tbuckley/cabot-search huggingface dataset:
Unilateral purpura resulting from deep vein thrombosis
Authors: Jason A. Freed, Andrew J. Hale
Journal: American Journal of Hematology (2018)

A 72-year-old man presented with complaint of acute swelling and pain in his right leg. He had been in his usual state of health until 2 days prior, when he developed pain in the right upper thigh, which then spread down the right lower extremity and was associated with a new rash. His past medical history was notable for cirrhosis (Childs-Pugh class C) secondary to alcohol abuse, complicated by esophageal varices and chronic thrombocytopenia. On exam, he was noted to have a unilateral, painless, purpuric rash on the right thigh (1), and the right lower extremity was significantly larger than the left. Laboratory values were notable for a white blood cell count of 10.2 × 103 cells/μL, hemoglobin 9.8 g/dL, platelets 57 × 103/μL, INR 1.8, fibrinogen 189 mg/dL, creatinine 1.0 mg/dL, AST 32 u/L, ALT 25 u/L, and total bilirubin of 2.3 mg/dL. Ultrasonography revealed an extensive, proximal deep vein thrombosis (DVT) involving the right femoral vein. Purpura results from blood extravasating from small vessels. This can be due to coagulopathy, immunologic injury to vessels,1 or increased venous pressure due to stasis.2 These processes are typically generalized and thus, if the lower extremities are involved, a degree of symmetry is expected. Rare cases of unilateral linear capillaritis have been described but the mechanism of such cases is unclear.3 Other rare causes of asymmetric purpura have been attributed to unilateral Schamberg disease4 or lichen purpuricus.5, 6 While DVT is associated with an acute increase in venous pressure, for unclear reasons it rarely causes purpura, having been described just once previously in the literature.7, 8 In our patient, we hypothesize that the purpura in this case was due to a combination of acutely increased venous pressure from the large proximal DVT on a background of coagulopathy and thrombocytopenia from advanced liver disease. Unilateral purpura is a rare presenting sign of DVT. None of the authors report any conflicts of interest. All co-authors have seen and agree with the contents of the manuscript and have contributed significantly to the work. The patient provided written informed consent.
Abstract P039: American Indian Youth Wellness Initiative
Authors: Francine C Gachupin, Jennie R Joe, Rohan Shirali, Susan B Racette
Journal: Circulation (2016)

American Indian youth have the highest prevalence of obesity of all ethnic groups in the U.S. Obese individuals are at higher risk for cardiovascular disease, high blood pressure, dyslipidemia, type 2 diabetes mellitus and stroke. Reducing childhood obesity will require effective prevention strategies that focus on environments and promotion of physical activity and a healthy diet. Objective: To understand trends in the prevalence of obesity and severe obesity among American Indian tribal youth during the past 20 years. Methods: Participants included American Indian boys and girls aged 10-15 years from 14 different tribes in the Southwest, primarily Arizona, who attended a 1-week residential summer wellness camp from 1995 to 2015. Height and weight were measured on the first day of camp; sex- and age-specific body mass index (BMI) percentile and BMI z-score were computed using CDC SAS code. Obesity in childhood is defined by age- and sex-specific BMI percentile greater than or equal to the 95th percentile; severe obesity is defined as BMI ≥ 120% of the 95th percentile of BMI-for-age or as BMI ≥ 35.0 kg/m2. Chi-square tests and two-sample t-tests were used to determine the effects of sex and time on obesity and severe obesity. The significance threshold was set at p &lt; .05. Results: Our sample was comprised of 354 youth, 154 males (43.5%) and 200 females (56.5%), aged 12.7 ± 1.6 years (mean ± SD). Across the 20-year period, the prevalence of obesity was 80.2% (284 of 354) overall, and was greater in males (85.7%; 132 of 154) than females (76.0%; 152 of 200, p = 0.02). Likewise, the prevalence of severe obesity was greater in males (65.6%; 101 of 154) than females (50.0%; 100 of 200, p = 0.003) and was 56.8% (201 of 354) overall. The mean BMI-for-age percentile and z-score were 94.5 ± 11.9 and 2.05 ± 0.71, respectively; BMI z-score was higher in males (2.17 ± 0.7) than in females (1.96 ± 0.7, p = 0.004). There were no clear trends in obesity among our American Indian youth campers from 1995 to 2015, but the prevalence was high in all years (range 62.5 - 95.0%; 10 of 16 youth in 2011 - 19 of 20 youth in 2003). Conclusions: Throughout the 20-year period, there was consistently a high prevalence of obesity and severe obesity among American Indian tribal youth. Boys displayed a higher prevalence and severity of obesity relative to girls. Given the strong association between obesity in youth and the risk for chronic disease, our results underscore the critical need to intervene early in regards to establishing healthy eating and exercise behaviors among American Indian youth.
Muscle Wasting Diseases: Novel Targets and Treatments
Authors: Regula Furrer, Christoph Handschin
Journal: The Annual Review of Pharmacology and Toxicology (2018)

