tbuckley/cabot-search huggingface dataset:
Variations in risks from smoking between high-income, middle-income, and low-income countries: an analysis of data from 179 000 participants from 63 countries
Authors: Thirunavukkarasu Sathish, Koon K Teo, Philip Britz-McKibbin, Biban Gill, Shofiqul Islam, Guillaume Paré, Sumathy Rangarajan, MyLinh Duong, Fernando Lanas, Patricio Lopez-Jaramillo, Prem K Mony, Lakshmi Pinnaka, Vellappillil Raman Kutty, Andres Orlandini, Alvaro Avezum, Andreas Wielgosz, Paul Poirier, Khalid F Alhabib, Ahmet Temizhan, Jephat Chifamba, Karen Yeates, Iolanthé M Kruger, Rasha Khatib, Rita Yusuf, Annika Rosengren, Katarzyna Zatonska, Romaina Iqbal, Weida Lui, Xinyue Lang, Sidong Li, Bo Hu, Antonio L Dans, Afzal Hussein Yusufali, Ahmad Bahonar, Martin J O’Donnell, Martin McKee, Salim Yusuf
Journal: The Lancet Global Health (2022)

Separate studies suggest that the risks from smoking might vary between high-income (HICs), middle-income (MICs), and low-income (LICs) countries, but this has not yet been systematically examined within a single study using standardised approaches. We examined the variations in risks from smoking across different country income groups and some of their potential reasons.We analysed data from 134 909 participants from 21 countries followed up for a median of 11·3 years in the Prospective Urban Rural Epidemiology (PURE) cohort study; 9711 participants with myocardial infarction and 11 362 controls from 52 countries in the INTERHEART case-control study; and 11 580 participants with stroke and 11 331 controls from 32 countries in the INTERSTROKE case-control study. In PURE, all-cause mortality, major cardiovascular disease, cancers, respiratory diseases, and their composite were the primary outcomes for this analysis. Biochemical verification of urinary total nicotine equivalent was done in a substudy of 1000 participants in PURE.In PURE, the adjusted hazard ratio (HR) for the composite outcome in current smokers (vs never smokers) was higher in HICs (HR 1·87, 95% CI 1·65-2·12) than in MICs (1·41, 1·34-1·49) and LICs (1·35, 1·25-1·46; interaction p<0·0001). Similar patterns were observed for each component of the composite outcome in PURE, myocardial infarction in INTERHEART, and stroke in INTERSTROKE. The median levels of tar, nicotine, and carbon monoxide displayed on the cigarette packs from PURE HICs were higher than those on the packs from MICs. In PURE, the proportion of never smokers reporting high second-hand smoke exposure (≥1 times/day) was 6·3% in HICs, 23·2% in MICs, and 14·0% in LICs. The adjusted geometric mean total nicotine equivalent was higher among current smokers in HICs (47·2 μM) than in MICs (31·1 μM) and LICs (25·2 μM; ANCOVA p<0·0001). By contrast, it was higher among never smokers in LICs (18·8 μM) and MICs (11·3 μM) than in HICs (5·0 μM; ANCOVA p=0·0001).The variations in risks from smoking between country income groups are probably related to the higher exposure of tobacco-derived toxicants among smokers in HICs and higher rates of high second-hand smoke exposure among never smokers in MICs and LICs.Full funding sources are listed at the end of the paper (see Acknowledgments).
Primum non placere?
Authors: S. Vaisrub
Journal: JAMA (1979)

Defined in<i>Butterworth's Medical Dictionary</i>as "a pharmaceutically inactive substance administered as a drug either to satisfy a patient's desire for medication or in the course of a drug trial," the placebo (Latin, "I will please") is currently under attack (<i>Scientific American</i>231:17-23, 1974). With its sharp edge blunted by informed consent regulations, the placebo has lost much of its effectiveness in controlled drug trials, and with increasing demands for patient participation in medical decisions, it is about to lose its long-held respectable place in therapy. A victim of consumerism, the placebo is in a precarious state. Transcending the dictionary definition of placebo as a nonentity masquerading as a drug is the broader concept of placebo effect, which extends beyond drug prescribing to laying on of hands, incantations, senseless surgical procedures, and innumerable other modes of therapy practiced through the ages. In fact, most therapy has and will have derived
Dispensing Drugs
Authors: Sidney H. Willig
Journal: JAMA (1961)

