tbuckley/cabot-search huggingface dataset:
Methadone Maintenance vs 180-Day Psychosocially Enriched Detoxification for Treatment of Opioid Dependence
Authors: Karen L. Sees, Kevin L. Delucchi, Carmen Masson, Amy Rosen, H. Westley Clark, Helen Robillard, Peter Banys, Sharon M. Hall
Journal: JAMA (2000)

ContextDespite evidence that methadone maintenance treatment (MMT) is effective for opioid dependence, it remains a controversial therapy because of its indefinite provision of a dependence-producing medication.ObjectiveTo compare outcomes of patients with opioid dependence treated with MMT vs an alternative treatment, psychosocially enriched 180-day methadone-assisted detoxification.DesignRandomized controlled trial conducted from May 1995 to April 1999.SettingResearch clinic in an established drug treatment service.PatientsOf 858 volunteers screened, 179 adults with diagnosed opioid dependence were randomized into the study; 154 completed 12 weeks of follow-up.InterventionsPatients were randomized to MMT (n = 91), which required 2 hours of psychosocial therapy per week during the first 6 months; or detoxification (n = 88), which required 3 hours of psychosocial therapy per week, 14 education sessions, and 1 hour of cocaine group therapy, if appropriate, for 6 months, and 6 months of (nonmethadone) aftercare services.Main Outcome MeasuresTreatment retention, heroin and cocaine abstinence (by self-report and monthly urinalysis), human immunodeficiency virus (HIV) risk behaviors (Risk of AIDS Behavior scale score), and function in 5 problem areas: employment, family, psychiatric, legal, and alcohol use (Addiction Severity Index), compared by intervention group.ResultsMethadone maintenance therapy resulted in greater treatment retention (median, 438.5 vs 174.0 days) and lower heroin use rates than did detoxification. Cocaine use was more closely related to study dropout in detoxification than in MMT. Methadone maintenance therapy resulted in a lower rate of drug-related (mean [SD] at 12 months, 2.17 [3.88] vs 3.73 [6.86]) but not sex-related HIV risk behaviors and in a lower severity score for legal status (mean [SD] at 12 months, 0.05 [0.13] vs 0.13 [0.19]). There were no differences between groups in employment or family functioning or alcohol use. In both groups, monthly heroin use rates were 50% or greater, but days of use per month dropped markedly from baseline.ConclusionsOur results confirm the usefulness of MMT in reducing heroin use and HIV risk behaviors. Illicit opioid use continued in both groups, but frequency was reduced. Results do not provide support for diverting resources from MMT into long-term detoxification.
Epigenome-wide differences in pathology-free regions of multiple sclerosis–affected brains
Authors: Jimmy L Huynh, Paras Garg, Tin Htwe Thin, Seungyeul Yoo, Ranjan Dutta, Bruce D Trapp, Vahram Haroutunian, Jun Zhu, Michael J Donovan, Andrew J Sharp, Patrizia Casaccia
Journal: Nature Neuroscience (2013)
Surgical vs Lifestyle Treatment for Type 2 Diabetes
Authors: David S. Ludwig, Cara B. Ebbeling, Edward H. Livingston
Journal: JAMA (2012)

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
Effects of acipimox, an antilipolytic drug, on the growth hormone (GH) response to GH-releasing hormone alone or combined with arginine in obesity
Authors: Mauro Maccario, Massimo Procopio, Silvia Grottoli, Salvatore Endrio Oleandri, Gian Mario Boffano, Marina Taliano, Franco Camanni, Ezio Ghigo
Journal: Metabolism (1996)
ACETANILID: ITS USE AS A PREVENTIVE MEASURE IN PREMATURE EXPULSION OF THE OVUM.
Authors: STEPHEN HARNSBERGER
Journal: JAMA (1898)

Squibb tells us that antifebrin and acetanilid are identical. This latter drug, under the title of antifebrin, was discovered by Gerhardt in 1845, but it was left to Cahn and Hepp in 1886 to bring it before the medical profession as a remedial agent. Acetanilid is a neutral chemic body, produced by the addition of glacial acetic acid in excess to anilin. It should be a white crystalline powder, slightly soluble in hot water, sparingly so in cold water, and quite easily dissolved in alcohol, strong wine or ether. To detect acetanilid in the urine the latter is shaken with chloroform, and the residue left on evaporation is heated with mercurious nitrate, when an intense green color develops. From the published clinical reports on the subject, it is plain that its clinical application has been confined principally to its use as an antipyretic, and to a less extent, to its
Hepatocyte-specific inhibitor-of-kappaB-kinase deletion triggers the innate immune response and promotes earlier cell proliferation during liver regeneration
Authors: Yann Malato, Leif E. Sander, Christian Liedtke, Malika Al-Masaoudi, Frank Tacke, Christian Trautwein, Naiara Beraza
Journal: Hepatology (2008)

