tbuckley/cabot-search huggingface dataset:
Treatment of obesity: need to focus on high risk abdominally obese patients
Authors: J.-P. Despres
Journal: BMJ (2001)

Editorial by Little and Byrne 

It is generally accepted that obesity is a health hazard because of its association with numerous metabolic complications such as dyslipidaemia, type 2 diabetes, and cardiovascular diseases.1 On that basis, health agencies 2 3 have proposed that obesity should be defined on the basis of weight in kg expressed over height in m2, the so called body mass index,4 initially described by Quetelet in 1869 (table). Epidemiological studies have reported a progressive increase in the incidence of chronic diseases such as hypertension, diabetes, and coronary heart disease with increasing body mass index.1-3 However, despite this well documented evidence, physicians are, in their daily practice, perplexed by the remarkable heterogeneity found in their obese patients. For instance, some patients show a relatively “normal” profile of metabolic risk factors despite the presence of substantial excess body fat, whereas others who are only moderately overweight can nevertheless be characterised by a whole cluster of metabolic complications, increasing the risk of type 2 diabetes, coronary atherosclerosis, and cardiovascular disease.

View this table:

Classification of obesity based on body mass index (BMI)2 3



#### Summary points

A simple measurement such as waist circumference can indicate accumulation of abdominal fat

Viscerally obese men are characterised by an atherogenic plasma lipoprotein profile

A triad of non-traditional markers for coronary heart disease found in viscerally obese middle aged men (hyperinsulinaemia, raised apolipoprotein B concentration, and small LDL particles) increases the risk of coronary heart disease 20-fold

Four out of five middle aged men with a waist measurement ≥90 cm and triglyceride concentrations ≥2 mmol/l are characterised by this triad

Even in the absence of hypercholesterolaemia, hyperglycaemia, or hypertension, obese patients could be at high risk of coronary heart disease if they have this “hypertriglyceridaemic waist” phenotype

In this regard, epidemiological and metabolic studies …
Pneumatic Dilatation and Surgical Myotomy for Achalasia
Authors: Steven R. Lopushinsky, David R. Urbach
Journal: JAMA (2006)

Pneumatic dilatation and surgical (Heller) myotomy are the 2 principal methods for treatment of achalasia. There are no population-based studies comparing outcomes of these 2 treatments in typical practice settings.To compare the outcomes of pneumatic dilatation and surgical myotomy for achalasia.Retrospective longitudinal study using linked administrative health data in Ontario. A total of 1461 persons aged 18 years or older received treatment for achalasia between July 1991 and December 2002, 1181 (80.8%) of whom had pneumatic dilatation and 280 (19.2%) of whom had surgical myotomy as the first procedure.Use of subsequent interventions for achalasia (pneumatic dilatation, surgical myotomy, or esophagectomy) following the first treatment during the study period, subsequent physician visits, and use of gastrointestinal medications among persons aged 65 years or older. We adjusted for confounding variables using regression models.The cumulative risk of any subsequent intervention for achalasia after 1, 5, and 10 years, respectively, was 36.8%, 56.2%, and 63.5% for persons treated initially with pneumatic dilatation and was 16.4%, 30.3%, and 37.5% for persons treated initially with surgical myotomy (adjusted hazard ratio [HR], 2.37; 95% confidence interval [CI], 1.86-3.02; P<.001). Differences in risk were observed only when subsequent pneumatic dilatation was included as an adverse outcome; there was no statistical difference between the 2 groups with respect to the risk of subsequent surgical myotomy or esophagectomy. Compared with persons treated initially with surgical myotomy, those treated with pneumatic dilatation were not statistically different with respect to subsequent physician visits (adjusted rate ratio, 1.01; 95% CI, 1.00-1.03), or time to use of histamine-2 receptor blockers (adjusted HR, 1.19; 95% CI, 0.79-1.80), proton pump inhibitors (HR, 1.02; 95% CI, 0.70-1.49), and prokinetic medications (HR, 0.92; 95% CI, 0.60-1.41).Subsequent intervention after the initial treatment of achalasia is common. Although the risk of subsequent interventions among persons treated with surgical myotomy in typical practice settings is higher than previously thought, the risk of subsequent intervention is greater among persons treated with pneumatic dilatation than with surgical myotomy. This difference is attributable to the use of subsequent pneumatic dilatation rather than surgical procedures.
An extremely interesting time to die
Authors: A. McPherson
Journal: BMJ (2009)

