tbuckley/cabot-search huggingface dataset:
Intervening in primary care against childhood bullying: an increasingly pressing public health need
Authors: Jeremy Dale, Rachel Russell, Dieter Wolke
Journal: Journal of the Royal Society of Medicine (2014)

Childhood bullying is a major risk factor for physical and mental health, educational attainment and social relationships. Epidemiological evidence has highlighted that its adverse consequences continue into adulthood leading to substantial health and wider societal costs. With the advent of cyber bullying, childhood bullying is increasingly pervasive. Children can now be reached and subjected to systematic peer abuse at all times. Given the limited impact of school-based initiatives, there is increasing interest in developing the role of primary care services to support the early identification and response to childhood bullying, but evidence-based interventions are lacking.

This paper considers the scale and health-related consequences of childhood bullying. It argues the need for greater awareness and responsiveness in primary care as part of a community-wide, integrated approach to stemming its harmful effects. Primary care is well-placed to identify affected children, provide support to children and their parents to help improve coping skills and mitigate the effects of bullying, where necessary making referrals to appropriate agencies for associated physical and mental health problems. However, evidence-based guidance on how best to achieve this is lacking. Effective interventions that can be delivered in primary care to identify affected children and intervene to minimise the consequences of being bullied are needed, and this paper suggests a number of research questions that need to be addressed.
An Acute Effect of Cigarette Smoking on Platelet Function
Authors: PETER H. LEVINE
Journal: Circulation (1973)

In a controlled, double blind study, the smoking of a single cigarette has been shown to increase the platelet's response to a standard aggregating stimulus. This phenomenon appears to be specifically related to the inhaling of tobacco smoke; it does not follow the smoking of lettuce leaf filled cigarettes. The platelet effect seems independent of the rise in plasma free fatty acids which follows cigarette smoking. Smoking-induced potentiation of platelet aggregation may help to explain the increased incidence of arterial thrombi and/or atheromatous plaques in cigarette smokers.
Rates for obstetric intervention among private and public patients in Australia: population based descriptive study
Authors: C. L Roberts
Journal: BMJ (2000)

<h3>Abstract</h3> <b>Objective:</b> To compare the risk profile of women receiving public and private obstetric care and to compare the rates of obstetric intervention among women at low risk in these groups. <b>Design:</b> Population based descriptive study. <b>Setting:</b> New South Wales, Australia. <b>Subjects:</b> All 171 157 women having a live baby during 1996 and 1997. <b>Interventions:</b> Epidural, augmentation or induction of labour, episiotomy, and births by forceps, vacuum, or caesarean section. <b>Main outcome measures:</b> Risk profile of public and private patients, intervention rates, and the accumulation of interventions by both patient and hospital classification (public or private). <b>Results:</b> Overall, the frequency of women classified as low risk was similar (48%) among those choosing private obstetric care and those receiving standard care in a public hospital. Among low risk women, rates of obstetric intervention were highest in private patients in private hospitals, lowest in public patients, and generally intermediate for private patients in public hospitals. Among primiparas at low risk, 34% of private patients in private hospitals had a forceps or vacuum delivery compared with 17% of public patients. For multiparas the rates were 8% and 3% respectively. Private patients were significantly more likely to have interventions before birth (epidural, induction or augmentation) but this alone did not account for the increased interventions at birth, particularly the high rates of instrumental births. <b>Conclusions:</b> Public patients have a lower chance of an instrumental delivery. Women should have equal access to quality maternity services, but information on the outcomes associated with the various models of care may influence their choices.
Cerebrospinal Fluid Analysis in the Workup of GLUT1 Deficiency Syndrome
Authors: Wilhelmina G. Leen, Ron A. Wevers, Erik-Jan Kamsteeg, Hans Scheffer, Marcel M. Verbeek, Michèl A. Willemsen
Journal: JAMA Neurology (2013)

