tbuckley/cabot-search huggingface dataset:
Trimetazidine, a Metabolic Modulator, Has Cardiac and Extracardiac Benefits in Idiopathic Dilated Cardiomyopathy
Authors: Helena Tuunanen, Erik Engblom, Alexandru Naum, Kjell Någren, Mika Scheinin, Birger Hesse, K.E. Juhani Airaksinen, Pirjo Nuutila, Patricia Iozzo, Heikki Ukkonen, Lionel H. Opie, Juhani Knuuti
Journal: Circulation (2008)

Background— The anti-ischemic agent trimetazidine improves ejection fraction in heart failure that is hypothetically linked to inhibitory effects on cardiac free fatty acid (FFA) oxidation. However, FFA oxidation remains unmeasured in humans. We investigated the effects of trimetazidine on cardiac perfusion, efficiency of work, and FFA oxidation in idiopathic dilated cardiomyopathy. Methods and Results— Nineteen nondiabetic patients with idiopathic dilated cardiomyopathy on standard medication were randomized to single-blind trimetazidine (n=12) or placebo (n=7) for 3 months. Myocardial perfusion, FFA, and total oxidative metabolism were measured using positron emission tomography with [ 15 O]H 2 O, [ 11 C]acetate, and [ 11 C]palmitate. Cardiac function was assessed echocardiographically; insulin sensitivity was assessed by the homeostasis model assessment index. Trimetazidine increased ejection fraction from 30.9±8.5% to 34.8±12% ( P =0.027 versus placebo). Myocardial FFA uptake was unchanged, and β-oxidation rate constant decreased only 10%. Myocardial perfusion, oxidative metabolism, and work efficiency remained unchanged. Trimetazidine decreased insulin resistance (glucose: 5.9±0.7 versus 5.5±0.6 mmol/L, P =0.047; insulin: 10±6.9 versus 7.6±3.6 mU/L, P =0.031; homeostasis model assessment index: 2.75±2.28 versus 1.89±1.06, P =0.027). The degree of β-blockade and trimetazidine interacted positively on ejection fraction. Plasma high-density lipoprotein concentrations increased 11% ( P &lt;0.001). Conclusions— In idiopathic dilated cardiomyopathy with heart failure, trimetazidine increased cardiac function and had both cardiac and extracardiac metabolic effects. Cardiac FFA oxidation modestly decreased and myocardial oxidative rate was unchanged, implying increased oxidation of glucose. Trimetazidine improved whole-body insulin sensitivity and glucose control in these insulin-resistant idiopathic dilated cardiomyopathy patients, thus hypothetically countering the myocardial damage of insulin resistance. Additionally, the trimetazidine-induced increase in ejection fraction was associated with greater β1-adrenoceptor occupancy, suggesting a synergistic mechanism.
The New York Medical Journal and the American Medical Association.
Authors: J. F. Jenkins
Journal: JAMA (1892)

A lengthy comment appears in the editorial columns of the<i>New York Medical Journal</i>, upon the affairs of the American Medical Association. To the reader, who has kept a close eye on the editorial columns of this journal, the present article is no surprise; from the fact that it is patent to the most casual observer, that there are a few members of our profession who regard the American Medical Association in the light of the old Romans, who were bound that Carthage should be destroyed. What appears to give the editor a large scope for finding fault is the report of the committee on the Section on Dermatology which appeared in theJournalof the Association I mention, and which the editor of the<i>New York Journal</i>comments on as follows: "It does not seem that the committee struck the keynote of the trouble. Verily the medical profession has
Effect of enzyme induction on nephrotoxicity of halothane-related compounds.
Authors: B A Hitt, R I Mazze
Journal: Environmental Health Perspectives (1977)

Nephrotoxicity following administration of methoxyflurane has been shown to be directly related to anesthetic metabolism to inorganic fluoride. Enzyme induction should increase metabolic rate and the amount of inorganic fluoride that is released. In vivo studies in Fischer 344 rats show that enzyme induction with phenobarbital or phenytoin increases defluorination following methoxyflurane anesthesia but not after enflurane or isoflurane. In vitro, methoxyflurane defluorinase activity was increased far more than that of any of the other anesthetics. These data suggest that treatment with enzyme inducing drugs increases the risk of nephrotoxocity only if methoxyflurane is the anesthetic agent.
US regulators relax restrictions on rosiglitazone
Authors: M. McCarthy
Journal: BMJ (2013)

The US Food and Drug Administration announced on 25 November that it is to lift most of its restrictions on GlaxoSmithKline’s antidiabetes drug rosiglitazone and would no longer limit its use to patients whose diabetes could not be controlled by other drugs.

