tbuckley/cabot-search huggingface dataset:
Health Care Spending on Diabetes in the U.S., 1996–2013
Authors: Ellen Squires, Herbert Duber, Madeline Campbell, Jackie Cao, Abigail Chapin, Cody Horst, Zhiyin Li, Taylor Matyasz, Alex Reynolds, Irl B. Hirsch, Joseph L. Dieleman
Journal: Diabetes Care (2018)

OBJECTIVE Health care spending on diabetes in the U.S. has increased dramatically over the past several decades. This research describes health care spending on diabetes to quantify how that spending has changed from 1996 to 2013 and to determine what drivers are increasing spending. RESEARCH DESIGN AND METHODS Spending estimates were extracted from the Institute for Health Metrics and Evaluation’s Disease Expenditure 2013 database. Estimates were produced for each year from 1996 to 2013 for each of 38 age and sex groups and six types of care. Data on disease burden were extracted from the Global Burden of Disease 2016 study. We analyzed the drivers of spending by measuring the impact of population growth and aging and changes in diabetes prevalence, service utilization, and spending per encounter. RESULTS Spending on diabetes in the U.S. increased from $37 billion (95% uncertainty interval $32–$42 billion) in 1996 to $101 billion ($97–$107 billion) in 2013. The greatest amount of health care spending on diabetes in 2013 occurred in prescribed retail pharmaceuticals (57.6% [53.8–62.1%] of spending growth) followed by ambulatory care (23.5% [21.7–25.7%]). Between 1996 and 2013, pharmaceutical spending increased by 327.0% (222.9–456.6%). This increase can be attributed to changes in demography, increased disease prevalence, increased service utilization, and, especially, increases in spending per encounter, which increased pharmaceutical spending by 144.0% (87.3–197.3%) between 1996 and 2013. CONCLUSIONS Health care spending on diabetes in the U.S. has increased, and spending per encounter has been the biggest driver. This information can help policy makers who are attempting to control future spending on diabetes.
Image Gallery: Facial sporotrichosis
Authors: Y.-K. Xiang, T. Qu
Journal: British Journal of Dermatology (2018)

Funding sources: none. Conflicts of interest: none declared. Dear Editor, An otherwise healthy 65‐year‐old woman presented with a 4‐month history of centrofacial eruption of multiple erythematous crusted papules, which initially appeared on the nose and then spread to the cheeks. Medical past history was of no significance. On examination, scattered papules and nodules with overlying haemorrhagic crusts were noted on her nose and perinasal area (a). No lesions were observed on the mucosal surfaces. There was no lymphadenopathy in the cervicofacial draining area. A biopsy specimen obtained from the patient's nose revealed a mixed granulomatous and pyogenic process in the dermis, containing inflammatory infiltrate of neutrophils, plasma cells, epithelioid cells, lymphocytes, histiocytes and eosinophils (d). Sporothrix schenckii, a thermal dimorphic fungus, was identified in cultures. Microscopic view of S. schenckii at 25 °C revealed thin, septate and branched hyphae with numerous attached conidia in ‘bouquet‐like’ arrangements (b). On the basis of these findings, a diagnosis of fixed cutaneous sporotrichosis was made. Treatment with oral itraconazole (200 mg daily) was initiated. A 3‐month course of itraconazole resulted in prominent and simultaneous improvement of all lesions (c). The patient was a farmer but no trauma was noticed preceding the onset of the lesions. The case reminds us of the strong relationship between occupation and sporotrichosis, also named rose gardener's disease.
An Update on the Management of Neonatal Brachial Plexus Palsy—Replacing Old Paradigms
Authors: Brandon W. Smith, Alecia K. Daunter, Lynda J.-S. Yang, Thomas J. Wilson
Journal: JAMA Pediatrics (2018)

