tbuckley/cabot-search huggingface dataset:
Investigating sudden hearing loss in adults
Authors: Jonathan M Fishman, Laura Cullen
Journal: BMJ (2018)

### What you need to know A 55 year old woman presented with difficulty in hearing from the left ear. She first noticed this when she found it difficult to hear her husband over dinner yesterday. She also described a feeling of dizziness, where the room spins around, and ringing in the left ear. She was otherwise well. Clinical examination revealed a normal tympanic membrane. Hearing loss affects 1 in 6 adults and has an enormous personal, social, and economic impact.1 Patients may be frightened by the sudden loss of hearing, and tinnitus can cause anxiety. Prompt diagnosis and management may improve hearing recovery.2 In this article, we review the assessment of sudden hearing loss in adults and provide an overview on initial diagnostic tests. A lack of specialist diagnostic tests within the primary care setting makes the condition challenging to diagnose, and an awareness and high index of suspicion are required when non-specialists are faced with a patient with acute hearing loss. Box 1 lists common causes of conductive and sensorineural hearing loss. Box 1 ### Common causes of adult onset hearing loss #### Conductive hearing loss Caused by any pathology in the external ear, tympanic membrane, middle ear air space, or ossicles, ie, structures that “conduct” sound waves to the cochlea: #### Sensorineural hearing loss Caused by abnormalities of the cochlea, auditory nerve, or other structures that translate neural impulses to the brain:RETURN TO TEXT
Mas Receptor Activation Slows Tumor Growth and Attenuates Muscle Wasting in Cancer
Authors: Kate T. Murphy, Mohammed I. Hossain, Kristy Swiderski, Annabel Chee, Timur Naim, Jennifer Trieu, Vanessa Haynes, Suzannah J. Read, David I. Stapleton, Sarah M. Judge, Jose G. Trevino, Andrew R. Judge, Gordon S. Lynch
Journal: Cancer Research (2018)

Abstract Cancer cachexia is a multifactorial syndrome characterized by a progressive loss of skeletal muscle mass associated with significant functional impairment. Cachexia robs patients of their strength and capacity to perform daily tasks and live independently. Effective treatments are needed urgently. Here, we investigated the therapeutic potential of activating the “alternative” axis of the renin-angiotensin system, involving ACE2, angiotensin-(1-7), and the mitochondrial assembly receptor (MasR), for treating cancer cachexia. Plasmid overexpression of the MasR or pharmacologic angiotensin-(1-7)/MasR activation did not affect healthy muscle fiber size in vitro or in vivo but attenuated atrophy induced by coculture with cancer cells in vitro. In mice with cancer cachexia, the MasR agonist AVE 0991 slowed tumor development, reduced weight loss, improved locomotor activity, and attenuated muscle wasting, with the majority of these effects dependent on the orexigenic and not antitumor properties of AVE 0991. Proteomic profiling and IHC revealed that mechanisms underlying AVE 0991 effects on skeletal muscle involved miR-23a–regulated preservation of the fast, glycolytic fibers. MasR activation is a novel regulator of muscle phenotype, and AVE 0991 has orexigenic, anticachectic, and antitumorigenic effects, identifying it as a promising adjunct therapy for cancer and other serious muscle wasting conditions. Significance: These findings demonstrate that MasR activation has multiple benefits of being orexigenic, anticachectic, and antitumorigenic, revealing it as a potential adjunct therapy for cancer. See related commentary by Rupert et al., p. 699
Aberrant Activation of β-Catenin Signaling Drives Glioma Tumorigenesis via USP1-Mediated Stabilization of EZH2
Authors: Li Ma, Kangyu Lin, Guoqiang Chang, Yiwen Chen, Chen Yue, Qing Guo, Sicong Zhang, Zhiliang Jia, Tony T. Huang, Aidong Zhou, Suyun Huang
Journal: Cancer Research (2018)

