tbuckley/cabot-search huggingface dataset:
Impact of health insurance transitions on cancer survivors and those with no cancer history.
Authors: Katherine S. Virgo, Chun Chieh Lin, Amy J. Davidoff
Journal: Journal of Clinical Oncology (2015)

6539 Background: 15.4% of the U.S. population was uninsured in 2012. Those without coverage face limited health care access and are more likely to have poor outcomes. Cancer survivors are particularly at risk of insurance gaps due to the long-term nature of the disease. This study examines the association between cancer history and health insurance transition patterns, including insurance gain or loss, and the impact on access to care. Methods: Using longitudinal data from the Medical Expenditure Panel Survey (MEPS) for 2008-2012 (panels 12-16), 2386 cancer survivors and 41,211 individuals with no cancer history ages 18-63 upon MEPS survey entry during 2008-2011 were selected. Individuals were categorized as initially uninsured or insured based on first stable consecutive three-month insurance status. Multivariate logistic regressions were used to assess the association between cancer history and insurance loss or gain based on first coverage change, adjusting for the MEPS complex survey design. Results: Uninsured cancer survivors were more likely to gain insurance and insured cancer survivors were less likely to lose insurance than those with no cancer history (42.5% and 34.1%; 9.9% and 14.6%, respectively). In adjusted analyses, cancer history was positively associated with insurance gain and negatively associated with insurance loss; but insignificant (p = 0.06; p = 0.11, respectively). Initially uninsured, younger (18-34), non-Hispanic white, occasionally employed, risk-averse individuals were more likely to gain insurance. Initially insured, younger (18-44), low income, occasionally employed males in fair to poor health were more likely to lose insurance. Those remaining uninsured or losing insurance were more likely to experience problems accessing needed medical care and less likely to have a usual source of care. Conclusions: Cancer history is associated with health insurance transition patterns. Different factors impact insurance gain and loss. Cancer survivors need stable health insurance coverage, yet coverage is inconsistent. Providing incentives to those with inconsistent access, such as the young, to enroll in health insurance could decrease volatility in coverage and improve continuity of care.
Is serum cholesterol a biological marker for major depressive disorder?
Authors: G F Oxenkrug, R J Branconnier, N Harto-Truax, J O Cole
Journal: American Journal of Psychiatry (1983)

An abnormally high serum cholesterol level has been suggested as a biological marker for major depression. However, in 192 depressed and normal subjects, age and sex influenced serum cholesterol level, but the diagnosis of major depression did not.
Cryptic prophages as targets for drug development
Authors: Xiaoxue Wang, Thomas K. Wood
Journal: Drug Resistance Updates (2016)

Bacterial chromosomes may contain up to 20% phage DNA that encodes diverse proteins ranging from those for photosynthesis to those for autoimmunity; hence, phages contribute greatly to the metabolic potential of pathogens. Active prophages carrying genes encoding virulence factors and antibiotic resistance can be excised from the host chromosome to form active phages and are transmissible among different bacterial hosts upon SOS responses. Cryptic prophages are artifacts of mutagenesis in which lysogenic phage are captured in the bacterial chromosome: they may excise but they do not form active phage particles or lyse their captors. Hence, cryptic prophages are relatively permanent reservoirs of genes, many of which benefit pathogens, in ways we are just beginning to discern. Here we explore the role of active prophage- and cryptic prophage-derived proteins in terms of (i) virulence, (ii) antibiotic resistance, and (iii) antibiotic tolerance; antibiotic tolerance occurs as a result of the non-heritable phenotype of dormancy which is a result of activation of toxins of toxin/antitoxin loci that are frequently encoded in cryptic prophages. Therefore, cryptic prophages are promising targets for drug development.
Jambo, Jahi
Authors: Claire Panosian Dunavan
Journal: JAMA (2005)

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
SP0212 TGFBeta: An Ambivalent Role in Bone and Cartilage
Authors: X. Cao
Journal: Annals of the Rheumatic Diseases (2015)

