tbuckley/cabot-search huggingface dataset:
Intracoronary Stenting and Risk for Major Adverse Cardiac Events During the First Month
Authors: Helmut Schühlen, Adnan Kastrati, Josef Dirschinger, Jörg Hausleiter, Shpend Elezi, Anne Wehinger, Jürgen Pache, Martin Hadamitzky, Albert Schömig
Journal: Circulation (1998)

Background —Our rationale for this study was to analyze the risk for procedural failure of attempted stenting and the risk for major adverse cardiac events (MACE) after success and to develop a risk stratification protocol for successful procedures. Methods and Results —Stenting was attempted in 2894 procedures during the 5-year study period (success in 98.3% of 3815 lesions). After failure, the MACE rate was 42.6%. The risk for failure was higher for lesions in the left circumflex coronary artery or in venous bypass grafts and after an acute occlusion before stenting; it increased with stenosis length or grade and decreased with vessel size and growing institutional experience in stenting. After success, death occurred in 0.8%, death or myocardial infarction in 2.0%, and any MACE in 3.6%. Independent risk factors for MACE were older age, diabetes, acute myocardial infarction, unstable angina, impaired left ventricular function, residual dissections, stent overlap, longer stented segments, and a postprocedural regimen without ticlopidine. Procedural factors were substantially stronger predictors than operator-independent variables available before procedures. Overall, the risk declined after the first 3 days. Two major factors exhibited time-dependent variations of their influence: while residual dissections were the dominant risk factor within the first 3 days with a reduction after that, no protective effect of ticlopidine could be identified before day 3. From these results, we derived a risk stratification protocol for individual procedures. Conclusions —These results underscore the importance of optimal angiographic results and the need for antiplatelet regimens with immediate onset. Our risk stratification protocol may guide individual postprocedural care and allow us to compare risk profiles of different study populations and to devise quality control programs for stenting.
USE OF MILTOWN (MEPROBAMATE) WITH PSYCHOTIC PATIENTS
Authors: VERONICA M. PENNINGTON
Journal: American Journal of Psychiatry (1957)

Miltown (meprobamate) was studied in 300 hospitalized psychotic patients. In the dosage range from two to twenty-four 400 mg. tablets daily, the drug produced complete remission of symptoms in 3% of patients, striking improvement in 35%, some improvement in an additional 46%, and no significant change in the remaining 16%. Physical gains resulting from better sleeping habits and relaxation were made in about half the patients. Paranoid schizophrenics appeared to derive greatest benefit from the drug. Noisy, assaultive, eneuritic, delusional, hallucinated patients were generally relieved of these symptoms, although psychological residuals usually remained. Psychological testing showed improvement in the Rorschach and Bender-Gestalt tests with an effort, in many cases still showing psychotic traits, to reach healthy relationships with their environment. Eight patients tested normal after taking the drug. Most of the remainder showed increased ability to sublimate their abnormal psychological drives, and to get along in their milieu. Thirty-three patients were able to be discharged from the hospital following Miltown treatment, and 27 were ready for release as soon as arrangements for family custody could be made. Retarded, blocked, hypoactive patients were not as markedly benefited as the hyperactive, noisy type. The safety of Miltown and its almost complete lack of side effects, except for hypotension in high dosage, makes it an ataraxic of choice. It is an important addition to the armamentarium of the neuropsychiatrist.
Studies raise doubts about benefit of athletics in reducing unhealthy behavior among adolescents
Authors: A. A. Skolnick
Journal: JAMA (1993)

ATHLETICS has been regarded widely as a means of encouraging children and adolescents to develop healthy habits and steering them away from smoking, drug abuse, and other detrimental behavior. Recent studies, however, raise some doubts about the role of sports in fostering healthy habits among the young.  At the 40th annual meeting of the American College of Sports Medicine, held in Seattle, Wash, new data were presented. Deborah J. Aaron, a doctoral student in epidemiology at the University of Pittsburgh (Pa) Graduate School of Public Health, reported preliminary findings of a 3-year longitudinal study of high-risk behavior among children in a metropolitan school district near Pittsburgh. Results from the first year suggest that school- and community-based athletic programs may provide little overall benefit in discouraging unhealthy behavior among adolescents, Aaron says.  In a related presentation at the conference, UCLA School of Medicine, Los Angeles, Calif, researchers reported study findings suggesting
NICE proposes to withdraw Alzheimer's drugs from NHS
Authors: Zosia Kmietowicz
Journal: BMJ (2005)

The drugs donepezil, rivastigmine, galantamine, and memantine should no longer be prescribed on the NHS to treat Alzheimer's disease, says new draft guidance from the National Institute for Clinical Excellence (NICE).

