tbuckley/cabot-search huggingface dataset:
Lung Microbiota Is Related to Smoking Status and to Development of Acute Respiratory Distress Syndrome in Critically Ill Trauma Patients
Authors: Ariane R. Panzer, Susan V. Lynch, Chaz Langelier, Jason D. Christie, Kathryn McCauley, Mary Nelson, Christopher K. Cheung, Neal L. Benowitz, Mitchell J. Cohen, Carolyn S. Calfee
Journal: American Journal of Respiratory and Critical Care Medicine (2017)

Cigarette smoking is associated with increased risk of acute respiratory distress syndrome (ARDS) in patients after severe trauma; however, the mechanisms underlying this association are unknown.To determine whether cigarette smoking contributes to ARDS development after trauma by altering community composition of the lung microbiota.We studied the lung microbiota of mechanically ventilated patients admitted to the ICU after severe blunt trauma. To do so, we used 16S ribosomal RNA gene amplicon sequencing of endotracheal aspirate samples obtained on ICU admission (n = 74) and at 48 hours after admission (n = 30). Cigarette smoke exposure (quantified using plasma cotinine), ARDS development, and other clinical parameters were correlated with lung microbiota composition.Smoking status was significantly associated with lung bacterial community composition at ICU admission (P = 0.007 by permutational multivariate ANOVA [PERMANOVA]) and at 48 hours (P = 0.03 by PERMANOVA), as well as with significant enrichment of potential pathogens, including Streptococcus, Fusobacterium, Prevotella, Haemophilus, and Treponema. ARDS development was associated with lung community composition at 48 hours (P = 0.04 by PERMANOVA) and was characterized by relative enrichment of Enterobacteriaceae and of specific taxa enriched at baseline in smokers, including Prevotella and Fusobacterium.After severe blunt trauma, a history of smoking is related to lung microbiota composition, both at the time of ICU admission and at 48 hours. ARDS development is also correlated with respiratory microbial community structure at 48 hours and with taxa that are relatively enriched in smokers at ICU admission. The data derived from this pilot study suggest that smoking-related changes in the lung microbiota could be related to ARDS development after severe trauma.
Intervention Improves Adherence to Opioid Prescribing Guidelines
Authors: Anita Slomski
Journal: JAMA (2017)

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 Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal
A randomized, double-blind, placebo-controlled phase II study of maintenance therapy with tasquinimod in patients with metastatic castration-resistant prostate cancer responsive to or stabilized during first-line docetaxel chemotherapy
Authors: K. Fizazi, A. Ulys, L. Sengeløv, M. Moe, S. Ladoire, A. Thiery-Vuillemin, A. Flechon, A. Guida, J. Bellmunt, M.A. Climent, S. Chowdhury, H. Dumez, M. Matouskova, N. Penel, S. Liutkauskiene, L. Stachurski, C.N. Sternberg, F. Baton, N. Germann, G. Daugaard
Journal: Annals of Oncology (2017)
Comparison Between Patent Ductus Arteriosus Stent and Modified Blalock-Taussig Shunt as Palliation for Infants With Ductal-Dependent Pulmonary Blood Flow
Authors: Andrew C. Glatz, Christopher J. Petit, Bryan H. Goldstein, Michael S. Kelleman, Courtney E. McCracken, Alicia McDonnell, Timothy Buckey, Christopher E. Mascio, Subi Shashidharan, R. Allen Ligon, Jingning Ao, Wendy Whiteside, W. Jack Wallen, Christina M. Metcalf, Varun Aggarwal, Hitesh Agrawal, Athar M. Qureshi
Journal: Circulation (2017)