Nuclear factor κB (NF-κB) is one of the main transcription factors involved in liver regeneration after partial hepatectomy (PH). It is activated upon IκB phosphorylation by the IκB kinase (IKK) complex comprising inhibitor of kappaB kinase 1 (IKK1), inhibitor of kappaB kinase 2 (IKK2), and nuclear factor-B essential modifier (NEMO). We studied the impact of hepatocyte-specific IKK2 deletion during liver regeneration. A 70% PH was performed on IKK2f/f (wild-type) and IKK2ΔLPCmice (hepatocyte-specific IKK2 knockout mice). PH in IKK2ΔLPC compared with IKK2f/f mice resulted in weaker and delayed NF-κB activation in hepatocytes, while nonparenchymal liver cells showed earlier NF-κB activation and higher tumor necrosis factor expression. Additionally, these animals showed increased and earlier serum amyloid A and chemotactic cytokine L-1 levels followed by enhanced polymorphonuclear cell recruitment to the liver. These results correlated with earlier Jun kinase activity, c-myc expression, and matrix metalloproteinase-9 activity, suggesting earlier priming in IKK2ΔLPC mice after PH. These data preceded a more rapid cell cycle progression and earlier hepatocyte proliferation as evidenced through cyclin and 5-bromo-2-deoxyuridine analysis. Interestingly, despite faster G1/S progression, IKK2ΔLPC mice exhibited an enduring mitosis phase, because mitotic bodies were still observed at later stages after PH. Conclusion: We demonstrate that PH in IKK2ΔLPC mice triggers a more rapid and pronounced inflammatory response in nonparenchymal liver cells, which triggers earlier hepatocyte proliferation. (HEPATOLOGY 2008.)
Canine Lipoproteins and Atherosclerosis
Authors: ROBERT W. MAHLEY, KARL H. WEISGRABER
Journal: Circulation Research (1974)

Canine plasma lipoproteins were fractionated into four distinct classes by ultracentrifugation combined with Geon-Pevikon block electrophoresis and characterized with respect to physical and chemical properties. The distribution of plasma lipids and lipoproteins was quite unlike that in man, the dog having approximately five to six times as much high density as lower density lipoproteins. Despite the marked difference in distribution, human lipoprotein equivalents were present. Very low density lipoproteins (VLDL) isolated at density less than 1.006 g/ml were triglyceride-rich particles ranging in size from 260 to 900 Å in diameter. The density range from 1.006 to 1.063 g/ml contained two classes of lipoproteins: one closely resembled aolow density lipoprotein (LDL) with β mobility and a particle size of approximately 200 Å and the other (called HDL 1 ) was closely related to the high density lipoproteins with respect to immunochemical reactivity, electrophoretic mobility, and apoprotein content. The HDL 1 particles ranged in size from 100 to 350 Å in diameter and appeared to be unlike any of the commonly described human lipoproteins. High density lipoproteins called HDL 2 isolated in the density range from 1.087 to 1.21 g/ml were protein-rich particles ranging in size from 55 to 85 Å. The apolipoprotein patterns of VLDL, LDL, and HDL 2 on polyacrylamide gel electrophoresis were similar to those of the corresponding lipoproteins of man.
Pravastatin Reduces Marfan Aortic Dilation
Authors: Darren McLoughlin, Jonathan McGuinness, John Byrne, Eloisa Terzo, Vilhelmiina Huuskonen, Hester McAllister, Alexander Black, Sinead Kearney, Elaine Kay, Arnold D.K. Hill, Harry C. Dietz, J. Mark Redmond
Journal: Circulation (2011)

