tbuckley/cabot-search huggingface dataset:
In patients with stroke or TIA and CYP2C19 loss-of-function alleles, ticagrelor vs. clopidogrel reduced 90-d stroke
Authors: Raed A. Joundi
Journal: Annals of Internal Medicine (2022)

ACP Journal ClubMarch 2022In patients with stroke or TIA and CYP2C19 loss-of-function alleles, ticagrelor vs. clopidogrel reduced 90-d strokeRaed A. Joundi, MD, DPhilRaed A. Joundi, MD, DPhilMcMaster University, Hamilton, Ontario, Canada (R.J.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/J22-0008 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationWang Y, Meng X, Wang A, et al. Ticagrelor versus clopidogrel in CYP2C19 loss-of-function carriers with stroke or TIA. N Engl J Med. 2021;385:2520-30. https://pubmed.ncbi.nlm.nih.gov/34708996Clinical Impact RatingsNeurology: References1. Wang Y, Wang Y, Zhao X, et al. Clopidogrel with aspirin in acute minor stroke or transient ischemic attack. N Engl J Med. 2013;369:11-9. [PMID: 23803136] Google Scholar2. Johnston SC, Easton JD, Farrant M, et al. Clopidogrel and aspirin in acute ischemic stroke and high-risk TIA. N Engl J Med. 2018;379:215-25. [PMID: 29766750] Google Scholar3. Johnston SC, Amarenco P, Denison H, et al. Ticagrelor and aspirin or aspirin alone in acute ischemic stroke or TIA. N Engl J Med. 2020;383:207-17. [PMID: 32668111] Google Scholar4. Wang Y, Zhao X, Lin J, et al. Association between CYP2C19 loss-of-function allele status and efficacy of clopidogrel for risk reduction among patients with minor stroke or transient ischemic attack. JAMA. 2016;316:70-8. [PMID: 27348249] Google Scholar5. Pereira NL, Farkouh ME, So D, et al. Effect of genotype-guided oral P2Y12 inhibitor selection vs conventional clopidogrel therapy on ischemic outcomes after percutaneous coronary intervention: the TAILOR-PCI randomized clinical trial. JAMA. 2020;324:761-71. [PMID: 32840598] Google Scholar Author, Article, and Disclosure InformationAffiliations: McMaster University, Hamilton, Ontario, Canada (R.J.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=J22-0008.This article was published at Annals.org on 1 March 2022. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics March 2022Volume 175, Issue 3Page: JC30KeywordsAllelesAntiplatelet therapyAspirinDisclosureGenotypingHemorrhageIschemic strokeStrokeTissue plasminogen activatorTransient ischemic attacks ePublished: 1 March 2022 Issue Published: March 2022 Copyright & PermissionsCopyright © 2022 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Cutaneous mycobacteriosis.
Authors: N W Horne
Journal: BMJ (1981)

A dementing illness changes the carers as well.They have to come to terms with the effects of the illness and learn to accept deteriorating standards and to take risks.Setting the house on fire, wandering in the street and being run over, and dying when lost in the park are all recognised risks and therefore genuine worries.The major task of the new breed of psychiatrists in caring for patients with dementia will thus be in family and neighbourhood therapy.What they must, however, ensure is that in defending the line of diminishing institutional resources they do not push people too far.The ultimate protest of someone who cannot cope any longer is murder.Many of our present services give priority to the elderly who live alone; in reality those who live with others may cause the greatest stress.In developing a policy of home care for the demented we mrust care for the carers.The staff in residential care and in long-stay hospitals will also require training and support.The college report is timely; it should be essential reading for all, for all must realise that a policy of coping with demented people at home implies that at times of illness the families will not be able to cope and will inevitably turn to us for help.Let us hope that such help will not be denied.
BODY WEIGHT CHANGE IN HYPERCOLESTROLEMIC RATS MODEL AFTER INTERVENTION WITH AVOCADO (Persea americana Mill) JUICE
Authors: Muhammad Luthfi Adnan, Raihan Lucky Buana, Dimas Agus Cholili, Hilmi Ardian Sudarto, Amalia Adityas Dyah Safitri, Tiar Ramadhan, Miranti Dewi Pramaningtyas
Journal: Metabolism (2022)
Is Noise The Bane Of Life?
Journal: JAMA (1964)