<h3>To the Editor:—</h3> With regard to the Question and Answer captioned, "Dispensing Drugs" (<i>JAMA</i><b>174</b>:1357 [Nov. 5] 1960), it would seem relevant and important that the questioner be advised that, in addition toThe Journal'sethical consideration of office dispensing of drugs, certain legal qualifications exist. These various legal considerations are interpretive of state and local regulations, as well as of universally applicable federal requirements. Similarly, the nature of the drug dispensed not only may pose extralegal restrictions on the physician, but also may color any ethical considerations. In New York State, for example, an M.D. is required by law when dispensing barbiturates, or any other hypnotic or somnifacient drugs, to record the date of dispensing, name of the drug, amount dispensed, and name and address of the patient. Likewise, physicians are required to place a label on the container stating their name and address, the name and address
6. Asthma
Authors: Robert F. Lemanske, William W. Busse
Journal: Journal of Allergy and Clinical Immunology (2003)

The increasing incidence and prevalence of asthma in many parts of the world continue to make it a global health concern. The heterogeneous nature of the clinical manifestations and therapeutic responses of asthma in both adult and pediatric patients indicate that it may be more of a syndrome rather than a specific disease entity. Numerous triggering factors including viral infections, allergen and irritant exposure, and exercise, among others, complicate both the acute and chronic treatment of asthma. Therapeutic intervention has focused on the appreciation that airway obstruction in asthma is composed of both bronchial smooth muscle spasm and variable degrees of airway inflammation characterized by edema, mucus secretion, and the influx of a variety of inflammatory cells. The presence of only partial reversibility of airflow obstruction in some patients indicates that structural remodeling of the airways may also occur over time. Choosing appropriate medications depends on the disease severity (intermittent, mild persistent, moderate persistent, severe persistent), extent of reversibility, both acutely and chronically, patterns of disease activity (exacerbations related to viruses, allergens, exercise, etc), and the age of onset (infancy, childhood, adulthood).
Eltrombopag Added to Immunosuppression in Severe Aplastic Anemia
Authors: Régis Peffault de Latour, Austin Kulasekararaj, Simona Iacobelli, Sofie R. Terwel, Riley Cook, Morag Griffin, Constantijn J.M. Halkes, Christian Recher, Fiorenza Barraco, Edouard Forcade, Juan-Carlos Vallejo, Beatrice Drexler, Jean-Baptiste Mear, Alexander E. Smith, Emanuele Angelucci, Reinier A.P. Raymakers, Marco R. de Groot, Etienne Daguindau, Erfan Nur, Wilma Barcellini, Nigel H. Russell, Louis Terriou, Anna-Paola Iori, Ursula La Rocca, Anna Sureda, Isabel Sánchez-Ortega, Blanca Xicoy, Isidro Jarque, James Cavenagh, Flore Sicre de Fontbrune, Serena Marotta, Talha Munir, Jennifer M.L. Tjon, Suzanne Tavitian, Aline Praire, Laurence Clement, Florence Rabian, Luana Marano, Anita Hill, Elena Palmisani, Petra Muus, Fabiana Cacace, Camilla Frieri, Maria-Teresa van Lint, Jakob R. Passweg, Judith C.W. Marsh, Gérard Socié, Ghulam J. Mufti, Carlo Dufour, Antonio M. Risitano
Journal: New England Journal of Medicine (2022)