Background— The sequelae of aortic root dilation are the lethal consequences of Marfan syndrome. The root dilation is attributable to an imbalance between deposition of matrix elements and metalloproteinases in the aortic medial layer as a result of excessive transforming growth factor-beta signaling. This study examined the efficacy and mechanism of statins in attenuating aortic root dilation in Marfan syndrome and compared effects to the other main proposed preventative agent, losartan. Methods and Results— Marfan mice heterozygous for a mutant allele encoding a cysteine substitution in fibrillin-1 (C1039G) were treated daily from 6 weeks old with pravastatin 0.5g/L or losartan 0.6 g/L. The end points of aortic root diameter (n=25), aortic thickness, and architecture (n=10), elastin volume (n=5), dp/dtmax (maximal rate of change of pressure) (cardiac catheter; n=20), and ultrastructural analysis with stereology (electron microscopy; n=5) were examined. The aortic root diameters of untreated Marfan mice were significantly increased in comparison to normal mice (0.161±0.001 cm vs 0.252±0.004 cm; P &lt;0.01). Pravastatin (0.22±0.003 cm; P &lt;0.01) and losartan (0.221±0.004 cm; P &lt;0.01) produced a significant reduction in aortic root dilation. Both drugs also preserved elastin volume within the medial layer (pravastatin 0.23±0.02 and losartan 0.29±0.03 vs untreated Marfan 0.19±0.02; P =0.01; normal mice 0.27±0.02). Ultrastructural analysis showed a reduction of rough endoplasmic reticulum in smooth muscle cells with pravastatin (0.022±0.004) and losartan (0.013±0.001) compared to untreated Marfan mice (0.035±0.004; P &lt;0.01). Conclusions— Statins are similar to losartan in attenuating aortic root dilation in a mouse model of Marfan syndrome. They appear to act through reducing the excessive protein manufacture by vascular smooth muscle cells, which occurs in the Marfan aorta. As a drug that is relatively well-tolerated for long-term use, it may be useful clinically.
Increased Atrial and Brain Natriuretic Peptides in Adults With Cyanotic Congenital Heart Disease
Authors: William E. Hopkins, Zengyi Chen, Naomi K. Fukagawa, Christian Hall, Harm J. Knot, Martin M. LeWinter
Journal: Circulation (2004)

Brain natriuretic peptide (BNP) levels are used in the evaluation of patients with heart disease, yet there is little understanding of the effect of hypoxia on natriuretic peptide secretion. Furthermore, recent data suggest that oxytocin may mediate stretch-induced atrial natriuretic peptide (ANP) secretion.Ten patients with cyanotic congenital heart defects and 10 control subjects were studied. N-terminal proatrial natriuretic peptide and N-terminal probrain natriuretic peptide levels were 4-fold (P=0.02) and 12-fold (P=0.03) greater in cyanotic patients than in control subjects. Cyanotic patients had reduced body water compared with control subjects, although the difference did not reach statistical significance (P=0.22). In a separate group of patients, cardiac myocytes were isolated from the right atrial appendage during CABG. The amount of oxygen in the buffered saline was varied to simulate hypoxia. Isolated hypoxic atrial myocytes had 43% fewer dense surface secretory granules compared with normoxic myocytes (P<0.0001). Immunohistochemical staining demonstrated decreased ANP and BNP in hypoxic compared with normoxic right atrial tissue. Isolated myocytes also degranulated when incubated with oxytocin (P<0.0001), but there was no difference in oxytocin levels in cyanotic patients compared with control subjects (P=0.49).ANP and BNP are markedly elevated in adults with cyanotic congenital heart disease despite reduced body water. Our results show that hypoxia is a direct stimulus for ANP and BNP secretion in human cardiac myocytes. These findings may have implications for the interpretation of BNP levels in the assessment of patients with heart and lung disease.
Determinants of polybrominated biphenyl serum decay among women in the Michigan PBB cohort.
Authors: H M Blanck, M Marcus, V Hertzberg, P E Tolbert, C Rubin, A K Henderson, R H Zhang
Journal: Environmental Health Perspectives (2000)

