tbuckley/cabot-search huggingface dataset:
What Are the Risks and Benefits of Keeping a Gun in the Home?
Authors: Gary Kleck
Journal: JAMA (1998)

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
Angiotropic large cell lymphoma presenting as fever of unknown origin
Authors: Ayoub Mirza, Dennis Torretti, William Tyler, Kishore Pachipala
Journal: American Journal of Hematology (2002)

To the Editor: Angiotropic lymphoma is an intravascular large cell lymphoma [1].Although fever is a common manifestation of this disease, it is extremely rare for it to be initially seen as fever of unknown origin (FUO) [2].A 67-year-old white woman was admitted with a 3-week history of nausea, vomiting, and diarrhea.She was not aware of fever before her admission and denied weight loss or cutaneous lesions.Her physical examination was notable only for a pulse of 107/min and dry mucous membranes.There were no cutaneous lesions, lymphadenopathy, or organomegaly.Initial laboratory investigations revealed a hemoglobin of 7.1 g/dL, hematocrit of 20.8%, platelet count of 368,000/L, and a white blood cell count of 6,800/L (differential WBC: 70% neutrophils, 13% lymphocytes, and 15% monocytes).While the patient was hospitalized, repeated episodes of fever up to 103°F were noted.An extensive workup for FUO, including repeated blood and urine cultures, chest x-ray, duplex scan of the lower extremities, and computed tomography scans of the chest, abdomen, and pelvis, was unrevealing.During the third week of hospitalization, a serum immunofixation study revealed the presence of a low-level IgG kappa monoclonal protein.Because of this finding, a punch biopsy of clinically normal abdominal skin and subcutaneous tissue was obtained to look for amyloidosis.The biopsy specimen revealed neoplastic cells filling the lumens of multiple small blood vessels in the dermis and subcutaneous tissue.Immunoperoxidase stains using antibodies to CD3, CD20, and CD79a revealed the cells to be CD20+, large neoplastic B cells indicative of angiotropic lymphoma (Fig. 1).Shortly after the skin biopsy was performed, the patient's condition worsened, and she died.
Risk of recurrence after a first seizure and implications for driving: further analysis of the Multicentre study of early Epilepsy and Single Seizures
Authors: L. J. Bonnett, C. Tudur-Smith, P. R. Williamson, A. G. Marson
Journal: BMJ (2010)

<b>Objective</b> To determine for how long after a first unprovoked seizure a driver must be seizure-free before the risk of recurrence in the next 12 months falls below 20%, enabling them to regain their driving licence. <b>Design</b> Randomised controlled trial: Multicentre study of early Epilepsy and Single Seizures (MESS). <b>Setting</b> UK hospital outpatient clinics from 1 January 1993 to 31 December 2000. <b>Participants</b> People entered MESS if they had had one or more unprovoked seizures and both the participant and the clinician were uncertain about the need to start antiepileptic drug treatment. The subset of people used for this analysis comprised participants aged at least 16 years with a single unprovoked seizure. <b>Main outcome measure</b> Risk of seizure recurrence in the 12 months after a seizure-free period of 6, 12, 18, or 24 months from the date of the first (index) seizure. Regression modelling was used to investigate how antiepileptic treatment and several clinical factors influence the risk of seizure recurrence. <b>Results</b> At six months after the index seizure the risk of recurrence in the next 12 months for those who start antiepileptic drugs was significantly below 20% (unadjusted risk 14%, 95% confidence interval 10% to 18%). For patients who did not start treatment the risk estimate was less than 20% but the upper limit of the confidence interval was greater than 20% (18%, 13% to 23%). Multivariable analyses identified subgroups with a significantly greater than 20% risk of seizure recurrence in the 12 months after a six month seizure-free period, such as those with a remote symptomatic seizure with abnormal electroencephalogram results. <b>Conclusion</b> After a single unprovoked seizure this reanalysis of MESS provides estimates of seizure recurrence risks that will inform policy and guidance about regaining an ordinary driving licence. Further guidance is needed as to how such data should be utilised; in particular, whether a population approach should be taken with a focus on the unadjusted results or whether attempts should be made to individualise risk. Guidance is also required as to whether the focus should be on risk estimates only or on the confidence interval as well. If the focus is on the estimate only our unadjusted estimates suggest that treated and untreated patients are eligible to drive after being seizure-free for six months. If the focus is also on confidence intervals, direction is needed as to whether a conservative or liberal approach should be taken. <b>Trial registration</b> Current Controlled Trials ISRCTN98767960.
Controversial aspects of adverse reactions to food
Authors: C Ortolani C, C Bruijnzeel‐koomen, U Bengtsson, C Bindslev‐jensen, B Björkstén, A Høst, M Ispano, R Jarish, C Madsen, K Nekam, R Paganelli, Lk Poulsen, B Wüthrich
Journal: Allergy (1999)
Ranking the potential carcinogenic hazards to workers from exposures to chemicals that are tumorigenic in rodents.
Authors: L S Gold, G M Backman, N K Hooper, R Peto
Journal: Environmental Health Perspectives (1987)

