tbuckley/cabot-search huggingface dataset:
WHO revises upwards estimated number of TB deaths associated with HIV
Authors: J. Zarocostas
Journal: BMJ (2009)

The World Health Organization said this week that more than 450 000 of the people who died from tuberculosis in 2007 were infected with HIV, more than double the estimated global total of 200 000 in 2006.

But it attributed the increase mainly to a big rise in testing for HIV among people being treated for tuberculosis, particularly in Africa.

“These findings point to an urgent need . . . to test for HIV in all patients with TB in order to provide prevention, treatment, and care,” said Margaret Chan, WHO’s director general.

“Countries can only do that through stronger collaboration programmes and stronger health systems that address both diseases,” …
The pharmacogenetics of imanitib
Authors: Stéphanie Dulucq, Maja Krajinovic
Journal: Genome Medicine (2010)

Imatinib mesylate (IM), a tyrosine kinase inhibitor, is one of the first molecularly targeted therapies to have been used in the clinic. It has proven to be efficient in the treatment of chronic myeloid leukemia and also in other malignancies that involve expression of a tyrosine kinase. However, some patients can develop resistance and others suffer from toxic side effects. The pharmacokinetics of IM depends on several enzymes and transporters, and several studies have attempted to identify genetic factors associated with variable drug levels and clinical responses using a candidate gene approach. Larger and more homogenous studies are still needed to replicate the findings obtained so far, or to analyze other genetic variations to get clearer insights into how IM treatment can be tailored to each patient's genetics. Here we summarize pharmacogenetic studies of IM and highlight the genetic markers that could be used to improve the treatment and management of diseases for which IM is used.
FACTORS INFLUENCING MUSCLE DAMAGE FROM ISOMETRIC EXERCISE
Authors: T Allen, T Jones, A Tsay, D Morgan, U Proske
Journal: British Journal of Sports Medicine (2014)

Background Most studies of exercise-induced muscle injury have focussed on eccentric contractions, which are known to produce damage and delayed soreness. It is less well known that isometric contractions also produce damage and soreness. This is a study of the damaging effects of isometric exercise. Objective To investigate the contributions of factors such as muscle length, force level, duration of contraction and number of contractions to muscle damage following isometric exercise of elbow flexor muscles. Design The study comprised 6 separate experiments using a repeated measures design. One arm acted as the experimental arm, while the other acted as the control. Damage measures were obtained pre-exercise, then at 0h, 2h and 24h post-exercise. Setting Exercise laboratory. Participants 50 untrained adults (29 male, 21 female) with no previous upper limb injuries. Interventions Exercise with isometric maximum voluntary contractions (MVCs) by each arm. The control arm always performed 30 MVCs, each 4s duration at an included elbow angle of 155° (long muscle length), with 1 min rest between contractions. In 6 experiments, altered variables for the experimental arm included muscle length, number of contractions, duration of contractions and duration of relaxation. Main outcome measurements Damage measures: MVC force, soreness rating, tenderness threshold. Exercise measures: muscle force, joint angle, contraction number, contraction duration, relaxation time, total contraction time. Results Post-exercise force deficit and muscle soreness were significantly greater for muscles exercised at longer length, despite force being significantly lower at these lengths. A longer relaxation phase did not significantly increase force deficit or soreness. The total contraction time had a greater influence on force deficit than either the number or duration of contractions. Conclusions Muscle damage from isometric contractions was principally related to muscle length and total contraction time, not number of contractions. Damage predominantly occurred during the plateau phase of each contraction and not the relaxation phase.
Early morning headache with vomiting in a 5 year old boy
Authors: B. R. T. Jones, S. A. Renowden, S. P. Lowis, K. M. Kurian
Journal: BMJ (2013)

A 5½ year old boy presented with a 10 day history of progressively worsening early morning headache, with vomiting and subsequent development of slurred speech. Before this presentation his development had been normal, with no delay in developmental milestones or abnormality in vision. He was referred to the emergency department for an urgent magnetic resonance imaging (MRI) scan, which showed a tumour arising from the fourth ventricle with a maximum dimension of 3 cm. There was slight dilation of the fourth ventricle, but no hydrocephalus or obvious disease in the spine or leptomeninges.

