tbuckley/cabot-search huggingface dataset:
Exosomes mediate hepatitis B virus (HBV) transmission and NK-cell dysfunction
Authors: Yinli Yang, Qiuju Han, Zhaohua Hou, Cai Zhang, Zhigang Tian, Jian Zhang
Journal: Cellular and Molecular Immunology (2016)

Evidence suggests that exosomes can transfer genetic material between cells. However, their roles in hepatitis B virus (HBV) infection remain unclear. Here, we report that exosomes present in the sera of chronic hepatitis B (CHB) patients contained both HBV nucleic acids and HBV proteins, and transferred HBV to hepatocytes in an active manner. Notably, HBV nucleic acids were detected in natural killer (NK) cells from both CHB patients and healthy donors after exposure to HBV-positive exosomes. Through real-time fluorescence microscopy and flow cytometry, 1,1'-dioctadecyl-3,3,3',3',-tetramethylindodicarbocyanine, 4-chlorobenzenesulfnate salt (DiD)-labeled exosomes were observed to interact with NK cells and to be taken up by NK cells, which was enhanced by transforming growth factor-β treatment. Furthermore, HBV-positive exosomes impaired NK-cell functions, including interferon (IFN)-γ production, cytolytic activity, NK-cell proliferation and survival, as well as the responsiveness of the cells to poly (I:C) stimulation. HBV infection suppressed the expression of pattern-recognition receptors, especially retinoic acid inducible gene I (RIG-I), on NK cells, resulting in the dampening of the nuclear factor κB(NF-κB) and p38 mitogen-activated protein kinase pathways. Our results highlight a previously unappreciated role of exosomes in HBV transmission and NK-cell dysfunction during CHB infection.
Career decisions in the early postresidency years
Authors: J L Cavanaugh
Journal: American Journal of Psychiatry (1975)

The author notes that the end of the postresidency military obligation necessitates earlier career decision making for the senior psychiatric resident. This problem is seen to be exacerbated by the eclectic nature of most psychiatric training. Issues for residents include the problem of role models and the "senior resident syndrome," the decision of whether to maintain their university affiliation, the role of private practice, questions of clinical maturity, etc. The author believes that programs must be developed to systematically and objectively present to residents the data that now exist regarding multiple career options.
PTH-229 Sehcat in the united kingdom: a multi-centre prospective survey
Authors: J McLaughlin, A Notghi, J Summers
Journal: Gut (2015)

<h3>Introduction</h3> Bile Acid Malabsorption (BAM) causes chronic diarrhoea and can be confirmed using SeHCAT retention. There are limited data on the use of SeHCAT for diagnosis and management of BAM, but its use is supported in dated BSG guidelines. Recently, NICE recommended that SeHCAT use in irritable bowel syndrome (IBS) and Crohn’s disease should be restricted. <h3>Method</h3> A prospective study evaluated SeHCAT usage across the UK. This resulted in a dataset with more than 200 variables, capturing centre and patient-level information. Eligible data from 38 centres and 1,036 patients were entered into a validated management system. <h3>Results</h3> Mean age was 50 years (6–89), 65% female. Prior colonoscopy was recorded in 76%, blood tests in 89%. Only 27% of patients had an IBS diagnosis reported. Overall, the centre-defined ‘normal’ retention was seen in 47% of cases, and ‘abnormal’ retention in 43%, the rest being considered borderline. Suspected Type 1 (BAM secondary to ileal resection/disease) was the smallest group (14%). Of these, 83% had Crohn’s disease and 64% had an ileal resection. SeHCAT retention was predictably low: mean 9%, (SD 13%), median 2%. The largest group (44%) with suspected Type 2 (idiopathic/primary BAM), had a mean retention of 21% (SD 17%), median 18%. In suspected Type 3 (41%; BAM secondary to various gastrointestinal diseases) mean retention was 22% (SD 20%), median 17%. Of these ​34% were post-cholecystectomy and 12% were diabetic. <h3>Conclusion</h3> SeHCAT in the UK is used widely. However protocols are variable and reliable cut-offs for clinical significance remain ill-defined. Dated BSG algorithms and recent NICE guidelines are not currently being consistently followed. Clinicians suspecting BAM predominantly consider this as primary bile acid diarrhoea or as secondary to other disorders. Analysis of the detailed clinical data acquired in this study will assist in the design of future definitive prospective research. <h3>Disclosure of interest</h3> None Declared.
Rheumatoid Arthritis in Agricultural Health Study Spouses: Associations with Pesticides and Other Farm Exposures
Authors: Christine G. Parks, Jane A. Hoppin, Anneclaire J. De Roos, Karen H. Costenbader, Michael C. Alavanja, Dale P. Sandler
Journal: Environmental Health Perspectives (2016)

