tbuckley/cabot-search huggingface dataset:
Medical Education and Chronic Disease
Authors: Nancy Morioka-Douglas
Journal: JAMA (2004)

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 I/D polymorphism of angiotensin-converting enzyme gene and asthma risk: a meta-analysis
Authors: Y.-G. Zhang, X.-B. Li, J. Zhang, J. Huang, C. He, C. Tian, Y. Deng, H. Wan, D. Shrestha, Y.-Y. Yang, H. Fan
Journal: Allergy (2010)

To cite this article: Zhang Y-G, Li X-B, Zhang J, Huang J, He C, Tian C, Deng Y, Wan H, Shrestha D, Yang Y-Y, Fan H. The I/D polymorphism of angiotensin-converting enzyme gene and asthma risk: a meta-analysis. Allergy 2011; 66: 197–205. Background: The insertion/deletion (I/D) polymorphism of angiotensin-converting enzyme (ACE) gene has been implicated in susceptibility to asthma, but a large number of studies have reported inconclusive results. The aim of this study is to investigate the association between the I/D polymorphism of ACE gene and asthma risk by meta-analysis. Methods: We searched Medline (Ovid), Pubmed, CNKI, Wanfang, and Weipu database, covering all papers until March 12, 2010. Statistical analysis was performed by using the software revman 4.2 (The Cochrane Collaboration, http://www.cochrane.org) and stata 10.0 (StataCorp, College Station, TX, USA, http://www.stata.com). Results: A total of 1946 cases and 2152 controls in 18 case–control studies were included in this meta-analysis. The results indicated that the DD homozygote carriers had a 59% increased risk of asthma, when compared with the homozygotes II and heterozygote DI [odds ratio (OR) = 1.59, 95% confidence interval (CI): 1.16–2.18]. In the subgroup analysis by ethnicity, significant elevated risks were associated with DD homozygote carriers in Asians (OR = 2.02 and 95% CI: 1.29–3.16 for DD vs DI+II) but not in Caucasians (OR = 1.14 and 95% CI: 0.76–1.72 for DD vs DI+II). In the subgroup analysis by age, significant elevated risks were associated with DD homozygote carriers in children (OR = 2.44 and 95% CI: 1.36–4.38 for DD vs II+DI) but not in adults (OR = 1.54 and 95% CI: 0.94–2.51 for DD vs II+DI). Conclusions: This meta-analysis suggested that the I/D polymorphism of ACE gene would be a risk factor of asthma. To further evaluate gene-to-gene and gene-to-environment interactions between polymorphisms of ACE gene and asthma risk, more studies with large groups of patients are required.
Neuroleptic malignant syndrome
Authors: M S Jahan, A I Farooque, Z Wahid
Journal: American Journal of Psychiatry (1987)

Neuroleptic malignant syndrome is a life-threatening reaction of neuroleptic medication. The estimated incidence rate of neuroleptic malignant syndrome is between 1% and 1.5% of patients treated with neuroleptics. The reported mortality rate varies from 11% to 38%. Risk factors include younger males (80% less than 40 years) and physical disability. Although 80% of neuroleptic malignant syndrome cases develop within the first 2 weeks of treatment, the syndrome can develop anytime during the therapy period. The clinical picture and laboratory findings are not always unique. Less than 50% of cases manifest with classical symptoms. Deaths usually result from cardiovascular collapse. Renal failure, pulmonary emboli, aspiration pneumonia, and respiratory failure are also reported. Familiarity with the syndrome, baseline laboratory values including creatine phosphokinase, lactate dehydrogenase, serum glutamicoxaloacetic transaminase, and complete blood cell count with a differential count, and a high index of suspicion are of the utmost importance in making the diagnosis of neuroleptic malignant syndrome. A judicial choice of neuroleptic medication and careful observation of patients may reduce the incidence, morbidity, and mortality of neuroleptic malignant syndrome.
Formulation development for AAV2 vectors: identification of excipients that inhibit vector aggregation
Authors: J. Fraser Wright, Tannie Le, Hoc Nguyen, Jurg M. Sommer, Glenn Pierce, Guang Qu
Journal: Molecular Therapy (2004)