He underwent craniotomy and gross total excision of the mass. Cytological examination of the cerebrospinal fluid showed no malignant cells. Histological examination of the tumour showed that it was a medulloblastoma, with large pale nuclei (high nuclear to cytoplasmic ratio), cell-cell wrapping, and a high mitotic rate. There were several foci of apoptosis but no sheets of necrosis. Molecular analysis of the tumour showed that the c-Myc and N-Myc genes were amplified. Chemotherapy was started in accordance with Children Cancer and Leukaemia Group guidelines. This involves high dose intensity chemotherapy followed by craniospinal hyperfractionated accelerated radiotherapy.



### 1 What is the differential diagnosis for his initial presenting symptoms of early morning headache with vomiting?

#### Short answer

Although relatively short, the history of early morning vomiting and slurred speech suggests a neurological cause. Differential diagnoses include raised intracranial pressure, migraine, and viral meningitis. Lack of meningism or signs of sepsis suggest that raised intracranial pressure is the most likely cause.

#### Long answer

A 10 day history of early morning …
Has the Time Come to Recommend Catheter Ablation of Atrial Fibrillation as First-Line Therapy?
Authors: Hugh Calkins
Journal: JAMA (2014)

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
Tacrolimus/sirolimus vs tacrolimus/methotrexate as GVHD prophylaxis after matched, related donor allogeneic HCT
Authors: Corey Cutler, Brent Logan, Ryotaro Nakamura, Laura Johnston, Sung Choi, David Porter, William J. Hogan, Marcelo Pasquini, Margaret L. MacMillan, Jack W. Hsu, Edmund K. Waller, Stephan Grupp, Philip McCarthy, Juan Wu, Zhen-Huan Hu, Shelly L. Carter, Mary M. Horowitz, Joseph H. Antin
Journal: Blood (2014)
A SIMPLE AND PRACTICAL METHOD FOR THE PREPARATION OF PURE BUTTERMILK
Authors: Sverre Oftedal
Journal: JAMA (1913)

The rôle of buttermilk, particularly in the artificial feeding of infants and in the treatment of gastro-intestinal disorders of the first two years of life, has made its use a matter of necessity among rich and poor alike. A practical method for its preparation seems, therefore, to be a matter of considerable importance. This idea was suggested through a study of the recent work of Clock and others along the lines of the lactic acid bacillus principle of treatment, and its use is largely based on the administration of the culture of the<i>Bacillus lactis bulgaricus</i>, Type A (Grigoroff), although its preparation is not necessarily dependent on this form of lactic acid bacillus culture preparation. There are two methods for the preparation of buttermilk according to this principle, the choice of which would depend on whether the physician or trained nurse is able to carry out the work in person,
miRTRAP, a computational method for the systematic identification of miRNAs from high throughput sequencing data
Authors: David Hendrix, Michael Levine, Weiyang Shi
Journal: Genome biology (2010)

Abstract MicroRNAs (miRs) have been broadly implicated in animal development and disease. We developed a novel computational strategy for the systematic, whole-genome identification of miRs from high throughput sequencing information. This method, miRTRAP, incorporates the mechanisms of miR biogenesis and includes additional criteria regarding the prevalence and quality of small RNAs arising from the antisense strand and neighboring loci. This program was applied to the simple chordate Ciona intestinalis and identified nearly 400 putative miR loci.
The impact of timing and prioritization on the cost-effectiveness of birth cohort testing and treatment for hepatitis C virus in the United States
Authors: Phil McEwan, Thomas Ward, Yong Yuan, Ray Kim, Gilbert L'Italien
Journal: Hepatology (2013)

