tbuckley/cabot-search huggingface dataset:
Long-Term Risk of Autoimmune and Autoinflammatory Connective Tissue Disorders Following COVID-19
Authors: Yeon-Woo Heo, Jae Joon Jeon, Min Chul Ha, You Hyun Kim, Solam Lee
Journal: JAMA Dermatology (2024)

Importance Few studies have investigated the association between COVID-19 and autoimmune and autoinflammatory connective tissue disorders; however, research with long-term observation remains insufficient. Objective To investigate the long-term risk of autoimmune and autoinflammatory diseases after COVID-19 over an extended observation period. Design, Setting, and Participants This retrospective nationwide population-based study investigated the Korea Disease Control and Prevention Agency–COVID-19–National Health Insurance Service (K-COV-N) cohort. Individuals with confirmed COVID-19 from October 8, 2020, to December 31, 2022, and controls identified among individuals who participated in the general health examination in 2018 were included in the analysis. Exposures Confirmed COVID-19. Main Outcomes and Measures Incidence and risk of autoimmune and autoinflammatory connective tissue disorders in patients after COVID-19. Various covariates, such as demographic characteristics, general health data, socioeconomic status, and comorbidity profiles, were balanced using inverse probability weighting. Results A total of 6 912 427 participants (53.6% male; mean [SD] age, 53.39 [20.13] years) consisting of 3 145 388 with COVID-19 and 3 767 039 controls with an observational period of more than 180 days were included. Alopecia areata (adjusted hazard ratio [AHR], 1.11 [95% CI, 1.07-1.15]), alopecia totalis (AHR, 1.24 [95% CI, 1.09-1.42]), vitiligo (AHR, 1.11 [95% CI, 1.04-1.19]), Behçet disease (AHR, 1.45 [95% CI, 1.20-1.74]), Crohn disease (AHR, 1.35 [95% CI, 1.14-1.60]), ulcerative colitis (AHR, 1.15 [95% CI, 1.04-1.28]), rheumatoid arthritis (AHR, 1.09 [95% CI, 1.06-1.12]), systemic lupus erythematosus (AHR, 1.14 [95% CI, 1.01-1.28]), Sjögren syndrome (AHR, 1.13 [95% CI, 1.03-1.25]), ankylosing spondylitis (AHR, 1.11 [95% CI, 1.02-1.20]), and bullous pemphigoid (AHR, 1.62 [95% CI, 1.07-2.45]) were associated with higher risk in the COVID-19 group. Subgroup analyses revealed that demographic factors, including male and female sex, age younger than 40 years, and age 40 years and older, exhibited diverse associations with the risk of autoimmune and autoinflammatory outcomes. In addition, severe COVID-19 infection requiring intensive care unit admission, the Delta period, and not being vaccinated were associated with higher risk. Conclusions and Relevance This retrospective cohort study with an extended follow-up period found associations between COVID-19 and the long-term risk of various autoimmune and autoinflammatory connective tissue disorders. Long-term monitoring and care of patients is crucial after COVID-19, considering demographic factors, disease severity, and vaccination status, to mitigate these risks.
Methylphenidate and Atomoxetine in Pregnancy and Possible Adverse Fetal Outcomes
Authors: Ester di Giacomo, Veronica Confalonieri, Fabio Tofani, Massimo Clerici
Journal: JAMA Network Open (2024)

