tbuckley/cabot-search huggingface dataset:
Mortality Benefit of Immediate Revascularization of Acute ST-Segment Elevation Myocardial Infarction in Patients With Contraindications to Thrombolytic Therapy
Authors: Mary Grzybowski, Elizabeth A. Clements, Lori Parsons, Robert Welch, Anne T. Tintinalli, Michael A. Ross, Robert J. Zalenski
Journal: JAMA (2003)

There are no definitive recommendations for the management of acute myocardial infarction (AMI) in patients with ST-segment elevation who have contraindications to thrombolytic therapy. It is not clear whether, and the extent to which, immediate mechanical reperfusion (IMR) reduces in-hospital mortality in this population.To determine whether IMR (defined as percutaneous coronary intervention or coronary artery bypass graft surgery) is associated with a mortality benefit in patients with acute ST-segment elevation AMI who are eligible for IMR but have contraindications to thrombolytic therapy.From June 1994 to January 2003, the National Registry of Myocardial Infarction 2, 3, and 4 enrolled 1 799 704 patients with AMI. A total of 19 917 patients with acute ST-segment elevation were eligible for IMR but had thrombolytic contraindications after excluding patients who were transferred in from or out to other facilities, patients who received intracoronary thrombolytics, and those who received no medications within 24 hours of arrival.In-hospital mortality.Of the 19 917 patients, 4705 patients (23.6%) received IMR and 5173 patients (25.9%) died. In-hospital mortality rates in the IMR and non-IMR treated groups in the unadjusted analysis were 11.1%, representing 521 of 4705 patients, and 30.6%, representing 4652 of 15 212 patients, respectively, for a risk reduction of 63.7% (odds ratio [OR], 0.28; 95% confidence interval [CI], 0.26-0.31). In a further analysis using a propensity matching score to reduce the effects of bias, 3905 patients who received IMR remained at lower risk for in-hospital mortality than 3905 matched patients (10.9% vs 20.1%, respectively, for a risk reduction of 45.8%; OR, 0.48; 95% CI, 0.43-0.55). Following a second logistic model applied to the matched groups to adjust for residual differences, a significant treatment effect persisted (OR, 0.64; 95% CI, 0.56-0.75).In this population, IMR was associated with a reduced risk of in-hospital mortality after appropriate adjustments. Of those we studied who were eligible for IMR, 15 212 patients (76.4%) did not receive it. These results suggest that using IMR in patients with acute ST-segment elevation AMI and contraindications to thrombolytics should be strongly considered.
Therapeutic Heat and Cold
Authors: Henry H. Stonnington
Journal: JAMA (1982)

This book is bound to become a classic. Justus Lehmann is well known for the research he has done and for the research he has stimulated. One of these areas is the scientific investigation of heat as a therapeutic modality. He is, therefore, eminently qualified to write and edit a textbook on this subject. Although this is called the third edition, it is an entirely new book. There is little similarity to the old book, but there is a nice link. The book starts off with a chapter on "History of Therapeutic Heat and Cold" by the late Sidney Licht. Sidney Licht was the editor not only of the previous edition of this volume but of the whole series of the Rehabilitation Medicine Library. John V. Basmajian, the new editor of the new editions of this library, is to be congratulated for having chosen such a brilliant and practical scientist,
The Aging Gastrointestinal Tract
Authors: R. F. ARCHAMBAULT
Journal: JAMA (1974)

<h3>To the Editor.—</h3> Most of us are concerned with the gastrointestinal tract only when there is evidence of a pathological lesion or some malfunction. No one has ever been concerned about the aging process of the gastrointestinal tract and the concomitant lack of absorption of vital elements in our food. Research work on normals does not apply to all individuals since no one knows the individual capacity of absorption from the gastrointestinal tract. This defective absorption of the gastrointestinal tract was well illustrated in the case of one of our patients who suffered from chilosis, for whom large doses of orally administered riboflavin were prescribed, and for whom this orally given vitamin accomplished nothing. Later, an accidental dose of riboflavin given intramuscularly in a small quantity cleared up this deficiency in a short period of time. This same experience repeated itself in three other persons who suffered from chilosis. Since
Hyperactive PiggyBac Transposons for Sustained and Robust Liver-targeted Gene Therapy
Authors: Mario Di Matteo, Emira Samara-Kuko, Natalie J Ward, Simon N Waddingon, John H McVey, Marinee KL Chuah, Thierry VandenDriessche
Journal: Molecular Therapy (2014)