Background:Farming has been associated with rheumatoid arthritis (RA), but the role of pesticides is not known.Objectives:We examined associations between RA and pesticides or other agricultural exposures among female spouses of licensed pesticide applicators in the Agricultural Health Study.Methods:Women were enrolled between 1993 and 1997 and followed through 2010. Cases (n = 275 total, 132 incident), confirmed by a physician or by self-reported use of disease modifying antirheumatic drugs, were compared with noncases (n = 24,018). Odds ratios (OR) and 95% confidence intervals (CI) were estimated using logistic regression models adjusted for age, state, and smoking pack-years.Results:Overall, women with RA were somewhat more likely to have reported lifetime use of any specific pesticide versus no pesticides (OR = 1.4; 95% CI: 1.0, 1.6). Of the 15 pesticides examined, maneb/mancozeb (OR = 3.3; 95% CI: 1.5, 7.1) and glyphosate (OR = 1.4; 95% CI: 1.0, 2.1) were associated with incident RA compared with no pesticide use. An elevated, but non-statistically significant association with incident RA was seen for DDT (OR = 1.9; 95% CI: 0.97, 3.6). Incident RA was also associated with the application of chemical fertilizers (OR = 1.7; 95% CI: 1.1, 2.7) and cleaning with solvents (OR = 1.6; 95% CI: 1.1, 2.4), but inversely associated with lifetime livestock exposure as a child and adult (OR = 0.48; 95% CI: 0.24, 0.97) compared with no livestock exposure.Conclusions:Our results suggest that specific agricultural pesticides, solvents, and chemical fertilizers may increase the risk of RA in women, while exposures involving animal contact may be protective.Citation:Parks CG, Hoppin JA, De Roos AJ, Costenbader KH, Alavanja MC, Sandler DP. 2016. Rheumatoid arthritis in Agricultural Health Study spouses: associations with pesticides and other farm exposures. Environ Health Perspect 124:1728–1734; http://dx.doi.org/10.1289/EHP129
AB0827 Hydroxychloroquine Does not Increase Psoriasis in Psoriatic Arthritis: Time on Drug Analysis Based on Real Life Data
Authors: S.Z. Aydın, B. Yılmazer, Ö. Bayındır, K. Aksu, E. Dalkılıç, M.F. Öksüz, E.F. Tarhan, M. Can, O. Küçükşahin, G. Kimyon, L. Akyol, A.M. Onat, B. Kısacık, A. Erden, A. Omma, E.D. Ersözlü Bozkırlı, C. Özişler, E. Gönüllü, S. Masatlıoğlu Pehlevan, M. Aydın Tufan, D. Solmaz, G. Yıldırım Çetin, L. Kılıç, S. Erten, T. Kaşifoğlu, S. Şenel, E. Kasapoğlu Günal, Y. Kabasakal, M. Sayarlıoğlu, U. Kalyoncu
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Antimalarials have been reported to worsen preexisting psoriasis, therefore is commonly avoided by the clinicians in the treatment of psoriatic arthritis (PsA). With the lack of any solid evidence, this precludes the potential use of hydroxychloroquine (HQ) as a part of the treatment. <h3>Objectives</h3> We aimed to analyze PsA patients who are treated with HQ, identify the time on drug and reasons of discontinuation of HQ. <h3>Methods</h3> PsART (Psoriatic Arthritis Registry of Turkey) is a prospective, multicentre, nationwide study in Turkey on patients with PsA. Patients are consecutively recruited to this registry, if they are diagnosed as PsA, regardless of any disease characteristics. From the registry, patients who have ever used HQ were identified including the time on HQ, whether they still continue to treatment, and the reasons of discontinuation in case of a withdrawal. <h3>Results</h3> Until December 2014, 746 patients were recruited. 114 patients (15.3%) were either currently using or have been used HQ previously. 51.8% of these patients were currently using HQ (fig 1). The distribution of joint patterns were 50.9% polyarthritis, 30.7% oligoarthritis, 2.6% monoarthritis, 13.2% distal interphalangeal joint involvement, 26.3% axial disease, including patients who had combinations of different patterns. Joint patterns were not different among patients who had ever used HQ or not. The duration of HQ treatment was 41.4 (SD:38.4) months among current users vs 45.6 (SD:51.2) months in withdrawers. The reason of discontinuity could be identified in 44/55 among non-users. Within these 44 patients the most frequent reason was inefficacy (n=25) and incompliance of the patient (n=7). Retinopathy was observed in 5 patients. Liver function test abnormalities, pregnancy, hyperpigmentation of the skin, step down for being in remission and nausea were observed in 1 case each and were reported to be the reason of stopping the treatment. There were only 2 cases who had to discontinue treatment because of an increase in psoriatic lesions. One of these patients used HQ for one month and the other patient for 21 months. <h3>Conclusions</h3> These data show that only 2/114 patients had an increase in psoriatic lesions in PsA in a mean duration of 3.5 years due to the HQ treatment suggesting that HQ is a safe treatment choice in PsA. The efficacy and added benefits of HQ in terms of reducing cardiovascular risk factors cannot be enclosed with this registry. <h3>Disclosure of Interest</h3> None declared
The Future of the Medical Profession
Authors: P M HOLST
Journal: JAMA (2018)