GLUT1 deficiency syndrome is a treatable neurometabolic disorder, characterized by a low concentration of glucose in cerebrospinal fluid (CSF) and a decreased CSF to blood glucose ratio. Reports of patients with apparently normal CSF glucose levels, however, have raised the question whether CSF analysis is a reliable screening tool for GLUT1 deficiency syndrome.To determine the value of CSF analysis in the workup of GLUT1 deficiency syndrome.PubMed was searched until July 2012 by using the terms glucose transporter 1 (GLUT-1) deficiency syndrome, glucose transporter defect, and SLC2A1-gene. Relevant references mentioned in the articles were also included. The CSF results of all patients with genetically proven GLUT1 deficiency syndrome described in literature were reevaluated.The levels of glucose in CSF, the CSF to blood glucose ratios, and the levels of lactate in CSF were reported for 147 (94%), 152 (97%), and 73 (46%) of 157 patients, respectively. The CSF glucose levels ranged from 16.2 to 50.5 mg/dL and were at or below the 10th percentile for all 147 patients. The CSF to blood glucose ratios ranged from 0.19 to 0.59 and were at or below the 10th percentile for 139 of 152 patients (91%), but they could be within the normal range as well. The CSF lactate levels ranged from 5.4 to 13.5 mg/dL and were at or below the 10th percentile for 59 of 73 patients (81%). A typical CSF profile for GLUT1 deficiency syndrome, which is defined as a CSF glucose level at or below the 10th percentile, a CSF to blood glucose ratio at or below the 25th percentile, and a CSF lactate level at or below the 10th percentile, was found in only 35 of 4099 CSF samples (0.9%) present in our CSF database of patients who received a diagnosis other than GLUT1 deficiency syndrome.We conclude that if age-specific reference values are applied, CSF glucose and lactate levels are adequate biomarkers in the diagnostic workup of GLUT1 deficiency syndrome. Future availability of whole-exome sequencing in clinical practice will make the existence of a reliable biomarker for GLUT1 deficiency syndrome even more important, in order to interpret genetic results and, even more importantly, not to miss SLC2A1-negative patients with GLUT1 deficiency syndrome.
Patient Care: Flowcharts on Diskette
Authors: Alan A. Aronson
Journal: JAMA (1992)

Patient Care: Flowcharts on Diskette is a computerized equivalent of the successful format found in the journal Patient Care . The program uses the concept of the algorithm to teach the subject under consideration. An algorithm divides any subject into subsets or trees, which is probably the way the clinician approaches a problem, and the computer is programmed accordingly.  There are two modes to the program, an interactive mode and a map mode. The interactive mode allows the user to view one of the algorithm boxes with the ability to query the program, answer the question, or read a background box that contains the latest information on a subject. The map mode allows one to see part of the algorithm tree. This gives the user an idea of where he or she is in the overall subject under discussion.  The instructions for loading the program, whether on hard disk or with
Artificial Insemination by Donors: The Need for Genetic Screening
Authors: William G. Johnson, Robin C. Schwartz, Abe M. Chutorian
Journal: New England Journal of Medicine (1981)

ARTIFICIAL insemination by donor has become a widely accepted method to induce pregnancy for infertile couples and to decrease the risk of inherited diseases. With increasing use of this method, however, some infants with genetic diseases will be born from such pregnancies. The only recent study1 of practices and policies in donor insemination concluded that donors of semen were screened only superficially for genetic diseases, although 26 per cent of physicians practicing donor insemination used the procedure to prevent transmission of a genetic disease.The GM2-gangliosidoses are recessively inherited deficiencies of the enzyme beta-D-Ɲ-acetylhexosaminidase2; in these disorders, . . .
Methotrexate treatment of rheumatoid arthritis: is a fortnightly maintenance schedule enough?
Authors: M Tishler, D Caspi, M Yaron
Journal: Annals of the Rheumatic Diseases (1992)