Aberrant activation of β-catenin signaling is a critical driver for tumorigenesis, but the mechanism underlying this activation is not completely understood. In this study, we demonstrate a critical role of β-catenin signaling in stabilization of enhancer of zeste homolog 2 (EZH2) and control of EZH2-mediated gene repression in oncogenesis. β-Catenin/TCF4 activated the transcription of the deubiquitinase USP1, which then interacted with and deubiquitinated EZH2 directly. USP1-mediated stabilization of EZH2 promoted its recruitment to the promoters of CDKN1B, RUNX3, and HOXA5, resulting in enhanced enrichment of histone H3K27me3 and repression of target gene expression. In human glioma specimens, expression levels of nuclear β-catenin, USP1, and EZH2 correlated with one another. Depletion of β-catenin/USP1/EZH2 repressed glioma cell proliferation in vitro and tumor formation in vivo. Our findings indicate that a β-catenin-USP1-EZH2 axis orchestrates the interplay between dysregulated β-catenin signaling and EZH2-mediated gene epigenetic silencing during glioma tumorigenesis. SIGNIFICANCE: These findings identify the β-catenin-USP1-EZH2 signaling axis as a critical mechanism for glioma tumorigenesis that may serve as a new therapeutic target in glioblastoma.
Sexual Dysfunction and Sex Hormone Abnormalities in Patients With Cirrhosis: Review of Pathogenesis and Management
Authors: Shuet Fong Neong, Emma O. Billington, Stephen E. Congly
Journal: Hepatology (2018)

Healthy sexual function is important to maintain a good quality of life but is frequently impaired in patients with cirrhosis. The degree of sexual dysfunction appears to be linked with the degree of hepatic dysfunction. In men, sexual dysfunction can be related to the hyperestrogenism of portal hypertension and/or to decreased testosterone resulting from testicular dysfunction. In women, suppression of the hypothalamic–pituitary–gonadal axis appears to be a principal contributor, with no significant effect of portal hypertension. There is also a huge psychological barrier to break through as there is a component of depression in many patients with cirrhosis. Sexual dysfunction is often underdiagnosed in the cohort with cirrhosis. Management of sexual disorders in patients with cirrhosis can be challenging as they are often multifactorial. A multidisciplinary approach is key in managing these patients. We review the current literature on the pathogenesis of sexual dysfunction in patients with cirrhosis and propose a stepwise algorithm to better manage these patients.
CT image features of peritoneal metastasis and outcomes of the advanced gastric cancer patients receiving second-line chemotherapy
Authors: S. Kita, A. Takashima, H. Hirano, M. Aoki, H. Imazeki, M. Ishikawa, H. Shoji, Y. Honma, S. Iwasa, N. Okita, K. Kato, K. Nagashima, N. Boku
Journal: Annals of Oncology (2018)
ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities
Authors: Andrew E. Epstein, John P. DiMarco, Kenneth A. Ellenbogen, N.A. Mark Estes, Roger A. Freedman, Leonard S. Gettes, A. Marc Gillinov, Gabriel Gregoratos, Stephen C. Hammill, David L. Hayes, Mark A. Hlatky, L. Kristin Newby, Richard L. Page, Mark H. Schoenfeld, Michael J. Silka, Lynne Warner Stevenson, Michael O. Sweeney
Journal: Circulation (2008)

37.6% VVI(R) to DDD(R): 3.1% DDD(R) dropout: 8.3% R*added to pacing mode designation indicates rate-responsive pacemakers implanted in all patients.(R)
Alcohol Use Screening and Behavioral Counseling With Adolescents in Primary Care
Authors: Carolyn A. McCarty, Sharon Levy, Sion Kim Harris
Journal: JAMA Pediatrics (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 Pediatrics 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 Pediatrics journal
Some concerns from Turkey
Authors: Emre Bilgin, İrem Ozarli, Levent Kılıç, Ertuğrul Çağrı Bölek, Gözde Kübra Yardımcı, Ömer Karadağ
Journal: Annals of the Rheumatic Diseases (2018)

We read the paper written by Kaneko et al with great interest.1 This study demonstrates the safety and efficacy of tocilizumab in patients with adult-onset Still’s disease (AOSD). This randomised placebo-controlled study could be one of the pioneer studies about the use of biological therapy in AOSD. We wanted to ask about some raising concerns.

