tbuckley/cabot-search huggingface dataset:
Captopril and Central Nervous System Effects
Authors: SAMUEL RAPOPORT
Journal: Annals of Internal Medicine (1983)

Letters and Corrections1 June 1983Captopril and Central Nervous System EffectsSAMUEL RAPOPORT, M.D., PH.D., PAMELA ZYMAN, M.D.SAMUEL RAPOPORT, M.D., PH.D.Search for more papers by this author, PAMELA ZYMAN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-98-6-1023_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Neurologic complications of captopril have only been reported to affect the peripheral nervous system (1, 2). We treated a patient who developed encephalopathy and worsening of focal neurologic signs after beginning treatment with captopril for hypertension.A 62-year-old man presented for evaluation of right-sided weakness, slurred speech, and ataxia with falling to the right, which developed over a week and began after he had taken five 25-mg doses of captopril. His wife had monitored his blood pressure at home during the week before hospitalization and noted no decrease below 140/80 mm Hg.His medical history included neurofibromatosis...References1. VIDTBRAVOFOUAD DEF. Captopril. N Engl J Med. 1982;306:214-9. CrossrefMedlineGoogle Scholar2. ATKINSONBROWNLEVER AJA. Neurological dysfunction in two patients receiving captopril and cimetidine. Lancet. 1980;2:36-7. CrossrefMedlineGoogle Scholar3. HEELBROGDENSPEIGHTAVERY RRTG. Captopril: a preliminary review of its pharmacological properties and therapeutic efficacy. Drugs. 1980;20:409-52. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: The New York Hospital-Cornell Medical Center New York, NY 10021 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byChorea after cardiopulmonary bypass: exacerbation by captoprilCerebrovascular aspects of antihypertensive treatmentCentral nervous system considerations in the use of β-blockers, angiotensin-converting enzyme inhibitors, and thiazide diuretics in managing essential hypertensionChapter 26. Renin Inhibition 1 June 1983Volume 98, Issue 6Page: 1023-1023KeywordsAtaxiaBlood pressureBrain diseasesCentral nervous systemHospitalizationsHypertensionPeripheral nervous system Issue Published: 1 June 1983 PDF downloadLoading ...
Ownership and uses of human tissue: Does the Nuffield bioethics report accord with opinion of surgical inpatients?
Authors: R D Start, W Brown, R J Bryant, M W Reed, S S Cross, G Kent, J C E Underwood
Journal: BMJ (1996)

<h3>Abstract</h3> <b>Objective</b>: To compare opinion of surgical inpatients with the conclusions of the report of the Nuffield Council on Bioethics regarding the ownership and uses of human tissue. <b>Design</b>: Survey of results of questionnaires completed by patients. <b>Setting</b>: Large teaching hospital. <b>Subjects</b>: 384 postoperative adult surgical patients. <b>Results</b>: There was strong support among patients for the use of tissues in medical education, research, and science with the exception of those tisssues which may transmit disease to others. Few patients (39; 10%) believed that they retained ownership of tissue removed at surgery. Most believed that the tissue belonged to the hospital (103; 27%), to nobody (103; 27%), or to the laboratory (77; 20%). Most patients had not been given any information about the possible uses of their tissues after removal. <b>Conclusions</b>: Surgical inpatients seem to endorse the conclusions of the Nuffield report regarding the ownership and uses of human tissue. The recommendations regarding patient information and consent procedures should be implemented at the earliest opportunity. <h3>Key messages</h3> Most surgical inpatients seem to concur with the conclusions and recommendations of the working party regarding the uses of such human tissue Alterations to patient consent forms and additional patient education represent reasonable requirements for continued and appropriately regulated access to human tissue for the purposes of medical education, research, and audit
Essays on Tropical Dermatology
Authors: V. J. Derbes
Journal: JAMA (1969)

This book was originally intended to include essays which would complement Simons'<i>Handbook of Tropical Dermatology and Mycology</i>, but he died, and it was completed by Prof J. Marshall. The book was written by a distinguished panel of experts, and the chapters are of uniformly high quality. For the most part, the subject matter does consist of tropical, or essentially tropical, dermatology, but, certainly, sarcoidosis and vaccination and its possible complications do not so qualify. Marshall does not contend that dermatology in the tropics differs from dermatology elsewhere, but he states, "The life of most indigenous inhabitants of the tropics is still poor, nasty, brutish and short." This necessarily favors the development of mycoses, pyodermas, treponematoses, and leprosy. All these entities are treated well, and, in addition, there are chapters on tropical phagedenic ulcer, kwashiorkor, lichen planus tropicus, sabra dermatitis, granuloma multiforme, and leishmaniasis. H. P. Wassermann presents a very
The clinical profile of acute hepatitis A infection: Is it really so severe?
Authors: Pietro Amoroso, Salvatore Buonocore, Gennaro Lettieri, Paola Pierri, Alfonso Mele
Journal: Hepatology (2004)