For 41 chemicals there exist both reasonable data on carcinogenic potency in experimental animals and also a defined Permissible Exposure Level (PEL), which is the upper limit of legally permissible chronic occupational exposure for U.S. workers. These 41 agents are ranked by an index that compares the permitted chronic human exposure to the chronic dose rate that induces tumors in 50% of laboratory animals. This index, the Permitted Exposure/Rodent Potency index, or PERP, does not estimate absolute risks directly, but rather suggests the relative hazards that such substances may pose. The PERP values for these 41 substances differ by more than 100,000-fold from each other. The PERP does not take into account the actual level of exposure or the number of exposed workers. Nevertheless, it might be reasonable to give priority attention to the reduction of allowable worker exposures to substances that appear most hazardous by this index and that some workers may be exposed to full-time near the PEL. Ranked by PERP, these chemicals are: ethylene dibromide, ethylene dichloride, 1,3-butadiene, tetrachloroethylene, propylene oxide, chloroform, formaldehyde, methylene chloride, dioxane, and benzene.
Depletion of FOXP3+ regulatory T cells promotes hypercholesterolemia and atherosclerosis
Authors: Roland Klingenberg, Norbert Gerdes, Robert M. Badeau, Anton Gisterå, Daniela Strodthoff, Daniel F.J. Ketelhuth, Anna M. Lundberg, Mats Rudling, Stefan K. Nilsson, Gunilla Olivecrona, Stefan Zoller, Christine Lohmann, Thomas F. Lüscher, Matti Jauhiainen, Tim Sparwasser, Göran K. Hansson
Journal: Journal of Clinical Investigation (2013)

Atherosclerosis is a chronic inflammatory disease promoted by hyperlipidemia. Several studies support FOXP3-positive regulatory T cells (Tregs) as inhibitors of atherosclerosis; however, the mechanism underlying this protection remains elusive. To define the role of FOXP3-expressing Tregs in atherosclerosis, we used the DEREG mouse, which expresses the diphtheria toxin (DT) receptor under control of the Treg-specific Foxp3 promoter, allowing for specific ablation of FOXP3+ Tregs. Lethally irradiated, atherosclerosis-prone, low-density lipoprotein receptor–deficient (Ldlr–/–) mice received DEREG bone marrow and were injected with DT to eliminate FOXP3+ Tregs. Depletion of Tregs caused a 2.1-fold increase in atherosclerosis without a concomitant increase in vascular inflammation. These mice also exhibited a 1.7-fold increase in plasma cholesterol and an atherogenic lipoprotein profile with increased levels of VLDL. Clearance of VLDL and chylomicron remnants was hampered, leading to accumulation of cholesterol-rich particles in the circulation. Functional and protein analyses complemented by gene expression array identified reduced protein expression of sortilin-1 in liver and increased plasma enzyme activity of lipoprotein lipase, hepatic lipase, and phospholipid transfer protein as mediators of the altered lipid phenotype. These results demonstrate that FOXP3+ Tregs inhibit atherosclerosis by modulating lipoprotein metabolism.
The Risk of Type 1 Diabetes Among Offspring of Immigrant Mothers in Relation to the Duration of Residency in Sweden
Authors: Hozan Ismael Hussen, Tahereh Moradi, Martina Persson
Journal: Diabetes Care (2015)