ACR20, ACR50 and ACR70 responses were used as composite indexes to assess disease activity. In the studies which investigate the effectiveness of a biologic agent in rheumatoid arthritis, general approach is to allow non-steroidal anti-inflammatory drugs (NSAID) if the dose had been stable for a while.2 However, we could not find any data of NSAIDs …
Haploidentical Stem Cell Transplantation with Post-Transplant Cyclophosphamide As Graft-Versus-Host Disease Prophylaxis in Pediatric Hematologic Malignancies
Authors: Gerardo Lopez-Hernandez, Norma Lopez-Santiago, Alberto Olaya-Vargas, Martín Pérez-García, Rosa María Nideshda Ramírez-Uribe, Haydée del Pilar Salazar-Rosales, Ángeles Del Campo-Martínez, Laura Alejandra Xiqui-Jardines
Journal: Blood (2018)
Prevalence and Severity of Nonalcoholic Fatty Liver Disease Among Caregivers of Patients With Nonalcoholic Fatty Liver Disease Cirrhosis
Authors: Mohammad Shadab Siddiqui, Salvatore Carbone, Robert Vincent, Samarth Patel, Carolyn Driscoll, Francesco S. Celi, Hayley Billingsley, Brando Rotelli, Binu John, Nicola Potere, Michele Viscusi, Veronica Adiletta, Arun J. Sanyal, Velimir A. Luketic, Trevor Reichman, Chandra S. Bhati
Journal: Clinical Gastroenterology and Hepatology (2018)
Treating the Patient With Appendicitis, Not Just the Appendicitis
Authors: Katherine M. Reitz, Brian S. Zuckerbraun
Journal: JAMA Surgery (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 Surgery 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 Surgery journal
Advancing Translational Science for Pulmonary Nontuberculous Mycobacterial Infections. A Road Map for Research
Authors: Shelby Daniel-Wayman, Getahun Abate, Daniel L. Barber, Luiz E. Bermudez, Rhea N. Coler, Michael H. Cynamon, Charles L. Daley, Rebecca M. Davidson, Thomas Dick, R. Andres Floto, Emily Henkle, Steven M. Holland, Mary Jackson, Richard E. Lee, Eric L. Nuermberger, Kenneth N. Olivier, Diane J. Ordway, D. Rebecca Prevots, James C. Sacchettini, Max Salfinger, Christopher M. Sassetti, Christine F. Sizemore, Kevin L. Winthrop, Adrian M. Zelazny
Journal: American Journal of Respiratory and Critical Care Medicine (2018)
Abstract 13954: Myocardial T1 Mapping at 3 T: Reference Values and Influencing Factors
Authors: Lei Zhao, Song-Nan Li, Lu Wang, Hui Lin, Song-Nan Wen, Man Ning, Xiao-Hai Ma, Rong-Hui Yu, De-Yong Long, Ri-Bo Tang, Cai-Hua Sang, Chen-Xi Jiang, Xin Du, Jian-Zeng Dong, Zhan-Ming Fan, Chang-Sheng Ma
Journal: Circulation (2015)

Introduction: T1 mapping is a robust application to provide quantitative measurement reflecting myocardial properties. Knowledge of normal values for quantitative cardiovascular magnetic resonance (CMR) is crucial to distinguish normal from disease. Hypothesis: T1 mapping methods provide information of myocardial properties, in normal cohort, whether there is difference of myocardial tissue characterization in different gender, age remained unclear. Methods: 40 healthy volunteers (27 females; mean age 46±13 years) underwent left-ventricular (LV) T1 mapping in 3 short-axis slices at 3 T. For T1 mapping, a validated modified Look-Locker inversion recovery sequence was used before and after injection of gadolinium contrast. T1 relaxation times were quantified for each slice and extracellular volume (ECV) fraction was calculated. The association between the T1 mapping parameters and potential influencing factors were determined using a Pearson correlation. Results: Mean global LV pre-contrast T1 times were 1267.3±39.0ms, post-contrast T1 times were 572.4±53.2ms, ECV were 27.2±2.7%. There were differences of T1 (pre-/post-contrast) times and ECV in different LV level: 1258.8 ms/578.7 ms/26% (base), 1267.8 ms/ 575.6 ms/ 26.5% (mid-ventricle), 1293.5 ms/564.5 ms/29.4% (apex). There were no significant differences of myocardium T1 times between male and females (all P&gt; 0.05), but ECV was slightly higher in women than men (P &lt;0.05). There was negative correlation between global LV ECV fraction and hematocrit (R=-0.65, P&lt;0.01), no correlation between age and T1 mapping parameters were found (all P &gt; 0.05). Conclusion: Myocardial T1 reference values for the specific CMR setting are provided. T1 mapping parameters show no gender and age differences in normal individuals.
RAS status and neoadjuvant chemotherapy impact CD8+ cells and tumor HLA class I expression in liver metastatic colorectal cancer
Authors: Fanny Ledys, Quentin Klopfenstein, Caroline Truntzer, Laurent Arnould, Julie Vincent, Leila Bengrine, Romain Remark, Romain Boidot, Sylvain Ladoire, Francois Ghiringhelli, Valentin Derangere
Journal: Journal for ImmunoTherapy of Cancer (2018)

