tbuckley/cabot-search huggingface dataset:
Recent Age-Related Trends in the Use of Thrombolytic Therapy in Patients Who Have Had Acute Myocardial Infarction
Authors: Jerry H. Gurwitz
Journal: Annals of Internal Medicine (1996)

To examine recent trends in the use of thrombolytic therapy in elderly patients who have had acute myocardial infarction and to determine whether failure to meet time-to-hospital presentation and electrocardiographic criteria might explain age-related differences in the use of thrombolytic therapy.A national registry of patients who have had acute myocardial infarction.1249 U.S. hospitals.350,755 patients who had an acute myocardial infarction from 1 July 1990 to 30 September 1994.Trends in the proportions of patients who received thrombolytic therapy were examined according to age and sex. The association between age and treatment with a thrombolytic agent was determined by crude and multivariable-adjusted analyses.Use of a thrombolytic agent was inversely related to patient age: Almost 51% of patients younger than age 55 years received a thrombolytic agent during hospitalization for acute myocardial infarction; this proportion decreased to 43.6% for patients aged 55 to 64 years, 33.0% for those aged 65 to 74 years, 19.0% for those aged 75 to 84 years, and 7.4% for those aged 85 years or older. However, relative increases in the use of thrombolytic therapy over time were greatest for patients in the oldest age groups. Between 1 July 1990 and 30 June 1991, 16.0% of patients aged 75 to 84 years received a thrombolytic agent compared with 21.4% between 1 June 1993 and 30 September 1994 (a 33.8% relative increase in use). Among persons aged 85 years or older, the proportion of treated patients increased from 5.3% to 9.1% over this same period (a 71.7% relative increase in use). Increases in thrombolytic use were most prominent for older women. After adjustment for sex, diagnosis by initial electrocardiogram, electrocardiogram-based infarction description, time from symptom onset to hospital presentation, and period of the acute myocardial infarction, the odds of receiving a thrombolytic agent were significantly reduced for patients in the older age groups compared with the odds for patients younger than age 55 years (for patients aged 75 to 84 years, the adjusted odds ratio was 0.27 [95% CI, 0.26 to 0.28]; for patients aged 85 years or older, the odds ratio was 0.09 [CI, 0.08 to 0.10]).Although older patients who have had acute myocardial infarction less commonly receive a thrombolytic agent, use of thrombolytic therapy in this population is expanding. However, substantial differences across age groups persist in the likelihood of receiving treatment, even after adjustment for potentially confounding factors. Age-related differences in thrombolytic use may not be completely explained by the degree to which older patients do not meet conventional eligibility criteria for thrombolytic therapy.
Evidence of myocardial ischaemia in severe scorpion envenomation
Authors: Mabrouk Bahloul, Chokri Ben Hamida, Khalil Chtourou, Hichem Ksibi, Hassen Dammak, Hatem Kallel, Adel Chaari, Hedi Chelly, Fadhel Guermazi, Noureddine Rekik, Mounir Bouaziz
Journal: Intensive Care Medicine (2003)
PET Pozitif İntratorasik Lenf Nodlarının Aydınlatılması İçin EBUS-TBNA - Uluslararası Çok-Merkezli Bir Deneyim
Authors: Robert C. Rintoul, Frcp, Kurt G. Tournoy, em> Hesham El Daly, em> Nicholas R. Carroll, Frcr, Robert C. Buttery, Mrcp, Klaas van Kralingen, em> Jan P. van Meerbeeck, em> Klaus F. Rabe, Jouke T. Annema, em
Journal: Journal of Thoracic Oncology (2009)
Abstract 15739: Statin Therapy and Inflammation in Patients With Diabetes Treated With High Dose Aspirin
Authors: Kevin Bliden, Rahil Rafeedheen, Udaya Tantry, Peter P Toth, Christopher Franzese, Martin Gesheff, Shachi Pandya, Paul A Gurbel
Journal: Circulation (2014)