OBJECTIVE The risk for type 1 diabetes mellitus (T1DM) is increased in the second compared with the first generation of immigrants in Sweden. We investigated the effect of the mother’s duration of stay in Sweden on the risk of T1DM in the offspring. RESEARCH DESIGN AND METHODS Using data from national registries, we identified all subjects with T1DM among 984,798 children born in Sweden (aged 0–18 years) between 1992 and 2009. Incidence rate ratios (IRRs) with 95% CI were estimated using Poisson regression. RESULTS Offspring of mothers living in Sweden for up to 5 years had a 22% lower risk of T1DM (adjusted IRR 0.78, 95% CI 0.63–0.96) compared with offspring of mothers living in Sweden for 11 years or more. The risk increased with the mother’s duration of stay in Sweden. CONCLUSIONS Our findings support the hypothesis that immigration to Sweden is associated with exposure to new environmental factors that contribute to the development of T1DM in genetically susceptible individuals.
New Strategies in Metastatic Melanoma: Oncogene-Defined Taxonomy Leads to Therapeutic Advances
Authors: Keith T. Flaherty, David E. Fisher
Journal: Clinical Cancer Research (2011)

The discovery of BRAF and KIT mutations provided the first basis for a molecular classification of cutaneous melanoma on therapeutic grounds. As BRAF-targeted therapy quickly moves toward regulatory approval and incorporation as standard therapy for patients with metastatic disease, proof of concept has also been established for targeting mutated KIT in melanoma. NRAS mutations have long been known to be present in a subset of melanomas and represent an elusive subgroup for targeted therapies. Matching patient subgroups defined by genetic aberrations in the phosphoinositide 3-kinase and p16/cyclin dependent kinase 4 (CDK4) pathways with appropriate targeted therapies has not yet been realized. And, an increasing understanding of lineage-specific transcriptional regulators, most notably MITF, and how they may play a role in melanoma pathophysiology, has provided another axis to approach with therapies. The foundation has been established for individual oncogene targeting, and current investigations seek to understand the intersection of these susceptibilities and other described potential targets and pathways. The melanoma field stands poised to take the lead among cancer subtypes in advancing combination therapy strategies that simultaneously target multiple biologic underpinnings of the disease.
Treatment of Spontaneous Pneumothorax
Authors: Karl P. Klassen
Journal: JAMA (1962)

The initial treatment of 135 patients who had spontaneous pneumothorax consisted of controlled thoracotomy tube suction. Prompt expansion of the lung without subsequent collapse was obtained in 81% of the patients so treated. The average period of hospitalization was 5 days. Thoracotomy, with resection of emphysematous blebs and abrasion of the parietal pleura were necessary in 30 patients because of recurrence, tube failure, or presence of large blebs. Bilateral resection of blebs was performed in 1 patient with simultaneous bilateral pneumothorax. Clinical investigation at the time of the occurrence of the spontaneous pneumothorax, microscopic examination of the tissue removed at surgery, and follow-up studies up to 10 years failed to demonstrate tuberculosis in any of these persons. Emphysematous blebs were found in all patients who underwent thoracotomy.
Pediatric Telephone Medicine: Principles, Triage, and Advice
Authors: Orest Dubynsky
Journal: JAMA (1990)

This book tackles a very important, frustrating, and potentially litigious area with which every pediatrician must wrestle on a daily basis. It is hard enough for the experienced physician to make a correct judgment call on the basis of a caller's often frightened observations and bias. Imagine how our office staff feel when they have to handle all those calls, all day long! We are all individualistic in our approach to telephone advice, and that is why many of the telephone advice books just don't come close enough to reflecting that personal practice style that we have all cultivated. Although I have the temerity to raise a few challenges to the advice given in this book, I do give it very high marks for both content and organization. <i>Pediatric Telephone Medicine</i>comes as a plastic spiral—bound, softcover book of medium size, spanning 237 pages. There are six chapters covering general
A CASE OF LEPROSY—A CASE OF MULTIPLE NEVUS PIGMENTOSUS.
Authors: BURNSIDE FOSTER
Journal: JAMA (1901)

The following case was seen in consultation with Dr. E. Boeckmann, March 13, 1901. The patient, J. J., 20 years of age, was born in Minnesota and has never been out of the state. His father, mother, two sisters and one brother are living and well. The other brother, older than this patient, died in May, 1898, of leprosy, from which he had suffered for about eight years. In infancy this brother had been nursed by a woman who had two brothers, both of whom were lepers and were known to be such in that community. It should be stated that the father of my patient came from a leprous district in Norway forty years ago, but that there is no leprosy in the family history. The mother was born in Minnesota. The patient presented the ordinary type of anesthetic leprosy, there being eruptions scattered about on different parts of
Serum dehydroepiandrosterone and DHEA-sulfate in patients with adult T-cell leukemia and human T-lymphotropic virus type I carriers
Authors: Kimiharu Uozumi, Toshiaki Uematsu, Maki Otsuka, Satoko Nakano, Yoshifusa Takatsuka, Masahito Iwahashi, Shuichi Hanada, Terukatsu Arima
Journal: American Journal of Hematology (1996)

