tbuckley/cabot-search huggingface dataset:
Determination of who may derive most benefit from aspirin in primary prevention: subgroup results from a randomised controlled trial
Authors: T W Meade, P J Brennan
Journal: BMJ (2000)

<h3>Abstract</h3> <b>Objective:</b> To determine which groups of patients may derive particular benefit or experience harm from the use of low dose aspirin for the primary prevention of coronary heart disease. <b>Design:</b> Randomised controlled trial. <b>Setting:</b> 108 group practices in the Medical Research Council9s general practice research framework who were taking part in the thrombosis prevention trial. <b>Participants:</b> 5499 men aged between 45 and 69 years at entry who were at increased risk of coronary heart disease. <b>Main outcome measures:</b> Myocardial infarction, coronary death, and stroke. <b>Results:</b> Aspirin reduced coronary events by 20%. This benefit, mainly for non-fatal events, was significantly greater the lower the systolic blood pressure at entry (interaction P=0.0015), the relative risk at pressures 130 mm Hg being 0.55 compared with 0.94 at pressures &gt;145 mm Hg. Aspirin also reduced strokes at low but not high pressures, the relative risks being 0.41 and 1.42 (P=0.006) respectively. The relative risk of all major cardiovascular events—that is, the sum of coronary heart disease and stroke—was 0.59 at pressures &lt;130 mm Hg compared with 1.08 at pressures &gt;145 mm Hg (P=0.0001). <b>Conclusion:</b> Even with the limitations of subgroup analyses the evidence suggests that the benefit of low dose aspirin in primary prevention may occur mainly in those with lower systolic blood pressures, although it is not clear even in these men that the benefit outweighs the potential hazards. Men with higher pressures may be exposed to the risks of bleeding while deriving no benefit through reductions in coronary heart disease and stroke.
The sphingosine-1-phosphate/sphingosine-1-phosphate receptor 2 axis regulates early airway T-cell infiltration in murine mast cell–dependent acute allergic responses
Authors: Carole A. Oskeritzian, Nitai C. Hait, Piper Wedman, Alena Chumanevich, Elizabeth M. Kolawole, Megan M. Price, Yves T. Falanga, Kuzhuvelil B. Harikumar, John J. Ryan, Sheldon Milstien, Roger Sabbadini, Sarah Spiegel
Journal: Journal of Allergy and Clinical Immunology (2014)
Electoral reform of GMSC
Authors: D. Roberts
Journal: BMJ (1995)

adequate measures to ensure the safety of those who perform abortions or work in facilities where the procedure is performed.Doctors and other health care workers who dedicate their lives to meeting the health care needs of Americans should be ensured the right to work in a safe environment.Violence against health care workers is unacceptable.The American Medical Association has long condemned acts of terrorism against health care workers and will continue to do so.
737. Efficient In Vivo Selection and Chemoprotection Following Drug Resistance Gene Therapy in a Nonmyeloablative Allogeneic Transplantation Setting in the Dog
Authors: Brian C. Beard, Sabine Gerull, Laura J. Peterson, Tobias Neff, Hans-Peter Kiem
Journal: Molecular Therapy (2006)

