tbuckley/cabot-search huggingface dataset:
Idiopathic chronic pancreatitis in India: phenotypic characterisation and strong genetic susceptibility due to SPINK1 and CFTR gene mutations
Authors: S. Midha, R. Khajuria, S. Shastri, M. Kabra, P. K. Garg
Journal: Gut (2010)

<h3>Objective</h3> To study the genetic predisposition, phenotype and prognosis of idiopathic chronic pancreatitis (CP). <h3>Design</h3> Prospective observational and case–control study. <h3>Setting</h3> Tertiary care academic centre. <h3>Patients</h3> Consecutive patients with CP. <h3>Interventions</h3> Detailed mutational analysis was done for the cationic trypsinogen, <i>SPINK1</i> and <i>CFTR</i> genes with single-strand conformational polymorphism or restricted fragment length polymorphism, and sequencing. Clinical and disease characteristics of idiopathic versus alcoholic CP, and early onset versus late onset idiopathic CP were compared. Response to multimodality treatment (medical, endoscopic and/or surgical) and prognosis were analysed. <h3>Main outcome measures</h3> Genetic mutations, phenotypic characterisation and prognosis of idiopathic CP. <h3>Results</h3> Of the 411 patients with CP, 242 had idiopathic aetiology (age 27.50±11.85 years; 154 men). Malnutrition and cassava were not risk factors. <i>SPINK1</i> N34S mutation was present in 42% of patients with idiopathic CP (vs 4% controls, p&lt;0.001) and 17% of patients with alcoholic CP (p=0.016 compared with controls). In the <i>CFTR</i> gene, nine patients with idiopathic CP had mutations and 41 patients had polymorphisms (50% vs 10% controls, p&lt;0.001). Diabetes developed in 35.53% of patients with idiopathic CP. About 85% of patients had significant pain relief with therapy. The probability of surviving for 35 years after onset of idiopathic CP was 83%. The typical features of tropical calcific pancreatitis were seen only in 5.8% of patients. <h3>Conclusion</h3> Strong genetic susceptibility due to <i>SPINK1</i> and <i>CFTR</i> gene mutations, and comparative phenotype of idiopathic CP in India suggest that the term 'tropical calcific pancreatitis' is a misnomer.
Sunscreen Use and the Risk for Melanoma: A Quantitative Review
Authors: Leslie K. Dennis, Laura E. Beane Freeman, Marta J. VanBeek
Journal: Annals of Internal Medicine (2003)

Background: Originally developed to protect against sunburn, sunscreen has been assumed to prevent skin cancer. However, conflicting reports include claims that sunscreen increases risk for melanoma. Objective: To examine the strength and consistency of associations between melanoma and sunscreen use in the published literature. Data Sources: A comprehensive MEDLINE search of articles published from 1966 to 2003 that reported information on sunscreen use and melanoma in humans. Study Selection: Analytic studies reporting data on sunscreen use before diagnosis of melanoma. Data Extraction: Two independent reviewers extracted data. Inconsistencies were rereviewed until agreement was achieved. When necessary, a third party resolved discrepancies. Data Synthesis: Odds ratios were pooled across studies by using standard meta-analytic techniques. Pooled odds ratios for ever use among 18 heterogeneous studies did not support an association between melanoma and sunscreen use. Variation among odds ratios was explained by studies that did not adjust for confounding effects of sun sensitivity. The lack of a dose–response effect with frequency of use (never, sometimes, or always) or years of use provided further evidence of a null association. Conclusions: No association was seen between melanoma and sunscreen use. Failure to control for confounding factors may explain previous reports of positive associations linking melanoma to sunscreen use. In addition, it may take decades to detect a protective association between melanoma and use of the newer formulations of sunscreens.
Louise Marson (Tebboth)
Authors: R. Torry, G. Marson
Journal: BMJ (2015)

Louise Marson, who practised under her maiden name of Tebboth, was born into a British family in Johannesburg and spent much of her early childhood in South Africa and Canada before finishing her schooling in Kingston-upon-Thames and attending medical school at Sheffield University.

