tbuckley/cabot-search huggingface dataset:
Body composition, not body weight, is related to cardiovascular disease risk factors and sex hormone levels in men.
Authors: K R Segal, A Dunaif, B Gutin, J Albu, A Nyman, F X Pi-Sunyer
Journal: Journal of Clinical Investigation (1987)

To clarify the independent relationships of obesity and overweight to cardiovascular disease risk factors and sex steroid levels, three age-matched groups of men were studied: (i) 8 normal weight men, less than 15% body fat, by hydrostatic weighing; (ii) 16 overweight, obese men, greater than 25% body fat and 135-160% of ideal body weight (IBW); and (iii) 8 overweight, lean men, 135-160% IBW, but less than 15% fat. Diastolic blood pressure was significantly greater for the obese (mean +/- SEM, 82 +/- 2 mmHg) than the normal (71 +/- 2) and overweight lean (72 +/- 2) groups, as were low density lipoprotein levels (131 +/- 9 vs. 98 + 11 and 98 + 14 mg/dl), the ratio of high density lipoprotein to total cholesterol (0.207 +/- 0.01 vs. 0.308 +/- 0.03 and 0.302 +/- 0.03), fasting plasma insulin (22 +/- 3 vs. 12 +/- 1 and 13 +/- 2 microU/ml), and the estradiol/testosterone ratio (0.076 +/- 0.01 vs. 0.042 +/- 0.02 and 0.052 +/- 0.02); P less than 0.05. Estradiol was 25% greater for the overweight lean group (40 +/- 5 pg/ml) than the obese (30 +/- 3 pg/ml) and normal groups (29 +/- 2 pg/ml), P = 0.08, whereas total testosterone was significantly lower in the obese (499 +/- 33 ng/dl) compared with the normal and overweight, lean groups (759 +/- 98 and 797 +/- 82 ng/dl). Estradiol was uncorrelated with risk factors and the estradiol/testosterone ratio appeared to be a function of the reduced testosterone levels in obesity, not independently correlated with lipid levels after adjustment for body fat content. Furthermore, no risk factors were significantly different between the normal and overweight lean groups. We conclude that (a) body composition, rather than body weight per se, is associated with increased cardiovascular disease risk factors; and (b) sex steroid alterations are related to body composition and are not an independent cardiovascular disease risk factor.
LRP8-Reelin-Regulated Neuronal Enhancer Signature Underlying Learning and Memory Formation
Authors: Francesca Telese, Qi Ma, Patricia Montilla Perez, Dimple Notani, Soohwan Oh, Wenbo Li, Davide Comoletti, Kenneth A. Ohgi, Havilah Taylor, Michael G. Rosenfeld
Journal: Neuron (2015)
Conflict of Interest Disclosure in Early Education of Medical Students
Authors: Kirsten E. Austad, Aaron S. Kesselheim
Journal: JAMA (2011)

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
Spatulous Fingers vs Clubbed Fingers
Authors: Balu H. Athreya
Journal: JAMA (1978)

To the Editor.—  I refer to a CLINICAL NOTE on Clubbing Secondary to an Arteriovenous Fistula Used for Hemodialysis (240:142, 1978). I am a clinician who becomes concerned when symptoms and signs are not defined as precisely as possible. Reading that article and looking at Fig 1,I believe those fingers are spatulous but are not really clubbed. To appreciate true clubbing, one should look at the profile of the fingers. The old method of looking at the angle between the plane of the nail and the plane of the distal phalanx is not accepted anymore. Sly and colleagues 1 have done some elegant and simple clinical studies to define true digital clubbing.
Superior Sagittal Sinus Thrombosis and HIV
Authors: Muhammed S. Karim
Journal: Annals of Internal Medicine (2002)

