tbuckley/cabot-search huggingface dataset:
Growing List of Infections Linked to TNF Blockers
Authors: B. M. Kuehn
Journal: JAMA (2011)

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 pattern analysis and the ABCD rule of dermoscopy in the detection of histological atypia in melanocytic naevi
Authors: P. Carli, V. De Giorgi, D. Massi, B. Giannotti
Journal: British Journal of Dermatology (2000)

Background Clinical features of melanocytic naevi correlate poorly with the presence, histopathologically, of architectural disorder and cytological atypia, making the detection of histological atypia by means of macroscopic appearance unreliable. Objectives The aim of this study was to investigate the diagnostic effectiveness of dermoscopy in the non‐invasive detection of histological atypia in naevi. Methods Observers blinded for histological diagnosis classified a series of 168 melanocytic naevi as common or atypical on the basis of their clinical features and on their dermoscopic profile. The diagnostic performance of both methods compared with the true (histopathological) diagnosis was assessed. Results Dermoscopy using pattern analysis showed better results than clinical examination in the non‐invasive detection of naevi with architectural disorder with or without cytological atypia (diagnostic accuracy 45% vs. 28%). A statistically significant difference in the frequency of dermoscopic parameters between atypical and common naevi was found for atypical pigment network (39% vs. 17%, P = 0·001) and dermoscopic regression structures (13% vs. 2%, P = 0·008). Dermoscopic features, which best predicted histological atypia in naevi, were regression structures (white scar‐like areas or peppering), irregular vascular pattern and grey–blue areas (positive predictive values 83%, 83% and 73%, respectively). In contrast, no statistically significant difference in the mean values of the ABCD score between common and atypical naevi was found. The best diagnostic performance of dermoscopy by means of the ABCD rule (cut‐off point of 4·0 of total dermoscopy score) was not dissimilar to that of clinical diagnosis (diagnostic accuracy 30%). Conclusions Dermoscopy by means of pattern analysis enhances the diagnostic accuracy of dermatologists in the prediction of histological atypia in melanocytic naevi as compared with clinical examination alone.
Insulin Resistance After Renal Transplantation
Authors: Jøran Hjelmesæth, Karsten Midtvedt, Trond Jenssen, Anders Hartmann
Journal: Diabetes Care (2002)

Patients With Type 1 Diabetes1,25-dihydroxyvitamin D 3 [1,25(OH) 2 D 3 ] not only regulates calcium metabolism but also modulates the immune system.Some reports have suggested that 1,25(OH) 2 D 3 helps to prevent the development of type 1 diabetes.The association between the vitamin D receptor (VDR) genotype and susceptibility to type 1 diabetes has been examined, but a definitive conclusion has not yet been reached (1,2).We examined the VDR genotype in juvenile Japanese patients with type 1 diabetes.A total of 108 diabetic patients (41 boys and 67 girls, age of onset 0.4 -18 years with a median age of 8.9) and 120 nonrelated nondiabetic subjects were studied.Three polymorphic restriction fragment-length polymorphisms (RFLPs), i.e., Fok I, ApaI, and TaqI, were genotyped by PCR-RFLP method.The genotype or allele frequencies were compared statistically by the 2 test.The significance of differences in each genotype for the age of onset was tested with the Mann-Whitney U test.Among the patients, the FF (n ϭ 50) and tt (n ϭ 5) genotypes were found relatively frequently, and aa (n ϭ 46) was infrequent compared with those in control subjects, but these differences were not statistically significant (P ϭ 0.14, 0.18, and 0.38 for FF, tt, and aa genotypes, respectively).There was also no significant difference in the allele frequency of each polymorphism, although the incidence of the F allele tended to be higher in the diabetic patients (P ϭ 0.051).Concerning the age of onset of diabetes, patients with the ff genotype (n ϭ 12, median 5.2 years, range 1.7-11.0)were significantly younger at onset than those with FF (n ϭ 50, 9.7 years, 0.4 -15.9, P ϭ 0.01) or Ff (n ϭ 46, 8.9 years, 0.9 -18.0,P ϭ 0.03).No significant association was observed between the TaqI or ApaI genotype and the age of onset.The ff genotype has been reported to be associated with a lower expression of VDR mRNA and reduced inhibition of phytohemagglutinin-stimulated growth of peripheral blood mononuclear cells.Thus, the Fok I genotype may influence the rate of the progression of insulitis by modifying the autoimmune process, which may have led to the significant difference in the age of onset.The relatively high frequency of the F allele in diabetic patients, which has also been found in Japanese adult diabetic patients (2), is apparently inconsistent with this observation.A possible explanation is that the impact of Fok I polymorphism may not be strong enough to prevent the progression of autoimmune insulitis into overt diabetes and thus does not influence susceptibility to the disease itself.In conclusion, VDR gene polymorphism does not appear to have a strong enough impact to clearly influence susceptibility to the disease itself, but Fok I polymorphism might influence the age of onset of diabetes in juvenile Japanese diabetic patients.
Cyclists should wear helmets
Authors: B. Pless, R. Davis
Journal: BMJ (1997)

