Fujimori. Effectiveness of the combined treatment with hsp90 inhibitor and heavy ion irradiation. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 3961. doi:10.1158/1538-7445.AM2014-3961
Ongoing Attention to Injurious Inpatient Falls and Pressure Ulcers
Authors: Grace M. Lee, Stephen B. Soumerai
Journal: JAMA Internal Medicine (2015)

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 Internal Medicine HomeNew OnlineCurrent IssueFor Authors Podcast 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) 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 Internal Medicine journal
Abstract 19931: Echocardiographic Assessment of Volume Status in Hemodialysis Patients: a Study Based on Inferior Vena Cava Diameter and Ventricular Interdependence
Authors: Xiushui Ren, Sherry Williams, Alexander Flint, Charles Feldman, Sharon Windust, Nelson Schiller, Ramesh Lingamneni
Journal: Circulation (2014)

Background: It is difficult to assess volume status in patients with end-stage renal disease (ESRD) undergoing hemodialysis (HD). The euvolemic state (dry weight) in ESRD patients is determined clinically but has limitations. We hypothesized that a combination of ventricular interdependence (VI)_the physiologic phenomenon whereby filling of one ventricle is affected by filling of the contralateral ventricle during different phases of the respiratory cycle_and inferior vena cava diameter (IVCd) predicts volume status in ESRD patients undergoing HD. Methods: Echocardiograms were performed in 20 patients immediately pre- and post-HD. Clinical assessment of volume status was performed by a single nephrologist blinded to echocardiographic data. VI was defined as peak expiratory to inspiratory mitral inflow E velocity ratio. Hypovolemia was defined as IVCd 20 mm and VI &gt;15%. Results: 65% of patients were men, and 60% had a history of heart failure. A total of 40 volume clinical assessments were performed (20 pre- and 20 post-HD): 23 were categorized as hypovolemic, 5 euvolemic, and 12 hypervolemic. 21 of 23 (91%) hypovolemic assessments met echo definition for hypovolemia. None of 5 (0%) euvolemic assessments met echo definition of euvolemia. 12 of 12 (100%) hypervolemic assessments met echo definition of hypervolemia. (Figure. Columns and error bars represent mean +/- standard error of mean. P=0.007, Kruskal-Wallis equality-of-populations rank test.) Conclusions: In ESRD patients undergoing HD, echocardiographic definition of volume status using IVCd and VI accurately predicts hypo- and hypervolemia. There was poor correlation between echo and clinical volume assessment for euvolemia. This is the first study to examine volume status in HD patients with concomitant cardiac disease using IVCd, and VI. Further studies are needed to determine whether clinical or echo assessment of euvolemia is accurate.
Abstract 16417: Role of Long Non-Coding RNAs in the Regulation of the Notch Pathway: Implication for Calcific Aortic Valve Stenosis
Authors: Fayez Hadji, M Boulanger, Sandra Guauque-Olarte, Rihab Bouchareb, Yohan Bossé, Patrick Mathieu
Journal: Circulation (2014)

Introduction: Calcific aortic valve stenosis (CAVS) is the most common valvular heart disease. The disease process is largely driven by an abnormal mineralization of leaflets. The Notch pathway is involved in the osteogenic transition of valve interstitial cells (VICs) and palys an important role in CAVS. However, the molecular processes involved in the regulation of Notch signaling in CAVS remain to be determined Hypothesis: Long non-coding RNAs (Long ncRNAs) may be involved in the control of the Notch pathway Methods: We analyzed the gene expression pattern of valvular tissues (controls and CAVS) using microarrays. Furthermore, we explored the role of a Long ncRNA on the mineralization of VICs. Signaling of the Notch pathway was investigated by promoter luciferase activity and by analyzing mRNA levels of target genes Results: A transcriptomic study revealed that a Long ncRNA is overexpressed in CAVS. This result was confirmed by q-PCR in a larger group of aortic valve tissues (n=152). Silencing and over...
Abstract 334: Serum MicroRNA-378 as a Novel Diagnostic Biomarker for Myocardial Infarction
Authors: Hua Zhu, Alessandro Lagana, Dario Veneziano, Timothy Adesanya, Peter Mohler, Miyuki Nishi, Hiroshi Takeshima, Ahmet Kilic
Journal: Circulation (2014)

