tbuckley/cabot-search huggingface dataset:
Comparison of ACC/AHA and ESC Guideline Recommendations Following Trial Evidence for Statin Use in Primary Prevention of Cardiovascular Disease
Authors: Jelena Pavlovic, Philip Greenland, Jaap W. Deckers, Jasper J. Brugts, Maryam Kavousi, Klodian Dhana, M. Arfan Ikram, Albert Hofman, Bruno H. Stricker, Oscar H. Franco, Maarten J. G. Leening
Journal: JAMA Cardiology (2016)

<h3>Importance</h3> The American College of Cardiology/American Heart Association (ACC/AHA) and the European Society of Cardiology (ESC) guidelines both recommend lipid-lowering treatment for primary prevention based on global risk for cardiovascular disease (CVD). However, randomized clinical trials (RCTs) for statin use have included participants with specific risk-factor profiles. <h3>Objective</h3> To evaluate the overlap between the ACC/AHA and ESC guideline recommendations and available evidence from RCTs for statin use in primary prevention of CVD. <h3>Design, Setting, and Participants</h3> We calculated the 10-year risk for hard atherosclerotic CVD (ASCVD) following the ACC/AHA guideline, 10-year risk of CVD mortality following the ESC guideline, and we determined eligibility for each of 10 major RCTs for primary prevention of CVD. Conducted from July 2014 to August 2015, this study included 7279 individuals free of CVD, aged 45 to 75 years, examined between 1997 and 2008 for the Rotterdam Study, a prospective population-based cohort. <h3>Main Outcomes and Measures</h3> Proportions of individuals qualifying for lipid-lowering treatment per guidelines, proportions of individuals eligible for any of the 10 RCTs, overlap between these groups, and corresponding ASCVD incidence rates. <h3>Results</h3> Of the 7279 individuals included in the study, 58.2% were women (n = 4238) and had a mean (SD) age of 61.1 (6.9) years. The ACC/AHA guidelines would recommend statin initiation in 4284 participants (58.9%), while the ESC guidelines would in 2399 participants (33.0%) (overlapping by 95.8% with ACC/AHA). A total of 3857 participants (53.0%) met eligibility criteria for at least 1 RCT. Recommendations from both guidelines and trial evidence overlapped for 1546 participants (21.2%), who were at high risk for ASCVD (21.5 per 1000 person-years). A further 1703 participants (23.4%) would be recommended for statins by the guidelines in the absence of direct trial evidence, while 1176 (16.2%) would have been eligible for at least 1 trial without being recommended statin treatment by any guideline. Finally, 1719 participants (23.6%) would not be recommended a statin, nor would qualify for any of the trials. These individuals had low incidence of ASCVD (3.3 per 1000 person-years). <h3>Conclusions and Relevance</h3> Based on this European population study, ACC/AHA and ESC prevention guidelines often did not align at the individual level. However, for one-fifth of the general population, guidelines on both sides of the Atlantic recommend statin initiation, with trial data supporting the efficacy. There should be no controversy about providing optimal preventive medication to these individuals.
Author's reply
Authors: Jonathan Gornall
Journal: BMJ (2007)

Carpenter et al fail to address the concern of David Hall, former president of the Royal College of Paediatrics and Child Health, that the conclusions of their paper were “seriously misleading.” Such defence as they do mount is equally misleading: “We did not materially change the cause of death for any case [Emery] knew about” and “No case previously attributed to either NAI or suspected or proven filicide was reclassified”. All true—but beside the point. The question that remains unanswered is why, after Emery's death, all but those seven cases of “NAI or suspected or proven filicide” came to be classified as “natural” deaths. 

The authors did, after all, admit that: “We cannot exclude the possibility in our study that some of the 13 cases in which enquiries were not possible were cases of covert homicide.” If so, then how can they justify classifying as “natural” all 13 of these unresolved cases—including seven in which parents or their representatives flatly declined to engage with the study? This benign exercise of the benefit of the doubt may be compassionate, but it is unscientific and alone invalidates the paper's findings. 