Importance Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurobehavioral disorders, and it afflicts about 7% of young people. As a consequence, many young women might be pregnant while taking medication for ADHD, but data about safety have not yet been strictly examined. Objective To examine adverse effects in offspring of mothers receiving treatment with atomoxetine and methylphenidate during pregnancy. Data Sources Electronic databases (PubMed, Embase, and PsycINFO) were searched for articles published through December 31, 2023, with the following search terms: ( atomoxetine OR methylphenidate ) AND ( pregnancy ). Study Selection Observational studies (eg, cohort studies, case-control studies, case-crossover studies, cross-sectional studies, and registry-based studies) that reported offspring outcomes in pregnancy with atomoxetine and/or methylphenidate and in mothers with ADHD but unexposed to ADHD treatment during pregnancy or from the general population were included. Ten studies of 656 records satisfied criteria. Data Extraction and Synthesis Two independent reviewers performed data extraction according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Meta-analyses were conducted based on reported odds ratios (ORs) and corresponding 95% CIs using a linear random effects model. Each study was inversely weighted by the reported variance of the estimators. Risk of publication bias and analysis of heterogeneity through univariate and multivariate metaregressions were also rated. Data were analyzed from January to March 2024. Main Outcomes and Measures Study outcomes included miscarriages and congenital anomalies. Results Ten studies involving 16 621 481 pregnant women, 30 830 of them affected by ADHD, were included. Congenital anomalies or miscarriages were not more frequent in offspring of mothers receiving treatment with methylphenidate or atomoxetine during pregnancy compared with unexposed offspring (OR, 1.14; 95% CI, 0.83-1.55; P = .41; I 2 = 8% for congenital anomalies; OR, 1.01; 95% CI, 0.70-1.47; P = .96; I 2 = 0% for miscarriages) or compared with the general population (OR, 1.19; 95% CI, 0.93-1.53; P = .16; I 2 = 74% for congenital anomalies; OR, 1.05, 95% CI, 0.81-1.37; P = .70; I 2 = 0% for miscarriage). Conclusions and Relevance Evidence from this meta-analysis, which involves a substantial sample of pregnant women with and without ADHD, suggests the maintenance of methylphenidate or atomoxetine during pregnancy is safe, given that congenital anomalies and miscarriages did not appear to significantly increase. Further studies are recommended to support and confirm these findings.
Quadrivalent Conjugate Vaccine and Invasive Meningococcal Disease in US Adolescents and Young Adults
Authors: Thomas Shin, Chad R. Wells, Affan Shoukat, Lilia Potter-Schwartz, Edith Langevin, Joanne M. Langley, Alison P. Galvani, Seyed M. Moghadas
Journal: JAMA Network Open (2024)

Importance Beginning in 2005, the US implemented routine immunization of adolescents with a quadrivalent conjugate vaccine (MenACWY) for the prevention of invasive meningococcal disease (IMD). Objectives To assess whether MenACWY immunization was associated with a reduced IMD burden among the US adolescent population and how the downward trajectory of IMD that began in the mid-1990s might have evolved in the absence of vaccination efforts. Design, Setting, and Participants In this decision analytical study, a bayesian hierarchical Poisson regression model was developed to investigate the potential trajectory of IMD among US adolescents and young adults without vaccination and evaluate the direct association of vaccination with IMD burden. The model included the entire age-stratified US population and was fitted to national incidence data for serogroups C, W, and Y from January 1, 2001, to December 31, 2021, with stratification by vaccination status for IMD cases. Intervention Simulated counterfactual scenario of absent vaccination from 2005 to 2021, while retaining the incidence rate of IMD for unvaccinated individuals estimated during model fitting. Main Outcomes and Measures The main outcomes were the estimated numbers of IMD cases and deaths averted by MenACWY vaccination among US adolescents and young adults aged 11 to 23 years. Results Among the entire US population from 2005 to 2021, MenACWY vaccination prevented an estimated 172 (95% credible interval [CrI], 85-345) cases of IMD among US adolescents 11 to 15 years of age and 328 (95% CrI, 164-646) cases of IMD among those aged 16 to 23 years. Absent vaccination, the cumulative incidence of IMD in these age groups would have been at least 59% higher than reported over the same period with vaccination. Using case fatality rates of unvaccinated individuals derived from national data, vaccination averted an estimated 16 (95% CrI, 8-31) deaths among adolescents aged 11 to 15 years and 38 (95% CrI, 19-75) deaths among those aged 16 to 23 years. Conclusions and Relevance This decision analytical model suggests that the MenACWY vaccination program in the US was associated with a reduced burden of meningococcal disease. Without vaccination, the incidence rates per 100 000 adolescents and young adults would have been substantially higher than those observed during the vaccine era.
Heart Failure With Preserved Ejection Fraction—A Role for Invasive Hemodynamics
Authors: Gregg C. Fonarow, James E. Udelson, Clyde W. Yancy
Journal: JAMA Cardiology (2024)