Louise cared passionately about people and making their lives better. She instinctively identified with and supported the underdog and was driven throughout her life by a desire to assist disadvantaged individuals and communities. This led her to work with leprosy patients in India and to spend most of her career in general practice in a socially deprived area of southeast London, with the Bermondsey and Lansdowne Medical Mission. Even when Louise returned …
Intramuscular triamcinolone acetonide in chronic severe asthma.
Authors: D T McLeod, S J Capewell, J Law, W MacLaren, A Seaton
Journal: Thorax (1985)

Seventeen subjects with chronic severe asthma completed a 48 week prospective, double blind study with crossover of treatment at 24 weeks, in which triamcinolone acetonide 80 mg intramuscularly every four weeks was compared with oral prednisolone 10 mg daily. Spirometry, twice daily measurements of peak expiratory flow rate, and self assessment of asthma symptom scores showed significant improvement during triamcinolone treatment; less extra prednisolone was required and there was significant weight loss. Two patients withdrew, one because of dissatisfaction with prednisolone and one because of side effects while taking triamcinolone. Three were withdrawn, one with proximal muscle weakness and two because of intercurrent illness. Adrenal suppression, bruising, and hirsuitism were worse with triamcinolone, other side effects being comparable. On completion of the study 16 of the 17 patients opted to continue taking triamcinolone acetonide. This treatment is an important addition to the therapeutic options available for chronic severe asthma.
Association of Diabetes Mellitus With Use of Atypical Neuroleptics in the Treatment of Schizophrenia
Authors: Michael J. Sernyak, Douglas L. Leslie, Renato D. Alarcon, Miklos F. Losonczy, Robert Rosenheck
Journal: American Journal of Psychiatry (2002)

OBJECTIVE: The development of both type I and type II diabetes after initiation of some atypical neuroleptics has been reported, primarily in studies involving small series of patients. This study used administrative data from a large national sample of patients with a diagnosis of schizophrenia to compare the prevalence of diabetes mellitus in patients receiving prescriptions for atypical and typical neuroleptics. METHOD: All outpatients with schizophrenia treated with typical and atypical neuroleptics over 4 months in 1999 in the Veterans Health Administration of the Department of Veterans Affairs (VA) were included in this study. Patients treated with atypical neuroleptics were those who received prescriptions for clozapine, olanzapine, risperidone, or quetiapine. Patients with a diagnosis of diabetes were also identified by using ICD-9 codes in VA administrative databases. The prevalence of diabetes mellitus across age groups and among patients receiving prescriptions for different atypical neuroleptics was examined with multiple logistic regression. RESULTS: A total of 38,632 patients were included in the study: 15,984 (41.4%) received typical neuroleptics and 22,648 (58.6%) received any atypical neuroleptic (1,207 [5.3%] received clozapine; 10,970 [48.4%], olanzapine; 955 [4.2%], quetiapine; and 9,903 [43.7%], risperidone; 387 patients received prescriptions for more than one atypical neuroleptic). When the effects of age were controlled, patients who received atypical neuroleptics were 9% more likely to have diabetes than those who received typical neuroleptics, and the prevalence of diabetes was significantly increased for patients who received clozapine, olanzapine, and quetiapine, but not risperidone. However, for patients less than 40 years old, all of the atypical neuroleptics were associated with a significantly increased prevalence of diabetes. CONCLUSIONS: In this large group of patients with schizophrenia, receipt of a prescription for atypical neuroleptics was significantly associated with diabetes mellitus.
The LungPath study: variation in the diagnostic and staging pathway for patients with lung cancer in England: Table 1
Authors: Paul Cane, Karen Linklater, George Santis, Henrik Møller, Michael Peake
Journal: Thorax (2015)

