tbuckley/cabot-search huggingface dataset:
Prevalence, Incidence, and Sensitization Profile of β-lactam Antibiotic Allergy in Hong Kong
Authors: Philip H. Li, Heather H. F. Yeung, Chak-Sing Lau, Elaine Y. L. Au
Journal: JAMA Network Open (2020)

<h3>Importance</h3> Allergy to β-lactam antibiotics is one of the most frequently reported drug reactions, but epidemiological data in Chinese populations are lacking. Ethnic- and region-specific sensitization patterns of skin testing for β-lactam antibiotic allergy are also unknown. <h3>Objective</h3> To identify the prevalence, 1-year incidence, and sensitization patterns of β-lactam antibiotic allergy in patients in Hong Kong. <h3>Design, Setting, and Participants</h3> This cross-sectional study obtained territorywide, anonymized electronic patient data from the Clinical Management Systems of the Hospital Authority, the sole publicly funded health care system in Hong Kong with facilities in 7 regions (Hong Kong East, Hong Kong West, Kowloon Central, Kowloon East, Kowloon West, New Territories East, and New Territories West). All referrals to Queen Mary Hospital for β-lactam antibiotic allergy testing from January 1, 2018, to December 31, 2019, were also analyzed for sensitization patterns. <h3>Main Outcomes and Measures</h3> Prevalence and cumulative incidence of β-lactam antibiotic allergy reported in Hong Kong, and sensitization patterns according to β-lactam antibiotic allergy skin testing. <h3>Results</h3> Complete records of 7 184 271 unique patients were analyzed, with a men to women ratio of 1:1.2 and with a median age of 44 years. The prevalence of physician-reported β-lactam antibiotic allergy was 2.0%, and the cumulative incidence was 107 per 100 000 population. Of the 34 402 new drug allergies reported in 2018, 8032 (23.3%) were β-lactam antibiotic allergies. Three hundred fifty-five patients with reactions suggestive of β-lactam antibiotic allergy underwent skin testing, and only 49 (13.8%; 95% CI, 10.64%-17.90%) of them had positive test results. Of these 49 patients, 14 (28.6%; 95% CI, 18.35%-44.49%) had selective reaction and 35 (71.4%; 95% CI, 59.84%-85.27%) had nonselective reaction. The sensitization rate to either benzylpenicilloyl polylysine or a minor determinant (benzylpenicilloate) was 47.0% (n = 23; 95% CI, 34.85%-63.21%), with 10 patients monosensitized to benzylpenicilloyl polylysine only (20.4%; 95% CI, 11.74%-35.48%) and 5 to benzylpenicilloate only (10.2%; 95% CI, 4.45%-23.42%). <h3>Conclusions and Relevance</h3> Results of this study suggest that patients in Hong Kong with β-lactam antibiotic allergy had much higher rates of monosensitization to benzylpenicilloyl polylysine and benzylpenicilloate, making these reagents essential in β-lactam antibiotic skin tests. Such a finding warrants future studies into whether this sensitization is specific to ethnicity or region.
Abstract 16932: Glucagon-Like Peptide 1 Receptor Agonist Mitigates Postinfarction Adverse Left Ventricular (LV) Remodeling in Mice; a Mechanism Linked to Mitophagy and the Restoration of Cardiac Fatty Acid Oxidation
Authors: Allen M Andres, Juliana Germano, Chengqun Huang, Jon Sin, Yang Song, Kyle C Tucker, Roberta A Gottlieb, Robert M Mentzer
Journal: Circulation (2018)