Rosiglitazone (marketed as Avandia) was approved in the United States in 1999, but its safety came into question after a meta-analysis published in 2007 by the New England Journal of Medicine found a 43% increase in the incidence of myocardial infarction and a 64% increase in death from cardiovascular causes.1

However, another …
Unexpected Gallium Uptake in Benign Pulmonary Pathology
Authors: RICHARD G. McLEAN, DANIEL CHOY, I PROVAN C. MURRAY
Journal: Clinical Nuclear Medicine (1984)

Two cases in which pulmonary gallium uptake was demonstrated in benign conditions are reported. In one, the abnormality permitted localization of a benign mesothelioma, while in the other patient it was associated with pulmonary fibrosis resulting from therapeutic irradiation. These cases extend the causes of gallium accumulation in which neither malignancy nor infection is responsible.
Reducing the Burden of Depression
Authors: Kenneth B. Wells, Jeanne Miranda
Journal: JAMA (2007)

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
Hemodynamic correlates of saralasin-induced arterial pressure changes.
Authors: J G de Carvalho, F G Dunn, D C Kem, S G Chrysant, E D Froholich
Journal: Circulation (1978)

Angiotensin antagonists have proved useful in elucidating the clinical role of the renin-angiotensin system; and their diagnostic and therapeutic efficacy in hypertension has been the subject of many reports but the hemodynamic effects remain unknown. Therefore, saralasin was infused intravenously (1.3 mg/min for 30 min) in 26 sodium-depleted patients with hypertension. Systemic hemodynamic alterations were determined before, during, and after infusion. On the basis of mean arterial pressure (MAP) changes, patients were classified as responders, nonresponders, or pressorresponders (MAP changes greater than or equal to 10 mm Hg). MAP fall in responders was achieved through reduced cardiac output and/or total peripheral resistance, with minimal or absent reflexive heart rate increase. In nonresponders, despite no change in MAP, output fell in parallel with stroke index and left ventricular ejection rate, In pressorresponders, saralasin increased vascular resistance. Thus, in addition to variable effects on vascular receptors, saralasin produced inhibitory cardiac effects either through altered venous return or inhibition of contractility.
Community infection ratio as an indicator for tuberculosis control
Authors: G. Madico, R.H. Gilman, L. Cabrera, K. Kacena, J.F. Díaz, R.H. Gilman, W. Checkley, I. Kohlstadt, R. Black
Journal: The Lancet (1995)

The epidemiology of tuberculosis remains poorly understood. We investigated the relative importance of within-household and community transmission of infection among children aged 6 months to 14 years living in a Peruvian shanty-town. The prevalence of Mycobacterium tuberculosis exposure among 175 contact children (sharing a household with a person who had confirmed pulmonary tuberculosis) and 382 control children (living in nearby households free of active tuberculosis) was defined as the proportion of children with a positive purified protein derivative (PPD) skin-test. 97 (55%) contact children and 129 (34%) controls were PPD positive. Living in a contact household (odds ratio 1.74, 95% CI 1.11-2.73) and age (1.11, 1.06-1.18) were significant risk factors for PPD positivity. We calculated the community infection ratio (CIR) as the odds ratio of PPD-positive controls to PPD-positive contacts: CIR = [formula: see text] A low CIR therefore suggests mainly household spread of infection, whereas a high value suggests frequent transmission outside the household. The adjusted odds ratio (for age, sex, within-household correlation, and household size) was 0.40 (95% CI 0.26-0.64), compared with values of 0.18-0.37 in studies elsewhere. Currently recommended tuberculosis control strategies are suitable for areas with low CIRs. Different strategies may be needed for areas, such as that we studied, with high values.
THE STATE IN THE CARE OF ITS INSANE
Authors: W. W. Godding
Journal: American Journal of Psychiatry (1890)