Neonatal brachial plexus palsy (NBPP) can result in persistent deficits for those who develop it. Advances in surgical technique have resulted in the availability of safe, reliable options for treatment. Prevailing paradigms include, "all neonatal brachial plexus palsy recovers," "wait a year to see if recovery occurs," and "don't move the arm." Practicing by these principles places these patients at a disadvantage. Thus, the importance of this review is to provide an update on the management of NBPP to replace old beliefs with new paradigms.Changes within denervated muscle begin at the moment of injury, but without reinnervation become irreversible 18 to 24 months following denervation. These time-sensitive, irreversible changes are the scientific basis for the recommendations herein for the early management of NBPP and put into question the old paradigms. Early referral has become increasingly important because improved outcomes can be achieved using new management algorithms that allow surgery to be offered to patients unlikely to recover sufficiently with conservative management. Mounting evidence supports improved outcomes for appropriately selected patients with surgical management compared with natural history. Primary nerve surgery options now include nerve graft repair and nerve transfer. Specific indications continue to be elucidated, but both techniques offer a significant chance of restoration of function.Mounting data support both the safety and effectiveness of surgery for patients with persistent NBPP. Despite this support, primary nerve surgery for NBPP continues to be underused. Surgery is but one part of the multidisciplinary care of NBPP. Early referral and implementation of multidisciplinary strategies give these children the best chance of functional recovery. Primary care physicians, nerve surgeons, physiatrists, and occupational and physical therapists must partner to continue to modify current treatment paradigms to provide improved quality care to neonates and children affected by NBPP.
UTX-mediated enhancer and chromatin remodeling suppresses myeloid leukemogenesis through noncatalytic inverse regulation of ETS and GATA programs
Authors: Malgorzata Gozdecka, Eshwar Meduri, Milena Mazan, Konstantinos Tzelepis, Monika Dudek, Andrew J. Knights, Mercedes Pardo, Lu Yu, Jyoti S. Choudhary, Emmanouil Metzakopian, Vivek Iyer, Haiyang Yun, Naomi Park, Ignacio Varela, Ruben Bautista, Grace Collord, Oliver Dovey, Dimitrios A. Garyfallos, Etienne De Braekeleer, Saki Kondo, Jonathan Cooper, Berthold Göttgens, Lars Bullinger, Paul A. Northcott, David Adams, George S. Vassiliou, Brian J. P. Huntly
Journal: Nature Genetics (2018)
Abstract 16008: Non-Indexed Wall Thickness Measurements Overestimate Left Ventricular Hypertrophy in Patients With Increased Body Size
Authors: Troy M Labounty, Eduardo Bossone, Theodore J Kolias, David S Bach
Journal: Circulation (2017)

Introduction:  Guidelines provide normal ranges of left ventricle (LV) wall thicknesses without indexing to body size.   Hypothesis:  Increased body size may result in over-estimation of LV hypertrophy using non-indexed values for wall thickness.   Methods:  We examined the relationship between LV septal wall thickness (SWT) and posterior wall thickness (PWT), and body-surface area in 11,554 patients undergoing echocardiography, after excluding patients with diabetes, hypertension or elevated blood pressure, renal insufficiency, left-sided valve disease, or hypertrophic cardiomyopathy. We further examined relationship between mortality and wall thickness.   Results:  Mean age was 50.6±15.8 years, and 57.8% were female. There were 915 deaths, and mean follow-up was 2.4±1.2 years. There is a linear relationship between BSA and both SWT and PWT (r=0.37, p   Conclusions:  Increased BSA is associated with greater wall thickness, and indexed wall thickness has a stronger relationship with mortality than non-indexed values. Existing definitions of normal LV wall thickness may result in over-diagnosis of LV hypertrophy in larger patients, particularly in women. We provide normal ranges for indexed wall thickness in our population.
Continuing Besifovir Dipivoxil Maleate versus switching from Tenofovir Disoproxil Fumarate for treatment of chronic hepatitis B: 96 weeks results of phase 3 trial
Authors: S.H. Ahn, W. Kim, H.J. Yim, J.M. Yang, J.Y. Jang, Y.O. Kweon, Y.K. Cho, Y.J. Kim, G.Y. Hong, D.J. Kim, S.H. Um, J.H. Sohn, J.-W. Lee, S.J. Park, B.S. Lee, J.H. Kim, H.S. Kim, S.K. Yoon, M.Y. Kim, K.S. Lee, Y.-S. Lim, W.S. Lee, K.-H. Han
Journal: Journal of Hepatology (2018)
TCTAP A-123 Impact of Myocardial Blush Grade on In-hospital Outcome After Primary Percutaneous Coronary Intervention
Authors: Md Minhaj Arefin, Afzalur Rahman, Mohammad Golam Azam, Abdul Momen, Mohammad Arifur Rahman, Jafrin Jahan, Fathima Aaysha Cader
Journal: Journal of the American College of Cardiology (2018)
Sex hormone binding globulin levels are increased in HIV-infected men and are independently associated with lower odds of nonalcoholic fatty liver disease regardless of HIV serostatus
Authors: J. Price, R. Wang, E. Seaberg, T. Brown, M. Budoff, L. Kingsley, F.P. Jr, M. Witt, W. Post, J. Lake, C. Thio
Journal: Journal of Hepatology (2018)
Government’s vaginal mesh audit does not go far enough, say campaigners
Authors: Jacqui Wise
Journal: BMJ (2018)

