tbuckley/cabot-search huggingface dataset:
Pacemaker and ICD Generator Reliability
Authors: William H. Maisel
Journal: JAMA (2006)

Despite there being millions of pacemaker and implantable cardioverter-defibrillator (ICD) generator implants worldwide, little is known about device reliability.To perform a meta-analysis of prospective pacemaker and ICD registries to determine annual rates of pacemaker and ICD malfunction and to identify trends in these rates.MEDLINE (January 1966 to April 2005), the Cochrane Central Register of Controlled Trials (through second quarter 2005), the Cochrane Database of Systematic Reviews (through second quarter 2005), and a bibliographic review of secondary sources. Search terms included pacemaker, artificial; defibrillators, implantable; registries; performance; and malfunction.Eligible registries were prospective; reported the number of patients with pacemaker, ICD, or both; and allowed determination of the annual number of device malfunctions. Of 1007 references screened, 3 registries meeting the selection criteria were identified and included 2.1 million pacemaker person-years and 14,821 ICD person-years of observation.Included the annual number of patients with pacemakers and ICDs at risk of device failure and the annual number of generator malfunctions (1983-2004 for pacemakers, 1988-2004 for ICDs). A device malfunction was defined as an integral component failure that required device explantation prior to reaching elective replacement. Failures of pacemaker and ICD electrodes were not included in the study.There were 2981 pacemaker and 384 ICD generator malfunctions. Pacemaker reliability improved markedly during the 1980s (P for trend <.001) and the pacemaker malfunction rate remained low during the remainder of the study. Implantable cardioverter-defibrillator reliability improved during the first 10 study years (P for trend <.001). From 1998-2002, however, the ICD malfunction rate increased more than 4-fold (P for trend <.001), before decreasing substantially in the latter 2 years of the study. Overall, the mean (SE) annual ICD malfunction rate was about 20-fold higher than the pacemaker malfunction rate (26.5 [3.8] vs 1.3 [0.1] malfunctions per 1000 person-years, P<.001). Battery malfunctions were the most common cause of device failure.Pacemaker reliability has improved markedly. In contrast, after more than a decade of improving device reliability, the ICD malfunction rate transiently increased before experiencing substantial reductions in the latter 2 study years. Whether increasing device sophistication accounts for the observed decrease in reliability is not known. Continued monitoring of pacemaker and ICD performance is required.
Compensation for Injured Research Subjects
Authors: Charles Marwick
Journal: JAMA (1998)

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
Revisiting the Holy Cross Football Team Hepatitis Outbreak (1969) by Serological Analysis
Authors: Lawrence S. Friedman
Journal: JAMA (1985)

Clinical and biochemical data collected during the Holy Cross College football team hepatitis A outbreak in 1969 suggested that 32 team members had icteric hepatitis, 58 had anicteric illness, and only seven were not infected. Using a currently available radioimmunoassay, we tested stored serum samples obtained during the outbreak for IgM antibody to hepatitis A virus (IgM anti-HAV). Only individuals with icteric hepatitis were found to have IgM anti-HAV in serum; those with presumed anicteric illness were shown not to be infected with hepatitis A virus. The attack rate was thus only 34%, not 93% as originally reported, and the incidence of icteric illness in those infected was 100%, not 33%. This serological analysis of a classic outbreak of hepatitis A illustrates the utility and importance of IgM anti-HAV testing in seroepidemiologic investigations of hepatitis outbreaks.
Reduced expression of inducible gelatinase B/matrix metalloproteinase-9 in monocytes from patients with myelodysplastic syndrome: correlation of inducible levels with the percentage of cytogenetically marked cells and with marrow cellularity
Authors: Mineo Iwata, Manoj Pillai, Aravind Ramakrishnan, Robert C. Hackman, H. Joachim Deeg, Ghislain Opdenakker, Beverly Torok-Storb
Journal: Blood (2006)
Sedation for Upper Gastrointestinal Endoscopy: a Comparative Study of Propofol and Midazolam
Authors: U. Carlsson, P. Grattidge
Journal: Endoscopy (1995)