To sum up then, since this paper has already been prolonged to too great a length, this Conference through its individual members should mould public sentiment in the direction of immediate action to provide in each State supervision and accommodation for all of its insane. Such provision implies an expenditure and effort out of proportion to what has hitherto been made, and one that must be annually renewed, but the burden once resolutely taken up and continously borne, and bearing fruits in the improved condition of these afflicted ones, it will no longer seem a burden, a twice blessed, ennobling charity rather, that "Blesseth him that gives, and him that takes." The provision made should be adapted to the varying conditions and so apportioned that no one class shall act as a detriment to any other. To this end provision and treatment should be individualized and not stereotyped. So, with ample space for every occupation and diversion, with buildings simply constructed but fitted to each varying want, grouped or scattered, distinct, yet, if need be, readily connected by covered or subterranean ways, in the near future we may realize in each State—not a Gheel, although something perhaps might be learned from that, and doubtless more from the Colony of Fitz James at Cleremont or Saxony's Asylum at Alt Scherbitz, but in no servile imitation of European systems although benefitting by the study of all—a distinctively American Home for all the insane, beneath whose soothing shadow and healing touch perchance some mentally blind gathered there might receive their sight.
Association of Nocturnal Arrhythmias with Sleep-disordered Breathing
Authors: Reena Mehra, Emelia J. Benjamin, Eyal Shahar, Daniel J. Gottlieb, Rawan Nawabit, H. Lester Kirchner, Jayakumar Sahadevan, Susan Redline
Journal: American Journal of Respiratory and Critical Care Medicine (2006)

Sleep-disordered breathing recurrent intermittent hypoxia and sympathetic nervous system activity surges provide the milieu for cardiac arrhythmia development.
Abstract 3759: Meat consumption, ornithine decarboxylase gene polymorphism, and outcomes after colorectal cancer diagnosis
Authors: Bruce S. Lin, Jason A. Zell, Argyrios Ziogas, Hoda Anton-Culver
Journal: Cancer Research (2011)

Abstract BACKGROUND. Arginine, and meat consumption (i.e., the primary dietary source of arginine) have been implicated in colorectal cancer (CRC) progression via polyamine-dependent processes. Genetic polymorphism in the polyamine-regulatory gene ornithine decarboxylase-1 (ODC1) has been shown to be prognostic for survival after CRC diagnosis. Here we examined the joint effects of meat consumption and ODC1 polymorphism on CRC-specific mortality among CRC cases. METHODS. The study included 329 incident stage I-III CRC cases from the population-based UC Irvine Gene-Environment Study of Familial CRC (diagnosed 1994-1996 with follow-up through March 2008). Genotyping of the ODC1 (National Center for Biotechnology Information SNP database ID rs2302615) +316 SNP was conducted using oligonucleotide primers designed to amplify a 172-bp fragment containing the polymorphic base at +316 (Applied Biosystems, Foster City, CA). Meat intake (frequency and serving size) was ascertained via questionnaires administered at baseline (cohort entry), where patients were asked to report their usual eating habits during the one year prior to CRC diagnosis. Multivariate CRC-specific survival analyses were stratified by TNM stage, and adjusted for age, gender, race/ethnicity, family history, tumor subsite within the colorectum, histology, treatment with surgery, radiation, chemotherapy, weekly meat consumption, ODC1 genotype, and a term representing the interaction of meat consumption and ODC1 genotype. The primary outcome was to assess the interaction of meat consumption and ODC1 genotype (GG vs. GA/AA) on CRC-specific mortality. RESULTS. ODC1 genotype distribution was 51% GG, 49% GA/AA). Median meat consumption was 6.95 and 7.40 servings per week in ODC1 GG group and GA/AA group respectively (P =0.31). In the multivariate model, a statistically significant interaction between ODC1 genotype, meat consumption, and CRC-specific mortality was observed, such that increasing levels of meat consumption were associated with higher CRC-specific mortality among ODC1 GA/AA compared to GG cases, adjusted colorectal cancer-specific survival hazards ratio, 12.75; 95% confidence interval, 2.71-60.12; P =0.001 (unadjusted HR 2.29; 95% CI 1.24-4.23; P =0.008). There was a strong interaction between meat consumption and ODC1 genotype, P-int =0.01. CONCLUSIONS. Among CRC cases with ODC1 GA/AA genotypes, higher levels of meat consumption are associated with poor survival outcomes. These data provide further evidence that polyamine metabolism, and its modulation by specific dietary factors, have relevance to CRC outcomes. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 3759. doi:10.1158/1538-7445.AM2011-3759
Gene Therapy in Human Beings: When Is It Ethical to Begin?
Authors: W. French Anderson, John C. Fletcher
Journal: New England Journal of Medicine (1980)

