tbuckley/cabot-search huggingface dataset:
Prostate Cancer Screening and Surveillance
Authors: C. Stewart Rogers
Journal: JAMA (2009)

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
Bacterial DNA induces myocardial inflammation and reduces cardiomyocyte contractility: role of Toll-like receptor 9
Authors: P. Knuefermann, M. Schwederski, M. Velten, P. Krings, H. Ehrentraut, M. Rudiger, O. Boehm, K. Fink, U. Dreiner, C. Grohe, A. Hoeft, G. Baumgarten, A. Koch, K. Zacharowski, R. Meyer
Journal: Cardiovascular Research (2008)

Myocardial function is severely compromised during sepsis. Several underlying mechanisms have been proposed. The innate immune system, i.e. toll-like receptor (TLR) 2 and 4, significantly contributes to cardiac dysfunction. Little is known regarding TLR9 and its pathogenic ligand bacterial DNA in the myocardium. We therefore studied the role of TLR9 in myocardial inflammation and cardiac contractility.Wild-type (WT, C57BL/6) and TLR9-deficient (TLR9-D) mice and isolated cardiomyocytes were challenged with synthetic bacterial DNA (CpG-ODN). Myocardial contractility as well as markers of inflammation/signalling were determined. Isolated cardiomyocytes incorporated fluorescence-marked CpG-ODN. In WT mice, CpG-ODN caused a robust response in hearts demonstrated by increased levels of tumour necrosis factor (TNF-alpha), interleukin (IL)-1beta, IL-6, inducible nitric oxide synthase (iNOS), and nuclear factor kappaB activity. This inflammatory response was absent in TLR9-D mice. Under similar conditions, contractility measurements of isolated ventricular cardiomyocytes demonstrated a TLR9-dependent loss of sarcomeric shortening after CpG-ODN exposure. This observation was iNOS dependent as the application of a specific iNOS inhibitor reversed sarcomeric shortening to normal levels.Our data suggest that bacterial DNA contributes to myocardial cytokine production and loss of cardiomyocyte contractility via TLR9.
P166 Quantiferon testing in close contacts of smear positive pulmonary TB identifies people at low risk of secondary progression
Authors: P. Haldar, H. Thuraisingam, H. Patel, W. Hoskyns, G. Woltmann
Journal: Thorax (2010)

<h3>Introduction</h3> Interferon gamma release assays (IGRAs) are recommended for screening close contacts of patients with active tuberculosis (TB) in the UK. Compared with tuberculin skin testing, greater specificity with IGRAs reliably informs the need for chemoprophylaxis in screened contacts by identifying latent Mycobacterium tuberculosis infection (LTBI) associated with a high risk of secondary disease progression. However, the risk of secondary progression varies with the nature of disease in the primary case and is greatest for contacts of smear positive pulmonary disease. The role of IGRAs in this very high risk population is not clear. <h3>Aim</h3> To evaluate the benefit of screening with QuantiFERON<sup>®</sup>-TB Gold (QFT) in contacts of smear positive pulmonary TB. <h3>Methods</h3> A prospective observational study. We have offered QFT based single step screening programme for all close contacts of smear positive pulmonary TB since January 2007. We present 2-year follow-up data in tested and untested contacts that did not receive chemoprophylaxis. Secondary disease risk is estimated with Kaplan–Meier analysis and subgroups compared with the log-rank test. <h3>Results</h3> 576 recorded contacts for 92 smear positive cases. Median follow-up 693 days (range 287–1146 days). 467 (81.1%) of contacts were QFT screened. 36% of tested contacts had a positive QFT; 83 QFT positive contacts did not receive chemoprophylaxis (group A); 101 contacts were not screened and untreated (group B); 301 were QFT negative (group C). Secondary disease occurred in 22 contacts (11 group A, 5 group B). Progression rates at 12 and 24 months are shown (Abstract P166 Table 1). Compared with the untested subgroup, a positive QFT results did not significantly increase progression risk (RR 2.1 (95% CI 0.7 to 5.9), p=0.13). A negative QFT result did significantly lower progression risk (RR 0.28 (95% CI 0.09 to 0.82) at 2 years, p=0.01). The negative predictive value of QFT compared with not testing was 93.2% (95% CI 85.8 to 97.5). <h3>Conclusion</h3> In contrast with other TB disease types, QFT screening in contacts of smear positive pulmonary TB does not identify contacts for chemoprophylaxis, but rather identifies contacts that we may choose not to treat.
A prospective study on drug monitoring of PEGasparaginase and Erwinia asparaginase and asparaginase antibodies in pediatric acute lymphoblastic leukemia
Authors: Wing H. Tong, Rob Pieters, Gertjan J. L. Kaspers, D. Maroeska W. M. te Loo, Marc B. Bierings, Cor van den Bos, Wouter J. W. Kollen, Wim C. J. Hop, Claudia Lanvers-Kaminsky, Mary V. Relling, Wim J. E. Tissing, Inge M. van der Sluis
Journal: Blood (2014)
Clinical pharmacology and economics of recombinant human erythropoietin in end-stage renal disease
Authors: A Besarab, K K Flaharty, A J Erslev, J B McCrea, P H Vlasses, F Medina, J Caro, E Morris
Journal: Journal of the American Society of Nephrology (1992)

