tbuckley/cabot-search huggingface dataset:
Trajectories of Childhood Adversity and Type 1 Diabetes: A Nationwide Study of One Million Children
Authors: Jessica Bengtsson, Andreas Rieckmann, Bendix Carstensen, Jannet Svensson, Marit E. Jørgensen, Naja H. Rod
Journal: Diabetes Care (2021)

OBJECTIVE Experiencing adversities in childhood may increase the risk of type 1 diabetes through hyperactivation of the stress response system, but the empirical evidence is conflicting. We aim to describe the age-specific incidence of type 1 diabetes for males and females separately in five predefined groups covering the most common trajectories of adversity among Danish children. RESEARCH DESIGN AND METHODS We included all 1,081,993 children without parental type 1 diabetes born in Denmark from 1980 to 1998. We used register data to estimate age-specific incidence rates of type 1 diabetes in five trajectory groups of adversity characterized by 1) low adversity, 2) early life material deprivation, 3) persistent material deprivation, 4) loss or threat of loss in the family, and 5) cumulative high adversity. All analyses were stratified by sex. RESULTS In total, 5,619 people developed type 1 diabetes before 2016. We found only minor differences when comparing the incidence rates of type 1 diabetes between the trajectory groups. The only clear exceptions were in the high versus low adversity group, in which males had a higher incidence of type 1 diabetes in childhood (&amp;lt;11 years [incidence rate ratio (IRR) 1.78 (95% CI 1.31–2.42)]) and females had a higher incidence in early adulthood (≥16 years [IRR 2.19 (95% CI 1.57–3.07)]). CONCLUSIONS Childhood adversities were generally not associated with age-specific incidence of type 1 diabetes except among those exposed to a very high and increasing annual rate of childhood adversities. Differences between highly exposed males and females seem to depend on age at onset of type 1 diabetes.
Response to: ‘Correspondence on ‘Prevalence and clinical outcomes of COVID-19 in patients with autoimmune diseases: a systematic review and meta-analysis’’ by Lee
Authors: Shintaro Akiyama, Shadi Hamdeh, Dejan Micic, Atsushi Sakuraba
Journal: Annals of the Rheumatic Diseases (2021)

We thank Lee1 for his comments to our research article ‘Prevalence and clinical outcomes of COVID-19 in patients with autoimmune diseases: a systematic review and meta-analysis’.2 

In our study, included patients were likely on glucocorticoids (GCs) for their underlying autoimmune diseases (ADs), not for COVID-19-associated pneumonia and cytokine release syndrome. Hence, our data suggested the possibility of harmful effects of chronic use of GCs on the risk of developing SARS-CoV-2 infection and severe COVID-19. We were unable to analyse the therapeutic effect of GCs in patients with ADs who developed COVID-19 pneumonia. As stated in the correspondence by Lee,1 a systematic review and …
Characteristics and outcomes for fecal occult blood test (FOBT) screen detected (SD) versus non-screen detected (NSD) colorectal cancer (CRC).
Authors: Shehara Ramyalini Mendis, Sumitra S Ananda, Wei Hong, Ian Faragher, Matthew Croxford, Ian Jones, Malcolm Steel, Azim Jalali, Grace Gard, Yat Hang To, Margaret Lee, Suzanne Kosmider, Rachel Wong, Jeanne Tie, Peter Gibbs
Journal: Journal of Clinical Oncology (2021)

