tbuckley/cabot-search huggingface dataset:
Intracoronary ST-Segment Shift Soon After Elective Percutaneous Coronary Intervention Accurately Predicts Periprocedural Myocardial Injury
Authors: Vruyr Balian, Michele Galli, Claudio Marcassa, Gianni Cecchin, Maurice Child, Fabio Barlocco, Ettore Petrucci, Giulia Filippini, Riccardo Michi, Marco Onofri
Journal: Circulation (2006)

Background— Elevation of cardiac biomarkers after coronary angioplasty (percutaneous coronary intervention [PCI]) reflects periprocedural myocardial damage and is associated with adverse cardiac events. We assessed whether periprocedural myocardial damage that occurs despite successful PCI could be rapidly and easily identified by intracoronary ST-segment recording with the use of a catheter guidewire. Methods and Results— In 108 consecutive stable patients undergoing elective single-vessel PCI, we recorded unipolar ECG from the intracoronary guidewire in the distal coronary before PCI and 2 minutes after the last balloon inflation. After PCI, intracoronary ST-segment shift ≥1 mm from baseline was considered significant. Troponin I levels were measured at baseline and at 8 and 24 hours after intervention, and myocardial damage was defined as troponin I increase above the upper normal value after intervention. All patients had normal cardiac marker values before PCI, and PCI was successful in all (residual stenosis &lt;20%, Thrombolysis in Myocardial Infarction grade 3 flow). After PCI, long-term follow-up data were collected; myocardial damage was detected in 50 patients (46%), although abnormal creatine kinase-MB values were documented in only 11 (10%). Significant intracoronary ST-segment shift after PCI was present in 40 patients (37%; group A) and absent in the remaining 68 (63%; group B). Procedural myocardial damage was documented in 37 group A patients (93%) and in 13 group B patients (19%; P &lt;0.001); significant ECG changes were found on standard ECG after intervention in only 5 patients (13%) and 1 patient (1%) ( P &lt;0.05). Sensitivity of intracoronary ST-segment shift for predicting myocardial damage was 74%, and specificity was 95%, with positive and negative predictive values of 93% and 81%, respectively. On multivariate analysis, intracoronary ST-segment shift was the sole independent predictor of myocardial damage (odds ratio, 54.1; 95% confidence interval, 12.1 to 240; P &lt;0.0001). At a median follow-up of 12±5 months, major coronary event–free survival was significantly worse in group A patients (log-rank test χ 2 =4.0; P &lt;0.05). Conclusions— After successful single-vessel PCI, intracoronary ST-segment shift allows the prompt and inexpensive identification of patients developing myocardial injury, who may require adjunctive therapy and longer in-hospital stay.
Monitoring compliance with the International Code of Marketing of Breastmilk Substitutes in west Africa: multisite cross sectional survey in Togo and Burkina Faso
Authors: V. M Aguayo
Journal: BMJ (2003)

To monitor compliance with the International Code of Marketing of Breastmilk Substitutes in health systems, sales outlets, distribution points, and the news media in Togo and Burkina Faso, west Africa.Multisite cross sectional survey.Staff at 43 health facilities and 66 sales outlets and distribution points, 186 health providers, and 105 mothers of infants aged < or =5 months in 16 cities.Six (14%) health facilities had received donations of breast milk substitutes. All donations were being given to mothers free of charge. Health providers in five (12%) health facilities had received free samples of breast milk substitutes for purposes other than professional research or evaluation. Health professionals in five (12%) health facilities had received promotional gifts from manufacturers. Promotional materials of commercial breast milk substitutes were found in seven (16%) health facilities. Special displays to market commercial breast milk substitutes were found in 29 (44%) sales and distribution points. Forty commercial breast milk substitutes violated the labelling standards of the code: 21 were manufactured by Danone, 11 by Nestlé, and eight by other national and international manufacturers. Most (148, 90%) health providers had never heard of the code, and 66 mothers (63%) had never received any counselling on breast feeding by their health providers.In west Africa manufacturers are violating the code of marketing of breast milk substitutes. Comparable levels of code violations are observed with (Burkina Faso) or without (Togo) regulating legislation. Legislation must be accompanied by effective information, training, and monitoring systems to ensure that healthcare providers and manufacturers comply with evidence based practice and the code.
Physiology of the circulation in human limbs in health and disease
Authors: Edward A. Edwards
Journal: JAMA (1963)