Adequate skeletal muscle plasticity is an essential element for our well-being, and compromised muscle function can drastically affect quality of life, morbidity, and mortality. Surprisingly, however, skeletal muscle remains one of the most under-medicated organs. Interventions in muscle diseases are scarce, not only in neuromuscular dystrophies, but also in highly prevalent secondary wasting pathologies such as sarcopenia and cachexia. Even in other diseases that exhibit a well-established risk correlation of muscle dysfunction due to a sedentary lifestyle, such as type 2 diabetes or cardiovascular pathologies, current treatments are mostly targeted on non-muscle tissues. In recent years, a renewed focus on skeletal muscle has led to the discovery of various novel drug targets and the design of new pharmacological approaches. This review provides an overview of the current knowledge of the key mechanisms involved in muscle wasting conditions and novel pharmacological avenues that could ameliorate muscle diseases.
Pharmacogenetics in Psychiatry: A Companion, Rather Than Competitor, to Protocol-Based Care—Reply
Authors: George S. Zubenko, Barbara R. Sommer, Bruce M. Cohen
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
Increased 18F-FDG Uptake in Lhermitte-Duclos Disease With Cowden Syndrome Revealed by PET-MRI
Authors: Eve Piekarski, Nadya Pyatigorskaya, Didier Dormont, Damien Galanaud, Aurélie Kas
Journal: Clinical Nuclear Medicine (2018)

A 62-year-old woman, with the history of breast and colorectal cancer, presented intermittent diplopia. A cerebellar lesion was revealed by F-FDG PET-MRI without post-gadolinium enhancement, but with increased perfusion and strong F-FDG uptake. The diagnosis of Cowden syndrome with PTEN gene mutation, linked to higher risk of neoplasia and occurrence of hamartomatous lesions characteristic of the Lhermitte-Duclos disease (LDD), was confirmed by genetic investigation.
Choline ameliorates cardiac hypertrophy by regulating metabolic remodelling and UPRmt through SIRT3-AMPK pathway
Authors: Man Xu, Run-Qing Xue, Yi Lu, Su-Yun Yong, Qing Wu, Yan-Ling Cui, Xiao-Ting Zuo, Xiao-Jiang Yu, Ming Zhao, Wei-Jin Zang
Journal: Cardiovascular Research (2018)