" Not ot bacteria, not viruses—but control of personal physical environment is the medical frontier of today," Lee E. Farr, MD of Houston, Texas, told physicians attending the AMA Clinical Meeting in Portland, Oregon last December. He specifically cited "everyday noise" (ie, noise encountered in the home and in ordinary transit) as "among the unadvertised contributors to the detriment of man's environment." Farr suggested that a new type of medical specialist—the personal environment physician—might be needed. "Individual control of a person's immediate environment to promote health and well-being or to avoid or mitigate illness, must be recognized as the physician's responsibility and prerogative and not an area of specific exercise of community police powers or extension of community health services." As early as 1938, investigators had expressed the opinion that "noise deafness constitutes the most serious and tangible of the ill noise effects ( echeoses), but there is in addition a host
Association of ICU Admission and Outcomes in Sepsis and Acute Respiratory Failure
Authors: George L. Anesi, Vincent X. Liu, Marzana Chowdhury, Dylan S. Small, Wei Wang, M. Kit Delgado, Brian Bayes, Erich Dress, Gabriel J. Escobar, Scott D. Halpern
Journal: American Journal of Respiratory and Critical Care Medicine (2021)

Rationale: Many decisions to admit patients to the ICU are not grounded in evidence regarding who benefits from such triage, straining ICU capacity and limiting its cost-effectiveness. Objectives: To measure the benefits of ICU admission for patients with sepsis or acute respiratory failure. Methods: At 27 United States hospitals across two health systems from 2013 to 2018, we performed a retrospective cohort study using two-stage instrumental variable quantile regression with a strong instrument (hospital capacity strain) governing ICU versus ward admission among high-acuity patients (i.e., laboratory-based acute physiology score v2 ⩾ 100) with sepsis and/or acute respiratory failure who did not require mechanical ventilation or vasopressors in the emergency department. Measurements and Main Results: Among patients with sepsis (n = 90,150), admission to the ICU was associated with a 1.32-day longer hospital length of stay (95% confidence interval [CI], 1.01-1.63; P < 0.001) (when treating deaths as equivalent to long lengths of stay) and higher in-hospital mortality (odds ratio, 1.48; 95% CI, 1.13-1.88; P = 0.004). Among patients with respiratory failure (n = 45,339), admission to the ICU was associated with a 0.82-day shorter hospital length of stay (95% CI, -1.17 to -0.46; P < 0.001) and reduced in-hospital mortality (odds ratio, 0.75; 95% CI, 0.57-0.96; P = 0.04). In sensitivity analyses of length of stay, excluding, ignoring, or censoring death, results were similar in sepsis but not in respiratory failure. In subgroup analyses, harms of ICU admission for patients with sepsis were concentrated among older patients and those with fewer comorbidities, and the benefits of ICU admission for patients with respiratory failure were concentrated among older patients, highest-acuity patients, and those with more comorbidities. Conclusions: Among high-acuity patients with sepsis who did not require life support in the emergency department, initial admission to the ward, compared with the ICU, was associated with shorter length of stay and improved survival, whereas among patients with acute respiratory failure, triage to the ICU compared with the ward was associated with improved survival.
Epidemic keratoconjuctivitis.
Authors: N R Grist, D Reed, E J Bell, J R Ellis
Journal: BMJ (1973)

Epidemic Keratoconjuctivitis SIR,-We are interested to read the account by Dr. D. L. Barnard and others (21 April, p. 165) of the outbreak in Bristol of keratoconjunctivitis caused by adenovirus type 8. Similar outbreaks occurred in the Clyde valley in 1956, 1967, and 1971.1-3Because of the importance of this disease as a cause of disability and occasional reduction in visual acuity, an attempt has been made to accumulate data in the Glasgow area during the interepidemic periods to determine whether the virus smouldered inconspicuously among industrial populations or among patients attending ophthalmic clinics or whether, as in Japan,4 the reservoir of infection was in children in whom the disease was unremarkable.To try and solve this problem virological surveillance of a sample of patients attending ophthalmic clinics with conjunctivitis and keratoconjunctivitis has been continued in Glasgow since the 1967 episode subsided.However, from over 1,000 conjunctival scrapings examined, only five isolations of adenovirus type 8 were found in 1968-they were obtained from members of a typical industrial group5-and no further isolations were made until the latest outbreak in 1971.Thus this continued six-year virus surveil- lance provides no clue as to the whereaibouts of adenovirus type 8 during the inter- epidemic period, but is compatible with the virus being periodically imported from other areas or countries-for example, by seamen, transport drivers, or other travellers.During the 1971 outbreak, in contrast to the findings in Bristol, there was very little family spread in Glasgow.In a survey of 584 family contacts of the 200 patients in- volved secondary spread occurred in only 14 contacts.It is likely that this was due to the strong propaganda measures (for example, to use separate towels, etc.) which were instituted at the start of the outbreak.It may be added that, though it should have been detectable by our methods, we encountered no case of picornaviral acute haemorrhagic conjunctivitis.6-Weare, etc.,
An array of mitochondrial alterations in the hepatocytes of Long-Evans Cinnamon rats*1
Authors: I STERNLIEB
Journal: Hepatology (1995)