Editor–We are not surprised that our letter on cycle helmets1 evoked such a strong response.2 We chose to ignore accidents involving cars because most cyclists' head injuries are not caused in this way. The main purpose of helmets is to protect the head in situations other than car accidents.

We too hope for a more fair environment with fewer cars, all being driven slowly and carefully. That there may be an element of victim blaming in helmet laws when an injury does involve …
Association of Spontaneous Mediastinal Emphysema and Acute Myocardial Infarction
Authors: Robert K. Nixon
Journal: New England Journal of Medicine (1952)

SPONTANEOUS mediastinal emphysema was first described as a clinical entity by Hamman1 a little more than a decade ago. Although the initial pathological report by Laënnec2 appeared in 1879, the clinical characteristics and diagnostic features were not elucidated until Hamman compiled his observations on 6 cases. A review of the literature reveals 58 cases reported, giving evidence of increasing awareness of the condition. All authors have emphasized the importance of recognizing this benign condition in the adult to differentiate it from other more serious diseases, notably coronary occlusion, pericarditis, pulmonary embolism and dissecting aneurysm of the aorta. In the light . . .
Evidence of Chlamydia pneumoniae infection obtained by the polymerase chain reaction (PCR) in patients with acute myocardial infarction and coronary heart disease
Authors: B.R. Naidu, Y.F. Ngeow, P. Kannan, R. Jeyamalar, A. Khir, K.L. Khoo, T. Pang
Journal: Journal of Infection (1997)
Procoagulant activity of endotoxin or tumor necrosis factor activated monocytes is enhanced by IgG from patients with lupus anticoagulant
Authors: Jean‐Fraņois Schved, Jean‐Christophe Gris, ValéRie Ollivier, Jean‐Luc Wautier, GÉRard Tobelem, Jacques Caen
Journal: American Journal of Hematology (1992)

Abstract The effect of lupus anticoagulant (LA) positive plasma on the expression of human monocyte procoagulant activity (PCA) was studied. LA positive plasma were able to enhance the endotoxin or TNF alpha induced monocyte associated PCA. The monocyte PCA had the characteristic of tissue factor activity (factor VII, factor × dependence). The enhancement of monocyte PCA could be confirmed using purified LA positive IgG. The stimulating effect was supported by the F(ab')2 fragments. © 1992 Wiley‐Liss, Inc.
Survival of cultured allografts in patients with burns assessed with probe specific for Y chromosome.
Authors: A. M. Burt, C. D. Pallett, J. P. Sloane, M. J. O'Hare, K. F. Schafler, P. Yardeni, A. Eldad, J. A. Clarke, B. A. Gusterson
Journal: BMJ (1989)

The aim of the study was to determine the fate of cultured skin allografts in patients with burns. In situ DNA hybridisation with a Y probe (pHY 2.1) was used to detect cells carrying the Y chromosome (the probe being visualised by the alkaline phosphatase-antialkaline phosphatase method) in biopsy specimens taken from cultured allografts derived from donors of the opposite sex to the recipients (20 patients with burns). Specimens were taken within a week, between one and three weeks, between four and six weeks, and more than six weeks after grafting. Only two of the 27 biopsy specimens contained cells that were the same sex as the donor; both were taken within a week after grafting. In the 25 other specimens the epithelial cells were the same sex as the recipient. Cultured skin allografts showed no evidence of survival in patients with burns, which suggests that they are probably not suitable for long term management of burns but may be useful as short term biological dressings.
NHS attracts German doctors
Authors: Roger Dobson
Journal: BMJ (2004)

More than 2000 German doctors are registered to work in the United Kingdom, despite nearly 5000 vacancies in Germany.