Successful development of AAV-based vectors for therapeutic use in humans requires the development of vector formulations that ensure optimal in vivo efficacy and safety. Prevention of vector particle aggregation is a critical challenge for parenteral formulation development. The objective of this study was to investigate the mechanism of AAV2 vector aggregation, and to identify classes of excipients to prevent the phenomenon. Previous studies have shown that aggregation of AAV vectors can occur following freeze-thaw cycling and during concentration of purified rAAV (Huang et al, Mol Therapy 1:S286). We have observd that vector aggregation can also be induced following reduction of the ionic strength (μ) by dilution of buffered solutions containing rAAV, and have used this as a model system to investigate the ability of various excipients to inhibit aggregation. Studies were performed on three independent AAV2 vector preparations, one purified by column chromatography (containing empty capsids), a second by CsCl gradient centrifugation (no empty capsids), the third by a hybrid method utilizing both purification process steps (no empty capsids). Dynamic light scattering (DLS) was used to assess aggregation. The contribution of hydrophobic interactions to aggregation was investigated by including Polysorbate 80, Polysorbate 20, or Pluronic F68 (concentrations from 0.01–10%) to inhibit interparticle hydrophobic interactions. At the concentrations examined, these surfactants did not reduced aggregation relative to buffer-only controls in the dilution model. We also examined the effect of glycerol, sorbitol, mannitol, or polyethyleneglycol (0.1–5%), and similarly observed no reduction of aggregation. Based on our previous report that AAV2 aggregation is pH dependent, suggesting involvement of charged amino acids on the vector particle surface (Qu et al, Mol Therapy 7:S348), we examined the ability of charged amino acids (Lys, Arg, Asp, Glu) to reduce aggregation. These amino acids inhibited aggregation only to the degree observed with an equivalent molar concentration of NaCl. The exponential dependence of ionic strength on the valency of contributing ionic species (μ=1/2 ∑cizi2) led us to investigate ionic excipients with valency >1. We observed that a number of these excipients inhibited aggregation more efficiently than NaCl. For example, the divalent salt Mg2+ SO42− inhibited aggregation at a molar concentration approximately 4-fold lower than that required using NaCl. Cumulatively, these data confirm that ionic interactions play a major role in AAV2 vector aggregation, and that use of excipients that maximize ionic strength is a promising strategy to reduce aggregation potential, providing optimal long-term stability and clinical dosing potential for AAV vectors.
Abstract 3649: Significance of HIV viral load and CD4 count on Kaposi sarcoma in the era of highly active antiretroviral therapy
Authors: Gentry T. King, Shivani Garg
Journal: Cancer Research (2014)

Abstract Background: Approximately 20% of patients with HIV will have Kaposi Sarcoma (KS) and about half will die within 3 months of diagnosis. Incidence and outcomes of KS have traditionally been linked to CD4 counts &amp;lt;350. More recently, KS has been increasingly described in higher CD4 counts and variable presentations in the era of Highly-Active-Antiretroviral-Therapy (HAART). No studies have established the role of Viral Load (VL) on KS. Objective: To determine the effect of CD4 count and HIV VL on KS presentation and outcomes. Methods: Retrospective review of KS patients with HIV admitted over 12 years (2000-2012). KS patients without HIV infection were excluded. Patients were divided into 4 groups based on CD4 count (≥200 or 100,000 or &amp;lt;100,000). Groups were analyzed with regards to KS severity (good vs poor risk), extent (soft tissue vs visceral), receipt of HAART and survival (6months). Statistical analysis was done via Chi-Square test. Results: 43 patients were included. KS affected predominantly young (30-40yrs), male (93%) HIV patients with VL &amp;gt;100,000 (85%) and CD4 counts 100,000 had a statistically significant increased incidence for visceral involvement (96%, p100,000 ((66.7% with good risk), increased survival (59.4% survived &amp;gt;6months) and less use of HAART (20%). Although, these differences were statistically insignificant. Conclusion: HIV VL of &amp;gt;100,000 is correlated with increased severity and extent of KS. Though statistically insignificant, CD4 counts &amp;lt;200 showed a trend for less severe disease and increased survival despite less use of HAART. Larger prospective studies are warranted to elucidate on these differences. Citation Format: Gentry T. King, Shivani Garg. Significance of HIV viral load and CD4 count on Kaposi sarcoma in the era of highly active antiretroviral therapy. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 3649. doi:10.1158/1538-7445.AM2014-3649
Synergistic effects between glycopyrronium bromide and indacaterol on a muscarinic agonist-induced contraction in airway smooth muscle
Authors: Hiroaki Kume, Shu Imbe, Takashi Iwanaga, Yuji Tohda
Journal: European Respiratory Journal (2012)