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 Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal
Clinical Science
Authors: W B SHELLEY, W A CARO
Journal: JAMA (1962)

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 Journals 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 2024 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
Syphilis Screening in Neurology
Authors: Christina M. Marra
Journal: JAMA Neurology (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 Neurology 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 Neurology journal
Reimbursing Wisely? CMS’s Trial of Medicare Part B Drug Payment Reform
Authors: Deborah Schrag
Journal: New England Journal of Medicine (2016)

Interview with Dr. Deborah Schrag on an experiment testing new ways of reimbursing physicians for drugs administered under Medicare Part B. (16:53)Download The Medicare Part B Drug Payment Model aims to nudge physicians to choose lower-cost alternatives to Part B drugs when reasonable ones exist. But ultimately, controlling Medicare spending will require addressing the underlying problem of sky-high drug prices.
Soundings: Looking for the man who fell off the roof
Authors: George Dunea
Journal: BMJ (2000)

Dr Mumps, a primary care physician, has a patient who fell off the roof and was taken to the University of Excellence Hospital, the one that advertises every morning on the radio.

In a capricious mood, Dr Mumps decides to find out how his patient is doing.

He is greeted by a friendly recording: “If you speak Spanish press one, if you speak Swahili press two, to speak to the laundry press three, for the kitchen four, for billing press five.... If you have exhausted all 12 possibilities stay on the line. Your call is very important to us and we will answer you promptly.”

Half an hour later Dr Mumps at last speaks to a human voice. It directs him to Dr Buggs, the attending physician, an infectious disease specialist.

Dr Buggs answers promptly, but says that he has been “off service” for a week and is back in the laboratory. He suggests calling Dr Chan, offers to transfer the call, but inadvertently disconnects the phone.

Undaunted, Dr Mumps tries again. Not once, but many times. Each time the same ritual: “If you speak Turkish press seven....” He looks for Dr Chan, but there are 25 Dr Chans working at the University of Excellence.