The LungPath project investigated differences in lung cancer diagnostic practice by following the diagnostic pathways of 1507 patients from 19 representative English lung cancer centres. We found large variation in the proportion of patients receiving positron emission tomography-CT scan (range 13%–64%) and endobronchial ultrasound (range 2%–31%). There was also wide variation in the proportion of patients with good performance status who had their tumours histologically confirmed (range 61%–100%). The variation is discussed with reference to current national guidelines and implications for patient care.
Rethinking Rapid Response Teams
Authors: Eugene Litvak, Peter J. Pronovost
Journal: JAMA (2010)

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
Hydration and thermal strain during tennis in the heat
Authors: Michael F Bergeron
Journal: British Journal of Sports Medicine (2014)

Competitive tennis in the heat can prompt substantial sweat losses and extensive consequent body water and electrolyte deficits, as well as a level of thermal strain that considerably challenges a player's physiology, perception of effort, and on-court well-being and performance. Adequate hydration and optimal performance can be notably difficult to maintain when multiple same-day matches are played on successive days in hot weather. Despite the recognised effects of the heat, much more research needs to be carried out to better appreciate the broader scope and full extent of the physiological demands and hydration and thermal strain challenges facing junior and adult players in various environments, venues and competition scenarios. However, certain recommendations of best practices should be emphasised to minimise exertional heat illness risk and improve player safety, well-being and on-court performance.
Multimodality Therapy for Locally Advanced Cervical Carcinoma: State of the Art and Future Directions
Authors: Bradley J. Monk, Krishnansu S. Tewari, Wui-Jin Koh
Journal: Journal of Clinical Oncology (2007)

Globally, cervical cancer is the second most common cause of cancer-related mortality among women causing approximately 234,000 deaths annually among developing countries and killing 40,000 in developed nations. Most of these deaths occur in women with bulky or locally advanced cervical cancer, International Federation of Gynecology and Obstetrics (FIGO) stages IIB through IVA, when lesions are not amenable to high cure rates with surgery or radiation (RT). The standard prescription for RT used to treat locally advanced cervical cancer has been dictated by common practice and patterns of care studies. In contrast, the addition of concomitant chemotherapy to RT has been studied in a number of randomized prospective trials, which are discussed in detail. When added to RT, cisplatin reduces the relative risk of death from cervical carcinoma by approximately 50% by decreasing local/pelvic failure and distant metastases. In 1999, weekly intravenous cisplatin at 40 mg/m 2 for 6 weeks in combination with RT was established as a new standard for the treatment of locally advanced cervical carcinoma. More recently, this recommendation has been expanded to include women with FIGO stage IB2 lesions as well as those with bulky stage IIA cancers. This monograph reviews the state of the art in treating locally advanced cervical cancer with combined chemotherapy and RT and discusses clinical and pathologic prognostic factors that impact cure. Quality of life during and after multimodality therapy is considered as well as ongoing clinical trials and future directions.
The Road to the Production of IgE Is Long and Winding
Authors: ALEXANDER KARNOWSKI, PHILIPP YU, GERNOT ACHATZ, MARINUS C. LAMERS
Journal: American Journal of Respiratory and Critical Care Medicine (2000)

