tbuckley/cabot-search huggingface dataset:
Intensive Treat-to-Target Statin Therapy in High-Risk Japanese Patients With Hypercholesterolemia and Diabetic Retinopathy: Report of a Randomized Study
Authors: Hiroshi Itoh, Issei Komuro, Masahiro Takeuchi, Takashi Akasaka, Hiroyuki Daida, Yoshiki Egashira, Hideo Fujita, Jitsuo Higaki, Ken-ichi Hirata, Shun Ishibashi, Takaaki Isshiki, Sadayoshi Ito, Atsunori Kashiwagi, Satoshi Kato, Kazuo Kitagawa, Masafumi Kitakaze, Takanari Kitazono, Masahiko Kurabayashi, Katsumi Miyauchi, Tomoaki Murakami, Toyoaki Murohara, Koichi Node, Susumu Ogawa, Yoshihiko Saito, Yoshihiko Seino, Takashi Shigeeda, Shunya Shindo, Masahiro Sugawara, Seigo Sugiyama, Yasuo Terauchi, Hiroyuki Tsutsui, Kenji Ueshima, Kazunori Utsunomiya, Masakazu Yamagishi, Tsutomu Yamazaki, Shoei Yo, Koutaro Yokote, Kiyoshi Yoshida, Michihiro Yoshimura, Nagahisa Yoshimura, Kazuwa Nakao, Ryozo Nagai
Journal: Diabetes Care (2018)

OBJECTIVE Diabetes is associated with high risk of cardiovascular (CV) events, particularly in patients with dyslipidemia and diabetic complications. We investigated the incidence of CV events with intensive or standard lipid-lowering therapy in patients with hypercholesterolemia, diabetic retinopathy, and no history of coronary artery disease (treat-to-target approach). RESEARCH DESIGN AND METHODS In this multicenter, prospective, randomized, open-label, blinded end point study, eligible patients were randomly assigned (1:1) to intensive statin therapy targeting LDL cholesterol (LDL-C) &amp;lt;70 mg/dL (n = 2,518) or standard statin therapy targeting LDL-C 100–120 mg/dL (n = 2,524). RESULTS Mean follow-up was 37 ± 13 months. LDL-C at 36 months was 76.5 ± 21.6 mg/dL in the intensive group and 104.1 ± 22.1 mg/dL in the standard group (P &amp;lt; 0.001). The primary end point events occurred in 129 intensive group patients and 153 standard group patients (hazard ratio [HR] 0.84 [95% CI 0.67–1.07]; P = 0.15). The relationship between the LDL-C difference in the two groups and the event reduction rate was consistent with primary prevention studies in patients with diabetes. Exploratory findings showed significantly fewer cerebral events in the intensive group (HR 0.52 [95% CI 0.31–0.88]; P = 0.01). Safety did not differ significantly between the two groups. CONCLUSIONS We found no significant decrease in CV events or CV-associated deaths with intensive therapy, possibly because our between-group difference of LDL-C was lower than expected (27.7 mg/dL at 36 months of treatment). The potential benefit of achieving LDL-C &amp;lt;70 mg/dL in a treat-to-target strategy in high-risk patients deserves further investigation.
Inventing a New Model of Hypertension Care for Black Men
Authors: Karen L. Margolis
Journal: New England Journal of Medicine (2018)

There are more than 200,000 deaths in the United States each year from heart disease, stroke, and hypertensive disease that could be avoided by timely and effective preventive medical care.1 The risk of avoidable cardiovascular deaths among black men is 80% higher than that among white men or black women. The combination of a high prevalence of hypertension and poor blood-pressure control is a major contributor to the high rates of cardiovascular death and disease among black men.2 Despite the high priority for finding ways to improve blood-pressure treatment in black men, few unequivocal success stories have been reported. The . . .
Oncolytic Virus Combination Therapy: Killing One Bird with Two Stones
Authors: Nikolas Tim Martin, John Cameron Bell
Journal: Molecular Therapy (2018)