Osteoarthritis (OA) is a highly prevalent joint cartilage degeneration disorder. Articular cartilage and subchondral bone act as a functional unit. TGFb in maintenance of articular cartilage metabolic homeostasis and structural integrity has been well established. However, understanding of subchondral bone in OA is still limited. In our recent study, we investigated subchondral bone-articular cartilage as a functional unit in the joints during progression of OA. We found uncoupled osteoclastic bone resorption in the subchondral bone 7 days post anterior cruciate ligament transaction (ACLT) of an OA mouse model. The levels of active TGFβ1 were significantly increased in the subchondral bone, which induced increase of mesenchymal stem cells (MSCs) and osterix<sup>+</sup> osteoprogenitors significantly in the subchondral bone marrow one month post ACLT, leading to uncoupled bone formation, angiogenesis and articular cartilage degeneration. As a result, the subchondral plate thickness and calcified cartilage zone increased as progression of OA. We also found that high levels of active TGFβ in the subchondral bone of human OA knee joints. To validate the role of high level of active TGFb in the subchondral bone, we generated and analyzed osteoblast tissue–specific TGFβ transgenic mice. All of the transgenic mice develop knee joint OA with increased osteoblast progenitors and angiogenesis in the subchondral bone. We then examined whether inhibition of TGFb activity in the subchondral bone could reduce development of OA. Injection of TβRI inhibitor (1mg/kg for 1 month) improved subchondral bone structure, decreased angiogenesis and partially attenuated articular cartilage degeneration. Furthermore, local administration of TGFβ antibody in the subchondral bone of ACLT rats prevented articular cartilage degeneration, indicating that the pathological changes in subchondral bone contribute to the progression of articular cartilage degeneration. Moreover, we knocked out TGFβ type II receptor (TβRII) specifically in nestin<sup>+</sup> MSCs by inducible nestin-CreER to further validate the role of nestin<sup>+</sup> cells in the onset of OA. The microarchitecture was significantly improved in TβRII knockout mice relative to WT mice since MSCs no longer respond to TGFβ. Importantly, proteoglycan loss, advances of calcified cartilage zone, MMP13 and type X collagen expression in chondrocytes were prevented in ACLT TβRII knockout mice. This study demonstrates that high levels of active TGFβ in the subchondral bone contribute to the pathological changes seen at the onset of OA. Alteration of subchondral bone structure likely changes the stress distribution on the articular cartilage and leads to its degeneration. Thus, inhibition of TGFb activity in the subchondral bone may provide a new avenue of treatment for OA. <h3>Disclosure of Interest</h3> None declared
Charismatic religious sects and psychiatry: an overview
Authors: M Galanter
Journal: American Journal of Psychiatry (1982)