To the Editor: The interesting editorial by Siłogren1 stresses the role of hepatitis A virus (HAV) as a cause of severe hepatitis and fulminant hepatitis, placing renewed focus on the issue of universal vaccination and suggesting that the policy of vaccinating only high-risk groups, which is currently adopted in the United States and in most western countries, be reconsidered.2, 3 In Italy, as in other economically developed areas, the epidemiology of HAV infection has changed drastically in the past 10 years, with a decrease in herd immunity and an increase in the number of susceptible adults and thus of symptomatic cases.4 Nonetheless, in our experience, the overall profile of the disease remains favourable, and fulminant and fatal cases are extremely rare. In particular, at the Domenico Cotugno Infectious-Disease Hospital of Naples, in which all cases of hepatitis in the metropolitan area are hospitalized, independently from their clinical complexity, and which is also the region's reference center for fulminant hepatitis, 1182 cases of HAV infection have been diagnosed in the past five years, based on serological evidence of immunoglobulin M anti-HAV (61% men; mean age, 16 ± 5 years; 4% of cases superimposed on subjects affected by chronic HBV or HCV infection). Although the clinical picture was serious for nearly one-third of these patients (22% with severe general symptoms; 20% with transaminase levels that were almost 30 times the normal values; 12% with serum bilirubin > 300 mmol/L; 6% with coagulopathy with international normalized ratio > 1.8; and 1.8% with a relapsing or a prolonged course), only 2 of them presented severe complications (i.e., pancreatitis and aplastic anemia), with resolution in both of them, and only 4 patients progressed to fulminant hepatitis.5. One of these patients, a pregnant women, required transplantation, and 3 recovered spontaneously; 1 of the latter 3 was suffering from chronic hepatitis C infection, and another had a history of low-dose acetaminophen intake, although nearly 20% of the patients without complications reported the use of this drug before the appearance of jaundice. In other words, only 0.3% of the more than 1,000 consecutive cases of HAV infection progressed to fulminant hepatitis, and none of the cases was fatal. These data are consistent with reports from Italy's national hepatitis surveillance system, which indicate that only 1 death has occurred among the 11,063 cases of HAV infection from 1965 to 2000.6
The American Alcoholic: The Nature-Nurture Controversy in Alcoholic Research and Therapy
Authors: Donald W. Goodwin
Journal: JAMA (1974)

This hodgepodgy book was written by an anthropologist who believes that alcoholism experts—himself and a few others excluded—can be divided into two groups: those who believe alcoholism is a biological disease and those who disagree. The two groups are locked in "mortal combat," each "resolved to destroy the other." As an anthropologist, the author prefers to view man as a "whole" and the aim of his book is to achieve a kind of<i>pax alcoholica</i>, synthesizing many theories. The result is chaos. The book has 473 references, many of them drawn from novels and the popular press. Much of the book consists of one quotation after another—sometimes six or seven to the page—with little apparent attempt to discriminate between theories of no merit, little merit, or considerable merit. The author on the one hand stresses how little we know and on the other smothers the reader in dogmatic and often
Pandemic Influenza Viruses — Hoping for the Road Not Taken
Authors: David M. Morens, Jeffery K. Taubenberger, Anthony S. Fauci
Journal: New England Journal of Medicine (2013)

Since the avian H7N9 influenza A virus that has emerged in China has some types of mutations associated with circulation in humans, some experts predict that it will become pandemic. But firm evidence of such well-defined viral-evolutionary pathways is lacking.
AUSCULTATION OF BRONCHIAL ASTHMA PATIENTS
Authors: M. J. Gutmann
Journal: JAMA (1953)

As a rule auscultation in cases of bronchial asthma does not present any particular difficulty, there being a prolonged expiration with normal inspiration heard uniformly over all parts of the lungs, as stated by the classical school. Actually, however, there is "prolongation of both phases of the respiratory cycle and in particular that of the expiratory phase is noteworthy." The typical musical rales, sibilant and sonorous, are more accentuated during expiration and frequently altogether inaudible during inspiration. As to the differentiation from other pathological conditions causative of prolonged expiration, diagnosis will depend on the character of the breath sounds. Thus, as R. A. Cooke justly states, "The diagnosis of asthma during the active stage is not as a rule very hard to make but the diagnosis of the existence of the asthmatic state or asthmatic predisposition is by no means easy. The necessity for some measure of diagnostic technic is
Mechanisms of disruption of the articular cartilage surface in inflammation. Neutrophil elastase increases availability of collagen type II epitopes for binding with antibody on the surface of articular cartilage.
Authors: H E Jasin, J D Taurog
Journal: Journal of Clinical Investigation (1991)

