tbuckley/cabot-search huggingface dataset:
Efficacy and toxicity of old and new disease modifying antirheumatic drugs
Authors: P. Tugwell
Journal: Annals of the Rheumatic Diseases (2000)

The goal of disease modifying antirheumatic drug (DMARD) treatment is “to induce remission and maintain control of inflammatory joint disease”.1 Disease modification has been recommended by Edmonds2 to focus on two components, firstly reduction in the structural damage shown by imaging techniques, and secondly improvement/maintenance of health status in association with decreased inflammatory synovitis. The optimal management of patients with rheumatoid arthritis requires the integration of art and evidence-based science to make a clinical judgement. The evidence-based component needs to incorporate the evidence on four aspects: (a) seriousness of the outcomes; (b) evidence for effectiveness and magnitude of treatment effect; (c) risk of adverse effects; and (d) cost effectiveness of treatment.

This affects many aspects as reflected in the “7Ds” listed in figure 1. The impact has often been underestimated, but recent evidence of the increased mortality, the substantial discomforts, psychosocial dysfunction, or physical disability and the costs incurred have now established rheumatoid arthritis as one of the top 10 conditions in the World Health Organisation's listing of the major causes of the burden of disease throughout the world in women.3



Figure 1 
Seriousness of outcome in rheumatoid arthritis: What are the “7Ds”?



For informed decision making about whether and when to start treatment with old and new treatment modalities, clinicians and their patients need to be provided with rigorous evidence on how much improvement has been demonstrated with these drugs.

This should be evidence-based. The most widely accepted approach is to assess the world literature using the Cochrane Collaboration approach to systematic reviews based upon the hierarchy of evidence shown in figure 2. We have completed systematic reviews for many of the “old” DMARDs; and systematic reviews are in progress for the “new” DMARDs such as Leflunomide and the TNF antagonists. Once completed, these are added …
Type II Hyperlipoproteinemia in Mother and Twins
Authors: GERALD B. LEE, GREGORY A. CULLEY, MAREN J. LAWSON, LEON L. ADCOCK, WILLIAM KRIVIT
Journal: Circulation (1969)

A 36-year-old housewife with type II hyperlipoproteinemia became pregnant with twins. Although the pregnancy was uneventful, the serum triglycerides were elevated during the third trimester, the delivery, and early puerperium. The mother had no complications directly related to the pregnancy despite hypercholesterolemia, coronary atherosclerosis, and hypertension. Cord blood cholesterol and beta lipoprotein in both twins were greater than twice normal. Despite this genetic defect in lipid transport the twins have developed normally during their first year of life. Since lipids and lipoproteins do not cross the placental barrier, it is concluded that type II hyperlipoproteinemia may have been present at birth.
Organizational Improvements to Enhance Modern Clinical Epidemiology
Authors: Robert M. Califf
Journal: JAMA (2008)

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 Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Severe Haemolytic Transfusion Reaction due to the Rh Factor
Authors: A. Beck, C. V. Harrison, J. M. Owen
Journal: BMJ (1944)

TRANSFUSION REACTION DUE TO Rh FACTOR BRITISJI times appears to accrue in cases in which evidence of mastoiditis was equivocal at the time of operation.The necessity for operation is governed by persistence of fever, diarrhoea, and/or vomiting and loss of weight despite every effort at resuscitation;the appearance under observation of enlarged posterior cervical glands gives support to the diagnosis, but neither their presence nor.their absence should influence the final decision to operate.There is general agreement that sulphonamides often fail to prevent the onset of mastoiditis and may actually be dangerous in masking the disease.Whether penicillin will succeed where sulphonamides have failed has not been adequately explored, but the present limited experience furnishes grounds for the hope that timely use of the drug will reduce appreciably the high case-fatality of infantile gastro-enteritis. SummaryFive cases of severe acute gastro-enteritis in infancy, with two deaths, are described; in three patients mastoidectomy was per- formed, resulting in (a) rapid resolution of suppurative processes found to be sterile at operation; (b) recovery from staphylococcal septicaemia cured by penicillin; (c) death from staphylococcal septi- caemnia uninfluenced by sulphonamides.Of the remaining two cases one patient with B. coli pyelitis improved rapidly with sulphathiazole while the other died from pneumococcal meningitis and septicaemia, not responding to sulphonamide or penicillin therapy.Our grateful thanks are due to Dr. R. Cruickshank, who carried out the bacteriological examinations, and to Miss Winifred Hall, who undertook the otological work.
Detection of Chlamydia pneumoniaein Human Nonrheumatic Stenotic Aortic Valves
Authors: Jukka Juvonen, Aino Laurila, Tatu Juvonen, Hannu Alakärppä, Heljä-Marja Surcel, Kari Lounatmaa, Johanna Kuusisto, Pekka Saikku
Journal: Journal of the American College of Cardiology (1997)
The Mechanism of Action of ACTH
Authors: Russell Hilf
Journal: New England Journal of Medicine (1965)