Glucagon-like peptide 1 receptor agonist (GLP1Ra) and its variants have been shown to protect against cardiac ischemic injury. Less is known about their effects on adverse post-MI LV remodeling. Based on our observation that GLP1Ra stimulated mitophagy in H9C2 cardiac cells, we evaluated its effects on post-MI remodeling. Mice underwent permanent coronary artery ligation (PCAL), ensuring remodeling would be independent of changes in infarct size. Vehicle or GLP1Ra (Sigma) were administered i.p. 2h after the infarct and then every other day for a total of 6 doses. LV remodeling was assessed 30 days post-MI via echo. Histology was used to examine immune cell infiltration 7 days post-MI (early phase) via hematoxylin and eosin staining, and fibrosis by Masson’s trichrome after 30 days (late phase). GLP1Ra-treated mice exhibited a marked reduction in immune cell infiltration ( A ), and fibrosis ( B ). This corresponded to a significant improvement in ejection fraction (EF) and fractional shortening (FS) ( C ), although not to the levels of sham-operated mice (EF 60% and FS 30%, data not shown). We assessed the importance of GLP1Ra-induced mitophagy in Parkin KO (PKO) mice. GLP1Ra failed to attenuate adverse remodeling ( D and E ) and immune cell infiltration ( F ) in PKO mice implicating the importance of mitophagy as an underlying mechanism. We next determined the effect of GLP1Ra on the activation state of the pyruvate dehydrogenase complex (PDC), which governs substrate utilization. Ischemically injured hearts shift fuel use towards carbohydrate oxidation, which we confirmed in our PCAL model via decreased phosphorylation of the PDC. Post-MI administration of GLP1Ra promoted PDC phosphorylation and thereby restored fatty acid utilization during the early phase of remodeling ( G and H ). These findings suggest that alterations in cardiac metabolic poise after ischemic injury play a role in adverse remodeling and that stimulation of mitochondrial turnover influences this process.
The prevalence and spectrum of colonic lesions in patients with cirrhotic and noncirrhotic portal hypertension*1
Authors: S GANGULY
Journal: Hepatology (1995)

Portal hypertension diffusely affects the gastrointestinal tract. The frequency and profile of distinct colonic mucosal lesions (portal colopathy) and rectal varices (RV; veins >4 cm above the anal verge) is not well studied. Fifty consecutive patients with portal hypertension (25 with cirrhosis, 10 with noncirrhotic portal fibrosis [NCpf], and 15 with extrahepatic portal vein obstruction [EHPVO]) were assessed clinically and by upper and lower gastrointestinal (GI) endoscopy. Colorectal lesions were seen in 35 (70%) patients, significantly more often in bleeders than in nonbleeders. Rectal varices were detected in 22 (44%) patients; larger and more often seen in EHPVO (80%) than in cirrhosis (28%) and NCPF (30%) (P < .01) patients. Portal colopathy was seen in 26 (52%) patients, with nearly similar frequency in cirrhotics, NCPF, and EHPVO patients. Previous sclerotherapy or presence of gastric varices had little influence on the development of these lesions. An association (P < .01) was, however, seen between the presence of colopathy and portal gastropathy. Overt bleeding was seen in 8% and 4% of patients with RV and colopathy, respectively. In conclusion, our results demonstrate that colorectal lesions are present in about two thirds of patients with portal hypertension. Patients with portal hypertension and lower GI bleeding should be colonoscoped. Patients with extrahepatic portal vein obstruction may in turn benefit from baseline sigmoidoscopic examination to define the presence and size of rectal varices.
Whole-Blood RNA Profiles Associated with Pulmonary Arterial Hypertension and Clinical Outcome
Authors: Christopher J. Rhodes, Pablo Otero-Núñez, John Wharton, Emilia M. Swietlik, Sokratis Kariotis, Lars Harbaum, Mark J. Dunning, Jason M. Elinoff, Niamh Errington, A. A. Roger Thompson, James Iremonger, J. Gerry Coghlan, Paul A. Corris, Luke S. Howard, David G. Kiely, Colin Church, Joanna Pepke-Zaba, Mark Toshner, Stephen J. Wort, Ankit A. Desai, Marc Humbert, William C. Nichols, Laura Southgate, David-Alexandre Trégouët, Richard C. Trembath, Inga Prokopenko, Stefan Gräf, Nicholas W. Morrell, Dennis Wang, Allan Lawrie, Martin R. Wilkins
Journal: American Journal of Respiratory and Critical Care Medicine (2020)