On the third attempt he finds the right one, but he has signed off the day to Dr Patel, who says that the patient belongs to Dr Mbawa, who believes that the patient belongs to Dr Rigamortis, who is doing a venepucture and cannot come to the phone. Dr Mumps asks for the patient's room: there is no reply. Perhaps he has gone for an x ray examination.

The next day Dr Rigamortis does not answer. The nurse is “on her break.” The medical student seems to be in charge, but does not know the patient and suggests calling medical education. Alas, the programme director is in a meeting that will last all day.

The secretary is “away from her desk,” but calls back later. Dr Rigamortis has gone for a job interview. His patients were to be followed by Dr Mbawa, she adds mournfully, but the good doctor fell off the roof last night and is in intensive care. “You could call the new attending physician, Dr Smith,” she muses, “but he has gone off to a meeting in Patagonia and Dr Buggs is covering for him.”
Sequential combination of low dose chemo-modulating Temozolomide and Fotemustine in metastatic melanoma: clinical and molecular evaluation
Authors: S. De Summa, R. Pinto, S. Strippoli, I. Natalicchio, A. Azzariti, A. Cramarossa, M. Signorile, A. Albano, V. Lorusso, G. Guida, M. Guida, S. Tommasi
Journal: Annals of Oncology (2015)
FRI0382 CXCR5 Directs Migration of Pathogenic Double-Negative T Cells in SLE
Authors: K. Ohl, A. Wiener, A. Schippers, N. Wagner, K. Tenbrock
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Double-negative T cells (DNTs) are expanded in the peripheral blood of patients with Systemic Lupus Erythematosus (SLE) and in murine lupus models. DNTs are capable to produce IFN-y and TNF-α and are regarded as the major producers of IL-17 in SLE. They furthermore induce IgG and anti-DNA antibody production and contribute to tissue damage by infiltrating kidneys of SLE patients. Therefore DNTs critically contribute to pathogenesis and kidney damage in SLE. However, signals that drive migration, occurrence and pathogenic expansion of DNTs remain to be elucidated. B6/lpr mice represent a well-established murine lupus model and develop splenomegaly and lymphadenopathy, caused by a massive expansion of DNTs. In accordance with DNTs from SLE patients, DNTs in these mice produce IL-17, infiltrate the kidneys and contribute to nephritis. <h3>Objectives</h3> We found high expression of CXCR5 on the surface of DNTs in lpr mice and therefore aimed to analyze, if CXCR5 directs migration of DNTs to spleens, lymph nodes and kidneys. <h3>Methods</h3> B6/lpr CXCR5 deficient and B6/lpr wild type mice were analyzed anatomically. Surface cell markers were characterized by cell type analysis (flow cytometry) and germinal centers were analyzed in frozen spleen sections by fluorescence microscopy. <h3>Results</h3> We generated B6/lpr mice which lack expression of CXCR5 (B6/lpr CXCR5<sup>-/-</sup> mice). CXCR5 deficient lpr mice developed reduced splenomegaly and lymphadenopathy paralleled by reduced levels of DNTs in these peripheral lymphoid organs, while DNT expression in the blood was unaltered. No germinal centers (GC) could be found in the spleens of these mice while B6/lpr wild type mice spontaneously developed GCs in the splenic follicles. Furthermore B6/lpr CXCR5<sup>-/-</sup> mice had a longer live time expectation compared to B6/lpr wild type mice. <h3>Conclusions</h3> We therefore suggest that expression of CXCR5 on DNTs might contribute to their migration into lymphoid organs and to SLE pathogenesis and that the CXCR5/CXCL13 axis represents a target for therapeutic interventions. <h3>Disclosure of Interest</h3> None declared
Carotid Endarterectomy for Asymptomatic Carotid Stenosis
Authors: H.J.M. Barnett, Stephen J. Haines
Journal: New England Journal of Medicine (1993)