Over the last 60 years an eclectic collection of microbes has been tested in a variety of pre-clinical models as anti-cancer agents. At the forefront of this research are a number of virus-based platforms that have shown exciting activity in a variety of pre-clinical models and are collectively referred to as oncolytic viruses. Our true understanding of the potential and limitations of this therapeutic modality has been substantially advanced through clinical studies carried out over the last 25 years. Perhaps not surprising, as with all other cancer therapeutics, it has become clear that current oncolytic virus therapeutics on their own are unlikely to be effective in the majority of patients. The greatest therapeutic gains will therefore be made through thoughtful combination strategies built upon an understanding of cancer biology.
Incorrect Conclusions of a Secondary Analysis—Reply
Authors: Gregory Curfman
Journal: JAMA Internal Medicine (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 Internal Medicine 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 Internal Medicine journal
Disparities in surgical resection for pancreatic cancer stratified by insurance coverage.
Authors: Sheetal Hegde, Jaswanth Kintada, Miren Peña, Sammira Rouhani, Ali Seifi, Pratap Kumar, Dimpy Shah
Journal: Journal of Clinical Oncology (2018)

451 Background: Roughly 50,000 Americans are diagnosed with pancreatic cancer yearly (Howlader, N, Noone, A, Krapcho, M. Cancer Stat Facts: Pancreas Cancer. http://seer.cancer.gov/statfacts/html/pancreas ). High mortality rates following pancreatic cancer make surgical resection the primary curative method for treatment. Literature suggests significantly higher mortality rates (12.3%) in patients classified as government payers vs those with private insurance (7.3%) (Glasgow, RE, Mulvihill, SJ (1996)). Hospital volume influences outcome in patients undergoing pancreatic resection for cancer. Western journal of medicine, 165(5),294). This study investigated disparities in use of resection as pancreatic cancer treatment, based on insurance status. Methods: A retrospective study was performed to evaluate use of pancreatic resection (ICD9: 52.51-52.53, 52.59, 52.6, 52.7) vs non-surgical options to treat patients with a principal diagnosis of pancreatic cancer (ICD9: 230.9, 157.1-157.4, 157.8, 157.9) from 2005-2014, using the Healthcare Cost and Utilization Project database. Rates of surgical resection were stratified based on insurance coverage status: private insurance, government insurance, or no insurance. Results: After adjusting for total discharges, we observed that percent pancreatic resections were highest for uninsured populations and lowest for Medicare. By 2014, the rate of surgical resections in uninsured patients decreased as a steady increase was observed for patients with Medicaid. Conclusions: Our preliminary findings suggest that the trends in rates of surgical resection as a treatment for pancreatic cancer vary by insurance status. Further research examining factors such as race, socioeconomic status, and comorbidities that increase the likelihood of uninsured patients receiving pancreatic resections vs other treatments are warranted. [Table: see text]
Early Intervention Service for Young People With Psychosis
Authors: Nikolai Albert, Trine Madsen, Merete Nordentoft
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
Prevalence and Progression of Late Gadolinium Enhancement in Children and Adolescents With Hypertrophic Cardiomyopathy
Authors: Anna Axelsson Raja, Hoshang Farhad, Anne Marie Valente, John-Paul Couce, John Lynn Jefferies, Henning Bundgaard, Kenneth Zahka, Harry Lever, Anne M. Murphy, Euan Ashley, Sharlene M. Day, Mark V. Sherrid, Ling Shi, David A. Bluemke, Charles E. Canter, Steven D. Colan, Carolyn Y. Ho, Jeff Towbin, Mark Russell, Amit Patel, Bette Kim, Matthew Taylor, Luisa Mestroni
Journal: Circulation (2018)