SEVERAL years have passed since Haynes and Berthet1 , 2 proposed a theory for the mechanism of action of ACTH in stimulating adrenocorticosteroidogenesis. Considerable research had been performed to test the validity of their theory. It seems advisable, therefore, to evaluate the present status of knowledge in this field and to determine the most fruitful approaches for future investigations.The response of the adrenal gland to specific treatments and to physiologic alterations may provide data that can be correlated with the mechanism of action of ACTH. Consideration of the differences in experimental design are of importance — for example, in vivo versus . . .
Ventilatory and pulmonary vascular response to hypoxia and susceptibility to high altitude pulmonary oedema
Authors: E Hohenhaus, A Paul, RE McCullough, H Kucherer, P Bartsch
Journal: European Respiratory Journal (1995)

Reduced tolerance to high altitude may be associated with a low ventilatory and an increased pulmonary vascular response to hypoxia. We therefore, examined whether individuals susceptible to acute mountain sickness (AMS) or high altitude pulmonary oedema (HAPE) could be identified by noninvasive measurements of these parameters at low altitude. Ventilatory response to hypoxia (HVR) and hypercapnia (HCVR) at rest and during exercise, as well as hypoxic pulmonary vascular response (HPVR) at rest, were examined in 30 mountaineers whose susceptibility was known from previous identical exposures to high altitude. Isocapnic HVR expressed as difference in minute ventilation related to difference in arterial oxygen saturation (delta V'E/ delta Sa,O2) (L.min-1/%) was significantly lower in subjects susceptible to HAPE (mean +/- SEM 0.8 +/- 0.1; n = 10) compared to nonsusceptible controls (1.5 +/- 0.2; n = 10), but was not significantly different from subjects susceptible to AMS (1.2 +/- 0.2; n = 10). Hypercapnic ventilatory response was not significantly different between the three groups. Discrimination between groups could not be improved by measurements of HVR during exercise (50% maximum oxygen consumption (V'O2,max)), or by assessing ventilation and oxygen saturation during a 15 min steady-state exercise (35% V'O2,max) at fractional inspiratory oxygen (FI,O2) of 0.14. Pulmonary artery pressure (Ppa) estimated by Doppler measurements of tricuspid valve pressure at an FI,O2 of 0.21 and 0.12 (10 min) did not lead to a further discrimination between subjects susceptible to HAPE and AMS with the exception of three subjects susceptible to HAPE who showed an exaggerated HPVR. It is concluded that a low ventilatory response to hypoxia is associated with an increased risk for high altitude pulmonary oedema, whilst susceptibility to acute mountain sickness may be associated with a high or low ventilatory response to hypoxia. A reliable discrimination between subjects susceptible to high altitude pulmonary oedema and acute mountain sickness with a low ventilatory response to hypoxia is not possible by Doppler echocardiographic estimations of hypoxic pulmonary vascular response.
Asthma and climatic conditions: experience from Bermuda, an isolated island community.
Authors: M J Carey, I Cordon
Journal: BMJ (1986)