Rationale:  Bronchodilators play an important role in therapy for stable chronic obstructive pulmonary disease (COPD). Anticholinergics and beta 2 -adrenoceotor agonists are widely used to improve lung function, symptoms, and QOL of patients with COPD. This study was designed to investigate whether combination of anticholinergics and beta 2 -adrenoceptor agonists is beneficial. Combined effects on airway smooth muscle contraction were examined using glycopyrronium bromide (GB), a long-acting muscarinic antagonist (LAMA), and indacaterol, a long-acting beta 2 -adrenoceptor agonist (LABA).   Methods:  For record of isometric tension, the strips of tracheal smooth muscle of guinea pigs were placed in the organ bath and were perfused with the physiological solution at a constant flow rate of 2 ml/min.   Results:  One nM indacaterol caused a modest (7.9%, n=18) inhibition of 1 μM methacholine (MCh)-induced contraction of tracheal smooth muscle. GB at 3, 10, and 30 nM caused a concentration-dependent inhibition of 1 μM MCh-induced contraction with values of percent inhibition of 11.1, 21.9, and 52.2%, respectively (each n=6). However, when equi-molars of GB were applied in the presence of 1 nM indacaterol, the inhibitory effects of GB (3, 10, and 30 nM) / indacaterol (1 nM) combination were markedly enhanced, with values of percent inhibition of 25.6 ( p  p  p    Conclusions:  Indacaterol synergistically potentiated GB-induced relaxation against cholinergic stimulation in airway smooth muscle. These results may underlie the clinical benefit of combination therapy of LABA and LAMA for patients with COPD.
A JUSTIFICATION OF THE DIAGNOSIS OF CHRONIC NERVOUS EXHAUSTION
Authors: John W. Macy, Edgar V. Allen
Journal: Annals of Internal Medicine (1934)