Background: Late gadolinium enhancement (LGE) on cardiac magnetic resonance imaging (CMR) is believed to represent dense replacement fibrosis. It is seen in ≈60% of adult patients with hypertrophic cardiomyopathy (HCM). However, the prevalence of LGE in children and adolescents with HCM is not well established. In addition, longitudinal studies describing the development and evolution of LGE in pediatric HCM are lacking. This study assesses the prevalence, progression, and clinical correlations of LGE in children and adolescents with, or genetically predisposed to, HCM. Methods: CMR scans from 195 patients ≤21 years of age were analyzed in an observational, retrospective study, including 155 patients with overt HCM and 40 sarcomere mutation carriers without left ventricular (LV) hypertrophy. The extent of LGE was quantified by measuring regions with signal intensity &gt;6 SD above nulled remote myocardium. Results: Patients were 14.3±4.5 years of age at baseline and 68% were male. LGE was present in 70 (46%) patients with overt HCM (median extent, 3.3%; interquartile range, 0.8–7.1%), but absent in mutation carriers without LV hypertrophy. Thirty-one patients had &gt;1 CMR (median interval between studies, 2.4 years; interquartile range, 1.5–3.2 years). LGE was detected in 13 patients (42%) at baseline and in 16 patients (52%) at follow-up CMR. The median extent of LGE increased by 2.4 g/y (range, 0–13.2 g/y) from 2.9% (interquartile range, 0.8–3.2%) of LV mass to 4.3% (interquartile range, 2.9–6.8%) ( P =0.02). In addition to LGE, LV mass and left atrial volume, indexed to body surface area, and z score for LV mass, as well, increased significantly from first to most recent CMR. Conclusions: LGE was present in 46% of children and adolescents with overt HCM, in contrast to ≈60% typically reported in adult HCM. In the subset of patients with serial imaging, statistically significant increases in LGE, LV mass, and left atrial size were detected over 2.5 years, indicating disease progression over time. Further prospective studies are required to confirm these findings and to better understand the clinical implications of LGE in pediatric HCM.
Blocking immune intrusion into the brain suppresses epilepsy in Rasmussen’s encephalitis model
Authors: Lawrence Steinman
Journal: Journal of Clinical Investigation (2018)

Rasmussen's encephalitis (RE) is a neuroinflammatory disease that typically affects only one hemisphere of the brain, resulting in severe seizures. Sixty years after the disease was first described, the preferred and best treatment option for RE is grotesque and involves removing a hemisphere of the brain (hemispherectomy); therefore, a better understanding of this seizure disorder may provide additional, less invasive therapeutic options. In this issue of the JCI, Carmant and colleagues have developed an animal model of this focal seizure disorder. The model provides experimental insights into the pathogenesis of RE and potential new treatments for this disease.
ウラルカンゾウ(Glycyrrhiza uralensis)栽培のための基礎研究 (1)
Authors: 芝野真喜雄, 川瀬さおり, 村上理恵, 喜多俊二, 草野源次郎, 柴田敏郎, 畠山好雄, 県功
Journal: Nature Medicine (2000)
Elevated Cardiac Troponin T in Patients With Skeletal Myopathies
Authors: Johannes Schmid, Laura Liesinger, Ruth Birner-Gruenberger, Tatjana Stojakovic, Hubert Scharnagl, Benjamin Dieplinger, Martin Asslaber, Roman Radl, Meinrad Beer, Malgorzata Polacin, Johannes Mair, Dieter Szolar, Andrea Berghold, Stefan Quasthoff, Josepha S. Binder, Peter P. Rainer
Journal: Journal of the American College of Cardiology (2018)