The development of robust nonviral vectors could facilitate clinical gene therapy applications and may overcome some of the immune complications of viral vectors. Nevertheless, most nonviral gene deliver approaches typically yield only transient and/or low gene expression. To address these caveats, we have explored piggyBac transposons to correct hemophilia B by liver-directed factor IX (FIX) gene therapy in hemophilic mice. To achieve this, we combined the use of: (i) a hyperactive codon-optimized piggyBac transposase, (ii) a computationally enhanced liver-specific promoter, (iii) a hyperfunctional codon-optimized FIX transgene (FIX R338L Padua), and (iv) a modification of the transposon terminal repeats. This combination strategy resulted in a robust 400-fold improvement in vector performance in hepatocytes, yielding stable supraphysiologic human FIX activity (>1 year). Liver-specific expression resulted in the induction of FIX-specific immune tolerance. Remarkably, only very low transposon/transposase doses were required to cure the bleeding diathesis. Similarly, PB transposons could be used to express supraphysiologic factor VIII levels using low transposon/transposase doses. PB transposition did not induce tumors in a sensitive hepatocellular carcinoma-prone mouse model. These results underscore the potency and relative safety of the latest generation PB transposons, which constitutes a versatile platform for stable and robust secretion of therapeutic proteins.
Anterior infarctional changes occurring during mid and late ventricular activation detectable by surface mapping techniques.
Authors: N C Flowers, L G Horan, J C Johnson
Journal: Circulation (1976)

This is a comparative body surface potential map study of 26 patients with a recent acute anterior myocardial infarction. The mean plus or minus two standard deviations (+/- 2 SD) for the voltage distribution was established at 5 msec intervals throughout the cardiac cycle in 30 normal subjects at each of 142 recording sites. Instances in which a patient's potential distribution fell outside the normal range were analyzed as to location, duration and intensity against the expected time course of ventricular activation. Only four patients had departures from the normal distribution confined to the Q time zone. Twenty patients had not only Q time zone abnormalities, but had areas of both positivity and negativity exceeding +/- 2 SD, which occurred well after 30 msec. Two patients with clearly documented diagnostic Q waves during the first few days of hospitalization had lost these findings by the date of body surface mapping. They did retain, however, departure map findings demonstrating significant abnormalities occurring between 30 and 60 msec after onset of ventricular activation. These changes occurring in the mid and late time zones of the activation sequence are not detectable by conventional electrocardiography or vectorcardiography, yet present a strikingly apparent finding by this technique of analysis and display.
Calcitonin stimulation of renal 25-hydroxyvitamin D-1 alpha-hydroxylase activity in hypophosphatemic mice. Evidence that the regulation of calcitriol production is not universally abnormal in X-linked hypophosphatemia.
Authors: T Nesbitt, B Lobaugh, M K Drezner
Journal: Journal of Clinical Investigation (1987)