Letters3 September 2002Superior Sagittal Sinus Thrombosis and HIVMuhammed S. Karim, MD, Muhammed K. Athar, MD, and Michel W. Ghobrial, MDMuhammed S. Karim, MDMercy Catholic Medical Center; Philadelphia, PA 19023Search for more papers by this author, Muhammed K. Athar, MDMercy Catholic Medical Center; Philadelphia, PA 19023Search for more papers by this author, and Michel W. Ghobrial, MDMercy Catholic Medical Center; Philadelphia, PA 19023Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-137-5_Part_1-200209030-00035 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Although myriad neurologic complications have been reported in patients with HIV infection, thromboembolic phenomena have been limited to scattered reports. Most of these reports have been anecdotal and have implicated lupus anticoagulant, anticardiolipin antibody, and protein S deficiency (1-3). To our knowledge, cerebral venous sinuses thrombosis, a rare disease described as early as 1825, has not been described as an initial presentation of HIV.A 34-year-old man presented with right-sided weakness. The patient had no family history of premature cardiac or cerebrovascular events. He had no history of recent falls or head trauma. He did not have ...References1. Becker DM, Saunders TJ, Wispelwey B, Schain DC. Case report: venous thromboembolism in AIDS. Am J Med Sci. 1992;303:395-7. [PMID: 1605169] CrossrefMedlineGoogle Scholar2. Saif MW, Greenberg B. HIV and thrombosis: a review. AIDS Patient Care STDS. 2001;15:15-24. [PMID: 11177584] CrossrefMedlineGoogle Scholar3. Laing RB, Brettle RP, Leen CL. Venous thrombosis in HIV infection [Editorial]. Int J STD AIDS. 1996;7:82-5. [PMID: 8737329] CrossrefMedlineGoogle Scholar4. Doberson MJ, Kleinschmidt-DeMasters BK. Superior sagittal sinus thrombosis in a patient with acquired immunodeficiency syndrome. Arch Pathol Lab Med. 1994;118:844-6. [PMID: 8060239] MedlineGoogle Scholar5. Pedraza S, Rovira A, Saballs M, Capdevila JA. [Thrombosis of the superior longitudinal sinus in patients with AIDS. A review of the literature]. Rev Neurol. 1997;25:247-9. [PMID: 9147749] MedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Mercy Catholic Medical Center; Philadelphia, PA 19023 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByReview: Thromboses among HIV-Infected Patients during the Highly Active Antiretroviral Therapy Era 3 September 2002Volume 137, Issue 5_Part_1Page: 375KeywordsCentral nervous systemHIVMagnetic resonance imagingSerologySubarachnoid hemorrhageTemperatureThrombosisThyroidUrineVital signs ePublished: 3 September 2002 Issue Published: 3 September 2002 CopyrightCopyright © 2002 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
ABC of Breast Diseases: Congenital Problems and Aberrations of Normal Breast Development and Involution
Authors: J M Dixon, R E Mansel
Journal: BMJ (1994)

Congenital abnormalitiesExtra nipples and breasts Between 1% and 5% of men and women have supernumerary or accessory nipples or, less frequently, supernumerary or accessory breasts.These usually develop along the milk line: the most common site for accessory nipples is just below the normal breast, and the most common site for accessory breast tissue is the lower axilla.Accessory breasts below the umbilicus are extremely rare.Extra breasts or nipples rarely require treatment unless unsightly, although they are subject to the same diseases as normal breasts and nipples.Usual sites of accessory breasts along milk lines.Patients with an accessory nipple (left) and bilateral accessory breasts (right).Absence or hypoplasia of the breast One breast can be absent or hypoplastic, usually in association with defects in pectoral muscle.Some degree of breast asymmetry is usual, and the left breast is more commonly larger than is the right.True breast asymmetry can be treated by augmentation of the smaller breast, reduction or elevation of the larger breast, or a combination of procedures.Left breast hypoplasia.Breast asymmetry.
Long-Term Prevention of Stroke
Authors: Paola De Rango, Gianbattista Parlani, Fabio Verzini, Giuseppe Giordano, Giuseppe Panuccio, Matteo Barbante, Piergiorgio Cao
Journal: Journal of the American College of Cardiology (2011)