Background: Infants with ductal-dependent pulmonary blood flow may undergo palliation with either a patent ductus arteriosus (PDA) stent or a modified Blalock-Taussig (BT) shunt. A balanced multicenter comparison of these 2 approaches is lacking. Methods: Infants with ductal-dependent pulmonary blood flow palliated with either a PDA stent or a BT shunt from January 2008 to November 2015 were reviewed from the 4 member centers of the Congenital Catheterization Research Collaborative. Outcomes were compared by use of propensity score adjustment to account for baseline differences between groups. Results: One hundred six patients with a PDA stent and 251 patients with a BT shunt were included. The groups differed in underlying anatomy (expected 2-ventricle circulation in 60% of PDA stents versus 45% of BT shunts; P =0.001) and presence of antegrade pulmonary blood flow (61% of PDA stents versus 38% of BT shunts; P &lt;0.001). After propensity score adjustment, there was no difference in the hazard of the primary composite outcome of death or unplanned reintervention to treat cyanosis (hazard ratio, 0.8; 95% confidence interval [CI], 0.52–1.23; P =0.31). Other reinterventions were more common in the PDA stent group (hazard ratio, 29.8; 95% CI, 9.8–91.1; P &lt;0.001). However, the PDA stent group had a lower adjusted intensive care unit length of stay (5.3 days [95% CI, 4.2–6.7] versus 9.19 days [95% CI, 7.9–10.6]; P &lt;0.001), a lower risk of diuretic use at discharge (odds ratio, 0.4; 95% CI, 0.25–0.64; P &lt;0.001) and procedural complications (odds ratio, 0.4; 95% CI, 0.2–0.77; P =0.006), and larger (152 mm 2 /m 2 [95% CI, 132–176] versus 125 mm 2 /m 2 [95% CI, 113–138]; P =0.029) and more symmetrical (symmetry index, 0.84 [95% CI, 0.8–0.89] versus 0.77 [95% CI, 0.75–0.8]; P =0.008] pulmonary arteries at the time of subsequent surgical repair or last follow-up. Conclusions: In this multicenter comparison of palliative PDA stent and BT shunt for infants with ductal-dependent pulmonary blood flow adjusted for differences in patient factors, there was no difference in the primary end point, death or unplanned reintervention to treat cyanosis. However, other markers of morbidity and pulmonary artery size favored the PDA stent group, supporting PDA stent as a reasonable alternative to BT shunt in select patients.
Brote de criptosporidiosis asociado con un parque de atracciones acuáticas en el Reino-Unido : Importancia de las recomendaciones
Authors: M Jones, D Boccia, M Kealy, B Salkin, A Ferrero, G Nichols, J M Stuart
Journal: Eurosurveillance (2006)

Tras la ocurrencia de tres brotes de criptosporidiosis en el Reino-Unido asociados a las atracciones acuaticas, se subrayo la necesidad de recomendaciones nacionales sobre este tipo de instalaciones. En agosto de 2003, se comunico un brote de criptosporidiosis al Instituto de Salud Publica del suroeste de Inglaterra. Dicho brote estaba asociado con un juego acuatico en un parque de atracciones. El juego fue implicado tras la identificacion de un numero elevado de coliformes y la deteccion de coliformes fecales en las muestras.
Se definio como caso como cualquier nino menor de 16 anos que hubiera visitado el parque en agosto, presentando seguidamente sintomas gastrointestinales y con una muestra fecal positiva para cryptosporidium. Se identificaron setenta y un ninos en esa cohorte. 
Este brote de criptosporidiosis se caracterizo por una tasa de ataque muy alta (del 89%), una duracion relativamente larga (mediana de ocho dias) y una tasa de hospitalizaciones bastante elevada (el 16% de los casos). La curva epidemica mostraba una sola fuente de infeccion, correspondiendo a la fecha en que el 80% de los casos habian visitado el parque. Este brote de criptosporidiosis se parece a dos otros notificados en 2003 que implicaban juegos acuaticos. Estos brotes plantean el problema de la gestion y mantenimiento de las atracciones acuaticas, relacionadas en muchos casos con los ninos. El articulo refleja las medidas de control basicas que pueden ser implementadas y subraya la necesidad de recomendaciones, especialmente por el aumento de la utilizacion de este tipo de atracciones. Tales recomendaciones fueron publicadas en el Reino-Unido por un grupo de expertos en tratamiento del agua, el “Pool Water Treatment Advisory Group”.
Abstract 13043: Atrial Fibrillation is Associated With Cardiovascular Events in Obese Japanese With One or More Cardiovascular Risk Factors: Japan Morning Surge Home Blood Pressure (J-HOP) Study
Authors: Hiroaki Watanabe, Tomoyuki Kabutoya, Satoshi Hoshide, Kazuomi Kario
Journal: Circulation (2015)

