tbuckley/cabot-search huggingface dataset:
Comparison of NHANES III and ERS/GLI 12 for airway obstruction classification and severity
Authors: Olinto Linares-Perdomo, Matthew Hegewald, Dave S. Collingridge, Denitza Blagev, Robert L. Jensen, John Hankinson, Alan H. Morris
Journal: European Respiratory Journal (2016)

The diagnosis and severity categorisation of obstructive lung disease is determined using reference values. The American Thoracic Society/European Respiratory Society in 2005 recommended the National Health and Nutrition Examination Survey (NHANES) III spirometry prediction equations for patients in USA aged 8–80 years. The Global Lung Initiative 2012 (GLI 12) provided spirometry prediction equations for patients aged 3–95 years. Comparison of the NHANES III and GLI 12 prediction equations for diagnosing and categorising airway obstruction in patients in USA has not been made. We aimed to quantify the differences between NHANES III and GLI 12 predicted values in Caucasians aged 18–95 years, using both mathematical simulation and clinical data. We compared predicted forced expiratory volume in 1 s (FEV 1 ) and lower limit of normal (LLN) FEV 1 /forced vital capacity (FVC) % for NHANES III and GLI 12 prediction equations by applying both a simulation model and clinical spirometry data to quantify differences in the diagnosis and categorisation of airway obstruction. Mathematical simulation revealed significant similarities and differences between prediction equations for both LLN FEV 1 /FVC % and predicted FEV 1 . There are significant differences when using GLI 12 and NHANES III to diagnose airway obstruction and severity in Caucasian patients aged 18–95 years. Similarities and differences exist between NHANES III and GLI 12 for some age and height combinations. The differences in LLN FEV 1 /FVC % and predicted FEV 1 are most prominent in older taller/shorter individuals. The magnitude of the differences can be large and may result in differences in clinical management.
THU0041 Anti-Citrullinated Protein Antibody Binding Profile to Human FC Gamma Receptors
Authors: A. Kempers, R. Nejadnik, Y. Rombouts, W. Jiskoot, T.W. Huizinga, R.E. Toes, H.U. Scherer
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> In rheumatoid arthritis (RA), anti-citrullinated protein antibodies (ACPA) are highly disease-specific biomarkers with suggested involvement in RA pathogenesis. Despite recent advances, their exact role in the inflammatory disease process and their effector mechanisms still have to be identified. <h3>Objectives</h3> To gain insight in ACPA Fc-mediated effector functions, we studied the binding of ACPA immune complexes to various Fc gamma receptors. <h3>Methods</h3> ACPA-IgG and non citrulline-reactive IgG (ncIgG) were isolated from plasma and synovial fluid samples of established RA patients by affinity chromatography using 2nd generation cyclic citrullinated peptide (CCP2) as an antigen. After further purification of the IgG1 subclass of both entities, immune complexes (IC) were generated using fluorescently labelled F(ab9)2 fragments directed against the F(ab9)2 part of IgG1 or by using citrullinated fibrinogen. The size of the IC was measured using asymmetric flow-field flow (AF4) molecular size/weight fractionation. ICs were incubated with various CHO cell lines stably transfected with different human Fc gamma receptors (FcγR). IC binding to these FcγR was analysed by flow cytometry. ACPA-IgG1 and IgG1 Fc glycosylation was measured by mass spectrometry. <h3>Results</h3> ACPA-IgG1 and ncIgG1 ICs of comparable size bound predominantly to activating FcγRs whereas less binding of the ICs was detected to the inhibitory receptor FcγRIIB. Most IC binding was observed to FcγRI and FcγRIIIA (V176), whereas much lower binding signals were detected for FcγRIIA. Strikingly, ACPA-IgG1 showed reduced binding to FcγRIIIA when compared to ncIgG1. This corresponded to enhanced core fucosylation of the ACPA-IgG1 Fc tail. Finally, we observed enhanced binding of ACPA-IgG1 IC to IFN-γ activated neutrophils. <h3>Conclusions</h3> The binding of ACPA-IgG1 to activating FcγR implies an enhanced immune activating effect with a particular role for FcγRI. Moreover, the reduced ACPA-IgG1 binding to FcγRIIIA suggests that the differential Fc glycosylation profile of ACPA could affect FcγR mediated effector functions. <h3>Disclosure of Interest</h3> None declared
Amoxapine and neuroleptic side effects: a case report
Authors: T Sunderland, P J Orsulak, B M Cohen
Journal: American Journal of Psychiatry (1983)

A depressed patient developed neuroleptic-like side effects while being treated with amoxapine alone. Elevation of her plasma prolactin level and significant ex vivo neuroleptic activity were found despite therapeutic amoxapine levels.
Case 53-1967
Authors: Howard Ulfelder, Rohert E. Scully
Journal: New England Journal of Medicine (1967)

