tbuckley/cabot-search huggingface dataset:
Efficacy and tolerability of anti-tumour necrosis factor therapy in psoriatic arthritis patients: results from the South Swedish Arthritis Treatment Group register
Authors: L E Kristensen, A Gulfe, T Saxne, P Geborek
Journal: Annals of the Rheumatic Diseases (2007)

<h3>Background:</h3> The use of tumour necrosis factor (TNF) blocking agents in psoriatic arthritis (PsA) is increasing, and the SSATG register has followed patients with PsA for more than 5 years. The aim of the present work therefore was to present efficacy and tolerability data of TNF-blocking agents on PsA in clinical practice, and to study potential predictors for drug survival (the length of time a patient continues to take a particular drug). <h3>Materials and methods:</h3> Patients (n = 261) with active PsA, starting anti-TNF therapy for the first time in southern Sweden, were included. Basal characteristics, disease activity measures, and termination reason for blockers were prospectively collected during the period April 1999 to September 2006. Cox proportional hazard models were used to investigate predictors for treatment termination. <h3>Results:</h3> Overall, response rates at 3–12 months for global visual analogue scale (VASglobal50) and pain VAS (VASpain50) were about 50%, whereas response rates for European League Against Rheumatism (EULAR) scoring "overall" and EULAR "good" were around 75% and 55%, respectively. Concomitant methotrexate (MTX) (hazard ratio (HR) 0.64, 95% CI 0.39–0.95, p = 0.03), etanercept (HR 0.49, 95% CI 0.28–0.86, p = 0.01), and high C-reactive protein (CRP) levels (HR 0.77, 95% CI 0.61–0.97, p = 0.03) at treatment initiation were associated with better overall drug survival. The improved drug survival of concomitant MTX appeared to be related to significantly fewer dropouts because of adverse events (HR = 0.24 (0.11–0.52), p&lt;0.01). The blockers were well tolerated with a rate of serious adverse events of 5–6% per year. No unexpected serious adverse events were observed. <h3>Conclusion:</h3> Concomitant MTX and high CRP levels are associated with treatment continuation of anti-TNF therapy in patients with PsA regardless of joint distribution. The positive effect of MTX was primarily linked to fewer dropouts because of adverse events.
Sometimes Consensus and Expert Opinion Is the Best We Can Do
Authors: Richard D. Schulick
Journal: JAMA Surgery (2013)

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 Surgery 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 Surgery journal
Molecular Control of Cell Cycle Progression in the Pancreatic β-Cell
Authors: Irene Cozar-Castellano, Nathalie Fiaschi-Taesch, Todd A. Bigatel, Karen K. Takane, Adolfo Garcia-Ocaña, Rupangi Vasavada, Andrew F. Stewart
Journal: Endocrine Reviews (2006)

Type 1 and type 2 diabetes both result from inadequate production of insulin by the β-cells of the pancreatic islet. Accordingly, strategies that lead to increased pancreatic β-cell mass, as well as retained or enhanced function of islets, would be desirable for the treatment of diabetes. Although pancreatic β-cells have long been viewed as terminally differentiated and irreversibly arrested, evidence now indicates that β-cells can and do replicate, that this replication can be enhanced by a variety of maneuvers, and that β-cell replication plays a quantitatively significant role in maintaining pancreatic β-cell mass and function. Because β-cells have been viewed as being unable to proliferate, the science of β-cell replication is undeveloped. In the past several years, however, this has begun to change at a rapid pace, and many laboratories are now focused on elucidating the molecular details of the control of cell cycle in the β-cell. In this review, we review the molecular details of cell cycle control as they relate to the pancreatic β-cell. Our hope is that this review can serve as a common basis and also a roadmap for those interested in developing novel strategies for enhancing β-cell replication and improving insulin production in animal models as well as in human pancreatic β-cells.
Breathlessness and plethora
Authors: J. Dua, W.-h. Cheung, S. Russell, Z. Dabbagh
Journal: BMJ (2011)

A 61 year old man presented to the emergency department with sudden onset breathlessness associated with cough productive of purulent sputum. He had been diagnosed with squamous cell carcinoma of the bronchus one month earlier. His staging was T4N2M1. Two weeks earlier he had developed a pathological clavicular fracture and was due to start radiotherapy. On admission he had no haemoptysis or chest pain. However, his blood pressure was 80/40 mm Hg, pulse rate was 140-160 beats/min, and respiratory rate was 18 breaths/min.