Introduction: Obesity has been shown as a risk of incidence and durability of atrial fibrillation. However, the relationship between obesity and prognosis of patients with atrial fibrillation remains unclear. Hypothesis: We assessed the hypothesis that obesity was associated with cardiovascular events in atrial fibrillation patients with cardiovascular risk factors. Methods: We enrolled 3,585 patients in the Japan Morning Surge Home Blood Pressure Study who had one or more cardiovascular risk factors. We conducted 12-lead electrocardiography, and atrial fibrillation was identified based on electrocardiography. Obesity was defined as body mass index over than 25 kg/m2. The primary endpoints were fatal/nonfatal cardiovascular events (myocardial infarction, stroke, hospitalization for heart failure, aortic dissection). Results: The number of patients whose electrocardiograms revealed atrial fibrillation was eighty-four. In obese patients, atrial fibrillation patients (N=35) suffered more cardiovascular events (log rank 7.17, p=0.007) than sinus rhythm patients (N=1282), but in nonobese patients, cardiovascular events were similar (log rank 0.10, p=0.76) in atrial fibrillation (N=48) and sinus rhythm patients (N=2220). After adjusting for age, gender, hypertension, smoking, and diabetes, atrial fibrillation was an independent predictor of cardiovascular events in the obese group (hazard ratio 3.02, 95% confidence interval 1.18-7.78). Conclusions: There was a significant difference in the association between atrial fibrillation and subsequent cardiovascular events in the presence or absence of obesity. Weight reduction might improve the prognosis of atrial fibrillation patients.
LAIR-1 limits neutrophil extracellular trap formation in viral bronchiolitis
Authors: Ruben J. Geerdink, Marije P. Hennus, Geertje H.A. Westerlaken, Alferso C. Abrahams, Kim I. Albers, Jona Walk, Esther Wesselink, Riny Janssen, Louis Bont, Linde Meyaard
Journal: Journal of Allergy and Clinical Immunology (2017)
Helen Clare Underhill
Authors: Laura de Rooy, Anne Wright
Journal: BMJ (2017)

Helen Clare Underhill was born in Libya, the oldest of three children. The family were forced to leave the country with the accession of Colonel Gaddafi to power, but returned to the Middle East shortly thereafter. Helen was educated in Oman and England. She announced her decision to become a doctor at the age of 8—and worked singlemindedly to achieve this goal, excelling at school and extracurricular activities. She studied medicine at St Bartholomew’s Hospital in London, graduating in 1989. House jobs at Barts and in Brighton followed, after which Helen started her paediatric training. Throughout this time, she followed her other passions: travel and people. It was during her travels to interesting and far way places that she met her husband, Powell Ettinger, who shared her passion and went on, in Helen’s own …
Doctor wins right to take GMC to employment tribunal
Authors: Clare Dyer
Journal: BMJ (2017)

The UK’s highest court has given doctors the go-ahead to bring employment tribunal claims against the General Medical Council (GMC) for sex, race, or disability discrimination in the way it handles complaints against them.1

The UK Supreme Court dismissed the GMC’s appeal against a Court of Appeal ruling in April 2016 opening the way for such claims.2 No further appeal is possible after the judgment of the country’s top court.