Rationale: Idiopathic and heritable pulmonary arterial hypertension (PAH) are rare but comprise a genetically heterogeneous patient group. RNA sequencing linked to the underlying genetic architecture can be used to better understand the underlying pathology by identifying key signaling pathways and stratify patients more robustly according to clinical risk.Objectives: To use a three-stage design of RNA discovery, RNA validation and model construction, and model validation to define a set of PAH-associated RNAs and a single summarizing RNA model score. To define genes most likely to be involved in disease development, we performed Mendelian randomization (MR) analysis.Methods: RNA sequencing was performed on whole-blood samples from 359 patients with idiopathic, heritable, and drug-induced PAH and 72 age- and sex-matched healthy volunteers. The score was evaluated against disease severity markers including survival analysis using all-cause mortality from diagnosis. MR used known expression quantitative trait loci and summary statistics from a PAH genome-wide association study.Measurements and Main Results: We identified 507 genes with differential RNA expression in patients with PAH compared with control subjects. A model of 25 RNAs distinguished PAH with 87% accuracy (area under the curve 95% confidence interval: 0.791-0.945) in model validation. The RNA model score was associated with disease severity and long-term survival (P = 4.66 × 10-6) in PAH. MR detected an association between SMAD5 levels and PAH disease susceptibility (odds ratio, 0.317; 95% confidence interval, 0.129-0.776; P = 0.012).Conclusions: A whole-blood RNA signature of PAH, which includes RNAs relevant to disease pathogenesis, associates with disease severity and identifies patients with poor clinical outcomes. Genetic variants associated with lower SMAD5 expression may increase susceptibility to PAH.
Endoscopic management of gastrointestinal motility disorders – part 2: European Society of Gastrointestinal Endoscopy (ESGE) Guideline
Authors: Bas L. A. M. Weusten, Maximilien Barret, Albert J. Bredenoord, Pietro Familiari, Jean-Michel Gonzalez, Jeanin E. van Hooft, Vicente Lorenzo-Zúñiga, Hubert Louis, Jan Martinek, Suzanne van Meer, Helmut Neumann, Daniel Pohl, Frederic Prat, Daniel von Renteln, Edoardo Savarino, Rami Sweis, Jan Tack, Radu Tutuian, Sauid Ishaq
Journal: Endoscopy (2020)

Main Recommendations ESGE suggests flexible endoscopic treatment over open surgical treatment as first-line therapy for patients with a symptomatic Zenker’s diverticulum of any size. Weak recommendation, low quality of evidence, level of agreement 100 %. ESGE recommends that emerging treatments for Zenker’s diverticulum, such as Zenker’s peroral endoscopic myotomy (Z-POEM) and tunneling, be considered as experimental; these treatments should be offered in a research setting only. Strong recommendation, low quality of evidence, level of agreement 100 %. ESGE recommends against the widespread clinical use of transoral incisionless fundoplication (TIF) as an alternative to proton pump inhibitor (PPI) therapy or antireflux surgery in the treatment of gastroesophageal reflux disease (GERD), because of the lack of data on the long-term outcomes, the inferiority of TIF to fundoplication, and its modest efficacy in only highly selected patients. TIF may have a role for patients with mild GERD who are not willing to take PPIs or undergo antireflux surgery. Strong recommendation, moderate quality of evidence, level of agreement 92.8 %. ESGE recommends against the use of the Medigus ultrasonic surgical endostapler (MUSE) in clinical practice because of insufficient data showing its effectiveness and safety in patients with GERD. MUSE should be used in clinical trials only. Strong recommendation, low quality evidence, level of agreement 100 %. ESGE recommends against the use of antireflux mucosectomy (ARMS) in routine clinical practice in the treatment of GERD because of the lack of data and its potential complications. Strong recommendation, low quality evidence, level of agreement 100 %. ESGE recommends endoscopic cecostomy only after conservative management with medical therapies or retrograde lavage has failed. Strong recommendation, low quality evidence, level of agreement 93.3 %. ESGE recommends fixing the cecum to the abdominal wall at three points (using T-anchors, a double-needle suturing device, or laparoscopic fixation) to prevent leaks and infectious adverse events, whatever percutaneous endoscopic cecostomy method is used. Strong recommendation, very low quality evidence, level of agreement 86.7 %. ESGE recommends considering endoscopic decompression of the colon in patients with Ogilvie’s syndrome that is not improving with conservative treatment. Strong recommendation, low quality evidence, level of agreement 93.8 %. ESGE recommends prompt endoscopic decompression if the cecal diameter is &gt; 12 cm and if the Ogilvie’s syndrome exists for a duration of longer than 4 – 6 days. Strong recommendation, low quality evidence, level of agreement 87.5 %.
Strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies
Authors: Erik von Elm, Douglas G Altman, Matthias Egger, Stuart J Pocock, Peter C Gøtzsche, Jan P Vandenbroucke
Journal: BMJ (2007)

Poor reporting of research hampers assessment and makes it less useful. An international group of methodologists, researchers, and journal editors sets out guidelines to improve reports of observational studies
Oral cobalamin for pernicious anemia. Medicine's best kept secret?
Authors: F. A. Lederle
Journal: JAMA (1991)