We recently observed that specific antibodies to type II collagen do not bind in appreciable amounts to the intact surface of articular cartilage, whereas antibodies to the minor collagen types V, VI, and IX do. These results suggest that the outermost cartilage surface layer prevented interaction of the antibodies with the major collagen type in articular cartilage. The present studies were designed to investigate the pathogenic mechanisms involved in the disruption of the cartilage surface layer in inflammatory arthritis. Articular cartilage obtained from rabbits undergoing acute antigen-induced arthritis of 72 h duration showed a significant increase in binding of anti-type II antibody to cartilage surfaces compared with normal control cartilage (P less than 0.01). Augmentation of anti-type II binding was also observed upon in vitro incubation of bovine articular slices or intact rabbit patellar cartilage for 1 h with human polymorphonuclear neutrophils (PMN), PMN lysates, or purified human PMN elastase. This increase was not inhibited by sodium azide, nor was it enhanced by incubation of cartilage with the strong oxidant hypochlorous acid. Chondrocyte-mediated matrix proteoglycan degradation in cartilage explants cultured in the presence of cytokines failed to increase antibody binding appreciably. The augmentation in antibody binding seen with PMN lysates was inhibited by the nonspecific serine-esterase inhibitor PMSF, but not by the divalent metal chelator EDTA. The elastase-specific inhibitor AAPVCMK also inhibited most of the PMN-induced increase in antibody binding, whereas the cathepsin G-specific inhibitor GLPCMK was much less effective. Incubation of intact cartilage with purified human PMN elastase indicated that this serine esterase could account for the increase in anti-type II collagen antibody binding to intact cartilage surfaces. These studies suggest that in an inflammatory response, PMN-derived elastase degrades the outer layer of articular cartilage, exposing epitopes on type II collagen. They also help clarify the pathogenic mechanisms involved in early articular cartilage damage in inflammatory joint diseases.
ANTICIPATION IN THE INHERITANCE OF DIABETES
Authors: R. T. WOODYATT
Journal: JAMA (1942)

The following lines are in Naunyn's<sup>1</sup>textbook on diabetes: Very interesting and instructive in its bearing on our conception of the hereditary transmission of the anlage is the fact that diabetes (in father and sons) can appear earlier in the sons than in the father. I have seen that once.... Quite similar cases are reported by Bence Jones,<sup>2</sup>Grube,<sup>3</sup>Niessen<sup>4</sup>(1865-1897). Niessen saw a child of 13 years after scarlatina that followed a typhus develop... diabetes and die of it a year later. The father, a chemist, often examined his own urine but found it always sugar free until five years later, when suddenly the disease also appeared in him.... The second case of Niessen's is entirely similar. Extending these earlier observations, Woodyatt<sup>5</sup>has noted further that when diabetes occurs in three generations of a single family it may appear earlier in the second than
Sympathetic nervous function in human heart as assessed by cardiac spillovers of dihydroxyphenylglycol and norepinephrine.
Authors: G Eisenhofer, M D Esler, I T Meredith, A Dart, R O Cannon, A A Quyyumi, G Lambert, J Chin, G L Jennings, D S Goldstein
Journal: Circulation (1992)

Measurement of cardiac norepinephrine spillover may indicate the amount of transmitter at neuroeffector sites but does not distinguish neuronal release or reuptake in determining this amount or provide information about other aspects of sympathetic function. This report examines how cardiac spillover of the norepinephrine metabolite dihydroxyphenylglycol (DHPG) provides additional distinct information about cardiac sympathetic function.Arterial and coronary venous blood samples were taken during cardiac catheterization and intravenous infusion of [3H]norepinephrine in 57 subjects. Subjects were given intravenous yohimbine or underwent mental stress, handgrip exercise, and cycling exercise to activate sympathetic nerves or were given intravenous desipramine to block norepinephrine reuptake. Cardiac DHPG spillover (601 +/- 41 pmol/min) was eightfold greater than norepinephrine spillover (78 +/- 10 pmol/min) at rest and increased during sympathetic activation by 65% of the increase of norepinephrine. This and the desipramine-sensitive cardiac production of [3H]-labeled DHPG from [3H]norepinephrine indicated that 10.5 times more endogenous norepinephrine is recaptured than escapes into plasma; that more than 90% of recaptured norepinephrine is sequestered into storage vesicles; and that under resting conditions, most cardiac spillover of DHPG and turnover of norepinephrine are from metabolism of transmitter leaking from vesicles; the latter process is independent of exocytotic transmitter release with a rate at rest over 100-fold that of norepinephrine spillover and over 10-fold that of norepinephrine reuptake.Cardiac spillover of DHPG provides information about processes close to or within sympathetic nerve endings that cannot be provided by measurements of norepinephrine spillover alone. This includes quantitative information about the role of neuronal uptake in terminating the actions of norepinephrine at neuroeffector sites and the importance of vesicular-axoplasmic exchange of norepinephrine as a dynamic process contributing to norepinephrine turnover.
Health Economic Benefits and Quality of Life During Improved Glycemic Control in Patients With Type 2 Diabetes Mellitus
Authors: Marcia A. Testa, Donald C. Simonson
Journal: JAMA (1998)