Accidental contamination of the food chain in Michigan in 1973 with polybrominated biphenyls (PBBs) led to the establishment of a registry of exposed individuals in 1976. Serum was collected and analyzed for PBB at the time of enrollment and for targeted studies in the following years. We used the archived PBB data to study the elimination of PBB and to identify factors associated with elimination. A total of 380 women >= 16 years of age who had an initial PBB level of 2 ppb and at least two serum samples drawn when they were not pregnant were included in the analysis. The mean initial PBB level was 20.9 ppb (median 4) and mean time between the first and last measurement was 4.2 years (range 0.5-11.1). PBB was assumed to reach equilibrium in the body before substantial amounts were eliminated and before the first serum measurements were taken; therefore, the entire body was modeled as a single compartment for PBB with exponential decay. Subject-specific decay rate estimates were regressed on predictor variables including initial age, body mass index (BMI), smoking history, breast-feeding duration, and parity. In women with an initial PBB level < 10 ppb, the median half-life was 12.9 years; in those with > 10 ppb, the median half-life was 28.7 years. Decay was significantly slower among women with an initial BMI at or above the median (BMI >= 23). The calculated half-life values are estimates of decay and can be used to estimate body burden of PBB at various points in time other than at the time of serum collection.
Antitumoral effects of intratumoral injection of two adenoviruses, one encoding IL-12 and another encodig MIP-3A in a murine model of liver metastatic pancreatic cancer
Authors: Guillermo Mazzolini, Inigo Narvaiza, Miguel Barajas, Cheng Qian, Ignacio Melero, Jesus Prieto
Journal: Journal of Hepatology (2002)
ALTERED c-H-ras GENE IN NON-NEOPLASTIC TISSUE
Authors: M.R. Stratton, C.J. Marshall, C.S. Cooper, Abhijit Nag, JeffreyA. Jones, RoyG. Smith, PatA. Wright, NickR. Lemoine, E. Dilwyn Williams, David Wynford-Thomas
Journal: The Lancet (1989)
Antenatal Magnesium Sulfate for Neuroprotection before Preterm Birth?
Authors: Fiona J. Stanley, Caroline Crowther
Journal: New England Journal of Medicine (2008)

Preterm infants are at increased risk for serious, lifelong neurologic abnormalities such as cerebral palsy.1,2 As the survival of preterm infants has improved with advances in perinatal care,2 the occurrence of cerebral palsy has increased further, since infants who would previously have died now survive with their cerebral pathology. Currently, more than 30% of children with cerebral palsy are born preterm.1 Compounding these concerns are the trends, particularly in the United States, to increases in preterm birth.3 An emphasis on improving the survival of very preterm infants without associated strategies to prevent preterm birth or the neurologic disorders associated . . .
Diagnosing Infertility: Who Is Qualified?-Reply
Authors: Anne Colston Wentz
Journal: JAMA (1993)

In Reply.  —The average resident in obstetrics and gynecology spends 2 months or less of a 4-year residency assigned to a reproductive endocrinology and  service, if such a service is even available. Subspecialty certification in reproductive endocrinology and  follows completion of an approved 2- or 3-year fellowship training program and requires passage of both a written and, 2 years later, an oral examination. Fecundity is age-dependent, and the worst enemy of an infertile couple is time. Making the correct diagnosis to explain the  takes training and experience, as well as specialized laboratory facilities, which will soon be required to undergo accreditation procedures. Laboratory accreditation and subspecialty certification provide some measure of accountability, credibility, and quality for the consumer. Unfortunately, the Yellow Pages contains many advertisements of self-proclaimed infertility specialists. The practices of certified subspecialists are filled with couples who have spent thousands of dollars and years of
CHRONIC INFLAMMATION AND ULCERATION OF THE DUODENUM, WITH RESULTANT REFLEXES.
Authors: JOHN M. ALLEN
Journal: JAMA (1897)

The duodenum is abundantly supplied with arterial blood. Its veins empty into the portal vein, any obstruction of which, either from the lungs, liver or heart, produces passive congestion of this organ. Its nervous connection with the brain is by branches from the par vagum and with the spinal cord by branches from it, with the sympathetic system by branches from the solar plexus, and with the thoracic plexus by the splanchnic nerve. It has within its structure the plexus of Meisner and Auerbach. It is studded with the glands of Lieberkuhn and Brunner, and with solitary glands as well as lymphatics. It is the physiologic receptacle of the chyme which is often perverted by functional disease of the stomach or over-repletion, either of which may be highly irritating to the duodenum. It also receives the secretion from the liver and pancreas and performs, possibly, as important a function in
Insertion-Deletion Polymorphism of the <i>ACE</i> Gene Modulates Reversibility of Endothelial Dysfunction With ACE Inhibition
Authors: Abhiram Prasad, Suresh Narayanan, Syed Husain, Feroz Padder, Myron Waclawiw, Neil Epstein, Arshed A. Quyyumi
Journal: Circulation (2000)