Webster's suggestion that a report by Professor Emery was doctored to support an argument is absurd. There is, as I showed in my article,1 overwhelming evidence that Emery's view of the proportion of repeat unexpected infant deaths that could be considered to be unnatural was seriously at odds with Carpenter et al's. The key and indisputable point of the passage that Webster attempts to obscure is that Emery believed suspicion was justified in a third of cases where there had been two unexpected infant deaths in a family. Even (or “only”) one third is a proportion sufficiently shocking and substantial to suggest that Professor Meadow was rather closer to the truth with his so-called “law” than his many critics are happy to admit—and to confirm that it was wrong to put Emery's name on this paper.
La surveillance sentinelle de la grippe en Europe, 1997/1998
Authors: M Zambon
Journal: Eurosurveillance (1998)

La circulation du virus de la grippe est associee a une augmentation des consultations chez les medecins generalistes (1), une augmentation des hospitalisations (2), un nombre de deces anormalement eleve (3) et doit etre prise en compte dans la planification des soins medicaux. En Europe occidentale, les virus de la grippe circulent generalement pendant les mois d'hiver, habituellement entre octobre et mars. Pendant cette saison, la surveillance des syndromes respiratoires est renforcee dans plusieurs pays europeens.
OXALIC ACID IN METABOLISM
Journal: JAMA (1934)

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
Ledipasvir plus sofosbuvir for 12 weeks in patients with hepatitis C genotype 4 infection
Authors: Armand Abergel, Sophie Metivier, Didier Samuel, Deyuan Jiang, Kathryn Kersey, Phillip S. Pang, Evguenia Svarovskaia, Steven J. Knox, Veronique Loustaud‐Ratti, Tarik Asselah
Journal: Hepatology (2016)

Genotype 4 hepatitis C virus (HCV) was considered difficult to treat in the era of pegylated interferon‐alpha (Peg‐IFN‐α) and ribavirin regimens. We evaluated the efficacy and safety of therapy with the nonstructural (NS) 5A inhibitor, ledipasvir, combined with the NS5B polymerase inhibitor, sofosbuvir, in patients with HCV genotype 4. In this phase 2, open‐label study, 44 patients (22 treatment naïve and 22 treatment experienced) received a fixed‐dose combination tablet of 90 mg of ledipasvir and 400 mg of sofosbuvir orally once‐daily for 12 weeks. The primary endpoint was the percentage of patients with HCV RNA &lt;15 IU/mL 12 weeks after stopping therapy (SVR12). Among study participants, HCV genotype 4 subtypes were well represented (4a, n = 25; 4d, n = 10; other subtypes, n = 9). Ten patients (23%) had compensated cirrhosis. Of the 22 treatment‐experienced patients, 21 (95%) had a non‐CC IL ‐ 28B genotype. All 44 patients completed the full 12 weeks of dosing. The SVR12 rate was 93% (41 of 44; 95% confidence interval, 81‐99). SVR12 rates were similar between treatment‐naïve (95%; 21 of 22) and treatment‐experienced (91%; 20 of 22) patients. All 3 patients who did not achieve SVR12 had virological relapse within 4 weeks of the end of treatment; all 3 had baseline HCV RNA ≥800,000 IU/mL, a non‐CC IL‐28B genotype, and pretreatment NS5A resistance‐associated variants. None of the patients who relapsed had cirrhosis. The most common adverse events were asthenia, headache, and fatigue. No patients experienced a serious adverse event. Conclusion : The all‐oral regimen of ledipasvir and sofosbuvir is an effective and safe treatment for a wide range of HCV 4 subtypes in both treatment‐naïve and ‐experienced patients, including those with compensated cirrhosis. (EudraCT number: 2013‐003978‐27; Clinicaltrials.gov NCT02081079) (H epatology 2016;64:1049‐1056)
Prognostic Implications of the SUVmax of Primary Tumors and Metastatic Lymph Node Measured by 18F-FDG PET in Patients With Uterine Cervical Cancer
Authors: Azmal Sarker, Hyung-Jun Im, Gi Jeong Cheon, Hyun Hoon Chung, Keon Wook Kang, June-Key Chung, E Edmund Kim, Dong Soo Lee
Journal: Clinical Nuclear Medicine (2015)

