tbuckley/cabot-search huggingface dataset:
Abstract C59: Human papillomavirus genotype distribution in northern India: Implications for vaccination
Authors: A. Raj Kumar Patro, Lalit Dar, Neerja Bhatla, Arti Gulati, Alka Kriplani, Sunil Kumar Pati, Pankaj Kumar, Shobha Broor
Journal: Cancer Research (2009)

Abstract Background: Cervical cancer caused by human papilloma virus (HPV), is the commonest cancer in Indian women, with an estimated 132000 new cases and 76000 deaths annually. More than 100 HPV genotypes have been identified in humans of which at least 40 HPV types are found in the genital tract. Several high-risk HPV types are known to cause the disease. There are only limited data available on the genotype distributions in this region. Methods: During the period three different cross-sectional studies were carried out: (1) a hospital-based cross-sectional study in which 106 women presenting with invasive cervical cancer; (2) a hospital-based cross-sectional study in which 524 women presenting to have an unhealthy cervix were invited to participate; (3) a community-based cross-sectional study in which 465 women also underwent HPV testing. HPV typing in these studies was done by using L1 consensus PCR followed by reverse line blot hybridization assay (Roche). Results: In the hospital-based population, among 106 invasive cervical cancers the six commonest HPV types were HPV-16, -18, -45, -59, -33 and 73. HPV-16/18, singly or in combination, were seen in 83% of cases. (2) In the hospital-based population, among the 524 symptomatic hospital subjects, the overall HPV prevalence was 15.5 % and the six commonest HPV types were as follows: HPV -16, -89, -39, -52, -33 and 18. Among the HPV positive women accounted for HPV-16/18 were associated with 34.3%, 45.4% and 65.7% of normal, low-grade and high-grade disease respectively. Among (3) the community-based women, the overall HPV prevalence was 7 % and the six commonest HPV types were as follows: HPV- 16, - 45, -52, -31, -66, and -18. Conclusions: A wide spectrum of HPV types is seen in north Indian women, with HPV-16/18 are the commonest types in all populations. However, thereafter there is considerable variation. It is estimated that the HPV -16/18 vaccine would reduce over 75% of the total cancer burden in this region. The community population is from a confined geographical area whereas the hospital population includes not only residents of Delhi and neighbouring areas but also further states of North India as well as neighboring countries of Nepal and Bangladesh. Thus more studies are required to establish the true picture of HPV type-distribution in this large and diverse region. Citation Information: Cancer Res 2009;69(23 Suppl):C59.
Community-acquired pneumonia in the elderly: A multivariate analysis of risk and prognostic factors.
Authors: R Riquelme, A Torres, M El-Ebiary, J P de la Bellacasa, R Estruch, J Mensa, J Fernández-Solá, C Hernández, R Rodriguez-Roisin
Journal: American Journal of Respiratory and Critical Care Medicine (1996)

To assess the risk and prognostic factors of community-acquired pneumonia occurring in the elderly (over age 65 yr) requiring hospitalization, two studies, case-control and cohort, were performed over an 8-mo period in a 1,000-bed university teaching hospital. We studied 101 patients with pneumonia (cases), age 78.5 +/- 7.9 yr (mean +/- SD). Each case was matched for sex, age (+/- 5 yr), and date of admission (+/- 2 d) with a control subject, without pneumonia during the preceding 3 yr, arriving at the emergency room. Etiologic diagnosis was obtained in 43 of 101 (42%) cases. The main microbial agents causing pneumonia were: Streptococcus pneumoniae (19 of 43, 44%), and Chlamydia pneumoniae (9 of 43, 21%). Gram-negative bacilli were uncommon (2 of 43, 5%). The multivariate analysis demonstrated that large-volume aspiration, and low serum albumin (< 30 mg/dl) were independent risk factors associated with the development of pneumonia. Crude mortality rate was 26% (26 of 101), while pneumonia-related mortality was 20% (20 of 101). The attributable mortality was 23% (odds ratio [OR]: 11.3; 95% confidence interval [CI]: 3.25 to 60.23; p < 0.0001). The multivariate analysis showed that patients had a worse prognosis if they were previously bedridden, had prior swallowing disorders, body temperature on admission was less than 37 degrees C, respiratory frequency was greater than 30/min or had three or more affected lobes on chest radiograph. Age by itself was not a significant factor related to prognosis. Among the significant risk factors, only nutritional status is probably amenable to medical intervention. The prognostic factors found in this study may help to identify, upon admission, those subjects at higher risk and who may require special observation.
A <i>CALR</i> Mutation Preceding <i>BCR-ABL1</i> in an Atypical Myeloproliferative Neoplasm
Authors: Xénia Cabagnols, Jean-Michel Cayuela, William Vainchenker
Journal: New England Journal of Medicine (2015)