Background:  The role of aspirin and statins in high risk patients with coronary artery disease (CAD) and diabetes mellitus (DM) is well established. We aim to evaluate the relationship of lipid lowering therapy with 1) in-vivo thromboxane (Tx) generation, a marker of inflammation, blood thrombogenicity, and cholesterol levels in DM patients with suspected coronary artery disease on high dose aspirin therapy.   Methods:  Patients with DM and suspected CAD on statins (n=167) were compared to DM not on statins (n=42) in the Multi-Analyte, Thrombogenic, and Genetic Markers of Atherosclerosis study. Urinary 11-dehydrothromboxane B2 (11-dh-TxB2) was measured using AspirinWorksTM ELISA assay. Lipid profile was determined by vertical density gradient ultracentrifugation and AtherOx testing was performed by immunoassay. Thrombogenicity was assessed by thrombelastography, and ADP and collagen-induced light transmittance aggregometry. Blood and urine samples were collected immediately prior to elective coronary angiography.CAD was defined as none/minor (   Results:  Sixty-six percent, 19%, and 15% of patients had severe, moderate, and no CAD, respectively. Statin therapy was associated with lower 11-dh-TxB2 (figure), collagen- induced aggregation, total cholesterol, total LDL, LDL3, oxidized LDL, Apo B 100, and ApoB100/A1 ratio (p more than 0.01 for all). Statin therapy was associated with a lower proportion of high urinary 11-dh-TxB2 (>1500 pg 11-dh-TxB2/ mg creatinine) compared to patients not on statin therapy (25% vs. 57%, p=0.01).   Conclusions:  Statin therapy appears to confer a further anti-inflammatory effect to high dose aspirin in patients with diabetes and CAD; measurement of urinary 11-dh-TxB2 may be a useful tool in personalizing statin therapy to optimally attenuate inflammation in DM.
Abstract 11835: Title: Quality and Efficacy of Patient Self-Management of Warfarin
Authors: Kathleen R Bonaventura, Kerry Milner
Journal: Circulation (2014)

Objective: Patient self-management (PSM) is self-testing and altering the dose of their warfarin which allows for more frequent self-testing of warfarin levels, rapid results, timely dosage change, less dependency on the healthcare provider, and can be done anywhere. The objective of this study was to determine if PSM of warfarin is as safe and effective as healthcare provider dosing. Method: The setting for this study was a large cardiology practice that manages over 1000 patients on warfarin. Of these patients, 500 (50%) were using warfarin due to a valve replacement and 155 (16%) were engaged in self-testing. The final sample included 50 (32%) patients using self-testing who completed a 2-hour structured educational program on PSM of warfarin and practiced PSM for a 13-week period. Percentage of time the INR was maintained in therapeutic range, variance from the prescribed INR, and the adverse events of bleeding or thromboembolism were measured for 13 weeks pre-PSM and 13 weeks during PSM. Data were analyzed using t-test, correlation and Wilcoxson rank sum test. Results: There was no significant difference in pre-PSM time in therapeutic range compared with during PSM time in therapeutic range (p = .74). The mean INR variance from the prescribed INR range decreased significantly during PSM compared with pre-PSM, (p = .03), and when the INR did vary from the patient-specific prescribed range it tended to be in the high range but this did not reach significance (p = .67). These were desirable effects because this patient population is at high risk for embolic events. There was no significant increase in adverse events during PSM (p = .32). Conclusion: PSM of Warfarin was found to be as safe and effective as provider management. Moreover, PSM resulted in tighter control of INR variance compared with provider dosing. These results support the use of PSM of warfarin for eligible patients. Furthermore the model of PSM used in this study elicited patient engagement in behaviors that reduced the impact of their disease and decreased the burden of care on the healthcare provider.
Abstract 649: Effect of Aging and Habitual Endurance Exercise on Vascular Endothelial NF-kappa;B Protein Expression and Dilation in Humans
Authors: Gary L Pierce, Anthony J Donato, Iratxe Eskurza, Phillip E Gates, Cassandra Roeca, Adam S Levy, Annemarie E Silver, Douglas R Seals
Journal: Circulation (2006)