A retrospective study of patients attending the emergency department with acute asthma was performed in Bermuda. Climatic data (barometric pressure, rainfall, humidity, and wind strength and direction) were obtained and compared with frequency of exacerbations of asthma. Three factors--namely, relative humidity, average daily temperature, and northeasterly winds--were found to be related to worsening asthma. Owing to Bermuda's lack of pollution and aeroallergens it was thought that these weather parameters had a direct effect on the asthmatic population.
CIRCULATING THYMIC-HORMONE ACTIVITY IN CONGENITAL IMMUNODEFICIENCY
Authors: V Lewis, J.J Twomey, G Goldstein, E Smithwick, S Pahwa, R O'Reilly, R Pahwa, R.A Good, H Schulte-Wisserman, S Horowitz, R Hong, J Jones, O Sieber, C Kirkpatrick, S Polmar, P Bealmear
Journal: The Lancet (1977)
Elevated Heart-Type Fatty Acid-Binding Protein Levels on Admission Predict an Adverse Outcome in Normotensive Patients With Acute Pulmonary Embolism
Authors: Claudia Dellas, Miriam Puls, Mareike Lankeit, Katrin Schäfer, Mayumi Cuny, Maik Berner, Gerd Hasenfuss, Stavros Konstantinides
Journal: Journal of the American College of Cardiology (2010)
Clinical Utility and Safety of a Protocol for Noncardiac and Cardiac Magnetic Resonance Imaging of Patients With Permanent Pacemakers and Implantable-Cardioverter Defibrillators at 1.5 Tesla
Authors: Saman Nazarian, Ariel Roguin, Menekhem M. Zviman, Albert C. Lardo, Timm L. Dickfeld, Hugh Calkins, Robert G. Weiss, Ronald D. Berger, David A. Bluemke, Henry R. Halperin
Journal: Circulation (2006)

Background— Magnetic resonance imaging (MRI) is an important diagnostic modality currently unavailable for millions of patients because of the presence of implantable cardiac devices. We sought to evaluate the diagnostic utility and safety of noncardiac and cardiac MRI at 1.5T using a protocol that incorporates device selection and programming and limits the estimated specific absorption rate of MRI sequences. Methods and Results— Patients with no imaging alternative and with devices shown to be MRI safe by in vitro phantom and in vivo animal testing were enrolled. Of 55 patients who underwent 68 MRI studies, 31 had a pacemaker, and 24 had an implantable defibrillator. Pacing mode was changed to “asynchronous” for pacemaker-dependent patients and to “demand” for others. Magnet response and tachyarrhythmia functions were disabled. Blood pressure, ECG, oximetry, and symptoms were monitored. Efforts were made to limit the system-estimated whole-body average specific absorption rate to 2.0 W/kg (successful in &gt;99% of sequences) while maintaining the diagnostic capability of MRI. No episodes of inappropriate inhibition or activation of pacing were observed. There were no significant differences between baseline and immediate or long-term (median 99 days after MRI) sensing amplitudes, lead impedances, or pacing thresholds. Diagnostic questions were answered in 100% of nonthoracic and 93% of thoracic studies. Clinical findings included diagnosis of vascular abnormalities (9 patients), diagnosis or staging of malignancy (9 patients), and assessment of cardiac viability (13 patients). Conclusions— Given appropriate precautions, noncardiac and cardiac MRI can potentially be safely performed in patients with selected implantable pacemaker and defibrillator systems.
Further Experiences with Blood Coagulation after Fat Meals and Carbohydrate Meals
Authors: JAIME BORRERO, ERWIN SHEPPARD, IRVING S. WRIGHT
Journal: Circulation (1958)

There have been conflicting reports as to whether the ingestion of fat increases the tendency for the blood to clot, and hence, by implication, the risk of thromboembolic complications in man. In this study the effect of a single meal containing a large amount of fat was compared with that of a practically purely carbohydrate isocaloric meal. Under carefully controlled conditions the clotting time varied widely under fasting conditions, and after both fat and carbohydrate meals the clotting time became longer, shorter, or remain unchanged. The results were unpredictable and although a slight trend toward shortened clotting times was evidenced after the fat meals, the results did not reach accepted statistical standards of probability.
Urinoma complicating papillary necrosis in diabetes.
Authors: Martin Dennis, M Hayes
Journal: BMJ (1984)

Detections par ultrasons d'un urinome (collection d'urine encapsulee) au niveau d'une papille renale necrosee chez une femme de 76 ans diabetique. Traitement efficace par ponction transcutanee guidee par ultrasons
Failure to diagnose infection
Authors: A. R. Holder
Journal: JAMA (1972)