Hypophosphatemia (Hyp) mice have defective regulation of 25(OH)D-1 alpha-hydroxylase activity in response to hypophosphatemia, hypocalcemia, and parathyroid hormone (PTH) administration. However, recent observations support the existence of anatomically distinct, independently regulated renal 1 alpha-hydroxylase systems in mammalian proximal convoluted and straight tubules. To more completely define the extent of the 1 alpha-hydroxylase regulatory defect in Hyp-mice, we compared enzyme maximum velocity in normal and mutants after infusion of calcitonin. Upon stimulation, renal 1 alpha-hydroxylase activity increased to similar levels in normal and Hyp-mouse renal homogenates. Moreover, time-course and dose-dependence studies revealed similar patterns of response in the animal models. Subsequently, we examined whether PTH and calcitonin stimulatory effects on enzyme activity are mediated through different mechanisms. In both animal models administration of PTH and calcitonin increased enzyme activity to levels greater than those obtained after maximal stimulation by either hormone alone, consistent with additive effects. These observations indicate that a calcitonin-sensitive component of 1 alpha-hydroxylase is not compromised in the X-linked hypophosphatemic syndrome.
Association of Methylenetetrahydrofolate Reductase Gene Polymorphisms and Sex-Specific Survival in Patients With Metastatic Colon Cancer
Authors: Wu Zhang, Oliver A. Press, Christopher A. Haiman, Dong Yun Yang, Michael A. Gordon, William Fazzone, Anthony El-khoueiry, Syma Iqbal, Andy E. Sherrod, Georg Lurje, Heinz-Josef Lenz
Journal: Journal of Clinical Oncology (2007)

Purpose Methylenetetrahydrofolate reductase (MTHFR) is a key enzyme regulating intracellular folate levels, which affects DNA synthesis and methylation. Two MTHFR gene polymorphisms, C677T and A1298C, are linked to altered enzyme activity. Several studies have shown these two polymorphisms to be associated with response to fluorouracil (FU) -based treatment in advanced colon cancer patients, but data are inconsistent and contradictory. Meanwhile, epidemiologic studies demonstrated that these MTHFR polymorphisms were associated with cancer risk in a sex-specific manner. We tested the hypothesis of whether these two polymorphisms are associated with sex-specific clinical outcome in metastatic colon cancer patients treated with FU-based chemotherapy. Patients and Methods This study included 318 patients (177 men and 141 women) with metastatic colon cancer treated between 1992 and 2003 at the University of Southern California/Norris Comprehensive Cancer Center or Los Angeles County/University of Southern California Medical Center. Peripheral blood samples were collected from each patient, and genomic DNA was extracted from WBCs. Two MTHFR gene polymorphisms (C677T and A1298C) were tested by fluorogenic 5′-nuclease assay. Results The A1298C polymorphism showed statistically significant differences in overall survival (OS) in female, but not male, patients with metastatic colon cancer (log-rank test, P = .038). Among females, OS was greater for patients with the A/A genotype (n = 67; median OS, 18.4 months) compared with patients with the A/C genotype (n = 50; median OS, 13.9 months) or C/C genotype (n = 10; median OS, 15.6 months). Conclusion Although preliminary, these data support the role of the A1298C polymorphism in MTHFR as prognostic marker in female patients with metastatic colon cancer. Further studies are needed to confirm these findings.
A denatured collagen microfiber scaffold seeded with human fibroblasts and keratinocytes for skin grafting
Authors: Margit Kempf, Yuki Miyamura, Pei-Yun Liu, Alice C.-H. Chen, Hideki Nakamura, Hiroshi Shimizu, Yasuhiko Tabata, Roy M. Kimble, James R. McMillan
Journal: Biomaterials (2011)
Persistence and Boosting of Bacille Calmette-Guérin–Induced Delayed-Type Hypersensitivity
Authors: Daniel F. Hoft, Jan M. Tennant
Journal: Annals of Internal Medicine (1999)