Background:  Aging is a major risk factor for clinical atherosclerotic diseases and is associated with impaired vascular endothelial function (e.g., decreased endothelium-dependent dilation, EDD) and reduced exercise capacity. Middle-aged and older adults who habitually perform aerobic exercise have a reduced risk of atherosclerotic diseases, preserved EDD and enhanced exercise capacity. The molecular mechanisms for these divergent effects are incompletely understood, but may involve different chronic states of low-grade vascular oxidative stress and inflammation. Nuclear factor-kappa B (NF-κB) is key redox-sensitive pro-inflammatory transcription factor linked to atherosclerosis. We hypothesized that these respective functional phenotypes of sedentary and physically active aging would be associated with increased and reduced endothelial NF-κB expression, respectively.   Methods:  EDD (brachial artery flow- mediated dilation), maximal exercise capacity (maximal oxygen uptake, VO 2  max) and venous endothelial cell protein expression of NF-κB p65 subunit (quantitative immunofluorescence of protein normalized to HUVEC control) were determined in young sedentary (YS: n=41, age 23 ± 1 yrs, 35M), older sedentary (OS: n=48, age 63 ± 1 yrs, 35M), and older trained (OT: n=22, age 63 ± 1 yrs, 22M) healthy adults.   Results:  There was decline in EDD (OS: 0.17 ± 0.01 mm, 4.35 ± 0.33 %; YS: 0.30 ± 0.01 mm, 7.52 ± 0.33 %, p 2  max (OS: 27.9 ± 0.7; YS: 44.7 ± 1.0, p 2  max (n=45; r =−0.365, p   Conclusions:  Vascular endothelial expression of NF-κB is increased in sedentary, but not in habitually exercising middle-aged and older healthy adults. These differences in endothelial NF-κB expression may be an important molecular mechanism contributing to differences in endothelial function, exercise capacity and risk of atherosclerotic diseases with sedentary and physically active aging in humans.
The Night Nurse
Authors: Sandra Stone
Journal: JAMA (2005)

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
Epidermal Langerhans cell apoptosis is induced<i>in vivo</i>by nonanoic acid but not by sodium lauryl sulphate
Authors: None Forsey, None Shahidullah, None Sands, None Mcvittie, None Aldridge, None Hunter, None Howie
Journal: British Journal of Dermatology (1998)

Exposure to irritants may cause chronic irritant contact dermatitis (ICD), characterized by irregular epidermal thickening and a predominantly dermal mononuclear cell infiltrate. The mechanisms involved, and why only certain individuals are affected, are not clearly understood. Different irritants may trigger different cellular and molecular interactions between resident skin cells and recruited inflammatory cells. In some individuals these interactions may become self-perpetuating resulting in persistent inflammation in the absence of continued exposure. This study examined Langerhans cell (LC) density in clinically normal skin of 46 patients with chronic ICD and 10 healthy individuals, and compared the action of the two irritants nonanoic acid (NA) and sodium lauryl sulphate (SLS) on the LCs and keratinocytes of clinically normal skin in patients with chronic ICD. There was a higher number of LCs/mm basement membrane in patients compared with controls, although there was no difference in the number of dendrites/LC nor in dendrite length. SLS induced keratinocyte proliferation after 48 h exposure, had no effect on LC number or distribution, and induced keratinocyte apoptosis after 24 and 48 h exposure. In contrast, NA decreased keratinocyte proliferation after 24 h exposure but this returned to basal levels after 48 h, and induced epidermal cell apoptosis after only 6 h exposure. NA dramatically decreased LC number after 24 and 48 h exposure, which was accompanied by basal redistribution and decreased dendrite length. Most significantly, NA induced apoptosis in over half of the LCs present after 24 and 48 h exposure.
Changing Treatment Paradigms in Metastatic Breast Cancer
Authors: Cesar A. Santa-Maria, William J. Gradishar
Journal: JAMA Oncology (2015)

Advances in understanding tumor biology, particularly signaling pathways, have led to the development and approval of many novel agents and have changed the landscape of therapy for patients with metastatic breast cancer. This review highlights some of the recent successes and failures in breast cancer drug development, including strategies to overcome endocrine and human epidermal growth factor 2-neu (HER2) resistance, targeting triple-negative breast cancers (which do not express the HER2, estrogen, and progesterone receptors) through novel receptors, harnessing the immune system, and new ways of targeting angiogenesis. For patients with metastatic breast cancer, expanding therapeutic options through clinical trial participation is a crucial part of modern oncology practice. As we continue to learn how to use targeted therapies in the context of genomic medicine, analysis of the tumor in real-time may become increasingly important, giving researchers the information needed to start combining therapies in a biologically informed manner.
Noninvasive Evaluation With Multislice Computed Tomography in Suspected Acute Coronary Syndrome
Authors: Maureen M. Henneman, Joanne D. Schuijf, Gabija Pundziute, Jacob M. van Werkhoven, Ernst E. van der Wall, J. Wouter Jukema, Jeroen J. Bax
Journal: Journal of the American College of Cardiology (2008)
Erratum
Authors: J. W. Dodd, S. V. Getov, P. W. Jones
Journal: European Respiratory Journal (2010)