PRESENTATION OF CASE First admission. A fifty-five-year-old woman entered the hospital because of a pelvic mass.Twenty-nine years previously she had been treated at another hospital for carcinoma of the cervix, Stage 2. The tumor was said to be large, with slight invasion of the vaginal mucosa; pathological examination showed that it was a poorly differentiated squamous-cell carcinoma. X-ray treatment, 2200 R, was administered to each of 6 portals, and radium was applied in the cervical and uterine canal and the vagina; the total intrauterine and vaginal dosage was 7700 milligram-hours. Four months later, because of the finding of a . . .
Identification of an Association of <i>TNFAIP3</i> Polymorphisms With Matrix Metalloproteinase Expression in Fibroblasts in an Integrative Study of Systemic Sclerosis–Associated Genetic and Environmental Factors
Authors: Peng Wei, Yang Yang, Xinjian Guo, Nainan Hei, Syeling Lai, Shervin Assassi, Mengyuan Liu, Filemon Tan, Xiaodong Zhou
Journal: Arthritis & Rheumatology (2015)

Objective Systemic sclerosis (SSc) is a fibrotic disease attributed to both genetic susceptibility and environmental factors. This study was undertaken to investigate the associations between SSc‐associated genetic variants and the expression of extracellular matrix (ECM) genes in human fibroblasts stimulated with silica particles in time‐course and dose‐response experiments. Methods A total of 200 fibroblast strains were examined for ECM gene expression after stimulation with silica particles. The fibroblasts were genetically profiled using Immunochip assays and then subjected to whole‐genome genotype imputation. Associations of genotypes and gene expression were first analyzed in a Caucasian cohort and then validated in a meta‐analysis combining the results from Caucasian, African American, and Hispanic subjects. A linear mixed model for longitudinal data analysis was used to identify genetic variants associated with the expression of ECM genes, and the associations were validated by using a haplotype‐based longitudinal association test on regions that included the loci identified. Results The single‐nucleotide polymorphism rs58905141 in TNFAIP3 was consistently associated with time‐course and/or dose‐response expression of MMP3 and MMP1 in the fibroblasts stimulated with silica particles in both the analysis of Caucasian subjects only and the meta‐analysis. Results of the haplotype‐based analysis validated the association signals. Conclusion Our findings indicate that a genetic variant of TNFAIP3 is strongly associated with the silica‐induced profibrotic response of fibroblasts. In silico functional analysis based on the ENCODE database revealed that rs58905141 might affect the binding activities of the transcription factors for TNFAIP3 . This is the first genome‐wide study of interactions between genetic and environmental factors in a complex SSc fibroblast model.
Infant Infections and Respiratory Symptoms in Relation to <i>in Utero</i> Arsenic Exposure in a U.S. Cohort
Authors: Shohreh F. Farzan, Zhigang Li, Susan A. Korrick, Donna Spiegelman, Richard Enelow, Kari Nadeau, Emily Baker, Margaret R. Karagas
Journal: Environmental Health Perspectives (2015)

Arsenic has been linked to disrupted immune function and greater infection susceptibility in highly exposed populations. Well arsenic levels above the U.S. EPA limit occur in our U.S. study area and are of particular concern for pregnant women and infants.We investigated whether in utero arsenic exposure affects the risk of infections and respiratory symptoms over the first year of life.We prospectively obtained information on infant infections and symptoms, including their duration and treatment (n = 412) at 4, 8, and 12 months using a parental telephone survey. Using generalized estimating equation models adjusted for potential confounders, we evaluated the association between maternal pregnancy urinary arsenic and infant infections and symptoms over the first year.Each doubling of maternal urinary arsenic was related to increases in the total number of infections requiring prescription medication in the first year [relative risk (RR) = 1.1; 95% CI: 1.0, 1.2]. Urinary arsenic was related specifically to respiratory symptoms (difficulty breathing, wheezing, and cough) lasting ≥ 2 days or requiring prescription medication (RR = 1.1; 95% CI: 1.0, 1.2; and RR = 1.2; 95% CI: 1.0, 1.5, respectively), and wheezing lasting ≥ 2 days, resulting in a doctor visit or prescription medication treatment (RR = 1.3; 95% CI: 1.0, 1.7; RR = 1.3; 95% CI: 1.0, 1.8, and RR = 1.5; 95% CI: 1.0, 2.2, respectively). Associations also were observed with diarrhea (RR = 1.4; 95% CI: 1.1, 1.9) and fever resulting in a doctor visit (RR = 1.2; 95% CI: 1.0, 1.5).In utero arsenic exposure was associated with a higher risk of infection during the first year of life in our study population, particularly infections requiring medical treatment, and with diarrhea and respiratory symptoms.Farzan SF, Li Z, Korrick SA, Spiegelman D, Enelow R, Nadeau K, Baker E, Karagas MR. 2016. Infant infections and respiratory symptoms in relation to in utero arsenic exposure in a U.S.Environ Health Perspect 124:840-847; http://dx.doi.org/10.1289/ehp.1409282.
Beta blockers are associated with increased risk of cardiovascular events after surgery
Authors: Jacqui Wise
Journal: BMJ (2015)