Purpose We conducted a meta-analysis to evaluate the prognostic value of the SUVmax measured in pretreatment primary lesions and metastatic lymph nodes (LNs) on 18F-FDG PET scans in patients with uterine cervical cancer. Methods A systematic search of EMBASE and MEDLINE was performed using the keywords “positron emission tomography (PET),” “uterine cervical cancer,” and “prognosis.” Event-free survival and overall survival were evaluated as outcomes. The impact of SUVmax on survival was measured by the effect size of the hazard ratio (HR). Results Fourteen eligible studies including 1150 patients were analyzed. Patients with a high primary SUVmax showed a worse prognosis, with an HR of 2.66 (95% confidence interval [CI], 1.90–3.74; P < 0.00001) for adverse events and an HR of 2.45 (95% CI, 1.74–3.45; P < 0.00001) for death. Patients with high SUVmax in metastatic pelvic LN (PLN) showed a worse prognosis, with an HR of 2.92 (95% CI, 1.94–4.39; P < 0.00001) for adverse events and an HR of 2.66 (95% CI, 1.60–4.43; P = 0.0002) for SUVmax in PLN for death. In addition, high SUVmax in metastatic para-aortic LN was associated with a worse prognosis, with an HR of 4.41 (95% CI, 2.32–8.38; P < 0.00001) for death. Conclusions Patients with uterine cervical cancer and a high SUVmax primary lesion, PLN, or para-aortic LN are at higher risk of adverse events or death.
Abstract 17415: Recombinant Human BDNF Can Mimic Effects of Exercise Training in Mice
Authors: Shingo Takada, Shintaro Kinugawa, Shouji Matsushima, Takashi Yokota, Wataru Mizushima, Takaaki Furihata, Junichi Matsumoto, Masaya Tsuda, Arata Fukushima, Koichi Okita, Hiroyuki Tsutsui
Journal: Circulation (2015)

Background: Brain-derived neurotrophic factor (BDNF), a member of the neurotrophic factor family, has been known to be increased by exercise training (ET) and associated with exercise capacity, which are dependent on mitochondrial function in the skeletal muscle (SKM). We thus hypothesized that an increase in BDNF and an activation of its binding receptor, tropomyosin-related kinase B (TrkB), could increase the exercise capacity by enhancing mitochondrial function in SKM in mice. Therefore, we investigated whether an administration of recombinant human (rh)BDNF into sedentary (SED) mice could mimic the effect of ET on exercise capacity and SKM. Methods and Results: C57BL/6J mice randomly assigned either SED (n=20) or ET (n=10), SED mice was divided into 2 groups of the treatment with vehicle (phosphate-buffered saline; n=10) or rhBDNF (10 mg/kg body weight/day, s.c.; n=10), for 5 weeks. ET was performed by swimming for 90 min/day and 5 times/week. SKM weight did not differ among groups. The work (distance x body weight) and peak oxygen uptake (VO2) evaluated by treadmill test were significantly increased in ET+vehicle compared to SED+vehicle (work 24±1 vs 32±1 J and peak VO2 150±2 vs 166±2 mL/kg/min, p&lt;0.05) and also in SED+rhBDNF to the same extent (work 29±1 and peak VO2 170±2). Serum BDNF levels was significantly increased in SED+rhBDNF compared to SED+vehicle, whereas it did not change in ET+vehicle. BDNF mRNA and protein expressions, and TrkB mRNA were increased in SKM from ET+vehicle compared with SED+vehicle (respectively, p&lt;0.05), whereas they did not change in SED+rhBDNF. Phosphorylation of TrkB, AMP-activated protein kinase (AMPK) and Sirt-1, and PGC-1α protein levels were increased in SED+rhBDNF and ET+vehicle compared with SED+vehicle (respectively, p&lt;0.05). Mitochondrial complex activities and citrate synthase activity were in parallel with these results. In C2C12 myotubes, rhBDNF significantly increased mRNA levels related to mitochondrial function and these effects were completely inhibited by anti-TrkB antibody or AMPK inhibitor, compound C. Conclusions: rhBDNF can mimic the effects of ET on exercise capacity. BDNF-TrkB pathway may play an important role in the beneficial effects of ET on the exercise capacity and SKM function.
Anti-GP2 IgA autoantibodies are associated with poor survival and cholangiocarcinoma in primary sclerosing cholangitis
Authors: Sebastian Torben Jendrek, Daniel Gotthardt, Thomas Nitzsche, Laila Widmann, Tobias Korf, Maike Anna Michaels, Karl-Heinz Weiss, Evaggelia Liaskou, Mette Vesterhus, Tom Hemming Karlsen, Swantje Mindorf, Peter Schemmer, Florian Bär, Bianca Teegen, Torsten Schröder, Marc Ehlers, Christoph Matthias Hammers, Lars Komorowski, Hendrik Lehnert, Klaus Fellermann, Stefanie Derer, Johannes Roksund Hov, Christian Sina
Journal: Gut (2016)