Recent United States guidelines recommend one-time birth cohort testing for hepatitis C infection in persons born between 1945 and 1965; this represents a major public health policy undertaking. The purpose of this study was to assess the role of treatment timing and prioritization on predicted cost-effectiveness. The MONARCH hepatitis C lifetime simulation model was used in conjunction with a testing and treatment decision tree to estimate the cost-effectiveness of birth cohort versus risk-based testing incorporating information on age, fibrosis stage and treatment timing. The study used a 1945-1965 birth cohort and included disease progression, testing and treatment-related parameters. Scenario analysis was used to evaluate the impact of hepatitis C virus (HCV) prevalence, treatment eligibility, age, fibrosis stage and timing of treatment initiation on total costs, quality-adjusted life years (QALYs), HCV-related complications and cost-effectiveness. The cost-effectiveness of birth cohort versus risk-based testing was $28,602. Assuming 91% of the population is tested, at least 278,000 people need to be treated for birth cohort testing to maintain cost-effectiveness. Prioritizing treatment toward those with more advanced fibrosis is associated with a decrease in total cost of $7.5 billion and 59,035 fewer HCV-related complications. Total QALYs and complications avoided are maximized when treatment initiation occurs as soon as possible after testing.This study confirms that birth cohort testing is, on average, cost-effective. However, this remains true only when enough tested and HCV-positive subjects are treated to generate sufficient cost offsets and QALY gains. Given the practical and financial challenges associated with implementing birth cohort testing, the greatest return on investment is obtained when eligible patients are treated immediately and those with more advanced disease are prioritized.
Electronic patient records in primary care: Study has serious flaw
Authors: N T Shaw
Journal: BMJ (2003)

<h3>Abstract</h3> There is growing evidence that racial and ethnic minorities bear a disproportionate burden from COVID-19. Temporal changes in the pandemic epidemiology and diversity in the clinical course require careful study to identify determinants of poor outcomes. We analyzed 6255 individuals admitted with PCR-confirmed COVID-19 to one of 5 hospitals in the University of Pennsylvania Health System between March 2020 and March 2021, using electronic health records to assess risk factors and outcomes through 8 weeks post-admission. Discharge, readmission and mortality outcomes were analyzed in a multi-state model with multivariable Cox models for each transition. Mortality varied markedly over time, with cumulative incidence (95% CI) 30 days post-admission of 19.1% (16.9, 21.3) in March-April 2020, 5.7% (4.2, 7.5) in July-October 2020 and 10.5% (9.1,12.0) in January-March 2021; 26% of deaths occurred after discharge. Average age (SD) at admission varied from 62.7 (17.6) to 54.8 (19.9) to 60.5 (18.1); mechanical ventilation use declined from 21.3% to 9-11%. Compared to Caucasian, Black race was associated with more severe disease at admission, higher rates of co-morbidities and low-income resident zip code. Between-race risk differences in mortality risk diminished in multivariable models; while admitting hospital, increasing age, admission early in the pandemic, and severe disease and low blood pressure at admission were associated with increased mortality hazard. Hispanic ethnicity was associated with fewer baseline co-morbidities and lower mortality hazard (0.57, 95% CI: 0.37, .087). Multi-state modeling allows for a unified framework to analyze multiple outcomes throughout the disease course. Morbidity and mortality for hospitalized COVID-19 patients varied over time but post-discharge mortality remained non-trivial. Black race was associated with more risk factors for morbidity and with treatment at hospitals with lower mortality. Multivariable models suggest there are not between-race differences in outcomes. Future work is needed to better understand the identified between-hospital differences in mortality.
Excision of the Uterus by the Vaginal (Three Cases) and Laparo-Vaginal Methods (One Case) for Cancer
Authors: J. Wallace
Journal: BMJ (1884)

the time, the pain wa § relieved, and the temperature reduced to 99'.I ordered her to continue one drop three times a day.At the end of a week, the pain continued, though the temperature stood at 99°. 10.A female, aged 45, had severe spasmodic asthma with distressing exacerbations.Tincture of aconite in drop-doses, given every ten minutes for two hours, gave no relief during an exacerbation.lThis drug was also continued every four hours for a fortnight in drop- doses.It did no-good.Much relief was experienced from amyl-ni.trate.and some also from nitro-glycerine.The heart was sound.11.This was a case of aortic regurgitation, with slight albuminuria.The tincture of aconite was given in one-drop doses three times daily for six weeks.In this case, the cardiac action was quieted, and
Long-term Ventricular Pacing in Treatment of Sinoatrial Block
Authors: T. J. Bayley
Journal: BMJ (1971)