Background and Study Aims: A benzodiazepine is generally used when sedation is required for endoscopy, whilst the newer agent propofol appears to have a more suitable pharmokinetic profile. The aim of this study was to compare the quality of sedation provided by midazolam and propofol under controlled conditions.
An economic evaluation of thrombolysis in a remote rural community
Authors: L. Vale, J. Silcock, J. Rawles
Journal: BMJ (1997)

<h3>Abstract</h3> <b>Objectives:</b> To assess the cost effectiveness of community thrombolysis relative to hospital thrombolysis by investigating the extra costs and benefits of a policy of community thrombolysis, then establishing the extra cost per life saved by community thrombolysis. <b>Design:</b> Economic evaluation based on the results of the Grampian region early anistreplase trial. <b>Setting:</b> 29 rural general practices and one secondary care provider in Grampian, Scotland. <b>Subjects:</b> 311 patients recruited to the Grampian region early anistreplase trial. <b>Interventions:</b> Intravenous anistreplase given either by general practitioners or secondary care clinicians. <b>Main outcome measures:</b> Survival at 4 years and costs of administration of thrombolysis. <b>Results:</b> Relative to hospital thrombolysis, community thrombolysis gives an additional probability of survival at 4 years of 11% (95% confidence interval 1% to 22%) at an additional cost of £425 per patient. This gives a marginal cost of life saved at 4 years of £3890 (£1990 to £42 820). <b>Conclusions:</b> The cost per life saved by community thrombolysis is modest compared with, for example, the cost of changing the thrombolytic drug used in hospital from streptokinase to alteplase. <h3>Key messages</h3> Community thrombolysis leads to increased survival relative to hospital thrombolysis at four years Relative to hospital thrombolysis, community thrombolysis provides this extra benefit at modest extra cost Methods of motivating general practitioners and facilitating routine community thrombolysis need to be ascertained
Food Poisoning Caused by Carbophenothion
Authors: J. Justin Older
Journal: JAMA (1969)

Seven members of a family became ill with symptoms of cholinergic crisis after eating tortillas made from contaminated flour. Six people were hospitalized and four became comatose but all recovered. The flour was found to contain large amounts of carbophenothion, an organophosphate insecticide which acts by inhibiting cholinesterase. The source of contamination is unknown, but evidence suggests that spillage of a liquid formulation of carbophenothion occurred at some time and place after the flour had been packaged and that the insecticide was then absorbed through the bottoms of the sacks.
Influence of acute myocardial depression on left ventricular stiffness and its elastic and viscous components.
Authors: G H Templeton, K Wildenthal, J T Willerson, J H Mitchell
Journal: Journal of Clinical Investigation (1975)

The influence of acute myocardial depression on ventricular stiffness and on its elastic and viscous components was studied in 19 dogs. After the animals were placed on cardiopulmonary bypass, stiffness was measured by sinusoidally injecting volume changes of 0.5 ml (deltaV) at 22 Hz into paced, isovolumically (deltaP) of the sinusoidal pressure response. Stiffness was linearly related to pressure (P) throughout the cardiac cycle, so that deltaP/delta V = alpha P + beta, where alpha and beta are constants. Myocardial depression was induced in one of three different ways: by coronary artery ligation, by administration of propranolol (Inderal), or by administration of pentobarbital. All three interventions caused significant increases in the slope, alpha, of the stiffness-pressure relationship, while the intercept, beta, remained unchanged. Release of the coronary occlusion or administration of acetylstrophantidin partially reversed depression and the change in alpha; Approximation of the mechanical nature of the left ventricle in terms of a linear second-order mechanical system permitted the division of stiffness into its elastic and viscous components. Like total stiffness, both the elastic and the viscous components were linearly related to ventricular pressure. Elastic stiffness was not changed, but the slope of the line relating viscous stiffness to pressure was significantly increased during ischemic depression, indicating that a change in viscosity was primarily responsible for the increase in total ventricular stiffness.
CHILD syndrome. Phenotypic dichotomy in eicosanoid metabolism and proliferative rates among cultured dermal fibroblasts.
Authors: M E Goldyne, M L Williams
Journal: Journal of Clinical Investigation (1989)