<h3>Background</h3> T lymphocytes and HLA expression on tumor cell both influence prognostic of localized colorectal cancer, but their role following chemotherapy in patients with liver metastatic colorectal cancer (mCRC) was not addressed. <h3>Methods</h3> One hundred fourteen patients treated in curative intend of liver mCRC were included in this retrospective study. Patients were either untreated or treated with neoadjuvant therapy containing an anti-EGFR, bevacizumab or oxaliplatin. Immune densities were quantified in the tumor core and in invasive margin of metastases, using Qupath software or a pathologist's quantification. CD8, NKp46, Foxp3, CD163, HLA, PD-L1 were analyzed and were correlated with progression free survival (PFS) and overall survival (OS) using multivariable Cox proportional hazards models. <h3>Results</h3> In the whole cohort only a high CD8+ cells infiltrate, a high HLA-I expression and wild-type RAS/RAF status were associated with a better overall survival in both univariate and multivariate model. Moreover, CD8+ cells immune infiltrate at invasive margin combined to HLA expression in cancer cell could increase patient's outcome prediction. RAS status but not immune cell infiltrate was associated with HLA expression on tumor cells. In comparison to untreated patients, neoadjuvant chemotherapy induced CD8+ cells recruitment and increased PD-L1 staining in immune infiltrates only for WT RAS patients. In this context, anti-EGFR and oxaliplatin based chemotherapy are the most powerful to induce CD8+ cells mobilization within the metastatic site. <h3>Conclusions</h3> While CD8 infiltrate and HLA expression appear to be prognostic for mCRC, CD8 and PD-L1 infiltrate are enhanced by neoadjuvant chemotherapy in mCRC under RAS status dependence.
Abstract 11809: Impact of Strong Lipophilic Statin on Left Ventricular Properties and the Incidence of Atrial Fibrillation in Elderly Patients With Hypertension; A Prospective Four-Years Study
Authors: Masafumi Kawade, Masanori Kawasaki, Ryuhei Tanaka, Shingo Minatoguchi, Koji Ono, Mayumi Kaneda, Maya Ishiguro, Reiko Matsuoka, Hirotaka Miwa, Shunichiro Warita, Shintaro Tanihata, Masazumi Arai, Toshiyuki Noda, Sachiro Watanabe, Shinya Minatoguchi
Journal: Circulation (2014)

Background: Strong lipophilic statins may attenuate cardiac hypertrophy. We assessed the hypothesis that a strong lipophilic statin (pitavastatin) could prevent left atrial (LA) remodeling and new-onset atrial fibrillation (AF) through preservation of diastolic function and lowering of pulmonary capillary wedge pressure (PCWP) in hypertension (HTN). Methods: Elderly patients with HTN and left ventricular ejection fraction (LVEF) > 50% but no history of AF were prospectively enrolled and divided to 2 groups: HTN with statin (n=140, age 72±5) and HTN without statin (n=234, age 73±6). LA volume (V), emptying function (EF), strain, strain rate (SR), stiffness and PCWP were obtained by speckle tracking echocardiography. PCWP was estimated as 10.7 - 12.4 x log (active LAEF / minimum LAV), as we previously reported. LA stiffness was defined as PCWP / LA strain. LV mass, LVEF and E/e’ were measured. All patients were followed for 4 years. Results: There were no differences in BP, cholesterol or LVEF between the 2...
Гліциризинова кислота: патофізіологічні аспекти формування фіброзу та ефективність у лікуванні захворювань печінки
Authors: Yu.М. Stepanov, V.B. Yagmur, А.V. Salenko
Journal: GASTROENTEROLOGY (2018)