Abstract Aims Cardiac hypertrophy is characterized by a shift in metabolic substrate utilization, but the molecular events underlying the metabolic remodelling remain poorly understood. We explored metabolic remodelling and mitochondrial dysfunction in cardiac hypertrophy and investigated the cardioprotective effects of choline. Methods and results The experiments were conducted using a model of ventricular hypertrophy by partially banding the abdominal aorta of Sprague Dawley rats. Cardiomyocyte size and cardiac fibrosis were significantly increased in hypertrophic hearts. In vitro cardiomyocyte hypertrophy was induced by exposing neonatal rat cardiomyocytes to angiotensin II (Ang II) (10−6 M, 24 h). Choline attenuated the mito-nuclear protein imbalance and activated the mitochondrial-unfolded protein response (UPRmt) in the heart, thereby preserving the ultrastructure and function of mitochondria in the context of cardiac hypertrophy. Moreover, choline inhibited myocardial metabolic dysfunction by promoting the expression of proteins involved in ketone body and fatty acid metabolism in response to pressure overload, accompanied by the activation of sirtuin 3/AMP-activated protein kinase (SIRT3-AMPK) signalling. In vitro analyses demonstrated that SIRT3 siRNA diminished choline-mediated activation of ketone body metabolism and UPRmt, as well as inhibition of hypertrophic signals. Intriguingly, serum from choline-treated abdominal aorta banding models (where β-hydroxybutyrate was increased) attenuated Ang II-induced myocyte hypertrophy, which indicates that β-hydroxybutyrate is important for the cardioprotective effects of choline. Conclusion Choline attenuated cardiac dysfunction by modulating the expression of proteins involved in ketone body and fatty acid metabolism, and induction of UPRmt; this was likely mediated by activation of the SIRT3-AMPK pathway. Taken together, these results identify SIRT3-AMPK as a key cardiac transcriptional regulator that helps orchestrate an adaptive metabolic response to cardiac stress. Choline treatment may represent a new therapeutic strategy for optimizing myocardial metabolism in the context of hypertrophy and heart failure.
Evaluating the Feasibility of Stress-Resilience Training in Surgical Residency
Authors: Taylor S. Riall
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
Abstract 18250: Favorable Modifiable Cardiovascular Risk Profile is Associated With Lower Healthcare Costs Among Cancer Patients: The 2013 Medical Expenditure Survey
Authors: Jai Singh, Javier Valero-Elizondo, Joseph A Salami, Haider Warraich, Oluseye Ogunmoroti, Erica S Spatz, Nihar Desai, Jamal S Rana, Salim S Virani, Ron Blankstein, Michael J Blaha, Khurram Nasir
Journal: Circulation (2016)

Background: Atherosclerotic cardiovascular disease (ASCVD) and cancer are among the leading causes of economic burden, morbidity and mortality in the US. We aimed to quantify the overall impact of CV modifiable risk factor (CRF) profile on health care expenditures among those with and without ASCVD and/or cancer. Methods: The 2013 Medical Expenditure Panel Survey (MEPS), a nationally representative adult sample (≥ 40), was utilized for the study. Direct costs were calculated for all-cause health care resource utilization. Variables included ASCVD, CRF (HTN, diabetes, hypercholesterolemia, smoking, physical activity and/or obesity), and cancer (all), obtained by ICD-9-CM codes, Clinical Classification System, and self-reported data. Two-part econometric models analyzed cost data; a generalized linear model with gamma distribution and link log assessed expenditures, given the survey’s complex design. Results: 13,058 MEPS participants (59 ± 9 years, 52% female) were studied and 18% had cancer, translating to...
Abstract 20396: Chronic Kidney Disease Disrupting Transmural Gradient of Transient Outward Potassium Current via Downregulation of KChIP2 May Promote Susceptibility to Ventricular Tachyarrhythmias
Authors: Kuan-Cheng Chang, An-Sheng Lee, Wei-Yu Chen, Chu-Huang Chen
Journal: Circulation (2016)

Introduction: Chronic Kidney Disease (CKD) is associated with a higher risk for ventricular tachyarrhythmias and sudden cardiac death. However, the underlying mechanism remains to be elucidated. In...
Multicenter randomized trial of arsenic trioxide and Realgar‐<i>Indigo naturalis</i> formula in pediatric patients with acute promyelocytic leukemia: Interim results of the SCCLG‐APL clinical study
Authors: Ming‐Hua Yang, Wu‐Qing Wan, Jie‐Si Luo, Min‐Cui Zheng, Ke Huang, Li‐Hua Yang, Hui‐Rong Mai, Jian Li, Hui‐Qin Chen, Xiao‐Fei Sun, Ri‐Yang Liu, Guo‐Hua Chen, Xiaoqin Feng, Zhi‐Yong Ke, Bin Li, Yan‐Lai Tang, Li‐Bin Huang, Xue‐Qun Luo
Journal: American Journal of Hematology (2018)