Around 350 partial and full registrations are being granted every year to German doctors, although a third of hospitals in Germany are considering introducing waiting lists because of a shortage of medical staff.

A report in Clinical Medicine (2004;4:57-9) says that German doctors are attracted by a range of factors, including systematic postgraduate training, better working conditions and pay, and opportunities for professional development.

“Such qualities are easily overlooked amid the near universal criticism of the NHS as an employer,” says the report, …
Atrophy of Foot Muscles
Authors: Henning Andersen, Michaela D. Gjerstad, Johannes Jakobsen
Journal: Diabetes Care (2004)

OBJECTIVE—Diabetic neuropathy is a length-dependent process that leads to reduced muscle strength and atrophy of leg muscles in some patients. We hypothesized that intrinsic foot muscles are atrophied in diabetic neuropathy and that the degree of atrophy is a measure of motor dysfunction closely related to the neuropathic process. RESEARCH DESIGN AND METHODS—Consecutive cross-sectional magnetic resonance images of the nondominant foot were obtained for stereological determination of the total volume of the intrinsic foot muscles (VFM) in 23 long-term diabetic patients with (n = 15) and without (n = 8) chronic neuropathy and in 23 matched healthy nondiabetic control subjects. Based on clinical examination, nerve conduction studies, and quantitative sensory examination, a neuropathy rank-sum score was calculated for each patient. RESULTS—Total VFM was 86 ± 52, 165 ± 34, and 168 ± 42 cm3 in neuropathic patients, nonneuropathic patients, and healthy control subjects, respectively (P &amp;lt; 0.001). There was a close inverse relationship between the neuropathy rank-sum score and the VFM (r = −0.75, P &amp;lt; 1 × 10−5). CONCLUSIONS—Total volume of the foot muscles is halved in patients with diabetic neuropathy. Atrophy of foot muscles is closely related to the severity of neuropathy and reflects motor dysfunction.
Differential expression of adipokines in infrapatellar fat pad (IPFP) and synovium of osteoarthritis patients and healthy individuals
Authors: Javier Conde, Morena Scotece, Verónica López, Vanessa Abella, Miguel Hermida, Jesús Pino, Francisca Lago, Juan J Gómez-Reino, Oreste Gualillo
Journal: Annals of the Rheumatic Diseases (2013)

Osteoarthritis (OA) is the most common form of arthritis and a major cause of pain and disability in elders. It is characterised by cartilage loss and structural changes in the whole joint. Although some mechanisms involved in the pathogenesis of OA are more and more understood, several factors involved in the onset and progression of the disease remain elusive. Together with aging and genetic factors, obesity is an important risk factor for OA.1 Recent data suggest a clear role of systemic inflammatory mediators, produced by fat mass, called adipokines, in OA.2–4 Actually, experimental evidences confirm the critical role of adipokines with an emphasis on old members, such as leptin and visfatin,3–5 but also on new members such as chemerin.2

To this regard, several lines of evidence indicate that these factors exert pro-inflammatory and pro-catabolic actions at cartilage level.2 ,4 ,5 For instance, leptin, chemerin and visfatin trigger the expression of nitric oxide, MMPs and PGE2 in chondrocytes.2 ,4 ,5

Leptin, chemerin and visfatin have been detected in synovial fluid obtained from OA patients.6–8 Moreover, the levels of these adipokines have …
Government welfare cuts are hitting children, says BMA
Authors: J. Wise
Journal: BMJ (2013)

Recent cuts to welfare benefits and social care will hit the most vulnerable children and widen social inequalities in the United Kingdom, warns a major new report from the BMA.