The government’s pelvic mesh audit has been labelled a whitewash by campaigners who claim that it misses crucial data and downplays the risks.

In January 2018 the government agreed to carry out a full audit of vaginal mesh implants in England,1 after pressure from campaigners and the all party parliamentary group on surgical mesh implants.23 More than 800 UK women are taking legal action against the NHS and the makers of the implants.

Last year, the UK National Institute for Health and Care Excellence said transvaginal mesh should not be used to treat vaginal wall prolapse because of “serious but well recognised concerns.”4 In February, the government announced a review, led by the peer Julia Cumberlege, which will examine how the NHS responded to worries about vaginal …
Arthur Robertson Makey
Authors: David Toase
Journal: BMJ (2018)

Arthur Robertson Makey was born in Dover and was awarded a Kitchener’s scholarship to study medicine. After preregistration jobs he did his national service with the Royal Air Force as a medical officer in Bombay from 1946 to 1948 and then returned to the Charing Cross and Brompton hospitals to continue his surgical training. At the Brompton he worked …
Novel protective role of kallistatin in obesity by limiting adipose tissue low grade inflammation and oxidative stress
Authors: Gema Frühbeck, Javier Gómez-Ambrosi, Amaia Rodríguez, Beatriz Ramírez, Víctor Valentí, Rafael Moncada, Sara Becerril, Xabier Unamuno, Camilo Silva, Javier Salvador, Victoria Catalán
Journal: Metabolism (2018)
Home Office powers to check NHS immigration data is severely restricted
Authors: Ingrid Torjesen
Journal: BMJ (2018)

The government has announced that Home Office powers to access information about patients—through a controversial data sharing arrangement with the NHS—to help officials locate people who have breached their right to remain in the UK, is to be limited.1

The announcement follows pressure from MPs, doctors’ groups, and health charities, who warned that the practice was deterring patients from seeking NHS care.2

Margot James, a minister in the Department for Digital, Culture, Media, and Sport, announced the rethink during …
The role of dendritic cells in different stages of non-alcoholic fatty liver disease
Authors: O.L. Ramírez-Pérez, B. Barranco-Fragoso, R. Pichardo-Bahena, V.C. Cruz-Ramón, P. Chinchilla-López, S. Canizales-Quinteros, N. Méndez
Journal: Journal of Hepatology (2018)
Proof-of-concept of full-length genome sequencing as diagnostic tool of acute viral hepatitis
Authors: I. Ruiz, G. Gricourt, S. Fourati, C. Stephane, A.L. Bouter, H. Regnault, V. Demontant, Frédéric L. Gal, E. Gordien, C. Hezode, C. Rodriguez, J.-M. Pawlotsky
Journal: Journal of Hepatology (2018)
Solute carrier family 9, subfamily A, member 3 (SLC9A3)/sodium-hydrogen exchanger member 3 (NHE3) dysregulation and dilated intercellular spaces in patients with eosinophilic esophagitis
Authors: Chang Zeng, Simone Vanoni, David Wu, Julie M. Caldwell, Justin C. Wheeler, Kavisha Arora, Taeko K. Noah, Lisa Waggoner, John A. Besse, Amnah N. Yamani, Jazib Uddin, Mark Rochman, Ting Wen, Mirna Chehade, Margaret H. Collins, Vincent A. Mukkada, Philip E. Putnam, Anjaparavanda P. Naren, Marc E. Rothenberg, Simon P. Hogan
Journal: Journal of Allergy and Clinical Immunology (2018)
Vedolizumab is associated with changes in innate rather than adaptive immunity in patients with inflammatory bowel disease
Authors: Sebastian Zeissig, Elisa Rosati, C Marie Dowds, Konrad Aden, Johannes Bethge, Berenice Schulte, Wei Hung Pan, Neha Mishra, Maaz Zuhayra, Marlies Marx, Maren Paulsen, Anne Strigli, Claudio Conrad, Dörthe Schuldt, Anupam Sinha, Henriette Ebsen, Sabin-Christin Kornell, Susanna Nikolaus, Alexander Arlt, Dieter Kabelitz, Mark Ellrichmann, Ulf Lützen, Philip C Rosenstiel, Andre Franke, Stefan Schreiber
Journal: Gut (2018)