NICE, the NHS prescribing watchdog for England and Wales, has retracted its previous guidance“issued in 2001 and which said that these drugs should be prescribed for Alzheimer's disease—after reviewing the latest evidence on efficacy and cost effectiveness. Patients currently receiving any of the drugs, however, can continue to do so. Memantine will be available only as part of …
HOW SHALL WE FEED THE BABY?
Authors: A. C. COTTON
Journal: JAMA (1897)

If at the breast and doing well, leave it alone. If not doing well, let us ascertain the cause. Does it present evidences of innutrition, malnutrition, acute indigestion or chronic indigestion? Is there starvation from insufficient or improper food, or starvation from repletion? In some cases the fault is apparent at a glance; in many it is quite difficult to determine at first wherein the trouble lies. The apparent error as to time, frequency of feeding and quantity having been corrected, the physician may finally have to face this question, "can this mother's milk be made to fill all the requirements of this babe?" and the sooner we ascertain just what and how much this mother is secreting, the sooner we are on the way to a solution of this problem. We must examine the breast milk as to its total amount and as to the relative quantity and quality
692. Aerosol Delivery of Concentrated pDNA/ PEI Formulations to the Murine Lung
Authors: Lee A. Davies, Stephen C. Hyde, Deborah R. Gill
Journal: Molecular Therapy (2006)

Plasmid DNA (pDNA) complexed to the cationic polymer polyethyleneimine (PEI) has been shown to retain transfection efficiency following aerosolisation and as a result, PEI has become a popular choice of gene transfer agent for lung gene therapy. Development of PEI for clinical applications has been hampered by the relatively low pDNA/PEI concentrations that can be prepared in the laboratory - typically less than 0.4mg/ml. We have investigated the use of a large-scale ultrafiltration protocol to generate stable concentrated pDNA/PEI formulations in excess of 8mg/ml and we have tested these formulations in a mouse lung model. Plasmid pCIKLux expressing the firefly luciferase gene under the control of the cytomegalovirus immediate/early promoter was complexed with branched 25kDa PEI (N:P of 10:1) at an initial concentration of 0.2mg/ml. This formulation was concentrated using a pressurised ultrafiltration cell incorporating a 100kDa cut-off cellulose membrane to produce final formulations containing 1,2,4 and 8mg/ml pDNA/ PEI complexes. Following concentration, pCIKLux/PEI formulations were administered to the lungs of female BALB/c mice (8–16wks) via nasal instillation (100μl) or whole body aerosol exposure (10ml aerosol) and luciferase expression was determined in whole lung homogenates 24hrs later. Although instillation of pCIKLux/PEI formulations at 1mg/ml resulted in good levels of luciferase gene expression (71.1±16.7 RLU/mg protein), the observed expression was not significantly different from that achieved following instillation of standard 0.2mg/ml formulation (41.6±10.4 RLU/ mg) (p=0.35 ANOVA). In addition, instillation of complexes to the mouse lung was associated with considerable dose-dependent toxicity, manifested by weight loss, histological changes and elevated neutrophil levels in bronchoalveolar lavage fluid (BALF). Instillation of pDNA/PEI complexes at 1mg/ml resulted in significant mortality and higher concentrations were not assessed. In contrast, aerosol delivery of concentrated pDNA/PEI formulations to the mouse lung resulted in high levels of reporter gene expression with minimal associated lung toxicity. Aerosol delivery of pCIKLux/PEI at 1mg/ ml produced luciferase expression at 133.2±11.2 RLU/mg compared to 18.8±1.9 RLU/mg for standard 0.2mg/ml formulations (p=0.0003 ANOVA). Higher concentrations resulted in increased luciferase expression at 2mg/ml (215.5±18.9 RLU/mg), 4mg/ml (274.0±39.2 RLU/mg) and even 8mg/ml (310.3±55.5 RLU/mg) although expression did not increase in a linear fashion relative to the delivered dose. Minimal evidence of lung toxicity was observed following aerosol delivery with moderate weight loss and a slight elevation of BALF neutrophil numbers observed only at doses of 4mg/ml and above. These results demonstrate that viable concentrated pDNA/PEI formulations can be produced which generate high levels of reporter gene expression and minimal toxicity in the mouse lung following aerosol delivery.
Elevated C-reactive protein levels are associated with myocardial ischemia early in the course of non-ST elevation coronary syndromes
Authors: Olga Papadaki, Michael N. Zairis, John A. Ambrose, Maria Thoma, Paraskevi Psarogianni, Stavros Manousakis, Olga Ampartzidou, Alexander Kardoulas, Mary DeVoe, Kostas Katsaros, Kostas Karidis, Stefanos Foussas
Journal: Journal of the American College of Cardiology (2003)
Mortality From Pulmonary Embolism
Authors: James R. Johnson
Journal: JAMA (1986)