We have previously demonstrated successful in vivo selection and chemoprotection in dogs that received myeloablative allogeneic stem cell transplantation with gene-modified cells. Here we wished to investigate whether I vivo selection, chemoprotection, and modulation of donor chimerism could also be achieved after nonmyeloablative transplantation which should be less toxic and thus more appropriate for older patients and patients with genetic diseases. We have used a lentivirus vector encoding the P140K mutant of methylguanine-DNA methyltransferase (MGMT-P140K) to transduce DLA matched littermate CD34+ cells. The use of a lentivirus vector allowed us to keep the ex vivo/transduction time short, less than 24 hours which improves engraftment in the allogeneic setting. Three dogs received a nonmyeloablative dose of total body irradiation (TBI) ranging from 200 cGy to 400 cGy before infusion of the gene-modified CD34+ cells and early post-transplant chemotherapy to facilitate engraftment. All three dogs had stable gene marking and donor chimerism, before receiving a course of treatment with O6BG/BCNU. One to three treatments led to a sustained increase in gene marking in all dogs with maximum levels achieved of >75%. Furthermore, the transduced cells conferred chemoprotection relative to control animals and prevented severe neutropenia even with ascending doses of BCNU. Our initial analysis of retrovirus integration with LAM-PCR suggest that before and after in vivo selection of chemoprotected cells multiple clones contribute to hematopoiesis and no side effects or malignancies have been observed. Our results suggest that drug resistance gene therapy and subsequent in vivo selection is feasible and safe in the nonmyeloablative transplantation setting. We are continuing to modify the pre-transplant immunosuppression and post-transplant in vivo selection to facilitate engraftment of gene-modified cells. In nonmyeloablative allogeneic transplantation for leukemia where post-transplant relapse remains a substantial complication, the application of this model could reduce the toxicity of chemotherapy treatment and allow for more intensive treatment regimens. In addition this strategy could be used to increase the percentage of gene-marked donor cells in patients with genetic diseases and low donor chimerism. These studies and future studies in the nonmyeloablative setting are required to assess the long-term safety of chemo-protective gene therapy.
LEFT ATRIAL EXPANSION INDEX IN PATIENTS WITH ATRIAL FIBRILLATION IS A PREDICTOR OF SINUS RHYTHM MAINTENANCE AFTER CARDIOVERSION
Authors: Malini Govindan, Anatoli Kiotsekoglou, Velislav Batchvarov, Samir K. Saha, Kate Dougal, Evaun Teoh, Lars-Ake Brodin, John Camm
Journal: Journal of the American College of Cardiology (2010)
Recalcitrant stress fracture--a case managed by drilling.
Authors: J. G. Williams
Journal: British Journal of Sports Medicine (1979)

Stress fractures are common in sport (McDougall, 1976;Devas, 1969;Slocum, 1967).Most clinicians dealing regularly with sports injuries are aware of their frequency and they are therefore commonly diagnosed.The usual treatment is a period of rest to allow healing.In some cases however symptoms persist and regular radiological examination reveals that healing is delayed.Management of such cases presents considerable problems in individuals who are anxious to return to sporting activity without undue delay.The case presented offers a radical method of management which may be of value in other recalcitrant cases.
Alveolar breath sampling and analysis to assess trihalomethane exposures during competitive swimming training.
Authors: A B Lindstrom, J D Pleil, D C Berkoff
Journal: Environmental Health Perspectives (1997)

Alveolar breath sampling was used to assess trihalomethane (THM) exposures encountered by collegiate swimmers during a typical 2-hr training period in an indoor natatorium. The breath samples were collected at regular intervals before, during, and for 3 hr after a moderately intense training workout. Integrated and grab whole-air samples were collected during the training period to help determine inhalation exposures, and pool water samples were collected to help assess dermal exposures. Resulting breath samples collected during the workout demonstrated a rapid uptake of two THMs (chloroform and bromodichloromethane), with chloroform concentrations exceeding the natatorium air levels within 8 min after the exposure began. Chloroform levels continued to rise steeply until they were more than two times the indoor levels, providing evidence that the dermal route of exposure was relatively rapid and ultimately more important than the inhalation route in this training scenario. Chloroform elimination after the exposure period was fitted to a three compartment model that allowed estimation of compartmental half-lives, resulting minimum bloodborne dose, and an approximation of the duration of elevated body burdens. We estimated the dermal exposure route to account for 80% of the blood chloroform concentration and the transdermal diffusion efficiency from the water to the blood to in excess of 2%. Bromodichloromethane elimination was fitted to a two compartment model which provided evidence of a small, but measurable, body burden of this THM resulting from vigorous swim training. These results suggest that trihalomethane exposures for competitive swimmers under prolonged, high-effort training are common and possibly higher than was previously thought and that the dermal exposure route is dominant. The exposures and potential risks associated with this common recreational activity should be more thoroughly investigated.
Allergen exposure, atopy and smoking as determinants of allergy to rats in a cohort of laboratory employees
Authors: P. Cullinan, A. Cook, S. Gordon, M.J. Nieuwenhuijsen, R.D. Tee, K.M. Venables, J.C. McDonald, A.J. Newman Taylor
Journal: European Respiratory Journal (1999)