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 Cardiology HomeNew OnlineCurrent IssueFor Authors Podcast JAMA+ AI Journals 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 2024 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 Cardiology journal
Prevalence of HFpEF in Isolated Severe Secondary Tricuspid Regurgitation
Authors: Jwan A. Naser, Tomonari Harada, Yogesh N. Reddy, Sorin V. Pislaru, Hector I. Michelena, Christopher G. Scott, Austin M. Kennedy, Patricia A. Pellikka, Vuyisile T. Nkomo, Mackram F. Eleid, Barry A. Borlaug
Journal: JAMA Cardiology (2024)

Importance Secondary tricuspid regurgitation (STR) is observed in multiple cardiac and pulmonary diseases. Heart failure with preserved ejection fraction (HFpEF) is a common cause of STR that may be overlooked, along with precapillary etiologies of pulmonary hypertension (PH). Objectives To investigate the prevalence of HFpEF and precapillary PH in patients with severe STR of undefined etiology (isolated STR) referred for exercise right heart catheterization (RHC), and to evaluate the performance of noninvasive measures to identify HFpEF. Design, Setting, and Participants This retrospective cross-sectional study included consecutive adults with severe STR in the absence of EF less than 50%, hemodynamically significant left-sided valve disease, congenital heart disease, infiltrative or hypertrophic cardiomyopathy, pericardial disease, or prior cardiac procedures who underwent rest-and-exercise RHC between February 2006 and June 2023 at Mayo Clinic and transthoracic echocardiography less than 90 days prior. Diastolic dysfunction (DD) was defined by at least 3 of 4 or 2 of 3 abnormal diastolic parameters (medial e’, medial E/e’, tricuspid regurgitation [TR] velocity, left atrial volume index). HFpEF was diagnosed when pulmonary arterial wedge pressure was at least 15 mm Hg at rest, at least 19 mm Hg with feet up, or at least 25 mm Hg during exercise. Data analysis was performed from November 2023 to March 2024. Main Outcomes and Measures The prevalence of HFpEF and precapillary PH in severe isolated STR was determined, and performance of noninvasive measures to identify HFpEF was evaluated. Results Overall, 54 patients with severe isolated STR (mean [SD] age, 70.8 [12.5] years; 34 [63%] female) were identified. The primary indication for RHC was evaluation of TR prior to potential intervention in 36 patients (67%), evaluation of PH in 13 (24%), and confirmation of HFpEF in 5 (9%). HFpEF was identified in 40 patients (74%) but was recognized prior to RHC in only 19 patients (35%). Of the 14 remaining patients without HFpEF, precapillary PH was diagnosed in 10 (71%). Guideline-defined DD was absent in 24 patients (60%) who were subsequently diagnosed with HFpEF. Left atrial emptying fraction (area under the receiver operating characteristic curve [AUC] = 0.90; 95% CI, 0.82-0.98) and strain (AUC = 0.91; 95% CI, 0.83-0.99) had robust discrimination for HFpEF. Conclusions and Relevance The findings suggest that HFpEF is underdiagnosed and should be rigorously evaluated for in patients with severe isolated STR, along with precapillary PH, as both have distinct requirements for management. Resting DD based on current guidelines is insufficiently sensitive in these patients, indicating a pressing need for other noninvasive diagnostic tools, such as left atrial function assessment.
Psychosis Spectrum Symptoms Before and After Adolescent Cannabis Use Initiation
Authors: K. Juston Osborne, Deanna M. Barch, Joshua J. Jackson, Nicole R. Karcher
Journal: JAMA Psychiatry (2024)