42 Background: FOBT based screening for CRC has been shown in multiple studies to reduce CRC mortality. Beyond the well described earlier stage at diagnosis, other characteristics of SD cancers have not been well studied. Since 2006 Australians aged 50-74 have regularly been mailed an immunochemical FOBT via the National Bowel Cancer Screening Program (NBCSP), with participation rate stable around 40%. Methods: To explore patient (pt), tumour, treatment and outcome data for SD compared to NSD, we examined a multi-site CRC database where prospectively collected data includes method of detection. Categories include SD via the NBCSP, cases that were symptomatic or incidentally found on imaging (NSD), and cases detected by screening outside the NBCSP (OSD). High risk features for Australian Clinicopathological Staging System (ACPS) Stage B included emergency presentation, T4, lymphovascular invasion and &lt;12 lymph nodes examined. Results: Of 6969 registry pts diagnosed 06/2006–06/2020, 4107 (59%) were aged 50-74, including 473 (12%) SD, 3228 (79%) NSD and 406 (10%) OSD. SD versus NSD pts were younger (mean 62.4 v 64.2 years), had better ASA score (ASA 1-2: 79% v 66%, Odds Ratio [OR] 1.9, p&lt;0.001), earlier stage at diagnosis (ACPS A/B/C/D = 38%/21%/28%/5% v 17%/29%/26%/21%, p&lt;0.001), were more often left-sided (41% v 33%, OR 1.44, p&lt;0.001) but less frequently located in the rectum (28% v 36% OR 0.70, p=0.001). There was no difference by gender. SD tumors were more often well/moderately differentiated (76% v 66%, OR 1.65, p&lt;0.001) and less often mucinous (16% v 20%, OR 0.66, p=0.002). SD stage A tumours were more often T1 (66% v 43%, OR 0.36, p&lt;0.001). SD stage B tumours were more often T3 (92% v 85%, OR 0.43, p=0.033), and had fewer high risk features (60% v 49%, OR 0.64, p=0.036). SD stage C pts had a similar rate of N2 disease (25% v 31%, p=0.20), but more often received adjuvant chemotherapy (96% v 86%, OR 3.6, p=0.002). De novo stage D and relapsed SD pts more often underwent metastatic resection (46% v 25%, OR 2.6, p&lt;0.001). Relapse free survival (RFS) in stage A-C, progression free survival in stage D (PFS), and overall survival (OS) was superior for SD and is in Table. Conclusions: We show for the first time to our knowledge that SD CRCs have many distinct and favourable prognostic features that appear to be driving favourable stage based outcomes when compared to NSD patients. This prognostic data could inform adjuvant therapy decision making and surveillance strategies for SD CRC. [Table: see text]
Food and Drug Administration Regulation of Food Safety
Authors: Katie Stewart, Lawrence O Gostin
Journal: JAMA (2011)

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
The Role of the Microenvironment and Immune System in Regulating Stem Cell Fate in Cancer
Authors: L. Paige Ferguson, Emily Diaz, Tannishtha Reya
Journal: Trends in cancer (2021)

Despite gains in knowledge of the intrinsic signals governing cancer progression, effective clinical management of cancer remains a challenge. Drug resistance and relapse, pose the greatest barriers to cancer care, and are often driven by the co-option of stem cell programs by subpopulations of aggressive cancer cells. Here, we focus on the role of the microenvironment in the acquisition and/or maintenance of stem cell states in cancer in the context of resistance and metastasis. We further discuss the role of cancer stem cells in immune evasion through the course of metastasis, dormancy, and relapse. Understanding the niche in which cancer stem cells live and the signals that sustain them may lead to new strategies that target them by disrupting microenvironmental support.
In Search of Clinical Biomarkers of Response to Checkpoint Inhibitor Therapy in Renal Cell Carcinoma
Authors: Alice C. Fan, John T. Leppert
Journal: JAMA Network Open (2021)

Neha Sati, BSc; Devon J. Boyne, MSc, PhD; Winson Y. Cheung, MD, MPH; Sarah B. Cash, BSc; Paul Arora, MSc, PhD
Rheumatoid arthritis, bone and drugs: a dangerous interweave
Authors: Salvatore Minisola, Jessica Pepe, Cristiana Cipriani
Journal: Annals of the Rheumatic Diseases (2021)

Rheumatoid arthritis (RA) is a chronic autoimmune inflammatory condition that leads, per se, to bone loss by three main mechanisms. The first one is represented by bone erosions around the involved joints. Second, there is focal subchondral bone loss owing to increased osteoclast activity. Finally, systemic inflammation causes universal bone loss, mainly manifesting at the axial skeleton (ie, vertebral bodies and hip).1 On the top of this, physical inactivity, also related to lower muscle mass and sarcopenia, further exacerbates bone loss. As a consequence, osteoporosis can be detected in 30%–50% of patients with RA, also depending on age and sex; prevalence and fracture risk both raise with disease duration and seropositivity.2 The importance of RA in determining both local and systemic osteoporosis is emphasised by the fact that RAis an input variable, as independent risk factor, in the calculation of future fracture risk by FRAX.