This is a fairly extensive monograph of a limited but important segment of hemodynamics—that is, the anatomic and physiologic basis for the response of the vessels in the various tissues of the limb in the direction of vasodilatation or vasoconstriction. The book reflects the timing and locale of the author's researches—namely, Great Britain, in the time when instruments such as the plethysmograph and various calorimetric devices furnished the essential part of the data. The experiments reflect the painstaking, simple approach with these apparatus, from which some rather refined deductions are drawn. Readers of the book will immediately think of the experiments reported by Lewis and by Pickering. While this book thus summarizes a large body of work done on the blood supply of the limbs, it fails to record work done upon the circulation as a whole and work done with more refined instrumentation, such as direct blood vessel flow
NEUTROPHIL TO LYMPHOCYTE RATIO PREDICTS CARDIOVASCULAR MORTALITY IN PATIENTS WITH HEART FAILURE WITH REDUCED EJECTION FRACTION
Authors: Mehmet Birhan Yilmaz, Ahmet Ekmekci, Hakan Gunes, Didem Oguz, Ali Ugur Uslu, Mehmet Eren
Journal: Journal of the American College of Cardiology (2014)
ANGPTL4 modulates vascular junction integrity by integrin signaling and disruption of intercellular VE-cadherin and claudin-5 clusters
Authors: Royston-Luke Huang, Ziqiang Teo, Han Chung Chong, Pengcheng Zhu, Ming Jie Tan, Chek Kun Tan, Chee Ren Ivan Lam, Ming Keat Sng, David Tai Wei Leong, Suet Mien Tan, Sander Kersten, Jeak Ling Ding, Hoi Yeung Li, Nguan Soon Tan
Journal: Blood (2011)
Echocardiography in Pediatric and Adult Congenital Heart Disease
Authors: Martin St. John Sutton
Journal: JAMA (2010)

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 Hypoglycemic Agents on Vascular Complications in Patients With Adult-Onset Diabetes
Authors: Genell L. Knatterud
Journal: JAMA (1978)

The University Group Diabetes Program is a long-term prospective clinical trial designed to evaluate the effects of various hypoglycemic agents on vascular complications in patients with asymptomatic adult-onset diabetes. Mortality and blood glucose levels were determined as well as certain nonfatal events for patients assigned to diet alone or to either of two insulin treatment regimens. Lower levels of blood glucose with mean values close to normoglycemia were achieved in the treatment group in which the insulin dosage was adjusted to achieve normoglycemia compared with the levels achieved in patients treated with diet alone or with a fixed dose of insulin. In spite of differences in blood glucose levels among the treatment groups, there were only minor differences in the occurrence of fatal or nonfatal events.
NON-INVASIVE CORONARY FLOW RESERVE ASSESSMENT PREDICTS ADVERSE OUTCOME IN WOMEN WITH SUSPECTED OR KNOWN CORONARY ARTERY DISEASE WITHOUT OBSTRUCTIVE CORONARY ARTERY STENOSIS
Authors: Roberta Montisci, Massimo Ruscazio, Francesca Tuveri, Norma Zedda, Cinzia Soro, Raimondo Pirisi, Luigi Meloni
Journal: Journal of the American College of Cardiology (2012)
Spontaneous Acute Leukemia in Polycythemia Vera
Authors: W. B. LUNDBERG
Journal: Annals of Internal Medicine (1976)