The clinical pharmacology of human recombinant erythropoietin (epoetin) was studied in order to compare the effectiveness of various routes and dosing schedules in dialysis patients. Thirty-six patients received epoetin beta three times a week i.v. for at least 12 wk. The mean dose needed to achieve target hemoglobin was 225 +/- 36 U/kg per week (median dose, 180 U/kg per week). Twenty-eight of 36 patients who were converted to a once-a-week i.v. schedule increased their requirements to 429 +/- 50 U/kg per week in order to maintain a target hematocrit of 33 to 40 vol%. Twelve of 28 patients could maintain their target hematocrit when dosed once a week s.c. at 84 +/- 10 U/kg. The other 16 patients required 137 +/- 15 U/kg per week divided into two doses. In the entire group of 28 patients, the weekly requirement for epoetin was reduced by 50% when the s.c. route was used two or three times a week. Pharmacokinetic studies performed during chronic therapy indicated rapid clearance of erythropoietin (t1/2 of 6.8 +/- 0.3 h). Single i.v. doses greater than 150 U/kg were required to increase basal erythropoietin by 30 mU/mL at 44 h postdosing. With s.c. dosing, such increments in erythropoietin levels frequently persisted beyond 60 h because of prolonged and slow absorption. Pharmacokinetic simulations in conjunction with clinical correlation of the erythropoietic response suggest that the duration that the erythropoietin levels are maintained, and not the absolute peaks, is the primary determinant of efficacy. This may result from nonlinearity in the dose response. Pharmacokinetic simulation also indicated that i.v. dosing could not maintain adequate interdialytic erythropoietin levels, whereas s.c. dosing could. Cost analysis indicated that the use of s.c. dosing two or three times a week at an average total weekly dose of 110 to 120 U/kg is effective treatment of anemia in most dialysis patients.
Longitudinal association between coping and psychological distress in rheumatoid arthritis: a systematic review
Authors: J. E. Vriezekolk, W. G. van Lankveld, R. Geenen, C. H. van den Ende
Journal: Annals of the Rheumatic Diseases (2011)

<h3>Objective</h3> To examine the longitudinal association between coping and psychological distress in rheumatoid arthritis (RA). <h3>Methods</h3> Bibliographic databases up to July 2010 were searched for longitudinal studies with a follow-up of ≥6 months. Two reviewers assessed the methodological quality of the included studies. Study characteristics, coping strategies and coping-psychological distress associations were extracted. Coping strategies were categorised using a hierarchical taxonomy. A best-evidence synthesis determined the level of evidence for a prognostic association of coping with depression, anxiety and general distress. <h3>Results</h3> From an initial set of 2605 potentially relevant studies, 19 studies (14 cohorts) met the predefined selection criteria. In all, 10 studies were of 'high quality' (≥12 of 18 quality criteria). Unadjusted bivariate correlations showed that baseline approach-oriented coping correlated with lower psychological distress (<i>r</i> between 0.007–0.46, p values &lt;0.05) and baseline avoidant-oriented coping correlated with higher psychological distress (<i>r</i> between 0.29–0.64, p values &lt;0.05) at follow-up. Adjusted for baseline psychological distress, limited evidence was found that avoidant-oriented coping was longitudinally associated with an increase in psychological distress. Specifically, the categories helplessness, avoidance and wishful thinking were prognostically associated with increased general psychological distress. Approach-oriented coping was not associated with subsequent psychological distress. <h3>Conclusions</h3> The prognostic value of coping strategies for later psychological distress in RA is weak. Limited evidence suggests that avoidant-oriented coping is associated with increased subsequent psychological distress. No evidence was found that approach-oriented coping protects against an increase of psychological distress.
Absorption, Metabolization, and Antiplatelet Effects of 300-, 600-, and 900-mg Loading Doses of Clopidogrel
Authors: Nicolas von Beckerath, Dirk Taubert, Gisela Pogatsa-Murray, Edgar Schömig, Adnan Kastrati, Albert Schömig
Journal: Circulation (2005)