It is now almost 14 years since I wrote my last personal view for the BMJ (1995;310:1339). At that time it was about being given a diagnosis of breast cancer, the treatment and prognosis of which have now improved immeasurably, such that presently breast cancer is more a “chronic” condition than a death sentence, with a five year survival rate of up to 90%. But what about the pancreatic cancer I now have, with a five year survival rate of 4% or worse? Two years after a Whipple procedure I was last week found to have a reoccurrence of my primary cancer, with secondaries in my lung. These are the bare facts. But in spite of their grim significance for me, this really is an extremely interesting time to die, given the present debates over resources, the rulings of the National Institute for Health and Clinical Excellence, developments in palliative care, arguments over assisted death, and the possibility of now being able to see …
High-Grade Urothelial Carcinoma of the Prostate on FDG PET-CT
Authors: Linh Ho, Vicki Quan, Robert Henderson, John Seto
Journal: Clinical Nuclear Medicine (2007)

We report the PET-CT appearance of a high-grade prostatic urothelial carcinoma in a 68-year-old man with a long history of urothelial carcinoma. The patient was initially diagnosed with urothelial carcinoma in the left ureter, status postleft nephrourethrectomy. He was subsequently, 11 years later, diagnosed with low-grade urothelial carcinoma involving the bladder for which he received monthly Bacillus Calmette-Guerin treatment. Three months after the diagnosis of the bladder tumor, he was found to have biopsy-proven high-grade urothelial carcinoma of the prostate for which he was referred to have a PET-CT scan to evaluate for distant metastasis.
Ego Development and Cultural Differences
Authors: CHARLES A. PINDERHUGHES
Journal: American Journal of Psychiatry (1974)

Analogues of aggressive-differentiating and affectionate-affiliating behavior are presumed to exist in human systems at all levels of organization—from cells to supranational organizations. The author offers hypotheses about the nature and relationships of these component subsystems of the body, the personality, and associated social structures. Integrating psychoanalytic, general systems, and physiological perspectives into a conception of the differentiating and affiliating modes in ego attitudes, emotional attachments, cognitive styles, and sociocultural forms, he illustrates his concept with a clinical description of a renal transplant patient.
Mites in the personal environment and their roleb in skin disorders*
Authors: MARK HEWITT, G.I. BARROW, D.C. MILLER, FRANK TURK, STELLA TURK
Journal: British Journal of Dermatology (2006)

An investigation into the incidence and distribution of'ecroparasites'in the close personal environment of patients with chronic unexplained dermatoses is described. Acari were found in 356 samples from 124 of 253 (50%) patients investigated. The house dust mite Dermatophagoides pteronyssinus and related species accounted for 157 (44%) of the 'parasites' identified. The clinical and laboratory parasite recovery techniques are described and their limitations considered. The possible significance of the results is discussed and the need for further work emphasized.
Kidney Swelling
Authors: LENA WALLIN, INGEMAR HELIN, MARIKA BAJC
Journal: Clinical Nuclear Medicine (1997)

Objective: To develop criteria identifying swollen kidneys on dimercaptosuccinic acid (DMSA) renal scintigraphy in acute pyelonephritis with regard to the DMSA distribution pattern, kidney functional size, and radioactive uptake. Subjects and methods: Thirty-eight children aged 15 days to 7 years with known pyelonephritis were examined with DMSA renal scintigraphy. All children were observed 2 or 3 times. In total, 94 scintigrams were evaluated. Qualitative and quantitative criteria for swelling were defined. Results: Thirty-one observed kidneys satisfied the criteria of swelling. Quantitatively, kidney length and width/length were greater in swollen kidneys. Kidney uptake in percent of injected dose and kidney uptake/background were lower in swollen kidneys. Qualitatively, focal radioactive uptake defects known from a previous examination were sometimes obscured by swelling, and reappeared at follow-up. In 5 children with signs of swelling on repeat imaging, scintigraphy reinfection at the time of swelling was verified. Conclusions: Swollen kidneys may be the only sign of acute pyelonephritis on DMSA scintigraphy and swelling may obscure focal radioactive uptake defects. Measurement of kidney size and radioactive uptake can help identify swollen kidneys at DMSA scintigraphy and disclose acute pyelonephritis in the absence of overt clinical symptoms.
Mitochondrial DNA: a new frontier in acquired and inborn gene defects
Authors: T. Randall
Journal: JAMA (1991)