Phenomena associated with contemporary charismatic religious sects raise questions about the combined impact of group influence and intensely held beliefs on group members' psychological functioning. The author considers the stages of membership in these sects, with emphasis on psychiatric aspects of conversion, long-term membership, and leaving. He discusses options for psychiatric intervention, including psychotherapy, conservatorships, and deprogramming. Systems theory is used to provide a psychological model for the relationship between group influence in these sects and current conceptions of individual psychopathology and normal adaptation.
AB0305 Pre-Treatment B-Cell Lymphopenia is Associated with a Low Response Rate to Abatacept in Patients with Rheumatoid Arthritis
Authors: P. Gazeau, Y. Renaudineau, V. Devauchelle-Pensec, P. Pochard, J.-O. Pers, A. Saraux, D. Cornec
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Abatacept (CTLA4-Ig) prevents T-cell activation through inhibition of B7-CD28 interaction. However, abatacept may also modulate B cells, which express B7 molecules. <h3>Objectives</h3> The objectives of this study were to evaluate if pre-treatment lymphocyte subtype levels may be associated with the response in patients with rheumatoid arthritis (RA), and to assess the effects of abatacept therapy on lymphocyte phenotype. <h3>Methods</h3> We included in this study 22 RA patients treated by abatacept in our center with available data on lymphocyte phenotype at the moment of abatacept initiation. Among them, 16 patients had another lymphocyte phenotyping 6 months later. Patients who previously received rituximab were excluded. Response was defined at 6 months using EULAR definition. Patients were compared to 22 age and sex-matched healthy controls. Peripheral blood lymphocyte phenotyping was performed by flow cytometry using the following surface markers: CD3, CD4, CD8, CD56, CD19, IgD, CD27, CD38, and CD24. Absolute numbers (expressed as cells/μL) of each lymphocyte subset were computed. <h3>Results</h3> Median age of the patients was 60 years (IQR 54-73.5), median disease duration 17 years (6-26.3), and sex ratio 16 females/6 males. We did not find significant differences in lymphocyte subset levels between RA patients and matched controls. 14 patients were responders at 6 months and 8 did not respond to abatacept. Responders and non-responders did not differ in terms of age, disease duration, sex ratio, ACPA positivity, previous therapies, concomitant steroids and methotrexate use, and total lymphocyte, T-cell and NK-cell counts. Conversely, responders had a higher CD19+ B cell count at baseline than non-responders: 290 (140-370) vs 121 (76-154), p=0.037. Using ROC curve analysis, 250 B cells/μL was the best cut-off to predict the response at 6 months, with a sensitivity of 57% and a specificity of 100%. Switched memory B cells (IgD-CD27+) but not pre-swithed memory B cells (IgD+CD27+) were lower in non-responders than in responders. In the 16 patients with baseline and 6-month lymphocyte phenotyping, we did not observe any variation in the levels of total lymphocytes, T cells or NK cells after abatacept; conversely, there was a significant decrease of CD19+ B cells in responders but not in non-responders. <h3>Conclusions</h3> The mechanism of action of abatacept in RA seems to rely largely on the presence of B cells. Further studies are needed to understand how abatacept may modulate B-cell physiology. <h3>Disclosure of Interest</h3> None declared
SAT0124 Efficacy and Safety of 23-Valent Pneumococcal Vaccine in Patients with Rheumatoid Arthritis
Authors: M.S. Naumtseva, B.S. Belov, G.M. Tarasova, D.E. Karateev, E.L. Luchikina, Y.V. Muravyev, E.N. Alexandrova, A.A. Novikov
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Concurrent infections have significant impact on morbidity and mortality, especially in autoimmune diseases. Therefore, prevention of infection is an integral part of supervision of these patients. <h3>Objectives</h3> To investigate efficacy, immunogenicity and safety of 23-valent pneumococcal vaccine in patients with rheumatoid arthritis (RA), receiving therapy with diseases modifying anti rheumatic drugs (DMARDs) and biological disease modifying anti rheumatic drugs (bDMARDs). <h3>Methods</h3> Out of 131 subjects (108 females, 23 males, aged 23-73 years) included into the study 79 were RA patients and 52 - controls with a history of ≥2 episodes of lower respiratory tract infections (bronchitis, pneumonia). 39 patients with RA were on methotrexate (MTX), 14-leflunomid, 26- tumor necrosis factor alpha (TNF-α) inhibitors+MTX. One dose (0,5 ml) of 23-valent pneumococcal vaccine “Pneumo-23” was administered subcutaneously without discontinuation of MTX/leflunomide, 28-30 days prior to administration of TNF-α inhibitors. Totally four study visits were planned: initial vaccination visit and 3 control visits in 1, 3 and 12 months after vaccination. Routine evaluation during each visit included physical exams and laboratory tests. Levels of antibodies to pneumococcal capsular polysaccharide were measured using VaccZymeTM PCP IgG 2 kit (The Binding Site Group Ltd, Birmingham, UK). <h3>Results</h3> Not a single case of clinical or radiographic pneumonia was documented during the follow up period. Dynamic of pneumococcal antibodies is presented in the table. In RA patients concentration of antibodies significantly increased by visit 2, reached maximum by visit 3 and slightly decreased by the end of the year as compared with the baseline values. Similar dynamics was observed in the control group. In one year after vaccination more than 2-fold increase of pneumococcal antibody titers was documented in RA patients and controls (<i>p</i>=0,001 and <i>p</i>=0,002, respectively). In 89 cases patients tolerated the vaccine perfectly, and there were no complications. In 34 cases injection-site local reactions, such as pain or discomfort, swelling and redness of the skin up to 2 cm was documented, and in 8 cases local reaction was accompanied subfebrile fever. These reactions had no casual relationship with current RA therapy, and fully resolved within 24 hours without additional treatment. During the follow-up period no exacerbations of RA or occurrence of any new autoimmune disorder were registered. Dynamic of DAS28 in RA patients was as follows: 1 visit – 4,2; 2 – 3,7; 3 – 3,4; 4 – 3,25. <h3>Conclusions</h3> Thus, obtained results indicate sufficient clinical efficacy, immunogenicity and good tolerability of 23-valent pneumococcal vaccine in RA patients. <h3>Disclosure of Interest</h3> None declared
Conversion Symptoms
Authors: Aaron Lazare
Journal: New England Journal of Medicine (1981)