Intravenous arsenic trioxide (ATO) has been adopted as the first-line treatment for acute promyelocytic leukemia (APL). Another arsenic compound named the Realgar-Indigo naturalis formula (RIF), an oral traditional Chinese medicine containing As4 S4 , has been shown to be highly effective in treating adult APL. In the treatment of pediatric APL, the safety and efficacy of RIF remains to be confirmed. This randomized, multicenter, and noninferiority trial was conducted to determine whether intravenous ATO can be substituted by oral RIF in the treatment of pediatric APL. From September 2011 to January 2017, among 92 patients who were 16 years old or younger with newly diagnosed PML-RARa positive APL, 82 met eligible criteria and were randomly assigned to ATO (n = 42) or RIF (n = 40) group. The remaining 10 patients did not fulfilled eligible criteria because five did not accept randomization, four died and one had hemiplegia prior to arsenic randomization due to intracranial hemorrhage or cerebral thrombosis. Induction and consolidation treatment contained ATO or RIF, all-trans-retinoic acid and low intensity chemotherapy. End points included event-free survival (EFS), adverse events and hospital days. After a median 3-year follow-up, the estimated 5-year EFS was 100% in both groups, and adverse events were mild. However, patients in the RIF group had significantly less hospital stay than those in the ATO group. This interim analysis shows that oral RIF is as effective and safe as intravenous ATO for the treatment of pediatric APL, with the advantage of reducing hospital stay. Final trial analysis will reveal mature outcome data.
Opioid Prescribing in the United States Before and After the Centers for Disease Control and Prevention's 2016 Opioid Guideline
Authors: Amy S.B. Bohnert, Gery P. Guy, Jan L. Losby
Journal: Annals of Internal Medicine (2018)

Background: In response to adverse outcomes from prescription opioids, the Centers for Disease Control and Prevention (CDC) released the Guideline for Prescribing Opioids for Chronic Pain in March 2016. Objective: To test the hypothesis that the CDC guideline release corresponded to declines in specific opioid prescribing practices. Design: Interrupted time series analysis of monthly prescribing measures from the IQVIA transactional data warehouse and Real-World Data Longitudinal Prescriptions population-level estimates based on retail pharmacy data. Population size was determined by U.S. Census monthly estimates. Setting: United States, 2012 to 2017. Patients: Persons prescribed opioid analgesics. Measurements: Outcomes included opioid dosage, days supplied, overlapping benzodiazepine prescriptions, and the overall rate of prescribing. Results: The rate of high-dosage prescriptions (≥90 morphine equivalent milligrams per day) was 683 per 100 000 persons in January 2012 and declined by 3.56 (95% CI, −3.79 to −3.32) per month before March 2016 and by 8.00 (CI, −8.69 to −7.31) afterward. Likewise, the percentage of patients with overlapping opioid and benzodiazepine prescriptions was 21.04% in January 2012 and declined by 0.02% (CI, −0.04% to −0.01%) per month before the CDC guideline release and by 0.08% (CI, −0.08% to −0.07%) per month afterward. The overall opioid prescribing rate was 6577 per 100 000 persons in January 2012 and declined by 23.48 (CI, −26.18 to −20.78) each month before the guideline release and by 56.74 (CI, −65.96 to −47.53) per month afterward. Limitation: No control population; inability to determine the appropriateness of opioid prescribing. Conclusion: Several opioid prescribing practices were decreasing before the CDC guideline, but the time of its release was associated with a greater decline. Guidelines may be effective in changing prescribing practices. Primary Funding Source: CDC.
Abstract 17642: Carvedilol Improves Prognosis in Sepsis-induced Cardiomyopathy Through the Activation of “telomere-p53-pgc Signaling"
Authors: Motoi Okada, Satoshi Kawaguchi, Yuta Kashiwagi, Kentaro Hayashi, Satoshi Fujita, Naoyuki Hasebe
Journal: Circulation (2016)