A case is described in which a patient with chronic myeloid leukemia associated with thrombocytosis was shown to have a CALR mutation as an initial genetic change and BCR–ABL1 translocation as a secondary event leading to a clinically unusual myeloproliferative neoplasm.
An Unusual Hernia
Authors: Devin S. Zarkowsky, Peter B. Cornell, Frederic Eckhauser
Journal: JAMA Surgery (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 Surgery HomeNew OnlineCurrent IssueFor Authors Podcast 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 Surgery journal
SIGNIFICANCE OF HEMORRHAGIC TAP IN APOPLEXY
Authors: A. H. Terry
Journal: JAMA (1941)

At one of the clinical conferences at the Beekman Street Hospital an intern unwittingly provided the stimulus for this paper, stating that he had never seen a patient recover who had a cerebral hemorrhage associated with a hemorrhagic or bloody spinal fluid. This started the ball rolling. Every one had a foggy prognostic idea but no one was sufficiently wise to settle the question. A search of the literature for the last ten years, as well as a review of the standard textbooks of pathology and neurology, failed to provide the answer. If the subject was touched on at all, a single statement that this was a poor sign was the sole conclusion—how poor a sign was never stated. The original articles in the literature safely attacked the problem from hindsight, analyzing autopsy material. Such studies disclosed that in cases coming to autopsy cerebral hemorrhages had a shorter existence when
Risk of ischaemic heart disease in patients with inflammatory bowel disease: a nationwide Danish cohort study
Authors: Christine Rungoe, Saima Basit, Mattis Flyvholm Ranthe, Jan Wohlfahrt, Ebbe Langholz, Tine Jess
Journal: Gut (2012)

<h3>Background</h3> Inflammatory bowel disease (IBD) is a chronic inflammatory disorder. Systemic inflammation increases the risk of atherosclerosis and ischaemic heart disease (IHD). <h3>Objective</h3> To examine the impact of IBD, including its duration and treatment, on the risk of IHD. <h3>Methods</h3> In a nationwide population-based cohort of 4.6 million Danes aged ≥15 years, we compared people diagnosed with IBD during 1997–2009 (n=28 833) with IBD-free individuals. Subjects with IHD were identified in the National Patient Register. Using Poisson regression, we estimated the incidence rate ratios (IRRs) for IHD with 95% CI with adjustment for age, gender, socioeconomic status, calendar year and use of drugs for comorbidities. <h3>Results</h3> A markedly increased risk of IHD was seen within the first year after IBD diagnosis (IRR=2.13 95% CI 1.91 to 2.38). During 1–13 years of follow-up after IBD diagnosis, the risk of IHD was 1.22 (95% CI 1.14 to 1.30). The risk of IHD was lower among patients with IBD using 5-aminosalicylic acids (IRR=1.16; 95% CI 1.06 to 1.26) than among non-users (IRR=1.36; 95% CI 1.22 to 1.51) (p=0.02), in particular among oral corticosteroid users, used as a proxy for disease severity. Likewise patients treated surgically or with thiopurines and tumour necrosis factor α antagonists tended to have reduced IRRs for IHD. <h3>Conclusions</h3> The risk of IHD was highest in the first year after IBD diagnosis, possibly owing to ascertainment bias. The increased long-term risk of IHD in IBD may be related to chronic inflammation, and interventions reducing the inflammatory burden may attenuate this risk.
Recognizing and Adjusting to Barriers in Doctor-Patient Communication
Authors: Timothy E. Quill
Journal: Annals of Internal Medicine (1989)