<h3>To the Editor.—</h3> As possible explanations for the decrease in fatal pulmonary embolism (PE) observed in their study, Dismuke and Wagner<sup>1</sup>point to the increasing use of prophylactic minidose heparin, pulmonary angiography, and therapeutic anticoagulation during the period of their study. Other factors, particularly changes in physicians' use of bed rest and early mobilization, may also have played a role. Immobility and prolonged bed rest are acknowledged risk factors for venous thrombosis and PE, and early mobilization of bed-bound patients has been shown to reduce the incidence of venous thrombosis.<sup>2</sup>Changes have occurred over recent years in the way physicians utilize activity as a mode of therapy, with a trend toward less enforced bed rest, earlier supervised mobilization, and shorter hospital stays. For example, in the 1950s patients with myocardial infarction (MI) were usually rested for four to eight weeks.<sup>3</sup>In 1970, even uncomplicated MI was still
Effects of Cholesterol-Lowering Drugs on Serum Triglycerides
Authors: Maurice M. Best, Charles H. Duncan
Journal: JAMA (1964)

THE ASSOCIATION of elevated levels of blood cholesterol with an increased risk of manifest coronary artery disease is supported by a number of retrospective and prospective studies. Similar data linking elevated blood levels of triglycerides with coronary atherosclerosis are far less numerous. Using an indirect method of estimating triglycerides, Albrink et al 1 reported that serum triglyceride levels effected a far more clear-cut separation between a group of patients with previous myocardial infarction and a group presumed to be normal than did serum total cholesterol levels. Schrade et al, 2 employing a more direct method of determining triglycerides, also noted that a group of patients with prior myocardial infarction had a greater increase of serum triglycerides than of cholesterol as compared with a presumably normal group. A final decision as to whether serum triglycerides provide a better predictive index of future coronary artery disease than does serum cholesterol will have
Myelin-Associated Glycoprotein Interacts with the Nogo66 Receptor to Inhibit Neurite Outgrowth
Authors: Marco Domeniconi, Zixuan Cao, Timothy Spencer, Rajeev Sivasankaran, Kevin C. Wang, Elena Nikulina, Noriko Kimura, Hong Cai, Kangwen Deng, Ying Gao, Zhigang He, Marie T. Filbin
Journal: Neuron (2002)
Cleft Palate and Harelip: The Earlier Operation on the Palate.
Authors: Edmund Owen
Journal: JAMA (1904)

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
Taking the temperature of Detroit
Authors: S. Frisch
Journal: BMJ (2014)

Suzy Frisch looks at health in the bankrupt city

The saying about Detroit goes, “When the nation catches a cold, Detroit gets pneumonia.” Battered by the turbulent US automotive industry, high unemployment, and global recession, Detroit has been critically ill for years, and its residents aren’t faring much better.

When the city declared bankruptcy last summer, it revealed festering problems that have been eroding this once vital American city. Detroit’s ugly financial crisis—including $18bn (11bn; €13bn) in liabilities and debt—unfolded dramatically as city services crumbled, crime rose to nation-leading levels, and residents’ access to jobs, insurance, and healthcare withered. Detroit was left with 23% unemployment—more than triple the national average—and 34.5% of residents living in poverty.

“The biggest health issue in the city is poverty,” notes Marianne Udow-Phillips, former director of the Michigan Department of Human Services, who now heads the University of Michigan’s Center for Healthcare Research and Transformation (CHRT). “There is a very high child poverty rate in Detroit, a very high adult poverty rate and illiteracy rate, and we know these things are more associated with poor health. It’s not that the bankruptcy is the cause, but they are so intertwined. It’s the story of changes in the auto industry leaving this city behind.”

As the auto industry began to flounder in the late 1960s, thousands of middle class jobs were lost causing a domino effect of brutal consequences. Though all of the blame can’t be dumped on the auto industry—Detroit’s leaders get a heaping dose of culpability for financial mismanagement—it certainly started the ball rolling.