It is also well known that patients with RA consume a number of drugs to mainly counteract inflammation and pain. However, some of the drugs used have detrimental effects on skeletal tissue, reducing bone strength and ultimately leading to fractures.

About 1% of adults in Britain and USA receive long-term oral glucocorticoids mainly for the treatment of joint problems but also for digestive and cutaneous diseases.3 4 The long-term or high doses of glucocorticoids use is associated with reduced skeletal strength; indeed, glucocorticoid induced osteoporosis is the most prevalent cause of secondary osteoporosis. Glucocorticoids exert their deleterious effects on bone by acting on the three main cell skeletal lines (osteoblasts, osteoclasts end osteocytes). Among the most important negative effects are: (1) a preferential differentiation of pluripotent precursor cells to adipocytes rather than osteoblasts; (2) a stimulation of the receptor activator of nuclear factor-kB (RANK)-RANK ligand (RANKL) production which at least initially increase …
Acute Pancreatitis
Authors: Michael A. Mederos, Howard A. Reber, Mark D. Girgis
Journal: JAMA (2021)

In the United States, acute pancreatitis is one of the leading causes of hospital admission from gastrointestinal diseases, with approximately 300 000 emergency department visits each year. Outcomes from acute pancreatitis are influenced by risk stratification, fluid and nutritional management, and follow-up care and risk-reduction strategies, which are the subject of this review.MEDLINE was searched via PubMed as was the Cochrane databases for English-language studies published between January 2009 and August 2020 for current recommendations for predictive scoring tools, fluid management and nutrition, and follow-up and risk-reduction strategies for acute pancreatitis. Several scoring systems, such as the Bedside Index of Severity in Acute Pancreatitis (BISAP) and the Acute Physiology and Chronic Health Evaluation (APACHE) II tools, have good predictive capabilities for disease severity (mild, moderately severe, and severe per the revised Atlanta classification) and mortality, but no one tool works well for all forms of acute pancreatitis. Early and aggressive fluid resuscitation and early enteral nutrition are associated with lower rates of mortality and infectious complications, yet the optimal type and rate of fluid resuscitation have yet to be determined. The underlying etiology of acute pancreatitis should be sought in all patients, and risk-reduction strategies, such as cholecystectomy and alcohol cessation counseling, should be used during and after hospitalization for acute pancreatitis.Acute pancreatitis is a complex disease that varies in severity and course. Prompt diagnosis and stratification of severity influence proper management. Scoring systems are useful adjuncts but should not supersede clinical judgment. Fluid management and nutrition are very important aspects of care for acute pancreatitis.
Framework for the evaluation of new tests for tuberculosis infection
Authors: Yohhei Hamada, Saskia den Boon, Daniela Maria Cirillo, Adam Penn-Nicholson, Morten Ruhwald, Dick Menzies, Olivia Oxlade, Dennis Falzon, Avinash Kanchar, Alexei Korobitsyn, Matteo Zignol, Alberto Matteelli, Tereza Kasaeva
Journal: European Respiratory Journal (2021)

The scale-up of tuberculosis (TB) preventive treatment (TPT) must be accelerated to achieve the targets set by the United Nations High-level Meeting on TB and the End TB Strategy. The scale-up of effective TPT is hampered by concerns about operational challenges to implement the existing tests for TB infection. New simpler tests could facilitate the scale-up of testing for TB infection. We present a framework for evaluation of new immunodiagnostic tests for the detection of TB infection, with an aim to facilitate their standardised evaluation and accelerate adoption into global and national policies and subsequent scale-up. The framework describes the principles to be considered when evaluating new tests for TB infection and provides guidance to manufacturers, researchers, regulators and other users on study designs, populations, reference standards, sample size calculation and data analysis and it is also aligned with the Global Strategy for TB Research and Innovation adopted by the World Health Assembly in 2020. In addition, we briefly describe technical issues that should be considered when evaluating new tests, including the safety for skin tests, costs incurred by patients and the health system, and operational characteristics.
Ensuring Effective Pain Treatment
Authors: Allyn L. Taylor, Lawrence O. Gostin, Katrina A. Pagonis
Journal: JAMA (2008)