The recent rapid expansion of research in the area of molecular genetics, resulting in large part from the application of recombinant-DNA technology, has produced uncertainty in the minds of some physicians about how much has been accomplished in the area of genetic engineering. Successful introduction of genes into intact mice1 , 2 and into mouse embryos3 indicates that the transfer of certain genes into human beings may now be technically feasible. Indeed, the Los Angeles Times reported on October 8 that an attempt at gene therapy in human beings was conducted this summer.4 Is it ethical to carry out such a new . . .
An Epidemic of Tuberculosis in a Medical School
Authors: Morton E. Alpert, Matthew E. Levison
Journal: New England Journal of Medicine (1965)

AN outbreak of tuberculosis was noted in the fall of 1963 among medical students and employees of a northeastern medical center. Between September, 1962, and March, 1964, 27 cases of tuberculosis were diagnosed in medical students and employees of the medical center by its tuberculosis service, whereas only 1 case had been diagnosed in the preceding two years.This report describes the results of an epidemiologic investigation instituted in late October, 1963, and re-emphasizes the hazard of tuberculosis to medical personnel.SettingLocated in an urban community of 130,000 people, the medical center consists of several autonomous institutions that occupy . . .
Does control of risk factors prevent coronary heart disease?
Authors: R W Turner
Journal: BMJ (1982)

case reported from this centre3 has highlighted the value of sigmoidoscopy in these circumstances.Visualisation of the characteristic pseudomembranes enabled immediate diagnosis, and treatment with vancomycin was started without waiting for stool or toxin assay.Rapid resolution of toxicity and mega- colon ensued.Sigmoidoscopy is considered hazardous in toxic megacolon because of the risks of perforation.Proctoscopy alone, however, may not show pseudomembranes, because of rectal sparing.4I would suggest that careful sigmoidoscopy with minimal insufflation performed in all cases of toxic megacolon may avoid delay in diagnosing the few cases so amenable to non-operative management.
Health Education at The University of Utah
Authors: Alma Nemir
Journal: JAMA (1966)

<h3>To the Editor:—</h3> The House of Delegates of the American Medical Association recently adopted the recommendations of the Council on Medical Services: That every institution of higher learning should have, as a part of general education, a health education program for all students. That health education should be appropriately related to the college physicians and health services with continuing medical collaboration in health education problems. That health educators should be thoroughly prepared and qualified in the health sciences with all teaching personnel brought into proper focus as members of the health team. That the department charged with primary responsibility for health education should possess sufficient resources and staff with teaching competence to carry out its educational mission without a division of interests detracting from the importance of health education.<sup>1</sup> The University of Utah requires of every student before graduation a one-quarter-hour course in personal health. Most students take this
* Association of the insulin-like growth factor 1 microsatellite with predisposition to colorectal cancer
Authors: K. J. Monahan, S. Spain, H. J. Thomas, I. P. Tomlinson
Journal: Gut (2011)