This study aimed to examine the relationship between exposure to rat urinary allergens, atopic status, smoking and the development of allergic symptoms and specific sensitization. It is a case-referent analysis of a cohort of 342 newly employed laboratory animal workers. Cases comprised persons developing symptoms of laboratory animal allergy or a positive skin prick test to rat urinary allergens; each was matched with up to two asymptomatic referents. Subjects were assigned to categories of exposure based on measurements of airborne rat urinary allergens. Of the cases, 80% reported that their symptoms started within 2 yrs of employment. The odds ratio (OR) for development of each symptom type (respiratory, eye or nose and skin) and of an immediate skin test reaction was increased in those with direct contact with rats. A gradient of increasing OR for the development of any such symptom across exposure categories was found; for respiratory symptoms and skin test reactions the OR for subjects in the highest exposure category were lower than those in intermediate categories, a pattern attenuated when the analysis was confined to outcomes developing within 2 yrs of first exposure. Atopy increased the OR of most outcomes as did cigarette smoking, although there was no evidence of a relationship between smoking and the development of a specific skin test reaction. In conclusion, allergen exposure was confirmed as the most important determinant of laboratory animal allergy; by implication, measures to reduce exposure may be the most effective means to reduce its incidence.
Case 20-1967
Authors: David S. Feingold, Austin L. Vickery
Journal: New England Journal of Medicine (1967)

Presentation of CaseA nineteen-year-old girl entered the hospital because of fever and a heart murmur.She had been well until nineteen days previously, when she began to experience myalgia, malaise, fever and a headache. Four days before that time she had scratched some pustules over the right eyebrow and cheek. The symptoms persisted, and the temperature rose to 104°F. on the day after their onset. On admission to another hospital on the following day a stiff neck was found, and she was intermittently delirious. The hematocrit was 37 per cent, and the white-cell count 8400, with 61 per cent . . .
What happened in Mexico
Authors: A. C. Laurell, J. R. Herrera
Journal: BMJ (2010)

Another important issue for the World Health Organization’s declaration of the AH1N1 pandemic1 is how the original outbreak was managed in Mexico.

After the outbreak was initially denied, a state of emergency was declared, which rapidly paralysed the economy and social life. This was later toned down, even though most deaths and illness occurred five months later. …
Plasma 25-Hydroxyvitamin D Concentration and Metabolic Syndrome Among Middle-Aged and Elderly Chinese Individuals
Authors: Jøran Hjelmesæth, Jo Røislien, Dag Hofsø, Jens Bollerslev
Journal: Diabetes Care (2009)

We read with interest the article by Lu et al. (1), which concluded that a low 25-hydroxyvitamin D [25(OH)D] level was associated with an increased risk of prevalent metabolic syndrome among middle-aged and elderly Chinese men and women. However, as the investigators acknowledge, vitamin D may exert its effects through the regulation of extra- and intracellular calcium. The calcium homeostasis, on the other hand, is tightly regulated by parathyroid hormone (PTH). There is therefore a close relationship between 25(OH)D, calcium, and PTH (2) to the extent that changes in the levels of any one of these biomarkers affect the …
Database Validity in Assessing Population Trends in Hip Fracture Rates in Canada
Authors: Cathrine M. Lofthus
Journal: JAMA (2010)

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
Effect of luminal pH on the output of bicarbonate and PGE2 by the normal human stomach.
Authors: J R Crampton, L C Gibbons, W D Rees
Journal: Gut (1987)