Vedolizumab, a monoclonal antibody directed against the integrin heterodimer α4β7, is approved for the treatment of Crohn's disease and ulcerative colitis. The efficacy of vedolizumab has been suggested to result from inhibition of intestinal T cell trafficking although human data to support this conclusion are scarce. We therefore performed a comprehensive analysis of vedolizumab-induced alterations in mucosal and systemic immunity in patients with inflammatory bowel disease (IBD), using anti-inflammatory therapy with the TNFα antibody infliximab as control.Immunophenotyping, immunohistochemistry, T cell receptor profiling and RNA sequencing were performed using blood and colonic biopsies from patients with IBD before and during treatment with vedolizumab (n=18) or, as control, the anti-TNFα antibody infliximab (n=20). Leucocyte trafficking in vivo was assessed using single photon emission computed tomography and endomicroscopy.Vedolizumab was not associated with alterations in the abundance or phenotype of lamina propria T cells and did not affect the mucosal T cell repertoire or leucocyte trafficking in vivo. Surprisingly, however, α4β7 antibody treatment was associated with substantial effects on innate immunity including changes in macrophage populations and pronounced alterations in the expression of molecules involved in microbial sensing, chemoattraction and regulation of the innate effector response. These effects were specific to vedolizumab, not observed in response to the TNFα antibody infliximab, and associated with inhibition of intestinal inflammation.Our findings suggest that modulation of innate immunity contributes to the therapeutic efficacy of vedolizumab in IBD.NCT02694588.
Is a telehealth-to-home group lifestyle intervention a feasible and safe option for specialist liver clinics?
Authors: I. Hickman, S. Keating, A. Hannigan, L. Elvin-Walsh, A. Barnett, C. Salisbury, M. Jarrett, J. Fawcett, I. Croci, K. Campbell, J. Coombes, G. Macdonald
Journal: Journal of Hepatology (2018)
Second-line treatment in patients with FOLFIRINOX-refractory pancreatic adenocarcinoma (PDAC): Doublets or single-agent chemotherapy?
Authors: Chiara Pellei, Andrea Lanese, Alessandro Bittoni, Kalliopi Andrikou, Matteo Santoni, Alessandro Conti, Giuseppe Tonini, Marco Russano, Daniele Santini, Stefano Cascinu
Journal: Journal of Clinical Oncology (2014)