In an attempt to identify the cellular targets of copper toxicity, we studied the ultrastructure of hepatocytes in the livers of 23 Long-Evans Cinnamon (LEC) rats ranging in age from 10 to 89 weeks. The hepatic copper concentration ranged from 325 to 2,126 (mean, 930) μg/g dry weight. Thirteen rats displayed varying degrees of jaundice at the time of killing. Numerous nuclei were indented by cytoplasmic invaginations. Conspicuous abnormalities were displayed by mitochondria. These included marked pleomorphism; increased or diminished matrical density, rearrangement, elongation, dilatation, stacking, or disappearance of cristae; absence of matrical granules; presence of matrical inclusions of flocculent electron-dense deposits; and degenerative changes. The severity of the ultrastructural changes did not correlate with the hepatic copper concentration but did correlate with the degree of the icterus displayed by the rats. Certain mitochondrial changes resembled those encountered in the hepatocytes of patients with Wilson's disease, confirming that these organelles are important targets of copper toxicity.
Living with multiple sclerosis.
Journal: BMJ (1978)

impairing absorption and causing protein loss from necrosis and ulceration.With so many factors that may contribute to the pathogenesis of cachexia in the individual patient their relative importance may be difficult to determine.The presence of nutritional depletion may be detected very simply: a recent loss of 1000 of total body weight, a serum albumin concentration of less than 34 g/l, and a negative reaction to a battery of skin test antigens.Patients depleted on the basis of those criteria require aggressive nutritional repletion (through the gut or by in- fusion) with the aim of preventing death from debility or infection, reducing the incidence of wound dehiscence, enhancing the immune response, and extending the limits of tolerance of cancer treatment.
Medizinische Klinik, Munich
Journal: JAMA (1964)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Epithelial RAC1-dependent cytoskeleton dynamics controls cell mechanics, cell shedding and barrier integrity in intestinal inflammation
Authors: Luz del Carmen Martínez-Sánchez, Phuong Anh Ngo, Rashmita Pradhan, Lukas-Sebastian Becker, David Boehringer, Despina Soteriou, Marketa Kubankova, Christine Schweitzer, Tatyana Koch, Veronika Thonn, Lena Erkert, Iris Stolzer, Claudia Günther, Christoph Becker, Benno Weigmann, Monika Klewer, Christoph Daniel, Kerstin Amann, Stefan Tenzer, Raja Atreya, Martin Bergo, Cord Brakebusch, Alastair J M Watson, Jochen Guck, Ben Fabry, Imke Atreya, Markus F Neurath, Rocío López-Posadas
Journal: Gut (2022)