On examination he had swelling and plethora of the face and neck. Crepitations were heard in the right mid zone of his lung field. Heart sounds were normal. His jugular venous pressure was non-pulsatile and was raised to the level of his ear lobes. His breathlessness and facial swelling were exacerbated by lying flat and coughing.

Electrocardiography showed sinus tachycardia. Arterial blood gas on room air showed a partial pressure of oxygen of 7 kPa, and a partial pressure of carbon dioxide of 4.2 kPa.

Chest radiography was performed (fig 1⇓).



Fig 1 Chest radiograph on admission



An echocardiogram showed no pericardial effusion but moderate left ventricular function and no right ventricular dysfunction. Figure 2⇓ is a picture of the patient at admission.



Fig 2 Patient on admission





### 1 What is the most likely diagnosis?

#### Short answer

Obstruction of the superior vena cava.

#### Long answer

This patient has obstruction of the superior vena cava. His chest is plethoric, and on closer inspection he has some distended thoracic veins (fig 3⇓).



Fig 3 Patient’s chest showing plethora and distended thoracic veins



His chest radiograph on admission shows a widened mediastinum and a right hilar …
Human corticotropin-releasing factor plus lysine vasopressin test during glucocorticoid therapy.
Authors: K Hashimoto, S Suemaru, T Takao, M Sugawara, T Hattori, J Kageyama, K Takahashi, Z Ota
Journal: Journal of Clinical Investigation (1988)

1.0 micrograms/kg body wt human corticotropin-releasing factor (hCRF) and 0.005 IU/kg body wt lysine vasopressin (LVP) were administered in a bolus dose to patients receiving daily or alternate-day glucocorticoid therapy. In normal subjects with this hCRF-LVP test, the plasma ACTH increment was significantly greater (approximately 2.5-fold) 15 min after injection than under the CRF test. In patients receiving daily glucocorticoid therapy (greater than 15 mg prednisolone or an equivalent daily dose), the plasma ACTH and cortisol responses to hCRF-LVP were suppressed 2 wk to 1 mo after the beginning of glucocorticoid administration but partially improved at 2-10 mo, and was markedly suppressed several years later. On the other hand, in patients receiving alternate-day glucocorticoid therapy, the plasma ACTH response was normal at 2 wk, normal or higher at 1-3 mo, and normal after 4 mo. A normal plasma cortisol response was observed throughout the test period in patients receiving alternate-day therapy after pulse therapy, whereas plasma cortisol response was gradually improved in patients receiving alternate-day therapy after several months of daily therapy.
Mitoxantrone, prednimustine, and vincristine for elderly patients with aggressive non-Hodgkin's lymphoma
Authors: Jonathan C. Yau, Colin Germond, Stefan Gluck, Christine Cripps, Shailendra Verma, Bruce F. Burns, Terry M. Koski, Diane C. Lister, Glenwood D. Goss
Journal: American Journal of Hematology (1998)

Elderly patients with intermediate- or high-grade non-Hodgkin's lymphoma have a worse outcome than those who are younger than 60 years. It has been shown that aggressive combination chemotherapy is poorly tolerated in older patients resulting in a subsequent decrease in dose intensity. A phase II trial was conducted with mitoxantrone, prednimustine, and vincristine (NSO) in this group of patients. NSO consists of mitoxantrone 12 mg/M2 intravenously on day one, vincristine 1.4 mg/M2 intravenously on day 1 (maximum dose of two mg), and prednimustine 100 mg/M2 orally once a day for four days. NSO was repeated every 21 days. Thirty-six patients were able to be evaluated. There were 18 males and 18 females with the median age of 71 (range 60–85). NSO was well tolerated and nonhematological toxicities were uncommon. More than 80% of the patients received 90% or greater of the intended dose. The complete response rate was 60.6% and partial response was 21.8%. At 60 months the Kaplan-Meier estimate of progression-free survival was 47.9% (standard error 8.6%) and actual survival was 40.6% (standard error 8.8%). There were no differences in outcome between those with performance status (PS) of zero or one and those with PS > 1. NSO is well tolerated by elderly patients including those with PS > 1. These results compare favorably with other combinations in elderly patients with aggressive non-Hodgkin's lymphoma. Am. J. Hematol. 59:156–160, 1998. © 1998 Wiley-Liss, Inc.
Immediate Skin-Test Reactivity in a General Population Sample
Authors: ROBERT A. BARBEE
Journal: Annals of Internal Medicine (1976)