The …
Introduction: Session IV
Authors: Harrison R. Hunt
Journal: JNCI Journal of the National Cancer Institute (1954)

Introduction: Session IV Get access Harrison R. Hunt Harrison R. Hunt Chairman Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 15, Issue 3, December 1954, Pages 653–654, https://doi.org/10.1093/jnci/15.3.653 Published: 01 December 1954
Incidencia de casos de sida en instituciones penitenciarias españolas mediante el método de captura-recaptura, 2000
Authors: E Acin, P. Gomez, P. Hernando, I Corella
Journal: Eurosurveillance (2003)

Se utilizaron las tres fuentes disponibles de informacion empleada en la vigilancia del sida en las prisiones espanolas para realizar un estudio de captura-recaptura. Los resultados reflejaron que el registro de casos de sida (RCS) subestima de manera considerable la incidencia de esta enfermedad en prisiones, al cubrir solamente el 50% de los casos. Este estudio subraya la necesidad de utilizar otras fuentes, ademas del RCS, para evaluar la incidencia real del sida en las prisiones de Espana.
Re-purposed use of a stiffening wire as a novel adjunct for direct cholangioscopy access
Authors: Vincent Zimmer
Journal: Endoscopy (2017)

I read with great interest the paper "Direct peroral cholangioscopy with a new anchoring technique using the guide probe of Kautz – first clinical experiences" by Lenze et al. published in the recent issue of Endoscopy [1]. Based on their initial individual report, the authors provide an extended case series on their unique alternative anchoring technique for direct cholangioscopy access, relying on a historic nonendoscopic Kautz probe, which, however, is not widely available in endoscopy services [2]. From this perspective, it is interesting to see how a highly innovative endoscopic procedure is being pimped up by creative re-purposing of historic endoscopy (or, in this case, radiology) accessories, blurring the lines between new and old, for which the authors are to be commended.
Somatic Mutations and Splicing Variants of Focal Adhesion Kinase in Non–Small Cell Lung Cancer
Authors: Bo Zhou, Gui-Zhen Wang, Zhe-Sheng Wen, Yong-Chun Zhou, Yun-Chao Huang, Ying Chen, Guang-Biao Zhou
Journal: JNCI Journal of the National Cancer Institute (2017)