<h3>Introduction</h3> <i>IGF1</i> may be important for colorectal cancer risk because of its role in cell growth and differentiation. High <i>IGF1</i> serum levels have been associated with increased risk of colorectal cancer. Variations in these serum levels have been associated with a CA repeat microsatellite 1 kilobase upstream of the transcription start site. We sought to determine the association of germline variation of the <i>IGF1</i> gene with colorectal cancer predisposition by performing a large case-control study. <h3>Methods</h3> Genescan 500 was used to differentiate alleles of the <i>IGF1</i> microsatellite among 2143 colorectal cancer cases (enriched for family history) and 1715 controls from the CORGI (COloRectal Gene Identification) study, with subsequent 100% confirmation of about 5% of genotypes by direct sequencing. Associations of genotypes with the following clinicopathological features were tested: sex; site of tumour; Dukes stage; age of onset; presence of adenomas. Using genotype data obtained from the Hap550 platform by colleagues1 plus the genotypes at the insertion/deletion, we reconstructed haplotype blocks around the <i>IGF1</i> gene in the controls using 68 tagging SNPs. <h3>Results</h3> All the alleles confer increased risk for colorectal neoplasia except ‘1929 (192 copies of CA repeat), which is a protective allele (allelic OR for ‘1929 =1.199; 95% CI 1.09 to 1.32; p = 0.000152). The population attributable risk (PAR) for the risk ‘allele9 (ie, where ‘X9=not ‘1929) is 2.94%. The risk alleles occurred more frequently in more advanced Dukes9 stage tumours (p=0.039, χ<sup>2</sup>). Several SNPs in close linkage disequilibrium with <i>IGF1</i> are also significantly associated with colorectal neoplasia risk. <h3>Conclusion</h3> This study demonstrates a novel association of <i>IGF1</i> microsatellite with colorectal cancer risk. The association is stronger with advanced stage colorectal cancers, and in colonic rather than rectal cancers. This microsatellite is in linkage disequilibrium with other significant SNPs in the promoter region of this gene.
Predicting factors of malignancy in dermatomyositis and polymyositis: a case-control study
Authors: Y-J. Chen, C-Y. Wu, J-L. Shen
Journal: British Journal of Dermatology (2001)

An association between dermatomyositis (DM)/polymyositis (PM) and malignancies has been widely reported in the literature. The validity of extensive evaluation for malignancies in those patients has also been questioned for decades. Only limited papers regarding the signs of malignancy and the prognostic factors in DM/PM have been reported.To define the potential risk factors of concomitant neoplastic diseases in patients diagnosed as having DM/PM.From 1 April 1983 to 30 June 1999, 147 patients were diagnosed as having probable or definite DM/PM at the Veterans General Hospital, Taichung, Taiwan. We excluded four patients who had preceding neoplastic diseases diagnosed before DM/PM, then retrospectively reviewed the data of the remaining 143 patients and subgrouped the cases as four main types: primary idiopathic DM, primary idiopathic PM, juvenile DM/PM and amyopathic DM (ADM). We next performed univariate analysis using logistic regression to evaluate the possible predictive factors for malignancies, such as mean age at onset, gender, manifestations at onset, association with other connective tissue diseases, initial skin presentations, complications and laboratory data. Then we chose the significant factors for multivariate analysis by logistic regression, to determine the independent risk factors of malignancies in DM/PM patients.Among the 143 patients, DM was the most common type (64%), followed by ADM (14%), juvenile DM/PM (13%) and PM (10%). The mean age at onset overall was 42.4 years. Other connective tissue diseases were present in 22% of all patients, especially PM (50%) and juvenile DM/PM patients (28%). Internal malignancies were present in 13% of patients, and most were associated with DM. Nasopharyngeal carcinomas (NPCs) were the most common tumours. Patients with primary idiopathic DM, with an older age at onset, higher serum creatine phosphokinase levels and male gender, had more chance of developing concomitant malignancies. Those associated with complications, especially interstitial lung diseases, had a lower risk of associated neoplasia. In multivariate analysis, an older age at onset (odds ratio 9.10) and male gender (odds ratio 4.06) were associated with greater risk of developing malignancies.The two independent predictive factors for malignancy (P < 0.05) in patients with DM/PM were an older age at onset (> 45 years) and male gender. The primary idiopathic DM group was shown to have higher risk of developing internal malignancies, especially NPC. However, this was not identified as an independent predictive factor for concomitant neoplastic diseases in multivariate analysis. In addition, patients who had the complication of interstitial lung disease had a significantly lower frequency of malignancies (P < 0.001).