Background —The aim of this study was to examine whether angiotensin-converting enzyme (ACE) inhibition improves coronary endothelial dysfunction in patients with atherosclerosis and its risk factors and whether this was related to the ACE insertion-deletion (I/D) polymorphism. Methods and Results —In 56 patients with atherosclerosis or its risk factors, we studied endothelium-dependent responses with acetylcholine and endothelium-independent function with sodium nitroprusside, before and after ACE inhibition with enalaprilat. Enalaprilat did not alter either resting coronary tone or vasodilation with sodium nitroprusside. However, it potentiated the coronary microvascular and epicardial responses with acetylcholine; coronary blood flow increased from 82±7 to 90±8 mL/min ( P =0.05) after enalaprilat. Patients with depressed endothelial function ( P &lt;0.001) and those with ACE DD or ID genotypes ( P =0.002) but not those homozygous for the I allele had the greatest improvement by multivariate analysis. Similarly, acetylcholine-mediated epicardial vasomotion improved in segments that initially constricted (endothelial dysfunction): from −10.1±1% to −1.4±2% ( P &lt;0.001) after enalaprilat. No augmentation was observed in segments that dilated (normal endothelial dysfunction) with acetylcholine. Patients with the D allele, hypercholesterolemia, and smokers (all P &lt;0.05) had greater improvement. Conclusions —Acute ACE inhibition improves coronary epicardial and microvascular endothelium-dependent vasomotion in patients with atherosclerosis or its risk factors who have endothelial dysfunction and presence of the D allele.
Generalization and Tinbergen's four whys
Authors: Ken Cheng
Journal: Behavioral and Brain Sciences (2001)

Shepard's exponential law provides a functional explanation of generalization. The account complements the more common mechanistic models. The elegant and powerful analyses answer one of Tinbergen's (1963) four whys of behavior: a benefit conferred on the animal by generalizing in this way. A complete account might address evolutionary and developmental questions in addition to mechanistic and functional ones. [Shepard]
PROGNOSTIC IMPLICATIONS OF TRICUSPID REGURGITATION IN PATIENTS UNDERGOING AORTIC VALVE REPLACEMENT
Authors: Halit Yerebakan, Robert Sorabella, Marc Najjar, Ayesha Mannan, Catherine Wang, Hiroo Takayama, Yoshifumi Naka, Mathew Williams, Michael Argenziano, Craig Smith, Isaac George
Journal: Journal of the American College of Cardiology (2014)
Final results of the PETACC-1 trial of bolus 5-FU/LV vs raltitrexed: An unsuccessful story?
Authors: I. Popov, J. Wils, A. Carrato, A. Sobrero, M. Vincent, D. J. Kerr, R. Labianca, F. Pignatti, M. Praet, B. Nordlinger
Journal: Journal of Clinical Oncology (2008)

4053 Background: PETACC-1 trial was initiated in 1998 to investigate non-inferiority of raltitrexed (Tomudex, T) to bolus 5-FU/LV in the adjuvant treatment of stage III colon cancer. Methods: Co-primary endpoints were relapse-free survival (RFS) and overall survival (OS). The non-inferiority hypothesis required that the hazard ratio (HR) for T versus 5-FU/LV be < 1.25, at the 1-sided 5% significance level (i.e., the upper limit of 90% CI for HR should be <1.25). This required 2,765 patients (703 events). Patients within 56 days of curative radical resection of stage III colon cancer and fit for chemotherapy were eligible. Treatment consisted of LV, 20 mg/m2 iv bolus, followed by 5-FU, 370–425 mg/m2 iv bolus on d1–5, q4w for 6 cycles (24 weeks) or T, 3.0 mg/m2, 15 minute iv on d1, q3w x 8 cycles (24 weeks). Results: A total of 1921 (70% of required) patients were randomized between March 1998 and July 1999, when the trial was suspended by an Independent Data Monitoring Committee because of 17 treatment related deaths observed on T arm (versus 7 in the 5-FU/LV arm). However, the sponsor, AstraZeneca, decided to close the study as it seemed unlikely to achieve its objectives. The per protocol population (PP) analysis (n=993) contains all eligible patients randomized until Jan 1999 who started and finished their allocated treatments. The intention to treat population (ITT) analysis (n=1,921) contains all randomized patients. Median follow-up was 4.1 years. The hematological and gastrointestinal toxicities were higher in the 5-FU/LV group whereas liver toxicity (transaminases increase) was higher in the T group. Treatment was stopped due to toxicity in 13.2% of patients on T vs 8.5% on 5-FU/LV. Sixty-day mortality was 9 patients on T vs 7 patients on 5-FU/LV. The HR for RFS was 1.14 (CI 1.01–1.29) in ITT population and 1.16 (CI 0.99–1.37) in PP. The HR for OS was 1.04 (CI 0.9- 1.21) in ITT and 1.01(CI 0.84–1.23) in PP. Conclusions: The trial failed to demonstrate non-inferior RFS for T. However, OS in T was within the boundary of non-inferiority to FU/LV, despite the higher number of toxic deaths in the T arm. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Expert Testimony Other Remuneration AstraZeneca Oncology AstraZeneca Oncology