e15186 Background: FOLFIRINOX represents an active regimen in first-line treatment of advanced pancreatic cancer (APC) patients (pts) with good performance status (PS). Currently, there are no accepted standard regimens in second-line therapy for patients with disease progression and data about efficacy of chemotherapy after FOLFIRINOX failure are lacking . Methods: We retrospectively investigated clinical and laboratory characteristics (including blood count, LDH and CA19.9) of APC pts treated between June 2011 and October 2013 in two italian institutions (AOU Ospedali Riuniti-Ancona and Campus Biomedico-Roma) with either doublet or single agent as second-line therapy after FOLFIRINOX failure. Survival estimates were quantified using Kaplan Meier curves, and differences between groups were compared with the log-rank test. Results: Among 48 pts treated with FOLFIRINOX as first-line chemotherapy, 29 pts received second-line treatment (60.4%). PDAC was locally advanced in 12 (41%) and metastatic in 17 pts (59%). Median age at diagnosis was 58.8 years (range 37-72); 19 pts were males; 13 females. Patients who received second line single agent (gemcitabine, docetaxel or nab-paclitaxel) or doublets (gemcitabine with either capecitabine, cisplatin or docetaxel) were 13 and 16, respectively. According to RECIST criteria, 2 pts achieved PR 2 (6.9%); 9 (31%) SD for ≥9 wks; 18 (62.1%) PD; Median progression-free survival (PFS) was 2.7 months and median overall survival (OS) was 3.41 months. ECOG≤ 1 resulted a favorable prognostic factor (p<0.05). Patients treated with single-agent chemotherapy had a better outcome in terms of OS (p=0.048) as compared with doublets, while no significant differences were found in terms of PFS and overall response rate. Conclusions: Our findings suggest that the choice of second line therapy in patients with FOLFIRINOX-refractory PDACs should be carefully evaluated. Single agent chemotherapy may represent a better option compared to combinations, although these data should be confirmed in prospective trials.
Neuroprotective Effects of Prenatal Folic Acid Supplementation
Authors: Joshua L. Roffman
Journal: JAMA Psychiatry (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 Psychiatry 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 Psychiatry journal
A deep-learning approach for pattern recognition allows rapid and reproducible quantification of histological NASH parameters: Integration into the QuPath platform
Authors: E. Rexhepaj, D. Nathalie, N. Benoit, H. Alison, B. Carole, R. Walczak, S. Megnien, D. Hum, B. Staels, J. Brozek
Journal: Journal of Hepatology (2018)
First results of universal screening for Lynch syndrome in a Mexican cohort of colorectal cancer patients.
Authors: Zuleyma Nieto, Ana Karen Valenzuela, Fidel David Huitzil Melendez, MÃ³nica Isabel Meneses Medina, Armando Gamboa Dominguez, Vanessa Rosas Camargo, Jazmin Arteaga Vazquez, Mauricio Mora Pineda
Journal: Journal of Clinical Oncology (2018)

590 Background: universal screening has been proposed as an alternative to clinical criteria for detection of Lynch syndrome (LS). Results of such policy have not been evaluated in mexican population with low incidence of colo-rectal cancer (CCR). Objective: to determine the proportion of patients tested by immunohistochemistry (IHC) for mismatch repair-deficient (dMMR) and characterize subsequent molecular and clinical work up for abnormal results. Methods: we identified all consecutive cases of CCR during 2016 at Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico. We recorded clinical variables, IHC for mismatch repair (MMR) proteins and/or clinical genetics evaluation and molecular confirmation of LS if available. Results: universal screening policy was adopted by our institution in 2016. 209 CRC patients had an outpatient consultation. The median age at diagnosis was 59.8 years. 103 IHC for MMR proteins were done (49%) regardless of age at diagnosis and a family history of CRC. 36/103 (35%) IHC showed abnormal result meaning lack of expression of at least one of four MMR proteins: 26 MLH1, 7 MSH2, 10 MSH6 and 23 PMS2. 11/36 patients (30%) had a family history of CRC. 26/36 (72%) were evaluated by clinical genetics service. Of 26 MLH1 deficient patients, only one case was tested for BRAF mutation. 14/36 patients (39%) were tested by sequencing analysis: 7 MLH1, 5 MSH2, 1 MSH6, 1 PMS2. 2/14 patients were tested by MLPA assay given negative sequencing analysis. Germ-line mutations were identified in 7/36 patients (19%). All mutations were identified in patients with a clinical suspicion given strong family history of CRC. No identified mutations could be attributed to universal screening policy. Conclusions: during the first year of implementing universal screening for LS in CRC patients only half of the patients were screened by IHC. Despite MLH1/PMS2 deficiency was the most frequent abnormality, BRAF mutation analysis was not performed as recommended, given the lack of access to the test. A clinical suspicion of LS was a determinant driver for confirmatory molecular testing therefore limiting the usefulness of universal screening.