In 15 patients with rheumatoid arthritis who were in clinical remission the weekly regimen of methotrexate treatment was changed to fortnightly without a change in dose. A total of 13 patients completed a 12 month trial. No change in clinical or laboratory parameters occurred. There was no change in the use of analgesics or non-steroidal anti-inflammatory drugs and the patients remained in remission. Two patients had to be withdrawn after two and four months respectively because of a flare in disease activity. It is suggested that in most patients with rheumatoid arthritis who are treated with methotrexate and whose disease activity is stable a fortnightly regimen can be permitted without affecting drug efficacy.
Role of Platelet-derived Growth Factor and Vascular Endothelial Growth Factor in Obliterative Airway Disease
Authors: Jussi M. Tikkanen, Maria Hollmén, Antti I. Nykänen, Jeanette Wood, Petri K. Koskinen, Karl B. Lemström
Journal: American Journal of Respiratory and Critical Care Medicine (2006)

Rationale: Platelet-derived growth factor (PDGF) is an important smooth muscle cell mitogen, and vascular endothelial growth factor (VEGF) is a known angiogenic and proinflammatory growth factor. We hypothesized that specific therapy aimed at these growth factors might inhibit the development of experimental obliterative airway disease (OAD).Methods: In fully mismatched rat tracheal allografts, we used imatinib and PTK/ZK, either alone or in combination, to block PDGF and VEGF receptor protein tyrosine kinase (RTK) action, respectively. Prophylaxis was initiated at the time of transplantation. Early treatment was commenced on Day 7 during the inflammatory phase and late treatment on Day 14 during the fibroproliferative phase of OAD. No immunosuppression was administered.Measurements and Main Results: Prophylaxis with either PTK/ZK or imatinib alone significantly reduced OAD, and combined prophylaxis completely prevented its development. Early treatment with PTK/ZK and imatinib also effectively reduced the development of OAD. Late treatment failed to show significant efficacy. Blocking VEGF RTK action with PTK/ZK reduced the activation of allograft blood vessels and the number of lymph vessels in the allograft airway wall, and significantly diminished allograft inflammation, whereas PDGF blockade with imatinib inhibited the growth of smooth muscle cells in the proliferating lesion.Conclusions: Combined prophylactic PDGF and VEGF RTK blockade completely prevents the development of OAD. Also, when early treatment with PTK/ZK and imatinib is commenced during the inflammatory phase of OAD development, it significantly attenuates the development of tracheal occlusion, suggesting that these drugs could potentially be used to treat bronchiolitis obliterans syndrome in its early phase.
Mutations in the human SC4MOL gene encoding a methyl sterol oxidase cause psoriasiform dermatitis, microcephaly, and developmental delay
Authors: Miao He, Lisa E. Kratz, Joshua J. Michel, Abbe N. Vallejo, Laura Ferris, Richard I. Kelley, Jacqueline J. Hoover, Drazen Jukic, K. Michael Gibson, Lynne A. Wolfe, Dhanya Ramachandran, Michael E. Zwick, Jerry Vockley
Journal: Journal of Clinical Investigation (2011)

Defects in cholesterol synthesis result in a wide variety of symptoms, from neonatal lethality to the relatively mild dysmorphic features and developmental delay found in individuals with Smith-Lemli-Opitz syndrome. We report here the identification of mutations in sterol-C4-methyl oxidase–like gene (SC4MOL) as the cause of an autosomal recessive syndrome in a human patient with psoriasiform dermatitis, arthralgias, congenital cataracts, microcephaly, and developmental delay. This gene encodes a sterol-C4-methyl oxidase (SMO), which catalyzes demethylation of C4-methylsterols in the cholesterol synthesis pathway. C4-Methylsterols are meiosis-activating sterols (MASs). They exist at high concentrations in the testis and ovary and play roles in meiosis activation. In this study, we found that an accumulation of MASs in the patient led to cell overproliferation in both skin and blood. SMO deficiency also substantially altered immunocyte phenotype and in vitro function. MASs serve as ligands for liver X receptors α and β(LXRα and LXRβ), which are important in regulating not only lipid transport in the epidermis, but also innate and adaptive immunity. Deficiency of SMO represents a biochemical defect in the cholesterol synthesis pathway, the clinical spectrum of which remains to be defined.
Treatment-Dependent Androgen Receptor Mutations in Prostate Cancer Exploit Multiple Mechanisms to Evade Therapy
Authors: Mara P. Steinkamp, Orla A. O'Mahony, Michele Brogley, Haniya Rehman, Elizabeth W. LaPensee, Saravana Dhanasekaran, Matthias D. Hofer, Rainer Kuefer, Arul Chinnaiyan, Mark A. Rubin, Kenneth J. Pienta, Diane M. Robins
Journal: Cancer Research (2009)