A single-group, phase 1-2 study indicated that eltrombopag improved the efficacy of standard immunosuppressive therapy that entailed horse antithymocyte globulin (ATG) plus cyclosporine in patients with severe aplastic anemia.In this prospective, investigator-led, open-label, multicenter, randomized, phase 3 trial, we compared the efficacy and safety of horse ATG plus cyclosporine with or without eltrombopag as front-line therapy in previously untreated patients with severe aplastic anemia. The primary end point was a hematologic complete response at 3 months.Patients were assigned to receive immunosuppressive therapy (Group A, 101 patients) or immunosuppressive therapy plus eltrombopag (Group B, 96 patients). The percentage of patients who had a complete response at 3 months was 10% in Group A and 22% in Group B (odds ratio, 3.2; 95% confidence interval [CI], 1.3 to 7.8; P = 0.01). At 6 months, the overall response rate (the percentage of patients who had a complete or partial response) was 41% in Group A and 68% in Group B. The median times to the first response were 8.8 months (Group A) and 3.0 months (Group B). The incidence of severe adverse events was similar in the two groups. With a median follow-up of 24 months, a karyotypic abnormality that was classified as myelodysplastic syndrome developed in 1 patient (Group A) and 2 patients (Group B); event-free survival was 34% and 46%, respectively. Somatic mutations were detected in 29% (Group A) and 31% (Group Β) of the patients at baseline; these percentages increased to 66% and 55%, respectively, at 6 months, without affecting the hematologic response and 2-year outcome.The addition of eltrombopag to standard immunosuppressive therapy improved the rate, rapidity, and strength of hematologic response among previously untreated patients with severe aplastic anemia, without additional toxic effects. (Funded by Novartis and others; RACE ClinicalTrials.gov number, NCT02099747; EudraCT number, 2014-000363-40.).
Effects of acute hormone therapy on recurrent ischemia in postmenopausal women with unstable angina Steven P. Schulman, David R. Thiemann, Pamela Ouyang, Nisha C. Chandra, Douglas S. Schulman, Steven E. Reis, Michael Terrin, Susan N. Townsend, Sandra Forman, Gary Gerstenblith. Johns Hopkisn Medical Institutions, Baltimore, MD, Maryland Medical Research Institute, Baltimore, MD
Journal: Journal of the American College of Cardiology (2001)
Is cancer irreversible?
Journal: BMJ (1978)

Is cancer irreversible?Evidence that cancer can remain latent goes back to the 1930s, though many clinicians and pathologists remained sceptical.Franks,' who found many "incidental" latent cancers, par- ticularly in the prostate, lung, kidney, and thyroid, described them as true cancers that were not developing or doing any harm.The preneoplastic lobules of the breast found in routine
Prophylaxis against Pneumocystis carinii pneumonia
Authors: S. J. Gabin
Journal: JAMA (1992)

<h3>In Reply.</h3> —Dr Gabin raises several issues that underscore the advantages of decision analysis. Importantly, the US Department of Health and Human Services has announced that results of a randomized controlled trial (AIDS Clinical Trials Group, protocol 021) of secondary prophylaxis for PCP agreed with the results of our decision analysis: TMP/SMZ should be used as first-line prophylaxis in patients able to tolerate and comply with the drug. Aerosolized pentamidine should be reserved for patients who cannot tolerate TMP/ SMZ. The diversity of diseases associated with AIDS makes it impossible to define a month-by-month mortality rate for this population. It is important to note, however, that changes in the AIDS mortality rate would not affect the outcome of the analysis. We agree that estimates of drug efficacy in the literature vary according to the types of patients enrolled, the use of antiviral agents, and the stringency of follow-up. However, as
Efficacy of regorafenib and 5-fluorouracil-based rechallenge treatment in the third-line treatment of metastatic colorectal cancer: A Turkish oncology group study.
Authors: Elif Şenocak Taşçi, Basak Oyan, Ozlem Sonmez, Arda Ulaş Mutlu, Muhammed Mustafa Atcı, Irem Oner, Havva Yesil Cinkir, Melek Karakurt Eryılmaz, Onur Yazdan Balçık, Nail Paksoy, Derya Kivrak Salim, Mirac Özen, Melike Ozcelik, Ali Arican, Ali Inal, Baran Akagunduz, Dinçer Aydın, Leyla Ozer, Nazim Serdar Turhal, Ahmet Gulmez
Journal: Journal of Clinical Oncology (2022)