Overexpression of focal adhesion kinase (FAK) has been reported in lung cancer, but the somatic mutations and alternative splicing variants of this nonreceptor tyrosine kinase remain to be investigated. FAK in 91 lung cancer patients was sequenced using genomic DNA and cDNA samples of tumor and paired normal lung tissues as templates, and the RNA-seq data of The Cancer Genome Atlas (TCGA) data set were assessed. The biological functions of abnormal FAK transcripts and their response to FAK inhibitors were analyzed in eight cell lines using tyrosine kinase activity assay, trypan blue exclusion assay, MTT (3-(4, 5)-dimethylthiahiazo (-z-y1)-3, 5-di-phenytetrazoliumromide) assay, and transwell assay. We identified an internal tandem duplication (ITD), an A1004S point mutation, an exon 5–27 deletion (ΔE5-27) truncation variant, and four FAK6,7 splicing variants (containing exons for Boxes 6 and 7) in seven (7.7%) patients. Smokers had more FAK abnormalities than nonsmokers. In FAK-ITD, the sequence encoding the C-terminal of the FERM domain and kinase domain was duplicated in-frame and produced a protein product with elevated autophosphorylation and sensitivity to FAK inhibitors. FAK6,7 was detected in the tumor but not counterpart normal lung tissues of four (4.4%) patients. In TCGA RNA-seq data, Box 6 and/or Box 7 (Box 6/7)–containing FAK variants were positive in 42 (8.3%) of 508 lung adenocarcinomas (LUADs) and 37 (7.4%) of 501 lung squamous cell carcinomas, and smokers had higher expression of Box 6/7 (+) FAK than reformed or nonsmokers with LUAD. FAK6,7 promoted cell proliferation and migration, exhibited increased autophosphorylation, and was more sensitive to FAK inhibitor compared with wild-type FAK. Somatic mutations and splicing variants of FAK may have a role in lung carcinogenesis and represent potential biomarkers for FAK-targeted therapies.
Interim safety analysis of a phase II trial of modified-FOXFOXIRI plus bevacizumab for RAS mutant mCRC (JACCRO CC-11)
Authors: Yu Sunakawa, Hironaga Satake, Yuji Miyamoto, Masato Nakamura, Hiroshi Nakayama, Akio Higuchi, Masahiro Takeuchi, Masashi Fujii, Takashi Sekikawa, Wataru Ichikawa
Journal: Annals of Oncology (2017)
Fluoroquinolone prophylaxis in haematological cancer patients with neutropenia: ECIL critical appraisal of previous guidelines
Authors: Malgorzata Mikulska, Diana Averbuch, Frederic Tissot, Catherine Cordonnier, Murat Akova, Thierry Calandra, Marcello Ceppi, Paolo Bruzzi, Claudio Viscoli, Murat Akova, Mahmoud Aljurf, Dina Averbuch, Rosemary Barnes, Ola Blennow, Pierre-Yves Bochud, Emilio Bouza, Stephane Bretagne, Roger Brüggemann, Thierry Calandra, Jordi Carratala, Simone Cesaro, Catherine Cordonnier, Oliver Cornely, Tina Dalianis, Rafael De La Camara, Peter Donnelly, Lubos Drgona, Rafael Duarte, Hermann Einsele, Dan Engelhard, Christopher Fox, Corrado Girmenia, Andreas Groll, Dag Heldal, Jannick Helweg Larsen, Raoul Herbrecht, Hans Hirsch, Elisabeth Johnson, Galina Klyasova, Minna Koskuenvo, Katrien Lagrou, Russel E. Lewis, Per Ljungman, Johan Maertens, Georg Maschmeyer, Malgorzata Mikulska, Marcio Nucci, Christophe Padoin, Livio Pagano, Antonio Pagliuca, Zdenek Racil, Patricia Ribaud, Christine Rinaldo, Valérie Rizzi Puechal, Emmanuel Roilides, Christine Robin, Montserrat Rovira, Markus Rupp, Sonia Sanchez, Peter Schellongowski, Peter Sedlacek, Janos Sinko, Monica Slavin, Isabella Sousa Ferreira, Jan Styczynski, Frederic Tissot, Claudio Viscoli, Katherine Ward, Anne-Therese Witschi
Journal: Journal of Infection (2017)
Deliberata disseminazione di agenti biologici: prime lezioni per l'Europa in seguito agli avvenimenti negli Stati Uniti
Authors: R Harling, B Twisselmann, N Asgari, D Morgan, N Lightfoot, M Reacher, A Nicoll
Journal: Eurosurveillance (2001)

L'esperienza vissuta nell'autunno 2001 dell'invio di lettere contenenti spore di antrace, ha avuto notevoli conseguenze negli Stati Uniti e in Europa. La minaccia di attentati non rivendicati diretti contro dei civili e divenuta una realta. In Europa, nonostante si siano moltiplicati scherzi di cattivo gusto, non si sono registrati casi di antrace legati ad azioni criminali e le sole lettere contaminate erano destinate ad ambasciate americane all'estero. Cio nonostante e arrivato il momento per l'Europa di preparare dei piani efficienti e tempestivi per rispondere al bioterrorismo, con il coordinamento della Commissione Europea.
Allergen specificity of early peanut consumption and effect on development of allergic disease in the Learning Early About Peanut Allergy study cohort
Authors: George du Toit, Peter H. Sayre, Graham Roberts, Kaitie Lawson, Michelle L. Sever, Henry T. Bahnson, Helen R. Fisher, Mary Feeney, Suzana Radulovic, Monica Basting, Marshall Plaut, Gideon Lack, Susan Chan, Adam Fox, Mable Abraham, Muhsinah Adam, Louise Coverdale, Claire Duncan, Amy Nixon, Una O’Dwyer-Leeson, Victoria Offord, Aine Sheridan, Fiona Watson, Natalie Witham, Kathryn Cockerell, Gail Harland, Tiffany Miller, Charlotte Stedman, Catherine Clarke, Richard Cleaver, Gemma Deutsch, Alicia Parr, Natalia Becares, Matthew Crossley, Natalia do Couto Francisco, Kerry Richards, Ewa Pietraszewicz, Alick Stephens, Asha Sudra, Rianne Wester, Alastair Wilson, Celine Wu, Jenna Heath, Kathryn Hersee, Devi Patkunam, Adam Asare, Eduard Chani, Judith Evind, Noha Lim, Audrey Plough, Judith Evind, Margarita Gomez Lorenzo, Joy Laurienzo Panza, Jackie Johnson, Jack Hu, Travis Mason
Journal: Journal of Allergy and Clinical Immunology (2017)