Cardiac troponins are often elevated in patients with skeletal muscle disease who have no evidence of cardiac disease. The goal of this study was to characterize cardiac troponin concentrations in patients with myopathies and derive insights regarding the source of elevated troponin T measurements. Cardiac troponin T (cTnT) and cardiac troponin I (cTnI) concentrations were determined by using high sensitivity assays in 74 patients with hereditary and acquired skeletal myopathies. Patients underwent comprehensive cardiac evaluation, including 12-lead electrocardiogram, 24-h electrocardiogram, cardiac magnetic resonance imaging, and coronary artery computed tomography. cTnT and cTnI protein expression was determined in skeletal muscle samples of 9 patients and in control tissues derived from autopsy using antibodies that are used in commercial assays. Relevant Western blot bands were subjected to liquid chromatography tandem mass spectrometry for protein identification. Levels of cTnT (median: 24 ng/l; interquartile range: 11 to 54 ng/l) were elevated (>14 ng/l) in 68.9% of patients; cTnI was elevated (>26 ng/l) in 4.1% of patients. Serum cTnT levels significantly correlated with creatine kinase and myoglobin (r = 0.679 and 0.786, respectively; both p < 0.001). Based on cTnT serial testing, 30.1% would have fulfilled current rule-in criteria for myocardial infarction. Noncoronary cardiac disease was present in 23%. Using cTnT antibodies, positive bands were found in both diseased and healthy skeletal muscle at molecular weights approximately 5 kDa below cTnT. Liquid chromatography tandem mass spectrometry identified the presence of skeletal troponin T isoforms in these bands. Measured cTnT concentrations were chronically elevated in the majority of patients with skeletal myopathies, whereas cTnI elevation was rare. Our data indicate that cross-reaction of the cTnT immunoassay with skeletal muscle troponin isoforms was the likely cause.
It Is Time for Women (and Men) to Be Brave
Authors: Julie A. Freischlag, Paula Faria
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 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
The Risk of Acute Pancreatitis After Initiation of Dipeptidyl Peptidase 4 Inhibitors: Testing a Hypothesis of Subgroup Differences in Older U.S. Adults
Authors: Jin-Liern Hong, John B. Buse, Michele Jonsson Funk, Virginia Pate, Til Stürmer
Journal: Diabetes Care (2018)

OBJECTIVE To examine whether dipeptidyl peptidase 4 inhibitors (DPP-4I) increase acute pancreatitis risk in older patients and whether the association varies by age, sex, and history of cardiovascular disease (CVD). RESEARCH DESIGN AND METHODS We conducted a cohort study of DPP-4I initiators versus thiazolidinedione (TZD) or sulfonylurea initiators using U.S. Medicare beneficiaries, 2007–2014. Eligible initiators were aged 66 years or older without history of pancreatic disease or alcohol-related diseases. Patients were followed up for hospitalization due to acute pancreatitis and censored at 90 days after treatment changes. Weighted Cox models were used to estimate the hazard ratio (HR) for acute pancreatitis. Analyses were performed overall as well as within subgroups defined by age, sex, and CVD history. RESULTS We found no increased risk of acute pancreatitis comparing 49,374 DPP-4I initiators to 132,223 sulfonylurea initiators (weighted HR 1.01; 95% CI 0.83–1.24) and comparing 57,301 DPP-4I initiators to 32,612 TZD initiators (weighted HR 1.11; 95% CI 0.76–1.62). Age and sex did not modify the association. Among patients with CVD, acute pancreatitis incidence was elevated in initiators of DPP-4I and sulfonylurea (2.3 and 2.4 per 1,000 person-years, respectively) but not in TZD initiators (1.5). Among patients with CVD, higher risk of acute pancreatitis was observed with DPP-4I compared with TZD (weighted HR 1.84; 95% CI 1.02–3.35) but not compared with sulfonylurea. CONCLUSIONS Our study provides evidence that DPP-4I is not associated with an increased risk of acute pancreatitis in older adults overall. The positive association observed in patients with CVD could be due to chance or bias but merits further investigation.
The efficacy of a nested polymerase chain reaction in detecting the cytochrome <i>c</i> oxidase subunit 1 gene of <i>Sarcoptes scabiei</i> var. <i>hominis</i> for diagnosing scabies
Authors: J.E. Hahm, C.W. Kim, S.S. Kim
Journal: British Journal of Dermatology (2018)