Background: Bacille Calmette-Guérin (BCG) vaccination may induce persistent and booster purified protein derivative (PPD) responses that complicate tuberculosis screening efforts. Objectives: To investigate the effects of BCG vaccination on serial PPD tests and to study correlations between persistent delayed-type hypersensitivity and other potential surrogate markers of protective immunity. Design: Cohort study. Setting: Midwestern urban university. Participants: 69 healthy adults. Interventions: BCG vaccination, blood samples drawn for immunologic studies, and PPD tests done sequentially over 1 to 3 years. Measurements: Serial PPD induration, lymphoproliferation, and interferon-γ responses. Results: 10% of participants (95% CI, 4% to 20%) had persistent PPD responses of 15 mm or greater, and 3% (CI, 0% to 10%) demonstrated PPD boosting of 15 mm or greater 1 to 3 years after BCG vaccination. Intradermal BCG vaccination induced a larger number of persistent responses that were 10 mm or greater than did percutaneous BCG vaccination (12 of 46 participants compared with 1 of 23 participants; P = 0.05). Persistent and boosted delayed-type hypersensitivity correlated with mycobacterial-specific lymphoproliferation and interferon-γ responses. Conclusions: Previous BCG vaccination reduces the predictive value of serial PPD testing. The lowest PPD predictive values will occur in persons without known tuberculosis exposure who were vaccinated recently or many times with intradermal BCG. In addition, BCG-related persistence and boosting of delayed-type hypersensitivity responses correlate with other potential surrogate markers of protective mycobacterial immunity.
t(14;16)-positive multiple myeloma shows negativity for CD56 expression and unfavorable outcome even in the era of novel drugs
Authors: T Narita, A Inagaki, T Kobayashi, Y Kuroda, T Fukushima, M Nezu, S Fuchida, H Sakai, N Sekiguchi, I Sugiura, Y Maeda, H Takamatsu, N Tsukamoto, D Maruyama, Y Kubota, M Kojima, K Sunami, T Ono, M Ri, K Tobinai, S Iida
Journal: Blood Cancer Journal (2015)

t(14;16)-positive multiple myeloma shows negativity for CD56 expression and unfavorable outcome even in the era of novel drugs
Circumscribed Pretibial Myxedema
Authors: Isadore Zugerman
Journal: New England Journal of Medicine (1954)

CIRCUMSCRIBED pretibial myxedema is an unusual but not a particularly rare skin disease. In an excellent article Curtis and his associates1 described this condition, and many cases have been reported in the society transactions of almost every volume of the Archives of Dermatology and Syphilology within the last ten years.A certain relation seems to exist between localized myxedema and exophthalmos, both features developing in connection with thyrotoxicosis (Graves's disease). It has been assumed that thyrotropic pituitary hormone plays an active part in their development.In the majority of cases toxic diffuse goiter with one or more thyroidectomies preceded the . . .
A prospective pilot study of the prevalence of pancreatic disease in patients with alcohol related liver disease using faecal elastase-1
Authors: R. Bhattacharyya, A. Ali, D. Majumdar, F. Akram, K. L. Dear, D. S. Sanders, D. C. Gleeson, M. A. Karajeh, J. S. Leeds
Journal: Gut (2011)

<h3>Introduction</h3> Excess alcohol intake is associated with liver disease and pancreatic disease, however, the majority of individuals appear to present with a single condition, for example, chronic liver disease. There is a paucity of studies assessing the prevalence of pancreatic disease in patients with alcohol related liver disease (ALD). Detecting pancreatic disease in patients with ALD may be important as symptoms may go untreated and nutrition may be affected. The aim of this study was to assess the prevalence of pancreatic disease in a cohort of patients with ALD. <h3>Methods</h3> Consecutive patients seen in the liver outpatient clinic were invited to participate. Demographics, severity of liver disease (as judged by Childs-Pugh score), presence of diabetes and presence of relevant symptoms were recorded. Participants were asked to provide a stool sample for analysis of faecal elastase-1 level (Fel-1). Abnormal Fel-1 was defined as &lt;200 μg/g stool. All patients had undergone abdominal imaging to assess their liver disease and these were reviewed. Prevalence of abnormal elastase was compared to two controls groups; patients with chronic diarrhoea (n=105) and non-diarrhoea controls (n=95) (both groups did not have liver disease). <h3>Results</h3> 79 patients with ALD were included (mean age 49.9, 48 males) with Childs-Pugh grades A/B/C of 23/34/22 respectively. The prevalence of abnormal Fel-1 was 20/79 (25.3%, 95% CI 16.2% to 36.4%), 3/105 (2.9%, 95% CI 0.6% to 8.2%) and 3/95 (3.2%, 95% CI 0.7 to 8.9) in those with ALD, chronic diarrhoea and non-diarrhoea controls respectively (p&lt;0.001). In the ALD group, abnormal elastase was not related to age, gender, severity of liver disease or the presence of relevant symptoms (all p&gt;0.1). Abnormal Fel-1 was associated with the presence of diabetes (9/20 Fel-1&lt;200 vs 11/59 Fel-1&gt;200, OR 3.6, 1.2–10.7, p=0.003). Abnormal pancreatic imaging was found predominantly in those with Fel-1&lt;200 (10/20 vs 2/59, p&lt;0.001). Sensitivity, specificity, positive predictive value and negative predictive value for Fel-1&lt;200 in those with ALD were 0.83, 0.85, 0.65 and 0.94 respectively. <h3>Conclusion</h3> Co-existent pancreatic disease is common in patients with ALD. Faecal elastase is a useful test in identifying cases in an ALD cohort as the only clinical marker is the presence of diabetes. More data is required to assess the effect of pancreatic disease in ALD and any potential advantage to enzyme replacement therapy.
George Geiger Glenner, MD
Authors: David N. Bailey
Journal: JAMA (1996)