Letters1 March 1976Spontaneous Acute Leukemia in Polycythemia VeraW. B. LUNDBERG, M.D., L. R. FARBER, M.D., E. C. CADMAN, M.D., R. T. SKEEL, M.D.W. B. LUNDBERG, M.D.Search for more papers by this author, L. R. FARBER, M.D.Search for more papers by this author, E. C. CADMAN, M.D.Search for more papers by this author, R. T. SKEEL, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-84-3-294 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptAcute leukemia has frequently developed in patients with polycythemia vera. However, its occurrence varies considerably depending on treatment. The occurrence in patients treated with ionizing radiation is higher than that in patients treated with chemotherapy (1) and the "spontaneous" (no leukemogenic exposure) development has been reported only rarely. Because of this discrepancy in the frequency of occurrence, it remains unclear whether acute leukemia is part of the natural history of polycythemia vera, is the consequence of therapy alone, or results from an interaction between these two factors. We treated a man in whom acute leukemia developed after only 4 years...References1. GLASSWASSERMAN JL: Primary polycythemia, in Hematology, edited by WILLIAMS WJ, BEUTLER E, ERSLEW AJ, et al. New York, McGraw-Hill Book Co., 1972, p. 538 Google Scholar2. DAMESHEK W: Physiopathology and course of polycythemia vera as related to therapy. JAMA 142:790-797, 1950 CrossrefMedlineGoogle Scholar3. WILLIAMSMENDLE MJ: Polycythemia vera terminating with myeloblastic leukemia; correlation of morphologic findings with leucocytic phosphatase studies. Blood 9:189-195, 1954 CrossrefMedlineGoogle Scholar4. Clinicopathologic conference. Polycythemia vera complicated by acute leukemia and a rapidly enlarging mass in the left upper abdominal quadrant. Am J Med 42:949-957, 1967 CrossrefMedlineGoogle Scholar5. Case Records of the Massachusetts General Hospital. Case 25-1973. N Engl J Med 288:1343-1350, 1973 CrossrefMedlineGoogle Scholar6. ROSENTHALMALONEY DW: Myeloproliferative disorders with documented leukemia transformation. XV Cong lnt Soc Hematol, 1974, p. 183 Google Scholar7. NEWSHUMANBROWN LME: Polycythemia vera and acute leukemia. Ann Intern Med 83:672-673, 1975 LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Department of Medical Oncology Yale University School of Medicine New Haven, Connecticut 06510 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByTherapy-Related Acute Myelogenous LeukemiaPolycythemia vera: myths, mechanisms, and managementPolycythemia vera in a child with acute lymphocytic leukemiaT cell acute lymphocytic leukemia terminating as malignant histiocytosis 1 March 1976Volume 84, Issue 3Page: 294-295KeywordsChemotherapyIonizing radiationPolycythemia vera Issue Published: 1 March 1976 PDF DownloadLoading ...
Ankle-to-Brachial Index and Dementia
Authors: Danielle Laurin, Kamal H. Masaki, Lon R. White, Lenore J. Launer
Journal: Circulation (2007)

Measurement of the ankle-to-brachial index (ABI) is a noninvasive test to assess peripheral arterial disease. A low ABI is a strong correlate of cardiovascular disease and subsequent mortality. Evidence indicates the existence of vascular components in the pathogenesis of dementia. Here, we examine the association of ABI with dementia and subtypes.Data are from the Honolulu-Asia Aging Study (HAAS), a prospective community-based study of 3734 Japanese American men 71 to 93 years of age at baseline in 1991 to 1993. The analysis included 2588 men who were free of dementia at the first assessment, had an ABI measure, and were examined up to 2 more times for dementia between 1994 and 1999. The sample included 240 incident cases of dementia (144 of Alzheimer's disease, 46 of vascular dementia, and 50 of dementia of other causes). Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated from Cox proportional-hazards models with age as the time scale after adjustment for education, year of birth, high blood pressure, body mass index, diabetes mellitus, cholesterol concentration, smoking status, alcohol consumption, and apolipoprotein E epsilon4 allele. A low ABI was associated with an increased risk of dementia and vascular dementia (HR, 1.66; 95% CI, 1.16 to 2.37; and HR, 2.25; 95% CI, 1.07 to 4.73, respectively). ABI was weakly associated with Alzheimer's disease (HR, 1.57; 95% CI, 0.98 to 2.53), particularly in the apolipoprotein E epsilon4 carriers (HR, 1.43; 95% CI, 1.02 to 1.96).These results suggest that ABI, a measure of atherosclerosis, is associated with the incidence of total dementia, vascular dementia, and Alzheimer's disease in carriers of the apolipoprotein E epsilon4 allele.
Marijuana as Medicine
Authors: Gabriel G. Nahas
Journal: JAMA (1995)

