tbuckley/cabot-search huggingface dataset:
The Purple Dye That Heals
Authors: Samantha Hsieh, Eric L. Maranda, Tarek Salih, Maria de la Paz Flores, Joaquin Jimenez
Journal: JAMA Dermatology (2016)

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 Dermatology 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 Dermatology journal
S111 Does rate of decline in lung function predict response to Pirfenidone therapy in patients with Idiopathic Pulmonary Fibrosis?
Authors: JA Eaden, C Barber, SM Bianchi
Journal: Thorax (2015)

<h3>Introduction and objectives</h3> Idiopathic pulmonary fibrosis (IPF) is a progressive, irreversible interstitial lung disease with a poor prognosis. Randomised, placebo-controlled clinical trials have shown that treatment of IPF patients with pirfenidone reduces disease progression. Published studies used incident forced vital capacity (FVC) values for study inclusion. Our objective was to determine whether the rate of decline in lung function predicts response to therapy. <h3>Methods</h3> The clinical records of 68 patients with IPF who started pirfenidone treatment between June 2013 and March 2015 at a UK tertiary referral centre were reviewed. 34 patients had lung function sufficient for a full evaluation. <h3>Results</h3> The mean (+/-SE) rate of decline in FVC per year pre-treatment was 196.0+/-66.1 ml versus 135.0+/-61.8 ml post treatment (p = 0.512). The decline in percent predicted FVC per year pre-treatment was 4.4+/-1.9% vs. 3.0+/-1.9% post treatment (p = 0.572). The decline in absolute total gas transfer (TLco) per year pre-treatment was 0.6+/-0.2 compared to 0.4+/-0.2 post treatment (p = 0.472). The decline in percent predicted TLco per year pre-treatment was 6.7+/-2.8% compared to 4.4 +/-2.0% post treatment (p = 0.504). Pirfenidone showed a trend towards positive benefit in all parameters measured. Patients were stratified into tertiles of slow, medium and rapid rate of FVC decline (pre-treatment). In slow and medium rate decliners (up to FVC decline of approximately 200 ml per year or 5.4% per year) no effect was seen (p = NS). In fast decliners (FVC decline 576.1+/-97.8 ml and FVC percent predicted decline 14.5+/-2.4% per year) a statistically significant effect was seen, reducing decline to 199.1+/-99.6 ml and 4.5+/-2.4% respectively (p = 0.022; 0.015). 16.2% of the patients died with a mean survival of 239 days post pirfenidone. <h3>Conclusions</h3> Pirfenidone treatment reduced disease progression (decline in FVC and TLco) in our total cohort. Our results indicate that patients with rapid decline in FVC may benefit most from pirfenidone. Those declining at less than 200 ml per year may not benefit. These results suggest that further clinical studies are warranted, including patients with evidence of rapid lung function decline with FVC &gt;80% predicted.
Case 1-2007
Authors: Michael Laposata, Elizabeth M. Van Cott, Michael H. Lev
Journal: New England Journal of Medicine (2007)

A 40-year-old woman was admitted to this hospital with epistaxis, hematemesis, and altered mental status. The patient had had heavy menstrual bleeding for 6 months, but bleeding developed at other sites 2 weeks before admission. She had no personal or family history of a bleeding disorder. On admission to this hospital, she had evidence of both bleeding and thrombosis; the laboratory evaluation showed markedly abnormal coagulation studies and a low-normal platelet count. On the 10th hospital day, the results of a diagnostic test were reported.
Sequential Coagulation Studies in Purpura Fulminans
Authors: Ray M. Antley, Campbell W. McMillan
Journal: New England Journal of Medicine (1967)

CORRECTION of abnormally low concentration of plasma components is usually attempted by replacement therapy. However, evidence from studies of purpura fulminans in man1 , 2 and from studies of the Shwartzman reaction in rabbits3 , 4 suggests that the coagulation deficiencies associated with these pathologically similar conditions5 are corrected more by anticoagulant therapy than by replacement therapy. This seemingly paradoxical treatment has developed with the concept that the deficiencies observed are due to intravascular coagulation.6 Indeed, these deficiencies are simitar to those existing in serum after in vitro coagulation of blood – for example, deficiencies of platelets and factors I (fibrinogen), II (prothrombin), V . . .
Buffalo Hump in a Patient with the Acquired Immunodeficiency Syndrome
Authors: D M Aboulafia, D Bundow
Journal: New England Journal of Medicine (1998)