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 Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Abstract 446: BAP1 mutation in mesothelioma and “BAP1 Cancer Syndrome”
Authors: Masaki Nasu, Andrea Napolitano, Sandra Pastorino, Mika Tanji, Erin Flores, Francine Baumann, Amy Powers, Giovanni Gaudino, Harvey I. Pass, Haining Yang, Michele Carbone
Journal: Cancer Research (2014)

Abstract Malignant mesothelioma (MM) is a lethal cancer whose pathogenesis results from complex interactions between host genetics and environmental carcinogens, such as asbestos and erionite fibers. Recently, BAP1 (BRCA associated protein 1) has been identified as a novel MM tumor suppressor gene located at 3p21, a region frequently deleted in MM, which encodes for a deubiquitinase enzyme known to target histones and other proteins. We discovered that germline BAP1 mutations cause a novel cancer syndrome characterized by a significant excess of both pleural and peritoneal MM, uveal and cutaneous melanoma and possibly other tumors. In the same study, we reported that 22% sporadic MM tumors, among the Caucasian population, harbored somatic BAP1 mutations. Several other studies supported a relevant role of BAP1 in MM. However, a significant variation in the frequency of BAP1 mutation was found across different studies and populations. In fact, one research group found BAP1 gene altered in 61% of tumor samples from a Japanese cohort, pointing out to a possible influence of ethnicity on the prevalence of BAP-1 alterations among MM patients. However, the limitations in tumor sample sizes and methodological differences across studies do not allow for conclusive associations. We are now further analyzing BAP1 status and possible clinicopathological associations using different and more sensitive methods, such as MPLA, DNA and RNA sequencing, DNA copy number and methylation. Our preliminary results indicate that, regardless of ethnicity, BAP1 plays a crucial role in MM pathogenesis. More experiments are urgently needed to see whether BAP1 expression could be used in diagnostic, prognostic, or therapeutic settings. The impact of this work will extend to other cancers with BAP1 mutations. Citation Format: Masaki Nasu, Andrea Napolitano, Sandra Pastorino, Mika Tanji, Erin Flores, Francine Baumann, Amy Powers, Giovanni Gaudino, Harvey I. Pass, Haining Yang, Michele Carbone. BAP1 mutation in mesothelioma and “BAP1 Cancer Syndrome”. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 446. doi:10.1158/1538-7445.AM2014-446
Loss of immunity-supported senescence enhances susceptibility to hepatocellular carcinogenesis and progression in Toll-like receptor 2-deficient mice
Authors: Heng Lin, Jun Yan, Ziyan Wang, Fang Hua, Jiaojiao Yu, Wei Sun, Ke Li, Hong Liu, Hongzhen Yang, Qi Lv, Jianfei Xue, Zhuo-Wei Hu
Journal: Hepatology (2012)