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
OP0058 Efficacy of infliximab in severe refractory ankylosing spondylitis (as). results of an open-label study
Authors: MA Breban, E Vignon, P Claudepierre, A Saraux, D Wendling, E Lespesailles, L Euller-Ziegler, J Sibilia, A Perdriger, C Alexandre, M Dougados
Journal: Annals of the Rheumatic Diseases (2001)

<h3>Background</h3> Early reports have emphasised the efficacy of the anti-TNF-alpha monoclonal antibody, infliximab, to treat spondylarthropathy patients. Further studies are required to evaluate the extent of such efficacy in large subgroups of well-defined patients. <h3>Objectives</h3> To examine the effect of infliximab, in severe AS with predominant axial symptoms. <h3>Methods</h3> Patients suffering of severe AS, with evidence of systemic inflammation (modified New-York criteria; BASDAI &gt; = 30/100; CRP &gt; = 15 mg/l)), and without present peripheral arthritis or extraskelettal manifestation were included. Previous DMARD’s had to be discontinued for &gt; = 3 months. Intake of NSAID had to be stable. Eligible patients received 3 infusions of infliximab (5 mg/kg, weeks 0, 2 and 6). Clinical and biological monitoring was planned for 6 months. <h3>Results</h3> We enrolled 48 parents (36 M/12 F; mean age = 36 ± 9 yr); 41/46 (89%) were HLA-B27+; 43 (90%) completed the treatment, as scheduled, whereas 5 received only 2 infusions. Interim result (wk 8) is shown, and compared to baseline in the table. Altogether, 44 patients (92%) were responders, as defined by a reduction of global pain on VAS of at least 20%, as compared to baseline level. <h3>Conclusion</h3> Our data confirm the remarkable efficacy of infliximab in AS. It indicate that most, patients suffering of inflammatory active AS promptly and dramatically respond to this treatment.
Radiolabeling of Gold Nanocages for Potential Applications in Tracking, Diagnosis, and Image‐Guided Therapy
Authors: Jichuan Qiu, Yongjian Liu, Younan Xia
Journal: Advanced Healthcare Materials (2021)

Abstract Gold nanocages (AuNCs) have emerged as a novel class of multifunctional nanomaterials with an array of applications in nanomedicine, including drug delivery, controlled release, as well as disease diagnosis and treatment. Labeling AuNCs with radionuclides not only offers additional therapeutic capabilities but also makes it easy to analyze their biodistribution, monitor their uptake by the tissue or organ of interest, and optimize their performance in both diagnosis and treatment. Here, an introduction to the chemical synthesis and optical properties of AuNCs is provided in the beginning. The methods developed for their radiolabeling are then showcased, followed by the use of radiolabeled AuNCs in tracking and quantifying their pharmacokinetics, including biodistribution, tumor uptake, and intratumoral distribution. Finally, their potential applications in targeted imaging and image‐guided therapy are discussed.
IRGM1 links mitochondrial quality control to autoimmunity
Authors: Prashant Rai, Kyathanahalli S. Janardhan, Julie Meacham, Jennifer H. Madenspacher, Wan-Chi Lin, Peer W. F. Karmaus, Jennifer Martinez, Quan-Zhen Li, Mei Yan, Jialiu Zeng, Mark W. Grinstaff, Orian S. Shirihai, Gregory A. Taylor, Michael B. Fessler
Journal: Nature Immunology (2021)
Implementation of hepatic artery infusion (HAI) chemotherapy for unresectable colorectal liver metastases (CRLM): The University of Miami experience.
Authors: Agustin Pimentel, Joshua Kronenfeld, Vikas Dudeja, Nipun B. Merchant, Lauren Nicole Gallegos, Kristin Kelly, Vivian McGhee, Alissette Naveda, Hoyan Ng-Chen, A. Craig Lockhart, Peter Joel Hosein, Nkiruka Ezenwajiaku, Bach Ardalan, Jashodeep Datta
Journal: Journal of Clinical Oncology (2021)