This study sought to evaluate long-term outcomes of carotid stenting (CAS) versus carotid endarterectomy (CEA) based on physician-guided indications. The issue regarding long-term outcome of CAS versus CEA in patients with carotid stenosis is clinically relevant but remains unsettled. Consecutive patients (71% men, mean age 71.3 years) treated by CEA (n = 1,118) or CAS (n = 1,084) after a training phase were reviewed. Selection of treatment was based on better-suitability characteristics (morphology and clinical). Data were adjusted with propensity score analysis and stratified by symptoms, age, and sex. Thirty-day stroke/death rates were similar: 2.8% in CAS and 2.0% in CEA (p = 0.27). The risk was higher in symptomatic (3.5%) versus asymptomatic (2.0%) patients (p = 0.04) but without significant difference between CAS and CEA groups. Five-year survival rates were 82.0% in CAS and 87.7% in CEA (p = 0.05). Kaplan-Meier estimates of the composite of any periprocedural stroke/death and ipsilateral stroke at 5 years after the procedure were similar in all patients (4.7% vs. 3.7%; p = 0.4) and the subgroups of symptomatic (8.7% vs. 4.9%; p = 0.7) and asymptomatic (2.5% vs. 3.3%; p = 0.2) patients in CEA versus CAS, respectively. Cox analysis, adjusted by propensity score, identified statin treatment (p = 0.016) and symptomatic disease (p = 0.003) associated with the composite end point. There were no sex- or age-related significant outcome differences. When physicians use their clinical judgment to select the appropriate technique for carotid revascularization CAS can offer efficacy and durability comparable to CEA with benefits persisting at 5 years.
A2.21 Toll-Like Receptor Dependent Autoantigens and Vesicles from P. gingivalis in Animal Models of RA to Modulate Collagen and Collagen Antibody Induced Arthritis
Authors: B Marklein, M Sohn, Z Konthur, K Grimm, G Steiner, F Apparailly, G-R Burmester, K Skriner
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background and Objectives</h3> A variety of animal models suggest that TLR signalling is important in the pathogenesis of RA and the generation of specific autoantibodies. This study was conducted with sera from patients with rheumatoid arthritis, as well as with arthritis animal models to identify identical autoantigens dependent on TLR7 and 9 in human and animal models for disease modifying use. Moreover TLR2 and TLR4 modulating bacterial vesicles from P. gingivalis containing PAD (Peptidyl-Arginine Deiminase) which is involved in citrullination was used to study the TLR2/4 in arthritis. <h3>Materials and Methods</h3> Using protein philtre technology (28000 human protein philtre) the autoantigen profile of RA patients, mouse collagen and zymosan induced arthritis, as well as collagen and pristan induced arthritis in rats and TLR7, TLR9 deficient double-deficient and MyoD88 and Tir8 deficient mice of the MRL-lpr/lpr background were obtained. Cationic liposomes transferring siRNAs, bacterial vesicles, lipomannan and LPS were used for the validation of their potential as therapeutic target in collagen or collagen antibody induced arthritis (CAIA). <h3>Results</h3> We found 18 identical proteins targeted in human and animal situations of arthritis. These data identify mRNA binding hnRNPs proteins which are part of P bodies, stress granules and components of messenger RNA stability complex as well as CRP binding proteins as target molecules in mice, rats and humans with RA. Moreover, we found MyoD88 independent autoantigens which are not expressed in the thymus or proteins such as high mobility group box proteins 1 and 2 which are MyoD88 independent sensors of nucleic-acid-mediated innate immune responses. Systemic administration of siRNAs with cationic liposomes inhibiting expression of Toll dependent autoantigens overexpressed and targeted by autoantibodies in the human and mouse synovial tissue were used for the validation of their potential to inhibit collagen induced arthritis in C57BL/6J mice. Moreover P. gingivalis vesicles containing the PAD induce a mild inflammatory response in the CAIA model of arthritis. P. gingivalis LPS and lipomannan treated animals show a 80% reduction of athrithis score compared to E coli LPS in a C57BL/6J CAIA model. <h3>Conclusions</h3> Systemic blocking of common RNA or DNA binding proteins overexpressed in synovial target tissue appears to modify arthritis. <i>P. gingivalis</i> vesicles evolved the ability to intercept and undermine a subset of TLR2/4 signalling events for corrupting innate immunity and modulate RA.
Intermittent Chemotherapy for Tuberculosis in an Urban Community
Authors: G. Poole, P. Stradling
Journal: BMJ (1969)