Background— For patients undergoing percutaneous coronary intervention, the administration of a clopidogrel loading dose ranging from 300 to 600 mg is currently recommended. It is unknown, though, whether loading doses higher than 600 mg exert additional suppression of platelet function. Methods and Results— Sixty patients with suspected or documented coronary artery disease admitted to our hospital for coronary angiography were included in this trial. They were allocated to 1 of 3 clopidogrel loading doses (300, 600, or 900 mg) in a double-blinded, randomized manner. Plasma concentrations of the active thiol metabolite, unchanged clopidogrel, and the inactive carboxyl metabolite of clopidogrel were determined before and serially after drug administration. Optical aggregometry was performed before and 4 hours after administration of clopidogrel. Loading with 600 mg resulted in higher plasma concentrations of the active metabolite, clopidogrel, and the carboxyl metabolite compared with loading with 300 mg ( P ≤0.03) and lower values for adenosine diphosphate-induced (5 and 20 μmol/L) platelet aggregation 4 hours after drug administration ( P =0.01 and 0.004). With administration of 900 mg, no further increase in plasma concentrations of active metabolite and clopidogrel ( P ≥0.38) and no further suppression of adenosine diphosphate-induced (5 and 20 μmol/L) platelet aggregation 4 hours after drug administration was achieved when compared with administration of 600 mg ( P =0.59 and 0.39). Conclusions— Single doses of clopidogrel higher than 600 mg are not associated with an additional significant suppression of platelet function because of limited clopidogrel absorption.
Gangrene in Behcet's syndrome.
Authors: B. A. Enoch
Journal: BMJ (1969)

It is regrettable that P.E.F.measure- ments continue ito be popular among clini- cians,' despite warnings about their relative lack of sensitivity in assessing airway obstruc- tion published in your columns years ago.2'More recent studies which have clarified the relationship between lung volume, expiratory flow rate, and alveolar pressure' 5 substanti- ate the view that "The measurement of the maximal expiratory flow rate . . .cannot be recommended as a single lung function test."'Maximum expiratory flow rates depend on lung volume, and flow rates at small lung volumes are more depressed under conditions of peripheral airway obstruction than P.E.F.5 7 ' Leuallen and Fowler' realized this fact long ago, when they introduced the measurement of mid-expiratory flow rate.Measurement of spirometric values such as the F.E.V.1 or mid-expiratory flow rate, or recordings of maximum expiratory flow- volume curves, all include, directly or indirectly; information on maximum flows occurring at smaller lung volumes than that at which P.E.F. is reached.Any one of these methods would have indicated the severity of the persistent airway obstruction in the patient of Dr. Gregg and Dr. Batten more adequately than P.E.
Indomethacin Blocks Enhanced Paracellular Backflux in Proximal Tubules
Authors: Carla R. Ramsey, Theresa J. Berndt, Franklyn G. Knox
Journal: Journal of the American Society of Nephrology (2002)

ABSTRACT. Renal interstitial hydrostatic pressure (RIHP) is a link between increased arterial BP and natriuresis. The mechanism whereby increases in RIHP inhibits sodium and water transport across the mammalian proximal tubule epithelium may involve changes in flux across the tight junction of the proximal tubule. The purpose of this study was to determine the effects of increases in RIHP and inhibition of cyclooxygenase on paracellular backflux of an extracellular marker from the renal interstitium into the proximal tubule of the rat. During in vivo microperfusion of proximal tubules, the extracellular tracer of paracellular flux, lanthanum (La), was infused directly into the renal interstitium via a chronically implanted matrix. The net paracellular interstitium-to-lumen lanthanum backflux was measured before and after direct renal interstitial volume expansion (DRIVE) in the absence and presence of indomethacin. DRIVE significantly increased RIHP by 37% (Δ1.8 ± 0.2 mmHg) and interstitium-to-lumen La backflux by 32% (Δ40.2 ± 16.6 pg/min per mm), and it significantly decreased proximal reabsorption by 27% (Δ−7.7 ± 3.8 nl/min; n = 6). In indomethacin-treated rats (n = 6), DRIVE again significantly increased RIHP by 40% (Δ1.9 ± 0.2 mmHg), but it did not increase La backflux (Δ−39.0 ± 24.4 pg/min per mm) or significantly decrease proximal reabsorption (Δ1.2 ± 2.3 nl/min). These results demonstrate that increased RIHP increases paracellular backflux of lanthanum from the renal interstitium to the proximal tubule lumen in association with decreases in proximal reabsorption. Furthermore, indomethacin blocks the effects of increased RIHP on proximal reabsorption and paracellular backflux of lanthanum through the intercellular tight junctions of the proximal tubule epithelium.
Human Reg I Gene Is Up–Regulated in Intrahepatic Cholangiocarcinoma and Its Precursor Lesions
Authors: Kenichi Harada, Yoh Zen, Yoshiko Kanemori, Tse-Ching Chen, Miin-Fu Chen, Ta-Sen Yeh, Yi-Yin Jan, Shinji Masuda, Yuji Nimura, Shin Takasawa, Hiroshi Okamoto, Yasuni Nakanuma
Journal: Hepatology (2001)