96 Background: In patients with unresectable liver-confined CRLM, regional chemotherapy via HAI in combination with modern systemic chemotherapy (CT) can achieve hepatic disease control and expand surgical resectability. We describe patient selection and early outcomes following implementation of a HAI program at our tertiary referral academic center. Methods: We analyzed demographics, previous systemic treatment, primary tumor location, molecular profiling, extent of hepatic/extrahepatic disease, perioperative HAI outcomes (toxicity, conversion to resection/ablation, radiographic response), and overall survival (OS) in CRLM patients selected for HAI treatment (01/2018—06/2020) after multidisciplinary review. Results: Of 35 patients with unresectable CRLM (primary: colon, n = 24; rectum, n = 11) selected for HAI, 57% were heavily pre-treated (with at least 2 lines of pre-HAI systemic chemotherapy), 71% had a Fong clinical risk score ≥3, 86% presented with synchronous disease, 80% had bilobar metastasis, and 86% had &gt; 5 tumors. All tumors were microsatellite stable, with 20% harboring KRAS/NRAS mutations and none had class I/II BRAF mutations. HAI was initiated at a median 14 (IQR 3, 64) months after CRLM diagnosis, and administered for a median of 7 (range 2, 16) cycles; 91% of patients (31/34) received concurrent HAI and systemic chemotherapy. Although most (69%) patients experienced some degree of hepatic toxicity during HAI therapy resulting in FUDR dose reduction and steroid administration, biliary sclerosis requiring intervention was observed in only 3 (9%) of patients. The overall perioperative morbidity was 17%, and there were no surgical-related 90-day mortalities following HAI pump placement. Excluding patients who initiated HAI treatment within the last 3 months of the study period (n = 3), 13 of 32 patients (41%) were rendered disease-free in the liver following complete resection and/or ablation in combination with HAI/systemic chemotherapy; in the remaining 19 patients (59%), hepatic progression-free survival was 7.3 months (IQR 4, 12). At a median follow-up of 11.2 months, post-HAI median OS for the overall cohort was 12.3 (IQR 7, 20) months. Patients undergoing complete resection/ablation demonstrated improved survival compared with those with progressive disease (median 20 vs 12 months, respectively). Conclusions: Implementation of a HAI program for multimodality liver-directed management of unresectable CRLM is feasible and is associated with meaningful clinical outcomes unlikely to be achieved with systemic therapy alone in heavily pre-treated patients.
Aspirin Resistance: An Underestimated Risk in Patients With Drug-Eluting Stents?⁎⁎Editorials published in the Journal of the American College of Cardiologyreflect the views of the authors and do not necessarily represent the views of JACCor the American College of Cardiology.
Authors: Dietmar Trenk, Franz-Josef Neumann
Journal: Journal of the American College of Cardiology (2008)
A diagnostic formulation of undergraduate medical education in the UK
Authors: Omar G Mustafa, Ghanim Alsheikh
Journal: BMJ (2021)

Dornan and colleagues’ article provides a diagnostic overview of some of the shortcomings of medical education in the UK.1

The shift to competency based training2 moved students away from being passive recipients of teaching to experiential learners, driven by inquiry. As stated in the article, readiness to practise safely does not mean demonstrably safer practice. This may …
Abstract 10443: Additional Mineralocorticoid-receptor Antagonist Improves Cardiovascular Mortality in Heart Failure Patients With Insufficient Dose of Guideline-recommended Medication
Authors: Takuro Abe, Kentaro Jujo, Noritoshi Fukushima, Yuichiro Minami, Motoko Kametani, Haruki Sekiguchi, Katsumi Saito, Nobuhisa Hagiwara
Journal: Circulation (2019)

Introduction: Aggregating evidence reveals that guideline-recommended medical therapy (GRMT) including angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker (ACEi/ARB) and beta...
SARS‐CoV‐2 spike protein positivity in pityriasis rosea‐like and urticaria‐like rashes of COVID‐19
Authors: E. Welsh, J.A. Cardenas‐de la Garza, A. Cuellar‐Barboza, R. Franco‐Marquez, R.I. Arvizu‐Rivera
Journal: British Journal of Dermatology (2021)

The spike (S) protein of SARS-CoV-2 is responsible for receptor recognition and cell membrane fusion.1 Positive immunohistochemistry (IHC) for SARS-CoV/SARS-CoV-2 spike protein has been found in lungs, tracheal mucosa, renal tubular epithelial cells, and recently in chilblain-like and erythema multiforme-like lesions of patients with COVID-19.2 Herein, we report on two patients, one with a pityriasis rosea-like rash, and one with an urticarial rash with positive IHC for SARS-CoV/SARS-CoV-2 spike protein.