Six patients with symptoms due to sinoatrial block are described in whom no relief or improvement in block occurred when they were treated with isoprenaline or ephedrine. All six patients were treated by ventricular cardiac pacing with complete relief of symptoms. Despite the theoretical disadvantages of parasystole and loss of accrochage in treating these patients by ventricular pacing they have survived for periods of 18 months to over five years.
Aspartame ingestion with and without carbohydrate in phenylketonuric and normal subjects: Effect on plasma concentrations of amino acids, glucose, and insulin
Authors: Louise C. Wolf-Novak, Lewis D. Stagink, Marvin C. Brummel, Thomas J. Persoon, L.J. Filer, Edward F. Bell, Ekhard E. Ziegler, Wilma L. Krause
Journal: Metabolism (1990)
Lymphoid-like fibroblast reticular cells in the secondary lymphoid tissues and tumor microenvironment induce immunosuppression via maintaining the tolerogenic function of myeloid populations
Authors: Yan Cui, Gang Guo
Journal: Journal for ImmunoTherapy of Cancer (2014)

Meeting abstracts Recently, compelling evidence reveals that stromal populations, especially the fibroblastic reticular cells (FRC), of the secondary lymphoid organs (SLO) not only serve as structure scaffold for organizing and maintaining the structure of the lymphoid tissues, but also possess
A Clinic for Physical Treatment in London
Authors: J. Mennell
Journal: BMJ (1927)

Sir,?In view of the prominence given in your issue of November 12th (p. 893) to a proposed clinic for physical treatment in London, may I draw attention to the fact that at the Physical Treatment Centre, Kensington, an attempt has already been made to meet the deficiency referred to in the article. In a footnote three typical cases from the clinic at Amsterdam are quoted to indicate the need for physical treatment centres. Our case sheets could provide similar cases by the score, if not by the hundred. All the ordinary forms of physical treatment are carried out here with the solitary exception of hydrotherapy. In the article mentioned it is saict,  Such clinics . . . have proved their value in other countries. I think we may justly claim that this clinic has proved its value in London, and at the present moment we have well over two hundred cases attending regularly for treatment?this without any official recognition from any approved society. The clinic was founded to meet the necessity of pro viding physical treatment for those who are ineligible, or socially unsuitable, for a hospital clinic, and who are yet j not in a position to secure the treatment privately. We also provide evening treatment so as to enable patients to come to us without interfering with their work. The numbers who avail themselves of this opportunity are ample proof of the need. The rules of this clinic are:
Methylation framework of cell cycle gene inhibitors in cirrhosis and associated hepatocellular carcinoma
Authors: Massimo Roncalli, Paolo Bianchi, Barbara Bruni, Luigi Laghi, Annarita Destro, Sonia Di Gioia, Leandro Gennari, Maurizio Tommasini, Alberto Malesci, Guido Coggi
Journal: Hepatology (2002)