Dermal fibroblasts from a patient with CHILD syndrome (an acronym for congenital hemidysplasia with ichthyosiform erythroderma and limb defects) were obtained and successfully maintained in culture. Fibroblasts from an area of chronically hyperkeratotic skin were compared with fibroblasts from the corresponding contralateral area of normal skin in regard to proliferative activity and to both unstimulated and stimulated generation of PGE2, an eicosanoid with documented effects on both epidermal cell and fibroblast function. Compared with the uninvolved skin fibroblasts, those from involved skin showed (a) a slower rate of proliferation, (b) a cyclical pattern of PGE2 synthesis, and (c) an approximately 20-fold greater synthesis of PGE2 in response to human purified IL-1, a cytokine known to be secreted by epidermal keratinocytes. Furthermore, we were able to demonstrate that the cyclical generation of PGE2 by the involved skin fibroblasts is responsible for their slower rate of growth when compared with the uninvolved skin fibroblasts. These data document a phenotypic dichotomy between the uninvolved and involved skin fibroblasts in CHILD syndrome that may be exploited to increase our understanding of the nature of dermal influences that may affect epidermal growth and differentiation.
A Sign for Cain: An Exploration of Human Violence
Authors: Marjorie C. Meehan
Journal: JAMA (1966)

That violence is widespread and possibly increasing in  20th century, none will deny. Yet few scientists have investigated  subject. Wertham, a psychiatrist with much experience in examining and treating members of minority groups, delinquents, criminals, and others prone to suffer or commit violence, has written this book to explore  topic. He states that  most fruitful approach combines dynamic clinical psychiatry and sociology but adds, It is often harder to obtain all  data of violence accurately than it is to interpret them. Description comes before analysis. Most of  book is a detailed description of 20th century violence, with some discussion of its causes.  As contributing factors, Wertham mentions alcohol, warlike toys, and advertising (including cigarette advertising). He expounds his objections to what he calls the Malthus myth, but does not make clear why he thinks concern about overpopulation is either cause or result of violence.
Posttransfusion Hepatitis in Acute Myelogenous Leukemia
Authors: Kenneth A. Foon
Journal: JAMA (1980)

We evaluated retrospectively the clinical outcome of 47 patients with acute myelogenous leukemia who entered an intensive chemoimmunotherapy treatment protocol between January 1975 and July 1978. Remission duration and survival were substantially longer in patients in whom hepatitis developed.
Recent advances on bioactive natural products from Chinese medicinal plants
Authors: Guo-wei Qin, Ren-sheng Xu
Journal: Medicinal Research Reviews (1998)

China has accumulated a rich body of empirical knowledge of the use of medicinal plants for the treatment of various diseases throughout its long history. Chemical studies on Chinese medicinal plants provide a valuable material base for the discovery and development of new drugs of natural origin. In this article recent chemical work on various Chinese medicinal plants is reviewed, including Mussaenda pubescens (Rubiaceae), Isatis indigotica (Cruciferae), Euphorbia fischeriana, and E. ebracteolata (Euphorbiaceae), and Stemona species (Stemonaceae). The structural diversity of the medicinal chemical constituents of the above plants is discussed. © 1998 John Wiley & Sons, Inc. Med Res Rev, 18, No. 6, 375–382, 1998.
Hypertension: Some Unanswered Questions
Authors: Wylie Burke
Journal: JAMA (1985)

The measurement of a patient's blood pressure is a routine procedure when a person visits a physician or health facility. We carry out this test because elevated blood pressure is an etiologic factor for the development of stroke, coronary heart disease, congestive heart failure, and renal failure. In recent years, many different drugs have become available to reduce blood pressure. Normalization of elevated blood pressure decreases the risk of the various complications, and vigorous therapy for hypertension is recommended by many authorities. Since the condition is common, millions of individuals are labeled as hypertensives and many are given antihypertensive drugs to lower their blood pressure. Our current policies raise many questions. While we define hypertension as a blood pressure of more than 160/90 mm Hg or thereabouts, this definition is arbitrary. The distribution of blood pressure in the normal population is continuous, with no "cutoff" pressure at which a person
Study of Educational Deficits as the Cause of Hospital Admission for Diabetes Mellitus in a Community Hospital
Authors: Jack Geller, Karen Butler
Journal: Diabetes Care (1981)