Growing up in the UK says that the current high levels of poverty in the UK, including among children, are unacceptable.1 The report says that intervening early with family support and education was cost effective and essential to reduce inequalities. It highlights the value of the Sure Start Children’s Centres but adds that with local authority budget cuts and services no …
Systolic Murmur Developing After Myocardial Ischemia or Infarction
Authors: David H. Holloway
Journal: JAMA (1965)

A systolic murmur is sometimes heard for the first time after an episode of myocardial ischemia or the occurrence of a myocardial infarction. This murmur may be due to the rupture of a papillary muscle, the rupture of the interventricular septum, papillary muscle dysfunction, or acute left ventricular dilatation. Now that corrective surgery is theoretically possible for the first two conditions, a precise functional and anatomical diagnosis should be made in patients who develop such a murmur so that the most effective long-term therapy may be instituted. Certain features of the history and physical examination help in the differential diagnosis. However, frequently it is necessary to resort to cardiac catheterization and cinefluorography to establish the correct diagnosis.
Toxic lipids stored by Kupffer cells correlates with their pro-inflammatory phenotype at an early stage of steatohepatitis
Authors: Anne Leroux, Gladys Ferrere, Vanessa Godie, Frédéric Cailleux, Marie-Laure Renoud, Françoise Gaudin, Sylvie Naveau, Sophie Prévot, Samira Makhzami, Gabriel Perlemuter, Anne-Marie Cassard-Doulcier
Journal: Journal of Hepatology (2012)
HIV in Nepal: Is the Violent Conflict Fuelling the Epidemic?
Authors: Sonal Singh, Edward Mills, Steven Honeyman, Bal Krishna Suvedi, Nur Prasad Pant
Journal: PLoS Medicine (2005)

IV/AIDS has reached alarming proportions in Southeast Asia [1]. The magnitude of the epidemic is projected to exceed that of sub-Saharan Africa in the 21st century [2]. More than 7 million South Asians are currently infected with HIV [3], nearly 5 million of whom are in India [3]. Nepal has had a comparatively lower prevalence of HIV/AIDS compared to other countries in Southeast Asia. Seasonal migration and sexual trafﬁ cking across a porous Indian border [4], fuelled by a bloody Maoist conﬂ ict (see Sidebar), has raised Nepal’s HIV prevalence to the second highest in the region after India. In this essay, we characterize the current HIV epidemic in Nepal, look at the ways in which the conﬂ ict may be fuelling the infection rate, and discuss the current local and international response from the health and development community. We argue that there is currently a short window of opportunity to take action to control the HIV epidemic in Nepal—and that inaction will lead to HIV becoming the biggest killer of the young and middle-aged in the next decade.
DETERMINATION OF THE RATE OF DISAPPEARANCE OF MUSTARD GAS AND MUSTARD INTERMEDIATES IN CORNEAL TISSUE 1
Authors: V. Everett Kinsey, W. Morton Grant
Journal: Journal of Clinical Investigation (1946)

Prior to World War II, the time of persistence of mustard gas (bis ,-chloroethyl) sulfide (hereafter referred to as H), in tissues had not ade- quately been determined.Although it was known that in aqueous environments H is rapidly hydrolysed to innocuous products, it seemed possible that this substance, because of its high lipoid solu- bility, might persist for much longer periods in the lipoid fractions of tissues.This possibility re- quired investigation because of its bearing upon the potential efficacy of methods of decontamina- tion, or treatment based upon the introduction into tissues of substances capable of reacting with and detoxifying H.The results of numerous in- vestigations carried out during the war years have established that H, as such, rapidly disappears from the skin and eye.The present paper, based on work carried out in 1942, presents the results of one of the quantitative chemical investigations bearing on this point.Similar conclusions may be derived from the results of other work, notably that of Henriques, Mortiz, Breyfogle and Patter- son (1941 to 1944) (1) on the skin, and that of Snell ( 1942Snell ( , 1943) ) (2) on the cornea.
Reuse of Disposable Syringe-Needle Units in the Diabetic Patient
Authors: Mary Crouch, Anne Jones, Elsie Kleinbeck, Edward Reece, Alice N Bessman
Journal: Diabetes Care (1979)

A comparison was made between reuse of plastic disposable needle-syringe units and glass syringes with daily new needles in diabetic patients who take daily insulin injections. Parameters studied were incidence of infection, clarity of syringe readings, ability to use syringe, and sharpness of needle. The plastic disposable units could be reused with safety and patient satisfaction by most patients for at least 3 days. Considerable cost benefit could accrue if disposable units were used more than one time for insulin injections.
European countries are urged to develop national policies to control chlamydia
Authors: J. Waters
Journal: BMJ (2009)

New guidance issued by the European Centre for Disease Prevention and Control (ECDC) urges countries to adopt national strategies for tackling the rising incidence of chlamydia infection.