202 Background: The optimal treatment for metastatic colorectal cancer (mCRC) after the second line is still controversial. Regorafenib (Reg) revealed promising results by improving overall survival compared to best supportive care. However, in real-world practice rechallenge chemotherapy (CTr) is often preferred even though supporting evidence is not enough. We aim to compare the efficacy of regorafenib and 5-fluorouracil-based (5-FU) rechallenge treatment in the third line setting of mCRC. Methods: In this retrospective multi-institutional trial, mCRC patients from 21 centers in Turkey progressing after 2 lines of chemotherapy between 2012-2020 were analyzed. Patients who were treated with Reg or rechallenge therapy in the third-line setting were eligible. Rechallenge chemotherapy was identified as the re-use of the 5-FU based regimen which was administered in one of the previous treatment lines. Overall survival (OS), objective response rate (ORR), progression free survival (PFS) and toxicity were analyzed. Chi-square, Kaplan-Meier method and Cox regression analysis were used for analysis. Results: The clinical data of 441 mCRC patients were analyzed. Of these, 284 received regorafenib while 156 received rechallenge chemotherapy. The mean age was 57 and 56% was male. Median OS since the diagnosis was better with CTr than with Reg (48 months (95% CI, 43.4–52.6) vs. 39 months (95% CI, 35.4–42.5), p&lt;0.001). Median OS after the third-line treatment was 12.0 (95% CI, 9.9–14) and 9.0 months (95% CI, 7.5–10.4) for CTr and Reg groups, respectively (p&lt;0.001). PFS was 6 months for patients receiving CTr and 4 months for those treated with Reg (p = 0.139). ORR was significantly higher in CTr group than Reg (p&lt;0.001). BRAF status, MSI status and treatment type (CTr vs. Reg) are factors found associated with OS in Cox regression analysis (p&lt;0.001, p=0.021 and p&lt;0.001, respectively). Adverse effects were seen in 82% and 68.2% of patients receiving Reg and CTr, respectively. Discontinuation of treatment due to adverse effects was higher in patients treated with Reg (10% vs. 2.5%). Conclusions: Our analysis revealed that rechallenge is an appreciated option, in both efficacy and toxicity, when the limited treatment options for mCRC is considered. Although regorafenib treatment contributes to survival, CTr shows better disease control. Our study has the highest number of patients in the literature. Still, prospective studies are mandatory for validation of CTr in the third-line treatment of mCRC.
COVID-19: a new lens for non-communicable diseases
Authors: None The Lancet
Journal: The Lancet (2020)

On Sept 19, 2011, global leaders met at the UN in New York, USA, to set an international agenda on non-communicable diseases (NCDs), which cause three-quarters of global deaths. This was only the second time in history that the UN General Assembly had met to discuss a health issue (the first was for HIV/AIDS in 2001). In 2015, Sustainable Development Goal 3.4 set the ambitious target for countries to reduce their risk of premature mortality from NCDs by a third relative to 2015 levels by 2030. The Lancet NCD Countdown 2030, published on Sept 3, reveals that, among high-income countries, only Denmark, Luxembourg, New Zealand, Norway, Singapore, and South Korea are on track to meet this target for both men and women if they maintain or surpass their 2010–16 average rates of decline.
Archives of Neurology, Chicago
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
Incidental Uptake of 18F-Fluciclovine by Type AB Thymoma
Authors: Vishal Somnay, Ishani Dalal
Journal: Clinical Nuclear Medicine (2022)