Barriers frequently develop in physician-patient encounters. If they go unrecognized, they can severely limit the therapeutic potential of the doctor-patient relationship. Because barriers are not always explicit, a strategy is presented for recognizing implicit signs such as verbal-nonverbal mismatch, cognitive dissonance, unexpected resistance, and physician discomfort. Once a potential barrier is identified, its source can be defined and explored using standard clinical reasoning techniques such as hypothesis generation and testing. Patients can often share in the process of generating hypotheses about the nature and sources of barriers. Once defined and understood, most barriers can be lessened and sometimes resolved using the basic communication skills of acknowledgment, exploration, empathy, and legitimation. When conflict exists, common interests and differences must be clarified. Conflict might involve disagreement about the presence of a barrier, its nature or source, its relevance to the physician-patient relationship, or about strategies for approaching it. Negotiation need not be limited to the initial positions, but can include creative solutions whereby both parties gain. The decision to confront a barrier depends on both doctor and patient readiness, as well as how critical the barrier is to the therapeutic process, and how amenable it is to change. By effectively uncovering and addressing barriers, the physician can often turn roadblocks to effective communication into means for enhancing the therapeutic relationship.
Comment on the updated AASLD practice guidelines for the diagnosis, management, and treatment of hepatitis C: Treating active drug users
Authors: Tracy Swan, Jen Curry
Journal: Hepatology (2009)

We commend the authors of the updated AASLD Practice Guidelines on hepatitis C virus (HCV) diagnosis, management, and treatment for their clear, comprehensive review.1 However, the Practice Guidelines contain a contradiction about hepatitis C virus (HCV) treatment for active drug users. The information in Table 11 ("Characteristics of Persons for Whom Therapy Should be Individualized") stipulates that "Current users of illicit drugs or alcohol [who are] willing to participate in a substance abuse program (such as a methadone program) or alcohol support program…..should be abstinent for a minimum period of 6 months prior to initiating HCV treatment." Elsewhere, the Practice Guidelines recommend consideration of HCV treatment for active drug users, inclusive of persons who currently use illicit drugs and individuals on a methadone maintenance program, "…provided they wish to take HCV treatment and are able and willing to maintain close monitoring and practice contraception." Rigid eligibility criteria pose a significant barrier for many candidates regardless of their need for or willingness to engage in HCV treatment; one multiple-city study reported that 96% of young injection drug users were considered ineligible for HCV treatment by conventional criteria.2 Research has demonstrated that certain treatment contraindications are modifiable.3 The literature offers several examples of successful models for delivering HCV care and treatment to active drug users.4-11 We hope that this contradiction is resolved so that the Practice Guidelines are internally consistent in suggesting that clinicians broadly consider HCV treatment for active drug users in the context of supportive, multidisciplinary care. We thank the authors for their support of more inclusive HCV treatment guidelines. Tracy Swan*, Jen Curry , * Treatment Action Group, New York, NY, Harm Reduction Coalition, Oakland, CA.
Serum intercellular adhesion molecule-1 levels in chronic hepatitis C: association with disease activity and response to interferon alpha.
Authors: K T Nouri-Aria, J Koskinas, C J Tibbs, B C Portmann, R Williams
Journal: Gut (1995)