To assess the prevalence and distribution of allergic skin-test reactions in a general population sample, allergy prick tests were applied to 3101 subjects older than 2 years of age. Test materials included allergens common to the Tucson environment, and subjects were randomly stratified by age, sex, and socioeconomic status. No difference in the prevalence of measurable reactions was found among male subjects versus female subjects. A definite age relation was apparent, however, with the peak prevalence of reactivity (more than 40%) occurring during the third decade, and falling rapidly past age 50. When present, reactions tended to be multiple, highly reproducible, and more frequent among those in the higher socioeconomic strata. The prick test was judged to be a useful tool for the assessment of atopy.
The Fas-associated death domain protein suppresses activation of NF-κB by LPS and IL-1β
Authors: Douglas D. Bannerman, Joan C. Tupper, James D. Kelly, Robert K. Winn, John M. Harlan
Journal: Journal of Clinical Investigation (2002)

Activation of NF-κB by bacterial LPS promotes the upregulation of proinflammatory cytokines that contribute to the pathogenesis of Gram-negative septic shock. LPS activation of NF-κB is dependent upon the interaction of two death domain–containing (DD-containing) proteins, MyD88 and IL-1 receptor–associated kinase IRAK. Another DD-containing protein, Fas-associated death domain (FADD), also binds MyD88 through respective DD-DD interactions. Although FADD has been classically described as a proapoptotic signaling molecule, several reports have implicated a role for FADD in mediating NF-κB activation. In the present report, we investigated whether FADD could mediate LPS activation of NF-κB. Overexpression of FADD blocked LPS-induced NF-κB activation, whereas absence of FADD enhanced activation of NF-κB by LPS. Further, LPS-induced expression of two NF-κB–dependent gene products, IL-6 and KC, was enhanced in FADD–/– mouse embryo fibroblasts (MEFs) compared with wild-type. This increase in NF-κB activity correlated with enhanced IκB degradation. FADD–/– MEFs were also resistant to NF-κB activation induced by IL-1β. Finally, reconstitution of full-length FADD in the FADD–/– MEFs completely reversed the enhanced activation of NF-κB elicited by either LPS or IL-1β. Together, these data indicate that FADD negatively regulates LPS- and IL-1β–induced NF-κB activation and that this regulation occurs upstream of IκB degradation.
Statistical procedures for determining the extent of cognitive change following concussion
Authors: A Collie, P Maruff, M Makdissi, M McStephen, D G Darby, P McCrory
Journal: British Journal of Sports Medicine (2004)

Neuropsychological (NP) testing is now often used to help to determine if the cognitive function of a concussed athlete has declined. The NP test score after concussion is compared with the baseline test score. Many clinicians simply subtract one from the other and make a clinical decision about the significance or otherwise of the resulting "difference score". Such techniques are inadequate, as they fail to account for the many factors that may confound interpretation of serially acquired cognitive test scores. This is a review of a number of alternative approaches used in other areas of medicine for differentiating "true" changes from changes caused by these confounding factors. A case example is used to illustrate the effect that the statistical approach may have on clinical decision making.
Catnip and Related Psychedelic Compounds
Authors: Joseph M. Benforado
Journal: JAMA (1969)

<h3>To the Editor:—</h3> Physicians will find in the article (<b>207</b>:1349, 1969) that catnip (<i>Nepeta cataria</i>) has been described in the US Dispensary as a treatment for various disorders including amenorrhea. It was official in the<i>United States Pharmacopeia</i>from 1840 to 1880 and it was used as a mild stimulant, as an emmenagogua, an agent that induces menstruation, and for its quieting effect on the nervous system.<sup>1</sup> Drugs have been used empirically for the treatment of disease from time immemorial and the lay public is confused by reports of tried but unproven medications. For marihuana, confusion is rampant. In a recent book widely read by enthusiasts and by young people in high school who are seeking information, the editor takes the view that marihuana should be legalized and says in his foreword: First, marihuana should be accorded the medical status it once had in this country as a
Anaphylaxis caused by banana
Authors: B. Savonius, L. Kanerva
Journal: Allergy (1993)