Regretfully, two of the table citations in the above paper were presented incorrectly.The first sentence of the ''Cognitive function and hypoxaemia'' section should have referred to table 2, not table 1.The same error occurred in the first paragraph, second sentence of the section, ''Is there a specific pattern of cognitive deficit in COPD?''; table 2 should also have been referred to here and not table 1.
Behavioral Cardiology
Authors: Alan Rozanski
Journal: Journal of the American College of Cardiology (2014)

Growing epidemiological evidence identifies key domains relevant to behavioral cardiology, including health behaviors, emotions, mental mindsets, stress management, social connectedness, and a sense of purpose. Each of these domains exists along a continuum, ranging from positive factors that promote health, to negative factors, which are pathophysiological. To date, there has been relatively little translation of this growing knowledge base into cardiology practice. Four initiatives are proposed to meet this challenge: 1) promulgating greater awareness of the potency of psychosocial risks factors; 2) overcoming a current "artificial divide" between conventional and psychosocial risk factors; 3) developing novel cost-effective interventions using Internet and mobile health applications, group-based counseling, and development of tiered-care behavioral management; and 4) in recognition that "one size does not fit all" with respect to behavioral interventions, developing specialists who can counsel patients in multidisciplinary fashion and use evidence-based approaches for promoting patient motivation and execution of health goals.
A conserved sorting-associated protein is mutant in chorea-acanthocytosis
Authors: Luca Rampoldi, Carol Dobson-Stone, Justin P. Rubio, Adrian Danek, Richard M. Chalmers, Nicholas W. Wood, Christine Verellen, Xavier Ferrer, Alessandro Malandrini, Gian M. Fabrizi, Robert Brown, Jeffery Vance, Margaret Pericak-Vance, Gabrielle Rudolf, Sophie Carrè, Elisa Alonso, Michela Manfredi, Andrea H. Németh, Anthony P. Monaco
Journal: Nature Genetics (2001)
Abstract 9349: Wave Reflection but Not Arterial Stiffness is Much Highly Correlated with Ambulatory Blood Pressure Parameters Including Blood Pressure Variability and Morning Blood Pressure Surge
Authors: Pai F Hsu, Shao Y Chuang, Hao M Cheng, Shih H Sung, Wen C Yu, Pesus Chou, Chen H Chen
Journal: Circulation (2011)

Background: With growing evidences that blood pressure (BP) variability, daily BP peak or morning BP surge are independently related to organ damage and future cardiovascular events. We try to invest the role of arterial stiffness and wave reflection, cardiac output in the association of those ambulatory BP parameters. Methods: A sample of 1156 normotensive and untreated hypertensive Taiwanese participants (546 women aged 30-79 years) was drawn from a community-based survey. All participants were recorded with 24 hours ambulatory blood pressure monitors. Besides, serum laboratory data, carotid-femoral pulse wave velocity (PWV, current gold standard for arterial stiffness), amplitude of the backward pressure wave decomposed from a calibrated tonometry-derived carotid pressure waveform (Pb, a transit-time independent index for wave reflections), and hemodynamic data include cardiac output were collected. Results: Mean 24 hours, day, and night systolic blood pressure (SBP), diastolic blood pressure (DBP), SBP standard deviation (SBPsd), DBP standard deviation (DBPsd), are all highly correlated to Pb, PWV, cardiac output (CO) and augmented pressure (r=0.506,0.274, 0.167, 0.419, all p&lt;0.01 with regard to 24 hour SBPsd). At multi-variates regression models, Pb remains the strongest predictor for early morning BP surge, SBPsd, and DBPsd even after adjusting possible confounders include age, sex, cholesterol, triglycerides, creatinine, and body weight index. Conclusion: Reflective wave Pb is the strongest independent factor for predicting daily BP variability, (SBPsd, DBPsd) and even mean-SBP, DBP, morning BP surge but not central arterial stiffness.
Vital signs: nonfatal, motor vehicle - occupant injuries (2009) and seat belt use (2008) among adults - United States.
Authors: Laurie F Beck, B A West
Journal: MMWR Morbidity and Mortality Weekly Report (2011)