A regimen designed for effective foolproof antituberculosis treatment, acceptable on a routine basis, was applied to all patients newly diagnosed at the Chest Clinic, Hammersmith Hospital, in 1963, 1964, and 1965. During the first three months of treatment patients received daily (six days a week) streptomycin 0.75 g. plus isoniazid 300 mg. plus sodium para-aminosalicylate (P.A.S.) 12 g. The P.A.S. was usually stopped when bacterial sensitivity reports made this possible. For a further 15 months streptomycin 1 g. plus isoniazid 600 mg. was given on three alternate days each week to complete a total of 18 months9 treatment. Of the total of 140 patients (66% sputum-positive) 112 (80%) completed the planned 18 months with intermittent streptomycin plus isoniazid and a further eight completed treatment on alternative regimens (a total of 85%). The equivalent figures for one year are 88% and 94%. Excellent clinical and radiological results, together with sputum conversion, were achieved in 138 of the 140 patients (99%). Only two patients were lost from surveillance, because of failure to co-operate, before quiescence was obtained. It is concluded that the total efficiency of supervised intermittent treatment is greater than that of unsupervised daily regimens. Since 100% arrest of tuberculosis is possible with co-operative patients, less should not be accepted in developed countries.
ANGLO-FRENCH HOSPITAL, NO. 2, CHATEAU TOURLAVILLE, CHERBOURG
Authors: M. L. Ramsay, F. A. Stoney
Journal: BMJ (1915)

ANGILC.FRENCHT HOSPiTAL, NO. 2. tTUNE 5, I915 stiffness.Tlle slhock, tlhrill, and bruit have all disappeared, and tlle pulse can be felt in the posterior tibial and dorsalis pedis vessels.
Treatment of Placenta Praevia
Authors: S. K. Kelkar
Journal: BMJ (1938)

<b>Background:</b> Meta-analysis shows FeNO guided treatment reduces the risk of asthma attacks compared to standard management. Here we test the hypothesis that there are sub groups of patients where FeNO guided treatment is associated with reduced risk for asthma attacks. <b>Methods:</b> Data from 7 clinical trials were pooled. Baseline characteristics included age, sex, ethnicity (white versus other), dose of inhaled corticosteroid (ICS), receipt of long acting beta agonist, receipt of leukotriene receptor antagonist (LTRA), %FEV1 and self-reported ICS adherence. The outcome was receipt of ≥1 course of oral corticosteroid (OCS) during the follow up period. Logistic regression related outcome to an interaction term between each characteristic and the trial arm (FeNO or standard treatment), including main effects and important covariates. <b>Results:</b> Data were available in 1115 children (58% male, mean age 12.6 years). The interaction term between LTRA treatment and trial group was significant (p=0.035): for those not treated with LTRA, 27% had ≥1 OCS course when treated by standard care and 20% with FeNO guided treatment; 38% treated with LTRA had ≥1 OCS course when treated by standard care and 43% when treated by FeNO guided management. There was a trend for outcomes to differ by ethnic group (p=0.070); for children other than white ≥1 OCS course was prescribed in 34% given standard treatment and 26% with FeNO guided treatment; and among white children the corresponding proportions were 19% and 23%. <b>Conclusions:</b> FeNO guided asthma treatment may be more effective in reducing the risk for asthma attacks among children who are non-white and not treated with LTRA.
Homograft Valved Right Ventricle to Pulmonary Artery Conduit as a Modification of the Norwood Procedure
Authors: Olaf Reinhartz, V. Mohan Reddy, Edwin Petrossian, Malcolm MacDonald, John J. Lamberti, Stephen J. Roth, Gail E. Wright, Stanton B. Perry, Sam Suleman, Frank L. Hanley
Journal: Circulation (2006)

Background— The use of a right ventricle to pulmonary artery (RV-PA) conduit in the Norwood procedure has been proposed to increase postoperative hemodynamic stability. A valve within the conduit should further decrease RV volume load. We report our clinical experience with this modification. Methods and Results— From February 2002 through August 2005, we performed 88 consecutive Norwood procedures using RV-PA conduits. We used composite valved conduits made from cryopreserved homograft and polytetrafluoroethylene (PTFE) in 66 cases (54 pulmonary, 12 aortic homografts), other valved conduits in 14, and unvalved PTFE in 8 cases. Hospital survival was 88.6% overall and increased to 93.1% after the initial year. Early interventions were required in 18 patients (16 for cyanosis). Prestage II cardiac catheterization was performed at a mean age of 126 days. Mean Qp/Qs was 1, with mean aortic saturation 71%, mean O 2 extraction 24%, and mean right ventricular end-diastolic pressure 9 mm Hg. Patient weight, use of an aortic homograft valve in the conduit, stage I palliation within the first year of our experience, and low O 2 extraction and high transpulmonary gradient prestage II were risk factors for overall death. Early interventions were more frequent in aortic valve conduits compared with all other conduits. Conclusions— The valved RV-PA conduit was associated with low early mortality after the Norwood procedure. The majority of these patients had normal cardiac output and well-maintained RV function. There may be a higher risk for early conduit interventions and death when aortic valve homografts are used in the RV-PA conduit.
GUN-SHOT WOUND OF THE STOMACH.
Authors: R. L. MURDY
Journal: JAMA (1905)