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
Abstract 1086: Discoidin domain receptor 1 contributes to tumorigenesis through modulation of TGFBI expression
Authors: Nandini Rudra-Ganguly, Daulet Satpayev, Christine Lowe, Liping Hu, Bally Randhawa, Mi Sook Chang, Alla Verlinsky, Jeffrey Coleman, Pia Challita-Eid, Peng Yang, Zili An, Karen Morrison, Art Raitano, Daniel S. Pereira, David Stover
Journal: Cancer Research (2012)

Abstract Discoidin domain receptor 1 (DDR1) is a member of the receptor tyrosine kinase family. It is activated by binding to its ligand, collagen and plays a key role in cell survival, adhesion, migration and invasion. Although DDR1 is present in several normal tissues, it is overexpressed in various cancer types, including lung, colon, ovary and breast tumors as well as in gliomas, where it is known to be associated with poor prognosis. The significance of DDR1 in cancer was illustrated using shRNA silencing, which impaired tumor cell growth, both in vitro and in vivo. Using microarray analysis of tumor cells with DDR1 knockdown, we identified an upregulation of TGFBI expression, which was subsequently confirmed at the protein level. TGFBI is a TGFβ induced extracellular matrix protein secreted by tumor cells and has been reported to act as either a tumor promoter or suppressor, depending upon tumor type. Exogenous addition of recombinant TGFBI to tumor cells inhibited clonogenic growth, recapitulating shRNA data. When grown in vivo as xenografts, the DDR1 knockdown cell lines demonstrated a similar phenotype of reduced growth and tumors exhibited an increase in TGFBI protein levels. In summary, our data suggests that DDR1 expression levels influences tumor growth in part through modulation of TGFBI expression. Ongoing studies will help to understand how DDR1 and TGFBI are linked and contribute to tumorigenesis. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 1086. doi:1538-7445.AM2012-1086
1721-51 Transcatheter Management of Pulmonary Atresia/Intact Ventricular Septum (PA/IVS) in 29 Neonates
Authors: Jean-François Piéchaud, Jean Kachaner, Angelica Delogu, Laurence Iserin, Yacine Aggoun, Daniel Sidi
Journal: Journal of the American College of Cardiology (1995)
Aminoglutethimide (with hydrocortisone) induced agranulocytosis in primary breast cancer.
Authors: M D Vincent, H M Clink, R C Coombes, I E Smith, R Kandler, T J Powles
Journal: BMJ (1985)

Reconviction rates of drug dependent patients treated in a residential therapeutic community: 10 year follow up A 10 year follow up study of criminal records and reconvictions of 61 drug dependent patients treated at the Ley Community, Oxford, is reported.
Simultaneous synthesis and degradation of rat liver glycogen. An in vivo nuclear magnetic resonance spectroscopic study.
Authors: M David, W A Petit, M R Laughlin, R G Shulman, J E King, E J Barrett
Journal: Journal of Clinical Investigation (1990)

Using 13C nuclear magnetic resonance spectroscopic methods we examined in vivo the synthesis of liver glycogen during the infusion of D-[1-13C]glucose and the turnover of labeled glycogen during subsequent infusion of D-[1-13C]glucose. In fasted rats the processes of glycogen synthesis and degradation were observed to occur simultaneously with the rate of synthesis much greater than degradation leading to net glycogen synthesis. In fed rats, incorporation of infused D-[1-13C]glucose occurred briskly; however, over 2 h there was no net glycogen accumulated. Degradation of labeled glycogen was greater in the fed versus the fasted rats (P less than 0.001), and the lack of net glycogen synthesis in fed rats was due to degradation and synthesis occurring at similar rates throughout the infusion period. There was no indication that suppression of phosphorylase a or subsequent activation of glycogen synthase was involved in modulation of the flux of tracer into liver glycogen. We conclude that in both fed and fasted rats, glycogen synthase and phosphorylase are active simultaneously and the levels of liver glycogen reached during refeeding are determined by the balance between ongoing synthetic and degradative processes.
Patient satisfaction with treatments for moderate-to-severe plaque psoriasis in clinical practice
Authors: K. Callis Duffin, H. Yeung, J. Takeshita, G.G. Krueger, A.D. Robertson, A.B. Troxel, D.B. Shin, A.S. Van Voorhees, J.M. Gelfand
Journal: British Journal of Dermatology (2013)