Seventy-eight consecutive patients admitted to a community hospital for diabetic complications over a 1-yr period were interviewed in regard to circumstances resulting in their hospitalization. Based on this interview, patients were categorized as to the cause for admission into three groups: (1) educational deficits; (2) psycho-socio-economic deficits; and (3) unavoidable hospital admission. Twenty-seven percent of the patients had a specific educational deficit which was judged to be responsible for their hospitalization; an additional 20% of patients had combined education and psycho-socio-economic deficits accounting for their admission.
Immune mechanisms at the maternal-fetal interface: perspectives and challenges
Authors: Mercy PrabhuDas, Elizabeth Bonney, Kathleen Caron, Sudhansu Dey, Adrian Erlebacher, Asgerally Fazleabas, Susan Fisher, Thaddeus Golos, Martin Matzuk, Joseph M McCune, Gil Mor, Laura Schulz, Michael Soares, Thomas Spencer, Jack Strominger, Sing Sing Way, Koji Yoshinaga
Journal: Nature Immunology (2015)
Changing Physicians' Practices
Authors: Peter J. Greco, John M. Eisenberg
Journal: New England Journal of Medicine (1993)

What causes physicians to change the way they practice? This question is especially important today because physicians' decisions influence not only the health of their patients but also the cost of their care. Thus, the ability to change physicians' practices could improve the quality of health care while controlling expenditures.Changes in practice are sometimes rapid and dramatic. For example, laparoscopic cholecystectomy has virtually replaced the traditional procedure in the past several years1. At other times physicians are reluctant to change their practices even when randomized trials demonstrate the effectiveness of a new treatment2. In this article we . . .
Aortic Insufficiency in Bacterial Endocarditis
Authors: FRANK M. GRIFFIN
Journal: Annals of Internal Medicine (1972)

The records of 28 patients with bacterial endocarditis and aortic valve insufficiency were studied to determine clinical indications for valve replacement before bacteriologic cure can be accomplished. The four patients who never developed heart failure did well with medical therapy alone. Seven of 11 patients with mild heart failure died suddenly during treatment. At autopsy four of these were found to have had myocardial infarctions, presumably embolic. Seven of eight patients with moderate or severe heart failure who were treated medically died, whereas four of five with severe heart failure who had aortic valve replacement survived. Patients with bacterial endocarditis and aortic insufficiency who have severe heart failure should have aortic valve replacement performed immediately. Early valve replacement should also be considered in patients with only mild heart failure because they appear to be at significant risk of sudden death from embolic myocardial infarction or arrhythmia.
Truth Telling in Medicine
Authors: David Morris
Journal: JAMA (1982)

To the Editor.—  I found the recent article Truth Telling in Medicine by Mark Sheldon, PhD (1982;247:651), to be interesting and thought-provoking. There is one aspect of this issue that needs more emphasis than it has received.  One of the most neglected aspects of the physician-patient relationship is the right of the patient to be a self-sovereign, autonomous, free human being. Throughout history, this right has been violated time and time again under the guise of helping the patient. If one concludes that it is in the best interest of a patient for the physician to lie to that patient, then one has decided that the physician— not the patient—is the true judge of the best interest of the patient. If that is true, the patient has no selfsovereignty, and the physician is sovereign over the patient.  Back in the days when blacks were totally enslaved, many slave owners justified
Pathophysiologically Relevant Concentrations of Tumor Necrosis Factor-α Promote Progressive Left Ventricular Dysfunction and Remodeling in Rats
Authors: Biykem Bozkurt, Scott B. Kribbs, Fred J. Clubb, Lloyd H. Michael, Vladimir V. Didenko, Peter J. Hornsby, Yukihiro Seta, Hakan Oral, Francis G. Spinale, Douglas L. Mann
Journal: Circulation (1998)