<h3>To the Editor.</h3> —The claims made by Dr Grinspoon and Mr Bakalar<sup>1</sup>have been rebutted by the facts of the scientific and medical record summarized in the Drug Enforcement Administration ruling of 1989,<sup>2</sup>which denied the rescheduling of marijuana from schedule I to schedule II. All of the pharmacological properties of crude marijuana have been attributed to its active ingredient Δ<sup>9</sup>-tetrahydrocannabinol (Δ<sup>9</sup>-THC). Besides Δ<sup>9</sup>-THC, marijuana smoke contains 60 other cannabinoids and 360 chemicals, some quite toxic, like carbon monoxide, acetaldehyde, vinyl chloride, phenol, creosol, naphthalene, and twice as many carcinogens as a tobacco cigarette of the same weight. The American Cancer Society stated in 1989 that results of clinical investigations did not warrant decontrol of marijuana smoking for medical use (especially as an antiemetic), as did the American Medical Association.<sup>3</sup> Δ<sup>9</sup>-Tetrahydrocannabinol was declassified from schedule I to schedule II
The mechanism of improved sodium homeostasis of low-dose losartan in preascitic cirrhosis
Authors: Florence Wong, Peter Liu, Laurence Blendis
Journal: Hepatology (2002)

Renal sodium retention on standing is one aspect of the abnormal renal sodium handling in preascitic, well-compensated patients with cirrhosis. Recently, it has been shown that low doses (7.5 mg) of the angiotensin II (Ang II) receptor antagonist, losartan, can reverse renal sodium retention on high, 200-mmol sodium/d diet in these patients and restore them to sodium balance. Therefore, the effect of 7.5 mg of losartan on sodium excretion, when changing from supine to erect posture for 2 hours, was examined in 10 well-compensated patients with cirrhosis and 9 age- and sex-matched controls on the same sodium diet, under strictly controlled metabolic conditions. In contrast to control subjects, in whom sodium excretion was unaffected, single 7.5-mg doses of losartan again restored the preascitic patients with cirrhosis to sodium balance. In addition, it blunted the fall in erect posture- induced renal sodium excretion by a reduction in proximal and distal tubular reabsorption of sodium. These changes occurred without any significant changes in blood volumes, systemic and renal hemodynamics, or glomerular filtration rate (GFR) and filtered sodium load compared with controls, and despite activation of the systemic renin-angiotensin-aldosterone system, which was still within normal levels. In conclusion, the beneficial natriuretic effects of low-dose losartan on erect posture - induced sodium retention in preascitic cirrhosis supports the suggestion that the pathophysiology of sodium retention in preascites is in part caused by an intrarenal tubular effect of Ang II in that posture.
Critical windows of exposure for children's health: the reproductive system in animals and humans.
Authors: J L Pryor, C Hughes, W Foster, B F Hales, B Robaire
Journal: Environmental Health Perspectives (2000)

Drugs and environmental chemicals can adversely affect the reproductive system. Currently, available data indicate that the consequences of exposure depend on the nature of the chemical, its target, and the timing of exposure relative to critical windows in development of the reproductive system. The reproductive system is designed to produce gametes in far greater excess than would seem to be necessary for the survival of species. Ten to hundreds of millions of spermatozoa are generated daily by most adult male mammals, yet very few of these germ cells succeed in transmitting their genetic material to the next generation. Although the number of oocytes produced in mammalian females is more limited, and their production occurs only during fetal life, most ovaries contain several orders of magnitude more oocytes than ever will be fertilized. Toxicant exposures may affect critical events in the development of the reproductive system, ranging from early primordial germ cell determination to gonadal differentiation, gametogenesis, external genitalia, or signaling events regulating sexual behavior. Although there are differences between the human reproductive system and that of the usual animal models, such models have been extremely useful in assessing risks for key human reproductive and developmental processes. The objectives for future studies should include the elucidation of the specific cellular and molecular targets of known toxicants; the design of a systematic approach to the identification of reproductive toxicants; and the development of sensitive, specific, and predictive animal models, minimally invasive surrogate markers, or in vitro tests to assess reproductive system function during embryonic, postnatal, and adult life.
THU0374 Vitamin D Levels and Effects of Vitamin D Replacement in Children with Periodic Fever, Aphthous Stomatitis, Pharyngitis, and Cervical Adenitis (PFAPA) Syndrome
Authors: S. Stagi, F. Bertini, D. Rigante, M. de Martino, F. Falcini
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> The periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (PFAPA) syndrome, is an autoinflammatory disease characterised by regularly recurrent fever episodes, due to seemingly unprovoked inflammation <h3>Objectives</h3> To assess serum 25-hydroxy cholecalciferol (25(OH)D) concentrations in children with PFAPA and to evaluate longitudinally the effect of wintertime supplementation on 25(OH)D status and immune response in these children <h3>Methods</h3> We have evaluated 25 Italian patients (19 males, 6 females, aged 2.4 - 5.3 years), fulfilled the Euro-Fever PFAPA criteria. For each patient, we recorded demographic and anthropometric data, clinical manifestations, serum calcium, phosphate, and 25(OH)D. After 400 UI 25(OH)D supplementation, clinical and auxological characteristics, calcium and phosphate, and 25(OH)D) concentrations were re-evaluated. Data was compared with a sex- and age-matched control group <h3>Results</h3> PFAPA patients showed very reduced 25(OH)D levels than controls (p&lt;0.0001). Regarding the effect of the different seasons on 25(OH)D status, 25(OH)D levels in winter were significantly reduced respect the summer (p&lt;0.005). These values are significantly lesser than controls (p&lt;0.005). However, 25(OH)D levels correlated with episodes of fever (p&lt;0.005), and CRP (p&lt;0.005). After vitamin D3 supplementation, PFAPA patients disclosed significantly increased 25(OH)D levels, showing a significative reduction of febrile episodes and his characteristics (mean duration of fever episodes p&lt;0.05, number of febrile episodes for year p&lt;0.005) <h3>Conclusions</h3> Deficient and insufficient vitamin D serum levels were found in most children with PFAPA. Hypovitaminosis D can be significant risk factor for PFAPA occurrence. However, After 25(OH)D supplementation seems significantly to reduce PFAPA episodes and fever duration, disclosing the importance of vitamin D as immunoregulatory factor in this syndrome <h3>Disclosure of Interest</h3> : None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.4630
SSRIs and gastrointestinal bleeding
Authors: Carol Paton, I Nicol Ferrier
Journal: BMJ (2005)