Immunoglobulins are found in two forms. As secreted proteins (sIg) they represent the effector arm of the humoral immune system. They are also found as integral membrane proteins on B lymphocytes (mIg). In this physical state they are connected to signal transduction cascades in the cell. They convey signals to guide the B cell along its differentiation pathway and allow it to respond to antigen. The mIg transmembrane segments are about 25 amino acids long and have the potential for interaction with other polypeptides (1). The cytoplasmic domains of mIgs are different in size and range from only three amino acid residues (KVK) in the case of mIgM and mIgD to 14 residues for IgA and 28 residues for the other mIg subclasses. The nature and effects of the signals generated by the antigen receptor, in particular mIgM and mIgD, are under intense study. For this article the role that was established for mIgM in the early development of the B cell, in the pre-B cell stage, is of significance: The expression of mIgM is an absolute prerequisite for further development (2). Also, later in development mIgM is essential for survival (3). About the function of the intracellular domains, little is known as to date. It is speculated that they can control mechanisms such as affinity maturation (4, 5), class switch (6, 7), memory induction (8), and differentiation into plasma cells. A step forward in the understanding of the role of mIgs other than mIgM or mIgD was achieved with mouse lines that carried mutations in the « (9) or g 1 (10) heavy chain gene. In mutant mice that lack the transmembrane domains of IgE or IgG 1 , serum IgE or IgG 1 are virtually absent, whereas in mice lacking the cytoplasmic domains of IgE or IgG 1 a severe impairment of T celldependent immune responses is seen. Class switch to IgE or IgG was not impaired by the targeting event. These results imply that the reduced IgE or IgG 1 titers found in the mutant lines are solely a reflection of the loss of biological activities associated with the transmembrane and cytoplasmic domains of IgE and IgG 1 . These data, and the data of Loder and colleagues from our own laboratory (11), unambiguously stress the importance of the signalling function of membrane-bound Ig for the survival and differentiation of the B cell. In this review we discuss events that lead to membrane expression of IgE.
Effects of Hemodialyzer Reuse on Clearances of Urea and β2-Microglobulin
Authors: ALFRED K. CHEUNG, LAWRENCE Y. AGODOA, JOHN T. DAUGIRDAS, THOMAS A. DEPNER, FRANK A. GOTCH, TOM GREENE, NATHAN W. LEVIN, JOHN K. LEYPOLDT
Journal: Journal of the American Society of Nephrology (1999)

Abstract. Although dialyzer reuse in chronic hemodialysis patients is commonly practiced in the United States, performance of reused dialyzers has not been extensively and critically evaluated. The present study analyzes data extracted from a multicenter clinical trial (the HEMO Study) and examines the effect of reuse on urea and β 2 -microglobulin (β 2 M) clearance by low-flux and high-flux dialyzers reprocessed with various germicides. The dialyzers evaluated contained either modified cellulosic or polysulfone membranes, whereas the germicides examined included peroxyacetic acid/acetic acid/hydrogen peroxide combination (Renalin®), bleach in conjunction with formaldehyde, glutaraldehyde or Renalin, and heated citric acid. Clearance of β 2 M decreased, remained unchanged, or increased substantially with reuse, depending on both the membrane material and the reprocessing technique. In contrast, urea clearance decreased only slightly (approximately 1 to 2% per 10 reuses), albeit statistically significantly with reuse, regardless of the porosity of the membrane and reprocessing method. Inasmuch as patient survival in the chronic hemodialysis population is influenced by clearances of small solutes and middle molecules, precise knowledge of the membrane material and reprocessing technique is important for the prescription of hemodialysis in centers practicing reuse.
Can sutures get wet? Prospective randomised controlled trial of wound management in general practice
Authors: Clare Heal, Petra Buettner, Beverly Raasch, Sheldon Browning, David Graham, Rachel Bidgood, Margaret Campbell, Robert Cruikshank
Journal: BMJ (2006)

<h3>Abstract</h3> <b>Objective</b> To compare standard management of keeping wounds dry and covered with allowing wounds to be uncovered and wet in the first 48 hours after minor skin excision. <b>Design</b> Prospective, randomised controlled, multicentre trial testing for equivalence of infection rates. <b>Setting</b> Primary care in regional centre, Queensland, Australia. <b>Participants</b> 857 patients randomised to either keep their wound dry and covered (n = 442) or remove the dressing and wet the wound (n = 415). <b>Results</b> The incidence of infection in the intervention group (8.4%) was not inferior to the incidence in the control group (8.9%) (P &lt; 0.05). The one sided 95% confidence interval for the difference of infection rates was ∞ to 0.028. <b>Conclusion</b> These results indicate that wounds can be uncovered and allowed to get wet in the first 48 hours after minor skin excision without increasing the incidence of infection.
Early eradication therapy against<i>Pseudomonas aeruginosa</i>in cystic fibrosis patients
Authors: G. Taccetti, S. Campana, F. Festini, M. Mascherini, G. Döring
Journal: European Respiratory Journal (2005)