Soluble intercellular adhesion molecule-1 (sICAM-1) is probably released from a variety of cells, including leukocytes and endothelial cells at sites of inflammation or in the circulation, and serum levels may therefore be used to give an indication of immune activation and inflammatory processes. In the present study, an ELISA was used to measure serum ICAM-1 levels in 43 patients with chronic hepatitis C and these were correlated with histological changes in the liver and the response to interferon alpha treatment. Serum ICAM-1 levels were significantly higher in patients with chronic hepatitis C infection than in normal subjects and correlated positively with the grade of histological activity, in particular the degree of portal, periportal, and lobular inflammation, but not with the presence of lymphoid aggregates. There was also a weak but significant positive correlation between sICAM-1 and serum aspartate aminotransferase activities, and sICAM-1 levels were substantially greater in patients with than those without cirrhosis. Serum ICAM-1 levels fell significantly in 11 responders out of 19 patients treated with interferon alpha, whereas levels remained unchanged in the non-responder group. sICAM-1 levels correlate with the clinical status of patients with chronic hepatitis C infection and fall with successful interferon treatment.
Effect of Immunoglobulin on Hepatitis A in Day-care Centers
Authors: Stephen C. Hadler
Journal: JAMA (1983)

Over a 21-month interval, we investigated the effectiveness of immunoglobulin (lg) in preventing hepatitis A spread in day-care centers. Immunoglobulin was given to all center and employees whenever hepatitis occurred in one center child or employee or parents in two families. Immunoglobulin programs were completed in 91 centers during the trial within an average of 17 days of onset of illness in the index case. Immunoglobulin intervention caused significant reduction in the average size of a day-care hepatitis outbreaks, from 7.3 cases in historically untreated centers to 6.0 cases in Ig-treated centers. Cases in center children and employees virtually ceased two weeks after Ig intervention, while those in household contacts decreased significantly within six weeks. Reported cases of hepatitis type A or unspecified in the community decreased 75%, and the number of new hepatitis outbreaks decreased 77% during the trial. A decrease occurred not only in day-care-associated cases, but in cases not directly associated with centers, probably due to decreased tertiary spread from day-care families into the community. Use of Ig to prevent hepatitis spread in day-care centers seems to be an excellent means of controlling this disease, both within the centers and the general community.
TB incidence in UK decreases for first time in two decades
Authors: P. Moszynski
Journal: BMJ (2011)

Last year saw a decline in new cases of tuberculosis in the United Kingdom, reversing a 20 year trend of increasing incidence, according to new figures released by the Health Protection Agency.

In 2010 a total of 8483 cases of tuberculosis were reported in the UK, a rate of 13.6 cases per 100 000 population. This is a decrease of 4.9% in the number of cases and a 5.6% decline in the rate from 2009.

The research also found, however, that one in 20 patients with tuberculosis was failing to complete the full treatment for their infection because they were “lost to follow-up.”

The …
The Economic Impact of Childhood Food Allergy in the United States
Authors: Ruchi Gupta, David Holdford, Lucy Bilaver, Ashley Dyer, Jane L. Holl, David Meltzer
Journal: JAMA Pediatrics (2013)

Describing the economic impact of childhood food allergy in the United States is important to guide public health policies.To determine the economic impact of childhood food allergy in the United States and caregivers' willingness to pay for food allergy treatment.A cross-sectional survey was conducted from November 28, 2011, through January 26, 2012. A representative sample of 1643 US caregivers of a child with a current food allergy were recruited for participation.Caregivers of children with food allergies were asked to quantify the direct medical, out-of-pocket, lost labor productivity, and related opportunity costs. As an alternative valuation approach, caregivers were asked their willingness to pay for an effective food allergy treatment.The overall economic cost of food allergy was estimated at $24.8 (95% CI, $20.6-$29.4) billion annually ($4184 per year per child). Direct medical costs were $4.3 (95% CI, $2.8-$6.3) billion annually, including clinician visits, emergency department visits, and hospitalizations. Costs borne by the family totaled $20.5 billion annually, including lost labor productivity, out-of-pocket, and opportunity costs. Lost labor productivity costs totaled $0.77 (95% CI, $0.53-$1.0) billion annually, accounting for caregiver time off work for medical visits. Out-of-pocket costs were $5.5 (95% CI, $4.7-$6.4) billion annually, with 31% stemming from the cost of special foods. Opportunity costs totaled $14.2 (95% CI, $10.5-$18.4) billion annually, relating to a caregiver needing to leave or change jobs. Caregivers reported a willingness to pay of $20.8 billion annually ($3504 per year per child) for food allergy treatment.Childhood food allergy results in significant direct medical costs for the US health care system and even larger costs for families with a food-allergic child.
Compendia Rheumatologica: Characteristic Features of the Most Important Rheumatic Diseases: A Practical Diagnostic Guide
Authors: A. B. Myles
Journal: Annals of the Rheumatic Diseases (1979)