Background —Although patients with heart failure express elevated circulating levels of tumor necrosis factor-α (TNF-α) in their peripheral circulation, the structural and functional effects of circulating levels of pathophysiologically relevant concentrations of TNF-α on the heart are not known. Methods and Results —Osmotic infusion pumps containing either diluent or TNF-α were implanted into the peritoneal cavity of rats. The rate of TNF-α infusion was titrated to obtain systemic levels of biologically active TNF-α comparable to those reported in patients with heart failure (≈80 to 100 U/mL), and the animals were examined serially for 15 days. Two-dimensional echocardiography was used to assess changes in left ventricular (LV) structure (remodeling) and LV function. Video edge detection was used to assess isolated cell mechanics, and standard histological techniques were used to assess changes in the volume composition of LV cardiac myocytes and the extracellular matrix. The reversibility of cytokine-induced effects was determined either by removal of the osmotic infusion pumps on day 15 or by treatment of the animals with a soluble TNF-α antagonist (TNFR:Fc). The results of this study show that a continuous infusion of TNF-α led to a time-dependent depression in LV function, cardiac myocyte shortening, and LV dilation that were at least partially reversible by removal of the osmotic infusion pumps or treatment of the animals with TNFR:Fc. Conclusions —These studies suggest that pathophysiologically relevant concentrations of TNF-α are sufficient to mimic certain aspects of the phenotype observed in experimental and clinical models of heart failure.
Pulmonary Alveolar Proteinosis with Systemic Nocardiosis
Authors: Burton R. Andersen
Journal: JAMA (1960)

This is believed to be the first reported case of disseminated mycotic infection complicating pulmonary alveolar proteinosis. The patient was hospitalized because of shortness of breath of two years' duration. He had suffered several episodes of malaise of respiratory origin. Histoplasmin and tuberculin tests were negative; sputum culture and gastric washings were negative for tuberculosis. Chest x-rays showed diffuse infiltration of tiny, poorly defined nodules throughout both lung fields. Microscopic study of lung biopsy revealed alveolar proteinosis. He was hospitalized three months later with hemoptysis, fever, cough, and profuse sweating. In spite of repeated therapy with antibiotics, intermittent fever continued. During the third week, surgical exploration drained an abscess in the left flank of pus containing Nocardia asteroides. A previously inoculated sputum culture also grew Nocardia. Treatment of the Nocardia infection resulted in improvement of all symptoms; however, the diffuse pulmonary lesions remained.
STRANGULATED HERNIA.Read at the Meeting of the Inter-County Medical Society, held at West Superior, Wis., July 11, 1893.
Authors: WILLIAM E. GROUND
Journal: JAMA (1893)

I would like to consider with you to-day the subject of strangulated hernia. Probably the two most important surgical subjects before the profession just now are appendicitis and hernia. Every cemetery contains the graves of patients who have unnecessarily died from these affections. The frequency of hernia varies somewhat at the different periods of life. It is met with very frequently during infancy. During early life it is generally of the congenital inguinal variety and is more common on the right than on the left side, probably owing to the fact that the root of the mesentery occupies a lower position on the right side. The greater proportionate length of the mesentery in infancy greatly favors the occurrence of hernial protrusions of the intestines during that period of life. Mr. Lockwood has shown that the mesentery in the infant measures one-fifth the length of the body, at puberty one-eighth and
HMG-CoA Reductase Inhibitors for Treatment of Hypercholesterolemia
Authors: John A. Oates, Alastair J.J. Wood, Scott M. Grundy
Journal: New England Journal of Medicine (1988)

THE recent introduction of a unique class of cholesterol-lowering drugs offers new promise for the treatment of hypercholesterolemia. These drugs are inhibitors of 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase, the rate-limiting enzyme in the synthesis of cholesterol. Relatively low doses of these agents will reduce plasma cholesterol levels markedly, and in short-term studies, they have not been found to produce serious side effects. Thus, in 1987 the Food and Drug Administration approved one HMG-CoA reductase inhibitor — lovastatin. If reductase inhibitors prove to be free of long-term adverse effects, they will undoubtedly be used widely for treating hypercholesterolemia. This review will examine . . .