CONVERSION symptoms are the relatively persistent losses or alterations in sensory or voluntary motor functioning that cannot be explained by known physical disorders or pathophysiologic mechanisms. Examples include paralysis, abnormal movements, aphonia, hypoesthesia, sensations of coldness or warmth, blindness, and deafness. Whether pain and disorders of the autonomic nervous system (such as fainting and vomiting) should be included in the definition of conversion is a matter of controversy.A conversion symptom can occur in isolation, as part of another psychiatric disorder, or as part of a medical or neurologic disorder. When the symptom occurs in isolation, the diagnostic label is . . .
Effects of haloperidol challenge on regional cerebral glucose utilization in normal human subjects
Authors: E J Bartlett, J D Brodie, P Simkowitz, S L Dewey, H Rusinek, A P Wolf, J S Fowler, N D Volkow, G Smith, A Wolkin
Journal: American Journal of Psychiatry (1994)

Positron emission tomography and the fluorodeoxyglucose (FDG) method were used to determine the brain's metabolic response to neuroleptic challenge in a normal, disease-free state.FDG measurements were obtained before and 12 hours after administration of 5 mg of haloperidol to 12 young normal men. These values were compared with test-retest FDG measures obtained from nine normal male control subjects who received no drug intervention.After haloperidol administration, the haloperidol subjects showed significantly lower glucose utilization in the neocortex, limbic cortex, thalamus, and caudate nucleus but not in the putamen or cerebellum. After adjustment for global effects, significant reductions were still evident in the frontal, occipital, and anterior cingulate cortex, whereas the putamen and cerebellum showed significant increases.This study, measuring the brain's metabolic response to acute receptor blockade, is a first step in the development of an assay of CNS pharmacological activity. By determining the response to neuroleptic challenge in a normal state, the study establishes a comparison group for determining response to challenge in various psychiatric conditions.
Effective immunochemotherapy of CALLA+C mu+ human pre-B acute lymphoblastic leukemia in mice with severe combined immunodeficiency using B43 (anti-CD19) pokeweed antiviral protein immunotoxin plus cyclophosphamide
Authors: FM Uckun, LM Chelstrom, D Finnegan, L Tuel-Ahlgren, C Manivel, JD Irvin, DE Myers, R Gunther
Journal: Blood (1992)
PTH-001 The learning curve to achieve competency in upper gastrointestinal endoscopy: analysis of completion rates using the jets database
Authors: ST Ward, A Hancox, T Ismail, R Valori, P Dunckley
Journal: Gut (2015)