Although the long-term health benefits of good glycemic control in patients with diabetes are well documented, shorter-term quality of life (QOL) and economic savings generally have been reported to be minimal or absent.To examine short-term outcomes of glycemic control in type 2 diabetes mellitus (DM).Double-blind, randomized, placebo-controlled, parallel trial.Sixty-two sites in the United States.A total of 569 male and female volunteers with type 2 DM.After a 3-week, single-blind placebo-washout period, participants were randomized to diet and titration with either 5 to 20 mg of glipizide gastrointestinal therapeutic system (GITS) (n = 377) or placebo (n = 192) for 12 weeks.Change from baseline in glucose and hemoglobin A1c (HbA1c) levels and symptom distress, QOL, and health economic indicators by questionnaires and diaries.After 12 weeks, mean (+/-SE) HbA1c and fasting blood glucose levels decreased with active therapy (glipizide GITS) vs placebo (7.5% 0.1% vs 9.3%+/-0.1% and 7.0+/-0.1 mmol/L [126+/-2 mg/dL] vs 9.3+/-0.2 mmol/L [168+/-4 mg/ dL], respectively; P<.001). Quality-of-life treatment differences (SD units) for symptom distress (+0.59; P<.001), general perceived health (+0.36; P= .004), cognitive functioning (+0.34; P=.005), and the overall visual analog scale (VAS) (+0.24; P=.04) were significantly more favorable for active therapy. Subscales of acuity (+0.38; P=.002), VAS emotional health (+0.35; P=.003), general health (+0.27; P=.01), sleep (+0.26; P=.04), depression (+0.25; P=.05), disorientation and detachment (+0.23; P= .05), and vitality (+0.22; P=.04) were most affected. Favorable health economic outcomes for glipizide GITS included higher retained employment (97% vs 85%; P<.001), greater productive capacity (99% vs 87%; P<.001), less absenteeism (losses = $24 vs $115 per worker per month; P<.001), fewer bed-days (losses = $1539 vs $1843 per 1000 person-days; P=.05), and fewer restricted-activity days (losses = $2660 vs $4275 per 1000 person-days; P=.01).Improved glycemic control of type 2 DM is associated with substantial short-term symptomatic, QOL, and health economic benefits.
A piece of my mind. The cabalist
Authors: M. A. Lacombe
Journal: JAMA (1988)

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
Discrepancies Between Patient and Physician Estimates for the Success of Stem Cell Transplantation
Authors: Stephanie J. Lee
Journal: JAMA (2001)

ContextStem cell transplantation is associated with considerable morbidity and mortality. The extent to which patients and their physicians correctly estimate these risks is unknown.ObjectiveTo measure the expectations of patients and physicians prior to stem cell transplantation and correlate them with actual outcomes after transplantation.DesignProspective cohort study with baseline questionnaire administered July 1996 through November 1999 and follow-up to May 2000.SettingTertiary care transplant center in the United States.ParticipantsOf 458 surveys mailed, evaluable returned surveys were included for 313 autologous and allogeneic stem cell transplantation patients and their physicians.Main Outcome MeasuresPatient and physician expectations prior to transplantation (measured on 6-point Likert scales) of treatment-related mortality, cure with transplantation, and cure without transplantation; actual treatment-related mortality and disease-free survival among patients with at least 1 year of follow-up after transplantation (n = 263).ResultsBoth patients and physicians were fairly accurate in estimating treatment-related mortality when actual mortality was less than 30%. However, in situations in which mortality was higher than 30%, such as with allogeneic transplantation for intermediate or advanced disease, physician expectations were lower, while patients remained optimistic. Similarly, physicians provided lower estimates of disease-free survival in cases of intermediate or advanced disease while patient expectations remained high and constant regardless of disease stage.ConclusionsPatients and their physicians have the most concordant and accurate expectations when the outcome of stem cell transplantation is likely to be favorable. However, patients with more advanced disease fail to recognize the higher risks associated with their situations.