Lack of well paid jobs prompted more crime, which led more employers and residents to leave. To make up for its shrinking tax base, the city raised taxes and cut services. Then race riots in the 1960s exacerbated white flight, leaving …
Merimepodib, pegylated interferon, and ribavirin in genotype 1 chronic hepatitis C pegylated interferon and ribavirin nonresponders
Authors: Vinod K. Rustgi, William M. Lee, Eric Lawitz, Stuart C. Gordon, Nezam Afdhal, Fred Poordad, Herbert L. Bonkovsky, Leif Bengtsson, Gurudatt Chandorkar, Matthew Harding, Lindsay McNair, Molly Aalyson, John Alam, Robert Kauffman, Shahin Gharakhanian, John G. McHutchison
Journal: Hepatology (2009)

Merimepodib (MMPD) is an orally administered, inosine monophosphate dehydrogenase inhibitor that has shown antiviral activity in nonresponders with chronic hepatitis C (CHC) when combined with pegylated interferon alfa 2a (Peg-IFN-alfa-2a) and ribavirin (RBV). We conducted a randomized, double-blind, multicenter, phase 2b study to evaluate the antiviral activity, safety, and tolerability of MMPD in combination with Peg-IFN-alfa-2a and RBV in patients with genotype 1 CHC who were nonresponders to prior therapy with Peg-IFN and RBV. Patients received 50 mg MMPD, 100 mg MMPD, or placebo every 12 hours, in addition to Peg-IFN-alfa-2a and RBV, for 24 weeks. Patients with a 2-log or more decrease from baseline or undetectable hepatitis C virus (HCV) RNA levels at week 24 were then eligible to continue Peg-IFN-alfa-2a and RBV for a further 24 weeks, followed by 24 weeks of follow-up. The primary efficacy endpoint was sustained virological response (SVR) rate at week 72 in all randomized patients who received at least one dose of study drug and had a history of nonresponse to standard therapy. A total of 354 patients were randomized to treatment (117 to placebo; 119 to 50 mg MMPD; 118 to 100 mg MMPD), and 286 completed the core study. The proportion of patients who achieved SVR was similar among the treatment groups: 6% (6/107) for 50 mg MMPD, 4% (5/112) for 100 mg MMPD, and 5% (5/104) for placebo (P = 0.8431). Adverse-event profiles for the MMPD combination groups were similar to that for Peg-IFN-alfa and RBV alone. Nausea, arthralgia, cough, dyspnea, neutropenia, and anemia were more common in patients taking MMPD. Conclusion: The addition of MMPD to Peg-IFN-alfa-2a and RBV combination therapy did not increase the proportion of nonresponder patients with genotype 1 CHC achieving an SVR. (HEPATOLOGY 2009.)
Ultrasound shows carotid stenosis in just half of cervical bruit cases
Authors: William A. Check
Journal: JAMA (1984)

Acervical bruit indicates the presence of substantial carotid stenosis only about half the time, according to researchers at the University of Toronto. They suggest that only in the minority of persons with a bruit and carotid stenosis—those in whom the stenosis is severe—is there a substantially increased risk of cerebrovascular events. Even then, the incidence of stroke and transient ischemic attack (TIA) is "surprisingly low," according to one of the Canadian clinicians. But cardiac events are more frequent and more often fatal. Those were the main conclusions that Brian Chambers, MD, a research fellow of the Ontario Heart and Stroke Foundation at Sunnybrook Medical Centre of the University of Toronto, reported to the Ninth International Joint Conference on Stroke and Cerebral Circulation. He and James W. Norris, MD, professor of neurology, are interested in clarifying the risk of stroke and TIAs in persons with cervical bruits. "Our data would suggest
Olig1 Function Is Required to Repress Dlx1/2 and Interneuron Production in Mammalian Brain
Authors: John C. Silbereis, Hiroko Nobuta, Hui-Hsin Tsai, Vivi M. Heine, Gabriel L. McKinsey, Dimphna H. Meijer, MacKenzie A. Howard, Magda A. Petryniak, Gregory B. Potter, John A. Alberta, Scott C. Baraban, Charles D. Stiles, John L.R. Rubenstein, David H. Rowitch
Journal: Neuron (2014)
Clinical and Cost Effectiveness of Hexaminolevulinate-guided Blue-light Cystoscopy: Evidence Review and Updated Expert Recommendations
Authors: J. Alfred Witjes, Marek Babjuk, Paolo Gontero, Didier Jacqmin, Alexander Karl, Stephan Kruck, Paramananthan Mariappan, Juan Palou Redorta, Arnulf Stenzl, Roland van Velthoven, Dirk Zaak
Journal: European Urology (2014)
A Crusted Plaque on the Right Nipple
Authors: Hsien-Yi Chiu, Tsen-Fang Tsai
Journal: JAMA (2012)