Figure 1. A 52-year-old man infected with the human immunodeficiency virus (HIV) was treated with zidovudine and lamivudine when his CD4+ lymphocyte count dropped to 105 cells per cubic millimeter and the viral load was 225,000 copies of HIV RNA per milliliter. This treatment was continued for 15 months, but when the viral load tripled, the regimen was changed to highly active antiretroviral therapy consisting of two nucleoside analogues (stavudine and lamivudine) and an HIV-protease inhibitor (indinavir). Within six weeks after the initiation of therapy, the viral load fell to less than 500 copies per milliliter. One year later, the . . .
The D-Xylose Absorption Test in Malabsorption Syndromes
Authors: J. A. Benson, P. J. Culver, S. Ragland, C. M. Jones, G. D. Drummey, E. Bougas
Journal: New England Journal of Medicine (1957)

THE oral dextrose tolerance test has been employed as the conventional estimation of carbohydrate absorption. Usually, in celiac disease and nontropical sprue the blood tolerance curves are flat or show delayed peaks, suggesting a deficient or retarded rate of absorption. The normal curves ordinarily found in pancreatic exocrine insufficiency help to differentiate digestive from absorptive defects in patients with steatorrhea. Dextrose tolerance tests can be unreliable, however, in the same situation. Sometimes a "starvation-type" curve with a high maintained peak is present in the malnourished patient with sprue whereas 20 to 40 per cent of tests in healthy subjects show . . .
Death of a President
Authors: D M Morens
Journal: New England Journal of Medicine (1999)

It was the best of times. The last war had ended a generation earlier, and a European war had just been avoided. Prosperity was visible. There were new medicines for frightening diseases. As snow blanketed the Virginia countryside, the young nation's future seemed bright. It was the last month of the century: December 1799.But on a frigid afternoon, three physicians, gathered around a dying man, were not so optimistic. The man's wife looked on as he gasped for air, constantly shifting position. His aide lay on the bed beside him, repositioning him, propping up his exhausted frame. Christopher Sheels, . . .
Control of Steroid Responsiveness of Th Cells in Asthma
Authors: Akio Mori, Satoshi Kouyama, Miyako Yamaguchi, Yo Iijima, Akemi Ohtomo-Abe, Arisa Kinoshita, Yosuke Kamide, Hiroaki Hayashi, Kentaro Watai, Chihiro Mitsui, Chiyako Oshikata, Kiyoshi Sekiya, Takahiro Tsuburai, Mamoru Ohtomo, Yuma Fukutomi, Masami Taniguchi, Takayuki Ohtomo, Osamu Kaminuma
Journal: Journal of Allergy and Clinical Immunology (2016)
Multiple Melanomas in the Axoloti &lt;italic&gt;Ambystoma mexicanum&lt;/italic&gt;
Authors: V V Khudoley, V V Eliseiv
Journal: JNCI Journal of the National Cancer Institute (1979)

Multiple melanophoromas in the axoloti Ambystome mexicanum were characterized by cell anaplasia and polymorphism. Pigment spots may be the first stage of tumor development.
Exclusion of Women of Childbearing Potential in Clinical Trials of Type 2 Diabetes Medications: A Review of Protocol-Based Barriers to Enrollment
Authors: Alannah L. Phelan, Allen R. Kunselman, Cynthia H. Chuang, Nazia T. Raja-Khan, Richard S. Legro
Journal: Diabetes Care (2016)