Motor vehicle crashes are the leading cause of death in the United States among persons aged 5-34 years. Seat belts have been shown to be the most effective method for reducing injuries among adults in the event of a crash. The CDC used 2009 data from the National Electronic Injury Surveillance System--All Injury Program to provide U.S. estimates of the number and rate of nonfatal, motor vehicle--occupant injuries treated in emergency departments among adults aged ≥18 years. In addition, CDC used 2008 data from the Behavioral Risk Factor Surveillance System to estimate the prevalence of self-reported seat belt use among adults in the United States. Seat belt use was examined further by type of state seat belt enforcement law. In 2009 in the United States, an estimated 2.3 million adult motor vehicle--occupants had nonfatal injuries treated in emergency departments. The nonfatal, motor vehicle--occupant injury rate declined 15.6% from 1,193.8/100,000 population in 2001 to 1,007.5/100,000 population in 2009. In 2008, self-reported seat belt use was higher in states with primary enforcement laws (88.2%), compared with states with secondary enforcement laws (79.2%). If the secondary law states had achieved 88.2% seat belt use in 2008, an additional 7.3 million adults would have been belted. From 2002-2008, self-reported seat belt use increased overall from 80.5% to 85.0%. Nonfatal, motor vehicle--occupant injuries treated in emergency departments have declined in recent years but still affect a substantial proportion of the adult U.S. population each year. Self-reported belt use increased from 2002-2008, and was higher in states with primary enforcement laws compared with states with secondary enforcement laws. Seat belt use is a proven method to reduce motor vehicle--occupant injuries, and the results of this analysis demonstrate that states with primary enforcement laws have higher prevalence of self-reported seat belt use. To help reduce the number of motor vehicle--occupant injuries, 19 states without primary enforcement laws should consider enacting them.
Abstract 14056: Prognostic Impact of Rho-kinase Activity in Circulating Leukocytes of Patients with Vasospastic Angina
Authors: Taro Nihei, Jun Takahashi, Ryuji Tsuburaya, Kiyotaka Hao, Yuji Odaka, Kensuke Nishimiya, Yasuharu Matsumoto, Kenta Ito, Hiroaki Shimokawa
Journal: Circulation (2014)

Background: Rho-kinase plays a central role in the pathogenesis of coronary artery spasm. We have recently demonstrated that Rho-kinase activity in circulating leukocytes is a useful biomarker for diagnosis and disease activity assessment of vasospastic angina (VSA). However, its prognostic impact in VSA patients remains to be examined. Methods: We prospectively enrolled 174 consecutive VSA patients (M/F 116/58, 62±12 [SD] yrs) and 53 non-VSA patients (M/F 32/21, 62±15 yrs) and followed them for 14±9 months. At the enrollment, Rho-kinase activity in circulating leukocytes (the ratio of phosphorylated/total form of myosin binding subunit, a Rho-kinase substrate) was measured. The primary endpoint was major adverse cardiac events (MACE). Results: Baseline Rho-kinase activity was significantly higher in VSA than in non-VSA patients (1.20±0.33 vs. 1.07±0.21, P&lt;0.01) and all VSA patients were treated with calcium channel blockers. During the follow-up period, MACE occurred in 9 VSA patients (5.2%) but none in non-VSA patients. Baseline Rho-kinase activity was significantly higher in VSA patients with MACE than in those without it (1.33±0.13 vs. 1.20±0.33, P&lt;0.001). Importantly, when we divided VSA patients into 2 groups by a median value of baseline Rho-kinase activity, Kaplan-Meier survival analysis showed a significantly worse prognosis in VSA patients with high Rho-kinase activity (p-MBS/t-MBS ≥1.20) ( Figure ). Univariate linear regression models showed that there was no association between established prognostic factors of VSA (e.g. history of out-of-hospital cardiac arrest, current smoking, angina at rest, significant organic stenosis and β-blocker use) and baseline increased levels of Rho-kinase activity. Conclusions: These results indicate that increased Rho-kinase activity in circulating leukocytes may be a useful and independent biomarker for long-term prognosis of VSA patients.