The gastric output of bicarbonate and prostaglandin E2 has been calculated using a perfusion technique before and after instillation of 100 mM hydrochloric acid into the stomach of seven healthy volunteers. A significant increase in bicarbonate output occurred from 258 +/- 38 mumol/30 min during the basal period to 531 +/- 86 mumol/30 min after return of the intragastric pH to neutral (p less than 0.05). Prostaglandin E2 output also increased significantly from 410 +/- 136 pmol/30 min to 1002 +/- 194 pmol/30 min (p less than 0.05). The changes were caused mainly by an increase in gastric secretory volume with only non-significant increases in concentrations of bicarbonate and prostaglandin E2. The results suggest that mechanisms exist to adjust the rate of gastric bicarbonate secretion to the prevailing intraluminal pH and that this may occur through the release of prostaglandin E2.
Hyperpnoea and emesis in a diabetic man
Authors: J Monjardino, D Smith, M Tisdall, N N Chan, S J Hurel
Journal: Journal of the Royal Society of Medicine (2002)

In diabetic ketoacidosis (DKA), breathlessness reflects the underlying respiratory alkalosis in response to metabolic acidosis. However, it can also be a manifestation of a rare respiratory complication.
A 96-Year-Old Woman With Insomnia
Authors: Wallace Mendelson
Journal: JAMA (1997)

<h3>Dr Delbanco:</h3> Mrs G is a 96-year-old widow who has had trouble sleeping for the past 30 years. She has lived in a long-term care facility for the past 3 years, where she was admitted due to increasing physical disability and falls. She has 1 son with chronic depression with whom she has minimal contact. Her insurance is through Medicare and a supplemental commercial insurance program. Mrs G began to have difficulty falling asleep at the age of 65 years. At that time, and over the next 30 years, she took acetaminophen each evening, which she claims helped her go to sleep. When she developed sciatica 3 years ago, she had more trouble with sleeping and began taking oxazepam irregularly. She started to take it regularly 1 year ago when, in addition to her physical discomfort, she was disturbed by her cognitively impaired roommate in the nursing home. Mrs G
Letter Regarding Article by Luo et al, “Adenovirus-Mediated Expression of β-Adrenergic Receptor Kinase C-Terminus Reduces Intimal Hyperplasia and Luminal Stenosis of Arteriovenous Polytetrafluoroethylene Grafts in Pigs”
Authors: Joris I. Rotmans, Erik S.G. Stroes, Gerard Pasterkamp
Journal: Circulation (2005)

With great interest we have read the article by Luo and coworkers 1 in which they described a reduction of intimal hyperplasia and luminal stenosis after adenoviral transduction of ␤ARKct in a pig model of ePTFE arteriovenous (AV) graft failure.This study confirms the potential of gene therapeutic approaches to prevent stenosis in AV grafts for hemodialysis. 2 An intriguing finding was the very low patency rate in the control group, which declined to 37.5% after 4 weeks.This is in sharp contrast to the 100% patency rate after 4 weeks in similar experiments performed in our laboratory. 3 The authors propose that "different structure" of the AV grafts between the studies may have contributed to the unexpectedly large discrepancy in patency rates.We believe, however, that other differences in methodology more likely explain the differences in patency rates.First, Luo and coworkers constructed 1 AV graft between the carotid artery and the contralateral jugular vein, whereas we constructed 2 bilateral AV grafts in each pig.The setup used by Luo et al is likely to be accompanied by significantly lower graft flow in view of the longer grafts (15 cm versus 7.5 cm in our experiments).Lower graft flow accelerates graft thrombosis, as reduction in flow is the best single predictor for graft thrombosis. 4Second, another pivotal observation is the absence of any newly formed thrombotic lesions in the histological sections, compatible with the onset of thrombosis between 1 and 2 weeks after implantation.In this respect, it is significant to note that no mention is made regarding the antiplatelet regimen in the thrombogenic pig model.In our experience, it is of the utmost importance to institute the use of both clopidogrel and acetylsalicylic acid to prevent early graft thrombosis in this AV graft model in the pig.It has been acknowledged generally that the most prevalent cause of early graft thrombosis pertains to technical failures rather than graft failure due to progressive stenosis at the venous outflow tract.Studies with low patency rates such as those reported by Luo et al 1 should be interpreted carefully, because early graft thrombosis and not gradual intimal hyperplasia may have been the main determinant of lumen loss during follow up.
Diagnostic Performance of Multislice Spiral Computed Tomography of Coronary Arteries as Compared With Conventional Invasive Coronary Angiography
Authors: Michèle Hamon, Giuseppe G.L. Biondi-Zoccai, Patrizia Malagutti, Pierfrancesco Agostoni, Rémy Morello, Marco Valgimigli, Martial Hamon
Journal: Journal of the American College of Cardiology (2006)
Shadowing Physicians—Reply
Authors: Elizabeth A. Kitsis
Journal: JAMA (2011)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Efficacy of pegylated interferon alpha-2b and ribavirin treatment on the risk of hepatocellular carcinoma in patients with chronic hepatitis C: A prospective, multicenter study
Authors: Eiichi Ogawa, Norihiro Furusyo, Eiji Kajiwara, Kazuhiro Takahashi, Hideyuki Nomura, Toshihiro Maruyama, Yuichi Tanabe, Takeaki Satoh, Makoto Nakamuta, Kazuhiro Kotoh, Koichi Azuma, Kazufumi Dohmen, Shinji Shimoda, Jun Hayashi
Journal: Journal of Hepatology (2012)
P111SCN1Bb: a new susceptibly gene underlying LQT syndrome
Authors: H Riuro, O Campuzano, P Beltran-Alvarez, E Arbelo, A Iglesias, J Brugada, GJ Perez, F Scornik, R Brugada
Journal: Cardiovascular Research (2014)