OBJECTIVE Women of childbearing potential are often excluded from participating in clinical trials owing to concerns about adverse fetal effects of treatment. This study aims to determine the prevalence of fertility-related exclusion criteria in clinical trials of type 2 diabetes medications and to determine whether these criteria are commensurate with drug risk. RESEARCH DESIGN AND METHODS ClinicalTrials.gov was queried for trials of type 2 diabetes medications that were phase 2 or 3, were based in the U.S., and enrolled participants 18–40 years old. Six hundred eighty-eight trials met criteria. Information collected about each trial included enrollment, trial length, exclusion and inclusion criteria, trial sponsor, and pregnancy category of drug(s) administered. RESULTS Most studies (59%) included one or more fertility-related exclusion criteria, most often excluding current pregnancy (55%) and breast-feeding (44%). Trials of medications with increased fetal risk were not more restrictive: trials of category C drugs (evidence of fetal risks in animals) were less likely to exclude pregnancy compared with trials of category B drugs (no known human or animal fetal risks) (45.6% vs. 69.8%, odds ratio [OR] 0.37 [95% CI 0.20, 0.65], P = 0.0005) or to require contraceptive use (29.9% vs. 57.1%, OR 0.32 [95% CI 0.18, 0.56], P = 0.001). CONCLUSIONS In clinical trials of type 2 diabetes medications, exclusion criteria affecting women of childbearing potential are often disproportionate to risk to the participant and fetus. These criteria have the potential to impede young women’s access to clinical trials and may hinder the acquisition of clinical knowledge critical for improving the care of women with diabetes.
Acute Myocardial Infarction and Left Bundle-Branch Block — Can We Lift the Veil?
Authors: Hein J.J. Wellens
Journal: New England Journal of Medicine (1996)

When a patient presents to the emergency room with an acute episode of cardiac ischemia, the challenges for the physician are to determine whether the patient is having a myocardial infarction or has unstable angina and to determine the amount of myocardium at risk and the responsible coronary artery. That information will influence the decision to restore blood flow to the jeopardized area with thrombolytic agents or balloon angioplasty. In the acute phase of cardiac ischemia, the electrocardiogram is still the most important source of information to address these questions. Both the QRS complex and changes in the ST-T segment . . .
PWE-435 Abdominal tuberculosis – 10 year experience from a uk district general hospital
Authors: M Ford, H Boyd-Carson, BR Disney, M Doherty, S Ishaq
Journal: Gut (2015)

<h3>Introduction</h3> The rate of tuberculosis has remained relatively stable over the past decade. However, the proportion of cases with extra-pulmonary disease has increased from 40.9% to 47.9%. Multiple studies have shown that diagnosis of abdominal tuberculosis (ATB) is often delayed due to non-specific symptoms in patients. The aim of this study was to examine a selection of patients from a UK district general hospital with a diagnosis of ATB and the process in which that diagnosis was reached. <h3>Method</h3> We performed a retrospective review of all patients at Russells Hall Hospital, Dudley, who had a diagnosis of ATB between 2004 and 2014. Demographic, clinical, laboratory and radiographical findings were collated including the time delay between hospital presentation and diagnosis. <h3>Results</h3> Sixteen cases of ATB were identified with a median age of 38.5 years at time of diagnosis (range 22–73 years) with a male gender of 56%. The majority (87.5%) were of non-white background; South Asian (69%), Afrocaribbean (19%) and White British (12%). The commonest features were abdominal pain (62.5%), weight loss (50%) and fevers (50%). The time between first presentation to hospital and diagnosis ranged from 2 days to 3 years. Basic investigations revealed mean haemoglobin of 11.9 ± 1.7 g/dL, CRP of 109 ± 92 mg/L, alkaline phosphatase of 200 ± 160 IU/L, and albumin of 37.1 ± 6.5 g/L. The chest x-ray was normal in 11 patients; abnormalities seen were consolidation in 3 patients and a cavitating lesion in 1 patient. One patient did not have an x-ray. There was a wide range of sites of disease including small bowel (25%), peritoneum (25%), lymph nodes (18.75%), appendix (12.5%), liver (12.5%) and omentum (6.25%). Tuberculin test was only performed in three patients and all of which were positive. Diagnosis was based on histology (43.75%), imaging (31.25%), microbiology (6.25%), or a combination of clinical suspicion and imaging or appearances at surgery (18.75%). The majority who received treatment (9/14) were given Rifater plus ethambutol. The remaining five patients all received a different combination of antituberculous treatment (Rifater alone, Rifinah ± Pyrazinamide and Ethambutol, Rifampicin/Isoniazid/Pyrazinamide ± Ethambutol). Two patients did not receive treatment as their diagnosis was made post-mortem. Of the sixteen patients, ten were treated and discharged, three died, two have on-going review and one was lost to follow up. <h3>Conclusion</h3> ATB is a difficult diagnosis to make and there can be a significant time delay between symptom onset and diagnosis as the symptoms can be varied and insidious in nature. It is an easily treatable condition and a combination of abdominal pain, fevers and weight loss in a non-Caucasian patient should raise suspicion and warrants further investigation. <h3>Disclosure of interest</h3> None Declared.
Immunoglobulin Class and Pattern of Nuclear Fluorescence in Systemic Lupus Erythematosus
Authors: Esther N. Gonzalez, Naomi F. Rothfield
Journal: New England Journal of Medicine (1966)