Ischemic stroke remains one of the most common devastating illnesses in developed countries, ranking third as the cause of death and extracting a huge socioeconomic toll because of the permanence of the disability experienced by many of those who survive. Possible medical and surgical measures to prevent stroke therefore assume paramount importance. Their potential impact demands that their value be affirmed or denied with all the certainty that can be brought to bear by modern methods.Carotid endarterectomy has been proposed as a stroke-preventing measure and employed with increasing enthusiasm since its introduction in 1954. The frequency of its application . . .
Consultation-liaison psychiatry: current responsibilities
Authors: W A Brown, E M Jacobson
Journal: American Journal of Psychiatry (1976)

The authors describe their experiences as consultation-liaison psychiatrists in two general teaching hospitals. Current medical house staff members appear to be more aware of the importance of psychosocial issues in patient care than were interns and residents in the past. Consultation-liaison teaching may now focus on the application of this psychologic awareness to patient management, the correct use of psychotropic drugs, and the differentiation of delirium from functional psychoses.
AB0551 Assessment of Ovarian Reserve in Premenopausal Patients with Systemic Lupus Erythematosus
Authors: A.A. Gasparin, L. Souza, M. Sibert, R.M. Xavier, R.M.D.S. Chakr, P.E. Palominos, J.C.T. Brenol, O.A. Monticielo
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> The ovarian reserve of patients with systemic lupus erythematosus (SLE) may be affected by disease activity and medication use<sup>1,2,3</sup>. Studies have found that patients with SLE have similar fertility rates to healthy women of the same age<sup>4</sup>. Anti-Müllerian Hormone (AMH) is a dimeric glycoprotein which belongs to the transforming growth factor-a family (TGFβ). In the ovary, AMH is secreted by the granulosa cells of growing follicles, and its serum levels have been found to be a reliable marker of ovarian reserve<sup>5</sup>. <h3>Objectives</h3> The goal of the present study was to investigate the ovarian reserve of patients with SLE by measuring anti-Müllerian hormone (AMH) levels, and compare it to that of healthy controls. <h3>Methods</h3> His was a case-control study performed on 80 premenopausal women, of whom 40 fulfilled the 1997 American College of Rheumatology (ACR) criteria for SLE and 40 healthy controls paired by oral contraceptive use. Serum concentrations of AMH in peripheral venous blood were measured using a Human AMH ELISA kit (CUSABIO, Wuhan, China). <h3>Results</h3> AMH serum levels did not differ between patients with SLE and controls (22.79±17.32 ng/ml versus 21.41±16.22 ng/ml, respectively, p=0.7), even after adjusting for age (21.03±2.074 ng/ml versus 23.97±2.71 ng/ml; p=0.5). AHM levels were not significantly correlated with disease duration (r=0.2; p=0.3), body mass index (BMI) (r=0.2; p=0.2) and disease activity [SLEDAI (r=0.1; p=0.7)] and damage indices [SLICC (r=0.1; p=0.7)]. No associations were found between AMH and ethnicity, current smoking, as well as current or prior use of cyclophosphamide and other immunosuppressants. <h3>Conclusions</h3> In this cross-sectional study, women with SLE demonstrated similar AMH levels to healthy controls, suggesting preserved ovarian reserve in this population. <h3>References</h3> Gayed M, Gordon C. Pregnancy and rheumatic diseases. Rheumatology (Oxford). 2007;46:1634-40. Appenzeller S, Blatyta PF, Costallat LT. Ovarian failure in SLE patients using pulse cyclophosphamide: comparison of different regimes. Rheumatol Int. 2008;28:567-71. Carp HJA, Selmi C, Shoenfeld Y. The autoimmune bases of infertility and pregnancy loss. Journal of Autoimmunity. 2012; 38:J266 e J274. Ekblom-Kullberg S, Kautiainen H, Alha P, Helve T, Leirisalo-Repo M, Julkunen H. Reproductive health in women with systemic lupus erythematosus compared to population controls. Scand J Rheumatol. 2009;38(5):375-80. La Marca A, Spada E, Grisendi V, Argento C, Papaleo E, Milani S, et al. Normal serum anti-Müllerian hormone levels in the general female population and the relationship with reproductive history. Eur J Obstet Gynecol Reprod Biol. 2012;163:180-4. <h3>Disclosure of Interest</h3> None declared