A HEALTHY 27-YEAR-OLD HETEROSEXUAL MAN PRESENTS WITH A CRUSTED plaque on his right nipple. The lesion formed gradually over a week after a bite during sexual intercourse and has persisted for a month. The patient reports that over the following 2 to 3 weeks, no significant change in size or morphology of this lesion occurred. The lesion is not painful; neither fever nor associated systemic symptoms are noted. Now, 1 month later, the patient presents with a generalized asymptomatic skin eruption. Physical examination reveals generalized pink macules on the trunk and extremities (FIGURE 1A). A crusted, erythematous plaque is noted over the enlarged right nipple (Figure 1B). What Would You Do Next?
Metabolism of the Food-Derived Carcinogen 2-Amino-1-methyl-6-phenylimidazo(4,5-b)pyridine by Lactating Fischer 344 Rats and Their Nursing Pups
Authors: C. D. Davis, A. Ghoshal, H. A. J. Schut, E. G. Snyderwine
Journal: JNCI Journal of the National Cancer Institute (1994)

An important class of dietary mutagens and carcinogens are the heterocyclic arylamine compounds that have been identified in a variety of cooked, protein-containing foods. Among these heterocyclic amines, 2-amino-1-methyl-6-phenylimidazo[4,5-b]-pyridine (PhIP) is potentially the most important carcinogen for human cancer risk. We have recently observed that PhIP-derived radioactivity is excreted into the breast milk of lactating rats administered [3H]PhIP.To better assess the significance of breast milk as a route of exposure of the newborn to dietary heterocyclic amines, we examined the metabolites of PhIP in breast milk and in urine of nursing pups.Lactating Fischer 344 rats with 5-day-old pups were given a single oral dose of 10 mg/kg of [3H]PhIP. We collected milk from the dams and urine from the pups and then analyzed the samples for metabolites of PhIP, using high-pressure liquid chromatography (HPLC). PhIP-DNA adduct levels in the tissues of the pups were determined by 32P-postlabeling analysis.Three radioactive peaks were observed by HPLC separation of milk samples: an unidentified early eluting peak, 4'-hydroxy-PhIP, and PhIP. Four metabolites and the parent compound were found in urine of the pups nursed by dams given radiolabeled PhIP: PhIP-4'-O-glucuronide, PhIP-4'-sulfate, 4'-hydroxy-PhIP, and N2-hydroxy-PhIP-N3-glucuronide. 4'-Hydroxy-PhIP and its conjugates contributed approximately 60% of the radioactivity found in the urine. By 32P-postlabeling analysis, PhIP-DNA adducts were detected in spleen, lung, heart, kidney, liver, and stomach of pups at mean levels ranging from 0.06 to 0.55 adducts/10(7) nucleotides.The large percentage of 4-hydroxy-PhIP and its conjugates in the urine indicates that 5-day-old pups detoxify PhIP and further metabolize 4'-hydroxy-PhIP obtained from the breast milk. The presence of the glucuronide conjugate of N-hydroxy-PhIP in the urine of pups and the lack of detectable conjugate or N-hydroxylamine itself in breast milk suggest that PhIP from breast milk undergoes metabolic activation via N-hydroxylation in 5-day-old rat pups. This conclusion was further supported by the observation that hepatic S9 fractions from the pups activated PhIP to a mutagen in the Ames Salmonella mutagenicity assay and by the presence of PhIP-DNA adducts in the tissues of the pups.The findings reported here may have carcinogenic and toxicologic implications for the offspring of women who breast-feed and consume a diet rich in cooked meat.
Combination of rapid heart-type fatty acid binding protein and wall motion analysis using echocardiography at emergency room improves an early diagnostic value of acute myocardial infarction
Authors: Eiichi Nagashima, Masako Okada, Takahiro Ota, Eriko Murata, Kenji Shimeno, Keiji Nagae, Shiro Yanagi, Kazuyoshi Hirota, Junichi Yoshikawa
Journal: Journal of the American College of Cardiology (2003)