Article1 January 1934A JUSTIFICATION OF THE DIAGNOSIS OF CHRONIC NERVOUS EXHAUSTIONJOHN W. MACY, M.D., EDGAR V. ALLEN, M.D., F.A.C.P.JOHN W. MACY, M.D.Search for more papers by this author, EDGAR V. ALLEN, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-7-7-861 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Excerpt"Chronic Nervous Exhaustion," a term synonymous in the minds of many persons with neurasthenia, psychasthenia, or neurocirculatory asthenia, lacks the clear-cut connotation of terms such as duodenal ulcer or pulmonary tuberculosis. The symptoms of chronic nervous exhaustion are protean; they may appear to originate in any or all bodily structures and systems. In its most common meaning, chronic nervous exhaustion indicates a long-present, subjective sensation of tiredness, disproportionately exceeding the effort which produces it and which cannot be accounted for by organic disease. Weakness, lack of energy and ambition, nervousness, unrestful sleep or insomnia, melancholia, tachycardia, and pains and aches... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Rochester, Minnesota*Submitted for publication March 25, 1933.From the Division of Medicine, The Mayo Clinic, Rochester, Minnesota. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byPsychiatric Disorders in Primary CarePsychische Störungen in der primärmedizinischen VersorgungThe epidemiology of chronic fatigue syndromeNeurasthenia and Chronic Fatigue: Theory and Practice in Britain and AmericaAre Functional Syndromes Culture-Bound?Old wine in new bottles: neurasthenia and ‘ME’ReferencesClinical Evaluation of Fatigue and Nervousness: Diagnosis and TreatmentPsychogenic Factors in SurgeryCommon Ailments of Dentists: A Statistical Study 1 January 1934Volume 7, Issue 7Page: 861-867KeywordsAnxietyDuodenal ulcersInsomniaPainSleepTachycardia Issue Published: 1 January 1934 PDF downloadLoading ...
The effect of carbon dioxide on susceptibility testing of azithromycin, clarithromycin and roxithromycin against clinical isolates of Streptococcus pneumoniae and Streptococcus pyogenes by broth microdilution and the Etest: Artemis Project—first-phase study
Authors: Jack Johnson, Sam Bouchillon, Dennis Pontani
Journal: Clinical Microbiology and Infection (1999)
Abstract 13196: The Prevalence and Prediction of Significant Coronary Artery Disease in Patients Referred for Valvular Heart Surgery
Authors: Jason M Lappe, Justin L Grodin, Yuping Wu, Corinne Bott-Silverman, Leslie Cho
Journal: Circulation (2014)

Background: The guidelines recommend preoperative diagnostic coronary angiography (DCA) prior to valvular heart surgery (VHS) in men ≥35 years, premenopausal women with CAD risk factors ≥35 years, and postmenopausal women. Objectives: To determine the prevalence and risk factors for significant CAD in patients, without a prior history, undergoing DCA as a part of a preoperative evaluation for VHS. To create a risk prediction model to identify very-low risk patients. Methods: Patients undergoing DCA between 2/1/2004 and 10/1/2013 as a part of a preoperative evaluation for VHS were included. Significant CAD was defined as either ≥50% stenosis on DCA or the use of bypass grafting at the time of VHS. Multivariate analyses were used to determine risk factors for CAD. Patients were randomly split into derivation and validation cohorts. A nomogram was created to predict the risk of significant CAD, and the performance was assessed using a ROC curve. Results: We identified 5,360 patients (age 63±14 years, male 57%, diabetic 16%, hypertension 50%, hyperlipidemia 39%), of which 1,035 (19.3%) were found to have significant CAD. In multivariate analysis, age, gender, diabetes, renal dysfunction, hyperlipidemia and a family history of CAD were related to the presence of CAD (p&lt;0.001 for all). After multivariate adjustment, the specific dysfunctional valve was not associated with the presence of significant CAD. The risk prediction nomogram (Figure) performed well in predicting the presence of significant CAD in the validation group (AUC 75.7%). Conclusions: In patients undergoing DCA prior to VHS, the prevalence of significant CAD is associated with demographics and traditional risk-factors, but not the specific dysfunctional valve. This data suggests there is a group with sufficiently low risk of significant CAD to merit non-invasive testing instead of DCA. The risk prediction nomogram created in this study can be used to identify patients with a very-low risk of significant CAD.
Prophylactic gastrectomy seems to extend life of patients with a family history of stomach cancer
Authors: Deborah Josefson
Journal: BMJ (2001)

Patients with a hereditary predisposition to stomach cancer may benefit from prophylactic total gastrectomy, according to recent case reports.

A multinational group of clinicians have reported in the latest issue of the New England Journal of Medicine the results of genetic testing, prophylactic gastrectomies, and pathological examination of the removed stomachs in five asymptomatic members of two families affected by familial diffuse gastric cancer (2001;344:1904-9).

The clinicians were led by Dr David Hunstman and colleagues from the British Columbia Cancer Agency's hereditary cancer programme in Vancouver, British Columbia, and Dr Carlos Caldas from Addenbrooke's Hospital at the University of Cambridge in England.