<h3>Objective</h3> Pancreatic autoantibodies (PABs), comprising antibodies against glycoprotein 2 (anti-GP2), are typically associated with complicated phenotypes in Crohn9s disease, but have also been observed with variable frequencies in patients with UC. In a previous study, we observed a high frequency of primary sclerosing cholangitis (PSC) in patients with anti-GP2-positive UC. We therefore aimed to characterise the role of anti-GP2 in PSC. <h3>Design</h3> In an evaluation phase, sera from 138 well-characterised Norwegian patients with PSC were compared with healthy controls (n=52), and patients with UC without PSC (n=62) for the presence of PABs by indirect immunofluorescence. Further, 180 German patients with PSC served as a validation cohort together with 56 cases of cholangiocarcinoma without PSC, 20 of secondary sclerosing cholangitis (SSC) and 18 of autoimmune hepatitis. <h3>Results</h3> Anti-GP2 IgA specifically occurred at considerable rates in large bile duct diseases (cholangiocarcinoma=36%, PSC and SSC about 50%). In PSC, anti-GP2 IgA consistently identified patients with poor survival during follow-up (Norwegian/German cohort: p Log Rank=0.016/0.018). Anti-GP2 IgA was associated with the development of cholangiocarcinoma in both PSC cohorts, yielding an overall OR of cholangiocarcinoma in patients with anti-GP2 IgA-positive PSC of 5.0 (p=0.001). Importantly, this association remained independent of disease duration, bilirubin level and age. <h3>Conclusions</h3> Anti-GP2 IgA can be hypothesised as a novel marker in large bile duct diseases. In particular, in PSC, anti-GP2 IgA identified a subgroup of patients with severe phenotype and poor survival due to cholangiocarcinoma. Anti-GP2 IgA may therefore be a clinically valuable tool for risk stratification in PSC.
Telomerase-Mediated Repair of Induced DNA Breaks Leads to Increased Genomic Instability in Multiple Myeloma Cells: Possible Mechanism and Translational Significance
Authors: Jagannath Pal, Masood Shammas, Subodh Kumar, Maria Gkotzamanidou, Puru Nanjappa, Leutz Buon, Nikhil C. Munshi
Journal: Blood (2014)
P-271 Feasibility of neoadjuvant chemotherapy with modified FOLFOX6 (combination chemotherapy of infusional 5-FU/l-Leucovorin and intermittent oxaliplatin) with bevacizumab in patients with locally advanced lower rectal cancer
Authors: C. Kosugi, K. Koda, K. Tanaka, Y. Miyazawa, K. Shuto, K. Matsuo, M. Mori, A. Hirano, S. Endo, Y. Hiroshima, T. Sazuka, H. Yanagibashi, Y. Kikuchi
Journal: Annals of Oncology (2016)
Behavior therapy and sex therapy
Authors: J P Brady
Journal: American Journal of Psychiatry (1976)

Behavior therapy is characterized by the way in which clinical data are collected, analyzed, and used in the treatment program-specifically, the application of the methods of experimental and social psychology. A case history of the behavioral treatment of a sexual problem is presented to illustrate this process. Many people have assumed that the "new sex therapy" is behavior therapy because of its focus on the here and now and similarities in particular treatment maneuvers. However, the author notes that sex therapy is behavior therapy only to the extent that it deals comprehensively with environmental, interpersonal, and organismic factors that operate to maintain the sexual problem.
Disclosure UK website gives “illusion of transparency,” says Goldacre
Authors: Zosia Kmietowicz
Journal: BMJ (2016)

Ben Goldacre, academic lead at the Evidence Based Medicine DataLab at the University of Oxford, who helped The BMJ with the analysis of data from Disclosure UK (www.disclosureuk.org.uk), the new website detailing payments to doctors from the drug industry,1 has criticised the website for its partial attempt at transparency.

“Doctors have an obligation to be open with their patients and colleagues,” he said. “A financial conflict of interest does not necessarily mean somebody is biased, and there are good reasons to work with the industry, but it does introduce risks. That’s why clearly declaring your conflicts matters, so we can all judge …
Relapsing Polychondritis Can Be Characterized by Three Different Clinical Phenotypes: Analysis of a Recent Series of 142 Patients
Authors: Jérémie Dion, Nathalie Costedoat‐Chalumeau, Damien Sène, Judith Cohen‐Bittan, Gaëlle Leroux, Charlotte Dion, Camille Francès, Jean‐Charles Piette
Journal: Arthritis & Rheumatology (2016)