Treatment satisfaction among patients with moderate-to-severe psoriasis has not been studied and compared across treatments using a validated instrument.
Labour's plans for health and social care would not require more "top-down" NHS changes, says Burnham
Authors: G. Iacobucci
Journal: BMJ (2013)

Ambitious proposals from the UK Labour Party to merge the budgets for health and social care and mental health services in England would be a challenge without another full scale reorganisation of the NHS, health policy experts have cautioned.

The proposals, launched on 24 January by Labour’s shadow health secretary Andy Burnham,1 have been put forward for consultation by the party, as they seek to formulate the party’s policy for the future of health and social care ahead of the next general election in 2015.

Burnham said that the demands of an ageing population, the changing burden of disease, and the perilous financial …
Optimism and Coping Styles: A Comparison of Candidates for Liver Transplantation with Candidates for Lung Transplantation
Authors: Carol S. Stilley, David J. Miller, Jan D. Manzetti, Ignazio R. Marino, Robert J. Keenan
Journal: Psychotherapy and Psychosomatics (1999)

&lt;i&gt;Background:&lt;/i&gt; Dispositional optimism and adaptive coping styles have been shown to correlate with each other and with physical and psychological well-being in a number of studies with medical patients. Few studies in the transplant literature evaluate psychological characteristics of patients across medical diagnoses. A comparison of optimism and coping styles among candidates for liver and lung transplantation is presented. &lt;i&gt;Method:&lt;/i&gt; Subjects were 73 candidates for lung transplantation at the University of Pittsburgh Medical Center and 76 candidates for liver transplantation at the Pittsburgh VA Healthcare System. All candidates were classified according to medical diagnosis and history of substance abuse (alcohol/drugs or smoking). There were no significant between- or within-group differences on optimism. &lt;i&gt;Results:&lt;/i&gt; There was a significant difference within both groups, according to history of substance abuse on the coping style ‘acceptance’. There were also significant between-group differences on a number of coping styles. &lt;i&gt;Conclusions:&lt;/i&gt; This preliminary study is intended to suggest direction for future research; studying psychological variables known to impact on health apart from medical diagnosis may provide data pertinent to selection criteria and the design of interventions to more effectively maximize the benefit of transplantation for all concerned.
Use of Antibiotics
Authors: CALVIN M. KUNIN
Journal: Annals of Internal Medicine (1973)

Antibiotics are overused in this country. Concern about the problem has been expressed by a Senate investigating committee, the Food and Drug Administration, and by many authorities in the field. Inappropriate use in office practice is common. This is both wasteful and associated with a high frequency of undesirable reactions. Studies in hospitals show that more than half the antibiotics used are not needed, or that an inappropriate agent is chosen, or the dose is incorrect. Antibiotics accounted for 19% to 34% of the pharmacy budgets in three representative hospitals in Madison, Wisconsin. Cephalosporins and aminoglycosides (mostly gentamicin) accounted for 69% of all hospital antibiotic costs. The use of cephalexin, a drug whose cost to the hospital almost equaled all other oral antibiotics combined, has been successfully controlled. Usage of the most expensive agents in hospitals should be controlled. Training in clinical pharmacology should be emphasized throughout the medical school curriculum.
Dorothy Black (nee Stewart)
Authors: D. Archer
Journal: BMJ (2009)