A widespread scabies infestation, associated with long‐term residence in nursing homes, is becoming an issue in high‐income countries. Mineral oil examination is regarded as the gold standard in diagnosing scabies, but the sensitivity of this method is generally low – approximately 50%. Molecular techniques may contribute to enhancing the sensitivity of current tests for laboratory diagnosis of human scabies. To develop new primers for a nested polymerase chain reaction (PCR) for the cytochrome c oxidase subunit 1 (cox1) gene of Sarcoptes scabiei var. hominis to increase the sensitivity of a previously developed conventional PCR. Patients with clinically suspected scabies underwent dermoscopy‐guided skin scraping with microscopic examination. The diagnosis was positive for scabies when mites or eggs were found under the microscope, and patients were then designated as ‘microscopy positive’. Patients who presented with negative microscopic results were placed in the ‘microscopy‐negative’ group. Skin scrapings were collected from both groups for PCR. Of the total 63 samples, 28 were microscopy positive and 35 were negative with no differences in sex and age between the two groups. All microscopically proven cases of scabies were positive using the cox1 nested PCR. Among microscopy‐negative samples, S. scabieiDNA was detected in nine. If sensitivity of the cox1 nested PCR is considered 100% [95% confidence interval (CI) 90·5–100], then sensitivity of microscopy is 75·7% (95% CI 58·8–88·2; P =0·004). Nested PCR can be successfully used as an alternative method for diagnosing suspected scabies. Therefore, infection control measures and treatments can be initiated before significant transmission occurs, minimizing the risk of outbreaks.
Politics in the Exam Room
Authors: Molly Imber
Journal: Annals of Internal Medicine (2018)

On Being a Doctor3 April 2018Politics in the Exam RoomMolly Imber, MDMolly Imber, MDLawrence Memorial Hospital, Lawrence, Kansas (M.I.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M17-2554 Audio Reading - “Politics in the Exam Room” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "Politics in the Exam Room," by M. Imber. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Before joining the medical profession, if I had considered the issue of politics in the exam room at all, I would have said that there was no reason for doctors to have political discussions with their patients. I have been in practice 8 years now, and my experiences have led me to a more complex and nuanced struggle with this topic. Politics has entered my exam room in many forms. On one memorable occasion, in the middle of a discussion about healthy diet, my patient burst out with, “Well, I'm not eating any of that quinoa Bill Clinton food!” I ... Author, Article, and Disclosure InformationAffiliations: Lawrence Memorial Hospital, Lawrence, Kansas (M.I.)Corresponding Author: Molly Imber, MD, 4525 West 6th Street, Lawrence, KS 66049; e-mail, molly.[email protected]org. PreviousarticleNextarticle Advertisement Audio Reading - “Politics in the Exam Room” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "Politics in the Exam Room," by M. Imber. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics 3 April 2018Volume 168, Issue 7Page: 523KeywordsDietEatingEmotionsFearFoodHealth careMedicarePatientsPrimary hypertension ePublished: 3 April 2018 Issue Published: 3 April 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
On properly characterizing moral agency
Authors: Blaine J. Fowers, Austen R. Anderson, Samantha F. Lang
Journal: Behavioral and Brain Sciences (2018)

Abstract Doris (2015b) develops a theory of moral agency to avoid a skeptical challenge arising from psychology studies indicating that (im)moral behavior is caused by trivial situational factors. His theory is flawed in attending only to situational influences on behavior and neglecting individual differences such as moral identity and virtue. A focus on individual differences in resilience to influence from trivial situational factors defangs the skeptical challenge and offers a better account of moral agency.
心房細動に対するBox Isolation中の左房内興奮伝導様式の変化-Noncontact Mapping Systemを用いた検討-
Authors: 熊谷浩一郎, 安達功, 村岡聡一, 光武ちはる, 高嶋英夫, 中島英子, 安田智生, 松本直通, 朔啓二郎
Journal: Circulation (2008)
PET Assessment of Epicardial Intimal Disease and Microvascular Dysfunction in Cardiac Allograft Vasculopathy
Authors: Sharon Chih, Aun Yeong Chong, Fernanda Erthal, Robert A. deKemp, Ross A. Davies, Ellamae Stadnick, Derek Y. So, Christopher Overgaard, George Wells, Lisa M. Mielniczuk, Rob S.B. Beanlands
Journal: Journal of the American College of Cardiology (2018)