Less than half of 29 countries currently have any national guidelines for controlling chlamydia, research by the centre shows, despite it being the most frequently reported sexually transmitted infection in Europe.

The number of confirmed cases of chlamydia infection reported by 22 European countries was 253 386 in 2007, and the overall prevalence was 122.6 cases per 100 000 population, although the true prevalence is thought to be much higher, as many infected people …
Abstract IA26: Regulation of metastasis in breast cancer
Authors: Zena Werb
Journal: Cancer Research (2013)

Abstract Breast cancer patients with metastatic disease have poor prognoses. A key transcription factor, the loss of GATA3 by mutation or loss of expression correlates with a worse prognosis. Indeed, GATA3 is the third most mutated gene in breast cancer progression. In mouse and human breast cancer cells, GATA3 suppresses metastasis by promoting tumor cell differentiation and by altering the tumor microenvironment. Although GATA3 has many direct targets, one major pathway downstream of GATA3 regulating metastasis is through its induction of miR29 expression. miR29b is enriched in luminal breast cancers, which are high in GATA3. miR29b inhibits metastasis directly by targeting a network of pro-metastatic regulators involved in angiogenesis, collagen remodeling and proteolysis. Loss of miR29b, even in GATA3-expressing cells increases metastasis and promotes a mesenchymal phenotype. That inhibiting metastasis by regulating tumor microenvironmental genes through a GATA3-miR29b axis opens up potentially new therapies for breast cancer. (Supported by Grant R01 CA129523). Citation Format: Zena Werb. Regulation of metastasis in breast cancer. [abstract]. In: Proceedings of the Third AACR International Conference on Frontiers in Basic Cancer Research; Sep 18-22, 2013; National Harbor, MD. Philadelphia (PA): AACR; Cancer Res 2013;73(19 Suppl):Abstract nr IA26.
Cell Therapy Trials for Lung Diseases: Progress and Cautions
Authors: Daniel J. Weiss, Luis A. Ortiz
Journal: American Journal of Respiratory and Critical Care Medicine (2013)

Idiopathic pulmonary fibrosis (IPF) is a catastrophic disease that in most patients is characterized by a progressive nature that confers upon it a high mortality (1). This is aggravated by lack of understanding of IPF pathogenesis, which undermines the ability to model the disease in animals and impedes development of effective therapies. Consequently, with the exception of oxygen administration and lung transplantation, the latter a limited option that improves survival in some patients, no currently effective treatment options are available (2). Despite this, the IPF community has made significant advances, and the last decade saw its transformation into a worldwide network of community- and academic-based organizations that, in conjunction with sponsorship from the pharmaceutical industry and the National Institutes of Health–sponsored IPF network, resulted in the development of rigorous clinical trials (reviewed in Reference 1). Although these were not successful in demonstrating drug efficacy in IPF treatment, they helped clarify the natural history of the disease and documented differences in disease progression, with some patients experiencing exacerbations and rapid progression, whereas others have a more protracted course (1). Genetic studies clarified the familial nature of IPF in a subset of patients and identified genetic mutations compromising telomerase function, thus linking the disease to bone marrow abnormalities (3). Clinical trials also contributed a unique repository of biological materials for identification and validation of biomarkers to follow disease progression (1). In a short period of time, these research initiatives have altered clinical practice by demonstrating that the use of azathioprine is toxic to patients with IPF, effectively eliminating the use of this drug in IPF, thus affirming the “primum non nocere” principle ({type:clinical-trial,attrs:{text:NCT00650091,term_id:NCT00650091}}NCT00650091) (4).