A large Danish study, published in JAMA Internal Medicine, has found that treatment with beta blockers was associated with a statistically significant increase in the rate of major adverse cardiovascular events and death within 30 days of non-cardiac surgery.1

The use of beta blockers during non-cardiac surgery is currently being re-evaluated because of concerns over the validity of some previous studies. Guidelines in the United States and Europe recommend continuing …
PTU-124 Development of a specialist anti-reflux service
Authors: AM Reece-Smith, T Royles, J Brewer, S Wajed
Journal: Gut (2015)

<h3>Introduction</h3> Surgical management of anatomical and functional failure of the lower oesophageal sphincter is becoming increasingly complex with advances in diagnostics, eg. high-resolution manometry (HRM), and further therapeutic options such as magnetic-bead sphincter augmentation (MSA).<sup>1</sup>With the increasing incidence in functional bowel / motility disorders which may create worse surgical outcomes, there is a need for specialisation in this field. We report on the development of a specialist anti-reflux service including the changing role of surgery and the increasing importance of physiology investigations. <h3>Method</h3> Data was retrieved from a prospective databases maintained by the clinical measurements and surgical departments to identify patients undergoing physiology investigations and surgical intervention over a 5 year period 2010–2014, since the start of the specialist service. Surgical data was cross-referenced against hospital coding data. <h3>Results</h3> Following introduction of a specialist anti-reflux clinic there has been a sustained rise in new referrals to the clinic (Figure 1)and patients treated surgically. Recent years have also seen a trend to increasing use of second generation physiology investigations such aswireless pH monitoring and HRM, as well as a rise in the total number of investigations (Figure 2). A peak in the upward trend was associated with the introduction of MSA, with subsequent divergence of MSA and fundoplication reflecting the relative popularity of these procedures (Figure 3). There was no significant change in the frequency of complex para-oesophageal hernia repair over the same period. <h3>Conclusion</h3> Introduction of a specialist anti-reflux service has led to a rise in the number of physiology investigation requested and patients treated operatively. Magnetic-bead sphincter augmentation appears to be a more acceptable alternative for patients than traditional fundoplication. Guidance and service requirements need to be developed including the identification of standards and quality indicators in the field of anti-reflux surgery to optimise patient outcomes in a field where an increased range of investigation and management expertise are required. <h3>Disclosure of interest</h3> None Declared. <h3>Reference</h3> Bonavina, <i>et al</i>. Ther Adv Gastroenterol. 2013;6(4):261–8
Margaret McCartney: Asthma and the catwalk
Authors: Margaret McCartney
Journal: BMJ (2016)

Are GPs guilty of issuing asthma inhalers to children as “fashion accessories,” as charged recently in the Archives of Disease in Childhood —subjecting young people to the adverse effects of corticosteroids with the same whim we use to furnish our wardrobes with this season’s catwalk collections?1

Or are we guilty of being party to the deaths of young people with asthma in the United Kingdom, of whom 93% were being inadequately managed, as suggested in a Royal College of Physicians audit that found 1200 such deaths?2

One conclusion is that GPs …
The Philosopher
Authors: Janet M. Torpy
Journal: JAMA (2012)

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
Case 39-1970
Authors: Richard C. Cabot, Benjamin Castleman, Betty U. McNeely, Peter M. Yurchak, Benjamin Castleman
Journal: New England Journal of Medicine (1970)

Presentation of Case First admission. A 78-year-old woman was admitted to the hospital because of pain in the chest and back.For many years she had had hypertension, with the blood pressure in the range of 220 systolic, 110 diastolic. She tolerated most medications poorly but took a rauwolffia preparation twice daily. During the two years before admission she took prednisone, 5 mg daily, at intervals because of arthritic pain. On the morning of entry, while dressing, there was the abrupt onset of severe pain in the low substernal region, with radiation straight through to the back. The pain . . .
A rare variant in <scp>CYP</scp>27A1 and its association with atopic dermatitis with high serum total IgE
Authors: H. Suzuki, Y. Makino, M. Nagata, J. Furuta, H. Enomoto, T. Hirota, M. Tamari, E. Noguchi
Journal: Allergy (2016)