THE presence of antibodies that react with nuclei in the serums of patients with systemic lupus erythematosus is well established. Human antibodies have been found to belong to 1 of 3 classes of immunoglobulins that can be distinguished from each other by antigenic differences in the heavy polypeptide chains. These are the IgG, the IgA and the IgM globulins. The immunoglobulin class to which the antinuclear factor belongs has previously been investigated in small numbers of patients. Goodman and Fahey1 first demonstrated the presence of both IgG and IgM antinuclear factors, and recent work by Barnett and his co-workers2 and . . .
S128 Soluble ADAM33 Causes Airway Remodelling To Promote Allergic Airway Inflammation
Authors: ER Davies, JA Whitsett, DE Davies, HM Haitchi
Journal: Thorax (2015)

<h3>Introduction and objectives</h3> <i>ADAM33 </i>is an asthma susceptibility gene associated with bronchial hyperresponsiveness (BHR). It encodes a membrane-anchored protein with metalloprotease (MP) activity whose ectodomain can be shed from the cell surface as a soluble protein (sADAM33-MP). sADAM33-MP levels are increased in asthmatic airways and inversely correlated with FEV1. We have previously generated a pulmonary epithelium-specific, doxycycline (DOX)-inducible double transgenic (dTg) mouse expressing human (h)sADAM33-MP and found that the transgene caused airway remodelling in the absence of inflammation or BHR. Therefore, as asthma involves gene-environment interactions, we postulated that there is a synergistic relationship between ADAM33-remodelled airways and responses to the common aeroallergen, house dust mite (HDM). <h3>Methods</h3> DOX was administered to dTg mice to induce hsADAM33 expression and airway remodelling for up to 6 weeks; single transgenic (sTg) littermate controls were similarly treated. Mice were then sensitised to HDM and challenged with HDM or saline. Airway resistance was measured in response to increasing concentrations of methacholine using the forced oscillation technique in anesthetised mice. Inflammatory cell counts were performed on bronchoalveolar lavage fluid (BALF) and indices of inflammation measured by RTqPCR and Luminex ELISA. <h3>Results</h3> We first performed a concentration-response experiment with HDM extract with a standard sensitisation protocol to determine the amount of HDM extract (6.25 μg), which elicited minimal BHR and eosinophilia. This low-dose allergen challenge protocol was then applied to dTg <i>Ccsp/ADAM33</i> and sTg control mice. Allergen challenge of dTg mice resulted in a significant increase in methacholine-induced airway resistance and eosinophilic airway inflammation compared to HDM-challenged sTg controls. The dTg mice also showed a significant increase in airway inflammatory mediators IL-5, IL-13 and eotaxin, in addition to markers of remodelling. <h3>Conclusions</h3> This study demonstrates that hsADAM33-MP driven airway remodelling enhances susceptibility to HDM with increases in BHR and inflammation. These functional studies demonstrate, for the first time, a gene-environment interaction involving ADAM33 to cause remodelling and the disproportional inflammatory responses seen in the asthmatic airway. sADAM33 might be a potential target for novel disease-modifying therapies.
The impact of hearing impairment and noise-induced hearing injury on quality of life in the active-duty military population: challenges to the study of this issue
Authors: Hasanat Alamgir, Caryn A. Turner, Nicole J. Wong, Sharon P. Cooper, Jose A. Betancourt, James Henry, Andrew J. Senchak, Tanisha L. Hammill, Mark D. Packer
Journal: Military Medical Research (2016)