BackgroundEarly introduction of dietary peanut in high-risk infants with severe eczema, egg allergy, or both prevented peanut allergy at 5 years of age in the Learning Early About Peanut Allergy (LEAP) study. The protective effect persisted after 12 months of avoiding peanuts in the 12-month extension of the LEAP study (LEAP-On). It is unclear whether this benefit is allergen and allergic disease specific.ObjectiveWe sought to assess the effect of early introduction of peanut on the development of allergic disease, food sensitization, and aeroallergen sensitization.MethodsAsthma, eczema, and rhinoconjunctivitis were diagnosed based on clinical assessment. Reported allergic reactions and consumption of tree nuts and sesame were recorded by questionnaire. Sensitization to food allergens and aeroallergens was determined by means of skin prick testing and specific IgE measurement.ResultsA high and increasing burden of food allergen and aeroallergen sensitization and allergic disease was noted across study time points; 76% of LEAP participants had at least 1 allergic disease at 60 months of age. There were no differences in allergic disease between LEAP groups. There were small differences in sensitization and reported allergic reactions for select tree nuts, with levels being higher in the LEAP consumption group. Significant resolution of eczema and sensitization to egg and milk occurred in LEAP participants and was not affected by peanut consumption.ConclusionEarly consumption of peanut in infants at high risk of peanut allergy is allergen specific and does not prevent the development of other allergic disease, sensitization to other food allergens and aeroallergens, or reported allergic reactions to tree nuts and sesame. Furthermore, peanut consumption does not hasten the resolution of eczema or egg allergy.Graphical abstract
Haemorrhagic bullae in the oral mucosa with gingival bleeding
Authors: César Rivera, Ítalo Torres, Wilfredo Alejandro González-Arriagada
Journal: BMJ (2017)

A 56 year old woman presented with a 2 day history of multiple painless violet haemorrhagic lesions on her gums, tongue, and buccal mucosa (fig 1⇓). This was associated with gingival bleeding, but there was no relevant medical history of comorbidity, medications, or local trauma. She was diagnosed with multiple haemorrhagic bullae. Blood tests done using fluorescence flow cytometry (Sysmex ​XS-1000i, Sysmex Corp. Japan) showed a platelet count of zero (reference range 150-400 ×109/L of blood). A manual platelet count was not performed. Coagulation, haemogram, and white blood cells tests were normal. A dermatological examination revealed further lesions on her chest and arms. She was treated with intravenous methylprednisolone (30 mg/kg/day) for seven days, and reached a count of 7 platelets ×109/L. Four days after the initial 7 day treatment, her platelets decreased rapidly to 3 ×109/L. The patient received a transfusion of 30×109/L platelets and prednisone (1 mg/kg/day). Five days after the transfusion, the woman left the hospital with a platelet count of 74 ×109/L.



Fig 1  Multiple violet haemorrhagic lesions on the gums, tongue, and buccal mucosa





### 1.What is the most likely diagnosis?

#### Short answer

Idiopathic thrombocytopenic purpura.

#### Discussion

Idiopathic thrombocytopenic purpura, also known as immune thrombocytopenic purpura, …