Increased apoptotic shedding has been linked to intestinal barrier dysfunction and development of inflammatory bowel diseases (IBD). In contrast, physiological cell shedding allows the renewal of the epithelial monolayer without compromising the barrier function. Here, we investigated the role of live cell extrusion in epithelial barrier alterations in IBD.Taking advantage of conditional GGTase and RAC1 knockout mice in intestinal epithelial cells (Pggt1biΔIEC and Rac1iΔIEC mice), intravital microscopy, immunostaining, mechanobiology, organoid techniques and RNA sequencing, we analysed cell shedding alterations within the intestinal epithelium. Moreover, we examined human gut tissue and intestinal organoids from patients with IBD for cell shedding alterations and RAC1 function.Epithelial Pggt1b deletion led to cytoskeleton rearrangement and tight junction redistribution, causing cell overcrowding due to arresting of cell shedding that finally resulted in epithelial leakage and spontaneous mucosal inflammation in the small and to a lesser extent in the large intestine. Both in vivo and in vitro studies (knockout mice, organoids) identified RAC1 as a GGTase target critically involved in prenylation-dependent cytoskeleton dynamics, cell mechanics and epithelial cell shedding. Moreover, inflamed areas of gut tissue from patients with IBD exhibited funnel-like structures, signs of arrested cell shedding and impaired RAC1 function. RAC1 inhibition in human intestinal organoids caused actin alterations compatible with arresting of cell shedding.Impaired epithelial RAC1 function causes cell overcrowding and epithelial leakage thus inducing chronic intestinal inflammation. Epithelial RAC1 emerges as key regulator of cytoskeletal dynamics, cell mechanics and intestinal cell shedding. Modulation of RAC1 might be exploited for restoration of epithelial integrity in the gut of patients with IBD.
Perinatal practice and compensation for handicap.
Authors: David Baum
Journal: BMJ (1980)

preservation of antimicrobial factors (other than milk cells) approaching 100%.There is no simple correct way of running a human milk bank.However, great caution should be exercised in recommending the wholesale adoption of a policy of using raw bacteriologically unmonitored human milk for sick low-birthweight infants, especially in hospitals which have had little or no previous experience of human milk banking.I believe that, apart from the use of fresh milk from an individual mother for her own baby, it is safer to opt for a simple system based on precise pasteurisation,2 which can be relied on to provide bacteriologically clean milk with the majority of its bacteriostatic properties intact.
PRACTICAL NOTES.
Journal: JAMA (1896)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Understanding the Potential Promise and Pitfalls of Intravenous Gentamicin as a Therapy for Epidermolysis Bullosa
Authors: Maria C. Bolling, Cristina Has, Anna L. Bruckner
Journal: JAMA Dermatology (2022)

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 Dermatology 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 Dermatology journal
Thalidomide Revisited
Journal: JAMA (1979)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Disparities in COVID-19 Vaccination Coverage Between Urban and Rural Counties — United States, December 14, 2020–January 31, 2022
Authors: Ryan Saelee, Elizabeth Zell, Bhavini Patel Murthy, Patricia Castro-Roman, Hannah Fast, Lu Meng, Lauren Shaw, Lynn Gibbs-Scharf, Terence Chorba, LaTreace Q. Harris, Neil Murthy
Journal: MMWR Morbidity and Mortality Weekly Report (2022)

Higher COVID-19 incidence and mortality rates in rural than in urban areas are well documented (1). These disparities persisted during the B.1.617.2 (Delta) and B.1.1.529 (Omicron) variant surges during late 2021 and early 2022 (1,2). Rural populations tend to be older (aged ≥65 years) and uninsured and are more likely to have underlying medical conditions and live farther from facilities that provide tertiary medical care, placing them at higher risk for adverse COVID-19 outcomes (2). To better understand COVID-19 vaccination disparities between urban and rural populations, CDC analyzed county-level vaccine administration data among persons aged ≥5 years who received their first dose of either the BNT162b2 (Pfizer-BioNTech) or mRNA-1273 (Moderna) COVID-19 vaccine or a single dose of the Ad.26.COV2.S (Janssen [Johnson & Johnson]) COVID-19 vaccine during December 14, 2020-January 31, 2022, in 50 states and the District of Columbia (DC). COVID-19 vaccination coverage with ≥1 doses in rural areas (58.5%) was lower than that in urban counties (75.4%) overall, with similar patterns across age groups and sex. Coverage with ≥1 doses varied among states: 46 states had higher coverage in urban than in rural counties, one had higher coverage in rural than in urban counties. Three states and DC had no rural counties; thus, urban-rural differences could not be assessed. COVID-19 vaccine primary series completion was higher in urban than in rural counties. However, receipt of booster or additional doses among primary series recipients was similarly low between urban and rural counties. Compared with estimates from a previous study of vaccine coverage among adults aged ≥18 years during December 14, 2020-April 10, 2021, these urban-rural disparities among those now eligible for vaccination (aged ≥5 years) have increased more than twofold through January 2022, despite increased availability and access to COVID-19 vaccines. Addressing barriers to vaccination in rural areas is critical to achieving vaccine equity, reducing disparities, and decreasing COVID-19-related illness and death in the United States (2).