<h3>Introduction</h3> Endoscopy training programmes assess competency of trainees to perform oesophago-gastric-duodenoscopy (OGD). The Joint Advisory Group (JAG) in the UK require trainees to intubate D2 &gt;95% of the time. Stipulation of a D2 completion rate is necessary but insufficient without specifying the minimum number of procedures over which the target completion rate is to be achieved. The number of OGDs required to achieve competency is not well established. The American Board of Internal Medicine recommends a minimum number of 100 while JAG requires 200. JAG developed a trainee e-portfolio, called the JAG endoscopy training system (JETS) which is used by all endoscopy training units and trainees in the UK. <h3>Method</h3> JETS was interrogated to retrieve all OGD records from the time of the inception on 1<sup>st</sup>September 2009 to 1<sup>st</sup>June 2014. Trainees who had performed a baseline number of &gt;20 procedures or submitted data for less than 20 procedures were excluded. The primary outcome measure was D2 intubation without physical assistance. The number of OGDs to achieve a D2 intubation rate of &gt;95% was calculated by moving average method and learning curve (LC)-Cusum analysis. With regard incomplete OGDs, the extent that trainees reached without assistance was determined. Factors associated with OGD completion were analysed by a mixed effects logistic regression model. <h3>Results</h3> 2336 trainees submitted data on 282,256 OGDs: 1542 trainees had an unknown or baseline number &lt;20. Of these, 1126 had submitted data for &gt;20 procedures. By LC-Cusum, the median number of procedures for competent trainees to attain 95% D2 intubation was 131. After 100 procedures, 66% trainees had attained competency, rising to 89% after 150 procedures. By moving average method, the 95% D2 intubation rate was achieved after 182 procedures. For incomplete OGDs, the extent reached without assistance by trainees was: stomach (45%), oesophagus (24%), D1 (18%), or failed intubation (13%). Factors associated with OGD completion were total number of OGDs performed, previous lower GI endoscopy experience, patient gender, endoscopic diagnosis. <h3>Conclusion</h3> This is the largest study on the learning curve to achieve competency at OGD. The number of procedures required for trainees to attain a D2 intubation rate of 95% is between 131 and 182. Although other criteria are required to certify a trainee as competent, this study does provide objective evidence for a benchmark number of procedures. Factors known to be associated with OGD incompletion are the same as those identified here within the learning context. <h3>Disclosure of interest</h3> None Declared.
PTU-214 Nicorandil and gastrointestinal adverse drug reactions (adr): a systematic review
Authors: U Pisano, J Deosaran, SJ Leslie, G Rushworth, I Ford, AJ Watson
Journal: Gut (2015)

<h3>Introduction</h3> Nicorandil is an anti-anginal drug with a double mechanism of action, featuring a nicotinamide portion which acts on K<sub>ATP</sub>channels and a nitric oxide group, which relaxes vascular smooth cells. Apart from common gastrointestinal adverse drug reaction (GI-ADR), its safety and tolerability are satisfactory. No ulceration involving the gastrointestinal tract was officially associated with it before 1997 but several reports have suggested a link with gastrointestinal ulceration and fistulas. The aim of this systematic review was to quantify and characterise nicorandil-associated GI-ADRs by identifying all relevant literature reporting side effects of Nicorandil therapy on the GI system per anatomical location. <h3>Method</h3> This study complied with the PRISMA statement and comprised a search of Medline, CINAHL, EMBASE, Biomedical Reference Collection, WHO ADR Database, MHRA reports and Cochrane Library using the keywords: <i>Nicorandil, gastrointestinal, side-effect, adverse reaction, ulcer, ulceration, mucosa, cutaneous, fistula</i>. Parameters recorded include median age, median dose, history of symptoms, length of therapy, healing time after withdrawal of the drug. Data from literature is synthesised calculating a median and interquartile range (IQR) for all medians of observations. Difference in distribution of quantitative data is analysed with a Mann-Whitney test. Correlation between quantitative variables is assessed with a Spearman's correlation coefficient. A p value &lt;0.05 was considered significant. <h3>Results</h3> Oral and distal GI involvements are the most common ADR (28–29% and 27–31% of all gastrointestinal ADR, respectively). The hepatobiliary system, the pancreatic and salivary glands were not affected by Nicorandil exposure. The median time to develop oral ulcerations was 74.0 weeks among people on &lt;30 mg/die (IQR 19.4–197.7) versus only 7.55 weeks (IQR 5.25–48.7) in individuals on higher regimens of Nicorandil (p = 0.47). There was a significant correlation between Nicorandil dose and ulcer healing time across all the data (Spearman's rho 0.525, p &lt; 0.001). <h3>Conclusion</h3> The ulcerogenic metabolite hypothesis is the most convincing theory of why nicorandil causes ulceration and this is supported by the data analysis. Nicorandil seems to act as a necessary, but not always sufficient, cause of the ulcerations. A triggering element should coexist, whether that be a minor aphthosis, diverticulitis, ischaemic colitis, surgical or mechanical trauma, an anal abscess or even a simple pruritus ani. Whether the action of the metabolites relies on a specific mechanism or a simple chemical ulceration still has to be established. <h3>Disclosure of interest</h3> None Declared.