THE TREATMENT of pernicious anemia with cobalamin is one of medicine's great success stories. However, the usual practice of giving the drug as an intramuscular injection has several drawbacks. Injections can be painful, difficult to provide for some patients who are elderly or living alone, 1 and costly if given by health professionals. 2 It is therefore not surprising that the search for an oral preparation began soon after cobalamin was isolated and introduced for parenteral use in 1948. Preparations containing oral intrinsic factor were tried, but antibody production caused some patients to become refractory and relapse. 3 Other studies revealed that a small but constant proportion of an oral dose of cyanocobalamin was absorbed without intrinsic factor, so that by sufficiently increasing the dose, adequate absorption could be attained. 4,5   Promising results from early studies of oral cyanocobalamin therapy led to the use of increasingly larger doses, and several
SAT0257 Some data about the hospital care and disability rate of ra in hungary
Authors: P Géher, G Héjj, L Kincses
Journal: Annals of the Rheumatic Diseases (2001)

<h3>Background</h3> Based upon population studies the prevalence of RA in Hungary is 1.01% among the adult population. (The estimated number of RA cases is 84,455.) RA is characterised by early disability and frequent hospitalisation. Health related quality of life of RA patients can be improved significantly with joint surgery. <h3>Objectives</h3> To describe the annual number of hospitalisation due to RA, the annual number of large joint surgery performed among RA patients, the number of new case of RA with permanent disability. <h3>Methods</h3> From the national hospital database all cases with the main diagnosis of RA (ICD code group M05 and M06) were selected for analysis. Multiple hospitalisation of the same patients were excluded. The number of disability pension for RA was drawn from the annual report of the National Institute for Medical Experts. <h3>Results</h3> There were 2,556,338 hospitalisation in Hungary in 1999. In 5,243 cases (0.2%) RA was the main diagnosis. This represents the 6.2% of all RA patients, calculated on the epidemiological data. In this year 7,106 total hip replacement and 2,539 knee replacement were performed, among them there were 75 cases of hip, and 78 cases of knee surgery in RA. Reconstructive surgery represents 2,9% of the total hospitalisation with RA. There were 3,667 new disability claimants with locomotor diseases (with any of the "M" ICD code) which is 10.6% of the total new pensionist. RA was the leading cause of disability in 231 (6.2%) cases. <h3>Conclusion</h3> Our hospitalisation data with RA are conflicting with the estimated total number of RA patients. Surgery (as measured by the number of large joint reconstuctive surgery) represents only a small proportion as an indication for hospitalisation with RA.
Science Has Not Proven That Screen Use Impacts Children's Brain Development
Authors: Martin L. Pall
Journal: JAMA Pediatrics (2020)

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
Mannose-sensitive receptors mediate the uptake of factor VIII therapeutics by human dendritic cells Reply
Authors: Eszter Herczenik, Simon D. van Haren, Aleksandra Wroblewska, Paul Kaijen, Maartje van den Biggelaar, Alexander B. Meijer, Anja ten Brinke, Jan Voorberg
Journal: Journal of Allergy and Clinical Immunology (2012)
PTH-064 Anatomical features of the ileocaecal junction and their implications for proof of colonoscopy completion
Authors: Ruth Townend, Amanda Choo, Eunice Wong, Cecilia Brassett, Jonathan Brown
Journal: Endoscopy (2018)

<h3>Introduction</h3> A completion rate for colonoscopy in excess of 90% is a Joint Advisory Group quality assurance standard; although images of the appendix orifice, tri-radiate fold and ileo-caecal junction (ICJ) are conventional markers for this, numerous studies have shown a lack of specificity confounded by variations in human anatomy. Terminal ileal intubation, with images of villiform mucosa, provides irrefutable evidence of completion but cannot always be achieved. We aimed to study the anatomy of the ICJ to determine the factors that may be relevant to documentation of proof of completion. <h3>Methods</h3> The features of 69 embalmed cadaveric ICJ specimens were assessed, including gross morphology and the ileocaecal angle. In addition, 100 consecutive colonoscopy videos performed by a single Bowel Cancer Screening colonoscopist showing ileal intubation were reviewed to determine ICJ morphology, time taken for ileal intubation and difficulties encountered. <h3>Results</h3> The morphology of all cadaveric ICJs was categorised, with all except 2 being labial or papillary in type. The average angle of ileal entry into the caecum was 106 degrees (range 59–180). Both major ICJ types had on average a greater distance from the posterior caecal wall to the tip of the top lip compared to the distance to the lower lip, giving the ICJ an inferior tilt. In nearly half of the labial-type valves, the top lip overhung the bottom lip. On average, labial-type valves had thinner lips and a narrower vertical opening than papillary-type valves. These features could render a labial-type valve more difficult to visualise and intubate at colonoscopy. In the colonoscopy videos, over a third of ICJs could not be fully visualised or categorised, with these having a lower rate of initial successful intubation than categorised valves. The median time taken for intubation was shorter for papillary compared to labial-type valves. Ileal intubation was faster in categorised valves when the appendix was visualised. It was also achieved more quickly in patients who were given buscopan pre-procedure. <h3>Conclusions</h3> Appreciating the anatomical features of the ICJ should assist endoscopists to approach ICJs which can be difficult to navigate. Administering buscopan as pre-medication and visualising the appendix prior to attempting ileal intubation have both been shown to decrease the time taken for successful intubation.
Diabetic Autonomic Neuropathy
Authors: P.J. Watkins
Journal: New England Journal of Medicine (1990)