One of the main regulatory pathways reported to be altered in hepatocellular carcinoma (HCC) is that of cell cycle control involving RB1 gene-related cell inhibitors. We investigated p14(ARF), p15(INK4B), p16(INK4A), p18(INK4C), and RB1 genes in a series of HCCs and associated cirrhosis with the goal of ascertaining their pattern of inactivation by gene methylation. Thirty-three HCCs, adjacent nonneoplastic cirrhotic tissues, and 6 HCC cell lines were studied. Cirrhoses (25 of 33, 76%), HCCs (31 of 33, 94%), and 3 of 6 (50%) cell lines showed 1 or more methylated genes. Cirrhoses (17 of 33, 51%) had more frequently than HCCs (11 of 33, 33%, P =.01) only 1 methylated gene. With the exception of p18(INK4C) the genes under study showed promoter methylation with frequency ranging from 82% (p16(INK4A) in HCC) to 33% and 39% (p15(INK4B) and p16(INK4A) in cirrhoses). In cases with only 1 methylated gene, p15(INK4B) in cirrhosis (8 of 17, 47%) and p16(INK4A) in HCC (10 of 11, 91%) were the more frequently altered. An optimal correlation was found between p15 and p16 gene methylation and complete protein loss in HCC detected by immunocytochemistry, whereas a partial loss of the same proteins was a feature of methylated cirrhoses. Inactivation by DNA methylation of several genes of the RB1 pathway is common to cirrhosis and HCC. An early pattern of methylatory events (1 methylated gene) is a feature of cirrhosis rather than HCC, whereas an advanced one (> or = 3 methylated genes) is characteristic of malignancy. Early methylation changes seem to involve p15(INK4B) and p16(INK4A) in cirrhosis and p16(INK4A) in HCC. In conclusion, a stepwise progression of methylating events is a feature of the sequence cirrhosis-HCC and contributes to the process of hepatic carcinogenesis with potential clinical implications.
Depression during pregnancy
Authors: Veronica O'Keane, Michael S Marsh
Journal: BMJ (2007)

introduction Depression during pregnancy is common.The case presented here highlights many of the key issues involved in the management of pregnant women with depression, particularly the importance of active treatment. How common is depression during pregnancy?Rates of depression in women are higher during the childbearing years than at any other time.w1 Estimated rates of depression during pregnancy vary from 7-15% in economically developed countries 1 w2 to 19-25% in poorer countries. 2w3 This compares with rates of around of 10% during the postpartum period w1 and 7% outside of the perinatal period.w4 Rates of relapse in pregnant women with a history of recurrent mood disorder are high, at about 50%. 3 w5 We do not know, however, whether the high prevalence of antenatal depression results only from rates of relapse or also reflects an increased incidence of depression. Who is at risk?Across cultures poverty, lack of education, and sex inequality predispose women to depression in pregnancy. 2w3 w6 w7 This is reflected in the high rates seen in low income countries, varying from 19-25% in Pakistan, 2 Goa, w8 and Rio de Janeiro.w3 Exposure to domestic violence also increases the risk of developing antenatal depression. 2 w3 w9 Similar effects of social adversity have been found among women living in relative poverty in Europe and America.w6 w7 Women with poor social support, with an unplanned pregnancy, and who are single or adolescent are also more vulnerable to depression during pregnancy.w10
The one-two punch: knocking out angiotensin II in the heart
Authors: Daniela Zablocki, Junichi Sadoshima
Journal: Journal of Clinical Investigation (2010)

Ang II plays an important role in the pathophysiology of cardiovascular disease. Angiotensin-converting enzyme (ACE) inhibitors lower Ang II levels by inhibiting conversion of Ang I to Ang II, but Ang II levels have been shown to return to normal with chronic ACE inhibitor treatment. In this issue of the JCI, Wei et al. show that ACE inhibition induces an increase in chymase activity in cardiac interstitial fluid, providing an alternate pathway for Ang II generation.
Dissolution of gall stones with an ursodeoxycholic acid menthol preparation: a controlled prospective double blind trial.
Authors: M Leuschner, U Leuschner, D Lazarovici, W Kurtz, A Hellstern
Journal: Gut (1988)

In a controlled prospective double blind trial patients with cholesterol gall bladder stones are treated with ursodeoxy-cholic acid (group A: UDCA 11.1 mg/kg per day; n = 16) and Ursomenth respectively (group B: a mixture of UDCA/menthol: 4.75 mg/kg per day each; n = 17). With same stone number and size (10-12 mm) there is a complete dissolution rate in group A of 38%, and of 53% in group B within 15-16.9 months. The response rate (complete + partial dissolution) amounted to 75% and 76% respectively. In group A there is one case of stone calcification, in group B none. Both preparations are free of unwanted effects. This suggests that the cyclic monoterpene menthol enhances the effect of UDCA and is of comparable effect to a mixture of six different terpenes used in former times.