Importance Adolescent cannabis use has been consistently posited to contribute to the onset and progression of psychosis. However, alternative causal models may account for observed associations between cannabis use and psychosis risk, including shared vulnerability for both cannabis use and psychosis or efforts to self-medicate distress from psychosis spectrum symptomology. Objective To test 3 hypotheses that may explain cannabis–psychosis risk associations by modeling psychosis spectrum symptom trajectories prior to and after cannabis initiation across adolescent development (approximately 10-15 years of age). Design, Setting, and Participants This cohort study used data from 5 waves across 4 years of follow-up from the Adolescent Brain Cognitive Development (ABCD) Study. The ABCD study is an ongoing large-scale, longitudinal study of brain development and mental and physical health of children in the US launched in June 2016. Data are collected from 21 research sites. The study included data from 11 868 adolescents aged 9 to 10 years at baseline. Three participants were excluded from the present analysis owing to missing data. Data analysis was performed from September 2023 to July 2024. Main Outcomes and Measures Discontinuous growth curve modeling was used to assess trajectories of psychosis spectrum symptoms before and after cannabis initiation. Control variables considered for this investigation were age, sex, internalizing and externalizing symptoms, socioeconomic status, parental mental health, and other substance use. Results Among the 11 858 participants at wave 1, the mean (SD) age was 9.5 (0.5) years; 6182 (52%) participants were male. Consistent with a shared vulnerability hypothesis, adolescents who used cannabis at any point during the study period reported a greater number of psychosis spectrum symptoms (B, 0.86; 95% CI, 0.68-1.04) and more distress (B, 1.17; 95% CI, 0.96-1.39) from psychosis spectrum symptoms relative to those who never used cannabis. Additionally, consistent with a self-medication hypothesis, the number of psychosis spectrum symptoms (B, 0.16; 95% CI, 0.12-0.20) and distress (B, 0.23; 95% CI, 0.21-0.26) from psychosis spectrum symptoms increased in the time leading up to cannabis initiation. We observed mixed evidence for an increase in psychosis symptoms after cannabis initiation (ie, contributing risk hypothesis). Conclusion and Relevance The findings underscore the importance of accounting for shared vulnerability and self-medication effects when modeling cannabis–psychosis risk associations.
TikTok Challenges—Unintentional Injuries vs Suicide Attempts
Authors: Onomeasike Ataga, Valerie K. Arnold
Journal: JAMA Psychiatry (2024)

This Viewpoint discusses injuries among US children that are attributable to TikTok challenges, addresses the challenge of distinguishing between unintentional injuries and suicide attempts, and explores potential methods of prevention, treatment, and clinical disposition for such injuries.
The Role of Fat in Frailty Assessment Before Transcatheter Aortic Valve Replacement
Authors: Alberto Somaschini, Amanda Casirati
Journal: JAMA Cardiology (2024)

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 Cardiology HomeNew OnlineCurrent IssueFor Authors Podcast JAMA+ AI Journals 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 2024 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 Cardiology journal
Use of Anti-PD1 Blockade After Hedgehog Inhibitors or as First-Line Therapy for Gorlin Syndrome
Authors: Robin Reschke, Jasmin Richter, Alexander H. Enk, Jessica C. Hassel
Journal: JAMA Dermatology (2024)

This case series examines treatment with anti–programmed cell death 1 (PD1) immunotherapy for patients with basal cell nevus syndrome.
The Need for More Effective Tools to Decrease Use of Low-Value Care
Authors: Nicole M. Mott, Alexander M. Chaitoff, Jeffrey T. Kullgren
Journal: JAMA Network Open (2024)

Joshua J. Fenton, MD, MPH; Camille Cipri, BS; Melissa Gosdin, PhD; Daniel J. Tancredi, PhD; Anthony Jerant, MD; Carly Ann Robinson, BS; Guibo Xing, PhD; Ilona Fridman, PhD; Gary Weinberg; Andrew Hudnut, MD
Psoriasis Risk With Immune Checkpoint Inhibitors
Authors: Sheng-Yin To, Cho-Hao Lee, Yi-Hsien Chen, Chia-Lu Hsu, Hui-Wen Yang, Ying-Shan Jiang, Yuan-Liang Wen, I-Wen Chen, Li-Ting Kao
Journal: JAMA Dermatology (2024)