Diabetes commonly causes widespread damage to the peripheral nervous system, involving chiefly the somatic sensory and autonomic nervous systems, although in individual patients the involvement of one system or the other may predominate. Small nerve fibers are probably the first to be affected, leading to early impairment of the sensations of pain and temperature, accompanied by a decline in autonomic function. Measurable autonomic defects are extremely common in diabetes, affecting possibly as many as one sixth of all patients.1 For unexplained reasons, symptoms of autonomic dysfunction develop in only a few, and fortunately they are only rarely devastating.Quantitative bedside . . .
Endoscopic rendezvous recanalization for complete anastomotic obstruction after retrosternal coloplasty: a novel approach through a cervicotomy
Authors: Michael Baboudjian, Mathieu Rouy, Mohamed Gasmi, Abel Tadrist, Pascal Thomas, Marc Barthet, Xavier Benoît D’Journo
Journal: Endoscopy (2020)

A healthy 19-year-old woman previously underwent a bipolar esophageal exclusion and total gastrectomy following caustic ingestion. After 13 months, she underwent an esophageal replacement by retrosternal left colonic interposition. She subsequently developed complete obstruction of the pharyngocolonic anastomosis. Because blinded antegrade reopening of the mucosa was considered too hazardous, we considered performing a combined antegrade–retrograde endoscopic rendezvous recanalization. Owing to the prior gastrectomy and because of the retrosternal route of the coloplasty, a left cervicotomy was considered to be the best choice for the retrograde access below the anastomosis.
CHROMOSOMAL REARRANGEMENTS IN PATIENTS WITH CONGENITAL CARDIAC DEFECTS: A META-ANALYSIS REVEALS NOVEL POTENTIAL CRITICAL REGIONS INVOLVED IN HEART DEVELOPMENT
Authors: Thor Thorsson, S. Sow, J. Levine, WW Russell, N. El-Kashlam, Jeffrey Innis, S. Zoellner, Mark Russell
Journal: Journal of the American College of Cardiology (2013)
Long-range cis-regulatory elements controlling GDF6 expression are essential for ear development
Authors: Guney Bademci, Clemer Abad, Filiz B. Cengiz, Serhat Seyhan, Armagan Incesulu, Shengru Guo, Suat Fitoz, Emine Ikbal Atli, Nicholas C. Gosstola, Selma Demir, Brett M. Colbert, Gozde Cosar Seyhan, Claire J. Sineni, Duygu Duman, Hakan Gurkan, Cynthia C. Morton, Derek M. Dykxhoorn, Katherina Walz, Mustafa Tekin
Journal: Journal of Clinical Investigation (2020)

Molecular mechanisms governing the development of the mammalian cochlea, the hearing organ, remain largely unknown. Through genome sequencing in 3 subjects from 2 families with nonsyndromic cochlear aplasia, we identified homozygous 221-kb and 338-kb deletions in a noncoding region on chromosome 8 with an approximately 200-kb overlapping section. Genomic location of the overlapping deleted region started from approximately 350 kb downstream of GDF6, which codes for growth and differentiation factor 6. Otic lineage cells differentiated from induced pluripotent stem cells derived from an affected individual showed reduced expression of GDF6 compared with control cells. Knockout of Gdf6 in a mouse model resulted in cochlear aplasia, closely resembling the human phenotype. We conclude that GDF6 plays a necessary role in early cochlear development controlled by cis-regulatory elements located within an approximately 500-kb region of the genome in humans and that its disruption leads to deafness due to cochlear aplasia.