Gastroprotection may be justified in some patients 

T here are theoretical reasons for believing that selective serotonin reuptake inhibitors (SSRIs), widely used to treat depression, might increase the risk of gastrointestinal bleeding. Gastroprotective drugs are advocated for high risk patients taking non-steroidal anti-inflammatory drugs, another class of drug that causes gastrointestinal bleeding. What is the evidence that this advice should be extended to patients receiving SSRIs?

Serotonin is released from platelets in response to vascular injury and promotes vasoconstriction and a change in the shape of the platelets that leads to aggregation.1 Platelets cannot themselves synthesise serotonin. SSRIs inhibit the serotonin transporter, which is responsible for the uptake of serotonin into platelets. It could thus be predicted that SSRIs would deplete platelet serotonin, leading to a reduced ability to form clots and a subsequent increase in the risk of bleeding.

We have reviewed the published database studies on the relation between SSRI use and gastrointestinal bleeding. Four of these studies compared the risk of an upper gastrointestinal bleed in those …
Mustn't grumble
Authors: I. Iheanacho
Journal: BMJ (2009)

“’Ello. Yeh . . . I’m on the bus . . . On the bus . . . THE BUS! Yeh, I’m gonna be late. Didn’t you get my email? . . . What? … WHAT?! . . . Look mate, there’s a really dodgy signal on this mobile. I’ll text you later.”

Nowadays you hear far too many of these half conversations in public spaces. However irritating, they actually represent triumphs of multimedia communication. And it would be silly and inadequate to blame technology for the shortcomings of its misusers. …
A Case of Congenital Hepatic Fibrosis: Usefulness of Hepatobiliary Scintigraphy
Authors: YASUTAMI MASUDA, HISASHI SAWA, OK HWA KIM, TERUO FUKUDA, HIRONOBU OCHI, YOSHIHARU KANAYAMMA
Journal: Clinical Nuclear Medicine (1980)

A case of operatively proven congenital hepatic fibrosis was studied by scintigraphy with Tc-99m-phytate and Tc-99m-Pl (a hepatobiliary radiopharmaceutical). Two focal defects were recognized in the liver on the colloid liver scintigram. Ultrasound and contrast angiography suggested that the two focal defects were cystic lesions. Radionuclide hepatobiliary imaging was performed with Tc-99m-PI, since intravenous cholangiography was unsatisfactory. One focal defect was proved to be a dilated intrahepatic bile duct and another was found to be a cyst. Radionuclide hepatobiliary imaging with Tc-99m-PI proved to be very useful in identifying dilated intrahepatic bile ducts in this patient as well as in following the progress of this disease.