Abstract Mutations in the androgen receptor (AR) that enable activation by antiandrogens occur in hormone-refractory prostate cancer, suggesting that mutant ARs are selected by treatment. To validate this hypothesis, we compared AR variants in metastases obtained by rapid autopsy of patients treated with flutamide or bicalutamide, or by excision of lymph node metastases from hormone-naïve patients. AR mutations occurred at low levels in all specimens, reflecting genetic heterogeneity of prostate cancer. Base changes recurring in multiple samples or multiple times per sample were considered putative selected mutations. Of 26 recurring missense mutations, most in the NH2-terminal domain (NTD) occurred in multiple tumors, whereas those in the ligand binding domain (LBD) were case specific. Hormone-naïve tumors had few recurring mutations and none in the LBD. Several AR variants were assessed for mechanisms that might underlie treatment resistance. Selection was evident for the promiscuous receptor AR-V716M, which dominated three metastases from one flutamide-treated patient. For the inactive cytoplasmically restricted splice variant AR23, coexpression with AR enhanced ligand response, supporting a decoy function. A novel NTD mutation, W435L, in a motif involved in intramolecular interaction influenced promoter-selective, cell-dependent transactivation. AR-E255K, mutated in a domain that interacts with an E3 ubiquitin ligase, led to increased protein stability and nuclear localization in the absence of ligand. Thus, treatment with antiandrogens selects for gain-of-function AR mutations with altered stability, promoter preference, or ligand specificity. These processes reveal multiple targets for effective therapies regardless of AR mutation. [Cancer Res 2009;69(10):4434–42]
The LiP (Lifestyle in Pregnancy) Study
Authors: Christina A. Vinter, Dorte M. Jensen, Per Ovesen, Henning Beck-Nielsen, Jan S. Jørgensen
Journal: Diabetes Care (2011)

OBJECTIVE To study the effects of lifestyle intervention on gestational weight gain (GWG) and obstetric outcomes. RESEARCH DESIGN AND METHODS The LiP (Lifestyle in Pregnancy) study was a randomized controlled trial in 360 obese women allocated in early pregnancy to lifestyle intervention or control. The intervention program included dietary guidance, free membership in fitness centers, physical training, and personal coaching. RESULTS A total of 360 obese pregnant women were included, and 304 (84%) were followed up until delivery. The intervention group had a significantly lower median (range) GWG compared with the control group of 7.0 (4.7–10.6) vs. 8.6 kg (5.7–11.5; P = 0.01). The Institute of Medicine (IOM) recommendations on GWG were exceeded in 35.4% of women in the intervention group compared with 46.6% in the control group (P = 0.058). Overall, the obstetric outcomes between the two groups were not significantly different. CONCLUSIONS Lifestyle intervention in pregnancy resulted in limited GWG in obese pregnant women. Overall obstetric outcomes were similar in the two groups. Lifestyle intervention resulted in a higher adherence to the IOM weight gain recommendations; however, a significant number of women still exceeded the upper threshold.
The Value of Targeted Case Management During Transitional Care
Authors: Peter A. Boling
Journal: JAMA (1999)