The serum levels of dehydroepiandrosterone (DHEA) and DHEA-sulfate (DHEA-S) were determined by radioimmunoassay in 38 patients with adult T-cell leukemia (ATL). Levels of serum DHEA and DHEA-S were also measured in 60 human T-lymphotropic virus type I (HTLV-I) carriers, and did not differ from those in 60 healthy control subjects. Serum levels in patients with ATL were lower than those in the age- and sex-matched healthy controls and in HTLV-I carriers with statistical significance. Serum DHEA and DHEA-S in male patients with acute and lymphoma-type ATL were 1.06 +/- 0.77 ng/ml and 245.8 +/- 192.9 ng/ml, respectively. Levels in male patients with chronic and smoldering-type ATL were 1.69 +/- 0.68 ng/ml and 477.6 +/- 251.5 ng/ml, respectively. Serum levels of DHEA and DHEA-S in patients with acute and lymphoma-type ATL were significantly lower than those in patients with chronic and smoldering-type ATL (P < 0.05). These data suggest that a decrease in serum levels of DHEA and DHEA-S may be associated with patients who have some clinical subtypes of ATL. Moreover, androgens may have a therapeutic role in patients with ATL, as administered in patients with hairy-cell leukemia. Because there is at present no curative chemotherapy for ATL, a trial combination of androgens and standard chemotherapy may be a reasonable therapeutic option in such patients.
Antiviral activity and toxicity of fialuridine in the woodchuck model of hepatitis B virus infection
Authors: Bud C. Tennant, Betty H. Baldwin, Lou Ann Graham, Mary A. Ascenzi, William E. Hornbuckle, Peter H. Rowland, Ilia A. Tochkov, Amy E. Yeager, Hollis N. Erb, Joseph M. Colacino, Carlos Lopez, Jeffery A. Engelhardt, Ronald R. Bowsher, Frank C. Richardson, William Lewis, Paul J. Cote, Brent E. Korba, John L. Gerin
Journal: Hepatology (1998)

Woodchucks were used to study the antiviral activity and toxicity of fialuridine (FIAU; 1,-2′deoxy-2′fluoro-1-β- d -arabinofuranosyl-5-iodo-uracil). In an initial experiment, groups of six chronic woodchuck hepatitis virus (WHV) carrier woodchucks received daily doses of FIAU by intraperitoneal injection for 4 weeks. At 0.3 mg/kg/d, the antiviral effect was equivocal, but at 1.5 mg/kg/d, FIAU had significant antiviral activity. No evidence of drug toxicity was observed during the 4-week period of treatment or during posttreatment follow-up. In a second experiment, groups of nine WHV carriers or uninfected woodchucks were given 1.5 mg/kg/d of FIAU orally for 12 weeks, and the results compared with placebo-treated controls. After 4 weeks, the serum WHV-DNA concentration in the FIAU-treated carrier group was two to three logs lower than that in the placebo-treated group. After 12 weeks of FIAU treatment, serum WHV DNA was not detectable by conventional dot-blot analysis, hepatic WHV-DNA replicative intermediates (RI) had decreased 100-fold, and hepatic expression of WHV core antigen was remarkably decreased. No evidence of toxicity was observed after 4 weeks, but, after 6 to 7 weeks, food intake decreased and, after 8 weeks, the mean body weights of woodchucks treated with FIAU were significantly lower than controls. Anorexia, weight loss, muscle wasting, and lethargy became progressively severe, and all FIAU-treated woodchucks died or were euthanized 78 to 111 days after treatment began. Hepatic insufficiency (hyperbilirubinemia, decreased serum fibrinogen, elevated prothrombin time), lactic acidosis, and hepatic steatosis were characteristic findings in the final stages of FIAU toxicity in woodchucks. The syndrome of delayed toxicity in woodchucks was similar to that observed previously in humans treated with FIAU, suggesting that the woodchuck should be valuable in future investigations of the molecular mechanisms of FIAU toxicity in vivo and for preclinical toxicological evaluation of other nucleoside analogs before use in patients.
A SIMPLE METHOD FOR THE MEASUREMENT OF BLOOD-CELLS
Authors: PHILIP ATLEE SHEAFF
Journal: JAMA (1910)