An anaphylactic reaction following ingestion of banana occurred in a 32‐year‐old female cook. The sensitization to banana occurred simultaneously with the development of occupational asthma caused by grain flour. The patient was sensitized to a wide range of airborne and ingestible proteins but not to rubber latex.
The Contribution of Supine/Upright Testicular Scintigraphy and Sonography in the Evaluation of an Atypical Presentation of Acute Scrotum
Authors: RUTH HARDOFF, AHARON LURIE, YOSEF MEIR
Journal: Clinical Nuclear Medicine (1992)

A scrotal inflammatory process is characterized by an intense, diffuse, increased Tc-99m sodium pertechnetate uptake of the swollen tender scrotum on scintigraphy. If an asymmetric photon-deficient area accompanies this pattern, torsion of the testicular appendages, or abscess formation, cannot be ruled out. Testicular scintigraphy on a patient with an acute scrotum showed an eccentric &ldquo;cold&rdquo; area. Upright imaging that demonstrated a shift of the &ldquo;cold&rdquo; area, followed by an ultrasonographic study, established the diagnosis of orchitis with fluid collection. Surgery was, therefore, deferred.
Bronchial reactivity in asthmatic adults with normal spirometric values.
Authors: T Higenbottam, T C Stokes, S Jamieson, L Hill
Journal: BMJ (1983)

A comparison was made between airways obstruction produced by exercise. Hyperventilation of cold air, hyperventilation of room air, and inhalation of ultrasonically nebulised distilled water. Seven asthmatics with no airflow obstruction were studied together with seven normal controls. All four provocations produced comparable mean reductions in forced expired volume in one second in the asthmatic patients, but no reduction was obtained in the controls. Whereas exercise, hyperventilation of cold air, and hyperventilation of room air were associated with heat loss from airways, inhalation of nebulised distilled water was not. Inhalation of ultrasonically nebulised distilled water offers a simple additional diagnostic test for asthma. Changes in the osmolality of airway surface liquid may possibly be the common mechanism by which "fog" and hyperventilation produce bronchoconstruction.
Epigenetic effects of child abuse and neglect propagate human cruelty
Authors: James E. Swain
Journal: Behavioral and Brain Sciences (2006)

The nature of children's early environment has profound long-term consequences. We are beginning to understand the underlying molecular programming of the stress-response system, which may mediate the destructive long-term effects of cruelty to children, explain the evolutionary stability of cruelty, and provide opportunities for its reversal of early trauma.
Fate of Orally Administered <sup>3</sup> H-Digitoxin in Man with Special Reference to the Absorption
Authors: BJÖRN BEERMANN, KJELL HELLSTRÖM, ANDERS ROSÉN
Journal: Circulation (1971)

3 H-digitoxin and polyethylene glycol (nonabsorbable marker) were given orally to five subjects provided with a gastrointestinal tube. Of the radioactivity administered, approximately 15, 30, and 70% had been absorbed when the test solution was passing the stomach, the duodenum, and the upper jejunum, respectively. The absorption was rapid, and the plasma contained detectable amounts of radioactivity after 5 minutes. There was no evidence of a disposition of 3 H-digitoxin in intestinal aspirates. On a sixth subject labeled digitoxin was instilled in the mid-jejunum. The concentration of label in the plasma and the pattern of elimination of radioactivity in the urine and the feces in this subject indicated that the absorption of digitoxin was effective also in the more distal part of the gut. The combined results from the present study indicate that the absorption of orally administered digitoxin is complete. The biliary excretion of label 4 to 24 hours after the start of the experiments was calculated from the bilirubin turnover and the mean radioactivity per mg bilirubin in duodenal aspirates obtained after intravenous injections of cholecystokinin. Less than 10% of the administered dose appeared to be excreted with the bile. The radioactivity recovered in plasma showed less decomposition than that found in duodenal bile and urine.
New Drugs: Thrombolytic treatment and new calcium antagonists
Authors: J. Feely, T. Pringle, D. Maclean
Journal: BMJ (1988)