Abstract This study investigated rare variants associated with atopic dermatitis. We performed exome analyses on 37 patients who were diagnosed with atopic dermatitis by board‐certified dermatologists and had total serum IgE levels greater than 1000 IU /ml. The exome analysis identified seven variants with &lt;1% allele frequency in Asian ( ASN ) population of 1000 Genomes Project phase 1 data and &gt;5% allele frequency in the atopic dermatitis exome samples. We then conducted a replication study using 469 atopic dermatitis patients with total serum IgE ≥1000 IU /ml and 935 Japanese controls to assess the presence of these 7 candidate variants. The replication study confirmed that CYP 27A1 rs199691576 (A/G) was associated with atopic dermatitis with high serum IgE levels ( P = 0.012, odds ratio = 2.1). CYP 27A1 is involved in the metabolism of vitamin D3, which plays important roles in modulating immune function. Previous studies have reported polymorphisms in vitamin D pathway genes that are associated with allergy‐related phenotypes. Our data confirm the importance of genes regulating the vitamin D pathway in the development of atopic dermatitis.
Patient-Controlled Sedation for Colonoscopy: a Randomized Trial Comparing Patient-Controlled Administration of Propofol and Alfentanil with Physician-Administered Midazolam and Pethidine
Authors: E.  Bright, C.  Roseveare, D.  Dalgleish, J.  Kimble, J.  Elliott, H.  Shepherd
Journal: Endoscopy (2003)

Background and Study Aims: Patient-controlled sedation (PCS) using propofol and alfentanil provides effective sedation for colonoscopy, with the advantage of a shorter recovery time in comparison with diazepam and pethidine. However, most endoscopy units in the United Kingdom are currently using midazolam (a shorter-acting benzodiazepine) as a sedative agent. This study compares the efficacy of sedation and recovery times between PCS and a combination of midazolam and pethidine. Patients and Methods: Sixty-seven patients undergoing colonoscopy were randomly assigned prospectively to receive sedation with either PCS, using propofol and alfentanil, or a bolus of midazolam and pethidine. Sedation and pain scores were recorded during the procedure by one specialist nurse. Patients' recollection of pain was recorded after the procedure. Recovery was assessed using number connection tests. The impact on subsequent activities and the level of amnesia, as well as overall satisfaction, were established by telephone call after 24 h. Results: The sedation method had no impact on the success, difficulty, or duration of the colonoscopy. PCS could be set up by the specialist nurse without affecting the time between cases. Patients in the PCS group recovered significantly faster (median 5 min vs 35 min; P < 0.0001) and left the department more quickly (median 40 min vs 75 min; P < 0.0001). Patients in the PCS group had significantly higher pain scores and significantly more recall than those in the midazolam and pethidine group. All patients were satisfied with the sedation they received. Conclusions: PCS provides an acceptable alternative to sedation with midazolam and pethidine with the advantage of significantly faster recovery times, which are of relevance in the outpatient setting.
Functional Conservation and Divergence of<i>daf-22</i>Paralogs in<i>Pristionchus pacificus</i>Dauer Development
Authors: Gabriel V. Markov, Jan M. Meyer, Oishika Panda, Alexander B. Artyukhin, Marc Claaßen, Hanh Witte, Frank C. Schroeder, Ralf J. Sommer
Journal: Molecular Biology and Evolution (2016)

Small-molecule signaling in nematode dauer formation has emerged as a major model to study chemical communication in development and evolution. Developmental arrest as nonfeeding and stress-resistant dauer larvae represents the major survival and dispersal strategy. Detailed studies in Caenorhabditis elegans and Pristionchus pacificus revealed that small-molecule communication changes rapidly in evolution resulting in extreme structural diversity of small-molecule compounds. In C. elegans, a blend of ascarosides constitutes the dauer pheromone, whereas the P. pacificus dauer pheromone includes additional paratosides and integrates building blocks from diverse primary metabolic pathways. Despite this complexity of small-molecule structures and functions, little is known about the biosynthesis of small molecules in nematodes outside C. elegans. Here, we show that the genes encoding enzymes of the peroxisomal β-oxidation pathway involved in small-molecule biosynthesis evolve rapidly, including gene duplications and domain switching. The thiolase daf-22, the most downstream factor in C. elegans peroxisomal β-oxidation, has duplicated in P. pacificus, resulting in Ppa-daf-22.1, which still contains the sterol-carrier-protein (SCP) domain that was lost in C. elegans daf-22, and Ppa-daf-22.2. Using the CRISPR/Cas9 system, we induced mutations in both P. pacificus daf-22 genes and identified an unexpected complexity of functional conservation and divergence. Under well-fed conditions, ascaroside biosynthesis proceeds exclusively via Ppa-daf-22.1. In contrast, starvation conditions induce Ppa-daf-22.2 activity, resulting in the production of a specific subset of ascarosides. Gene expression studies indicate a reciprocal up-regulation of both Ppa-daf-22 genes, which is, however, independent of starvation. Thus, our study reveals an unexpected functional complexity of dauer development and evolution.