В оглядовій статті наведені сучасні дані щодо чинників виникнення та розвитку фіброзу печінки. Цей стан обумовлений надмірним накопиченням позаклітинного матриксу, продуцентом якого є здебільшого печінкові зірчасті клітини, які при активації набувають можливості продукувати патологічний колаген І та ІІІ типів. Відкладання фібрилярної тканини та колагену у просторі Діссе призводить до появи базальної мембрани в епітелії синусоїдів, унаслідок чого відбувається їх капіляризація. Портальна гіпертензія поглиблюється виникненням ендотеліальної дисфункції та патологічною продукцією вазоконстрикторів. Подальше прогресування фіброзу печінки є фактором ризику виникнення цирозу та навіть гепатоцелюлярної карциноми. Наведені дані щодо досліджень антифібротичних властивостей гліциризину — препарату рослинного походження. Майже 40-річна історія офіційного вивчення довела його протизапальні, противірусні, антифібротичні властивості. Дія гліциризину відбувається завдяки впливу на імунні клітини, гальмуванню апоптозу гепатоцитів та прискоренню апоптозу патологічно активованих зірчастих клітин. Вибірковою дією на фактори транскрипції можна пояснити протиканцерогенний ефект препарату при тривалому перебігу вірусних гепатитів.
Abstract 20153: Predicting the Need for Transfusions in Endovascular Aneurysm Repair (EVAR)
Authors: Eitezaz Mahmood, Sajid Shahul, Peter Soden, Marc Schermerhorn, Ferozeuddin Mahmood, Robina Matyal
Journal: Circulation (2015)

Purpose: The majority of patients undergoing EVAR do not require blood transfusion, yet blood type and screen (T&amp;S) is routinely performed. Identifying patients in whom T&amp;S can be avoided presents a substantial cost saving opportunity. Hypothesis: We hypothesized that intraoperative blood transfusions can be predicted preoperatively. Methods: Using the Vascular Study Group of New England database from 2003-2014, we performed a retrospective review of 4700 patients who underwent EVAR. The cohort was split randomly into a training (60%) and validation (40%) set. A backwards logistic regression analysis was performed to identify predictors of intraoperative blood transfusion in the training set. The model was then tested in the validation set to estimate the receiver operating curves (ROC) and goodness of fit. Results: Preoperative hemoglobin, urgency (elective, symptomatic, or ruptured), age, maximal anterior-posterior AAA diameter, female gender, and history of CHF (asymptomatic, mild, moderate, or severe) were all significant predictors of intraoperative blood transfusions. The c-statistic for our model was .82 in the training set and .84 in the validation set, and the Hosmer-Lemenshow goodness-of-fit statistic was 0.99. Conclusions: Intraoperative blood transfusions can be routinely predicted preoperatively. Avoidance of T&amp;S in low risk populations provides a substantial cost-saving opportunity.
High-Deductible Insurance and Delay in Care for the Macrovascular Complications of Diabetes
Authors: J. Frank Wharam, Christine Y. Lu, Fang Zhang, Matthew Callahan, Xin Xu, Jamie Wallace, Stephen Soumerai, Dennis Ross-Degnan, Joseph P. Newhouse
Journal: Annals of Internal Medicine (2018)

Background: Little is known about the long-term effects of high-deductible insurance on care for chronic medical conditions. Objective: To determine whether a transition from low-deductible to high-deductible insurance is associated with delayed medical care for macrovascular complications of diabetes. Design: Observational longitudinal comparison of matched groups. Setting: A large national health insurer during 2003 to 2012. Participants: The intervention group comprised 33 957 persons with diabetes who were continuously enrolled in low-deductible (≤$500) insurance plans during a baseline year followed by up to 4 years in high-deductible (≥$1000) plans. The control group included 294 942 persons with diabetes who were enrolled in low-deductible plans contemporaneously with matched intervention group members. Intervention: Employer-mandated transition to a high-deductible plan. Measurements: The number of months it took for persons in each study group to seek care for their first major macrovascular symptom, have their first major diagnostic test for macrovascular disease, and have their first major procedure-based treatment was determined. Between-group differences in time to reach a midpoint event rate were then calculated. Results: No baseline differences were found between groups. During follow-up, the delay for the high-deductible group was 1.5 months (95% CI, 0.8 to 2.3 months) for seeking care for the first major symptom, 1.9 months (CI, 1.4 to 2.3 months) for the first diagnostic test, and 3.1 months (CI, 0.5 to 5.8 months) for the first procedure-based treatment. Limitation: Health outcomes were not examined. Conclusion: Among persons with diabetes, mandated enrollment in a high-deductible insurance plan was associated with delays in seeking care for the first major symptoms of macrovascular disease, the first diagnostic test, and the first procedure-based treatment. Primary Funding Source: National Institute of Diabetes and Digestive and Kidney Diseases.