Botulinum toxin, the most potent biological toxin, has become a powerful therapeutic tool for a growing number of clinical applications. This review draws attention to new findings about the mechanism of action of botulinum toxin and briefly reviews some of its most frequent uses, focusing on evidence based data. Double blind, placebo controlled studies, as well as open label clinical trials, provide evidence that, when appropriate targets and doses are selected, botulinum toxin temporarily ameliorates disorders associated with excessive muscle contraction or autonomic dysfunction. When injected not more often than every three months, the risk of blocking antibodies is slight. Long term experience with this agent suggests that it is an effective and safe treatment not only for approved indications but also for an increasing number of off-label indications.
E2F7 Can Regulate Proliferation, Differentiation, and Apoptotic Responses in Human Keratinocytes: Implications for Cutaneous Squamous Cell Carcinoma Formation
Authors: Liliana Endo-Munoz, Alison Dahler, Ngari Teakle, Danny Rickwood, Mehlika Hazar-Rethinam, Ibtissam Abdul-Jabbar, Scott Sommerville, Ian Dickinson, Pritinder Kaur, Sophie Paquet-Fifield, Nicholas Saunders
Journal: Cancer Research (2009)

Abstract The E2F family of transcription factors plays a crucial role in the regulation of genes involved in cell proliferation, differentiation, and apoptosis. In keratinocytes, the inhibition of E2F is a key step in the control and initiation of squamous differentiation. Because the product of the recently identified E2F7a/E2F7b gene has been shown to repress E2F-regulated promoters, and to be abundant in skin, we examined its role in the epidermis. Our results indicate that E2F7b mRNA expression is selectively associated with proliferation-competent keratinocytes. Moreover, E2F7 was able to antagonize E2F1-induced proliferation and apoptosis. In contrast, although E2F7 was able to inhibit proliferation and initiate differentiation, it was unable to antagonize the differentiation suppression induced by E2F1. These data indicate that E2F7-mediated suppression of proliferation and apoptosis acts through E2F1-dependent pathways, whereas E2F7-induced differentiation acts through an E2F1-independent pathway. These data also suggest that proliferation, differentiation, and survival of primary human keratinocytes can be controlled by the relative ratio of E2F1 to E2F7. Because deregulated proliferation, differentiation, and apoptosis are hallmarks of cancer, we examined the expression levels of E2F1 and E2F7 in cutaneous squamous cell carcinomas (CSCC). We found that both genes were overexpressed in CSCCs compared with normal epidermis. Furthermore, inhibition of E2F7 in a SCC cell line sensitized the cells to UV-induced apoptosis and doxorubicin-induced apoptosis. Combined, these data suggest that the selected disruption of E2F1 and E2F7 in keratinocytes is likely to contribute to CSCC formation and may prove to be a viable therapeutic target. [Cancer Res 2009;69(5):1800–9]
Observations on the Kveim reaction using an animal model of granulomatous bowel disease.
Authors: I C Mitchell, J L Turk
Journal: Gut (1991)

Striking differences were observed between the visceral and cutaneous responses after tests with validated Kveim and normal spleen suspensions in a guinea pig model of granulomatous bowel disease. Five of six animals sensitised with BCG showed positive responses at the ileal Kveim test site whereas all six had negative cutaneous Kveim tests. Conversely, two of six animals sensitised with irradiated Mycobacterium leprae showed positive cutaneous Kveim tests and only one a positive response in the ascending colon. All six showed negative responses at the ileal Kveim test site. No positive visceral or cutaneous responses were observed in either group of animals after tests with normal spleen suspension. These findings are discussed in relation to the positive Kveim responses previously reported among patients with Crohn9s disease, tuberculoid and lepromatous leprosy, and among seemingly healthy BCG vaccinated subjects. The findings provide further evidence in support of a possible mycobacterial aetiology for sarcoidosis and Crohn9s disease.
Rural health and higher tobacco taxes are key priorities in India's 2014-15 budget
Authors: S. Bagcchi
Journal: BMJ (2014)

India’s finance minister has laid out new measures in the budget for 2014-15 to strengthen the country’s medical infrastructure and restrict the use of tobacco.

In the budget, announced in parliament on 10 July, Arun Jaitley said that 15 model rural health research centres would be established to provide better healthcare facilities in non-urban areas. The centres will carry out research on local health issues, he said. …