Background: Stress-induced cardiomyopathy is a complication of severe sepsis. It is characterized by left ventricular dilatation and depressed ejection fraction. Recent meta-analysis suggested that...
Abstract 18726: Heme Oxygenase-1 (HO-1) Regulates microRNA-122-5p and -365-3p against Apoptosis in Cardiac Progenitor Cell (CPC) Therapy
Authors: Qianhong Li, Yiru Guo, Ibrahim Elkhawas, Mir Y Khan, Mohamed I Shaji, Qinghui Ou, Yibing Nong, Roberto Bolli
Journal: Circulation (2017)

Although overexpression of HO-1 in CPCs enhances the efficacy of cell therapy for attenuating LV dysfunction and remodeling after myocardial infarction (MI), its mechanism is unknown. To this end, ...
Bawa-Garba case: GMC chief executive should resign, says consultants’ union
Authors: Abi Rimmer
Journal: BMJ (2018)

The Hospital Consultants and Specialists Association has called for Charlie Massey to step down as chief executive of the General Medical Council over his handling of the case of the trainee paediatrician Hadiza Bawa-Garba.

Bawa-Garba was found guilty of gross negligence manslaughter in November 2015 for contributing to the death of 6 year old Jack Adcock from septic shock at Leicester Royal Infirmary.1

A medical practitioners tribunal, which took account of systemic failings at the hospital and the extreme pressure under which she was working, decided to suspend her for 12 months rather than strike her off.2 But the GMC …
Association between pretreatment lymphocyte count and response to PD1 inhibitors in head and neck squamous cell carcinomas
Authors: Won Jin Ho, Mark Yarchoan, Alex Hopkins, Ranee Mehra, Stuart Grossman, Hyunseok Kang
Journal: Journal for ImmunoTherapy of Cancer (2018)

Low absolute lymphocyte count (ALC) has previously been established as a marker of poor prognosis in multiple cancer types. There is growing evidence that ALC may also be associated with response to immunotherapy. This study explores whether response to PD1 inhibitors in recurrent and/or metastatic head and neck squamous cell carcinoma (R/M HNSCC) is associated with pretreatment ALC.Thirty-four R/M HNSCC patients who received either nivolumab or pembrolizumab between January 2014 and May 2018 at Johns Hopkins were identified retrospectively. Pretreatment blood counts in patients with and without clinical benefit from PD1 inhibitors were compared. Time-to-progression analyses were performed by dichotomizing the study cohort with the threshold of ALC 600 cells/μl, which is approximately 1.5 standard deviations away from treatment-naïve baseline mean.Patients with lower ALC appeared to have significantly less clinical benefit from anti-PD1 therapy. Those patients with pretreatment ALC < 600 cells/μl also had shorter PFS than patients with pretreatment ALC ≥ 600 cells/μl (median PFS 60 days vs. 141 days, p < 0.05). These results were consistent with multivariate proportional hazards analyses demonstrating significant association with progression. These observations were further supported by an expansion cohort analysis incorporating additional fourteen R/M HNSCC patients who received other checkpoint immunotherapy regimens at our institution.This study for the first time demonstrates that pretreatment ALC is significantly associated with response to PD1 inhibitors in R/M HNSCC patients.
Abstract 14983: Paradoxical Endothelial Dysfunction in Murine Model of Increased Endothelial Insulin Sensitivity - Role of PYK2 and Reactive Oxygen Species
Authors: Hema Viswambharan, Nadira Yuldasheva, Piruthivi Sukumar, Anshuman Sengupta, Richard Cubbon, Helen Imrie, Matthew Gage, Natalie Haywood, Anna Skromna, Natalia Makova, Pooja Shah, Ajay Shah, Celio Santos, Stephen Wheatcroft, Mark Kearney
Journal: Circulation (2014)

Introduction: Insulin resistant type 2 diabetes, is well-established as a risk factor for the development of cardiovascular diseases. Insulin sensitizing agents such as glitazones failed to improve...