Purpose: Chest pain represents one of the most common reasons for a visit to the emergency department accounting for ~10% of all visits. Of these only 45% represented true acute coronary syndromes (ACS) (stable angina, unstable angina or myocardial infarction (MI)). The current methods to detect a true ACS have a clinic delay of several hours and hence it is the focus of our experiments to explore a novel diagnostic biomarker that can detect myocardial infarction more rapidly and reliably. Methods and Results: In order to establish a library of potential diagnostic biomarkers, we developed a novel non-thoracotomy model of MI in the Ovis aries to minimize potential confounders of serum microRNA changes due to unrelated thoracotomy induced injuries. We obtained serum samples from different time points following MI and level of circulating microRNAs were detected by a microRNA array and compared to the concentration of Troponin I from the same sample. Among more than 300 identified microRNA in the array, 12 microRNA were tested with the highest fold expression change, and a single microRNA, miR-378, identified as a promising biomarker of MI. We used a mouse model of left coronary artery ligation induced MI to quantify the dynamics of miR-378 levels in response to MI injury (Figure) , we found miR-378 was non-detectable before MI, reached peak at 4 hours post MI; whereas Troponin I reached peak at 6 hours. Conclusion: In both a large and small animal models of MI, microRNA-378 showed a reproducible time frame of peak expression that may serve as a more efficient diagnostic biomarker for myocardial infarction.
Abstract 13374: Variant Angina Is Associated with a Higher Incidence of MACE in Patients with Vasospastic Angina-A Report from the Nationwide Multi-Center Registry by the Japanese Coronary Spasm Association-
Authors: Yusuke Takagi, Satoshi Yasuda, Ryusuke Tsunoda, Yasuhiro Ogata, Atsushi Seki, Tetsuya Sumiyoshi, Motoyuki Matsui, Toshikazu Goto, Yasuhiko Tanabe, Shozo Sueda, Toshiaki Sato, Satoshi Ogawa, Norifumi Kubo, Shin-ichi Momomura, Hisao Ogawa, Hiroaki Shimokawa
Journal: Circulation (2010)

Background: Coronary vasospasm plays an important role in the pathogenesis of a wide variety of ischemic heart diseases. In patients with vasospastic angina (VSA), variant angina (VA) is characteri...
Abstract 18523: Simultaneous Consideration of Imaging and Blood Markers for Prediction of Hemorrhagic Transformation in Acute Ischemic Stroke
Authors: Hye-Yeon Choi
Journal: Circulation (2014)

Introduction:  Prediction of hemorrhagic transformation (HT) may be helpful for the treatment decision in patients with acute ischemic stroke. Lower scores of Alberta Stroke program early CT score (ASPECTS), or high levels of plasma MMP-9 have been suggested to predict hemorrhage after thrombolytic treatment.   Hypothesis:  Combined measurements of baseline MMP-9 levels and ASPECTS can be surrogate markers of HT in acute ischemic stroke patients.   Methods:  Enrolled for this study were patients with acute cerebral infarction in the carotid artery territory who visited within 6 hours after symptom onset. Among them, those whose blood samples could be obtained before the thrombolytic treatment or before administration of any antithrombotic agent, and whose initial non-contrast CT of the brain was available were included. The baseline CT scans were scored by consensus approach of two neurologists. Plasma MMP-9 levels were measured by enzyme-linked immunosorbent assays. Severity of neurologic deficits was assessed based on National Institute of Health Stroke Scale (NIHSS) score at baseline. HT was assessed by CT or MRI. Symptomatic hemorrhage was defined as any increase in the NIHSS score related to the hemorrhage.   Results:  Total 124 patients were included (67 men, mean age 66 years). Fifty-three patients received the thrombolytic treatment. Median ASPECTS was 9 (range 2-10). Median NIHSS score at baseline was 8 (range 0-25). Median MMP-9 was 22.23 ng/ml (range 0.85-90.02 ng/ml). HT occurred in 40 patients (symptomatic in eight). HT including symptomatic and asymptomatic hemorrhages, was associated with low ASPECTS score, high MMP-9 values, high initial NIHSS score, and thrombolytic treatment in multiple logistic regression analysis. The Receiver operating curve (ROC) analysis was performed to compare predicting power of MMP-9, ASPECTS score, and both of them. The area under the ROC curve performed from the values of both MMP-9 and ASPECTS was greater than those from MMP-9 or ASPECTS alone (0.900 for MMP-9, 0.708 for ASPECTS score, 0.921 for both).   Conclusions:  Simultaneous assessments and consideration of ASPECTS as an imaging marker and MMP-9 as a blood marker could enhance predictability of hemorrhagic transformation in acute stroke patients.
Response to a selective COX‐2 inhibitor in patients with urticaria/angioedema induced by nonsteroidal anti‐inflammatory drugs
Authors: I. Doña, N. Blanca‐López, L. R. Jagemann, M. J. Torres, C. Rondón, P. Campo, A. I. Gómez, J. Fernández, J. J. Laguna, A. Rosado, M. Blanca, G. Canto
Journal: Allergy (2011)