Acral melanoma occurs on the soles and palms and under the nails (subungual melanoma).Benign pigmented naevi may also occur in these sites, but the seven points in the table will help to differentiate them.Talon noir, due to haemorrhage from trauma-for example, playing squashmay cause much concern but the distinct blood filled papillae seen on paring the lesion make the diagnosis plain.The prognosis ofmalignant melanoma is related to the depth ofinvasion.Superficial lesions with a tumour thickness ofless than 1 mm have a good prognosis if removed early (80-90% survival at five years).Histologically, the thickness of the tumour is measured from the granular layer (Breslow thickness).Deeper invasion carries a poor prognosis (only 40-50% survival for a tumour deeper than 3 mm).It is therefore very important to remove any malignant melanoma while it is in the superficial stage.
Hepatitis B Virus DNA in Patients with Chronic Liver Disease and Negative Tests for Hepatitis B Surface Antigen
Authors: Christian Bréchot, Françoise Degos, Claire Lugassy, Valérie Thiers, Serge Zafrani, Dominique Franco, Henri Bismuth, Christian Trépo, Jean-Pierre Benhamou, Jack Wands, Kurt Isselbacher, Pierre Tiollais, Pierre Berthelot
Journal: New England Journal of Medicine (1985)

We assessed the presence of hepatitis B virus (HBV) DNA in liver or serum samples from 134 patients with hepatitis B surface antigen (HBsAg)-negative chronic liver disease, including 20 with hepatocellular carcinoma. HBV DNA sequences were detected in 52 of the 88 liver samples (59 per cent), including 17 of the 20 samples from patients with hepatocellular carcinoma. Presumably "replicative forms" of HBV DNA were detected in only 5 of the 88 liver samples, 3 of which were from patients with no serologic marker for HBV. In most of the liver samples the DNA patterns were consistent with the presence of HBV or a closely related virus. Of the 105 serum samples tested, HBV DNA sequences were identified in 10 (9.5 per cent), 6 of which had no HBV serologic marker. Moreover, HBsAg-associated determinants were detected in 5 of 17 patients who were positive for HBV DNA and in none of 14 patients who were negative. This study demonstrates the high frequency of HBsAg-negative HBV DNA-positive viral infection of the liver and suggests that multiplication of HBV may occur in the absence of any conventional serologic marker for HBV.
Chronic diseases in the rubber industry
Authors: H. A. Tyroler, Dragana Andjelkovic, Robert Harris, Wayne Lednar, Anthony McMichael, Mike Symons
Journal: Environmental Health Perspectives (1976)

An overview is presented of epidemiologic studies of chronic diseases in the rubber industry. Analyses of the mortality experience during the period 1964-1972 of workers age 40–64 and retirees age 65–84 of two large rubber and tire manufacturing companies consistently disclosed excesses of deaths attributed to leukemia and lymphosarcoma, and for cancers of the stomach, large intestine, and prostate. The relation of site-specific malignancies to work histories and grouped occupational titles as surrogate measures of work-related exposures to possible carcinogens is described. There was no evidence of company-wide, sizable, consistent excess for the other major chronic diseases causes of death. Although a total cohort deficit in the mortality rate for lung cancer was found, there was a history of increased frequency of exposure to certain work areas among lung cancer decedents. Morbidity studies, including analysis of disability retirements, and ad hoc questionnaire and health testing surveys, disclosed excesses of chronic pulmonary diseases. There was evidence of an interactive effect in the association of work and smoking histories with pulmonary disability retirement.
Clinical risk management: enhancing patient safety.
Authors: Peter Sloan
Journal: British Journal of Sports Medicine (2001)

Clinical risk management is a strange subject which will perplex many readers. If this was a book about cricket, it would have chapters on no balls, wides, missed stumpings, and accusations by Indian bookmakers, but it probably would not talk about how to be a successful cricketer. As a result, some readers will be a bit put off by both its lay out and content. However, for those …