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
Glutamate Receptor Ion Channels: Structure, Regulation, and Function
Authors: Stephen F. Traynelis, Lonnie P. Wollmuth, Chris J. McBain, Frank S. Menniti, Katie M. Vance, Kevin K. Ogden, Kasper B. Hansen, Hongjie Yuan, Scott J. Myers, Ray Dingledine
Journal: Pharmacological Reviews (2010)

The mammalian ionotropic glutamate receptor family encodes 18 gene products that coassemble to form ligand-gated ion channels containing an agonist recognition site, a transmembrane ion permeation pathway, and gating elements that couple agonist-induced conformational changes to the opening or closing of the permeation pore. Glutamate receptors mediate fast excitatory synaptic transmission in the central nervous system and are localized on neuronal and non-neuronal cells. These receptors regulate a broad spectrum of processes in the brain, spinal cord, retina, and peripheral nervous system. Glutamate receptors are postulated to play important roles in numerous neurological diseases and have attracted intense scrutiny. The description of glutamate receptor structure, including its transmembrane elements, reveals a complex assembly of multiple semiautonomous extracellular domains linked to a pore-forming element with striking resemblance to an inverted potassium channel. In this review we discuss International Union of Basic and Clinical Pharmacology glutamate receptor nomenclature, structure, assembly, accessory subunits, interacting proteins, gene expression and translation, post-translational modifications, agonist and antagonist pharmacology, allosteric modulation, mechanisms of gating and permeation, roles in normal physiological function, as well as the potential therapeutic use of pharmacological agents acting at glutamate receptors.
Exposure of human islets to cytokines can result in disproportionately elevated proinsulin release
Authors: Katleen Hostens, Dejan Pavlovic, Yasmeeni Zambre, Zhidong Ling, Christiaan Van Schravendijk, Décio L. Eizirik, Daniel G. Pipeleers
Journal: Journal of Clinical Investigation (1999)

Infiltration of immunocytes into pancreatic islets precedes loss of β cells in type 1 diabetes. It is conceivable that local release of cytokines affects the function of β cells before their apoptosis. This study examines whether the elevated proinsulin levels that have been described in prediabetes can result from exposure of β cells to cytokines. Human β-cell preparations were cultured for 48 or 72 hours with or without IL-1β, TNF-α, or IFN-γ, alone or in combination. None of these conditions were cytotoxic, nor did they reduce insulin biosynthetic activity. Single cytokines did not alter medium or cellular content in insulin or proinsulin. Cytokine combinations, in particular IL-1β plus IFN-γ, disproportionately elevated medium proinsulin levels. This effect expresses an altered functional state of the β cells characterized by preserved proinsulin synthesis, a slower hormone conversion, and an increased ratio of cellular proinsulin over insulin content. The delay in proinsulin conversion can be attributed to lower expression of PC1 and PC2 convertases. It is concluded that disproportionately elevated proinsulin levels in pre–type 1 diabetic patients might result from exposure of their β cells to cytokines released from infiltrating immunocytes. This hormonal alteration expresses an altered functional state of the β cells that can occur independently of β-cell death.
Patients' demands for prescriptions in primary care
Authors: N. Britten
Journal: BMJ (1995)

The Audit Commission's recent report on prescribing in general practice in England and Wales estimated that up to pounds sterling275m could be saved from the NHS drugs bill if overprescribing was reduced.1 The report lists several overprescribed drugs, including antibiotics and non-steroidal anti-inflammatory drugs. The authors clearly believe that patients' expectations of treatment are partly responsible for the problem, as do many general practitioners.2 Perhaps the most memorable view came from Marinker, who said, “We may see the doctor as helpless in the face of a population of patients who have an overwhelming need to alter chemically their experiences of the world in which they live.”3 He compared a general practitioner in a consulting room to a barmaid in a gin shop, implying that not only do patients know exactly what they want but that they usually get it. But what evidence is there that patients' demands for prescriptions have any effect on doctors' prescribing habits other than prompting repeat prescribing?

Much of the …