The objectives of this research were to 1) summarize the available evidence on the impact of hearing loss on quality of life (QOL) among U.S. active-duty service members, 2) describe the QOL instruments that have been used to quantify the impact of hearing loss on quality of life, 3) examine national population-level secondary databases and report on their utility for studying the impact of hearing loss on QOL among active-duty service members, and 4) provide recommendations for future studies that seek to quantify the impact of hearing loss in this population. There is a lack of literature that addresses the intersection of hearing impairment, the military population, and quality of life measures. For audiological research, U.S. military personnel offer a unique research population, as they are exposed to noise levels and blast environments that are highly unusual in civilian work settings and can serve as a model population for studying the impact on QOL associated with these conditions. Our team recommends conducting a study on the active-duty service member population using a measurement instrument suitable for determining decreases in QOL specifically due to hearing loss.
Diarrhea Associated with Mesalamine in a Patient with Chronic Nongranulomatous Enterocolitis
Authors: Kenneth D. Fine, Harry E. Sarles, Byron Cryer
Journal: New England Journal of Medicine (1998)

To the Editor: The use of mesalamine (5-aminosalicylic acid) for the treatment of inflammatory bowel disease seems paradoxical, since structurally similar acetylsalicylic acid and other nonsteroida...
Prolonged Nocturnal Hypoglycemia Is Common During 12 Months of Continuous Glucose Monitoring in Children and Adults With Type 1 Diabetes
Journal: Diabetes Care (2010)

OBJECTIVE To characterize the amount of nocturnal hypoglycemia and evaluate factors associated with nocturnal hypoglycemia assessed with continuous glucose monitoring (CGM) in adults and children with type 1 diabetes who participated in the Juvenile Diabetes Research Foundation CGM randomized clinical trial. RESEARCH DESIGN AND METHODS The analysis included 36,467 nights with ≥4 h of CGM glucose readings between 12 midnight and 6:00 a.m. from 176 subjects assigned to the CGM group of the trial. The percentage of nights in which hypoglycemia occurred (two consecutive CGM readings ≤60 mg/dl in 20 min) was computed for each subject. Associations with baseline characteristics and clinical factors were evaluated using a multivariate regression model. RESULTS Hypoglycemic events occurred during 8.5% of nights, with the median percentage of nights with hypoglycemia per subject being 7.4% (interquartile range 3.7–12.1%). The duration of hypoglycemia was ≥2 h on 23% of nights with hypoglycemia. In a multivariate model, a higher incidence of nocturnal hypoglycemia was associated with 1) lower baseline A1C levels (P &amp;lt; 0.001) and 2) the occurrence of hypoglycemia on one or more nights during baseline blinded CGM (P &amp;lt; 0.001). The hypoglycemia frequency was not associated with age or with insulin modality (pump versus multiple daily injections). CONCLUSIONS Nocturnal hypoglycemia is frequent and often prolonged in adults and children with type 1 diabetes. Patients with low A1C levels are at an increased risk for its occurrence. One week of blinded CGM can identify patients who are at greater risk for nocturnal hypoglycemia.
Maintenance Antiretroviral Therapies in HIV-Infected Subjects with Undetectable Plasma HIV RNA after Triple-Drug Therapy
Authors: Diane V. Havlir, Ian C. Marschner, Martin S. Hirsch, Ann C. Collier, Pablo Tebas, Roland L. Bassett, John P.A. Ioannidis, M.K. Holohan, Randi Leavitt, Gloria Boone, Douglas D. Richman
Journal: New England Journal of Medicine (1998)

Combination antiretroviral therapy with indinavir, zidovudine, and lamivudine can suppress the level of human immunodeficiency virus (HIV) RNA in plasma below the threshold of detection for two years or more. We investigated whether a less intensive maintenance regimen could sustain viral suppression after an initial response to combination therapy.