Importance Immune checkpoint inhibitors (ICIs) are recognized as revolutionary cancer therapies but have raised concerns about immune-related adverse events, including the development of autoimmune diseases. Objective To evaluate the psoriasis risk associated with the use of ICIs in patients with cancer. Design, Setting, and Participants This nationwide cohort study with a target trial emulation design used data from the Taiwan National Health Insurance database and the Taiwan Cancer Registry. The participants included were patients who received antineoplastic medications for cancer at stages III and IV between January 1, 2019, and June 30, 2021. Data were analyzed from May 2023 to July 2024. Exposures Patients treated with ICIs were classified as ICI users, while those who received chemotherapy or targeted therapies were categorized as non-ICI users. Main Outcome and Measures The primary outcome was the incidence of psoriasis during the follow-up period. Stabilized inverse probability of treatment weighting (IPTW) was used to mitigate potential confounders. Cox and Fine-Gray hazard models were used to calculate hazard ratios (HRs) for psoriasis risk between groups. Results Of 135 230 patients who received antineoplastic medications (mean [SD] age, 62.94 [13.01] years; 45.1% female), 3188 patients were eligible for the ICI user group, while 132 042 patients were eligible for the non-ICI user group. ICI users experienced a higher incidence of psoriasis at 5.76 cases per 1000 person-years, compared to 1.44 cases in the non-ICI group. After adjusting for demographics and comorbidities, ICI users were found to have a 2-fold increase in the risk of developing psoriasis (IPTW-adjusted HR, 3.31; IPTW-adjusted subdistribution HR, 2.43). Both as-started design and on-treatment design showed consistent findings, and the results were consistent and robust across all follow-up intervals and all sensitivity analyses. Conclusions and Relevance In this cohort study, patients with cancer treated with ICIs faced an increased risk of psoriasis. Medical professionals should be aware of the potential adverse effects of immunotherapy to ensure optimal cancer care.
Regional Disparities, Economic Development, and Neonatal Mortality and Hospital Delivery in China
Authors: Hai Fang, Haijun Zhang, Arturo Vargas Bustamante, Shusheng Luo, Xi Chen, Yanqiu Gao, Jianmeng Liu
Journal: JAMA Network Open (2024)

Importance A negative association between neonatal mortality and hospital delivery has been found in some low- and lower-middle-income countries but not in rural settings characterized by poor quality of maternal and child health care. Objective To examine the association between neonatal mortality and hospital delivery in China across urban and rural regions, regional disparities, and varying levels of economic development. Design, Setting, and Participants This retrospective cohort study used county-level data from 2008 to 2020 from the National Maternal &amp;amp;amp; Child Health Statistics across mainland China. Statistical analysis was conducted from March to December 2023. Exposures Since 2008, China has strategically leveraged hospital deliveries with national subsidies to diminish neonatal mortality, particularly in rural areas. Main Outcomes and Measures Neonatal mortality and hospital delivery rates were calculated, and their association was estimated using multivariable fixed-effects linear models of county-level cohort data to adjust for time-invariant differences across counties and controls for gross domestic product (GDP) per capita, women’s years of education, hospital beds, and health workers. Results The analysis included data from 2930 counties, with 198.7 million live births across 36 255 county-year records between 2008 and 2020. The mean (SD) neonatal mortality rate per 1000 live births decreased in rural areas from 12.3 (7.5) in 2008 to 3.9 (2.7) in 2020 and decreased in urban areas from 5.0 (3.1) in 2008 to 2.0 (1.3) in 2020. Hospital delivery rates increased in rural areas from a mean (SD) of 93.4% (11.8%) in 2008 to 99.9% (0.6%) in 2020 and increased in urban areas from 97.7% (6.1%) in 2008 to 100.0% (0.1%) in 2020. In rural areas, an increase of 10 percentage points in hospital deliveries was associated with a neonatal mortality rate of −1.4 (95% CI, −1.9 to −1.0; P &amp;amp;lt; .001) per 1000 live births, whereas this negative association was not observed in urban areas. When the analysis was stratified by regions and incomes, the negative association became considerably stronger in the western and central regions of China, as well as in counties with lower GDP per capita. Conclusions and Relevance This cohort study of more than 2900 counties in China suggests that an increase in hospital deliveries was associated with reduced neonatal mortality in rural and economically underdeveloped areas in China. To further reduce neonatal mortality and improve newborn health, it is imperative to increase the accessibility of hospital delivery services.
Homelessness and Maternal and Infant Health
Authors: Mark E. McGovern, Dan Treglia, Erica L. Eliason, Amanda Spishak-Thomas, Joel C. Cantor
Journal: JAMA Network Open (2024)

This cross-sectional analysis of pregnancy risk data from US individuals with live births analyzes the association of homelessness with utilization of primary care, rates of stress-induced health behaviors, and allostatic load and anxiety.