All five patients carried germline mutations for familial diffuse gastric cancer but were asymptomatic when they decided to undergo the radical surgery. In addition, conventional imaging studies and periodic endoscopic biopsies were repeatedly negative …
Abstract 16423: Integrated miRNA and mRNA Responses to Acute Human Left Ventricular Ischemia
Authors: Louis A Saddic, Tzuu-Wang Change, Martin I Sigurdsson, Mahyar Heydarpour, Benjamin Raby, Stanton K Shernan, Sary F Aranki, Simon C Body, Jochen D Muehlschlegel
Journal: Circulation (2014)

Background: MicroRNAs (miRNAs) play a significant role in ischemic heart disease. Animal models of left ventricular (LV) ischemia demonstrate a unique miRNA profile, however, these models have limitations in describing human disease. We describe the changes in miRNA that take place following human cardiac ischemia, and integrate this expression profile with whole-genome mRNA changes. Methods and Results: In nine patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) and cardioplegic arrest, high-throughput miRNA and mRNA sequencing was performed on LV tissue obtained immediately after aortic cross clamping (baseline) and before aortic cross clamp removal (post-ischemic). Of 1,237 identified miRNAs, 21 were differentially expressed between baseline and post-ischemic LV samples. Target prediction analysis of these miRNAs was integrated with mRNA expression from the same LV samples to identify anti-correlated miRNA-mRNA pairs. Gene enrichment studies of candidate mRNA targets demonstrated an a...
Abstract 19924: National Cost Comparison of Trans Catheter Aortic Valve Replacement With Surgical Aortic Valve Replacement in Moderate to High Risk Patients With Severe Symptomatic Aortic Stenosis in New Zealand
Authors: Srija Bhattacharyya, Matthew Roskruge, Sanjeevan Pasupati, Gerard Devlin, David Smyth, Mark Webster, Peter Ruygrok
Journal: Circulation (2014)

Introduction: AS is a condition with an increasing prevalence in New Zealand (NZ). The natural history of severe AS is such that patients face a poor prognosis once the disease becomes clinically evident. Surgical aortic valve replacement (SAVR) is the standard of care, yet many are at high risk of poor outcomes due to comorbidity, frailty or anatomical limitations. Clinically TAVR may be an appropriate alternative treatment; however, at present it remains an expensive technology: the procurement cost of an Edwards Sapien trans catheter valve is NZD$30,000. Expansion of TAVR could have a major budget impact on the NZ public healthcare system. Conversely, the high cost of the transcatheter valve may be offset by intensive care unit stay and the cost of complications related to SAVR. Methods: To explore this further, we retrospectively compare index admission cost in AS patients with Euroscore 2 &gt; 4 undergoing SAVR with those having TAVR. Patients were excluded if they had surgery outsourced to the private sector, if they had not had their procedure by 31/3/2014 or if full costing data could not be extracted from the hospital business department. Clinical variables include date of admission, date of procedure, age, gender, weight, Euroscore 2, renal function (GFR), LV function and previous sternotomy. Data was collected across the three TAVR centers in NZ. A total of 170 TAVR patients are compared with 168 SAVR patients. Initial Results: Mean Euroscore 2 was 9.8 +/- 5.4 in the TAVR group compared with 7.4 +/- 4.3 in the SAVR group. The mean cost of SAVR vs TAVR was $65,793 and $52,582 respectively. Median cost was $54,826 for SAVR and $46,899 for TAVR. 57% of the mean cost of TAVR was due to the valve. Average length of stay in TAVR patients was half that of SAVR patients. ICU cost in SAVR patients was $10,021 higher than in the TAVR patients. On average, TAVR required 10% of the blood product costs associated with SAVR. Conclusions: We show that the average index admission cost of SAVR is significantly higher than TAVR in this group of patients who were at moderate to high risk of surgery. Also, non-device costs are much higher in SAVR, suggesting higher hospital resource requirements compared to TAVR. This data has implications for TAVR funding in the NZ public healthcare system.