In the microscopic examination of blood it sometimes becomes desirable for purposes of comparison and classi- fication to know, with some degree of accuracy, the size of certain cells.The method about to be described is simple, fairly accurate, and can be used by anyone who cares to expend a little patience in adapting the eye- 3\ m=3/ 4\ 7\ m=1/ 2\ 11\ m=1/ 4\ 15 Sketch illustrating a simple method for the measurement of blood-cells.View of field, with available measurements in microns, when the radius is divided into halves and thirds.Spun glass A B C giving black line effect and forming gauge.
GONOCOCCAL PERITONITIS COMPLICATING GONORRHEAL VULVOVAGINITIS
Authors: Morris Gleich
Journal: JAMA (1926)

A girl, aged 4 years, awoke suddenly one evening complaining of severe abdominal pain. This pain, followed by vomiting and fever, continued all night. On examination next day the child was moribund. The abdomen was soft and relaxed. No tenderness was evident. The labia and introitus were red. There was no vaginal discharge. The rest of the examination was negative. Twenty-four hours from the onset of symptoms, the child succumbed. Necropsy revealed an acute, diffuse, purulent peritonitis, with markedly inflamed tubes, ovaries and uterine endometrium. About 4 ounces of yellowish-red, odorless, purulent fluid was obtained from the pelvis. The liver and spleen were studded with necrotic foci. There was cerebral and pial edema. The appendix was normal. Histologic studies showed the typical acute, exudative, inflammatory reaction. Smears from the pelvic pus and vaginal mucosa showed gram-negative intracellular diplococci and many pus cells. <h3>COMMENT</h3> Peritonitis following gonorrheal vulvovagino-endocervicitis is rare. When
13 Bile duct injury in response to expression of antigen on the surface of biliary epithelium
Authors: Y YOUNG, J BUXBAUM, C KHUU, B SHNEIDER, P ALLEN, M PETERS
Journal: Hepatology (2003)

To understand the mechanisms involved in immunological tolerance to skin-associated antigens, we have developed transgenic (Tg) mice that express a model self-antigen, membrane-bound chicken ovalbumin (OVA), under the control of a keratin 14 (K14) promoter. K14-mOVA Tg mice express OVA mRNA in the epidermis, and appear normal. K14-mOVA Tg mice failed to mount T cell and delayed type hypersensitivity reactions to OVA, suggesting that the Tg mice were tolerant to OVA. Skin dendritic cells, including Langerhans cells, may contribute to the tolerance induction because migratory skin DC derived from K14-mOVA efficiently activated CD8+ T cells from OVA-specific T-cell receptor (Va2/Vb5) Tg (OT-I) mice. OT-I cells expanded and accumulated in skin-draining lymph nodes after intravenous injected into K14-mOVA mice and exhibited activation markers. Graft-versus-host disease-like skin lesions appeared in K14-mOVA mice by day 7 after injection of OT-I cells. These studies demonstrate that K14-mOVA Tg mice are susceptible to an autoimmunelike skin disease induced by passively transferred naïve CD8+ OVA T-cell receptor Tg T cells, and serve as a good model for understanding self-tolerance and for the investigation of the pathogenesis, treatment and potential prevention of cell-mediated autoimmune reactions in skin.
Nanoparticle penetration of human cervicovaginal mucus: The effect of polyvinyl alcohol
Authors: Ming Yang, Samuel K. Lai, Tao Yu, Ying-Ying Wang, Christina Happe, Weixi Zhong, Michael Zhang, Abraham Anonuevo, Colleen Fridley, Amy Hung, Jie Fu, Justin Hanes
Journal: Journal of Controlled Release (2014)
Source Attribution of Health Benefits from Air Pollution Abatement in Canada and the United States: An Adjoint Sensitivity Analysis
Authors: Amanda Joy Pappin, Amir Hakami
Journal: Environmental Health Perspectives (2013)

Decision making regarding air pollution can be better informed if air quality impacts are traced back to individual emission sources. Adjoint or backward sensitivity analysis is a modeling tool that can achieve this goal by allowing for quantification of how emissions from sources in different locations influence human health metrics.