The Reg I gene (regenerating gene) and its product (Reg protein) are a regenerating and/or proliferating factor(s) of pancreatic islet cells. The ectopic expression of REG Iα was shown in colorectal carcinomas, suggesting that REG Iα is related to their carcinogenesis. In this study, we examined the expression of REG I in intrahepatic cholangiocarcinoma (ICC) and its precursor lesion (biliary dysplasia). By polymerase chain reaction and in situ hybridization (ISH) studies using a total of 16 fresh liver specimens, REG Iα mRNA was demonstrated in 6 of 11 (55%) ICC cases, but in 0 of 5 (0%) normal livers. Immunohistochemistry for REG I protein was performed in 100 formalin–fixed, paraffin–embedded sections obtained from the 18 cases of ICC alone, 45 hepatolithiasis with ICC (n = 19) or biliary dysplasia (n = 26), 21 hepatolithiasis alone (all with hyperplasia), and 16 normal livers. In ICC, the expression of REG I protein was significantly dependent on the histologic differentiation; 12 of 13 (92%) cases in papillary and well–differentiated, 6 of 16 (38%) cases in moderately differentiated, and 0 of 8 (0%) cases in poorly differentiated types. Moreover, in the lesions of hyperplasia, low–grade dysplasia, and high–grade dysplasia in hepatolithiasis, REG I protein was expressed in 4 of 21 (19%), 7 of 12 (58%), and 13 of 14 (93%) cases, respectively. In normal liver, intrahepatic bile ducts were constantly negative for REG I protein. These findings suggest that neoexpression of REG I is a good marker for biliary mucosa at risk for development of ICC, and also that REG I plays a role in the early stages of biliary carcinogenesis, probably via a cell–proliferative effect. (Hepatology 2001;33:1036–1042.)
Patient empowerment or the emperor's new clothes
Authors: P. Salmon, G. M Hall
Journal: Journal of the Royal Society of Medicine (2004)

Patient empowerment pervades clinical practice, teaching and research: patients are expected to take control over their illnesses or treatments where possible, and doctors are expected to encourage or 'empower' them to do so. The concept is in tune with a wider political and cultural emphasis on individual choice, and gains scientific justification from psychological research and theory that attests to the superiority of ways of coping with challenges—including illness or treatment—that exert control over the challenge.1 The validity of the view that patients should be empowered to take control and make choices is therefore widely assumed to be unassailable.

Nevertheless, patient empowerment sits uncomfortably with other current medical ideologies, in particular evidence-based medicine.2 Moreover it is, in reality, constrained by organizational, clinical or economic factors. The scientific basis for the importance of choice and control is also weaker than it first appears. Although controlled studies of empowerment—for example, arranging for patients to choose the nature or timing of treatment, or teaching them 'coping skills'—do often favour intervention groups,1 effects are variable; sometimes they are transient or favour lack of choice. Moreover, whereas it is normally assumed that such interventions enhance feelings of choice or control, researchers have rarely demonstrated that they do. In a study of treatment choice in breast cancer, even though patients of surgeons who offered choice were happier, choice was not the critical factor.3