Relapsing polychondritis (RP) is a rare condition characterized by recurrent inflammation of cartilaginous tissue and systemic manifestations. Data on this disease remain scarce. This study was undertaken to describe patient characteristics and disease evolution, identify prognostic factors, and define different clinical phenotypes of RP.We performed a retrospective study of 142 patients with RP who were seen between 2000 and 2012 in a single center.Of the 142 patients, 86 (61%) were women. The mean ± SD age at first symptoms was 43.5 ± 15 years. Patients had the following chondritis types: auricular (89%; n = 127), nasal (63%; n = 89), laryngeal (43%; n = 61), tracheobronchial (22%; n = 32), and/orcostochondritis (40%; n = 57). The main other manifestations were articular (69%; n = 98), ophthalmologic (56%; n = 80), audiovestibular (34%; n = 48), cardiac (27%; n = 38), and cutaneous (28%; n = 40). At a mean ± SD followup of 13 ± 9 years, the 5- and 10-year survival rates were 95 ± 2% and 91 ± 3%, respectively. Factors associated with death on multivariable analysis were male sex (P = 0.01), cardiac abnormalities (P = 0.03), and concomitant myelodysplastic syndrome (MDS) (P = 0.004) or another hematologic malignancy (P = 0.01). Cluster analysis revealed that separating patients into 3 groups was clinically relevant, thereby separating patients with associated MDS, those with tracheobronchial involvement, and those without the 2 features in terms of clinical characteristics, therapeutic management, and prognosis.This large series of patients with definite RP revealed an improvement in survival as compared with previous studies. Factors associated with death were male sex, cardiac involvement, and concomitant hematologic malignancy. We identified 3 distinct phenotypes.
Phase II Trial Evaluating the Safety and Efficacy of Atorvastatin for the Prophylaxis of Acute Graft Vs. Host Disease (aGVHD) in Patients with Hematological Malignancies Undergoing HLA-Matched Related Donor Allogeneic Hematopoietic Stem Cell Transplantation (allo HSCT)
Authors: Yvonne A Efebera, Susan Geyer, Anissa Bingman, Patrick Elder, Rhonda Kitzler, Kevin Coombes, Carrie Hennelly, Katie Cortright, Leslie A. Andritsos, Samantha M. Jaglowski, Sumithira Vasu, William Blum, Rebecca B. Klisovic, Sam Penza, Craig C Hofmeister, Don M Benson, Gerard Lozanski, Steven M. Devine
Journal: Blood (2014)
Human monkeypox in Kasaï Oriental, Zaire (1996-1997)
Authors: P. T. Mwanbal, K F Tshioko, A Moudi, V Mukinda, G. N. Mwema, D Messinger, L Okito, D Barakymfyte, P Malfait, R Pebody, M Szczeniowski, K Esteves, D Heymann, Y Hutin, R J Williams, A. S. Khan, J J Esposito
Journal: Eurosurveillance (1997)

Monkeypox is an orthopoxvirus with enzootic circulation in the rainforests of central and western Africa; the virus can be transmitted to humans and cause a syndrome clinically similar to smallpox (e.g., pustular rash, fever, respiratory symptoms, and in
Discontinuation and restarting in patients on statin treatment: prospective open cohort study using a primary care database
Authors: Yana Vinogradova, Carol Coupland, Peter Brindle, Julia Hippisley-Cox
Journal: BMJ (2016)

To estimate rates of discontinuation and restarting of statins, and to identify patient characteristics associated with either discontinuation or restarting. Prospective open cohort study. 664 general practices contributing to the Clinical Practice Research Datalink in the United Kingdom. Data extracted in October 2014. Incident statin users aged 25-84 years identified between January 2002 and September 2013. Patients with statin prescriptions divided into two groups: primary prevention and secondary prevention (those already diagnosed with cardiovascular disease). Patients with statin prescriptions in the 12 months before study entry were excluded. Discontinuation of statin treatment (first 90 day gap after the estimated end date of a statin prescription), and restarting statin treatment for those who discontinued (defined as any subsequent prescription between discontinuation and study end). Of 431 023 patients prescribed statins as primary prevention with a median follow-up time of 137 weeks, 47% (n=204 622) discontinued treatment and 72% (n=147 305) of those who discontinued restarted. Of 139 314 patients prescribed statins as secondary prevention with median follow-up time of 182 weeks, 41% (n=57 791) discontinued treatment and 75% (43 211) of those who discontinued restarted. Younger patients (aged ≤50 years), older patients (≥75 years), women, and patients with chronic liver disease were more likely to discontinue statins and less likely to restart. However, patients in ethnic minority groups, current smokers, and patients with type 1 diabetes were more likely to discontinue treatment but then were more likely to restart, whereas patients with hypertension and type 2 diabetes were less likely to discontinue treatment and more likely to restart if they did discontinue. These results were mainly consistent in the primary prevention and secondary prevention groups. Although a large proportion of statin users discontinue, many of them restart. For many patient groups previously considered as "stoppers," the problem of statin treatment "stopping" could be part of the wider issue of poor adherence. Identification of patient groups associated with completely stopping or stop-starting behaviour has positive implications for patients and doctors as well as suggesting areas for future research.