To cite this article: Doña I, Blanca‐López N, Jagemann LR, Torres MJ, Rondón C, Campo P, Gómez AI, Fernández J, Laguna JJ, Rosado A, Blanca M, Canto G. Response to a selective COX‐2 inhibitor in patients with urticaria/angioedema induced by nonsteroidal anti‐inflammatory drugs. Allergy 2011; 66 : 1428–1433. Abstract Background: In subjects with hypersensitivity reactions with cross‐intolerance to nonsteroidal anti‐inflammatory drugs (NSAIDs), tolerance to selective COX‐2 inhibitors has not been evaluated in large series of well‐phenotyped cases. Methods: We evaluated 252 patients with urticaria and/or angioedema caused by hypersensitivity owing to cross‐intolerance to NSAIDs. In addition to the clinical history, diagnosis was confirmed by provocation to an alternative NSAID. Two groups were considered: (A) patients with cross‐intolerance to NSAIDs and intolerance to paracetamol and (B) patients with cross‐intolerance to NSAIDs and good tolerance to paracetamol. Etoricoxib was administered to Group A patients and to a representative sample of Group B patients. In the event of a positive response, serum tryptase levels were determined and skin biopsy was performed in five patients in each group. Results: Ibuprofen was the most commonly implicated drug, followed by acetylsalicylic acid (ASA). Urticaria was the most common manifestation, followed by angioedema. Most of the patients developed symptoms within 1 h. Twenty‐five percent in Group A ( n = 47) and 6% in Group B ( n = 50) were intolerant to etoricoxib. Skin biopsy showed mast cell activation with the release of tryptase to the extracellular space but without the increase in serum tryptase levels. Conclusion: Selective COX‐2 inhibitors may be unsafe in subjects with urticaria and/or angioedema caused by hypersensitivity reactions to NSAIDs with cross‐intolerance if they are intolerant to paracetamol. A quarter of patients who were intolerant to this drug were also intolerant to etoricoxib. In subjects with hypersensitivity to NSAIDs and intolerance to paracetamol, selective COX‐2 inhibitors should be administered as a controlled, incremental dose provocation test to assess tolerance.
Assessment of obesity and its clinical implications
Authors: Thang S Han, Naveed Sattar, Mike Lean
Journal: BMJ (2006)

Obesity can be assessed in several ways. Each method has advantages and disadvantages, and the appropriateness and scientific acceptability of each method will depend on the situation.

View this table:

Levels of health risks associated with waist circumference (cm), defined by waist circumference action levels in white men and women



The assessment methods often measure different aspects of obesity—for example, total or regional adiposity. They also produce different results when they are used to estimate morbidity and mortality. When there is increased body fat, there will also be necessary increases in some lean tissue, including the fibrous and vascular tissues in adipose tissue, heart muscle, bone mass, and truncal or postural musculature. All these non-fat tissues have a higher density (1.0 g/ml) than fat (0.7 g/ml). The density of non-fat tissues is also increased by physical activity, which of course tends to reduce body fat.



The correlation of visceral fat with waist circumference is strong. Adapted from Han TS et al. Int J Obes Relat Metab Disord 1997 ; 21 : 587 - 93 



In general, measurements of body weight and body dimensions (anthropometry) are used to reflect body fat in large (epidemiological) studies or in clinic settings as such measurements provide a rapid and cheap way to estimate body fatness and fat distribution. Densitometry or imaging techniques are used in smaller scale studies such as clinical trials.

View this table:

Classification of body fatness based on body mass index according to World Health Organization



Body mass index (BMI) has traditionally been used to identify individuals who are the most likely to be overweight or obese. It is calculated by dividing the weight (in kilograms) by the height …