Because of these contradictions and ambiguities, the concept of empowerment needs to be more closely examined than it has been. The term empowerment purports to describe the positivity of patients' experience of involvement in managing illness. Therefore the validity of the concept should be tested by studying the experience of patients who have been empowered.
Three-dimensional Imaging of Cystoid Macular Edema in Retinal Vein Occlusion
Authors: Noritatsu Yamaike, Akitaka Tsujikawa, Masafumi Ota, Atsushi Sakamoto, Yuriko Kotera, Mihori Kita, Kazuaki Miyamoto, Nagahisa Yoshimura, Masanori Hangai
Journal: Ophthalmology (2007)
Phase II study of first-line LY231514 (multi-targeted antifolate) in patients with locally advanced or metastatic colorectal cancer: An NCIC Clinical Trials Group study
Authors: C. Cripps, M. Burnell, J. Jolivet, G. Batist, W. Lofters, J. Dancey, J. Iglesias, B. Fisher, E.A. Eisenhauer
Journal: Annals of Oncology (1999)
Postinfarction Treatment With an Adenoviral Vector Expressing Hepatocyte Growth Factor Relieves Chronic Left Ventricular Remodeling and Dysfunction in Mice
Authors: Yiwen Li, Genzou Takemura, Ken-ichiro Kosai, Kentaro Yuge, Satoshi Nagano, Masayasu Esaki, Kazuko Goto, Tomoyuki Takahashi, Kenji Hayakawa, Masahiko Koda, Yukinori Kawase, Rumi Maruyama, Hideshi Okada, Shinya Minatoguchi, Hiroyuki Mizuguchi, Takako Fujiwara, Hisayoshi Fujiwara
Journal: Circulation (2003)

Background— Hepatocyte growth factor (HGF) is implicated in tissue regeneration, angiogenesis, and antiapoptosis. However, its chronic effects are undetermined on postinfarction left ventricular (LV) remodeling and heart failure. Methods and Results— In mice, on day 3 after myocardial infarction (MI), adenovirus encoding human HGF (Ad.CAG-HGF) was injected into the hindlimb muscles (n=13). As a control (n=15), LacZ gene was used. A persistent increase in plasma human HGF was confirmed in the treated mice: 1.0±0.2 ng/mL 4 weeks later. At 4 weeks after MI, the HGF-treated mice showed improved LV remodeling and dysfunction compared with controls, as indicated by the smaller LV cavity and heart/body weight ratio, greater % fractional shortening and LV ±dP/dt, and lower LV end-diastolic pressure. The cardiomyocytes near MI, including the papillary muscles and trabeculae, were greatly hypertrophied in the treated mice. The old infarct size was similar between the groups, but the infarct wall was thicker in the treated mice, where the density of noncardiomyocyte cells, including vessels, was greater. Fibrosis of the ventricular wall was significantly reduced in them. Examination of 10-day-old MI revealed no proliferation or apoptosis but showed augmented expression of c-Met/HGF receptor in cardiomyocytes near MI, whereas a greater proliferating activity and smaller apoptotic rate of granulation tissue cells in the HGF-treated hearts was observed compared with controls. Conclusions— Postinfarction HGF gene therapy improved LV remodeling and dysfunction through hypertrophy of cardiomyocytes, infarct wall thickening, preservation of vessels, and antifibrosis. These findings imply a novel therapeutic approach against postinfarction heart failure.
Salmonella typhimurium. Transmission by fiberoptic upper gastrointestinal endoscopy
Authors: H. J. Beecham
Journal: JAMA (1979)

During a four-month period,<i>Salmonella typhimurium</i>developed in seven persons within five days of fiberoptic upper gastrointestinal (GI) endoscopy. A retrospective cohort study confirmed the association between<i>S typhimurium</i>infection and fiberoptic upper GI endoscopy.<i>Salmonella typhimurium</i>was cultured from the endoscopic equipment and the accessory suction equipment. The<i>Salmonella</i>isolated from the endoscopic and accessory suction equipment was identical to that recovered from the seven patients with salmonellosis by serotype, antimicrobial susceptibility pattern, and bacteriophage lysis pattern.<i>Salmonella</i>transmission was attributed to inadequate disinfection of the endoscope and accessory equipment between procedures. The original source of the contamination was not discovered. (<i>JAMA</i>241:1013-1015, 1979)
Orofacial injuries and international rugby players' attitudes to mouthguards.
Authors: P J Chapman
Journal: British Journal of Sports Medicine (1990)

This is the first such study of British rugby and the third yet published, the other two involving the 1984 Australian Wallabies and the 1987 United States Eagles. The report shows that while all 30 players believed mouthguards provided local protection, nine did not wear a mouthguard. Only one of the 21 who wore a mouthguard was willing to play without it, while eight mouthguard wearers felt mouthguards should be compulsory for adult rugby players. Twelve players had previously sustained an orofacial injury playing rugby which required treatment, only one of whom was wearing a mouthguard at the time. The full results are presented and compared with those of the previous two reports.