It seems likely that many of the soft tis! described, such as joint effusions, enlarged ly rheumatoid nodules, and oedema of the soft be evident clinically, so that their demon radiological means may not give additional or help with the management of the patient. is left wondering about the practical importai of the changes described.However, there is n( the radiology of the soft tissues has been nel this book may well do something to ove deficiency.
The Final Stages of the Global Eradication of Polio
Authors: T. Jacob John
Journal: New England Journal of Medicine (2000)

It is the year 2000, the target date set by the World Health Organization (WHO) for the global eradication of poliomyelitis. In 1999, there were 7090 cases of polio, and in 1848 of these cases, the virus was isolated. During the first half of this year, only 678 cases of polio and 154 wild (natural) poliovirus isolates were documented. Transmission of this virus is now confined to 30 countries in South Asia and West and Central Africa. These were the last regions to eliminate smallpox. Polio will also be eliminated in these regions, albeit a bit later than we had . . .
Providing Support and Assistance for Low-Income or Homeless Women-Reply
Authors: Ellen L. Bassuk
Journal: JAMA (1996)

<h3>In Reply.</h3> —Based on our clinical and research experiences, we agree with the hypothesis of Ms Plummer and colleagues that posttraumatic stress disorder and depression may inhibit high-risk women from participating in long-term services and programs. While we have data to examine these issues, we have not yet conducted the analyses to support this conclusion. We know that barriers to participation go well beyond mental health and include factors such as racial discrimination and inadequate income, child care, and transportation.<sup>1</sup>In addition, some low-income women have had difficulty accessing traditional services and understandably have become distrustful of clinicians and institutions. Programs for low-income women must include specific approaches for responding to the extremely high rates of violent victimization and its aftermath (ie, posttraumatic stress disorder and its associated disorders—major depressive disorder and substance abuse) and for identifying women who have been abused or assaulted. At the least, treatment programs modeled from
Spectrin mutations cause spinocerebellar ataxia type 5
Authors: Yoshio Ikeda, Katherine A Dick, Marcy R Weatherspoon, Dan Gincel, Karen R Armbrust, Joline C Dalton, Giovanni Stevanin, Alexandra Dürr, Christine Zühlke, Katrin Bürk, H Brent Clark, Alexis Brice, Jeffrey D Rothstein, Lawrence J Schut, John W Day, Laura P W Ranum
Journal: Nature Genetics (2006)
Opportunities and Challenges of Laboratory Testing at Alternative Sites
Authors: Charles R. Handorf
Journal: JAMA (1995)

A 15th-century woodcut portrays a physician making a house call at the bedside of his patient.<sup>1</sup>The physician's right hand is on the patient's pulse while he points with his left hand to a flask of the patient's urine held up to the light by an assistant. In observing the urine, the physician is practicing the art of uroscopy, that is, the attempted gleaning of knowledge of the patient's condition from the direct observation of fresh urine. The science of laboratory medicine advanced little from the 15th to the 19th century, whereupon the introduction of medical microscopy greatly advanced the ability of physicians to observe and diagnose patients. Scientific and technical advances accelerated in the 20th century, especially after World War II, with astonishing speed and breathtaking scientific elegance. These advances allowed a remarkable enhancement of the physician's ability to diagnose; however, they carried a price: the transfer of