Although gun-shot wounds of the stomach are among the most serious which a physician or surgeon is called on to treat, modern surgery has done a great deal to place the treatment of these injuries of the stomach and of other abdominal viscera on a more scientific basis and to give more hope for recovery in a large class of these cases. The tendency to pneumonia after the treatment of these injuries has been suggested by W. J. Mayo and is markedly demonstrated in this case. <h3>History of Shooting.</h3> —On Feb. 3, 1905, at 5:30 p. m., a family fracas occurred in which the senior member of a family was used for a target by his stepdaughter, who used a 22-caliber revolver, shooting twice from in front. One shot took effect over the costal cartilages of the ribs about two inches to the left of the median line, taking a
Molecular nexopathies: a new paradigm of neurodegenerative disease
Authors: Jason D. Warren, Jonathan D. Rohrer, Jonathan M. Schott, Nick C. Fox, John Hardy, Martin N. Rossor
Journal: Trends in Neurosciences (2013)

•How proteinopathies damage brain networks is a key issue in neurodegenerative disease.•Here, we outline a solution based on the concept of 'molecular nexopathies'.•The concept is founded on specific interactions of network and protein properties.•This new paradigm has far-reaching biological and clinical implications. Neural networks provide candidate substrates for the spread of proteinopathies causing neurodegeneration, and emerging data suggest that macroscopic signatures of network disintegration differentiate diseases. However, how do protein abnormalities produce network signatures? The answer may lie with 'molecular nexopathies': specific, coherent conjunctions of pathogenic protein and intrinsic network characteristics that define network signatures of neurodegenerative pathologies. Key features of the paradigm that we propose here include differential intrinsic network vulnerability to propagating protein abnormalities, in part reflecting developmental structural and functional factors; differential vulnerability of neural connection types (e.g., clustered versus distributed connections) to particular pathogenic proteins; and differential impact of molecular effects (e.g., toxic-gain-of-function versus loss-of-function) on gradients of network damage. The paradigm has implications for understanding and predicting neurodegenerative disease biology. Neural networks provide candidate substrates for the spread of proteinopathies causing neurodegeneration, and emerging data suggest that macroscopic signatures of network disintegration differentiate diseases. However, how do protein abnormalities produce network signatures? The answer may lie with 'molecular nexopathies': specific, coherent conjunctions of pathogenic protein and intrinsic network characteristics that define network signatures of neurodegenerative pathologies. Key features of the paradigm that we propose here include differential intrinsic network vulnerability to propagating protein abnormalities, in part reflecting developmental structural and functional factors; differential vulnerability of neural connection types (e.g., clustered versus distributed connections) to particular pathogenic proteins; and differential impact of molecular effects (e.g., toxic-gain-of-function versus loss-of-function) on gradients of network damage. The paradigm has implications for understanding and predicting neurodegenerative disease biology.
Severe Anaphylactoid Reaction to Radiographic Contrast Media
Authors: Jack S. Madowitz
Journal: JAMA (1979)

Patients with a history of anaphylactoid reaction to radiographic contrast medium (RCM) are at increased risk for subsequent reaction. To date, 275 of these high-risk patients have been studied with use of prophylactic pretreatment with diphenhydramine hydrochloride or prednisone or both without a single severe anaphylactoid reaction on readministration of RCM. This report describes a patient who received pretreatment as described in the literature but suffered a life-threatening anaphylactoid reaction on readministration of RCM. Premedication does not eliminate the possibility of a fatal reaction on readministration of RCM. (<i>JAMA</i>241:2813-2815, 1979)