Long QT Syndrome (LQTS) is a rare inherited cardiac disorder with a high risk of sudden cardiac death in a structurally normal heart. To date, pathogenic mutations have been described as responsible for approximately 70-75% of LQTS patients, mainly in ion channel genes. Mutations in genes encoding the sodium channel α subunit or other regulatory proteins, affecting cardiac sodium current, have been previously related to LQTS. Five sodium channel β subunits have been identified, which are encoded by four genes (SCN1B-4B). Pathogenic mutations in the SCN4B gene, but not in other β subunits, have been reported in LQTS. We tested whether mutations in SCN1B-4B could be responsible for LQTS in patients without mutations in the common LQTS-related genes. We screened for mutations in SCN1B-4B genes in 30 non-related patients clinically diagnosed with LQTS carrying no mutations in the major LQTS-related genes. The screening revealed a novel mutation in the SCN1B gene in an 8-year-old boy. The base change resulted in an amino acid variation from proline to threonine in the alternative C-terminus of the sodium channel β1 subunit (β1b). Using the patch clamp technique, we measured sodium current density, and Nav1.5 gaiting properties, in HEK cells transiently transfected with Nav1.5 and β1b subunits. Our electrophysiological analysis revealed that the mutant β1b altered Nav1.5 function by shifting the window current to negative potentials, increasing recovery from inactivation, decreasing slow inactivation, and increasing late sodium current. In addition, we recorded action potentials from mouse atrial cardiomyocytes, HL-1 cells, transfected with β1b subunits. These experiments revealed that the action potential duration significantly increased when the mutant β1b was overexpressed compared to β1bWT. These findings suggest that the mutation in β1b could explain the LQTS in our patient, revealing SCN1Bb as a new susceptibility gene for LQTS. Our results confirm the importance of sodium channel β subunits in the modulation of cardiac sodium channel. In addition, they highlight the need for further investigation to detect new candidate genes underlying the LQTS patients that currently remain without genetic diagnosis.
Book Review Plum and Posner's Diagnosis of Stupor and Coma (Contemporary Neurology Series. 71.) Fourth edition. By Jerome B. Posner, Clifford B. Saper, Nicholas D. Schiff, and Fred Plum. 401 pp., illustrated. New York, Oxford University Press, 2007. $79.50. 978-0-19-532131-9
Authors: Allan H. Ropper
Journal: New England Journal of Medicine (2007)