Biochemical recurrence of prostate cancer, detected by a rising PSA, may reflect intraprostatic or extraprostatic recurrence. 18F-Fluciclovine (Axumin), a synthetic amino acid substrate in tumor metabolism, has frequently been used for to localize recurrent prostate cancers. We present a 71-year-old man with biochemical recurrence of prostate cancer but no convincing imaging findings on 18F-fluciclovine PET/CT. Of note, however, was an incidental uptake within the anterior mediastinum, which was found on biopsy to be a type AB thymoma. With this, we stress that awareness of false-positive uptake patterns is crucial for accurate diagnosis of recurrent prostate cancer.
Mapping the human genome raises question: which road to take?
Authors: B. Merz
Journal: JAMA (1987)

MOVE OVER, RAND MCNALLY. Molecular biologists are embarking on a cartographic project that is expected to yield the most important map in history. In the last 18 months, both the Department of Energy (DOE) and the National Institutes of Health have undertaken initiatives directed at mapping the human genome. The project is expected to require at least a decade and cost from $100 million to $3 billion. When the proposal to mount an interdisciplinary attack on the genome was suggested in January 1986 by Charles DeLisi, PhD, associate director, health and environmental research, of the DOE's Office of Energy Research, it sent shock waves through the biosciences community. Unlike physical scientists, biologists were unaccustomed to thinking in terms of "big science." However, they seem to have adapted to the idea during the ensuing months. Biologists who once asked "Should we be doing this?" are now inquiring "How should we be
Single-cell immune profiling reveals functional diversity of T cells in tuberculous pleural effusion
Authors: Yi Cai, Yejun Wang, Chenyan Shi, Youchao Dai, Fuxiang Li, Yuzhong Xu, Peize Zhang, Fanhui Kong, Guofang Deng, Zhihua Wen, Qi Zhou, Boxi Chris Kang, Amit Singhal, Qianting Yang, Carl G. Feng, Xinchun Chen
Journal: The Journal of Experimental Medicine (2022)

Orchestration of an effective T lymphocyte response at infection sites is critical for protection against Mycobacterium tuberculosis (Mtb) infection. However, the local T cell immunity landscape in human tuberculosis is poorly defined. Tuberculous pleural effusion (TPE), caused by Mtb, is characterized by an influx of leukocytes to the pleural space, providing a platform suitable for delineating complex tissue responses to Mtb infection. Using single-cell transcriptomics and T cell receptor sequencing, we analyzed mononuclear cell populations in paired pleural fluid and peripheral blood of TPE patients. While all major cell clusters were present in both tissues, their relative proportions varied significantly by anatomic location. Lineage tracking analysis revealed subsets of CD8 and CD4 T cell populations with distinct effector functions specifically expanded at pleural sites. Granzyme K–expressing CD8 T cells were preferentially enriched and clonally expanded in pleural fluid from TPE, suggesting that they are involved in the pathogenesis of the disease. The findings collectively reveal the landscape of local T cell immunity in tuberculosis.
Surgical Pathology and Principles.
Journal: JAMA (1898)

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
Tetanus
Authors: Stanford Wessler
Journal: JAMA (1969)

Dr. John W. Sullivan, Junior Assistant Resident in Medicine, Jewish Hospital of St. Louis, and assistant in Medicine, Washington University School of Medicine: A 67-year-old white woman was admitted to the Jewish Hospital for the first time on July 30, 1968, because of shoulder and neck pain and inability to open her mouth. Eleven days before admission, a nail, thrown by a motorized lawnmower, had pierced her right calf. The nail was removed, the laceration sutured, and tetanus toxoid administered. On subsequent questioning the patient did not recall previous tetanus immunization. During the ensuing several days the patient noted a foul odor of the wound when she changed the dressing. Eight days after the injury, she first noted tightened facial muscles and a persistent pain between her scapulae. Shortly thereafter, she was unable to swallow her oral secretions. Her physician reopened the laceration, administered penicillin G potassium parenterally, and transferred