In cystic fibrosis (CF) patients early antibiotic treatment of lung infection has been shown to lead to Pseudomonas aeruginosa eradication. The present study determined: 1) the time period from eradication to new P. aeruginosa acquisition; 2) P. aeruginosa re-growth and new acquisition; and 3) the impact of eradication therapy on lung function, antimicrobial resistance, emergence of other pathogens and treatment costs. Ciprofloxacin and colistin were used to eradicate P. aeruginosa in 47 CF patients. Bacterial pathogens, lung function decline, P. aeruginosa antimicrobial resistance and anti-pseudomonal serum antibodies were assessed quarterly and compared with an age-matched CF control group. Additionally, costs of antibiotic therapy in both groups were assessed. Early antibiotic therapy leads to a P. aeruginosa free-period of a median (range) of 18 (4–80) months. New acquisition with different P. aeruginosa genotypes occurs in 73% of episodes. It also delays the decline of lung function compared with chronically infected patients, prevents the occurrence of antibiotic resistant P. aeruginosa strains, does not lead to emergence of other pathogens, and significantly reduces treatment costs. The treatment substantially lowers P. aeruginosa prevalence in CF. In conclusion, early antibiotic therapy exerts beneficial effects on the patient's clinical status and is cost-effective compared with conventional antibiotic therapy for chronically infected cystic fibrosis patients.
Intraventricular rifampicin in severe tuberculous meningo-encephalitis
Authors: W Vincken, M Meysman, D Verbeelen, S Lauwers, J D'Haens
Journal: European Respiratory Journal (1992)

We present a patient acutely ill from severe tuberculous meningo-encephalitis, in whom acute hepatic and renal failure, due to intercurrent septic shock, precluded the administration of full systemic dosage of antituberculous drugs. Daily direct intraventricular administration of 5 mg rifampicin, via a subcutaneous Ommaya reservoir connected to a catheter placed in the right lateral cerebral ventricle, resulted in rapid improvement without neurological sequelae. Intraventricular rifampicin administration for 50 consecutive days was well-tolerated without local or systemic side-effects. In well-selected patients with severe tuberculous meningo-encephalitis, intraventricular rifampicin may safely and highly effectively be added to systemic antituberculous therapy.
Plasma Adiponectin Levels and Risk of Myocardial Infarction in Men
Authors: Tobias Pischon
Journal: JAMA (2004)

ContextAdiponectin, a recently discovered adipocyte-derived peptide, is involved in the regulation of insulin sensitivity and lipid oxidation and, purportedly, in the development of atherosclerosis and coronary heart disease in humans.ObjectiveTo assess prospectively whether plasma adiponectin concentrations are associated with risk of myocardial infarction (MI).Design, Setting, and ParticipantsNested case-control study among 18 225 male participants of the Health Professionals Follow-up Study aged 40 to 75 years who were free of diagnosed cardiovascular disease at the time of blood draw (1993-1995). During 6 years of follow-up through January 31, 2000, 266 men subsequently developed nonfatal MI or fatal coronary heart disease. Using risk set sampling, controls were selected in a 2:1 ratio matched for age, date of blood draw, and smoking status (n = 532).Main Outcome MeasureIncidence of nonfatal MI and fatal coronary heart disease by adiponectin level.ResultsAfter adjustment for matched variables, participants in the highest compared with the lowest quintile of adiponectin levels had a significantly decreased risk of MI (relative risk [RR], 0.39; 95% confidence interval [CI], 0.23-0.64; P for trend &lt;.001). Additional adjustment for family history of MI, body mass index, alcohol consumption, physical activity, and history of diabetes and hypertension did not substantively affect this relationship (RR, 0.41; 95% CI, 0.24-0.70; P for trend &lt;.001). Further adjustment for hemoglobin A1c or C-reactive protein levels also had little impact, but additional adjustment for low- and high-density lipoprotein cholesterol levels modestly attenuated this association (RR, 0.56; 95% CI, 0.32-0.99; P for trend = .02).ConclusionsHigh plasma adiponectin concentrations are associated with lower risk of MI in men. This relationship can be only partly explained by differences in blood lipids and is independent of inflammation and glycemic status.