Abstract Hepatocellular carcinoma (HCC) is a complication at the endstage of chronic inflammatory liver diseases with dismal prognosis. Targeting of Toll-like receptor (TLR) 2 attenuates tumor metastases; we hypothesized that blocking TLR2 might also play a crucial role in reducing hepatocarcinogenesis. Surprisingly, we found that the genetic deletion of TLR2 increased susceptibility to diethylnitrosamine (DEN), a genotoxic carcinogen that can induce HCC. Indeed, TLR2-deficient mice showed a significant increase in carcinogenesis and progression of HCC as indicated by increases in tumor nodule size, tumor volume, and animal death. The enhanced susceptibility to DEN-induced HCC was associated with a broad-spectrum reduction in the immune response to DEN-induced liver injury. We found that TLR2 deficiency caused a decrease in the infiltration of macrophages and an attenuation of apoptosis signal regulating kinase 1 (ASK1) / p38 mitogen-activated protein kinase (p38 MAPK) / nuclear factor kappa B (NF-κB) signaling, which led to a decrease in the expression of interferon-gamma (IFN-γ), tumor necrosis factor alpha (TNF-α), interleukin (IL)-1α/β, IL-6, and Cxcl-2 as well as suppression of autophagy flux and increases in oxidative stress and p62 aggregation in liver tissue. The defects in immune networks resulted in suppressed p21- and p16/pRb-dependent senescence, which caused an increase in proliferation and a decrease in apoptotic and autophagy-associated cell death in mouse livers. Restoring cellular senescence and autophagy flux by treating TLR2-deficient mice with IFN-γ, a T helper 1 (Th1) cytokine and positive modulator of senescence and autophagy, could attenuate the carcinogenesis and progression of HCC associated with TLR2-deficient animals. Conclusion : The loss of immune networks supporting cellular senescence and autophagy flux is attributed to enhanced susceptibility to DEN-induced hepatocellular carcinogenesis and progression in TLR2-deficient mice. These findings may be used to prevent the development of liver cancer. (Hepatology 2013)
TCT-655 Evaluation of Aortocoronary Saphenous Vein Graft Disease Using Serial Intravascular Ultrasound Imaging. Insights From The Cardiac CAtheterization For Bypass Graft Patency Rate Optimization (CABG-PRO) Study
Authors: Anna Kotsia, Tesfadelt Michael, Bavana Rangan, Carlos DiMaio, Matthias Peltz, Michelle Roesle, Michael Jessen, Bernice Willis, Lampros Michalis, Michail I. Papafaklis, Dimitrios I. Fotiadis, Jeffrey L. Hastings, Jerrold Grodin, Shuaib Abdullah, Subhash Banerjee, Emmanouil Brilakis
Journal: Journal of the American College of Cardiology (2013)
Banding of the Pulmonary Artery
Authors: CARL E. HUNT, GUSTAVE FORMANEK, MYRON A. LEVINE, ALDO CASTANEDA, JAMES H. MOLLER
Journal: Circulation (1971)

The results of banding of the pulmonary artery in 111 children with cardiac malformations associated with excessive pulmonary blood flow are presented. Thirty-three of these children died, eleven either of late band complications or after a corrective operation. Patients with ventricular septal defect represent the largest group of malformation among the 111 patients. The overall mortality for banding in patients with isolated ventricular septal defect is 10%, as compared to 36% in patients with ventricular septal defect complicated by an associated lesion. In all infants with ventricular septal defect banded under age 3 months the mortality is 59%, as compared to a mortality of 21% in those banded after age 3 months and only 7% if banded after age 1 year. The overall mortality figures for pulmonary arterial banding have not changed appreciably since 1966; future improvement in banding mortality will depend on improved postoperative management of these infants. Serial hemodynamic studies in patients banded under the age of 2 years have shown a fall in the pulmonary resistance toward normal, with none showing a progression of pulmonary vascular disease. In several patients thickening of the pulmonary valve occurred as a complication of banding.
Fool's Gold
Authors: Nicholas J. Leeper, Gurpreet Dhaliwal, Sanjay Saint, Ronald M. Witteles
Journal: New England Journal of Medicine (2008)

A 20-year-old man presented to the emergency department after a syncopal episode. During the previous 2 weeks, he had had persistent low-grade fever, anorexia, rhinorrhea, and headache. On the morning of admission, he felt weak and then collapsed while walking into a room; he had no other antecedent symptoms.
The Reciprocity of Recognition — What Medicine Exposes about Self and Other
Authors: Rita Charon
Journal: New England Journal of Medicine (2012)

Mrs. N announced triumphantly that she'd become a U.S. citizen. Her husband, whose English she relied on, said, "She took the test, and then she said the words with her hand like this." He put his hand over his heart. She blushed and shyly pointed to her new hearing aid.
Hyperosmolar Non-ketotic Diabetic Coma: With Particular Reference to Vascular Complications
Authors: M. J. Whelton, D. Walde, C. W. H. Havard
Journal: BMJ (1971)

Two West Indian men with no previous history of diabetes mellitus developed hyperosmolar non-ketotic diabetic coma. Intra-abdominal catastrophes secondary to mesenteric thrombosis played a major part in the death of these patients, in both of whom control of the hyperosmolar state had been achieved. Both patients had evidence of infarction of intestine at necropsy. Vascular thromboses are a major complication of this form of coma and must be considered when such patients develop signs of an acute abdomen.