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
Positively Parents: Caring for a Severely Disabled Child; Taking Care; Running a Team for Disabled Children and Their Families; The Integration of Disabled Children into Mainstream Education: Ambitions, Theories and Practices
Authors: L. Rosenbloom
Journal: BMJ (1995)

Positively Parents: Caring for a Severely Disabled Child , Bryony Beresford Social Policy Research Unit/HMSO, £12.50, pp 125 ISBN 0 11 701837

Taking Care Alison Cowen Joseph Rowntree Trust , pp 80. Available free of charge from The Family Fund, P O Box 50, York YO1 2ZX ISBN 1 872470 95 5

Running a Team for Disabled Children and Their Families , Martin F Robards MacKeith Press/Cambridge University Press, £25, pp 113 ISBN 0 901260 99 1

The Integration of Disabled Children into Mainstream Education: Ambitions, Theories and Practices , OECD, F Fr 40, pp 55 ISBN 92 64 14071 9

The implications that childhood disability has for families, professional practice, and society are widely recognised. This does not mean, however, that coherent or even sensible provisions are available for disabled children and their families or even that the research …
1166 A/C Polymorphism of the Angiotensin II Type 1 Receptor Gene and the Response to Short-Term Infusion of Angiotensin II
Authors: Karl F. Hilgers, Matthias R. W. Langenfeld, Markus Schlaich, Roland Veelken, Roland E. Schmieder
Journal: Circulation (1999)

Background —Previous studies reported an association of the 1166 A/C polymorphism of the angiotensin II (Ang II) type 1 receptor gene with high blood pressure and cardiovascular disease. We tested the hypothesis that this polymorphism affects the blood-pressure, renal hemodynamic, and aldosterone response to infused Ang II. Methods and Results —Young, male, white volunteers (n=116) with normal (n=65) or mildly elevated (n=51) blood pressure on a high salt intake were genotyped for the 1166 A/C polymorphism. Two doses of Ang II (0.5 and 3 ng · kg −1 · min −1 over 30 minutes each) increased blood pressure, plasma aldosterone, glomerular filtration rate, and filtration fraction and decreased renal blood flow. The blood-pressure, renal hemodynamic, and aldosterone responses were not significantly different between subjects homozygous for the A allele (n=56) and heterozygous subjects (n=47) or subjects homozygous for the C allele (n=13). Comparison of A allele homozygotes with all C allele carriers pooled (n=60) or restriction of the analysis to normotensive volunteers also revealed no significant differences between genotypes. Conclusions —The 1166 C variant of the Ang II type 1 receptor does not lead to a greater blood-pressure, aldosterone, or renal vascular response to infused Ang II in young, male, white subjects. We conclude that the 1166 A/C polymorphism does not have a major effect on these actions of Ang II.
Percutaneous Coronary Interventions for Silent Ischemia After Myocardial Infarction
Authors: Nihat Kalay, Ibrahim Ozdogru
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